Relationship-Based Practice in Therapeutic Residential Care: A Double-Edged Sword

Abstract

AbstractThis article draws on the lived experiences and perspectives of young people and practitioners in therapeutic residential care to examine what constitutes relationship-based practice. Eight young people and twenty-six practitioners across three residential care services in Australia participated in this qualitative study. Framework analysis identifies that personalised engagement, a delicate balance between care and control, and perseverance through turbulent times are conducive to relationship-based practice in therapeutic residential care. Relationship-based practice is also found to be employed in a unique historical and relational context that demands mindful navigation through three specific professional boundary issues including self-disclosure, over-identification and physical contact. Against this context, relationship-based practice in therapeutic residential care is considered a ‘double-edged sword’, offering practitioners copious opportunities to build connections with young people in informal environments whilst needing to mitigate multiple ethical ambiguities. Implications for practice include the need to safeguard the ‘do no harm’ priority whilst resisting defensive or detached practice. Contextualising relationship-based practice within an ethical practice framework to embed ethics work in day-to-day practice becomes paramount.