Distinguishing Residential Child Care, Therapeutic Child Care, Treatment, and Trauma-informed Residential Care
Currently these terms are used interchangeably, and this is causing confusion.
For example, it is not uncommon to hear, ‘This child needs a therapeutic placement’, this only comes with a longer-term stay, whereas in fact the seeker was looking for short-term treatment.
Or a research study comparing trauma-informed with other models. All the models are different and to be distinguished. The research then leads to children being directed to the appropriate model. With differing needs and context there will be a different primary task and differing outcomes that are not comparable.
A succinct distinguishing of terms can assist us in understanding the children’s needs and the response needed.
Having moved ourselves beyond the use of the work ‘complex’ when describing needs and now using ‘multiple co-occurring and interacting ‘, in the same way we now need to be to succinctly distinguish Residential Child Care, Therapeutic Child Care, Treatment, and Trauma-informed Residential Care.
The term ‘therapeutic’ is distinctive and requires a clarity when used. It has become diluted. It is an approach that require rigour.
The words of Adrian Ward come to mind. “If they are not therapeutic, then what are they?” (Intuition is not enough p6)
Similarly, trauma‑informed care is not a “type” of placement but a lens that should inform all the above.
The following 2 sections from What works in Residential Child Care (NCERCC/NCB) are important waymarkers for our seeking of clarity.
Theories for practice
It is essential that each residential setting has a clear theory or general philosophy that guides its practice, focusing on the fine detail of children’s needs and ways of addressing them using individual and group methods.
Clarity of purpose
All children’s homes are required to have a Statement of Purpose and well-articulated objectives, consistent throughout the organisation. Defining the primary task of an organisation may be set out as ‘What are we here for?’ or ‘What are we in the business of doing?’ Its importance lies in the fact that it is to the definition of the core task that all parties should return when evaluating the work of a home. A children’s home is more likely to be successful if the primary task is understood and agreed by all parties: parents, children, residential staff, head of home, external management, and outside professionals.
The table can be seen to correspond to the three groupings observable in the residential sectors.
- children with relatively simple or straightforward needs who require either short-term or relatively ‘ordinary’ substitute care (likely kinship or fostering)
- children or families with deep rooted, complex or chronic needs with a long history of difficulty and disruption, including abuse or neglect requiring more than simply a substitute family (mainstream ‘family group’ type homes providing supportive developmental and maturational opportunity)
- children with extensive, complex and enduring needs compounded by very difficult behaviour who require more specialised and intensive resources (identifiably treatment orientated – therapeutic, secure, psychiatric, disability)
In the immediate future NCERCC will adopt the stance of seeking clarity in the uses of terms. It will also sees it will be helpful for there to be a challenge to any seeking of merging or cherry picking of categories.
