Reflections on Quality and Care Experiences Among Early, Middle, and Late Adolescents in Residential Group Care

Background and Purpose: Youth served in residential care are a distinct but heterogenous subset of high needs youth who require placement in settings that provide greater structure and service intensity beyond what can be provided in lower-level care settings. Although the majority of youth served in RGC are adolescents, research suggests the reasons for placement and needs of youth vary at different stages of adolescent development. These differences likely impact youth experiences and, ultimately, their responses to treatment, a topic that has been neglected in research that may have implications for residential placement and treatment. The purpose of this study was to explore youth experiences in residential group care at different stages of adolescence. This study sought to respond to the question: How do youth perceptions of their experiences in residential care differ between early (9-13), middle (14-16 years), and late adolescents (17-21 years)?

Methods: Data for this exploratory study were drawn from a larger, statewide study of the quality of care in residential group homes. For the current study, the sample included 382 youth who participated in an online survey using the Quality Standards Assessment. Data were collected between January 2020 to March 2021. A qualitative content analysis was used to classify the open-ended text into interpretable categories and sub-categories by early, middle, and late adolescents’ developmental stages.

Results: Comments showed differences across developmental stages in 10 categories. Comments reflected youth’s positive views of their placement, with most comments (51%) coming from youth in late adolescents. Those youth in late adolescents spoke more positively about rules and accountability that their placement provided. Early and late adolescent youth comments focused on safety, where discussions of safety were less prominent for middle adolescents. There were noted differences in views on support, where late adolescent youth shared positive insights on the support they were receiving, specific to their physical health, independence, education, and planning for the future. Middle and early adolescent youth comments on support had a higher focus on emotional support and learning coping skills. Differences were also noted in middle and late adolescents, where middle adolescents expressed experiencing positive changes in themselves and late adolescents shared positive changes on their outlook on the future because of their time in residential care. Other differences were noted in discussion of relationships with staff, other youth, family, and DCF case managers, and insights on being understood and respected by staff.

Conclusions and Implications: The findings indicate differences across adolescent developmental stages on their views on residential care placements. Youth in late adolescents were more contemplative about their time in group care, expressing appreciation, positive insights, and hope for the future. Youth in middle and early adolescents articulated their experiences differently (e.g., less expressive) and experiences varied. While some research finding suggests interventions such as residential care may be more important to younger adolescents, our findings suggest adolescents experiences and expressions on how their placements contributed to their development differs in important ways across adolescence. We discuss implications for policy and practice.