Abstract
This review summarizes the literature for residential treatment, family preservation services, treatment foster care, and individualized services and evaluates characteristics of each model, methodological limitations of outcome studies, and treatment effectiveness with children. Although residential care is often viewed negatively, empirical evidence does not suggest differential levels of effectiveness compared to nonresidential alternatives. The results of some nonresidential outcome studies are promising, but efficacy claims should be viewed critically due to the absence of methodologically rigorous evaluations for both residential and nonresidential approaches. Future research should focus on establishing empirically grounded placement criteria, identifying what presenting problems are most amenable to each form of treatment, and maximizing the maintenance of treatment gains in the postdischarge environment.
Similar content being viewed by others
References
Barker, P. (1988). The future of residential treatment for children. In C. Schaefer & A. Swanson (Eds.),Children in residential care: Critical issues in treatment (pp. 1–16). New York: Van Nostrand Reinhold Company.
Barth, R.P., Courtney, M., Berrick, J.D., & Albert, V. (1994).From child abuse to permanency planning: Child welfare services pathways and placements. New York: Aldine de Gruyter.
Bath, H.I., & Haapala, D.A. (1993). Intensive family preservation services with abused and neglected children: An examination of group differences.Child Abuse and Neglect, 17, 213–225.
Bath, H.I., Richey, C.A., & Haapala, D.A. (1992). Child age and outcomes correlates in intensive family preservation services.Children and Youth Services Review, 41, 389–406.
Beker, J. (1991). Back to the future: Effective residential group care and treatment for children and the Fritz Redl legacy.Residential Treatment for Children and Youth, 8(4), 57–71.
Beker, J. (1994). Does institutional care do more harm than good? No. In E. Gambrill & T. J. Stein (Eds.),Controversial issues in child welfare (pp. 279–288). Boston: Allyn and Bacon.
Bereika, G.M., & Mikkelsen, E.J. (1992). Individualized residential treatment as an alternative to acute psychiatric hospitalization for children and adolescents.Community Alternatives: International Journal of Family Care, 4, 97–117.
Berrick, J.D., Courtney, M., & Barth, R.P. (1993). Specialized foster care and group home care: Similarities and differences in characteristics of children in care.Children and Youth Services Review, 15, 453–473.
Berry, M. (1991). The assessment of imminence of risk of placements: Lessons from a family preservation program.Children and Youth Services Review, 13, 239–256.
Berry, M. (1992). An evaluation of family preservation services: Fitting agency services to family needs.Social Work, 37, 314–321.
Bettelheim, B. (1950).Love is not enough. New York: Free Press.
Bettelheim, B. (1974).A home for the heart. New York: Knopf.
Braukmann, C.J., Bedlington, M.M., Belden, B.D., Braukmann, P.D., Husted, J.J., Ramp, K.K., & Wolf, M.M. (1985). Effects of community-based group-home treatment programs on male juvenile offenders’ use and abuse of drugs and alcohol.American Journal of Drug and Alcohol Abuse, 11, 249–278.
Bryant, B. (1981). Special foster care: A history and rationale.Journal of Clinical Child Psychology, 10, 8–20.
Bryant, B., Simmens, F., & McKee, M. (1989). Doing it in public: A review of foster family treatment program development in Missouri.Children and Youth Services Review, 12, 159–175.
Bryant, B., & Snodgrass, R.D. (1990). Therapeutic foster care: Past and present. In P. Meadowcroft & B. Trout (Eds.),Troubled homes: A handbook of therapeutic foster care (pp. 1–20). Washington D.C.: Child Welfare League of America.
Burchard, J.D., Burchard, S.N., Sewell, R., & VanDenBerg, J. (1993).One kid at a time: Evaluative case studies and description of the Alaska Youth Initiative demonstration project. Washington D.C.: CASSP Technical Assistance Center, Georgetown University Press.
Burchard, J.D., & Clarke, R.T. (1989). Individualized approaches to treatment: Project Wraparound. In A. Algarin, R. Friedman, A. Duchnowski, K. Kutash, S. Silver, & M. Johnson (Eds.),Second Annual Conference Proceedings from the Children’s Mental Health Services and Policy Conference: Building a Research Base. (pp. 51–57). Tampa: Research and Training Center for Children’s Mental Health, Florida Mental Health Institute, University of Southern Florida.
Burchard, J.D., & Clarke, R.T. (1990). The role of individualized care in a service delivery system for children and adolescents with severely maladjusted behavior.The Journal of Mental Health Administration, 17, 48–60.
Burchard, J.D., Clarke, R.T., & Hamilton, R.I. (1990). Project Wraparound: A state-university partnership in training clinical psychologists to serve severely emotionally disturbed children. In P. Magrab & P. Wolford (Eds.),Improving psychological services for children and adolescents with severe mental disorders: Clinical training in psychology (pp. 179–184). Washington, D.C.: American Psychological Association.
Burns, B.M. (1990). Mental health service use by adolescents in the 1970’s and 1980’s. In A. Algarin & R. Friedman (Eds.),Third Annual Conference Proceedings: A System of Care for Children’s Mental Health: Building A Research Base (pp. 3–19). Tampa: Research and Training Center for Children’s Mental Health, Florida Mental Health Institute, University of Southern Florida.
Catalano, R.F., Hawkins, J.D., Wells, E.A., Miller, J., & Brewer, D. (1991). Evaluation of the effectiveness of adolescent drug abuse treatment, assessment of risks for relapse, and promising approaches for relapse prevention.The International Journal of the Addictions, 25, 1085–1140.
Chamberlain, P., Moreland, S., & Reid, K. (1992). Enhanced services for foster parents: Effects on retention rates and outcomes for children.Child Welfare, 71, 387–401.
Chamberlain, P., & Reid, J.B. (1991). Using a specialized foster care community treatment model for children and adolescents leaving the state mental hospital.Journal of Community Psychology, 19, 266–276.
Clark, H.B., Prange, M.E., Lee, B., Boyd, L.A., McDonald, B.A., & Stewart, E.S. (1994). Improving adjustment outcomes for foster children with emotional and behavioral disorders: Early findings from a controlled study on individualized services.Journal of Emotional and Behavioral Disorders, 2, 207–218.
Clarke, R.T., Schaefer, M., Burchard, J.D., & Welkowitz, J.W. (1992). Wrapping community-based services around children with severe behavioral disorder: An evaluation of Project Wraparound.Journal of Child and Family Studies, 1, 241–261.
Colton, M.J. (1988).Dimensions of substitute child care. A comparative study of foster and residential care practices. Brookfield, VT: Avebury.
Curry, J.F. (1991). Outcome research on residential treatment: Implications and suggested directions.American Journal of Orthopsychiatry, 61, 348–357.
Day, D.M., Pal, A., & Goldberg, K. (1994). Assessing the post-residential functioning of latency-aged conduct disordered children.Residential Treatment for Children and Youth, 11, 45–61.
Dollard, N., Evans, M.E., Lubrecht, J., & Schaeffer, D. (1994). The use of flexible service dollars in rural community-based programs for children with serious emotional disturbance and their families.Journal of Emotional and Behavioral Disorders, 2, 117–125.
Dowrick, P.W. (1988). Alaska Youth Initiative. In P. Greenbaum, R. Friedman, A. Duchnowski, K. Kutash, & S. Silver (Eds.),Conference Proceedings, Children’s Mental Health Services and Policy: Building a Research Base (pp. 59–61). Tampa: Research and Training Center for Children’s Mental Health, Florida Mental Health Institute, University of Southern Florida.
Duchnowski, A.J., Johnson, M.K., Hall, K.S., Kutash, K., & Friedman, R.M. (1993). The Alternatives to Residential Treatment study: Initial findings.Journal of Emotional and Behavioral Disorders, 1, 17–26.
Durkin, R.P., & Durkin, A.B. (1975). Evaluating residential treatment programs for disturbed children. In M. Guttenberg & E.L. Struening (Eds.),Handbook of evaluation research: Vol. 2 (pp. 275–339). Beverly Hills, CA: Sage Publications.
Ensign, K. (1991).Prevention services in child welfare: An exploratory paper on the evaluation of family preservation and family support programs. Washington D.C.: U.S. Department of Health and Human Services.
Evans, M.E., Armstrong, M.I., Dollard, N., Kuppinger, A.D., Huz, S., & Wood, V.M. (1994). Development and evaluation of treatment foster care and family-centered intensive case management in New York.Journal of Emotional and Behavioral Disorders, 2, 228–239.
Feldman, L.H. (1991). Evaluating the impact of intensive family preservation services in New Jersey. In K. Wells & D. Biegel (Eds.),Family preservation services: Research and evaluation (pp. 47–71). Newbury Park, CA: Sage Publications.
Forsythe, P.W. (1989). Family preservation in foster care: Fit or fiction?Child and Youth Services, 12, 63–73.
Frankel, H. (1988). Family-centered, home-based services in child protection: A review of the research.Social Service Review, 62, 137–157.
Fraser, P.M., Fraser, M.W., & Haapala, D.A. (1992). Intensive home-based family preservation services: An update from the FIT project.Child Welfare, 71, 177–188.
Fraser, M., Pecora, P., & Haapala, D. (1991).Families in crisis: The impact of family preservation services. Hawthorne, NY: Aldine de Gruyter.
Goldman, S.K., & Stroul, B.A. (1991). Descriptive research: One approach to the study of community-based services for children and adolescents who have serious emotional disturbances. In A. Algarin & R. Friedman (Eds.),Third Annual Conference Proceedings; A System of Care for Children’s Mental Health: Building a Research Base (pp. 197–211). Tampa: Research and Training Center for Children’s Mental Health, Florida Mental Health Institute, University of Southern Florida.
Guterman, N.B., Hodges, V.G., Blyth, B.J. & Bronson, D.E. (1989). Aftercare service development for children in residential treatment.Child and Youth Care Quarterly, 18, 119–130.
Harding, E., Bellew, J., & Penwell, L. (1978). Project Aftercare: Follow-up to residential treatment.Behavioral Disorders, 4, 13–22.
Hawkins, R.P. (1989). The nature and potential of therapeutic foster family care programs. In R. Hawkins & J. Breiling (Eds.),Therapeutic foster care: Critical issues (pp. 5–36). Washington D.C.: Child Welfare League of America.
Hawkins, R.P., Almeida, M.C., & Samet, M. (1989). Comparative evaluation of foster-family-based treatment and five other placement choices: A preliminary report. A. Algarin, R. Friedman, A. Duchnowski, K. Kutash, S. Silver, & M. Johnson (Eds.),Second Annual Conference Proceedings, Children’s Mental Health Services and Policy: Building a Research Base (pp. 91–111). Tampa: Research and Training Center for Children’s Mental Health, Florida Mental Health Institute, University of Southern Florida.
Hawkins, R.P., Meadowcroft, P., Trout, B A., & Luster, W.C. (1985). Foster family-based treatment.Journal of Clinical Child Psychology, 3, 220–228.
Hess, A. (1990). Residential treatment: Beyond time and space.Residential Treatment for Children and Youth, 7, 41–55.
Hodges, V., Guterman, N., Blythe, B., & Bronson, D. (1989). Intensive aftercare services for children.Social Casework: The Journal of Contemporary Social Work, (September, 1989), 397–404.
Hudson, J., Galaway, B., & Harmon, P. (1989). Providing competence building and normalizing environments: The specialist family placement program of human service associates.Child and Youth Services, 12, 223–234.
Jenson, J.M., Hawkins, J.D., & Catalano, R.F. (1986). Social support in aftercare services for troubled youth.Children and Youth Services Review, 8, 323–347.
Jenson, J.M., & Whittaker, J.K. (1987). Parental involvement in children’s residential treatment: From preplacement to aftercare.Children and Youth Services Review, 9, 81–100.
Jones, M.A. (1991). Measuring outcomes. In K. Wells & D. Biegel (Eds.),Family preservation services: Research and evaluation (pp. 33–46). Newbury Park, CA: Sage Publications.
Kahan, B. (1984). The state of the art. In T. Philpot (Ed.),Group care practice: The challenge of the next decade (pp. 15–19). Surrey: Business Press International Limited.
Kelley, P.C., & Carruth, J.B. (1989). The community as advocate for youth: The programs and services of the National Youth Advocate Program, Inc.Child and Youth Services, 12, 211–222.
Kinney, J., Haapala, D., & Booth, C. (1991).Keeping families together: The Homebuilders model. Hawthorne, NY: Aldine de Gruyter.
Kinney, J., Haapala, D., Booth, C., & Leavitt, S. (1990). The Homebuilders model. In J.K. Whittaker, J. Kinney, E.M. Tracy, & C. Booth (Eds.),Reaching high risk families: Intensive family preservation services (pp. 31–64). Hawthorne, NY: Aldine de Gruyter.
Kinney, J., Madsen, B, Fleming, T., & Haapala, D. (1977). Homebuilders: Keeping families together.Journal of Consulting and Clinical Psychology, 4, 667–673.
Lewis, W.W. (1982). Ecological factors in successful residential treatment.Behavioral Disorders, 7, 149–155.
Lourie, I.S., & Katz-Leavy, J. (1991). New directions for mental health services for families and children.Families in Society, 15, 24–26.
Lyman, R.D., Prentice-Dunn, S., Wilson, D.R., & Taylor, G.E. (1989). Issues in residential and inpatient treatment. In R. Lyman, S. Prentice-Dunn, & S. Gabel (Eds.),Residential and inpatient treatment of children and adolescents (pp. 3–22). New York: Plenum Press.
Lyman, R.D., & Wilson, D.R. (1992). Residential and inpatient treatment of emotionally disturbed children and adolescents. In C. Walker & M. Roberts (Eds.),Handbook of clinical child psychology (pp. 829–843). New York: John Wiley & Sons.
Magura, S. (1981). Are services to prevent foster care effective?Children and Youth Services Review, 3, 193–212.
Maluccio, A.N., & Marlow, W.D. (1972). Residential treatment of emotionally disturbed children: A review of the literature.Social Service Review, 46, 230–250.
Meadowcorft, P. (1989). Treating emotionally disturbed children and adolescents in foster homes.Children and Youth Services Review, 12, 23–24.
Meadowcroft, P., Thomlison, B., & Chamberlain, P. (1994). Treatment foster care services: A research agenda for child welfare.Child Welfare, 73, 565–581.
Millham, S. (1984). The lessons of research. In T. Philpot (Ed.),Group care practice: The challenge of the next decade (pp. 87–97). Surrey: Business Press International Limited.
Moore, K.J., & Chamberlain, P. (1994). Treatment foster care: Toward development of community-based models for adolescents with severe emotional and behavioral disorders.Journal of Emotional and Behavioral Disorders, 2, 22–30.
Nelson, K.E. (1988).Factors contributing to success and failure in family based child welfare services: Executive summary. Iowa City: The University of Iowa, School of Social Work.
Nelson, K.E. (1990). How do we know that family-based services are effective?The Prevention Report, (Fall 1990). Iowa City: The University of Iowa, National Resource Center on Family Based Services, School of Social Work.
Nelson, K.E. (1991). Populations and outcomes in five family preservation programs. In K. Wells & D. Biegel (Eds.),Family preservation services: Research and evaluation (pp. 72–91). Newbury Park, CA: Sage Publications.
Orenstein, R. (1989). The New Brunswick therapeutic home program.Child and Youth Services, 12, 235–242.
Oswalt, G.L., Daly, D.L., & Richter, M.D. (1991). A longitudinal follow-up study of Boys’ Town residents: Implications for treating “at risk” youth. In A. Algarin and R. Friedman (Eds.),Fourth Annual Research Conference Proceedings; A System of Care for Children’s Mental Health: Expanding the Research Base (pp. 155–161). Tampa: Research and Training Center for Children’s Mental Health, Florida Mental Health Institute, University of Southern Florida.
Pecora, P.J., Whittaker, J.K., Maluccio, A.N., Barth, R.P., & Plotnick, R.D. (1992).The child welfare challenge: Policy, practice, and research. Hawthorne, NY: Aldine de Gruyter.
Peterson, M. (1989). PATH: Putting foster parents in charge.Child and Youth Services, 12, 205–210.
Pfeiffer, S.I., & Strzelecki, S.C. (1990). Inpatient psychiatric treatment of children and adolescents: A review of outcome studies.Journal of the American Academy of Child and Adolescent Psychiatry, 29, 847–852.
Ponce, D.E., & Jo, H.S. (1991). Substance abuse and psychiatric disorders: The dilemma of increasing incidence of dual diagnosis in residential treatment centers.Residential Treatment for Children & Youth, 8, 5–15.
Redl, F. (1966).When we deal with children. New York: Free Press.
Rosen, L.D., Heckman, T., Carro, M.G., & Burchard, J.D. (1994). Satisfaction, involvement, and unconditional care: The perceptions of children and adolescents receiving wraparound services.Journal of Child and Family Studies, 3, 55–67.
Rossi, P.H. (1992). Assessing family preservation programs.Children and Youth Services Review, 14, 77–97.
Rossi, P.H. (1994). [Review of the bookFamilies in crisis: The impact of intensive family preservation services].Children and Youth Services Review, 16, 461–465.
Rubenstein, J.S., Armentrout, J.A., Levin, S., & Herald, D. (1978). The Parent-Therapist program: Alternate care for emotionally disturbed children.American Journal of Orthopsychiatry, 48, 654–662.
Scholte, E.M. (1992). Prevention and treatment of juvenile problem behavior. A proposal for a socio-ecological approach.Journal of Abnormal Child Psychology, 20, 247–262.
Schuerman, J.R., Rzepnicki, T.L., Littell, J.H. & Budde, S. (1992). Implementation Issues.Children and Youth Services Review, 14, 193–206.
Schuerman, J.R., Rzepnicki, T.L., Littell, J.H. & Chak, A. (1993).Evaluation of the Illinois Family First placement prevention program: Final report. Chicago, IL: Chapin Hall Center for Children.
Schwartz, I.M. (1994). Does institutional care do more harm than good? Yes. In E. Gambrill & T. J. Stein (Eds.),Controversial issues in child welfare (pp. 276–279; 288–289). Boston: Allyn and Bacon.
Schwartz, I.M., AuClaire, P., & Harris, L.J. (1991). Family preservation services as an alternative to out-of-home placement of adolescents: The Hennepin County experience. In K. Wells & D. Biegel (Eds.),Family preservation services: Research and evaluation (pp. 33–46). Newbury Park, CA: Sage Publications.
Small, R., Kennedy, K., & Bender, B. (1991). Critical issues for practice in residential treatment: The view from within.American Journal of Orthopsychiatry, 61, 327–338.
Stone, L.A. (1979). Residential treatment. In J.D. Noshpitz (Ed.),Basic handbook of child psychiatry: Vol. 3 (pp. 231–262). New York: Basic Books.
Tracy, E.M. (1991). Defining the target population for family preservation services. In K. Wells & D. Biegel (Eds.),Family preservation services: Research and evaluation (pp. 138–158). Newbury Park, CA: Sage Publications.
Tuma, J.M. (1989). Mental health services for children: The state of the art.American Psychologist, 44, 188–199.
VanDenBerg, J.E. (1989). The Alaska Youth Initiative: An experiment in individualized treatment and education. In A. Algarin, R. Friedman, A. Duchnowski, K. Kutash, S. Silver, & M. Johnson (Eds.),Second Annual Conference Proceedings from the Children’s Mental Health Services and Policy Conference: Building a Research Base. (pp. 64–78). Tampa: Research and Training Center for Children’s Mental Health, Florida Mental Health Institute, University of Southern Florida.
VanDenBerg, J.E. (1993). Integration of individualized mental health services into the system of care for children and adolescents.Administration and Policy in Mental Health, 20, 247–257.
Van Hagen, J. (1988). Family work in residential treatment. In C. Schaefer & A. Swanson (Eds.),Children in residential care: Critical issues in treatment (pp. 134–144). New York: Van Nostrand Reinhold Company.
Washington State Department of Social and Health Services (1995). An evaluation of worker referral practices and perceptions of intensive family preservation services in Washington. Unpublished manuscript.
Webb, D.B. (1988). Specialized foster care as an alternative therapeutic out-of-home placement model.Journal of Clinical Child Psychology, 17, 34–43.
Wells, K. (1988). Approaches to description of children and families in need of mental health services. In P. Greenbaum, R. Friedman, A. Duchnowski, K. Kutash, & S. Silver (Eds.),Conference Proceedings: Children’s Mental Health Services and Policy: Building a Research Base (pp. 44–46). Tampa: Research and Training Center for Children’s Mental Health, Florida Mental Health Institute, University of Southern Florida.
Wells, K. (1991a). Long-term residential treatment for children: Introduction.American Journal of Orthopsychiatry, 61, 324–326.
Wells, K. (1991b). Placement of emotionally disturbed children in residential treatment: A review of placement criteria.American Journal of Orthopsychiatry, 61, 339–347.
Wells, K., & Biegel, D. (1992). Intensive family preservation services research: Current status and future agenda.Social Work Research and Abstracts, 28, 21–27.
Wells, K., & Whittington, D. (1990). Prior services used by youths referred to mental health facilities: A closer look.Children and Youth Services Review, 12, 243–256.
Wells, K., & Whittington, D. (1993a). Characteristics of youths referred to residential treatment: Implications for program design.Children and Youth Services Review, 15, 195–217.
Wells, K., & Whittington, D. (1993b). Child and family functioning after intensive family preservation services.Social Services Review, 67, 55–83.
Wells, K., Wyatt, E., & Hobfoll, S. (1991). Factors associated with adaptation of youths discharged from residential treatment.Children and Youth Services Review, 13, 199–216.
Wheeler, C.E., Reuter, G., Struckman-Johnson, D., Yuan, Y.Y. (1992).Evaluation of State of Connecticut intensive family preservation services: Phase V annual report. Sacramento, CA: Walter R. McDonald & Associates.
Whittaker, J.K. (1979).Caring for troubled children. San Francisco: Jossey-Bass.
Whittaker, J.K., & Maluccio, A N. (1989). Changing paradigms in residential services for disturbed/disturbing children and youth: Retrospect and prospect. In R. Hawkins & J. Breiling (Eds.),Therapeutic foster care: Critical issues (pp. 81–102). Washington D.C.: Child Welfare League of America.
Whittaker, J.K., Overstreet, E.J., Grasso, A., Tripodi, T., & Boylan, F. (1988). Multiple indicators of success in residential youth care and treatment.American Journal of Orthopsychiatry, 58, 143–147.
Whittaker, J.K., & Pecora, P. (1984). A research agenda for residential care. In T. Philpot (Ed.),Group care practice: The challenge of the next decade (pp. 87–97). Surrey: Business Press International Limited.
Whittaker, J.K., & Pfeiffer, S.I. (1994). Research priorities for residential group child care.Child Welfare, 73, 583–601.
Yuan, Y.Y., McDonald, W.R., Wheeler, C.E., Struckman-Johnson, D., & Rivest, M. (1990).Evaluation of AB 1562 In-Home Care Demonstration Projects: Volume I Final Report. Sacramento, CA: Walter R. McDonald & Associates.
Zimmerman, D.P. (1990). Notes on the history of adolescent inpatient and residential treatment.Adolescence, 25, 9–38.
Zimmerman, D.P. (1993). The little turtle’s progress: A reconsideration of the short versus long-term residential treatment controversy.Children and Youth Services Review, 15, 219–243.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Bates, B.C., English, D.J. & Kouidou-Giles, S. Residential treatment and its alternatives: A review of the literature. Child Youth Care Forum 26, 7–51 (1997). https://doi.org/10.1007/BF02589364
Issue Date:
DOI: https://doi.org/10.1007/BF02589364