Therapeutic content in Swedish residential care for children and youth – managers choices and the reasoning behind

Abstract

ABSTRACT The field of residential care for children and youth in Sweden is fragmented; there is a diversity both in terms of ownership and in terms of therapeutic content. This article analyses how decisions regarding therapeutic content are made in residential care settings. The data consists of interviews with representatives of different types of residential care organisations. The results indicate that the field is impacted by different logics as well as multiple actors and environmental elements shaping the prerequisites for decisions about therapeutic content. Local managers have substantial discretion in deciding which models and treatments that should be used in their settings and they can in that capacity be viewed as key actors in the field. The decisions of managers are influenced by a mix of professional and market logics, but there are also some traces of a family logic. Signs of a professional logic can be discerned in claims about models and treatments viewed as evidence-based and/or locally evaluated, but such claims are also perceived as competitive on the market. A gap between descriptions of models and treatments and actual practice is acknowledged by managers and believed to be fuelled by procurement processes and market considerations.