Pub Date : 2020-09-09DOI: 10.1080/0886571X.2020.1814937
H. Steinkopf, D. Nordanger, Anne Halvorsen, Brynjulf Stige, A. Milde
ABSTRACT Many adolescents in residential care have a history of traumatization, often with consequences on regulating emotions, thoughts, behaviors, as well as on establishing healthy relationships. Such evidence-based knowledge has paved the way for various trauma-informed models of care that emphasize the adolescents’ need to be other-regulated through caring adults. Being a “regulating other” requires the ability of self-regulation, which may be challenging for staff faced with intense emotional and behavioral expressions from the adolescents. In this qualitative study, fifteen social workers at a residential care unit for adolescents in Norway were individually interviewed on themes addressing what they perceived as necessary prerequisites for maintaining a regulated state in their context of work. Descriptions were analyzed in accordance with principles for thematic analysis. The informants regarded self-reflection and self-acceptance as essential prerequisites for self-regulation. Other salient themes were associated with having a regulating work environment and a trustworthy theoretical model to be guided by. These findings are important for institutions involved in offering competence building in residential care units and academic institutions that educate social workers, as to include systematic training in self-reflection and self-acceptance skills, to strengthen the ability to be a mature regulating other.
{"title":"Prerequisites for Maintaining Emotion Self-regulation in Social Work with Traumatized Adolescents: A Qualitative Study among Social Workers in A Norwegian Residential Care Unit","authors":"H. Steinkopf, D. Nordanger, Anne Halvorsen, Brynjulf Stige, A. Milde","doi":"10.1080/0886571X.2020.1814937","DOIUrl":"https://doi.org/10.1080/0886571X.2020.1814937","url":null,"abstract":"ABSTRACT Many adolescents in residential care have a history of traumatization, often with consequences on regulating emotions, thoughts, behaviors, as well as on establishing healthy relationships. Such evidence-based knowledge has paved the way for various trauma-informed models of care that emphasize the adolescents’ need to be other-regulated through caring adults. Being a “regulating other” requires the ability of self-regulation, which may be challenging for staff faced with intense emotional and behavioral expressions from the adolescents. In this qualitative study, fifteen social workers at a residential care unit for adolescents in Norway were individually interviewed on themes addressing what they perceived as necessary prerequisites for maintaining a regulated state in their context of work. Descriptions were analyzed in accordance with principles for thematic analysis. The informants regarded self-reflection and self-acceptance as essential prerequisites for self-regulation. Other salient themes were associated with having a regulating work environment and a trustworthy theoretical model to be guided by. These findings are important for institutions involved in offering competence building in residential care units and academic institutions that educate social workers, as to include systematic training in self-reflection and self-acceptance skills, to strengthen the ability to be a mature regulating other.","PeriodicalId":45491,"journal":{"name":"Residential Treatment for Children & Youth","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2020-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/0886571X.2020.1814937","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44706245","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 : 2020-09-02DOI: 10.1080/0886571X.2020.1787924
Sonderman, van der Bekkens, van der Helm, Van de Mheen
ABSTRACT Interactions among peers in residential youth care are an important dynamic factor affecting behavioral adjustment and treatment success. Assessment and monitoring of the quality of peer interactions are potentially important for promoting a positive peer culture at the living group, contributing to a positive social climate. However, currently, there are no measures available to assess peer interactions in residential youth care. The present study describes the development, construct validity, and reliability of the Peer Interactions in Residential Youth Care questionnaire (PIRY) in a sample of 345 adolescents (age M = 15.45, SD = 1.59, 44.9% male) in the Netherlands. Confirmatory factor analysis of a two-factor model (peer support and acceptance, and relational aggression) showed a good fit to the data, and internal consistency reliabilities were good for both scales. Partial strict measurement invariance for gender was established, and no significant differences were found between boys and girls on latent factor means. The PIRY can be used in practice to assess and monitor both positive and negative peer interactions in residential youth care at the group level. Implications for research and practice are discussed.
{"title":"Peer Interactions in Residential Youth Care: A Validation Study of the Peer Interactions in Residential Youth Care (PIRY) Questionnaire","authors":"Sonderman, van der Bekkens, van der Helm, Van de Mheen","doi":"10.1080/0886571X.2020.1787924","DOIUrl":"https://doi.org/10.1080/0886571X.2020.1787924","url":null,"abstract":"ABSTRACT Interactions among peers in residential youth care are an important dynamic factor affecting behavioral adjustment and treatment success. Assessment and monitoring of the quality of peer interactions are potentially important for promoting a positive peer culture at the living group, contributing to a positive social climate. However, currently, there are no measures available to assess peer interactions in residential youth care. The present study describes the development, construct validity, and reliability of the Peer Interactions in Residential Youth Care questionnaire (PIRY) in a sample of 345 adolescents (age M = 15.45, SD = 1.59, 44.9% male) in the Netherlands. Confirmatory factor analysis of a two-factor model (peer support and acceptance, and relational aggression) showed a good fit to the data, and internal consistency reliabilities were good for both scales. Partial strict measurement invariance for gender was established, and no significant differences were found between boys and girls on latent factor means. The PIRY can be used in practice to assess and monitor both positive and negative peer interactions in residential youth care at the group level. Implications for research and practice are discussed.","PeriodicalId":45491,"journal":{"name":"Residential Treatment for Children & Youth","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2020-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/0886571X.2020.1787924","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45795049","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 : 2020-08-31DOI: 10.1080/0886571X.2020.1803783
Kathryn Seymour, S. Batchelor, Alison Schneidereit
ABSTRACT San Miguel Family Center in New South Wales, Australia, provides support in short-medium term housing for young homeless parents and their children, followed by post-exit outreach support of up to 36 months. The service was developed and is independently operated by the Australian Lasallian charity yourtown. San Miguel’s holistic model of intensive long-term support aims to fill a key gap in the child protection system by simultaneously addressing homelessness, parenting, independent living skills, and child safety. Parents as young as 16 years, and their partners, come to the service with their children or during the last trimester of pregnancy. Many have grown up in out-of-home care, some have already lost children to state care and all are at risk of losing children to care. San Miguel facilitates parent–child reunification and prevents family breakdown where possible. In this case study narrative, we discuss the model in practice and outline key aspects of the service. We conclude by looking to the future, discussing key challenges, lessons learned, and tensions in the model.
{"title":"Partnering to Independence: A Residential Care Response Keeping Young Homeless Parents and Children Safe and Together","authors":"Kathryn Seymour, S. Batchelor, Alison Schneidereit","doi":"10.1080/0886571X.2020.1803783","DOIUrl":"https://doi.org/10.1080/0886571X.2020.1803783","url":null,"abstract":"ABSTRACT San Miguel Family Center in New South Wales, Australia, provides support in short-medium term housing for young homeless parents and their children, followed by post-exit outreach support of up to 36 months. The service was developed and is independently operated by the Australian Lasallian charity yourtown. San Miguel’s holistic model of intensive long-term support aims to fill a key gap in the child protection system by simultaneously addressing homelessness, parenting, independent living skills, and child safety. Parents as young as 16 years, and their partners, come to the service with their children or during the last trimester of pregnancy. Many have grown up in out-of-home care, some have already lost children to state care and all are at risk of losing children to care. San Miguel facilitates parent–child reunification and prevents family breakdown where possible. In this case study narrative, we discuss the model in practice and outline key aspects of the service. We conclude by looking to the future, discussing key challenges, lessons learned, and tensions in the model.","PeriodicalId":45491,"journal":{"name":"Residential Treatment for Children & Youth","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2020-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/0886571X.2020.1803783","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46367792","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 : 2020-08-31DOI: 10.1080/0886571x.2020.1800550
Fiona McIlwaine, Kerry Proctor, K. O’Sullivan, Lynda Manley
ABSTRACT In this Practice Paper, family therapists working in a large Australian non-government agency reflect on their experience of family inclusive practice with children and adolescents living in the organization’s residential care homes. This paper draws on relevant literature in the out-of-home care (OOHC) sector and the substantial research and practice experience which validates the importance and benefits of partnering with families and kin, wherever possible. The primary focus of the authors is an exploration of constraints or roadblocks to effective implementation of family partnering. They also discuss how they are working to navigate these constraints with strategies that can be implemented at all levels in OOHC. Two case studies are presented to highlight the challenges and opportunities in this work, along with some innovative and valuable initiatives in progress. The authors advocate for the need to draw on the voices of children and their families who have been part of the OOHC sector to guide the further development of systemic and collaborative practice.
{"title":"Practitioners’ Perspectives: Partnering with Families in Out of Home Care (OOHC) – From ‘On the Outer’ to Shared Caring","authors":"Fiona McIlwaine, Kerry Proctor, K. O’Sullivan, Lynda Manley","doi":"10.1080/0886571x.2020.1800550","DOIUrl":"https://doi.org/10.1080/0886571x.2020.1800550","url":null,"abstract":"ABSTRACT In this Practice Paper, family therapists working in a large Australian non-government agency reflect on their experience of family inclusive practice with children and adolescents living in the organization’s residential care homes. This paper draws on relevant literature in the out-of-home care (OOHC) sector and the substantial research and practice experience which validates the importance and benefits of partnering with families and kin, wherever possible. The primary focus of the authors is an exploration of constraints or roadblocks to effective implementation of family partnering. They also discuss how they are working to navigate these constraints with strategies that can be implemented at all levels in OOHC. Two case studies are presented to highlight the challenges and opportunities in this work, along with some innovative and valuable initiatives in progress. The authors advocate for the need to draw on the voices of children and their families who have been part of the OOHC sector to guide the further development of systemic and collaborative practice.","PeriodicalId":45491,"journal":{"name":"Residential Treatment for Children & Youth","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2020-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/0886571x.2020.1800550","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43758558","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 : 2020-08-31DOI: 10.1080/0886571X.2020.1810599
S. Nowalis, C. Pederson, Paula J. Fite, Elizabeth C. Tampke, Rebecca L. Griffith
ABSTRACT Perceived containment, the belief that authorities can effectively set limits on behavior, may explain why behavioral interventions produce moderate effects in youth exhibiting callous-unemotional traits. Examining whether callous-unemotional traits and perceived containment work together to confer risk for antisocial behaviors has implications for both screening and intervention in detained populations. In a sample of detained youth (Mage = 15.94; 70.4% Male), path analyses indicated that perceived containment mediated the association between callous-unemotional traits and behavioral problems characterized by challenging the authority of facility staff. Implications for screening and identification of individuals in need of additional support as well as a potential cognitive target for intervention are discussed.
{"title":"Perceived Containment as a Mediator in the Association between Callous-unemotional Traits and Behavioral Problems in Detained Youth","authors":"S. Nowalis, C. Pederson, Paula J. Fite, Elizabeth C. Tampke, Rebecca L. Griffith","doi":"10.1080/0886571X.2020.1810599","DOIUrl":"https://doi.org/10.1080/0886571X.2020.1810599","url":null,"abstract":"ABSTRACT Perceived containment, the belief that authorities can effectively set limits on behavior, may explain why behavioral interventions produce moderate effects in youth exhibiting callous-unemotional traits. Examining whether callous-unemotional traits and perceived containment work together to confer risk for antisocial behaviors has implications for both screening and intervention in detained populations. In a sample of detained youth (Mage = 15.94; 70.4% Male), path analyses indicated that perceived containment mediated the association between callous-unemotional traits and behavioral problems characterized by challenging the authority of facility staff. Implications for screening and identification of individuals in need of additional support as well as a potential cognitive target for intervention are discussed.","PeriodicalId":45491,"journal":{"name":"Residential Treatment for Children & Youth","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2020-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/0886571X.2020.1810599","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46438286","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 : 2020-07-19DOI: 10.1080/0886571X.2020.1786486
P. McNamara
ABSTRACT Therapeutic residential care (TRC) privileges healing from trauma for vulnerable children and young people. It presents an opportunity for staff to partner with families to overcome trauma-induced conflicts and separations and build positive, resilient relationships. Co-parenting of residents by staff and parents can become possible. Positive impacts of effective family partnering in residential care generally, and within TRC specifically, are affirmed by international evidence. Family partnering in TRC has not, however, been formally researched in Australia. This preliminary scoping study aimed to explore approaches to family partnering within Australian TRC, along with elements of best practice. It also attempted to identify opportunities and challenges encountered in the partnering process. Australian experience is contextualized more broadly by international informants. Interviews with managers (N = 8) and experts (N = 6) were undertaken. Findings suggest that staff commitment to building trusted relationships with parents and children, within sibling groups and with significant others is critical to effective partnering. Healing family trauma and estrangement can be facilitated by ensuring optimum family access to and inclusion within the program. Equity and empowerment strategies and support of diverse family, family-like and community relationships appear critical to effective policy and programmatic development. This study provides a platform for larger scale research.
{"title":"Family Partnering in Australian Therapeutic Residential Care: A Scoping Study","authors":"P. McNamara","doi":"10.1080/0886571X.2020.1786486","DOIUrl":"https://doi.org/10.1080/0886571X.2020.1786486","url":null,"abstract":"ABSTRACT Therapeutic residential care (TRC) privileges healing from trauma for vulnerable children and young people. It presents an opportunity for staff to partner with families to overcome trauma-induced conflicts and separations and build positive, resilient relationships. Co-parenting of residents by staff and parents can become possible. Positive impacts of effective family partnering in residential care generally, and within TRC specifically, are affirmed by international evidence. Family partnering in TRC has not, however, been formally researched in Australia. This preliminary scoping study aimed to explore approaches to family partnering within Australian TRC, along with elements of best practice. It also attempted to identify opportunities and challenges encountered in the partnering process. Australian experience is contextualized more broadly by international informants. Interviews with managers (N = 8) and experts (N = 6) were undertaken. Findings suggest that staff commitment to building trusted relationships with parents and children, within sibling groups and with significant others is critical to effective partnering. Healing family trauma and estrangement can be facilitated by ensuring optimum family access to and inclusion within the program. Equity and empowerment strategies and support of diverse family, family-like and community relationships appear critical to effective policy and programmatic development. This study provides a platform for larger scale research.","PeriodicalId":45491,"journal":{"name":"Residential Treatment for Children & Youth","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2020-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/0886571X.2020.1786486","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49201924","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 : 2020-07-02DOI: 10.1080/0886571X.2019.1590172
K. van Gink, L. van Domburgh, L. Jansen, N. Goddard, Ron Ottenbros, B. van der Stegen, A. Popma, R. Vermeiren
ABSTRACT Non-violent Resistance (NVR) is a method to manage child and adolescent aggressive behavior and to decrease parental helplessness. Although developed for a family setting, this paper describes the adaptation of NVR for child and adolescent residential settings, reports on the possible hampering and facilitating elements of implementing NVR in four different institutions and finally presents seclusion and restraint rates before and after implementation. Retrospective analysis of the different implementation processes suggested the following elements to facilitate implementation: awareness that NVR is not a quick fix, a considerable amount of time and financial investment, a team-wide perspective, support from all levels in an organization and influential team members committed to NVR to decrease the risk of falling back into more familiar patterns. Seclusion and restraint figures pre-post point in the direction that the implementation of an adapted version of NVR in residential settings could result in decreased seclusion and restraint. Furthermore, this decrease was most pronounced in sites with a successful implementation process. This observational study provides a starting point for an empirical basis for the use of NVR within child and adolescent residential settings. Further research on successful implementation processes for multi-level, milieu-based interventions, such as NVR, is required.
{"title":"The Development and Implementation of Non-Violent Resistance in Child and Adolescent Residential Settings","authors":"K. van Gink, L. van Domburgh, L. Jansen, N. Goddard, Ron Ottenbros, B. van der Stegen, A. Popma, R. Vermeiren","doi":"10.1080/0886571X.2019.1590172","DOIUrl":"https://doi.org/10.1080/0886571X.2019.1590172","url":null,"abstract":"ABSTRACT Non-violent Resistance (NVR) is a method to manage child and adolescent aggressive behavior and to decrease parental helplessness. Although developed for a family setting, this paper describes the adaptation of NVR for child and adolescent residential settings, reports on the possible hampering and facilitating elements of implementing NVR in four different institutions and finally presents seclusion and restraint rates before and after implementation. Retrospective analysis of the different implementation processes suggested the following elements to facilitate implementation: awareness that NVR is not a quick fix, a considerable amount of time and financial investment, a team-wide perspective, support from all levels in an organization and influential team members committed to NVR to decrease the risk of falling back into more familiar patterns. Seclusion and restraint figures pre-post point in the direction that the implementation of an adapted version of NVR in residential settings could result in decreased seclusion and restraint. Furthermore, this decrease was most pronounced in sites with a successful implementation process. This observational study provides a starting point for an empirical basis for the use of NVR within child and adolescent residential settings. Further research on successful implementation processes for multi-level, milieu-based interventions, such as NVR, is required.","PeriodicalId":45491,"journal":{"name":"Residential Treatment for Children & Youth","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2020-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/0886571X.2019.1590172","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46719994","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 : 2020-07-02DOI: 10.1080/0886571X.2019.1619500
Cecilia Andrée Löfholm, Tina M Olsson, K. Sundell
ABSTRACT Although research has repeatedly shown that residential care for youth with a serious behavior problem has little rehabilitation success, there is a group of youth for whom residential care in a locked setting is necessary. In this article, a manualized therapeutic residential treatment model for adolescents with serious behavior problems, MultifunC, is evaluated. The program theory of MultifunC is based on a review of the literature and synthesis effective treatment components. This study included 80 youth aged 15–17 years with a medium high or high risk for reoffending. Half of the participants received MultifunC, and half treatment as usual (TAU). Although non-randomized, the two groups were found to be equivalent on important background variables. After 24 months, this first evaluation of MultifunC demonstrated that youth participating in MultifunC had a reduced need for residential care in a locked setting as well as out-of-home placement in general compared to youth in the TAU group. The economic analysis found MultifunC to be a cost-effective alternative to TAU due to the reduced need of residential care in locked settings. There were no significant effects on reoffending or psychiatric care.
{"title":"Effectiveness and Costs of a Therapeutic Residential Care Program for Adolescents with a Serious Behavior Problem (MultifunC). Short-Term Results of a Non-Randomized Controlled Trial","authors":"Cecilia Andrée Löfholm, Tina M Olsson, K. Sundell","doi":"10.1080/0886571X.2019.1619500","DOIUrl":"https://doi.org/10.1080/0886571X.2019.1619500","url":null,"abstract":"ABSTRACT Although research has repeatedly shown that residential care for youth with a serious behavior problem has little rehabilitation success, there is a group of youth for whom residential care in a locked setting is necessary. In this article, a manualized therapeutic residential treatment model for adolescents with serious behavior problems, MultifunC, is evaluated. The program theory of MultifunC is based on a review of the literature and synthesis effective treatment components. This study included 80 youth aged 15–17 years with a medium high or high risk for reoffending. Half of the participants received MultifunC, and half treatment as usual (TAU). Although non-randomized, the two groups were found to be equivalent on important background variables. After 24 months, this first evaluation of MultifunC demonstrated that youth participating in MultifunC had a reduced need for residential care in a locked setting as well as out-of-home placement in general compared to youth in the TAU group. The economic analysis found MultifunC to be a cost-effective alternative to TAU due to the reduced need of residential care in locked settings. There were no significant effects on reoffending or psychiatric care.","PeriodicalId":45491,"journal":{"name":"Residential Treatment for Children & Youth","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2020-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/0886571X.2019.1619500","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49374207","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 : 2020-07-02DOI: 10.1080/0886571X.2019.1622168
D. Crenshaw, Kara Cannelli
ABSTRACT The therapist’s office can often be an intimidating space for children and adolescents, especially those in residential care who have experienced multiple traumas. This environment can block the therapeutic process and hinder a therapeutic alliance from forming between the clinician and the youth. Although unconventional, integrating the method of stealth therapy into the therapeutic work with children and adolescents has shown impressive results in building a stronger therapeutic bond and putting them at ease when discussing difficult topics. Stealth therapy involves the therapist meeting the youth where they are most comfortable and giving the youth space and time to adjust to the therapist’s presence. Allowing the youth to have some control over the situation gives them a sense of safety and security that they may not have ever experienced. Once the youth feel safe with the therapist, they are more likely to open up and discuss traumatic events. Therapists in Therapeutic Residential Care (TRC) traditionally felt guilty if they didn’t offer weekly formal psychotherapy to the youth with complex trauma that populate contemporary TRC. But the outpatient model of traditional psychotherapy meets the needs of a small portion of the youth in TRC. This paper describes an alternative model emphasizing creativity and flexibility in the therapeutic engagement of youth with complex trauma to more adequately meet their needs.
{"title":"Reflections on “Stealth Therapy” in Therapeutic Residential Care","authors":"D. Crenshaw, Kara Cannelli","doi":"10.1080/0886571X.2019.1622168","DOIUrl":"https://doi.org/10.1080/0886571X.2019.1622168","url":null,"abstract":"ABSTRACT The therapist’s office can often be an intimidating space for children and adolescents, especially those in residential care who have experienced multiple traumas. This environment can block the therapeutic process and hinder a therapeutic alliance from forming between the clinician and the youth. Although unconventional, integrating the method of stealth therapy into the therapeutic work with children and adolescents has shown impressive results in building a stronger therapeutic bond and putting them at ease when discussing difficult topics. Stealth therapy involves the therapist meeting the youth where they are most comfortable and giving the youth space and time to adjust to the therapist’s presence. Allowing the youth to have some control over the situation gives them a sense of safety and security that they may not have ever experienced. Once the youth feel safe with the therapist, they are more likely to open up and discuss traumatic events. Therapists in Therapeutic Residential Care (TRC) traditionally felt guilty if they didn’t offer weekly formal psychotherapy to the youth with complex trauma that populate contemporary TRC. But the outpatient model of traditional psychotherapy meets the needs of a small portion of the youth in TRC. This paper describes an alternative model emphasizing creativity and flexibility in the therapeutic engagement of youth with complex trauma to more adequately meet their needs.","PeriodicalId":45491,"journal":{"name":"Residential Treatment for Children & Youth","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2020-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/0886571X.2019.1622168","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43105060","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 : 2020-07-02DOI: 10.1080/0886571X.2020.1760641
Bethany R. Lee
The year 2020 has presented both challenges and opportunities to the field. In the wake of a pandemic, we are newly aware of how interconnected we are across the globe and the importance of learning from and with each other. In this issue of Residential Treatment for Children and Youth, we hear from researchers and practitioners implementing and evaluating novel interventions in residential programs. Several innovative models are considered in this issue. First, Van Gink and colleagues from the Netherlands present nonviolent resistance (NVR) as an approach for managing youth aggression. Their preliminary findings are promising for reducing seclusion and restraint incidents. Then, Jolivette and colleagues introduce a fidelity tool for FacilityWide implementation of Positive Behavior Interventions and Support (FW-PBIS) and their process for tool development that included broad stakeholder input. Next, the outcomes and cost effectiveness of MultifunC in Sweden are presented by Lofholm and colleagues. Even after two years, participants who received MultifunC had lower rates of needing secure residential care compared to similar youth, which allowed for significant cost savings. Finally, Crenshaw and Cannelli introduce the idea of “Stealth Therapy” as an approach for flexibly engaging clinically with youth in the residential milieu. Given the traumas youth in residential programs have experienced and the known importance of building a strong therapeutic alliance, stealth therapy offers an approach that considers these realities. As we rise to face the challenges of this time, perhaps these interventions and other ideas currently being developed and researched will elevate the quality of care for youth in residential programs and promote positive outcomes for youth and their families.
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