Childhood maltreatment and motivation for treatment in girls in compulsory residential care

The first objective of the current study was to examine the relationship between childhood maltreatment, trauma-related symptoms and motivation for treatment in girls in compulsory residential treatment facilities. The second objective was to examine the extent to which various forms of childhood maltreatment, trauma-related symptoms and motivation for treatment predicted (time to) dropout from these facilities. Participants were 154 adolescent girls recruited from three residential treatment settings in The Netherlands. Multiple linear regression analysis revealed that age and ethnicity were associated with motivation for treatment. Furthermore, emotional abuse contributed to motivation for treatment. In addition, internalizing symptoms (e.g., anxiety and depression) significantly predicted level of distress; symptoms of dissociation predicted doubt about treatment. Logistic regression analyses with multiple imputation and competing risk regression analyses revealed no significant predictors for (time to) dropout. The findings suggest that clinicians and therapists should focus on experiences of emotional abuse, traumatic symptoms and treatment motivation in girls in compulsory residential care settings.     

A review of private residential care in Hong Kong: implications for policy and practice

Hong Kong government policy encourages and facilitates families to care for their older members as long as possible by providing families and their older relatives with community support services. Residential care for the elderly is viewed as a last resort. Due to the inadequate supply of community support services, the long period of care required, and the gradual breakdown of values of filial support, families may increasingly give up their caring roles and seek residential care for their dependent elderly relatives. A shortfall in subsidized residential care may lead to needy elderly persons' being cared for in private residential facilities. The demand for private residential care is projected to increase, despite criticism about the standard of care provided. Although an Ordinance, a Regulation, and a Code of Practice for residential care homes are in place to control, monitor, and upgrade private residential care in Hong Kong, problems remain that put the elderly at risk of receiving substandard services. These include the existence of substandard private aged care homes operating either with or without a license; the provision of substandard "places" to the elderly under the government's "bought place" scheme and "enhanced bought place" scheme; ineffective inspection; a lack of grading to indicate the quality of private aged care homes; and a general neglect of the quality of care. We provide recommendations to address these concerns. This requires paying attention to both the quality of care, as well as to the physical environment of homes.     

A culture of education: Enhancing school performance of youth living in residential group care in Ontario

This article presents a synthesis of what is known about the educational experiences of youth living in residential group care based on a literature review that highlights both the experiences of the youth themselves and the operational context of residential group care in Ontario as it pertains to educational performance. The author argues that there is little emphasis on education within the residential group care sector in Ontario that could translate into more productive educational experiences for youth. The article then provides a framework for developing a culture of education for residential group care that can be acted upon expeditiously. Enhancing the educational performance of young people living in group care will require a cultural approach that provides for daily and pervasive education supports and encouragement, and aims to enhance the lived experience of young people pursuant to their education.     

Planned treatment and outcomes in residential youth care: Evidence from Sweden

A recurring theme in evaluations of Swedish residential youth care is that treatment is often unplanned. Using a data set of teenagers placed in youth care in 1991 (N = 357), we show that planned treatment — in the sense of a known expected duration of treatment — is strongly positively associated with treatment outcomes. In the short term, teenagers with planned treatment are 32% less likely to experience a treatment breakdown and 25% less likely to be reassigned to other forms of residential care after completed treatment. In the long term, teenagers with planned treatment are 21% less likely to engage in criminal behavior and 40% less likely to be hospitalized for mental health problems. The results are robust to controlling for a rich set of potentially confounding factors: Even though observable pre-treatment teenager characteristics explain about one fifth of the variation in criminal behavior 5-10 years after treatment, they have almost no predictive power for whether treatment is planned or unplanned.     

A tool for selecting residential child care workers: an initial report

What strengths and talents make an outstanding child care worker? How can these qualities be measured? How can one predict whether an individual will succeed as a child care worker? The authors attempt to answer these questions by focusing on the "life themes" of highly rated child care workers and using a technique to measure these themes.     

Black adolescents' participation in a prenatal care program

This study explores the relationship between socio-demographic variables and the participation in a prenatal care program among Black adolescents living in a southern community. The analysis of data found that the number of months pregnant and type of living arrangement significantly influenced participation. Greater participation was found among adolescents in the first trimester of pregnancy and those who lived with their mothers only or in other living arragements than with both parents. These findings suggest outreach to sustain participation and the need for additional research with Black adolescents in two-parent families.This study was made possible by funding from the University of Alabama Research Grants Committee, 1988.     

NAATP guidebook not only for residential care

The National Association of Addiction Treatment Providers (NAATP) has released its draft guidebook for minimum standards for members (see ADAW, April 22, https://onlinelibrary.wiley.com/doi/10.1002/adaw.32334 ). NAATP is not only for residential treatment providers, however. “Our position at NAATP is that we are a membership association for providers along the entire continuum and that, while residential holds an important place in our work and is our historical foundation, our membership is in no way limited to residential,” NAATP Executive Director Marvin Ventrell told ADAW last week. “Even apart from our membership, we intend our resources, including ethics and the guidebook, to reach and guide the entire continuum. It is true that some of the guidelines have application more or less relative to type of care, but as a whole it should be viewed as a provider guide, not just a residential provider guide.” We regret any confusion. The field — and prominent organizations within it — is changing.     

Managing the process of change in residential child care: A consultancy approach

This article explores the impact of a consultancy undertaken with groups of residential child care staff within a large local authority who were experiencing considerable changes in their working environment as a result of a review of residential care structures. The authors were invited to engage directly with staff on an individual and group basis to help them work through the barriers they perceived to changing their approach to practice. The theoretical underpinning for the work was Charles Handy's [1993, Understanding Organisations (Harmondsworth, Penguin)] belief that change is more likely to have a positive outcome when staff have an investment in and contribution to the change processes. The model of change utilised within the sessions with staff was Kurt Lewin's three stages of 'unfreezing', 'change' and 'refreezing'. The consultancy raised a number of issues about the process of change and how this can be achieved within the residential child care context. In particular, it highlighted the problems of assuming that change is a linear process which can be directly controlled and managed in the flux and uncertainty which characterises this sector.     

Compulsory residential care: An examination of treatment improvement of individual and family functioning

The aim of the present study was to examine the treatment progress of both adolescent's and their families' functioning in a new compulsory residential treatment program. The sample consisted of 339 admitted adolescents (56.3% boys). The mean age at time of entry was 15.69 (SD = 1.30). Adolescents stayed on average 9.42 months (SD = 4.66) in a new residential treatment program. Data on adolescents' internalizing and externalizing problems were assessed using self-reports, parent reports, and group care worker reports. In addition, adolescents reported their substance use and delinquency and parents also reported family functioning and level of perceived parental stress. The findings revealed a significant decrease in adolescents' self-reported internalizing and externalizing problems, delinquency, and substance use. According to parent ratings, a significant improvement was found concerning adolescents' problem behaviors during treatment. However, according care worker ratings, adolescents showed no improvement on internalizing problems and showed an increase in externalizing problems. Concerning families, although there was no improvement in family functioning, parental stress significantly improved over time. Further research should examine whether improvements experienced during treatment are maintained after treatment.     

Repeated entries to the Swedish addiction compulsory care system: A national register database study

This study identified and described specific client groups who have repeated entries to the Swedish addiction compulsory care system. Specifically, through the use of baseline data from the Swedish government Staten's Institutions Styrelse (SiS) database, for 2658 individuals who were assessed at their compulsory care intake interview by social workers in the national social welfare system between 2001 and 2009 the study identified the associations between specific predisposing, enabling and need characteristics and repeated addiction compulsory care entries. The logistic regression model identified that individuals whose children have been mandated to the child welfare system, who have experienced prior compulsory care including compulsory treatment through LVU (law (1990:52) with specific provision about care of young people under 18), and those who have been in prison are more likely to have two or more entries in the addiction compulsory care system compared to their counterparts. Individuals who have been mandated to compulsory care for their substance use disorder two or more times have significant multiple complex problems and repeated experiences of institutionalization. These individuals are a group in need of a well-coordinated and integrated system of aftercare services to reduce the likelihood of re-entry into addiction compulsory care.     

Mental health interventions for children in foster care: A systematic review

Children in foster care have high rates of adverse childhood experiences and are at risk for mental health problems. These problems can be difficult to ameliorate, creating a need for rigorous intervention research. Previous research suggests that intervening with children in foster care can be challenging for several reasons, including the severity and complexity of their mental health problems, and challenges engaging this often transitory population in mental health services. The goal of this article was to systematically review the intervention research that has been conducted with children in foster care, and to identify future research directions. This review was conducted on mental health interventions for children, ages 0 to 12, in foster care, using ERIC, CINAHL, PsycINFO, PubMed, ProQuest's Dissertation and Theses Database, Social Services Abstracts, and Social Work Abstracts. It was restricted to interventions that are at least “possibly efficacious” (i.e., supported by evidence from at least one randomized controlled trial). Studies were evaluated for risk of bias. Ten interventions were identified, with diverse outcomes, including mental health and physiological. Six interventions were developed for children in foster care. Interventions not developed for children in foster care were typically adapted to the foster context. Most interventions have yet to be rigorously evaluated in community-based settings with children in foster care. Little research has been conducted on child and family engagement within these interventions, and there is a need for more research on moderators of intervention outcomes and subgroups that benefit most from these interventions. In addition, there is no consensus regarding how to adapt interventions to this population. Future research should focus on developing and testing more interventions with this population, rigorously evaluating their effectiveness in community-based settings, determining necessary adaptations, and identifying which interventions work best for whom.     

Keyworking in residential child care: Lessons from research

Developing quality relationships is recognised as an active ingredient for effective interventions with young people in care. Essentially, care staff has the opportunity and capacity to positively influence the young person's experiences in care, through the positive relationships they form. This paper presents selectively on the findings of two separate but related qualitative Irish studies exploring relationship-based approaches in residential child care practice, from the perspectives of both residential child care workers and young care leavers. Thirty-two professionals and four care leavers participated in either focus group or individual interviews. The findings are integrated in this paper with the wider literature on young people leaving care, with the aim of identifying core knowledge that is needed by service providers who are tasked with the support of young people making the transition out of care and towards independent living. In this paper we attempt to identify the knowledge base on relationship-building which is needed by care staff in order to carry out their role. It is argued that an explicit knowledge base is overdue now that the complex needs of young people in care are increasingly visible through advances in research and more recently the emerging literature concerning the personal testimonies of care graduates.     

Preparation for residential treatment: An anticipatory mourning process

This paper discusses the intense emotional bonding between parent and adolescent as it interferes with the adolescent and family's ability to tolerate the physical separation inherent in long-term residential treatment. It describes the mourning process through which both adolescent and parent experience and partially relinquish their attachment to one another in anticipation of the separation. The process is completed when both parent and child accept the need for placement and are ready to accept the possibility of new relationships in the residential treatment setting.     

Unpacking barriers to quality care for Deaf people in residential aged care facilities

Residential aged care providers often face difficulties in meeting the needs of residents with a lifelong disability. In this article, I explore these issues from the perspective of signing Deaf residents. While previous studies have documented a number of issues around staff training and communication for Deaf residents, there remains a dearth of literature considering the root causes of these problems. Drawing on interviews with a variety of service providers, this article suggests a number of ways current practices might be improved as well as discussing funding changes required to ensure Australian Deaf residents do not fall through the cracks.