Pub Date : 2021-10-02DOI: 10.1080/0886571x.2021.1967016
Bethany R. Lee
{"title":"Editor’s Note","authors":"Bethany R. Lee","doi":"10.1080/0886571x.2021.1967016","DOIUrl":"https://doi.org/10.1080/0886571x.2021.1967016","url":null,"abstract":"","PeriodicalId":45491,"journal":{"name":"Residential Treatment for Children & Youth","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2021-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43048308","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-09-24DOI: 10.1080/0886571X.2021.1978034
K. Visser, R. Vermeiren, A. Popma, L.M.C. Nauta-Jansen, M. C. Kasius
ABSTRACT In residential settings for juveniles with Mild Intellectual Disability (MID) employees have to face tough work conditions, because of frequent aggressive incidents Eventually, this might result in a negative work climate, high staff-turnover and absenteeism. In turn, it hampers a positive therapeutic environment for youngsters. A method that may endorse a better work climate is Non-violent Resistance (NVR). As earlier research suggests that the residential NVR, adjusted for juveniles with MID, is successful in diminishing aggressive incidents and improving group climate, we hypothesize that NVR-MID will be also effective in enhancing work climate. We investigated the perception of work climate by staff of three residential settings before, during and after implementation of NVR-MID. Work climate was assessed both quantitatively and qualitatively. Outcomes were subsequently integrated. Quantitative data was collected using the Living Group Working Climate Inventory (LGWCI). Multilevel analyses were carried out to analyse the development of work climate over time. Qualitative data were collected via semi-structured interviews with NVR-MID trained staff and analysed through qualitative coding. Quantitative results showed that Job Satisfaction decreased after NVR-MID implementation. However, within qualitative reports, staff members experienced a positive influence on work climate of NVR-MID.
{"title":"Improving Work Climate in a Residential Setting for Juveniles with Mild Intellectual Disability through Training of Staff in Non-violent Resistance","authors":"K. Visser, R. Vermeiren, A. Popma, L.M.C. Nauta-Jansen, M. C. Kasius","doi":"10.1080/0886571X.2021.1978034","DOIUrl":"https://doi.org/10.1080/0886571X.2021.1978034","url":null,"abstract":"ABSTRACT In residential settings for juveniles with Mild Intellectual Disability (MID) employees have to face tough work conditions, because of frequent aggressive incidents Eventually, this might result in a negative work climate, high staff-turnover and absenteeism. In turn, it hampers a positive therapeutic environment for youngsters. A method that may endorse a better work climate is Non-violent Resistance (NVR). As earlier research suggests that the residential NVR, adjusted for juveniles with MID, is successful in diminishing aggressive incidents and improving group climate, we hypothesize that NVR-MID will be also effective in enhancing work climate. We investigated the perception of work climate by staff of three residential settings before, during and after implementation of NVR-MID. Work climate was assessed both quantitatively and qualitatively. Outcomes were subsequently integrated. Quantitative data was collected using the Living Group Working Climate Inventory (LGWCI). Multilevel analyses were carried out to analyse the development of work climate over time. Qualitative data were collected via semi-structured interviews with NVR-MID trained staff and analysed through qualitative coding. Quantitative results showed that Job Satisfaction decreased after NVR-MID implementation. However, within qualitative reports, staff members experienced a positive influence on work climate of NVR-MID.","PeriodicalId":45491,"journal":{"name":"Residential Treatment for Children & Youth","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2021-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46222101","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-09-21DOI: 10.1080/0886571X.2021.1978035
Ane Slaatto, A. Mellblom, L. C. Kleppe, G. Baugerud
ABSTRACT In inpatient and residential youth facilities, staff concerns over actual and potential aggression and conflict frequently affect both the quality of care and staff wellbeing. This study investigated 1) staff perceptions of safety at the residential facilities where they work, and 2) staff experiences with the Basic Training Program in Safety and Security, initiated by the Norwegian Directorate of Children, Youth and Family Affairs (Bufdir), to enhance prevention and management of aggression and conflict. We conducted three focus-group interviews at three different public residential facilities with a total of 18 staff members who work daily with youth. Findings show that staff regard safety as essential and perceive enhanced safety as linked to predictability, stability, team coordination, education and training, organizational support, and trusting and supportive relationships. They also indicate that staff regard the training program as having improved their feelings of safety, enhancing awareness of conflict situations before, during and after they occur, and contributing to more systematic work processes and cooperative and coordinated teamwork. These findings have implications for all facilities providing care and treatment to youth.
{"title":"Safety in Residential Youth Facilities: Staff Perceptions of Safety and Experiences of the “Basic Training Program in Safety and Security”","authors":"Ane Slaatto, A. Mellblom, L. C. Kleppe, G. Baugerud","doi":"10.1080/0886571X.2021.1978035","DOIUrl":"https://doi.org/10.1080/0886571X.2021.1978035","url":null,"abstract":"ABSTRACT In inpatient and residential youth facilities, staff concerns over actual and potential aggression and conflict frequently affect both the quality of care and staff wellbeing. This study investigated 1) staff perceptions of safety at the residential facilities where they work, and 2) staff experiences with the Basic Training Program in Safety and Security, initiated by the Norwegian Directorate of Children, Youth and Family Affairs (Bufdir), to enhance prevention and management of aggression and conflict. We conducted three focus-group interviews at three different public residential facilities with a total of 18 staff members who work daily with youth. Findings show that staff regard safety as essential and perceive enhanced safety as linked to predictability, stability, team coordination, education and training, organizational support, and trusting and supportive relationships. They also indicate that staff regard the training program as having improved their feelings of safety, enhancing awareness of conflict situations before, during and after they occur, and contributing to more systematic work processes and cooperative and coordinated teamwork. These findings have implications for all facilities providing care and treatment to youth.","PeriodicalId":45491,"journal":{"name":"Residential Treatment for Children & Youth","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2021-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46805717","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-09-05DOI: 10.1080/0886571X.2021.1973940
Steve Geoffrion, Josianne Lamothe, C. Drolet, S. Dufour, Amélie Couvrette
ABSTRACT In situations where the immediate safety of children or others is at risk, residential workers are authorized to use specific measures intended as last resort, namely restraint and seclusion (R&S). This study sought to identify and detail the reasons invoked by residential workers when justifying their decision to restrain or seclude a child. Researchers reviewed and coded 628 anonymized official R&S reports written by residential workers from two different residential treatment centers over the 14 months between September 2015 and May 2017. Researchers used qualitative thematic analysis to analyze official reports. Researchers found nine reasons invoked by residential workers that they regrouped into four themes as follows: workers justified their use of R&S based on their own perceptions of 1) the danger associated with children’s affects and behaviors; 2) their obligation to yield to external constraints; 3) the benefits associated with R&S for children, and 4) the demands imposed by their professional culture. Researchers found that the reasons invoked in official reports by residential workers to justify their decisions are not always consistent with R&S as being methods of last resort. Specifically, residential workers appear to be missing the training and organizational resources needed to use alternative forms of intervention.
{"title":"Exploring Reasons Motivating the Use of Restraint and Seclusion by Residential Workers in Residential Treatment Centers: A Qualitative Analysis of Official Reports","authors":"Steve Geoffrion, Josianne Lamothe, C. Drolet, S. Dufour, Amélie Couvrette","doi":"10.1080/0886571X.2021.1973940","DOIUrl":"https://doi.org/10.1080/0886571X.2021.1973940","url":null,"abstract":"ABSTRACT In situations where the immediate safety of children or others is at risk, residential workers are authorized to use specific measures intended as last resort, namely restraint and seclusion (R&S). This study sought to identify and detail the reasons invoked by residential workers when justifying their decision to restrain or seclude a child. Researchers reviewed and coded 628 anonymized official R&S reports written by residential workers from two different residential treatment centers over the 14 months between September 2015 and May 2017. Researchers used qualitative thematic analysis to analyze official reports. Researchers found nine reasons invoked by residential workers that they regrouped into four themes as follows: workers justified their use of R&S based on their own perceptions of 1) the danger associated with children’s affects and behaviors; 2) their obligation to yield to external constraints; 3) the benefits associated with R&S for children, and 4) the demands imposed by their professional culture. Researchers found that the reasons invoked in official reports by residential workers to justify their decisions are not always consistent with R&S as being methods of last resort. Specifically, residential workers appear to be missing the training and organizational resources needed to use alternative forms of intervention.","PeriodicalId":45491,"journal":{"name":"Residential Treatment for Children & Youth","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2021-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43179881","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-08-25DOI: 10.1080/0886571X.2021.1960240
Lisa M. Purdy, Becky F. Antle
Considered the most intensive level of out-of-home care for youth (James et al., 2012), residential treatment was initially developed in the 1940s as a response to the needs of the most seriously emotionally disturbed youth (Lieberman, 2004). A residential treatment center (RTC) is defined as a facility operating 24/7, which is not licensed as a hospital, offering mental health treatment programs for seriously emotionally disturbed children (Connor et al., 2002). The youths entering RTCs typically have multiple-placement disruptions, neuropsychiatric diagnoses, chronic traumatic experiences, and multiple-attachment disruptions (Connor et al., 2003). These treatment centers strive to address the developmental, psychological, behavioral, and relationship needs of the youth through therapeutic services and reliance on the therapeutic milieu as an intervention (Lieberman, 2004). Residential direct care staff have the most direct contact with these youths. Residential direct care staff are those staff who reside with youth in shifts, and are responsible for meal planning, hygiene, oversight of homework/learning activities, crisis management, household therapeutic and entertainment activities, and general emotional support to the youth, many of whom have limited contact with family or others outside the residential treatment center (Eastwood & Ecklund, 2008; Seti, 2008). The work can be emotionally taxing and by its nature expose these residential direct care professionals to both direct and indirect trauma. More specifically, research has shown that those working in the field of child welfare have a greater risk of developing a form of indirect trauma called “secondary traumatic stress” than do others within
寄宿治疗被认为是青少年最密集的家庭外护理（James et al.，2012），最初是在20世纪40年代发展起来的，是为了满足情绪最严重的青少年的需求（Lieberman，2004）。住院治疗中心（RTC）被定义为一个全天候运营的设施，它没有医院许可证，为严重情绪障碍的儿童提供心理健康治疗计划（Connor等人，2002）。进入RTC的年轻人通常有多次安置中断、神经精神诊断、慢性创伤经历和多次依恋中断（Connor等人，2003）。这些治疗中心努力通过治疗服务和对治疗环境的干预来满足年轻人的发展、心理、行为和关系需求（Lieberman，2004）。住宿直接护理人员与这些年轻人的接触最为直接。住宿直接护理人员是指与青年一起轮班居住的工作人员，负责膳食计划、卫生、家庭作业/学习活动监督、危机管理、家庭治疗和娱乐活动，以及对青年的一般情感支持，其中许多人与寄宿治疗中心外的家人或其他人接触有限（Eastwood和Ecklund，2008；Seti，2008）。这项工作可能会带来情感上的负担，而且从本质上讲，这些住院直接护理专业人员会受到直接和间接的创伤。更具体地说，研究表明，那些在儿童福利领域工作的人比其他人更容易患上一种被称为“继发性创伤压力”的间接创伤
{"title":"Reducing Trauma in Residential Direct Care Staff","authors":"Lisa M. Purdy, Becky F. Antle","doi":"10.1080/0886571X.2021.1960240","DOIUrl":"https://doi.org/10.1080/0886571X.2021.1960240","url":null,"abstract":"Considered the most intensive level of out-of-home care for youth (James et al., 2012), residential treatment was initially developed in the 1940s as a response to the needs of the most seriously emotionally disturbed youth (Lieberman, 2004). A residential treatment center (RTC) is defined as a facility operating 24/7, which is not licensed as a hospital, offering mental health treatment programs for seriously emotionally disturbed children (Connor et al., 2002). The youths entering RTCs typically have multiple-placement disruptions, neuropsychiatric diagnoses, chronic traumatic experiences, and multiple-attachment disruptions (Connor et al., 2003). These treatment centers strive to address the developmental, psychological, behavioral, and relationship needs of the youth through therapeutic services and reliance on the therapeutic milieu as an intervention (Lieberman, 2004). Residential direct care staff have the most direct contact with these youths. Residential direct care staff are those staff who reside with youth in shifts, and are responsible for meal planning, hygiene, oversight of homework/learning activities, crisis management, household therapeutic and entertainment activities, and general emotional support to the youth, many of whom have limited contact with family or others outside the residential treatment center (Eastwood & Ecklund, 2008; Seti, 2008). The work can be emotionally taxing and by its nature expose these residential direct care professionals to both direct and indirect trauma. More specifically, research has shown that those working in the field of child welfare have a greater risk of developing a form of indirect trauma called “secondary traumatic stress” than do others within","PeriodicalId":45491,"journal":{"name":"Residential Treatment for Children & Youth","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2021-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47499797","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-08-25DOI: 10.1080/0886571X.2021.1964415
L. Theall, K. Arbeau, K. Willoughby, J. St. Pierre, Gwynne Ng, S. Stewart
ABSTRACT This study investigated whether children/youth in Ontario triaged to residential services showed a higher intensity of need than those referred to outpatient services, and whether residential treatment gains were sufficient for transition to community services. Participants included 2053 children/youth assessed at 23 diverse mental health agencies across Ontario using the interRAI™ Child and Youth Mental Health (ChYMH) instrument. Various presenting problems were examined utilizing scales including: Disruptive/Aggressive Behavior, Hyperactive/Distraction, Social Disengagement, Anxiety, and Sleep Difficulties. Analyses were conducted separately for boys and girls. Notable differences were found in the initial assessment, with residential boys scoring higher on all scales than outpatient boys, and residential girls scoring higher on the externalizing scales (Disruptive/Aggressive Behavior, Hyperactive/Distraction) than outpatient girls. Treatment gains at residential discharge included improvements in Anxiety, Social Disengagement, Hyperactive/Distraction and Sleep Difficulties for boys and girls to levels at or below the initial scores of outpatient peers. Disruptive/Aggressive Behavior is still a high need following residential services. The results highlight differences in severity of mental health presentation between children/youth receiving residential and outpatient services, and how multiple agencies in Ontario are providing services that successfully reduce the severity of mental health needs.
{"title":"Assessing Needs and Outcomes of Children and Youth Receiving Intensive Services","authors":"L. Theall, K. Arbeau, K. Willoughby, J. St. Pierre, Gwynne Ng, S. Stewart","doi":"10.1080/0886571X.2021.1964415","DOIUrl":"https://doi.org/10.1080/0886571X.2021.1964415","url":null,"abstract":"ABSTRACT This study investigated whether children/youth in Ontario triaged to residential services showed a higher intensity of need than those referred to outpatient services, and whether residential treatment gains were sufficient for transition to community services. Participants included 2053 children/youth assessed at 23 diverse mental health agencies across Ontario using the interRAI™ Child and Youth Mental Health (ChYMH) instrument. Various presenting problems were examined utilizing scales including: Disruptive/Aggressive Behavior, Hyperactive/Distraction, Social Disengagement, Anxiety, and Sleep Difficulties. Analyses were conducted separately for boys and girls. Notable differences were found in the initial assessment, with residential boys scoring higher on all scales than outpatient boys, and residential girls scoring higher on the externalizing scales (Disruptive/Aggressive Behavior, Hyperactive/Distraction) than outpatient girls. Treatment gains at residential discharge included improvements in Anxiety, Social Disengagement, Hyperactive/Distraction and Sleep Difficulties for boys and girls to levels at or below the initial scores of outpatient peers. Disruptive/Aggressive Behavior is still a high need following residential services. The results highlight differences in severity of mental health presentation between children/youth receiving residential and outpatient services, and how multiple agencies in Ontario are providing services that successfully reduce the severity of mental health needs.","PeriodicalId":45491,"journal":{"name":"Residential Treatment for Children & Youth","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2021-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41924907","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-07-03DOI: 10.1080/0886571X.2021.1927428
Bethany R. Lee
Greetings, readers! This issue of Residential Treatment for Children and Youth focuses on interventions that have been implemented and tested in residential settings. The issue begins with analysis of findings from a national survey to describe the treatment approaches in behavioral health programs for youth in the United States (Herbell & Ault). Then, the issue presents implementation studies of two evidence-supported interventions: the uptake of motivational interviewing by residential care staff in the Netherlands (Eenshuistra et al.) and a feasibility study on adapting dialectical behavior therapy for use in a residential program in the US (Klodnick et al.). Next, a team from the United States piloted the efficacy of relational savoring as a treatment for youth in residential care (Wang et al.). Subsequently, van Wijk-Herbrink and colleagues from Netherlands introduced SafePath, a milieu-based intervention that uses Schema Therapy techniques, and presented promising findings for group climate. Finally, the issue closes with a thoughtful cross-national commentary (Huefner & Ainsworth) that calls us to remember the importance of the milieu as a special component of the transformational potential of a residential program. If your residential program is implementing an innovative practice or adapting an evidence-based intervention for a residential setting, we welcome your submissions to the journal. The journal welcomes full-length research articles as well as shorter practice-focused papers that describe a novel approach or case study. We are interested in learning about practice around the world and how to continue to improve the care provided to youth in residential programs.
读者们，大家好！本期《儿童和青年寄宿治疗》侧重于在寄宿环境中实施和测试的干预措施。该问题始于对一项全国性调查结果的分析，该调查描述了美国青少年行为健康计划中的治疗方法（Herbell&Ault）。然后，该问题介绍了两种证据支持干预措施的实施研究：荷兰住院护理人员采用动机访谈（Eenshuistra et al.）和美国住院项目中使用辩证行为疗法的可行性研究（Klodnick et al.），来自美国的一个团队在寄宿护理中试行了关系品味作为青少年治疗的疗效（Wang等人）。随后，来自荷兰的van Wijk Herbrink和同事引入了SafePath，这是一种使用模式治疗技术的基于环境的干预措施，并对群体氛围提出了有希望的发现。最后，本期以一篇深思熟虑的跨国家评论（Huefner&Ainsworth）结束，该评论呼吁我们记住环境作为住宅项目转型潜力的特殊组成部分的重要性。如果您的住宿项目正在实施创新实践或将循证干预措施应用于住宿环境，我们欢迎您向该杂志投稿。该杂志欢迎长篇研究文章以及描述新颖方法或案例研究的以实践为重点的简短论文。我们有兴趣了解世界各地的实践，以及如何继续改善寄宿项目中为青年提供的护理。
{"title":"Editor’s Note","authors":"Bethany R. Lee","doi":"10.1080/0886571X.2021.1927428","DOIUrl":"https://doi.org/10.1080/0886571X.2021.1927428","url":null,"abstract":"Greetings, readers! This issue of Residential Treatment for Children and Youth focuses on interventions that have been implemented and tested in residential settings. The issue begins with analysis of findings from a national survey to describe the treatment approaches in behavioral health programs for youth in the United States (Herbell & Ault). Then, the issue presents implementation studies of two evidence-supported interventions: the uptake of motivational interviewing by residential care staff in the Netherlands (Eenshuistra et al.) and a feasibility study on adapting dialectical behavior therapy for use in a residential program in the US (Klodnick et al.). Next, a team from the United States piloted the efficacy of relational savoring as a treatment for youth in residential care (Wang et al.). Subsequently, van Wijk-Herbrink and colleagues from Netherlands introduced SafePath, a milieu-based intervention that uses Schema Therapy techniques, and presented promising findings for group climate. Finally, the issue closes with a thoughtful cross-national commentary (Huefner & Ainsworth) that calls us to remember the importance of the milieu as a special component of the transformational potential of a residential program. If your residential program is implementing an innovative practice or adapting an evidence-based intervention for a residential setting, we welcome your submissions to the journal. The journal welcomes full-length research articles as well as shorter practice-focused papers that describe a novel approach or case study. We are interested in learning about practice around the world and how to continue to improve the care provided to youth in residential programs.","PeriodicalId":45491,"journal":{"name":"Residential Treatment for Children & Youth","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2021-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/0886571X.2021.1927428","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49255864","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-07-03DOI: 10.1080/0886571X.2021.1915225
J. Huefner, F. Ainsworth
ABSTRACT Therapeutic residential care differs markedly from other forms of out-of-home care for children and youth. Support for the view that therapeutic residential care needs to be a milieu approach that leverages all interactions in the living environment to achieve a beneficial emotional and behavioral experience for children and youth is presented. A therapeutic milieu has the advantage of maintaining focus on what is in the best clinical interest for a child by aligning and coordinating all interactions and activities. We provide a rationale for a milieu-based foundation for therapeutic residential care that consists of five elements: care, treatment, nurturing, teaching, and order. Attending to milieu as defined will provide a sound foundation upon which effective and well-implemented treatment can be fully expressed.
{"title":"Commentary:Recognizing the value of the milieu in therapeutic residential care for children and youth","authors":"J. Huefner, F. Ainsworth","doi":"10.1080/0886571X.2021.1915225","DOIUrl":"https://doi.org/10.1080/0886571X.2021.1915225","url":null,"abstract":"ABSTRACT Therapeutic residential care differs markedly from other forms of out-of-home care for children and youth. Support for the view that therapeutic residential care needs to be a milieu approach that leverages all interactions in the living environment to achieve a beneficial emotional and behavioral experience for children and youth is presented. A therapeutic milieu has the advantage of maintaining focus on what is in the best clinical interest for a child by aligning and coordinating all interactions and activities. We provide a rationale for a milieu-based foundation for therapeutic residential care that consists of five elements: care, treatment, nurturing, teaching, and order. Attending to milieu as defined will provide a sound foundation upon which effective and well-implemented treatment can be fully expressed.","PeriodicalId":45491,"journal":{"name":"Residential Treatment for Children & Youth","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2021-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/0886571X.2021.1915225","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41812536","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-06-04DOI: 10.1080/0886571X.2021.1936343
E. Buchbinder, Hadas Yagen
ABSTRACT Hosting families host children, who are deprived of contact with their own families. They aim to create a positive family model and supportive relationships for these children. This qualitative study was based on in-depth semi-structured interviews with 20 couples in 20 hosting families (20 interviews, 40 interviewees). The present article describes and analyzes the dialectics in the families’ experience: on one pole is the moral obligation to accept the child with a life history and ongoing difficulties; on the other pole is the stress derived from the child’s emotional distress, risk behavior, and crisis situations. The hosting families experience distress and, sometimes, helplessness. At the same time, their commitment to the choice to become a hosting family is reinforced. The article emphasizes hosting families’ need for support and counseling to help strengthen their coping capacities.
{"title":"Hosting Families of Children Living in Residential Care","authors":"E. Buchbinder, Hadas Yagen","doi":"10.1080/0886571X.2021.1936343","DOIUrl":"https://doi.org/10.1080/0886571X.2021.1936343","url":null,"abstract":"ABSTRACT Hosting families host children, who are deprived of contact with their own families. They aim to create a positive family model and supportive relationships for these children. This qualitative study was based on in-depth semi-structured interviews with 20 couples in 20 hosting families (20 interviews, 40 interviewees). The present article describes and analyzes the dialectics in the families’ experience: on one pole is the moral obligation to accept the child with a life history and ongoing difficulties; on the other pole is the stress derived from the child’s emotional distress, risk behavior, and crisis situations. The hosting families experience distress and, sometimes, helplessness. At the same time, their commitment to the choice to become a hosting family is reinforced. The article emphasizes hosting families’ need for support and counseling to help strengthen their coping capacities.","PeriodicalId":45491,"journal":{"name":"Residential Treatment for Children & Youth","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2021-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/0886571X.2021.1936343","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41540051","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-05-24DOI: 10.1080/0886571X.2021.1929660
Alexandra Matte-Landry, D. Collin-Vézina
ABSTRACT Trauma-informed care (TIC) is receiving growing interest and support as a promising approach to reducing the use of restrictive measures (restraints, seclusions and time-outs) in children and youth living in residential care. In this study, we aimed to compare the use of restrictive measures prior to and following the implementation of a TIC staff training initiative in 44 residential units for children and youth and to explore differences between units and type of measures used. Patterns of change in monthly use of restrictive measures 6 months before and 12 months after the training were compared using growth curve models. Restraints, seclusions and time-outs decreased by 41.82%, 19.91%, and 48.15%, respectively, over a year following the training. Despite these important declines, trajectories of restrictive measures did not change significantly from pre- to post-training when holding the TIC training against stringent criteria. Nonetheless, some units’ characteristics were associated with successful changes. Results are promising, but not conclusive about the ability of this TIC training to produce changes in trajectories of restrictive measures, at least in the first year of implementation. This study highlights the need for rigorous statistical models in further studies to ensure accurate empirical evaluation of TIC staff training programs.
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