Quality of experience in residential care programmes: Retrospective perspectives of former youth participants

Abstract

This exploratory study examined perceptions of care quality within parent-pay youth treatment programmes such as therapeutic boarding schools, residential treatment centres, wilderness therapy programmes, and intensive outpatient programmes. Reflecting on their personal experiences as youths, 214 adults reported on a total of 75 different treatment settings. Two indices developed for this study measured participants' perceptions of quality of experience and the totalistic programme characteristics of their care settings. Regression analyses and ANOVA tests of means indicated a negative relationship between totalistic programme characteristics and quality of experience index scores. Significant relationships were not found between quality of experience and forcible transport, intake decade, or the amount of time in treatment. K E Y W O R D S quality of care, residential care, therapeutic boarding school, totalistic, totality of conditions, wilderness therapy 1 | INTRODUCTION This exploratory study examined perceptions of care quality within parent-pay youth treatment programmes such as therapeutic boarding schools, residential treatment centres, wilderness therapy programmes, and intensive outpatient programmes. Reflecting on their personal experiences as youths, 214 adults reported on a total of 75 different treatment settings. Two indices developed for this study measured participants' perceptions of quality of experience (QOE) and

Mapping the Concept, Content, and Outcome of Family-Based Outdoor Therapy for Children and Adolescents with Mental Health Problems: A Scoping Review

“…According to the authors, the mixed results shown in their study may be partly explained by involuntary treatment admission and feeling of parental rejection, where out of home placement may have negatively impacted attachment relationships. Results from another study, however, have indicated that the use of forcible transport did not affect program outcomes among youth participating in residential care programs [38], but the validity of these results has been questioned [39].…”

“When Can I Call Home?” Coercive Control, Structural Isolation, and Functional Isolation Among Attendees of Residential Behavioral Modification Programs

“…With this limited oversight, many concerns never come to the attention of authorities. As a result, there is no knowledge as to the demographic spread of the population, no existing list of the programs themselves or how many there are, the staff or their credentials, nor how many minors are enrolled in such programs (Chatfield et al, 2021; Friedman et al, 2006). It also means there is little knowledge as to how the programs operate, including how they benefit or harm those served (Chatfield et al, 2021; Mohr, 2009).…”

“…As a result, there is no knowledge as to the demographic spread of the population, no existing list of the programs themselves or how many there are, the staff or their credentials, nor how many minors are enrolled in such programs (Chatfield et al, 2021; Friedman et al, 2006). It also means there is little knowledge as to how the programs operate, including how they benefit or harm those served (Chatfield et al, 2021; Mohr, 2009). With the primary focus being behavioral modification alongside little to no regulation presents significant risk for the mistreatment of program attendees, specifically the risk of behavioral modification through abusive tactics such as coercive control.…”

“…The federal or state governments do not claim oversight over the programs in this industry. As a result, it is unclear how many of these programs exist, how many minors are in residential treatment programs, or how these programs operate, including how they benefit or harm those served (Chatfield et al, 2021; Friedman et al, 2006).…”

Involuntary Youth Transport (IYT) to Treatment Programs: Best Practices, Research, Ethics, and Future Directions

“…Chatfield et al (2021) suggested "forcible transport" may be a more appropriate description than IYT, stating, "the practice relies on the implicit or explicit use of force and because the voluntary or involuntary nature of such practices may be less salient for young people who have no legal right to refuse treatment" (p. 134). However, Chatfield et al's (2021) research failed to find any association between forcible transport and youths' perceived quality of experience in residential care. IYT has also been criticized as a form of social control or "strong-arm rehabilitation" that can elicit traumatic responses (Mooney & Leighton, 2019;Rosen, 2021).…”