Effectiveness of mental-health interventions for children and adolescents placed in residential care by the welfare services: A systematic review

Abstract

Background

Children and adolescents in residential youth care are a vulnerable population with great needs of mental health.

Purpose

The present study undertook a systematic review to seek available mental health interventions and investigate its effectiveness.

Methods

Following PRISMA guidelines, a systematic search was performed for publications between 1992 and July 2023 in seven databases and relevant journals for residential care. Methodological quality was assessed using the Mixed Methods Appraisal Tool. After multi-stage screening, 14 eligible articles were retrieved for analysis and a narrative synthesis performed.

Results

Thirteen interventions were identified, predominantly focusing on internalising difficulties, showing congruently positive results mostly on internalised-related outcomes. Most interventions were based on cognitive-behaviour therapy and outdoor-based therapies (surf-, animal assisted, and forest-therapy). Short-term interventions, delivered on a weekly basis in group format, were the most frequent delivery mode. Most studies managed to recruit a comparison group but follow-ups were generally absent. Poor reporting and lack of methodological rigor were common features of the reviewed studies.

Conclusions

This systematic review extends the state of the art regarding psychological interventions in residential youth care. Evidence-based interventions are still needed, and future research should focus on developing and rigorously testing more interventions within this care system.