Methods: Our systematic review procedures adhered to best practices as outlined by Cooper (2010) and Littell, Corcoran, and Pillai (2008). We also incorporated A Measurement Tool to Assess Systematic Reviews (AMSTAR) and Preferred Reporting Items for Systematic Reviews and Meta Analyses (PRISMA) guidelines. Search terms were informed via consultation with a university social science reference librarian, and four electronic databases were searched. Our search was inclusive of both published studies and studies in the gray literature. Using a priori inclusion and exclusion criteria, team-based search and screening procedures yielded a final sample of 47 relevant studies.
Results: Studies varied with respect to publication status; sample size; research design; youth gender identity; youth racial/ethnic identify; youth behavioral, psychological, and developmental or intellectual concerns at intake; outcome measures; and interventions evaluated. Evaluated interventions could be clustered into one of five categories: (a) modifications to system of treatment, (b) therapeutic modalities, (c) educational/alternative programs, (d) practice behaviors, and (e) post-discharge engagement. The majority of studies noted youth outcome improvements; however, some studies also yielded mixed, inconclusive, or null results.
Conclusions/Implications: Taken together, findings demonstrate the wide diversity of practice interventions currently deployed in youth residential treatment settings. Interventions studied ranged from more “traditional” cognitive-behavioral approaches to more “innovative” practices. They also ranged in scope, from system-level philosophy changes to practitioner-youth interactions. Overall, we would characterize the breadth and depth of research to be insufficient in providing residential programs and policymakers a clear and firm understanding of “what works” in residential treatment settings for youth. A major implication of our review is the need for more research in this area and efforts to incentivize the evaluation of ongoing practices in youth PRTFs.