The lesser evil for youth with behavioural problem: Basis for decision-making on time-out placements in child welfare

• Case-related factors such as age, aggressiveness, or the youth’s level of cooperation are those that are most prevalent in the areas of agreement between child welfare practitioners to use Time-out placement. • Factors associated with decision-makers (child welfare practitioners) are factors that are not always legitimate to raise in the process of making a decision to use Time-out placements. • The lack of accuracy and synchronization of procedures, and the security nature of transportation to the Time-out placement contribute to increasing its threshold for use and viewing the practice as a lesser evil. • The consequences/benefits of Time-out placements remain unclear and would also explain the variation in decision thresholds among child welfare practitioners. When faced with the behavioural problems of certain youth placed in a youth residential care centre, the use of more restrictive measures remains delicate and based on complex decision-making. While many studies have looked at the decision-making process in child welfare, very few have looked at time-out placements. Time-out placements are very short-term placements with the main objective of providing a temporary break between the context in which the youth is acting out and their environment, while avoiding a definitive move to another resource. Thus, the present study documents the decision-making process that accompanies this measure. Four group interviews with 5 child welfare practitioners (n = 20) involved in the decision-making process preceding a time-out placement were conducted with clinical scenarios. The study employs the Decision-Making Ecology framework both as a conceptual framework and as a basis for data analysis. The analytical approach is inspired by the qualitative consensus approach. The results reveal certain observations regarding the tolerance threshold of the child welfare practitioners before turning to a time-out type of intervention. While the accumulation of risk factors among youth can serve as a justification, certain inconsistencies between sometimes vague intervention objectives and various organizational issues are more of an obstacle. In such a context, the decision to resort to a time-out placement becomes a lesser evil as it is perceived as the “least worst” possible option.