Ethnography in the Study of Group Home Care

Background and Purpose:

Group home care (GHC) for youth with emotional and behavioral disorders has traditionally been treated as a monolithic construct in the practice and research literature. In general, GHC settings are described as 24-hour facilities, which employ shift staff to serve youth who are in need of more intensive and restrictive care. Clear operational distinctions between different GHC settings do not exist in the research literature despite considerable variability in size, target population, and treatment approach across different settings. Obscuring such differences has confounded the building of a solid knowledge base in this area. – As part of a symposium on GHC, this presentation discusses the utility of ethnography in the study of GHC. Within the context of an ethnography of several GHs, this presentation describes various ethnographic methods (from rapid ethnography to long-term immersion, writing of fieldnotes, interpretation and writing up of findings) that can be used to access and engage GHs as well as generate findings about ‘usual GHC.' In addition, an observational measure will be introduced that can augment traditional ethnographic methods.

Methods:

The fieldwork for this project was conducted in five different group homes. While exploratory and ultimately inductive, the fieldwork had two guiding objectives: (1) to begin developing an understanding of “usual care” within different GH settings; and (2) to explore key elements of GHC that would need to be the focus of any efforts toward improving care and outcomes. The extent of the fieldwork varied depending on the GH, but generally involved on-site visits over several months as well as multiple interviews with administrative, clinical and child care staff. Whenever possible, interviews or focus group were conducted with GH youth and alumni. I also attended staff meeting/trainings, clinical meetings and other GH-related events. The observational measure was used to structure observations. Finally, a review of salient GH documents was undertaken. Throughout this process, field notes were taken and subsequently coded according to a methodology of “Coding Consensus, Co-occurrence, and Comparison” outlined by Willms et al. (1990) and rooted in grounded theory.

Results:

Several broad themes emerged through the fieldwork, such as (1) home-like but not quite home; (2) centrality of the child care staff; (3) “life after;” and (4) “where is the family?” These findings will be briefly highlighted. However, the main focus will be on placing findings within the larger context of what can be achieved through ethnography in the study of GHC. The presentation will be used to demonstrate how findings from this study are used to build a program of funded research in this area.

Conclusions and Implications:

GHC is highly diverse and regulated by policies at multiple levels (federal, state, county, organizational). Ethnographic methods are useful in getting access and engaging different GHs and gaining a sense of key elements to be leveraged to improve care. Findings from fieldwork conducted in GHs can be used to guide the development of quantitative work on GHC.