Since 2005, Dutch Youth Care has focused on strengthening client participation and self-management. However, the evaluation of the Youth Act in 2018 showed that these aspects are not sufficiently guaranteed. Additionally, professionals and clients reported moral challenges when trying to implement them. Therefore, an innovative participatory action research study was conducted to explore the contribution of Moral Case Deliberation (MCD) with clients to client participation and self-management.
MCD is a conversational method that supports joint reflection and moral inquiry into ethical issues. Three types of MCD with clients were evaluated: A) MCD with clients only, B) MCD with students and client representatives in educational settings, and C) MCD with professionals and clients in youth care institutions. The findings were generated through a mixed-methods approach and further reflected upon in a focus group of 16 participants representing the different perspectives.
MCD with clients appears to foster client participation and self-management when clients feel heard, seen, involved, and taken seriously. It also supports mutual learning between professionals and clients and strengthens an attentive relationship between professionals, students, and clients. Additionally, MCD with client participation is a suitable method for training students to foster participation and self-management in close collaboration with clients. The findings also highlight important considerations for MCD facilitators before and during deliberations.