Residential Care

Residential care refers to any group living arrangement where children are looked after by paid staff in a specially designated facility. It covers a wide variety of settings ranging from emergency shelters and small group homes, to larger-scale institutions such as orphanages or children’s homes. As a general rule, residential care should only be provided on a temporary basis, for example while efforts are made to promote family reintegration or to identify family based care options for children. In some cases however, certain forms of residential care can operate as a longer-term care solution for children.

Residential care can be a positive alternative for some girls and boys when it is used appropriately and meets certain standards. For example, small group home living arrangements or supported independent living can work well in cases where children (often older teenagers) don’t feel comfortable in a family setting, or where large groups of siblings want to stay together. Similarly in cases where children have suffered trauma, severe abuse or neglect, have a severe disability or require specialised support, small group settings where trained staff can provide therapeutic care may be an appropriate care option. As much as possible, residential facilities should be small, community-based, organised to resemble a family-type or small-group situation and allow for sufficient staff to provide individualised attention to children.

It is important to distinguish between residential care and institutional care, which should only be used as a last and temporary resort for children. Institutional care refers to large-scale group care within big institutional facilities and has been associated with a wide range of problems for children including physical, social and emotional under-development - with babies and infants under the age of three especially vulnerable to lasting harm. Long periods in an institution can deprive children of positive individual attention from consistent caregivers, make it difficult for them to assimilate back into a family and community, and are often linked to increased risk of sexual and physical abuse, a lack of stimulation, and harsh discipline.

In recent years, deinstitutionalisation has been at the heart of national care reform efforts, which seek to reduce reliance on institutional care and to promote family and community based care options for children instead. This includes efforts to promote ethical volunteerism within residential care centres, educate donors and to avoid proliferation of orphanages and children’s homes after humanitarian emergencies.

The documents in this section outline residential care options for children, examine the damaging impact of institutions, explore family and community-based care alternatives and describe care reform efforts including initiatives around ethical volunteerism.

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A study of depression, externalizing, and internalizing behaviors among adolescents living in institutional homes

Archana Vinnakota, Ravneet Kaur - International Journal of Applied & Basic Medical Research, 19 Apr 2018

The objectives of the study were to describe and study the extent of depression in adolescent boys and girls living in institutional homes and to study the association between depression and externalizing and Internalizing behaviors among adolescents in institutional homes.

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Assets and pathways in achieving future goals of residential care alumni

Yafit Sulimani-Aidan - Children and Youth Services Review, 18 Apr 2018

The goal of this study was to explore the assets and pathways in pursuing the future goals of 25 care leavers in Israel.

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Needs and preferences of parents of adolescents with multiple and complex needs in residential care

Helena Van den Steene, Dirk van West & Inge Glazemakers - Child & Family Social Work, 17 Apr 2018

Drawing upon in‐depth interviews with 12 parents of adolescent girls with multiple and complex needs in residential child welfare, this exploratory study describes parents' own needs and preferences with regard to care delivery.

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Measuring movement into residential care institutions in Haiti after Hurricane Matthew: A pilot study

Celina Jensen, Beth L. Rubenstein, Matthew MacFarlane, Lindsay Stark - Alliance for Child Protection in Humanitarian Action, 16 Apr 2018

The purpose of this study was to determine the feasibility of evaluating movement of children into residential care following an emergency.

Residential child care workers: Relationship based practice in a culture of fear

Teresa Brown, Karen Winter, Nicola Carr - Child & Family Social Work, 16 Apr 2018

In a contemporary context dominated by reports of the historical institutional abuse of children and young people in residential children's homes, and where the voice of workers is largely absent, this study explores the views and experiences of 26 workers in the Republic of Ireland regarding relationship‐based practice.

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Residential child care workers: Relationship based practice in a culture of fear

Teresa Brown, Karen Winter, Nicola Carr - Child & Family Social Work, 16 Apr 2018

This study explores the views and experiences of 26 workers in the Republic of Ireland regarding relationship‐based practice.

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Discriminating baseline indicators for (un)favorable psychosocial development in different 24-h settings

Harmke Leloux-Opmeer, Chris H. Z. Kuiper, Hanna T. Swaab, Evert M. Scholte - Children and Youth Services Review, 14 Apr 2018

The study consisted of a comparative follow-up study with a pretest-posttest design which explored the association between baseline child, family, and care characteristics and the psychosocial development of 121 schoolaged Dutch children during their first year of placement in foster care (FC), family-style group care (FGC), and residential care (RC).

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Country Care Review: Haiti

Better Care Network, 13 Apr 2018

This country care review includes the care-related Concluding Observations adopted by the Committee on the Rights of the Child and the Committee on the Rights of Persons with Disabilities.

Report of the Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health

Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health , 10 Apr 2018

This report from the UN Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health calls for an end to the use of detention and confinement as a tool "to promote public safety, “morals” and public health."

Hazards to Early Development: The Biological Embedding of Early Life Adversity

Charles Nelson - Biological Psychiatry, 09 Apr 2018

This talk, given by Dr Charles Nelson, focuses on two strands of work that reflect very different types of adversity: (1) the effects of early, profound psychosocial deprivation (including a review of the most recent findings from the Bucharest Early Intervention Project, a randomized controlled trial of foster care as an intervention for early institutionalization in Romania) and (2) the effects of growing up in a low resource urban center where children are exposed to a large number of both biological (e.g., malnutrition) and psychosocial (maltreatment) stressors (including a review of recent findings from a large study taking place in Dhaka, Bangladesh).

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