Promoting a relational approach to residential child care through an organizational program model: Impacts of CARE implementation on staff outcomes

Abstract

We evaluated the impact of Children and Residential Experiences (CARE), an organization-wide program model implemented in 13 residential child care agencies in one Southeastern state. CARE implementation lasted three years and involved the application of six evidence-informed principles throughout the organization in order to create more therapeutic environments and improve the quality of care for children.A wait-list design was used with one cohort of agencies starting CARE immediately and a second cohort waiting 12 months before starting, allowing them to serve as a comparison group. Agency staff completed annual surveys assessing curricular knowledge, their beliefs about and their use of practices that reflect a relational approach to care. Using linear mixed models that accounted for clustering within agencies and several important covariates, results showed significant increases in all staff outcomes. CARE effects on knowledge and beliefs emerged in Year 1 and CARE effects on practice emerged in Year 3. Exploratory analyses showed that the CARE effects were evident across all staff demographic and agency subgroups, with evidence of more pronounced effects for some subgroups. Results contribute to an emerging pattern of evidence that CARE implementation improves the capacity of agencies to provide effective therapeutic care for children.