Residential Youth Research Articles

Young Adults with a History of Residential Youth Care: A Cohort Profile of a Hard-to-Reach Population

Adults with a history of living in residential youth care (RYC) face elevated risks across various life domains. In this cohort profile paper, we outline the design of a comprehensive follow-up study—the VINGO study—targeting young adults (22–30 years) with a history of living in RYC (T2). We describe the recruitment strategy and present sample characteristics. Data were collected in the baseline study (T1) from 2011 to 2014. At T1, the 400 adolescent participants showed a high prevalence of mental disorders, maltreatment experiences, substance use, and self-reported suicide attempts. Data collection at T2 10 years later (2021–2023) included self-reported sociodemographic information, physical health, childhood maltreatment, dissociation, quality of life, social support, and self-esteem using standardized and validated instruments. A diagnostic psychiatric assessment and subjective evaluation of service utilization were conducted by telephone interviews. Additionally, a qualitative sub-study involved in-depth interviews of fourteen participants. We reached a 52% response rate at T2. Comparing participants (n = 157, 107 females) to non-participants (n = 243, 123 females) based on T1 data revealed that T2 participants had a higher prevalence of depression, anxiety, and conduct disorder and a lower prevalence of ADHD at T1. Furthermore, T2 participants reported more suicide attempts, experiences of maltreatment, and problematic substance use at T1. Our results show that we reached a burdened population, positioning the VINGO study as a unique opportunity to examine a vulnerable population of emerging adults.

Toward promoting resilience of gender and sexually diverse youth in South African rural school ecologies

IntroductionGender and sexually diverse youth in schools experience exclusion, which detrimentally affects their ability to cope with the consequences of minority stress and may lead to absenteeism or dropout. The purpose of the study is to highlight a pressing need for inclusive policies and practices to aid in enabling LGBTQ+ learners in schools.MethodsThis paper explores how multiple systems intersect to promote a sense of inclusion and engagement within the school environment and impact the resilience of LGBTQ+ youth in a rural school setting. This paper presents findings from a qualitative interpretive phenomenological study with twelve purposively selected self-identifying LGBTQ+ youth residing in a rural South African community. Data was gathered through semi-structured interviews.ResultsThis study shows the significance of teacher emotional support, addressing homophobic bullying, moving away from gender-based uniform prescriptions and designating some school bathrooms as gender-neutral to LGBTQ+ learners' resilience.ConclusionThe findings of this study demonstrate how certain schools in rural settings employ innovative methods to support LGBTQ+ learners despite limited resources and the absence of comprehensive, inclusive policies on gender and sexually diverse learners. The findings have implications for LGBTQ+ learners in rural community schools worldwide. Future longitudinal studies could focus on how school ecologies inclusive of teachers, parents and the wider community can foster the resilience of LGBTQ+ learners, particularly in rural community contexts.

Adverse Childhood Experiences, Quality of Life and the Mediating Roles of Self-Efficacy and Self-Directedness in Youth Residential Care Leavers

Adverse Childhood Experiences, Quality of Life and the Mediating Roles of Self-Efficacy and Self-Directedness in Youth Residential Care Leavers

“Surviving against the odds. The impact of peer support workers on a chronically suicidal adolescent in secure residential youth care: a single case report from the Netherlands”

ABSTRACT Background The use of peer support workers to support suicidal adolescents is underdeveloped. This study focuses on the effects of a one-year intervention with peer support workers on a chronically suicidal adolescent residing in a secure residential youth care facility in the Netherlands. Moreover, we explore the mechanisms that underpin the role of peer support workers in detail. Method This study employed a single case study design. We conducted seven semi-structured interviews with staff, peer support workers, and a chronically suicidal adolescent. The interviews were analysed using a thematic analysis. Results The results indicate that the suicidal tendencies of the adolescent decreased significantly one year after the peer support intervention compared to the initial baseline. Working mechanisms that underpinned the peer support intervention emphasized building meaningful and trust-based relationships, providing recognition and hope, and practical support from a recovery-oriented perspective. Conclusion The results suggest that peer support has a beneficial impact on the adolescent and treatment teams. Peer support workers contribute to a sense of belonging and connection, coping with suicidality, rediscovering life goals, and improving adolescent self-management. Barriers and facilitators to implementing peer support workers are also discussed.

Dr. M. van Dorp, I will stand by you: A shared journey towards seclusion reduction in secure residential youth care (Vrije Universiteit Amsterdam, 12 juni 2024)

Dr. M. van Dorp, I will stand by you: A shared journey towards seclusion reduction in secure residential youth care (Vrije Universiteit Amsterdam, 12 juni 2024)

“… I still need to learn some things”: an interpretative phenomenological analysis of the lived experience of extended residential youth care in Denmark

ABSTRACT Youth residential home care is, in many countries, terminated at 18 years of age. However, current research suggests that leaving care at 18 is associated with several negative or suboptimal outcomes. Denmark has, in response to this, established an extension of care which can continue until the age of 23 years. This study aimed to provide a detailed understanding of the experiences of living in the Danish extended care program. This qualitative study explored the experiences of eight young adult residents (4 men and 4 women). Interpretative phenomenological analysis was used to analyze the residents’ accounts which constructed three group experiential themes: (1) “It was me; I just didn’t want to listen:” The experience of the transition to adulthood while in residential care. (2) “I still need to learn some things:” The experience of maturation in extended care. (3) “They don’t come running to me every day anymore:” The experience of preparing to transition out of extended care. This study has important implications for practice given the sample’s perceived inability to live independently outside of care at 18 years of age. The findings support current arguments for establishing an extended care system in countries which currently only offer juvenile residential care.

Effectiveness of mental-health interventions for children and adolescents placed in residential care by the welfare services: A systematic review

BackgroundChildren and adolescents in residential youth care are a vulnerable population with great needs of mental health. PurposeThe present study undertook a systematic review to seek available mental health interventions and investigate its effectiveness. MethodsFollowing PRISMA guidelines, a systematic search was performed for publications between 1992 and July 2023 in seven databases and relevant journals for residential care. Methodological quality was assessed using the Mixed Methods Appraisal Tool. After multi-stage screening, 14 eligible articles were retrieved for analysis and a narrative synthesis performed. ResultsThirteen interventions were identified, predominantly focusing on internalising difficulties, showing congruently positive results mostly on internalised-related outcomes. Most interventions were based on cognitive-behaviour therapy and outdoor-based therapies (surf-, animal assisted, and forest-therapy). Short-term interventions, delivered on a weekly basis in group format, were the most frequent delivery mode. Most studies managed to recruit a comparison group but follow-ups were generally absent. Poor reporting and lack of methodological rigor were common features of the reviewed studies. ConclusionsThis systematic review extends the state of the art regarding psychological interventions in residential youth care. Evidence-based interventions are still needed, and future research should focus on developing and rigorously testing more interventions within this care system.

The Impact of Trauma-Informed Training for a Youth Residential Center on Staff Attitudes and Behavior

ABSTRACT Purpose Children with behavioral issues in residential care settings have high rates of trauma, with a range of trauma experiences such as abuse and neglect, issues with attachment, and multiple disruptions in placements. Staff in these settings should have an understanding of trauma, its impact, and how to engage in trauma-informed practice. The purpose of this study was to examine whether a trauma-informed training, developed specifically based on the identified needs of a residential group care facility, had an impact on future staff attitudes and behaviors. Materials and methods A 3-h training was delivered by the researchers. Three identical sessions were provided to all 48 staff, regardless of education and role, across a 3-day period. Prior to the training, staff were given a pretest survey measuring components of trauma-informed (TI) practice that indicated how often the staff members engaged in TI practice. Thirty days later, the same participants completed a posttest survey to gauge if the training had an impact on their subsequent attitudes and behavior. Results There were improvements in many of the trauma-informed practice areas on the posttest survey. T-test analysis revealed five trauma-informed practice areas had improvements that were statistically significant from the pretest survey. Discussion The findings present the opportunity for recommendations for trauma-informed training development and delivery, as well as providing implications for the field of social work. Conclusion This study demonstrates the feasibility of administering a trauma-informed training program and observing relatively rapid improvements in future attitudes and behavior among staff.

Finding the beat: A partnership to address the relationship between a music program and health among youth who have experienced trauma.

Expertise on treating trauma and traumatic stress sequelae has been siloed in the mental health professions, although somatic psychotherapies and adjuncts to treatment are gaining attention. Alternative and accessible interventions are needed, especially for youth who have experienced trauma. Lost Voices is a community-based group providing trauma-informed music therapy to youth who have experienced trauma in southern Michigan. The purpose of this program evaluation was to use a community-based participatory research approach to create a thoughtful partnership between an academic partner and a nonprofit organization in order to evaluate the outcomes of a music therapy intervention currently being delivered by professional musicians to youth who have experienced trauma. This program evaluation used semistructured interviews with 19 key stakeholders (e.g., youth participants, facility staff, musicians) from two residential youth programs in southern Michigan. A total of four themes were identified from the interviews, including (a) processing emotion, (b) building trust, (c) self-expression, and (d) future orientation. Subthemes included individual story and coping within the theme processing emotion, a focus on outside role models and peer connection within the theme building trust, the fun aspect of the intervention and confidence as part of the theme self-expression, and future orientation encompassed the motivation that youth participants gained as well as forward thinking. This program evaluation provides data to help build the evidence for alternative mental health treatments that specifically reach those impacted by a lack of access and availability of treatments due to social determinants of health. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Effect of growth trajectories in communication skills on juvenile recidivism

AbstractPurposeIncreasing numbers of children with behaviour problems in school are recognized as having language and communication difficulties. However, communication limitations have not been assessed adequately as a risk factor for juvenile recidivism. The aim of this study was to examine how changes in communication skills impacted subsequent engagement in crime among youth.MethodsFour waves of longitudinal data of youth who were placed in juvenile justice residential facilities were used for the study. Group‐based trajectory and multivariate regression analyses were used to investigate how the growth trajectories of communication skills impacted recidivism.ResultsGroup‐based trajectory analysis revealed heterogeneous growth in communication skills among residential youth. More interestingly, the scale of growth predicted recidivism.ConclusionsThis study extends an understanding of juvenile aggression and criminal offences by underlining communication limitation issues as a focal predictor of recidivism. Sufficient resources are needed for the development, evaluation and implementation of intervention programmes to help youth overcome limitations in communication.

Characteristics Associated With Mental Health Treatment Prior to Suicide Among Youth in the United States

To examine individual and contextual characteristics associated with receipt of mental health treatment prior to youth suicide. Data from the US National Violent Death Reporting System, Area Health Resource File, and Social Vulnerability Index were used to examine characteristics associated with receipt of mental health treatment within 2 months before death among youth suicide decedents aged 5 to 17 years from 2013 to 2020 (N= 6,229). The association between individual (demographic, precipitating circumstances, and clinical characteristics) and contextual-level variables (county health resources, Social Vulnerability Index) and mental health service use was modeled using logistic regression. Mental health treatment was received by 31.6% of youth suicide decedents (n= 1,967) in the 2 months before suicide. Male individuals and youth from all racial and ethnic minority groups were less likely to receive mental health treatment in the 2 months prior to suicide, as were youth residing in non-metropolitan counties and living in counties characterized by high compared to low levels of social vulnerability. A history of family problems, a recent crisis, criminal/legal problems, and suicidal thoughts and attempts were associated with increased odds of receiving mental health services. Youth suicide decedents who were male, members of a racial or ethnic minority group, and residing in counties that are non-metropolitan and/or socially disadvantaged were less likely to have received mental health services in the months prior to death. Suicide prevention efforts that focus on improving access to care are essential for these vulnerable populations at risk for suicide.

Neighborhood Sorting, Metros, and Tomorrow's Labor Force

In this Economic Commentary, we look at how households sort into neighborhoods in different metro areas and analyze these patterns by race, ethnicity, and income. We find that in many metros, Black households face a significant tradeoff between a neighborhood's Black population share and its socioeconomic status (SES), with many high-income Black households residing in lower SES neighborhoods than is the case for white households of similar income. A similar pattern exists for Hispanic households. Because a neighborhood's SES correlates with the labor market outcomes of the children who grow up there, these sorting patterns could, over time, act to limit workforce productivity, and individual earnings, by restraining skill acquisition for youth residing in under-resourced areas.

A construct validation of the perceived Negative Context of Reception Scale with Indian American youth.

Crucial to the resettlement experiences of immigrants is the degree to which the receiving country accepts them and affords them social support and opportunities. Through the factor structure and incremental validity of scores generated by the Negative Context of Reception (NCR) Scale, in the present study, we examine Indian American youths' perception of their context of reception using a sample of youth residing in the United States. Data came from a sample of 223 Indian American youth (aged 12-17) as part of a larger convergent mixed-methods project. Using confirmatory factor analysis, we examined the scale's validity and the relationship between perceived NCR and criterion-related factors such as perceived discrimination and depressive and anxiety symptoms. Interpretive Phenomenological Analysis was then used to analyze qualitative data from 11 of these Indian American youth. Qualitative data provided additional insights about NCR in this population. NCR scores evidenced strong psychometric properties among Indian American youth. Confirmatory factor models demonstrated good model fit. NCR yielded significant associations with perceived discrimination (r = .33, p < .001) and depressive symptoms (r = .25, p < .002). Two major themes (parental/family sacrifices and being treated differently from White peers) emerged from the qualitative data. Results validate NCR as a construct relevant to Indian American youth and associated with negative mental health symptoms such as anxiety and depression. Furthermore, these results underscore the importance of a welcoming and supportive environment for Indian American youths' well-being. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Cultural and Religious Equity and Disparity in the Group Climate Experience of Moroccan Girls in Dutch Residential Youth Care Settings.

The group climate within residential youth care institutions is considered a transactional process, both within a group of youth from various cultural backgrounds and between them and their group workers. The ongoing interaction between the cultural characteristics of these girls may influence the quality of the group climate. This study aimed to provide an in-depth account of the living group climate experiences and perceptions of Dutch girls with a Moroccan cultural background in Dutch residential groups. Interpretative phenomenological analysis was employed to explore the girls' group climate experiences. Three major themes emerged, namely (a) level of involvement of Moroccan girls in their living group, (b) perceptions of Moroccan girls' sense of belonging in a living group, and (c) cultural and religious equality or disparity results in two interaction patterns. The findings revealed that equality or disparity in language, culture, and religion affect Moroccan girls' experiences and perceptions of the living group climate. A crucial finding was that cultural and religious disparity leads to interaction patterns wherein the girls pre-emptively exclude themselves from receiving support from native group workers. Professionals must be aware of the cultural and religious dynamics, including the interplay and impact of cultural and religious equality and disparity, influencing Moroccan girls' group climate experiences.

Social Workers as Allies? Gender Confirming Practices and Institutional Limitations in Youth Residential Homes

AbstractPrevious research shows that LGBTQ+ youth are over-represented in out-of-home care and that especially transgender and non-binary youth face challenges during their placement. These challenges stem from, among other factors, the lack of knowledge and competence of professionals regarding the unique needs of transgender and non-binary youth. In Sweden, there are policies that aim to protect transgender and non-binary youth from discrimination and to promote their sexual and reproductive health and rights, and an increasing number of residential homes claim to have LGBTQ competence when competing for placements. However, it is unclear how this affects the everyday experiences of trans and non-binary youth at residential homes. The purpose of this study is to investigate the practices and challenges of clinical social workers at residential care homes when working with gender identity and sexual health issues among young transgender and non-binary youth. Eight semi-structured interviews focusing on professionals’ knowledge and experiences were conducted and analysed using reflexive thematic analysis. Four themes emerged: i) Knowledge being a personal matter; ii) Heteronormativity and binarity creating consequences; iii) Handling discrimination and harassments; and iv) Creating a trustful alliance. The results show that knowledge is a personal matter, and social work professionals seek the knowledge they need instead of receiving it in education or training. The contextual heteronormativity and binarity creating consequences at the residential care home pose challenges for social workers and they have to find creative ways to support transgender and non-binary youth and address the harassments and discrimination that these youth face. Moreover, the social workers share their strategies regarding how they are creating a trustful alliance. Overall, they identify significant challenges to developing clinical social work that is affirming of transgender and non-binary youth.

Hitting the road together: how do care workers develop pedagogical praxis in relation to a positive living climate in residential youth care?

ABSTRACT One of the key factors in providing high-quality support in residential youth care (RYC) is developing a positive living climate. The role of group worker and his/her elaboration of the pedagogical praxis are particularly relevant in this regard. Despite its importance, the development of this pedagogical praxis in the current relational and societal context seems to be under pressure. In this study, we aim to investigate how care workers cultivate pedagogical praxis in RYC services. We aim to gain insight into (1) which pedagogical actions are considered as meaningful, (2) which struggles to influence this pedagogical praxis, and (3) how care workers deal with these struggles. Together with the participants, a qualitative research process was co-created. Care workers describe the importance of a basic pedagogy: a pedagogy that is not pre-structured but that allows one to reflect and act in a given situation. However, they mention different struggles on micro-, meso- and macro-level that put pressure on the development of basic pedagogy. On top of that, care workers describe a perceived unsafe context to work in. Actions to deal with this complex matter are described in terms of fight, flight or freeze reactions.

START NOW WebApp—promoting emotion regulation and resilience in residential youth care and correctional institutions: study protocol for a cluster randomized controlled trial

BackgroundAdolescents and young adults in residential care and correctional institutions face various challenges, leading to negative life outcomes. Implementation barriers within these institutions, such as limited financial and spatial resources, pose significant hurdles to providing necessary support. Web-based approaches address these challenges by offering cost-effective, accessible solutions. This study aims to assess the efficacy of a newly developed web-based version of the existing evidence-based START NOW skills training in fostering emotion regulation and resilience among institutionalized adolescents and young adults. We present the study protocol (Version 5, August 2023) of the trial titled “Implementation of an e-version of the skills training START NOW for promoting emotion regulation and resilience in residential youth care and correctional institutions”.MethodsThe study is a monocentric, prospective, confirmatory randomized controlled trial with 150 institutionalized adolescents and young adults with a need to improve resilience (predefined cut-offs). Participating institutions will be randomized to one of three conditions: (i) 9-week web-based group training guided by a facilitator, (ii) 9-week web-based self-help training, (iii) and treatment as usual. The primary endpoint is the change in psychological flexibility, assessed by the Avoidance and Fusion Questionnaire for Youth score, from baseline to follow-up 12 weeks post skills training. Secondary objectives encompass assessing pre-post changes in psychological flexibility and other psychological health-related outcome measures in participating adolescents, young adults, and caretakers from baseline, to post training, and to 12- and 24-week follow-ups.DiscussionThis study evaluates the efficacy of START NOW as web-based training for institutionalized adolescents and young adults, providing valuable insights into web-based interventions and aiming to optimize support levels.Trial registration {2a and 2b}ClinicalTrials.gov NCT05313581. Registered on 6 April 2022.

Same job, same working conditions? A cross-sectional study to examine the similarities and differences of the working situation in ambulatory and residential youth welfare workers

BackgroundEmployees in social work exhibit high rates of sick leave due to mental health issues. Additionally, work-related demands in youth welfare have increased in recent years. Particularly in light of the escalating shortage of skilled professionals in this field, this trend becomes especially critical. The aim of this study is to systematically examine health-relevant working conditions, coping strategies, and health indicators in youth welfare. A special focus is placed on a differentiated analysis of job-related characteristics in the context of outpatient and residential youth welfare.MethodsMean values, standard deviations and the reliability of scales are measured. In addition to descriptive statistics, t-tests for analyzing mean differences, as well as correlation analyses and odds ratios as measures of association, are computed.ResultsA total of N = 1044 employees in youth welfare participated in the online survey. Among them, 671 individuals belonged to the field of residential youth welfare, and 373 to outpatient youth welfare. The results indicate that, in youth welfare in general, a variety of emotional, social, qualitative, and quantitative demands exhibit high levels. The comparison between outpatient and residential youth welfare reveals differences in half of the demands. The significant differences are observed for social demands and aggression from clients, which are statistically significant higher in the residential setting. Regarding resources, the most significant difference is observed for autonomy, which is higher in the outpatient setting. Overall, the association patterns reveals more similarities than differences between outpatient and residential settings. In both settings working conditions seem to have deteriorated during the pandemic.ConclusionsIn conclusion, the identified job-related characteristics in outpatient and residential youth welfare exhibit more similarities than differences. Nevertheless, the identified differences provide insights into the specific features of each work context, offering valuable starting points for targeted health promotion in practice.Trial registrationThis trial is recorded at the Hamburg University Ethics Committee (AZ 2022_027).

Residential Youth Workers’ Perceptions of Grief and Loss in Residential Care

ABSTRACT Youth in residential care typically experience significant losses during their childhood, which often result in grief. The presence of supportive adults who acknowledge these losses has been found to be a significant protective factor for youth in residential care. Residential youth workers consistently interact with the children they support; thus, they have a unique opportunity to address children’s losses and associated grief. This project uses a mixed methods design to explore how residential youth workers conceptualize and account for grief and loss. Specifically, we explore service providers’ perceptions of how loss affects children’s behavior. Three narrative vignettes describing a hypothetical child’s behavior were used to elicit these opinions. Residential youth workers (n = 101) were recruited from British Columbia to complete a brief questionnaire that assessed their perceptions of behaviors they encounter and their experiences supporting grieving youth. A one-way ANOVA revealed no statistically significant group differences; however, a thematic analysis revealed that while grief and loss are often accounted for, participants feel under-resourced to provide grief-informed care to a population experiencing complex losses. The findings suggest that clinical and policy changes are necessary to better support residential youth workers and the youth they care for.

Friluftsliv in residential youth care: a resilience perspective on character-forming outdoor experiences

ABSTRACT We explore care workers’ descriptions of friluftsliv (outdoor life) in Norwegian residential care homes in the context of child and youth care. Tracing a brief history of friluftsliv in Norway, we describe how it is appreciated for its health benefits and character-forming qualities. We also touch upon barriers to friluftsliv, which largely follow socioeconomic patterns, and situate friluftsliv in a broader international context of outdoor approaches. The data consists of nine semi-structured interviews describing care workers` experiences with friluftsliv at residential care. Using thematic analysis based on descriptive phenomenology, we generated two themes that depict what care-workers describe as character forming qualities of friluftsliv that are relevant for the adolescents: ‘coping with challenges’ and ‘becoming familiar with culturally valued pursuits.’ We use resilience theory as a framework to examine these qualities of friluftsliv.