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Background: Adolescents with intellectual disability in residential child care are a highly vulnerable population. The main goal of this study is to explore the characteristics of young people with intellectual disability in therapeutic residential care (TRC) in Spain and to identify the key variables associated with their referral to these services., Method: The total sample consisted of 473 young people in residential child care in Spain (63.8% boys), aged between 12 and 17 years ( M  = 15.32), divided into three different groups for comparison. An ad hoc questionnaire and the Youth Self-Report were used to collect information., Results: Participants with intellectual disability in TRC presented a higher frequency of externalising problems and risk behaviours than adolescents with disability in general residential programmes. However, it was lower than that of their peers without disability in TRC., Conclusions: Needs of adolescents with intellectual disability should be assessed before a referral to these facilities, in order to adapt the interventions provided.

Purpose: This conceptual paper connects the literature on the experiences and needs of youth in therapeutic residential care, trauma-informed frameworks utilized in these settings, and early research on trauma-informed design to facilitate an understanding of these connections and move towards developing a blueprint for trauma-informed design in residential settings for traumatized youth. Methods: A critical literature review drawing on trauma theory, trauma-informed care, evidence-based design, and trauma-informed design was conducted to inform the argument presented in this conceptual paper. Results: While many therapeutic residential care models engage trauma-informed care approaches to support staff in promoting healing environments for youth who have histories of complex trauma, the focus has remained on the psychosocial environment of care, and has yet to be systematically applied to the design of the built environment in which these programs are implemented. By applying the principles of trauma-informed care to the built environment, trauma-informed design has the potential to reduce retraumatization and promote resiliency among youth in care. Conclusions: Ultimately, this conceptual paper illustrates the value of further developing trauma-informed design principles to apply to settings that serve traumatized youth, such as therapeutic residential care facilities., Competing Interests: Conflict of InterestWe have no known conflict of interest to disclose., (© The Author(s), under exclusive licence to Springer Nature Switzerland AG 2023. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.)

Early psychosocial rehabilitation of young people presenting mental disorders is a major challenge. In France, the therapeutic residential care called " soins-études ," combining care and educational provision, in the Fondation Santé des Etudiants de France (FSEF) can have a role in this rehabilitation. After recalling the history and the concept underpinning soins-études in psychiatry, we performed a systematic review of the literature based on the PRISMA statement via a search for quantitative studies on soins-études facilities. Eleven quantitative studies on 10 different samples of young people hospitalised in psychiatry in FSEF were identified between the opening of the first unit in 1956 and 2016. The young people involved were mostly aged 16-20 years, which reflects the curricula covered in the FSEF establishments. These young people generally presented severe chronic psychiatric disorders. Their previous care trajectory had lasted for more than 3 years and 24-55% of them had attempted suicide at least once. Their stays lasted more than 6 months. Depending on the severity of the disorders, 44-63% of the young people were considered to have improved at discharge. The contribution of soins-études appears valuable for these young people, since there was a clinical improvement for 54-74% of them 1-15 years after their hospitalisation, with resumption of schooling, professional training or entry into employment in 60-75% of the cases. These results are compared with data in the international literature concerning therapeutic residential care, and lines for future research are identified., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2021 Hirot, Huas, Durand and Godart.)

Background: Approximately one-third of children in residential care are elementary-school aged. Yet, little is known about the subset of younger children in residential care and the nature of these placements., Objective: This study identified latent classes of younger children in residential care and compared the purposes for placement, treatment processes, and outcomes across classes., Participants and Setting: The sample included 216 children (ages 5-10) placed in therapeutic residential care., Methods: A three-step latent class model was used to estimate conditional effects of class membership on impairment at discharge, length of stay, and discharge placement. A content analysis of a randomly selected sample of case records from each class was used to explore placement processes., Results: There were three classes identified (class 1: child welfare/multi-problem families; class 2: mental-health/angry-oppositional; class 3: strong families/attachment). All classes experienced large improvements in functioning. Children in class 3 were in care longer (CI 95% 1.72, 15.48) and experienced greater reductions in impairment (CI 95% -11.17, -32.06) than class 2. Classes did not differ in rates of discharge to family-based care, however, more children in classes 1 (20.9%) and 3 (21.6%) discharged to group-based placements than class 2 (11.1%). The content analysis revealed similarities in reasons for placement and treatment processes across classes with some distinctions. Service goals were similar across classes and focused on emotional management, social skills, and developing trust., Conclusion: The results supported individualized approaches to facilitate discharge to stable, family-based care and reduced risks for re-entry and prolonged out-of-home care for younger children., (Published by Elsevier Ltd.)

Complex trauma (CT) is the experience, or witness, of prolonged abuse or neglect that negatively affects children's emotional and psychological health. Youth in residential care experience higher incidences of complex trauma than youth in community-based care, with notable gender differences and presentation of psychological symptoms. This study examined the effects of trauma-informed residential care and the relation between CT and gender. A sample ( n  = 206) from an evaluation of a youth psychiatric residential facility in the Midwest that transitioned from a traditional care model to a trauma-informed care model was used. A hierarchical regression was used to model the main effects of model of care, gender, CT, length of stay, and crisis response on treatment outcomes; and the moderating effects of gender and CT. The results support the high prevalence of CT in residential care populations. The final model explained 30.2% of the variance with a statistically significant interaction between gender and length of stay in treatment, indicating that longer lengths of stay in treatment are associated with less change in functional impairment for girls than boys. Youth gender and prior trauma are important factors to consider when monitoring experiences and treatment outcomes in youth residential care., Competing Interests: Conflict of InterestAuthors Lauren H. K. Stanley and Shamra Boel-Studt declare they have no conflict of interests to report., (© Springer Nature Switzerland AG 2019.)