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This paper describes the findings of a three year study of the use and effectiveness of secure accommodation in Scotland. Data were collected on 53 young people shortly after their admission to secure accommodation. Most young people were admitted because they were a danger to themselves and/or they were likely to abscond; a third were considered a danger to others. Secure accommodation was considered to have benefits in relation to keeping young people safe and addressing health issues. On other dimensions, such as behaviour or family relationships, signs of benefit were more ambiguous. Thirty-three young people were considered to have clearly benefited from placement. At follow-up, after two years, outcomes were assessed as: ‘good’ – 14 (26%); ‘medium’- 24 (45 %); and ‘poor’ – 15 (28%). The research highlighted the importance of effectively managing the transition from secure care. Social workers attributed a good outcome more to an appropriate placement and education being offered when the young person left secure rather than simply the placement itself. A gradual ‘step-down’ approach from the structure and supervision of the secure setting was also linked to better outcomes. Young people respond well when offered continuity and the opportunity to develop relationships with one or more reliable adults who can help with problems as they arise.