Research Update: Understanding Relationships in Therapeutic Residential Care

Oct 2023

Written by Kelly Royds Lynne McPherson

The Centre for Excellence in Therapeutic Care (CETC) is engaged in ongoing research to understand how positive, trusting relationships and social connections can be fostered for young people in Therapeutic Residential Care settings in Australia.

Led by CETC Director Janise Mitchell and SCU Associate Professor Lynne McPherson, this project also includes contributions from other Australian researchers and international expertise from Emeritus Professor Robbie Gilligan of Trinity College Dublin.

What progress have we made so far?

The team has successfully conducted 38 individual interviews with young people living in Intensive Therapeutic Care (ITC) or Intensive Therapeutic Care-Significant Disability homes in New South Wales. Additionally, focus group interviews have been completed with 50 ITC staff, therapeutic specialists, managers, and 20 Department of Community and Justice representatives, including policy advisers.

“What has struck me about the research so far is how willing and engaged young people have been in sharing their thoughts about the role of relationships in their care experience”, reflected Lynne and Janise.

A first in Australian research

This is the first large-scale, mixed-methods study in Australia that captures the experiences and perspectives of both young people and staff about what helps or hinders the development of positive relationships and social connections in Therapeutic Residential Care settings.

Next steps

The project’s next phase involves data analysis and the development of a survey tool for the project’s third phase. Janise Mitchell has recently collaborated with Lynne McPherson and other team members to begin a preliminary analysis of the findings, which will be reported in the coming months.

We are continuing to recruit young people to participate in interviews, in particular those living in Sydney.

Thank you and call out!

We extend our gratitude to all agencies that have facilitated our work by connecting us with young people who can share their experiences.

For those interested in contributing to this research, particularly if you are involved with a young person in ITC in Sydney, please reach out to Lynne McPherson at lynne.mcpherson@scu.edu.au for opportunities to participate in individual interviews.

You may be interested in: Residential care Therapeutic care

Creating positive social climates and home-like environments in therapeutic care - Practice guide
Creating positive social climates and home-like environments in therapeutic care - Practice guide
This guide has been developed to support the implementation of Essential Element: Physical Environments from the Ten Essential Elements of Therapeutic Care. It explores how to create therapeutic care contexts...
Read more
Putting theory into practice
Putting theory into practice
Sometimes you might wonder why you need to learn about theory. I have heard people say:   Residential work with young people is often conducted amidst high anxiety, uncertainty and...
Read more
What does stability in residential care mean? Part I
What does stability in residential care mean? Part I
After four years working in residential care, both on the floor and as a clinician, I wanted to better understand what stability really means for young people in residential care?...
Read more
Stability in residential Care: Part II
Stability in residential Care: Part II
Sarah is 14 and has been in placement for 18 months. She lives in a residential house with two boys and one girl. The boys display aggressive behaviours and are...
Read more
8 ways to support young people in residential care during COVID-19
8 ways to support young people in residential care during COVID-19
How do we keep to the therapeutic care principles of safety, consistency, predictability, and routine in a world that feels like it has turned upside down overnight? It’s near impossible!...
Read more
How do we create excellence in Intensive Therapeutic residential care practice?
How do we create excellence in Intensive Therapeutic residential care practice?
What creates high quality therapeutic residential care? This is the question often asked of agencies, of staff, of policy makers and of the young people themselves. There is no simple...
Read more
Cultivating curiosity in Therapeutic residential care
Cultivating curiosity in Therapeutic residential care
Curiosity is something that has excited me my whole life. I am sure a lot of you share my fascination and enthusiasm for curiosity. There seems to be wide support...
Read more
Therapeutic residential workers? Who are we?
Therapeutic residential workers? Who are we?
This blog is to introduce my recent research with therapeutic residential workers. Further blogs and practice guides relating to finding, keeping, acknowledging and celebrating the best person for the job...
Read more
10 ways to enable young people's participation in therapeutic residential care
10 ways to enable young people's participation in therapeutic residential care
In this blog, I’m keen to offer practitioners in therapeutic residential care some ideas about how to involve young people in decisions that affect their lives. Many young people in...
Read more
The Intensive Therapeutic Care dance
The Intensive Therapeutic Care dance
Therapeutic residential work can be conceptualised as a dance. It works best when therapeutic workers display therapeutic presence, are in sync with the young person, can making meaning of the...
Read more
Understanding and supporting young people who self-harm in residential care
Understanding and supporting young people who self-harm in residential care
Some of the young people we care for in the ITC programs deal with emotional distress and pain by hurting themselves physically. Young people hurting themselves is distressing to them...
Read more
What are the needs of Aboriginal and Torres Strait Islander children and young people in care? Research brief
What are the needs of Aboriginal and Torres Strait Islander children and young people in care? Research brief
Indigenous children and young people face unique challenges in the child welfare system. The dimensions of this problem are complex and multifaceted. Providing culturally safe and traumainformed therapeutic care to...
Read more
‘Tis the Season to be Jolly’ – but not for everyone
‘Tis the Season to be Jolly’ – but not for everyone
It’s all too easy to get wrapped up in the fun and happiness of Christmas and forget that, for others, the season isn’t necessarily a joyful one. For some the...
Read more
The 10 essential elements of Intensive Therapeutic Care NSW - Practice guide
The 10 essential elements of Intensive Therapeutic Care NSW - Practice guide
This guide has been developed to describe the 10 Essential Elements that form the basis for Intensive Therapeutic Care (ITC) service provision in NSW. The 10 Essential Elements have been...
Read more
What makes a good therapeutic residential care worker? Practice guide
What makes a good therapeutic residential care worker? Practice guide
Trained staff and consistent rostering are essential elements of therapeutic residential care. The purpose of this guide is to consider more broadly what makes an excellent therapeutic residential care worker...
Read more
How do you prepare for the transitioning of young people into an Intensive Therapeutic Care house? Part 2
How do you prepare for the transitioning of young people into an Intensive Therapeutic Care house? Part 2
In the first part of the Blog, we explored limit and expectation setting, maintaining a state of occupancy and the planning process for a successful transition. In part two of...
Read more
How do you prepare for the transitioning of young people into an Intensive Therapeutic Care house? Part 1
How do you prepare for the transitioning of young people into an Intensive Therapeutic Care house? Part 1
This is a two-part blog and will focus on the transition of young people into an Intensive Therapeutic Care house; however, most of the content is transferrable to other placement...
Read more
Changing your practice to being trauma informed in therapeutic residential care
Changing your practice to being trauma informed in therapeutic residential care
Whilst the following Arabian proverb takes a bit to get your head around it leads rather nicely into this blog and our brief introduction on the relevance of the conscious...
Read more
How to thrive in lock down, lean into what works in therapeutic care
How to thrive in lock down, lean into what works in therapeutic care
Lockdown means we lose touch with many things: friends, family, freedom. For young people, therapeutic youth workers and other staff in Intensive Therapeutic Care, however, it also offers an opportunity...
Read more
Trauma-informed relationship-based recovery reflection tool - Practice tool
Trauma-informed relationship-based recovery reflection tool - Practice tool
Children and young people need adults who can co-regulate with them and teach them about feelings and their inner world. This Trauma Informed Relationship-Based Recovery Reflection tool can be used...
Read more
Client mix and client matching in therapeutic care - Practice guide
Client mix and client matching in therapeutic care - Practice guide
Client mix and the process of client matching is one of the 10 Essential Elements underpinning the Intensive Therapeutic Care (ITC) system in New South Wales. This guide has been...
Read more
Trauma-informed care - Research brief
Trauma-informed care - Research brief
This research briefing aims to define and clarify what trauma, complex trauma and trauma informed care are. Extensive literature has now surmised that exposure to adverse experiences such as child...
Read more
Q&A with the trainer: Harmful sexual behaviour
Q&A with the trainer: Harmful sexual behaviour
Working with young people who engage in harmful sexual behaviour is complex and challenging. Cyra Fernandes and Dan Howell have spent over a 1000 hours in the past year helping carers and professionals...
Read more
Strengthening connections & relationships project
Strengthening connections & relationships project
What is this research about? Young people in residential care face major challenges that can prevent them from forming healthy relationships and a strong personal identity, which are critical building...
Read more
Pulse check survey
Pulse check survey
The ITC Pulse Check Survey and Outcome Report provides a point-in-time reflection on the experiences of the reform process by ITC agency staff. To this end, the survey results clearly...
Read more
Come on it’s only a game
Come on it’s only a game
Many of you will have experienced something like the following… A residential worker is observing two young people playing table tennis in the rear yard of the residential unit. One...
Read more
Do ‘no touch’ policies in residential care keep workers and children safe? It’s not that simple
Do ‘no touch’ policies in residential care keep workers and children safe? It’s not that simple
Lyn was 16 and had grown up in foster and residential care. Lyn was interviewed about her experience and views about out of home care. She was extremely positive about...
Read more
What Was I Thinking? Handling the Amygdala Hijack
What Was I Thinking? Handling the Amygdala Hijack
Remember that time when you put the child you care for back to bed for the fourth time? Your thoughts suggested a level of desperation and wishful thinking, hoping that...
Read more
Christmas in residential care: It doesn’t need to be the most wonderful time of the year
Christmas in residential care: It doesn’t need to be the most wonderful time of the year
Christmas is a time of joy and celebration for many Australians, but it can also bring pressure and unrealistic expectations. The shops are decorated, Christmas songs are everywhere, and cheesy...
Read more
Can we provide trauma-informed care for children without changing our beliefs about their behaviour?
Can we provide trauma-informed care for children without changing our beliefs about their behaviour?
This blog article was written by Noel Macnamara, Executive Manager - Research and Policy and Deputy Director, Centre for Excellence in Therapeutic Care, CETC. There is a growing tendency to...
Read more
How are restrictive practices interpreted in therapeutic residential care?
How are restrictive practices interpreted in therapeutic residential care?
This blog article was written by Glenys Bristow,  Senior Specialist, Therapeutic Residential Care, CETC. Restrictive practice in therapeutic care The Royal Commision into Violence, Abuse and Exploitation of People with...
Read more
Hard vs soft skills: which are more important in residential care work?
Hard vs soft skills: which are more important in residential care work?
Not everyone is suited to being a therapeutic residential worker. Working in therapeutic care requires special skills and qualities, some that can be taught or mentored, and others that are...
Read more
The most difficult thing about residential care work
The most difficult thing about residential care work
The most difficult aspect of working in residential care is not managing the behavioural challenges of the children and young people, the demanding shifts, or the lack of resources. Rather,...
Read more
Meet the CareSouth team
Meet the CareSouth team
CareSouth was recently awarded the Outstanding Therapeutic Residential Care Team Award at Youth Action NSW's Youth Work Awards. The CETC proposed the new Outstanding Therapeutic Residential Care Team award category...
Read more
Christmas time when glad tidings of joy should abound, and love be with us all
Christmas time when glad tidings of joy should abound, and love be with us all
Christmas, for many, is an exciting time of year. However, for some children and young people, particularly those who have experienced attachment difficulties, trauma and/or adverse childhood events, Christmas can...
Read more
Q&A with the trainer: Trauma-informed supervision
Q&A with the trainer: Trauma-informed supervision
Over the recent decades, we have seen leaps in research and practice promoting the importance of taking a holistic trauma-informed approach to caring for children and young people with trauma....
Read more
What is neuroaffirming practice and how can it help young people in out-of-home care?
What is neuroaffirming practice and how can it help young people in out-of-home care?
The 2nd of April is World Autism Awareness Day, celebrating and promoting understanding and inclusiveness of people on the autism spectrum. In out-of-home care, neurodiversity is a highly prevalent and...
Read more
The essential role of collaboration in clinical assessments for young people experiencing complex trauma
The essential role of collaboration in clinical assessments for young people experiencing complex trauma
As a clinician supporting young people who engage in harmful sexual behaviour, I have the privilege of travelling across the northern region of Victoria and engaging with many residential workers....
Read more
“I’m not a Barbie girl”: Spatial design reform in residential care
“I’m not a Barbie girl”: Spatial design reform in residential care
The Create Voices in Action conference was held in Adelaide in March 2024. Three compelling voices at the conference belonged to Professor Suzie Attiwill and Create Consultants Hayley and Ella.  ...
Read more
Holding on by a thread - Connecting with adolescents in a culture of disconnection
Holding on by a thread - Connecting with adolescents in a culture of disconnection
Recently I listened to the Brené Brown podcast Unlocking Us episode from 20th March 2024, where she spoke with Esther Perel on the new “AI” – Artificial Intimacy. There were...
Read more
What you told us about restrictive practices
What you told us about restrictive practices
In July 2023 we asked for your help to better understand how ‘restrictive practices’ were understood and interpreted in therapeutic residential care (TRC) across Australia. Through a blog on our...
Read more
Ask us: How do you help young people feel safe in residential care?
Ask us: How do you help young people feel safe in residential care?
At the CETC, we know how important it is to listen and learn from residential care workers about what works for young people in care. Recently, we interviewed several residential...
Read more
Research findings - Phase 1: Policy Analysis
Research findings - Phase 1: Policy Analysis
Phase 1: Policy Analysis This document presents an overview of the findings from Phase 1 of the Strengthening Relationships and Connections in Therapeutic Residential Care project. This phase focused on analysing...
Read more
Online gambling harms: Why young people in care need targeted protection
Online gambling harms: Why young people in care need targeted protection
Online gambling is a significant risk for young people, particularly those in out-of-home care. The Australian Government is currently considering its response to the 31 recommendations from the parliamentary inquiry...
Read more