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Developing effective residential treatment for youth?

2009

Hello Friends,
 
I am working on a specific project and am looking for a few good articles on ‘developing a residential treatment program’ for troubled youth.  And I am not having much luck locating any.
 
So ... I was wondering if any of you know of a good one — something that talks about what needs to happen in the process in order to develop an effective program.
 
And, thinking that there likely is no such animal, I would appreciate any thoughts you have yourself about what it takes to develop, and maintain, effective residential treatment.
 
Any help would be appreciated.
 
Thom
...

Hi Thom,
I have a number of wonderful papers, articles and books on the subject and will compile a list for you. However can I suggest a rather unusual source for you. Right at the beginning of my career I saw the film The Quiet One [Concord Films]. It inspired me then and it inspires me now. I have set up many residential homes over the years and that film, more than anything else, has informed my choices and conditioned my hopes and preserved my faith in the healing potential of residential care. It was made in 1948 in black and white which is now very shaky but the soundtrack is pure poetry. It is available from the net by free download and I do urge you to have a look.
 
Yours,
David Pithers
...
 
Hi Thom
 
Not sure if this is exactly what you are looking for but we did a series of articles on foundational principles and practices for shelter care that might be useful. Some of it may be a bit dated but it reflects our experience and thinking at the time:
 
Scribner, E., Gerber, K., Skott-Myhre, H.A. (1998). Curious
conversations: The wonder of youth work. New Designs for Youth Development. Winter..
 
Reed, C.,  Skott-Myhre, H.A., Wade, K. (1995) We mean to do this: An experiment in post-modern youth work. New Designs for Youth Development.  Fall..
 
Skott-Myhre, H.A.  (1994). A post-modern approach in runaway shelters for adolescents. New Designs for Youth Development. Vol. 11 No. 2, Fall..
 
Skott-Myhre, H.A.  (1994). Discovering competence; A coevolutionary model for human services. New Designs for Youth Development.Vol. 11 No. 1. January.
 
Hans Skott-Myhre
Brock University
...
 
Thom,
I have just the link for you. The article is in a recent Relational Child and Youth Work journal and titled, "Jen's Place". The full article is available as a link on our Website www.jens-place.org. (It is the 6th bullet on the "who we are" page.) It gives the overview you identified wanting to find. It focuses on the development of the effective residential program targeting youth. We will have to now work on the article re maintaining the program.
 
On maintaining ideas that immediately pop to mind are the need for qualified staffing working in a program that supports them via schedules that work and salaries that represent the professional staffing, thus allowing for reduced turn over and consistency in care. Developing a program that allows for and continues to change with the youth currently in it and finds them always a partner in there treatment goals and plans. 
 
I will take some time to further reflect on this, I hope the article is helpful in what you are looking for.
 
Take Care,
Jenn Dyment
...
 
I would suggest that you get in touch with Emmanuel Grupper, at Youth Aliyah -- emang,netvision.net.il  and ask for suggestions.  Youth Aliyah, which began as an immigrant absorption agency, now provides residential care for several types of  out-of-home children.

David Macarov
...
 
Hi Thom,
 
I would (modestly) suggest that the framework outlined in the results of my grounded theory research on group homes (Pain, Normality and the Struggle for Congruence: Reinterpreting Residential Care for Children and Youth, Haworth, 2002) offers at least a good starting point for understanding core elements and dynamics of an effective residential treatment program.
 
If you have read it, and disagree, I would be interested in your comments on how it may fall short in suggesting "what needs to happen in the process in order to develop an effective program". Just for your information, to date, four states in Australia have been using the framework for re-designing residential care across the states, and the Residential Child Care Project at Cornell University has revised its training curriculum for residential workers using this framework as a way of integrating their knowledge and skills into a coherent whole.
 
As ever, best regards, 
Jim
 
James P. Anglin
...
 
Hi Thom
 
Here is some of my thoughts.
 
To add to your project I want to mention a report - if you have not already heard of it as you probably have everything on residential care.
 
The report is called Reclaiming Residential Care: A Positive Choice for Children and Young People in Care.
 
It was funded by The Winston Churchill Memorial Trust of Australia and written by Lisa Hillan a 2005 Churchill Fellow. Lisa explored different models and outcomes of residential care with an examination of the links to evidence and research in the design and evaluation of residential care. She includes a bibliography. She also visited many residential facilities in Scotland, England, Vancouver, Chicago and New York.
 
I have had the opportunity to establish a couple residential programs and have learned that one of the first steps is the standards as established by the municipal, provincial and federal governments. For example, fire and health regulations, location, sleeping accomodations, record keeping, medications and so on.
 
Training of staff and dealing with writing matters. How many times have we heard that we spend more time writing reports than in working with the youth. There is report writing, logs, plans of care, assessments, progress reports, serious occurrence reports, consent forms and so on.
 
However, I find this nothing as compared to the actual establishment of a residential service that provides the best care we can for the children and youth we care for.
 
I appreciate you wanting to maintain effective residential treatment. My personal view is that the key to this is staff. It truly bothers me when I hear of the many facilities where the staff turnover is higher than the youth in the program. We encourage youth to "trust" us and then staff turnover is much too high. We must give residential staff what we expect them to give to the youth in care. Respect, good supports (financial and benefits) and to listen to them.
 
Thom, thank you for giving me this opportunity to provide some feedback and I wish you all the luck in your endeavour.
 
Sheldon Reinsilber
...

Hey Thom:
 
I wrote a piece called "Ten Principles of Residential Care" that is available in the latest issue of the Scottish Journal of Residential Care. It covers my thoughts on the issue of maintaining (but not on setting up) an effective residential care/treatment environment.  Also, I would recommend you read the first installment of the Harry Potter series (I am quite serious) and pay special attention to the organizational make up of the principal setting; it's not really treatment-oriented, but a brilliant basis for any out of home life space environment.
 
Kiaras
...
 
http://www.archive.org/details/the_quiet_one
 is the link for the film "The Quiet One" to which David Pithers referred.
 
Alfonso Ramirez, Jr.
...
  

Hi Thom -
 
I teach a course developed by the National Resource Center for Youth Services entitled "Residential Child and Youth Care Professional Curriculum" and I think it's great.  It includes four modules:
1. Creating a culture of care
2. Overview of child development
3. Building relationships
4. Teaching discipline. 
 
It is very interactive and, dare I say, fun!
 
You can find out more about it here:
http://www.nrcys.ou.edu/training/tot/tot_rcycp.shtml
 
Emily
Chicago, IL
...

Hey Thom,
 Hope you're well. If I were gonna suggest a couple of things, I'd say most importantly, from the beginning I'd implement a daily non-directive group session that would serve as a place where workers and residence have an opportunity to process what happens in the milieu, and learn to draw close to each other. I would place it in the morning, right after hygiene, and meals to convey the message that after basic needs are met, being together and growing together is the priority. If the team is multidisciplinary, and there are traditional roles like, "therapists" & "frontline", both should be present in the group. Secondly I would strongly suggest those doing the "frontline" be diploma/degree holding members of their professional association. I could go on, but have to get back to work.
 
Thanks,
Mike Wattie, CYC, cert.
...
 
Hi Thom,
Treatment foster care in Cobourg is just starting up a Mixed Modality program and have done some research into what good treatment is.

They have also been successful in promoting a Treatment foster care network and are part of a study regarding the center of excellence for child welfare.  Nitza Perlman was the woman conducting this you can google her for information.  Duane Durham is the contact at Treatment foster care his e-mail is duane.durham@treatmentfostercare.ca.
 
I work with long term care children and youth at Durham Children's Aid Society.  I also worked in residence prior to this and in between at a school program and at Big Sister's.  When working on the floor we had the best shifts when we had the youth involved in doing things, sports, activities, group discussions that weren't prolonged and were meaningful. We had a team of individuals who were young all educated with three year diploma's from a college and varying degrees of experience.
 
From the side of a child welfare worker the best treatment facilities are those that stick with difficult youth even when they are "difficult", some treatment centers are better at managing difficult behaviour than other's and many give up, just as the youth are becoming comfortable.  I have had placements where children / youth constantly AWOL and the staff take them back, make them comfortable, process long and short term goals with them, let the youth know they have a place to come back to and try and give them a skill set so they can keep themselves safe when on the street, and then there are other programs where if youth AWOL they give notice.  (Our agency will also give notice if youth are gone more than 2 weeks, financial constraints).  It seems to me that the agencies that are willing to stick with children through thick and thin, have some sort of school program and lots of programming are most successful.  Programming as in sports, or some interest unique to the child, realizing that most of the "treatment" occurs in the milieu.
 
I hope that is helpful to you.
...

I also downloaded and watched the movie "The Quiet One" - really great, I will be showing it to all our staff. ( http://www.archive.org/details/the_quiet_one )
 
Thanks.
 
Werner van der Westhuizen
Port Elizabeth, South Africa
...
 
Hi Thom.
 
I use the book Healing Spaces by Michael Burns in my course Child and Youth Care Practice when discussing residential programs. I find it captures all the essential ingredients of the therapeutic milieu very well. There are checklists for review or assessments of programs included.
 
Reclaiming youth at risk, and the Circle of Courage book/staff development video accompaniment also guide staff reflection on whether the elements of the Circle are reflected in programming.
 
Dawne MacKay-Chiddenton
...
 
Thom
I teach a course Groups in Context which tries to teach CYW's how to manage groups and build positive groups
 
Believe it or not I was forced to use the old The Other 24 Hours but it was too dated and wordy so I'm now in the same boat.
 
There's great stuff on classroom management which is relevant. Glasser's Schools without Failure is good. I use parts of that. Found one specific to Foster Care but we need a new CYW "bible" to teach the importance of routines rules and structure as well as group dynamics and predicting and preventing group catastrophies.
 
Good luck,
Respond if you have questions.. I have been struggling with this for a few years
 
Peter Hoag
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