Therapeutic residential care services in Australia

Therapeutic residential care services in Australia

A description of current service characteristics

Sara McLean

CFCA Paper No. 52 — August 2019
Portrait of Australian Boy at Lismore, NSW, Australia

Overview

Therapeutic residential care is a relatively recent development in out-of-home care service provision for young people who are unable to be placed in family-based care. This report is intended to complement a recent CFCA publication on this topic, Therapeutic residential care: An update on current issues in Australia (McLean, 2018; CFCA paper No. 49). This companion paper provides a snapshot of current practice of therapeutic residential care services conducted in Australia. It describes the configuration and characteristics of current therapeutic residential care services in Australia. The views of therapeutic residential care service providers included in our consultations are summarised, together with issues to be considered in further development of this form of care for young people.

Key messages

There is likely some variability in the way that the therapeutic residential care services we consulted with are configured, and in the framework and models that are drawn on to inform practice.

A common configuration for therapeutic homes is a four-bed home, set in the community, with two on-site staff. However, other arrangements also existed; there is insufficient evidence about the benefit of one service configuration over another.

Recommendations for further development included improving referral, matching and transitioning pathways for young people; more emphasis on a child-centred approach to service design; and the introduction of intensive and secure care models to meet the needs of defined groups of young people.

Therapeutic residential care services may benefit from the introduction of specialised therapeutic residential care models and the development of specific assessment and outcome frameworks and tools that are useful to therapeutic care.

Legislative changes are needed to 'enable' more effective therapeutic care and increase flexibility in the way services are commissioned and funded.

Several aspects of service delivery, staffing and structure were identified as issues that warrant further exploration.

Authors and Acknowledgements

Sara McLean is a psychologist with expertise in young people with developmental difference arising from early adversity, prenatal substance exposure, and interpersonal trauma and neglect. Sara's publications synthesise emerging knowledge from the fields of neuropsychology, clinical psychology and forensic psychology; and translate this knowledge into evidence-informed approaches to support young people living in out-of-home care settings. Sara was awarded the ACU Linacre Fellowship at Oxford University in recognition of her work supporting young people in care with complex behavioural needs. She is a Consultant Psychologist in Child Protection; an Adjunct Research Fellow at the Australian Centre for Child Protection, University of South Australia; and a member of Emerging Mind's National Workforce Centre for Child Mental Health.

The author would like to acknowledge the generous input of residential care service managers and leaders across Australia. The author would like to acknowledge the support of the National Therapeutic Residential Care Alliance in contributing to the design of survey questions and in promoting this study. The author is grateful to Howard Bath and Laurel Downey for their feedback on this paper.

Featured image: © GettyImages/Thurtell

Publication details

CFCA Paper
No. 52
Published by the Australian Institute of Family Studies, August 2019.
28 pp.
ISBN: 
978-1-76016-207-8

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