Abstract
ABSTRACT This paper explores the design and implementation of a comprehensive, continuous outcome evaluation for youth in therapeutic residential care (TRC) to measure program efficacy, based on The Joint Commission (TJC) accreditation guidelines. Over a 10-year implementation period, researchers analyzed changes in 281 residential care youth from baseline to reassessment after 4–6 months in treatment. The primary assessment instruments included the SASSI-A2, the FACES III, the Measure of Psychosocial Development (MPD), the Behavioral and Emotional Rating Scale (BERS), and the Youth Comprehensive Risk Assessment (YCRA). Results indicated reductions in the risk areas of self-harm, conduct disorder behaviors, and substance abuse. Significant increases occurred in psychosocial development, family engagement, and personal strengths. However, results also revealed continued low levels of youth development in trust vs mistrust, ego integrity vs despair, willingness to disclose loss of control, recognition of negative consequences of substance misuse, and response to conduct disorder treatments. Implications and recommendations for ongoing program evaluation, staff development, and institutional change are discussed.
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