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Meeting the needs of children in care

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A new collected volume takes a fresh look at therapeutic residential care as a powerful intervention in working with the most troubled children who need intensive support. The Danish contribution focuses on high-resource-using children, using unique administrative data to analyse the needs, characteristics and placement decisions concerning this group.

Edited by James Whittaker, Jorge F. del Valle and Lisa Holmes, the newly published “Therapeutic Residential Care for Children and Youth” critically examines current research and innovative practice and addresses the key questions: how does it work, what are its critical “active ingredients” and does it represent value for money?

The volume features a wide range of international contributions – among them my own, which focuses on the needs and characteristics of high-resource-using children and youths compared to the needs and characteristics of low-resource-using children and youths in a Danish context.

Unique data opportunities

Detailed analysis of children in out-of-home care in Denmark is made possible by the existence of national administrative register data from Statistics Denmark that can be used for research purposes. This on-going collection of high-quality data and information gives a unique opportunity to systematically analyse the placement decisions, specifically in terms of whether high-resource-using children get high-resource treatment and care.

Firstly, the register data on all children can be linked by personal ID codes with information about their own and their parents’ demographic, ethnic and socioeconomic backgrounds, diagnosed illnesses (including mental illness), substance abuse, delinquency and placement outside the home.

Secondly, SFI – The Danish National Centre for Social Research has collected data in the Danish Longitudinal Study of children born in 1995 (DALSC), financed by the Danish Ministry of Social Affairs, where a subsample of the study focuses on children in care (DALSC-CIC). The study follows all children born in 1995 who are or have been in out-of-home care approximately every three years. (The analyses here use data from the 2011 data collection period, when the children were 15 years old.)

Combining these two data sources provides a valuable opportunity to analyse the difference in needs and characteristics of high-resource-using children and youth.

High- and low-resource-using children

The chapter focuses on the fundamental differences between high-resource-using children and low-resource-using children. This split reflects both sides of the care system – both the children and youth in care and the care environment.

High-resource-using children are characterized by being highly troubled, based on their mental and physical health, behavioural patterns, and other kinds of behavioural disorders. They are being cared for in high-resource care environments such as socio-pedagogical homes and residential care, characterized as therapeutic residential care, which is financially demanding with highly skilled staff.

Low-resource-using children are characterized by being less troubled; having vulnerable parents according to demographic and socioeconomic factors as well as mental and physical health issues. They are being cared for in low-resource care environments such as foster parents, who are less financially demanding and who, with short and practical training, can use their parental skills to treat the low-resource-using children in care.

In Denmark, we can therefore conclude that the needs and characteristics of the high-resource-using children are correctly met by the financially demanding, highly skilled, therapeutic residential care environment.

International perspectives

As James Whittaker notes in his commentary to the chapter, the North American reader will notice the variations in care settings, specifically the special Danish brand, social pedagogical care units, in which close to 20 percent of the children in out-of-home care reside.

These units are best compared to treatment fostering, also presented in the book. They are privately owned, though publicly approved housing institutions, where the principals (often a married couple with socio-pedagogical experience) are living at the setting (e.g. an old farm being used as a riding school for the locals too) employing 24-hour staff. The socio-pedagogical homes are usually small but highly specialized to take care of children and youths with specific types of problems or psychiatric diagnoses.

For non-Danish readers, these theoretical, epistemological and cultural underpinnings of social pedagogy represent an interesting topic to investigate further.

James K. Whittaker, Jorge F. del Valle and Lisa Holmes.(eds.): “Therapeutic Residential Care for Children and Youth – Developing Evidence-Based International Practice.”  Jessica Kingsley Publishers (Child Welfare Outcomes), September 2014.

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