Defining Seclusion: A Qualitative Multiphase Study Based on the Perspectives of Youth and Professionals in Secure Residential Youth Care in the Netherlands

M van Dorp, Karin S. Nijhof, EA Mulder, A Popma

Research output: Contribution to journalArticleAcademicpeer-review

11 Citations (Scopus)


Using seclusion in youth mental health care is controversial, as it
can have physical and psychological consequences for youth
and professionals. Notably, there is a wide disparity in how
seclusion is defined in literature and practice. This leads to
a diffuse image of what seclusion comprises, complicates
measuring its prevalence, and hampers initiatives to reduce its
use. Therefore, the objective of this study was to establish an
unambiguous and measurable definition of seclusion supported
by youth and professionals in secure residential youth care in
the Netherlands. A qualitative multiphase approach was used to
examine which elements of the definition are essential and
receive consensus among youth and professionals. After
a brief literature review, a Delphi survey and focus groups
were performed. In total, 11 (ex-)clients and 33 professionals
with extensive experience in secure residential youth care
participated. Youth and professionals arrived at the following
definition: “an involuntary placement in a room or area the
client is not allowed or able to leave”. During the implementation
process, observations showed broad support for the definition
by youth and professionals. With this, a foundation has
been provided to monitor and reduce the use of seclusion in
secure residential youth care in the Netherlands.
Original languageEnglish
Pages (from-to)404-423
Number of pages20
JournalResidential Treatment for Children and Youth
Issue number4
Early online date2021
Publication statusPublished - 5 Feb 2021
Externally publishedYes


  • Residential youth care
  • Seclusion
  • perspectives of youth and professionals

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