“When You First Get There, You Wear Red”: Youth Perceptions of Point and Level Systems in Group Home Care

A common intervention utilized in group home care is behavior management systems operationalized as points, token economies and level systems. This poster extends the findings of researchers who have studied youth perception of group home and residential interventions (Anglin, 2004; Calheiros & Patrcio, 2014; Polvere, 2011; Southwell & Fraser, 2009) by focusing on youth perception of behavior management. The exploratory questions were:  (1) How do youth describe these behavioral interventions when used in a group home; (2) How do they perceive the implementation and what are their affective and behavioral responses to these interventions; and (3) Do youth perceive the interventions to be effective?

 Adolescents were eligible for the study if they were 18 or older, currently in or transitioned from child welfare services within five years and had experienced out-of-home placement. Six focus groups were conducted with 40 young adults.  The groups were recorded and professionally transcribed and the transcripts were read by the three team members and discussed with the student member of the team, an alumnus of foster care.  Thematic analysis was the primary qualitative analytic method (Braun & Clarke, 2006).  Rather than allowing the questions to emerge from the data, an analyst-driven approach was used, directed by the research questions.  All segments of text which referred to “group home” “token economies” or “point and level” or “behavior” systems were reviewed as well any references to “restrictions”.  These segments of text were initially coded, reviewed and then further refined and organized using NVivo 8 (QSR International, 2008).  The next step in the analysis process was looking for consistencies and patterns with the codes which were condensed into themes, as well as examining any codes which did not fit within the themes.  This iterative process resulted in a rich description about how youth perceive behavior management in group homes.

 Youth described the interventions to be level systems with tokens or points and in some placements requiring them to dress or wear visual cues about the level that they had achieved.  Rewards for positive behavior were not part of the intervention and whether the system was implemented consistently depended upon the staff. The youth felt that staff were inconsistent and used the system to punish them.  Many youth spoke of the negative emotional consequences of this approach: they felt de-humanized and worthless.  The youth believed that there was a need for structure, rules and limits in a group home but in their experiences, how structure was operationalized felt impersonal, restrictive, non-normative and non-individualized. Rather than “supporting” positive behavior, negative behavior was “managed” by a system of rules and negative sanctions which seemed to be applied with little therapeutic intent. 

The findings suggest that point and level systems applied without supervision and in the absence of therapeutic intent and positive staff-youth relationships were not effective interventions for these youth. A fruitful area for Social Work intervention research is developing Evidence Based Interventions for residential care which includes individualized and developmentally appropriate limits, positive behavior support and therapeutic alliance with staff.