¶ … placement of children and youth within residential group treatment programs group treatment will be reviewed. As will be reflected within the literature review, while there has been little direct attention focused on the use of groups and group treatment within residential placement settings for children and adolescents, there are a number of factors associated with residential placement that may be significant and meaningful to future efforts to further examine group treatment, group dynamics and group living experiences within residential programs. Initially, an overview will be provided of current information available on the use of residential placement as a treatment modality for meeting the service needs of children and adolescents. This will be followed by a discussion of current perceptions regarding residential placement and the problems associated with it. Finally, an overview will be provided of ongoing policy, practice and research issues associated with residential group care.
Overview of the Current Status of Residential Placement
According to Whitaker (2000a), group care services provided for children within residential settings have been described as a component of the child welfare system within the U.S. Such services are designed to provide 24-hour care for a child in a residential facility designed as a therapeutic environment. Within this setting are integrated treatment services, educational services, and group living on the basis of an individual plan for each child who cannot be effectively helped in his or her own home, (or) with a substitute family (Whitaker, 2000a). As further delineated by Braziel (1996), residential treatment centers and community-based group homes most often represent the primary forms of group care offered under the auspices of residential placement. The settings in which such services are offered include community-based apartments, group homes, campus-based facilities, foster care homes and other self-contained facilities, including secure units. Within these settings, as noted by Braziel (1996), typically a range of service are offered and include counseling, education, recreation, health, nutrition, daily living experiences, independent living skills, reunification services, and aftercare/post placement services. There has been an increasing effort to improve the linkages between the child or adolescent in residential care with his/her family and community.
As described by Melton (1998), most often residential placement services are provided under public, voluntary nonprofit, and proprietary auspices, in child welfare, child mental health, and juvenile justice systems, often to the same populations of youths. According to Melton, the divisions existing between such services are largely based on arbitrary regulatory and payment structures rather than real differences in purpose, type of services, clientele, or source of referral. As explained by Whitaker (2000a), while the diversity that exists among such programs are minimal, the children and adolescents receiving services by residential placement programs tend to represent clients from all or most of the major children's service systems (i.e., child welfare, juvenile justice, mental health). Historically, efforts at limiting the use of residential care in one service system area (i.e., child welfare, juvenile justice, mental health) for the purposes of deinstitutionalization most often has been accompanied by an increase in residential placements in another area of the system (Whitaker, 2000a). Thus, as noted by Whitaker, there has been a growing awareness that there is need for the development of a cross-system perspective in relation to residential placement for children and adolescents.
As a review of the literature suggests, it is difficult to obtain accurate population estimates of those children and adolescents placed in residential care within the U.S. On the basis of more recent information, a national study commissioned by the U.S. Children's Bureau provides a total population estimate of approximately 500,000 children and adolescents in out-of-home care in the mid-1990s (USDHHS, 1997). As found within the report provided by the U.S. Department of Health and Human Services (USDHHS), the majority of those children and adolescents placed within residential care settings were served in family foster care arrangements in comparison to the approximate one-fourth of all children in out-of-home care who were served in residential group care facilities.
Melton (1998) suggested that such estimates represent an inaccurate accounting of the actual numbers of children and adolescents who are served in residential placement. As further explained by Melton, there is a "hidden sector" found within residential care most often represented by those children and adolescents who are placed within private psychiatric settings as well as those who are in the custody of the juvenile justice system and placed within residential...
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