Plantje groeit tussen steen
Plantje groeit tussen steen

From intuition to method: successful approach in the care sector now backed up by science

A treatment method that has delivered repeated successes over many years in the field of youth care, but had not previously been given a platform, now has a robust scientific basis, thanks to the PhD research of Carine Heijligers and Sonja Graafstal. ‘This method is about much more than just learning a trick: it brings about an intrinsic change in a person.’ Heijligers and Graafstal will be awarded their PhDs together on 20 February.

Carine Heijligers has been working with young people in care for 45 years, the last 25 of which within the organisation Stichting Koraal, where she has been supporting young people with mild intellectual disabilities and severe behavioural problems. It was clear from the outset that her method delivers results. Young people made progress in their development, became more sociable and contributed to their environment at their own particular level. Heijligers: ‘I achieved success with young people who nobody knew what to do with. But I didn’t know exactly how I managed to do that.’

Prof. Anna Bosman, from the Faculty of Pedagogical Sciences at Radboud University, put Heijligers in touch with Sonja Graafstal. Together they tried to find a theoretical basis for Heijligers’ method. ‘Research is important, as a scientifically sound method in the field of counselling can receive recognition and benefit from financial support,’ says Graafstal.


Heijligers and Graafstal analysed scientific literature and watched videos of clients and counsellors. They discovered that behind Heijligers’ method is a mechanism that can be traced back to the basis of human interaction: the ability to connect with another person, resulting in reciprocal contact. ‘Imagine that a baby is watching a bird. The mother follows the baby’s gaze and watches the bird too. She then makes eye contact with the baby, who smiles’, says Graafstal, giving an example. ‘Research shows that following and leading are the basis for togetherness and autonomy. Every type of behaviour can be traced back to this fundamental movement of following or being followed.’

Disrupted pattern

However, this pattern can be disrupted in all kinds of ways, which is then expressed through problematic behaviour: a child who does not follow, does not listen to an instruction, for example, or cannot keep walking nicely next to someone or talk quietly in the library. Heijligers’ method therefore focuses on the disrupted underlying pattern of interaction rather than on the bad behaviour itself. ‘The counsellor first follows the movements of the client, which creates a connection’, explains Heijligers. ‘Then the counsellor adds a movement of his/her own, which the client follows. In this way they work together towards achieving the desired behaviour.’

Timo and his counsellor Myra are each painting a picture. Timo is painting in large strokes onto the paper and also onto the table. Myra is using a small brush to paint thin lines in the middle of her sheet. She then notices how, in Timo’s case, paint is also ending up on the table because of the big movements he is making. Myra picks up a large brush and also starts putting paint onto her paper with big movements. However, she stays within the edges of her sheet. She points out to Timo that she is now also painting with a big brush and they both laugh about the big, thick, fat lines they are painting. Then Myra gradually starts making her movements smaller and smaller, so she can stay within the edges of the sheet more easily. Unwittingly, Timo reduces his movements too and now also stays nicely on the paper. (Example taken from the thesis by Heijligers and Graafstal)

The method has already delivered numerous successes amongst young people of different ages and with a wide range of behavioural problems. ‘A person who can follow feels a sense of connection and harmony with another. A person who can lead feels competent and independent’, says Heijligers. ‘This results in a positive change in behaviour. It is about much more than just learning a trick: it brings about an intrinsic change.’


In spite of the successes achieved and the fact that the method has been taught at Radboud University and within Stichting Koraal since 2010, it is not yet widely used in the field of youth care. There is a rigid way of thinking in counselling that is based on looking at, interpreting and then changing behaviour. Heijligers and Graafstal look at the underlying pattern of reciprocity in movements and analyse whether both individuals are capable of following and taking the initiative. ‘It is another way of dealing with the same issue. But because you’re dealing with it differently, you get different results.’

According to Heijligers and Graafstal, the scientific basis to which everyone now has access underlines the importance of the ‘Beweging-als-houvast’ (‘Movement as a support’) method for individuals and society. ‘Investing now could save a huge amount of money in the future’, says Heijligers. ‘But the most important thing is that it makes life more bearable for people in care.’

Contact information

Meer weten? Neem contact op met Persvoorlichting & Wetenschapscommunicatie via 024 361 6000 of media [at] (media[at]ru[dot]nl). 

Behaviour, Upbringing, Health & Healthcare