The Struggle: A Review of Common and Evidence-Based Practices in Shelter Care, Residential Treatment, and Day Treatment for Youth

Abstract

Higher placements for youth face a unique challenge: developing a flexible, evidence-based intervention system for a particularly high-risk population. Common themes in the lives of these youth include complex trauma, self-harm, conduct problems, and lack of developmentally-appropriate social skills. A number of practices are reviewed in the present study, including models for the treatment milieu, specific intervention procedures, models of therapy, and measures to assess children’s mental health outcomes. The review revealed that a number of evidence-based practices are available for this population, but appropriate models should be chosen depending on the characteristics (i.e. age, presenting problem) of the population. Integration of multiple evidence-based practices is recommended in order to best serve youth, and continuous evaluation of said practices and exploration of further practices is likely necessary in order to achieve and maintain improved program outcomes. Common themes within these models is the need for a social-emotional curriculum, trauma-informed care, a relationship-based system, adequate staff and system supports, use of reinforcement, reduction of punishment, preventative practice, a data driven system, and including input from youth. In accountability measures, the Child and Adolescent Needs and Strengths Assessment Tool (CANS) seemed to be the most cost-effective, least time-intensive measure while retaining strong psychometric properties. This report was prepared for St. Joseph’s Home for Children in Minneapolis (a division of Catholic Charities of St. Paul and Minneapolis) and its emergency shelter, residential treatment, and day treatment programs, with support from the University of Minnesota Center for Urban and Regional Affairs.