Federation Research Bulletin: May 2019

This month’s research bulletin includes articles and reports about ways to improve outcomes in therapeutic residential care programs, models for reducing aggressive incidents in residential youth care, child-centred decision-making approaches, screening tools for vulnerable youth, and factors that strengthen support networks for youth aging out of care. It includes the following articles and summaries.

  1. Determinants and outcomes of social climate in residential youth care
  2. Aggressive Incidents in Residential Youth Care 
  3. Decision-making in foster care: A child-centered approach
  4. Understanding support network capacity during the transition from foster care
  5. Screening for human trafficking among homeless young adults

For more information, additional research, and/or if you have feedback about how we can make this member service more useful, please contact The Federation’s Research and Policy Coordinator, Pam Alcorn at pam@fcssbc.ca.

Determinants and outcomes of social climate in therapeutic residential youth care: A systematic review

Netherlands/Norway, 2019

To date, studies on the effectiveness of therapeutic residential youth care (TRC) offer limited evidence on how TRC achieves treatment goals. The goal of this systematic literature review was to learn more about how results are achieved, rather than investigating the achieved results themselves. To do so, the researchers focused their research specifically on how the social climate within TRC programs affects outcomes.

They found that a wide variety of determinants in terms of staff, youth, and organizational characteristics were associated with a positive social climate and subsequently positive outcomes for youth.

Staff members that incorporate the strengths of the youths into their daily lives and treatment plans were associated with a much more positive perception of the social climate. For youth, feelings of involvement in the treatment program, being supported, living in an open unit, and having a social personality match with the therapist are things that best created a positive social climate.

In terms of organizational characteristics, TRC programs that are small in size, structured, have daily intensive routines and protocols in place for dealing with incidents are most related to a positive social climate—likely because these aspects create more space for a constructive focus on the treatment of behavioural problems and promote a sense of autonomy in young people.

Factors that affect social climate in a negative way included: a large number (more than 5) previous placements, past inability to get along with staff, and less positive attention from staff as a result of pretreatment profiles. As such, the specific problems that youth bring with them when entering TRC programs require consideration in order to tailor treatments plans that may create a supportive social climate and promote positive outcomes.

2. Aggressive Incidents in Residential Youth Care

Netherlands, 2018

This research study compares a series of residential youth care models and the frequency of aggressive incidents within each. Specifically, the researchers compare the number and nature of aggressive incidents in open and therapeutic group models to those in semi-secure and secure care residential facilities.

Their key finding was that those youth in semi-secure or open were generally more positive about their opportunities for growth and that the perception of a positive climate was related to fewer aggressive incidents. The key determinant associated with an increased likelihood of aggression was the length of residency—the longer a stay, the more likely were aggressive outbursts.

However, the researchers admitted that there are a number explanations for such differences, including the nature of the residency (voluntary/non-voluntary), the previous number of placements, past/existing psychiatric diagnoses, and differences in youth experiences of prior facilities.

Overall, this paper provides a number of insights into considerations related to best supporting youth and minimizing aggressive behaviour in youth facilities. Of key importance are (1) group dynamics, (2) individual circumstances preceding youth’s residency, and (3) the specific ongoing training for staff that may or may not enable them to foster learning, enable community participation, and provide unique and individual support based on the needs of each youth.

3. Decision-making in foster care: A child-centered approach to reducing toxic stress in foster children

USA, 2018

In the complex decisions involved in foster care, the needs of adult caregivers and the needs of children may sometimes reflect competing priorities. Other times, priorities are not always as clear. Sometimes, foster children are negatively impacted by adult-centred decisions that cause trauma beyond that which led to the child’s entrance into the system.

This article explores several considerations that (if acted upon to the extent possible at all levels of the system) may lead to a reduction in the emotional trauma caused by the impact of foster care decisions. Though there are systemic, legal, and personal barriers that can make child-centred decision-making challenging, the authors offer three considerations that they suggest will optimize child-centred decision-making and reduce stress: (1) reducing the time a child must wait for a stable placement, (2) a focus on critical-thinking versus rigid rule adherence when making decisions, and (3) increased communication between the child and foster parent.

Overall, the researchers urge that (where there is room for discretion) the child’s need for stability and security should take precedence sooner rather than later in the decision-making process. As such, they recommend that current policies should be reconsidered with this in mind.

4. Understanding support network capacity during the transition from foster care: Youth-identified barriers, facilitators, and enhancement strategies

USA, 2018

This study explores the relationship between foster care experiences of youth and the support network available to young people as they exit the foster care system. The researchers conceptualize this relationship in terms of the capacity of the network members to provide adequate support and the stability of the support network—the cohesion within and across supportive relationships over long periods of time.

The most consistent theme for youth who felt well-supported was self-determination—both in terms of specific relationships with service providers and in terms of learning to or being able to “work with the system” and direct services according to their own preferences and self-identified needs. Importantly, a perceived lack of self-determination was most often identified by youth who voiced unmet support needs (e.g., difficulties understanding and accessing the services for which they were eligible, not having a voice when it came to important placement decisions).

The most common youth-recommended strategies (for improvement) were less likely to focus on specific relationships or support types, and more likely to be skill development strategies to strengthen their overall capacity to access both formal and informal supports and resources.

5. Screening for human trafficking among homeless young adults

USA, 2018

Human trafficking is a public health issue affecting homeless young adults across the world—even in developed western countries. However, screening tools for trafficking this population are often lengthy and onerous. The aim of this study was to develop a sensitive, brief, and user-friendly trafficking screening tool for homeless young adults.

The new screening tool created and validated by researchers is called Quick Youth Indicators for Trafficking (QYIT) and is, allegedly, the first highly sensitive, comprehensive trafficking screening tool that is truly brief and does not require a trafficking expert to administer. According to the research, QYIT allows providers to effectively screen for trafficking among homeless young adults—an affirmative answer to at least one QYIT question is 86.7% sensitive and 76.5% specific in identifying a trafficking experience.

And while QYIT over-identifies trafficking among homeless young adults, a substantial portion of those who were false positives for a trafficking experience had other trauma and/or exploitation histories that required a more in-depth interview with clinical staff. In other words, the study also demonstrated that young adults involved in illegal activities and transactions unrelated to commercial sex may also be in exploitative situations.

Though the screening took is relatively new, the researchers argue that the use of QYIT at appropriate agencies will better enable social service providers to systematically detect and serve homeless young adults who have labour and/or sex trafficking experiences.