How young people portrayed their experiences in therapeutic residential care in Portugal: A mixed methods study

Abstract

In contrast to the international context of residential care and the preference for family based care, residential care in Portugal is the only option for most young people in the child protection system. Despite this, research in Portugal has yet to focus on Therapeutic Residential Care (TRC) and has rarely considered the narratives of young people. By adopting the conceptual framework proposed by Farmer et al. (2017) and focusing on five critical domains (Setting, Staffing, Treatment Approach, Safety, and Milieu Factor), we aimed to identify a subset of factors that contribute to youth improvement. This convergent parallel mixed methods study involved conducting semi-structured interviews with 14 young people, mostly female (71%), aged 14–18 years (M = 16.3, SD = 1.8), at five TRC facilities in Portugal. Young people and staff also completed a sociodemographic questionnaire and the youth self-report or child behaviour checklist to assess internalising and externalising symptoms. Content analysis revealed mostly positive perceptions and experiences across the domains (Setting, Staffing, Treatment Approach, Safety, Milieu Factor and Profile Characteristics). However, half of the youth reported being vulnerable to peer contagion and females with higher internalising and externalising symptoms reported more negative perceptions and experiences of TRC. These findings highlight that creating an organisational social context that supports participatory approaches to assessing quality may provide invaluable insights into how services can be responsive to young people’s needs. Focusing on establishing high-quality relationships with staff, peers, family, and the community may be key to ensuring the long-term success of TRC.