Commentary:Recognizing the value of the milieu in therapeutic residential care for children and youth

Huefner, Jonathan C.; Ainsworth, Frank

doi:10.1080/0886571x.2021.1915225

Cited by 12 publications

(7 citation statements)

References 50 publications

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“…Contrary to this, however, a more negative SC lowered the QoL for the contrasted severe problems group. This finding demonstrates the significance of a positive SC in TRC as discussed in recent studies (e.g., Huefner & Ainsworth, 2021; Leipoldt et al, 2021; Levrouw et al, 2020; Pellerin et al, 2020; Strijbosch et al, 2019; Van der Helm et al, 2018) and is further illustrated by TRC and youth characteristics and SC showing a large effect on QoL. More specifically, the lower experienced physical well-being of TRC youth compared to outpatient youth and the general population (Jozefiak & Sønnichsen Kayed, 2015) could be explained by more experiences of childhood abuse and adversities (Greger et al, 2015, 2016).…”

Section: Discussionsupporting

confidence: 86%

“…SC is considered to be a critical aspect for change or development of young people in TRC (e.g., Attar-Schwartz, 2017; Bastiaanssen et al, 2012; Hair, 2005; Huefner & Ainsworth, 2021; Lanctôt et al, 2016; Leipoldt et al, 2019; Mathys, 2017; Mathys et al, 2013; Moore et al, 2018; Souverein et al, 2013; Van der Helm, 2011, 2019; Ward, 2004). It can be defined as… the quality of the social and physical environment in terms of the provision of sufficient and necessary conditions for the physical and mental health, well-being, and personal growth of the residents, with respect for their human dignity and human rights as well as (if not restricted by judicial measures) their personal autonomy, aimed at participation in society (Stams & Van der Helm, 2017, p. 4).…”

Section: The Present Studymentioning

confidence: 99%

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The mediating role of social climate in the association of youth and residential service characteristics and quality of life.

Leipoldt¹,

Harder²,

Kayed

et al. 2022

American Journal of Orthopsychiatry

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Previous research has shown that social climate (SC) is important for the daily life of youths living in therapeutic residential youth care (TRC). However, little is known on how SC can promote a positive quality of life (QoL) for the heterogeneous TRC population. This study, therefore, investigates how TRC and youth characteristics are associated with SC and QoL. We employed a combination of person-centered and variable-centered approaches in a cross-sectional design using a sample of 400 Norwegian youths. We used previously established TRC and youth classes in a structural equation model, where these classes were regressed on latent SC and QoL. Both direct and indirect effects were analyzed. All youth classes were associated with SC and QoL, such that youth with family problems, incidental problems, and the migrant background class scored higher on SC and QoL compared to the severe problems class. In addition, SC mediated the association of the incidental problems and migrant background classes on QoL. TRC staff should acknowledge that a positive SC

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Section: Discussionsupporting

confidence: 86%

Section: The Present Studymentioning

confidence: 99%

The mediating role of social climate in the association of youth and residential service characteristics and quality of life.

Leipoldt¹,

Harder²,

Kayed

et al. 2022

American Journal of Orthopsychiatry

View full text Add to dashboard Cite

show abstract

“…In line with our PAR commitment to practical utility (Baum et al, 2006), the steering group organized themes into a simple infographic–concentric circles were used to create a visual schematic that conveyed research findings in a simple and accessible way for staff and young people alike. Prior to the second analysis workshop Kate Lessing reframed these circles as 'layers of an egg', devising a relatable metaphor that reinforces the necessity of all components and the intersecting relationship between them, similar to Huefner and Ainsworth's model of therapeutic residential care (2021). Further discussions in steering group meetings and via email refined the metaphor diagram and theme properties and supported selection of relevant illustrative quotes.…”

Section: Methodsmentioning

confidence: 99%

Co‐producing to understand what matters to young people living in youth residential rehabilitation services

Ennals

Lessing

Spies

et al. 2021

Early Intervention Psych

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Aim: Residential group care is an important service for vulnerable young people experiencing mental health, substance abuse and/or behavioural challenges. Yet little is written about specific models and their outcomes, especially from the perspectives of the young people who use these services. This project aimed to explore what matters to young people living in a 12-month voluntary residential program for young people aged 16-25. Methods: This participatory action research study was co-produced with Youth Residential Rehabilitation Service residents and staff as co-researchers. A steering group comprising residents, staff and researchers oversaw all research stages. 18 young people and 17 staff members participated in either individual or group interviews to discuss what was important in Youth Residential Rehabilitation Services. Data analysis drew on grounded theory techniques; subsequent codes and themes were refined in the steering group.Results: We identified the 'change work' that young people were expected to do, and the milieu factors that created a supportive environment. As young people were figuring out their directions and learning new skills, they needed to be understood as the developing expert of their own lives. Real relationships with staff and other young people created a culture of belonging, safety and feeling known. These findings are metaphorically captured in the image of an egg.Conclusions: Our study highlights that real relationships between all Youth Residential Rehabilitation Service community members are central to creating the atmosphere of safety and belonging that enables healing and self-development to occur. K E Y W O R D S consumer involvement, participatory research, personal recovery, residential care, youth mental health 1 | INTRODUCTION Globally, a range of residential group care options are available to vulnerable young people experiencing mental health, substance use and/or behavioural challenges. Whilst significant variations are seen across models, they generally offer accommodation and intensive support to promote safe and healthy development (Whittaker et al., 2016).

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“…At the same time, specialist residential settings should aim to align everyday practice to principles of care rather than meticulously implementing a programme or care curriculum (Gilligan, 2014). Huefner and Ainsworth (2021) emphasise the importance of a caregiving environment that maximises the potential of all day-to-day interactions to achieve a beneficial emotional and behavioural experience. A trauma-informed caregiving milieu is one where care is predictable, dependable, and ordered, enabling children to feel worthwhile and have their specific needs taken care of, leading to improved functioning for children and young people with emotional and behavioural challenges (Huefner and Ainsworth, 2021).…”

Section: Introductionmentioning

confidence: 99%

“…Huefner and Ainsworth (2021) emphasise the importance of a caregiving environment that maximises the potential of all day-to-day interactions to achieve a beneficial emotional and behavioural experience. A trauma-informed caregiving milieu is one where care is predictable, dependable, and ordered, enabling children to feel worthwhile and have their specific needs taken care of, leading to improved functioning for children and young people with emotional and behavioural challenges (Huefner and Ainsworth, 2021). Since children who have been let down or harmed may have little capacity to connect with helping adults, such relational caring practices need to be purposefully undertaken by staff who are skilled, competent and empowered (Smart and Thorpe, 2020).…”

Section: Introductionmentioning

confidence: 99%

Interrupting a cycle of placement instability with short-term residential care: Trauma-informed family-like relational practice in one specialist unit

MacDonald,

Gillespie

2023

Adoption & Fostering

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Continuous caring relationships are crucial to the wellbeing of children living in out-of-home care, with the family environment of long-term foster care usually the preferred placement for achieving relational permanence. Some children, however, experience a cycle of instability with the impact of placement disruption exacerbating emotional and behavioural difficulties and thereby undermining subsequent foster relationships. This paper reports on a service evaluation of a residential facility specialising in short-term placements for children who have experienced disruption, with the aim of interrupting the cycle of placement instability. Overview of 34 children’s placement trajectories show that most were enabled to re-enter foster care and of those who are now aged over 18 years ( n = 29), over half ( n = 16) remained in family placements until adulthood. For four children, detailed individualised assessment indicated residential care as the most appropriate option for avoiding future disruption. The paper gives cause for optimism that relationships in the residential setting have the potential to build emotional resilience and capacity for connection. There is paucity of information on how residential staff achieve these relationships in practice. Focus groups and interviews with ten staff and managers illuminate relational practices in the residential setting that are simultaneously family-like and trauma-informed.

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Commentary:Recognizing the value of the milieu in therapeutic residential care for children and youth

Cited by 12 publications

References 50 publications

The mediating role of social climate in the association of youth and residential service characteristics and quality of life.

The mediating role of social climate in the association of youth and residential service characteristics and quality of life.

Co‐producing to understand what matters to young people living in youth residential rehabilitation services

Interrupting a cycle of placement instability with short-term residential care: Trauma-informed family-like relational practice in one specialist unit

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