What do we know about providing good residential care for children and what do we actually do?
Even though much has changed in child care over the last seventy years, the gap between what we know and what we do with the knowledge seems as wide as ever.
A framework for practice, based on a valid theory of how children change and develop, motivates both children and staff to adhere to routines, structures, and processes minimizing the potential for interpersonal conflict. Without a clear framework for providing care, there are lost opportunities throughout the day to help children achieve developmental and treatment goals. A framework for practice provides consistency in message and approach with the children and congruency throughout the organization.
The Children And Residential Experiences: Creating Conditions for Change (CARE) practice model, built on six principles that form the foundation for creating conditions for change in residential care, provides such a framework. These core principles: developmentally focused, family involved, relationship based, competence centered, trauma informed, and ecologically oriented, have a strong research and/or theoretical relationship to positive child outcomes, and can be incorporated into a wide variety of programs and treatment models.
The implementation of these principles to achieve congruence in the best interests of children throughout all levels of a residential care organization is the goal of the CARE practice model.
If you are interested in learning more about the RCCP's CARE Model, read our book, Children and Residential Experiences (CARE): Creating Conditions for Change.
To order the book now, click below; it may also be ordered from the Child Welfare League of America at http://www.cwla.org/pubs/pubdetails.asp?PUBID=1262
CARE is now listed as a Promising Research Evidence-based model
RCCP is very pleased to announce that our Children And Residential Experiences (CARE) program is now listed as a Promising Research Evidence based model by the California Evidence-Based Clearinghouse for Child Welfare (CEBC). The link to the listing is:
We want to extend our heartfelt thanks to our colleagues around the world for their hard work and dedication, and to our CARE agenciesfor their amazing contributions to this process.
The CARE model earned a Scientific Rating of 3 (Promising Research Evidence) and a rating of High Relevance by the California Evidence-Based Clearinghouse for Child Welfare (CEBC) in 2017. The CEBC is a critical tool for identifying, selecting, and implementing evidence-based child welfare practices that will improve child safety, increase permanency, increase family and community stability, and promote child and family well-being.
As mentioned above, CARE is a principle-based program designed to enhance the social dynamics in residential care settings through targeted staff development and ongoing reflective practice. Using an ecological approach, CARE aims to engage all staff at a residential care agency in a systematic effort to orient practices in order to provide developmentally enriched living environments and to create a sense of normality for youth. CARE is organized around six principles related to attachment, trauma recovery, and, ecological theory.
The CARE model research
Using a quasi-experimental design, CARE had an impact on the prevention of aggressive or dangerous behavioral incidents involving youth living in group care environments in 11 agencies (Izzo, Smith, Holden, Norton-Barker, Nunno, and Sellers, 2016). Measures included monthly administrative reports of behavioral incidents and the Organizational Social Context (OSC). Results indicate that there were significant program effects on incidents involving youth aggression toward adult staff, property destruction, and running away. Effects on aggression toward peers and self-harm were also found but were less consistent. In addition, the young-person – adult interaction quality improved as well as the young person attachment measures using the Inventory of Parent and Peer Attachment as an anchor in the surveys (Sellers, 2017).
Another interrupted time series study examined the impact of CARE on the interactional quality among staff and youth in therapeutic residential care (Nunno, Smith, Martin, and Butcher, 2017). Data were collected over 12 years and divided into a 6-year baseline phase prior to the start of CARE in January 2009 and a 6-year implementation phase. Measures utilized include the Organizational Social Context (OSC) and behavioral report incidents. Results indicate that CARE implementation reduces the prevalence of critical incidents, and that reductions are sustained following the 3-year implementation period.