Therapeutic Residential Care

The Therapeutic Residential Care Evidence Brief seeks evidence in a number of specific areas, including the use of seclusion rooms.

The purpose of this document is to provide evidence in the specific areas requested, grounded in the wider context of Therapeutic Residential Care (TRC), as it is referred to internationally. This brief is indicative only, as it draws on a time-limited search that was not comprehensive or exhaustive and further examination might be required.

• While residential care for children and young people has been the topic of polarised debate, research and experience from practice show that residential care is an important part of the care continuum, necessary for a small number of the most vulnerable children with complex needs, for whom a family placement is not currently appropriate.
• Indigenous models of TRC place heavy emphasis on cultural safety, promoting connection with culture, participation in local communities, and meaningful connection with families.
• Living environments in residences have a large impact on the effectiveness and safety of TRC. As such, living environments in residences should be developmentally enriching, responsive, and therapeutic for children and young people in care.
• Trauma-informed environments and models of care in TRC also help to prevent rates of absconding and violent behaviour.
• Seclusion has a negative impact on children, who report experiencing feelings of fear, anger, abandonment, confusion, and punishment.  For children with trauma-related histories, the experience of seclusion is re-traumatising, making therapeutic goals more difficult to attain.
• Effective inter-professional collaboration is required to effect positive change in TRC, supported by strong communication based on mutual respect between professionals and agencies.