Background/Aims: Children and young people in residential care often exhibit complex emotional and behavioural needs. Attachment theory is frequently used to explain these difficulties, whereby a young person’s early experience can influence their internal representations of relationships and their subsequent interactions within the residential milieu. Thus, residential childcare staff have a fundamental role supporting young people, to facilitate therapeutic change and mitigate poor long-term outcomes. Policy and research often recommend staff training and attachment-informed care, yet there is very limited understanding of how this translates into practice or influences outcomes. Therefore, this thesis aimed to systematically review literature on the types, measurement and effectiveness of residential staff training, focussed upon psychosocial outcomes. It also aimed to construct an explanatory theory of how residential staff make sense of, and use, attachment theory in practice. Methods: Research aims are addressed in two studies. Literature on residential staff training was systematically reviewed in Journal Article 1. This was conducted through a search of electronic databases, quality assessment of included studies, and subsequent narrative synthesis. Journal Article 2 used qualitative methodology in the form of constructivist grounded theory. Semi-structured interviews were conducted with twenty residential staff members through an iterative process of data collection and analysis, and theoretical sampling, until theoretical saturation was achieved. Results: Eighteen studies were included in the systematic review. Results highlight heterogeneous staff training, often evaluated through measurement of staff knowledge, skills and/or attitudes, and/or child behaviour frequency. Findings offer tentative support for the positive impact of training upon staff skills but other outcomes remain unclear. Results from Journal Article 2 indicate that staff had difficulty articulating attachment theory and often did not have a coherent narrative to describe attachment theory to practice links. Instead, they focussed upon a natural process of building relationships within a challenging context, with attachment theory only coming to the forefront when deemed relevant. Conclusions: The effectiveness of residential staff training remains unclear due to the methodological limitations of included studies. Significant improvements are identified for future evaluations of training to address this issue. Future staff training may benefit from limiting jargon, developing theory to practice links, and facilitating staff reflective function. Recommendations of attachment-informed care must also recognise the complexity of the residential system; and the current disparity between attachment theory narrative within policy and research, and practice.
