Mechanisms to Enhance Resilience and Post-traumatic Growth in Residential Care: a Narrative Review

Abstract

Residential care is primarily considered most appropriate for young people with complex needs, often due to multi-type traumas. Children in care are disproportionately disadvantaged, with children in residential care most vulnerable, which is why it is so important to understand mechanisms that support resilience and post-traumatic growth for this group of young people. This review aimed to advance our understanding of how interventions, reflections upon experience, and constructs of resilience can enhance developing resilience in children’s homes for young people in care. International quantitative and qualitative studies were sought to identify features and mechanisms of care that underpin developing resilience. Following a systematic search of six databases, 25 papers were selected for review, with a total sample of 3198 individuals up to the age of 30 years old who were either receiving residential care (N = 3037) or who were care leavers (N = 161). Themes from the quantitative studies and a narrative synthesis of qualitative studies were developed. Therapeutic mechanisms and processes to support the development of resilience included experiencing love and trust with staff in homes through therapeutic relationships, nurturing self-compassion, promoting self-value and self-belief, positive future thinking, problem-focused coping, school engagement, constructing a positive origin story, and positive visualisations of a stable future. Measures of resilience could more accurately reflect post-traumatic growth and potential for resilience development for this unique group of young people, which in turn could inform intervention design and evaluation. Measures appreciative of intrapersonal, relational, community and environmental factors could be particularly useful for intervention design.