Strengthening client participation and self-management: the contribution of moral case deliberation with clients

Abstract Since 2005, Dutch Youth Care has focused, amongst other things, on strengthening client participation and self-management. However, the evaluation of the Youth Act in 2018 showed that neither of these aspects is sufficiently guaranteed. Furthermore, professionals and clients reported encountering moral challenges when seeking to implement client participation and self-management. 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 upon and a moral inquiry into moral issues. Three types of MCD with clients were evaluated: A) MCD with clients only, B) MCD with students and client representatives within educational settings, and C) MCD with professionals and clients in youth care institutions. The findings were generated through a mixed-methods approach and subsequently subjected to critical reflection within a focus group comprising 16 participants, who represented the different participating perspectives in the study. MCD with clients appears to foster client participation and self-management, insofar as clients feel heard, seen, involved and taken seriously. Moreover, it supports professionals and clients to learn from each other. Finally, it appears to be a suitable method through which to support the attentive relationship of both professionals and students towards clients. MCD with client participation is a suitable method for training students in how to foster client participation and self-management in close cooperation with them. The findings have generated points of interest for MCD facilitators, both prior to and during the deliberations.