Residential and Specialised Care Models: Outcomes for Children in Out-of-Home Care
December 28, 2007
Osborn and Bromfield state that residential care may be the ideal option for some children in out-of-home care. This supports the conclusions of Bath (1998) and Barber and Gilbertson (2001) who found comparable health and well being outcomes across groups of foster/kinship and residential care.
The “continuum of care” requires a range of placement options to meet the diverse needs of children. It is suggested that for children with extreme behavioural-emotional responses a residential setting may provide the support, structure and therapeutic intervention that they need. There is a call in Australia for more research into innovative options for out-of-home care for children.
A meta-analysis of 9 Australian studies comparing foster/kinship and residential care between 1994 and 2006 concluded across the studies that for children with highly unstable placements, residential care might be more suitable. Their vulnerability to placement breakdown may exacerbate behavioural-emotional responses. A reasonable long-term option for sibling groups, high placement instability, and those moving on to independent living could well be some form of residential care.
Residential care needs to be recognised for the benefits that it can bring to some children with special needs. Child protection agencies need to explore a mix of out-of-home options. Evaluation of residential care options can bring significant change. The aim is to be better able to place a child in a matched environment early in the placement process. This protects secondary trauma; confusion, self-blame and aggression/dis-affective behaviours and cognitions.
The elements that characterise care (i.e., levels of discipline, routine, autonomy and free time) rather than the type of care (foster or residential) could be the determinate of how restrictive a placement will be. Instead of first placing a high needs child within a home setting, and risk multiple breakdowns and subsequent trauma, utilise residential care. Currently, many residential facilities in Australia do not actively implement and monitor intervention theories and models.
“A greater use of treatment foster care involving specially trained foster carers whose remuneration and training is commensurate with the difficulty of the task they are undertaking” is also called for by Osborne and Bromfeild.
Literature highlights the real need to address the limited number of care options available for children and young people with high support needs in Australia (Delfabbro & Osborn, 2005; Delfabbro et al., 2005; Flynn et al., 2005). However, at present, few conclusions can be drawn about what constitutes “appropriately designed residential and specialised models of care”.
What are your thoughts on residential care for children in out-of-home care?
For further information on Foster care and its many isues, please read:
We are Not Victims, We are Survivors
Praise for New South Wales for Creativity Regarding Foster Care
Comments
5 Responses to “Residential and Specialised Care Models: Outcomes for Children in Out-of-Home Care”
Got something to say about the above post or child safety in general?
Copyright © 2007 
I think residential care can be very useful for some people. There is social contact; they meet other persons and learn how to deal with other people with some behaviour problems.
It is necessary that they get a good accompaniment from a professional.
Hey Char,
like Erik I think that residential care can be beneficial to some young people. The move away from deinstitutionalisation saw a new kind of homeless - it just swapped one problem for another.
The reality of the kid in care situation is that we cannot get foster placements, let alone decent placements where carers are well trained and well paid for their generosity of child safety care. Residential care happens vicariously. The number of kids i9n care placed on motel rooms with youth workers blows my mind! This is fast become an instutionalised alternative to family living in a one family home.
While I do not support the large institutions of our sad, cruel and traumatic past, I do support a therapeutic model of group home where a number of children can be placed.
Placement in a single family home is the ideal - so is democracy, but do we really have it?
Hey Charmaine
I have seen both therapuetic home environments (and worked in one, some years ago) and selected specialist carer households work very well for some young people. I think the children and young people who have experienced all forms of “care” (home, foster care, shared “specialist” homes and therapuetically set up home environments) could inform us best of their perspective of what has been most helpful for their growth and wellbeing? What do you think about young people participating?
Hi Charmaine,
(and all my friends at and of Imaginif…)
Yes to young people participating! I hope we get it soon, that their perspective is valid and more informed about many things we can never learn through research and studies.
As I was reading this and thinking about my personal opinion that high quality, (fully staffed and supported with the best people for each position,) residential facilities could be the most viable solution, at this time, world-wide, for the many of the ever increasing child abuse and neglect cases, as well as for the serious behavioral cases, a pop-up alerted me to a new e-mail that coincidentally is the following:
Orphaned Children Show Higher Intelligence And Fare Better In Foster Care Than In Institutions
However, I remain convinced that the residential alternative needs to be explored as an option for all ages and other variables, since foster care is so abysmal in far too many cases, and privatized home visitation care (here in the USA) is proving to be another way for some to make money with a minimum of actual delivery of services.
Being an optimist in some cases…one being a hope for the children of tomorrow, if not today…I can’t help thinking about possibilities that combine some of the failings of society in order to promote other alternatives. For example, quality residential facilities that provide for the safety, health, education and general welfare of children, augmented by programs of some degree of stipend for “foster grandparents,” or “foster families” committed to the development of long term relationships with a child or siblings, to provide the nuturance and stability that extended families can. I see them providing that element of time intensive “specialness” that can be lost in residential care, writing, phone calls, visits, taking child for holidays, etc. There are so many children needing loving relationships and so many able adults who do as well, but programs that try to fill that need here, like Big Brothers/Big Sisters, Foster Grandparents, etc. leave too much to be desired. And too much risk to the children because of insufficient oversight. Given a residential facility interactions between adult and child can be observed randomly…
Sorry! It occurs to me that I am getting carried away here as a comment so I’m returning to my blog where anyone interested can pick up any additional ramblings…
A Child is Waiting.
Take care…be aware,
Nancy Lee
http://childpersonfromthesouth.blogspot.com
lol to Nancy. I’ve just been over at your site and read your post about this. Welcome to the world of finding there are even more issues that you are passionate about than what you first thought. Excellent post that you wrote and thanks for linking back to Char and Imaginif.