Family-Centered Practice (FCP) is supported in research and policy, yet little is known about how professionals in (semi) residential youth care interpret its principles and involve families in daily practice. In this preregistered qualitative study, we interviewed 20 professionals in the FamilyTotal program in the Netherlands to explore their guiding attitudes, strategies, and facilitators and barriers related to skills, organizational conditions, and families' responsiveness. Four major themes emerged describing key principles of FCP: (1) parents should parent, (2) services should address the whole family and broader youth context, (3) professionals should collaborate in partnership with families, and (4) services should be tailored to families' needs and wishes, highlighting a whole-family focus and redistributing power between families and professionals. In practice, professionals emphasized alliance building and shared decision-making to elicit families' intrinsic motivation to change. Facilitators included sufficient time for observation and contact, team support, inter- and intrapersonal skills, and an open learning environment, whereas barriers involved engaging families' wider networks and addressing families' complex needs requiring specialized expertise or limited cognitive abilities. This study provides rich, practice-based insights into the daily processes shaping FCP in (semi) residential youth care, identifying strategies and conditions relevant to professional practice and program development.
Dark Triad traits have been increasingly studied due to their relevance for understanding emotional and behavioral adjustment. However, little is known about how these traits operate in vulnerable youth populations, particularly adolescents living in residential care. This study examined the direct and indirect effects of Dark Triad traits on psychological adjustment among institutionalized adolescents, considering the roles of coping strategies and social support. Participants were 433 adolescents aged 12 to 18 years (M = 15.33; 45% boys and 55% girls) from 46 Portuguese residential care institutions. Adolescents completed self-report measures assessing Dark Triad traits, coping strategies, perceived social support, and psychological adjustment. Correlational analyses and path analysis were conducted to test relationships between variables, and sex differences were also explored. Results showed that psychopathy had the strongest association with psychological adjustment, mainly through avoidant coping strategies. Machiavellianism and narcissism presented weaker effects. Problem-focused coping and higher levels of social support were associated with better psychological adjustment, whereas avoidant coping was consistently related to greater difficulties. Some patterns varied by sex. These findings highlight the importance of promoting adaptive coping strategies and strengthening social support in residential care settings to improve psychological outcomes among at-risk youth.
The recruitment, retention, and training of a suitable workforce is a common challenge across different children's residential care systems. In the UK context, the workforce regulation has been expanded over the last two decades to respond to this challenge. Devolution has also led to significant divergence between the UK nations in how it is applied and to whom. This paper explores the experiences of induction, training, and continuing professional development of residential childcare workers working in Wales, where registration of the workforce has been in place for over 15 years, and in England, where it has yet to be introduced. Data were collected through an online survey of those working in children's homes in both England and Wales (n = 899) and semi-structured interviews in both countries (n = 32) with those entering the workforce for the first time. Participants felt that the workforce registration is a mechanism for professionalizing the workforce and influencing the amount and types of training provided to workers by employers. We found some limited evidence of a positive impact of registration on the average number of hours of training provided, with those registered more likely to report undertaking 5 or more hours a month on an average. However, we also noted that many reported having to complete training and qualifications in their own time.
Residential care is a key component of child welfare systems, particularly for adolescents with complex support needs. Trauma-informed care (TIC) emphasizes safety, predictability, and supportive relationships by recognizing the pervasive impact of trauma on development. While previous research has examined TIC extensively at the program level, less is known about how trauma-informed elements are represented in residential care service descriptions used in public procurement processes. This study examined how trauma-informed elements are represented in Finnish residential care service descriptions and how these elements relate to one another. A qualitative content analysis of documents, complemented by a co-occurrence analysis, was conducted on 84 anonymized residential care service descriptions. Following an abductive approach, the codes were refined into three trauma-informed elements: dyadic, systemic, and integrated. Trauma-informed dyadic elements, particularly key-worker meetings, were most frequently described. Systemic elements such as structured routines, youth and parent participation, and multi-professional collaboration were also widely described. However, explicit integration of these elements was rare. While dyadic and systemic structures supporting safety and participation were described, limited integration across elements suggests a need for more coherent and context-sensitive TIC models that bridge relational and organizational practices. These findings may also inform international discussions on how trauma-informed care can be operationalized and integrated within residential care systems.
This study examined the physical activity levels, lesson context, and social interactions of incarcerated youth participating in a martial arts-based program. The aim was to evaluate how such programming - delivered within a correctional setting emphasizing life skills - supports both physical and social development. Eight male participants were systematically observed across 16 sessions using the System for Observing Children's Activity and Relationships during Play (SOCARP). Observations captured physical activity intensity, contextual lesson elements, and social behaviors. Participants engaged in 49% moderate-to-vigorous physical activity, including 30% vigorous activity. Prosocial behaviors occurred frequently (M = 16 per session), while antisocial behaviors were rare and often ignored. Findings suggest that martial arts-based instruction can promote meaningful physical activity and prosocial engagement among incarcerated youth. These results highlight the potential for pedagogically structured, nontraditional content to advance physical education goals within correctional and alternative education contexts.
Limited information is available concerning the long-term mental health of adolescents after discharge from residential treatment, wilderness therapy, and therapeutic boarding school. This study aimed to address this knowledge gap by examining the long-term outcomes of these programs and identifying demographic and clinical factors moderating post-treatment outcomes. Using data from the Practice Research Network of the National Association of Therapeutic Schools and Programs, a subset of 1063 adolescent clients was randomly selected. The researchers explored the trajectories of clients' mental health from admission to months and years post-discharge. Findings suggested that adolescents entered treatment with clinically significant levels of mental health distress and discharged with significantly improved functioning. These treatment gains were sustained, in some adolescents, up to six and a half years after discharge. Adolescents' age at admission, grade-point average, and family functioning all impacted trajectories of change. The results of this study align with existing research, which suggests that adolescents often function with improved mental health in the months and years following discharge from private pay out-of-home treatment.
A great deal of attention has been paid to the prison visitation experience, including that of incarcerated parents and their children. To date, though, most of our understanding of the parental visitation experience comes from research on adult populations. There has been virtually no effort to understand the experiences of incarcerated teen parents. The goal of the current study is to fill this gap. Using surveys administered to youth released from correctional facilities in Florida, this study finds that incarcerated teen parents are visited quite frequently and by a variety of sources, but that relatively few teen parents receive visits from children. When youth do receive visits from children, female visitors (i.e. mothers) are most likely to accompany them and youth who receive visits from children view them quite positively. Some parents, however, do not receive visits because they are housed far from home, they rejected visits, or experienced some other barrier to visitation. The results presented here suggest that child visits could be better encouraged by juvenile correctional facilities and that additional work is needed on this unique population.
Institutional care plays a vital role in shaping the emotional and behavioral development of children deprived of family environments. Guided by Attachment Theory and Social Control Theory, this study examined the relationships among perceived institutional neglect (PIN), attachment insecurity (AI), emotional dysregulation (ED), and conduct problems (CP) among children living in residential care settings. A cross-sectional survey was conducted with 480 children residing in various government, NGO-operated, and privately managed homes across Karachi, Pakistan. Four validated 5-point Likert-type scales were used to measure PIN, AI, ED, and CP. Data were analyzed using IBM SPSS and AMOS through structural equation modeling. The results indicated that PIN was significantly associated with higher levels of AI and showed significant direct relationships with both ED and CP. Furthermore, AI statistically mediated the relationships between PIN and children's emotional and behavioral outcomes. These findings suggest that children's maladaptive emotional and behavioral patterns in institutional care are closely associated with relational and systemic challenges within caregiving environments rather than solely with individual characteristics. The study highlights the importance of enhanced caregiver training, emotional support mechanisms, and the establishment of nurturing and stable environments within residential institutions to promote children's psychological well-being and social adjustment.
Limited global evidence on effective Therapeutic Residential Care (TRC) mechanisms is particularly concerning, given recent Portuguese legislation (Decree-Law 39/2025) that reclassified TRC as a Specific Unit pending defined standards. To address this critical gap, our qualitative, cross-sectional study identified key factors for youth improvement and the therapeutic elements of TRC from the perspective of front-line staff. Adopting an established evidence-based framework as a foundational structure for this inquiry, this study explored the perspectives of 13 frontline staff (10 caseworkers and three caregivers), predominantly female (69.2%) and aged 25-48 across five nonprofit facilities in Portugal. Data were collected via questionnaires and semi-structured interviews and analyzed using a manifest content analysis that combined deductive and inductive approaches. Alongside Setting, Staffing, Treatment Approach, and Safety, three additional domains emerged: Milieu Factor, Youth Risk Profile Characteristics, and Job Characteristics. Findings showed staff viewed TRC positively, but predominantly focused on youth risk factors rather than protective factors. While trusting staff-youth relationships were central, enhancing broader Milieu Factor elements, such as peer, family, and community relationships, may be just as crucial. These insights underscore an urgent need for strategic shifts in practice and policy to integrate protective and relational factors within Portugal's evolving legislative landscape.
Runaway behavior is a prevalent problem among adolescents in residential care centers and represents an opportunity to use psychoactive substances. For some adolescents in residential care centers, running away, like substance use, seems to be a strategy for regulating negative emotions. Although some studies point to emotional regulation difficulties among young runaways, to our knowledge, strategies associated with running away have not been addressed. The aim of the study is to examine associations between cognitive emotional regulation strategies and runaway behavior in adolescents in residential centers and to explore whether psychoactive substance use moderates this association. To address these objectives, 199 adolescent males (124 young runaways), aged 15-17 years, housed in residential care units, completed self-report questionnaires. Results of multivariate logistic regressions indicate that only the positive refocusing strategy was negatively associated with the presence of runaway. Moreover, the use of the positive refocusing and the refocus on planning strategies were negatively associated with the presence of runaway, but only among non-psychoactive substance using adolescents. Findings underscore the importance of helping adolescents in residential care centers develop adaptive emotional regulation strategies to prevent runaway, and the relevance of differential interventions specifically addressing the needs of substance users.
Children and youth caregivers in Residential Care are particularly vulnerable to emotional exhaustion, which can impair their responsive care. However, investigation into the processes that contribute to explaining this phenomenon in these professionals is scarce. The present study analyzed the contribution of sociodemographic and professional dimensions (e.g. age, sex, years of education, emotional regulation), contextual (youth-caregiver ratio), and emotional regulation variables in understanding emotional exhaustion. The sample included 212 caregivers from 21 RC facilities in Portugal. Self-report measures included a sociodemographic questionnaire, the Oldenburg Burnout Inventory (OLBI) and the Affect Regulation Checklist (ARC). Hierarchical Multiple Regression showed that being younger, female, having higher education, working longer in an RC facility, having a higher youth-caregiver ratio for those within the educative team, higher dysregulation, and lower adaptative reflection were significant predictors of exhaustion. The results are critically examined in light of their significant implications for the training and supervision of residential care professionals.
The Caribbean Netherlands lacks specialized care facilities for young people with histories of neglect, abuse, and challenging behavior, leading some to be placed in secure residential youth care (RYC) in the European Netherlands. These transnational placements are far reaching due to geographic distance and their involuntary nature. This study explores the experiences of Dutch Caribbean young people and family members regarding such placements. We conducted retrospective interviews with eight young people and four family members, and analyzed data thematically. Young people described growing up in environments with unmet basic needs, abuse, neglect, and instability in the Caribbean Netherlands. While placements in the European Netherlands provided improved access to basic needs, education, employment, and leisure, young people faced challenges including adapting to the closed RYC setting, cultural dislocation, and geographical separation from family. Limited parental involvement hindered maintaining familial relations. Transnational placements are highly disruptive and should be a last resort. Strengthening family support and developing small-scale RYC in the Caribbean Netherlands could reduce their necessity. When unavoidable, placements should facilitate parental involvement and preserve parent - child relationships. To support the wellbeing and resilience of young people in transnational secure RYC, interventions must be tailored to cultural, familial, and structural contexts.
The enrollment of young people in residential care in higher education remains significantly lower compared to their non-institutionalized peers. This study explores the role of personal agency in the decision-making process of care-experienced youth entering higher education. In-depth interviews were conducted with 12 young individuals currently in residential care and pursuing higher education. Thematic analysis, revealed variations in influencing factors, such as internal versus external agency and future orientation, which led to the identification of three distinct profiles. Further analysis examined how experiences in residential care, school, and extended family shaped their educational pathways. Findings underscore the importance of targeted interventions that foster internal motivation and emotional resilience, essential for navigating higher education and the transition to independent living. The study highlights the critical need for collaborative efforts across care systems, emphasizing the value of nurturing supportive relationships and fostering belief in the aspirations of these youth.
This article investigates how care and treatment is practiced in Norwegian therapeutic residential care facilities (TRCFs) for adolescents with severe behavioral challenges. Drawing on Skjervheim's concept of the instrumentalist mistake and theories of professional discretion and scaffolding, this article investigates how care and treatment is practiced in Norwegian therapeutic residential care facilities (TRCFs) for adolescents with severe behavioral challenges. Particular attention is given to variations in practice and the factors that contribute to these differences. The variations reflect different institutional logics shaped by professional orientation, access to tools and support, and how staff discretion is structured and guided. The analysis identifies two recurring risks: overly rigid standardization that undermines relational engagement, and unstructured flexibility that leads to inconsistency and therapeutic drift. Rather than advocating for or against standardization, this study argues for operational frameworks that support sound professional judgment. The findings have broader relevance for therapeutic care systems seeking to balance structure and autonomy for staff that promote accountable, adaptive, and ethically grounded practice.
Assessment of general functioning provides a full picture of youth mental health, but little work has been done on assessing functioning within the high-risk population of adolescents in residential treatment. A new composite measure was created based on key domains identified from expert interviews and literature review and was tested in a sample of 626 adolescents in residential care. Results indicated that the causal indicator model supported the proposed measure. Individual items showed unique patterns of association with specific types of functioning (i.e. school, family). A composite score was calculated from the individual items and was associated with well-being, depression and anxiety. Differences based on sexual orientation were found. Limitations and clinical and research implications are discussed.
International research has shown the significance of care-leavers' participation in planning for a successful transition from care to young adulthood. While most countries in the Global North have developed policies that allow care-leavers to plan their transition in partnership with a care worker, many countries in the Global South lack policy, programs, and engaged and skilled care workers. This qualitative description study thus aimed to describe how a small sample of Ethiopian female care-leavers from a single institution experience and perceive their participation in the care-leaving process. The study is informed by Lundy's model of child participation and Elder's life course theory. Fifteen care-leavers and one care worker participated in the study, involving qualitative interviews. Findings reveal the profound lack of mutual participation in preparation for leaving care, highlighting the need for better skilled care workers and guidelines for participative care-leaving plans.
