Rethinking Residential Care
In a world where residential care for children is often viewed as a “last resort,” Professor Bruce Henderson’s evidence-based approach brings a refreshing perspective. His comprehensive analysis of the research challenges longstanding assumptions about what’s best for vulnerable children in out-of-home care.
Professor Henderson’s experience with Black Mountain Home for Children in North Carolina provides a compelling case study. What began as a struggling facility with outdated approaches was transformed through quality leadership into a model organisation offering a continuum of care. Today, Black Mountain provides not only residential care but also foster care, adoption services, family reunification support, and programs to help young people transition to independence. This approach recognises that children’s needs are diverse and often change over time.
The concept of “fit” emerges as central to Henderson’s argument. Rather than adhering to a rigid hierarchy of placements where family-based care is always prioritised, Professor Henderson advocates for matching each child’s specific needs, history, and circumstances to the most appropriate care environment. For some children, especially those who have experienced multiple failed foster placements or who need to remain with siblings, high-quality residential care may be the most appropriate first choice – not a last resort after everything else has failed.
One of the most disturbing statistics Professor Henderson shares is about children who have experienced dozens of placements. He mentions a young person who had been in 35 different placements by age 15, and the interviewer notes working with a child who had experienced 50 placements. The damage caused by this constant upheaval – educationally, socially, and psychologically – is immeasurable. For these children, stability in a well-run residential setting may be far preferable to continuing the cycle of failed family-based placements.
Professor Henderson’s critical analysis of the research literature is particularly valuable. He points out that much of the negative perception of residential care stems from a handful of influential studies, particularly research on Romanian institutions, which examined exceptionally poor care provided to infants and very young children. These findings have been inappropriately generalised to all forms of residential care for children of all ages. Meanwhile, research showing positive outcomes from quality residential care – including survey research with alumni who report positive experiences – receives much less attention.
The core issue, Professor Henderson emphasises repeatedly, is quality rather than setting. “You can find good and bad versions of every kind of care,” he notes. Quality care comes down to relationships – selecting the right staff, training them properly, supporting them adequately, and providing stability. When these elements are in place, children can thrive in residential settings.
Professor Henderson challenges the “family first” language common in child welfare policy, preferring the Danish approach of “children first.” This subtle but profound shift places the focus where it belongs – on the needs of individual children rather than on ideological preferences about care models. For some children, particularly older adolescents or sibling groups, quality residential care may be the environment where they can best heal, develop, and prepare for independent adulthood.
As jurisdictions around the world reconsider their approaches to child welfare, Professor Henderson’s evidence-based perspective offers a valuable corrective to simplistic thinking. Rather than eliminating residential care options, we should be focused on ensuring quality across all care settings and making placement decisions based on the specific needs of each child. Our obligation is to provide vulnerable children with environments where they can heal from trauma and develop to their full potential – whatever form that environment might take.
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About Bruce:
Bruce is Professor Emeritus of Psychology at Western Carolina University, and is a child psychologist (PhD for Minnesota) whose research until 2018 focused on the development of curiosity and memory in children, and on teaching in higher education. Since then, most of his writing has been about residential care. His book Challenging the Conventional Wisdom about Residential Care for Children and Youth: A Good Place to Grow (Routledge, 2024) is a critical appraisal of the research on residential care and a defense of high-quality residential care for children who need it. For over 35 years, Bruce has been involved with the Black Mountain Home for Children, Youth, and Families, an organization that provides residential care, but also has foster care and adoption services, transitional and independent living programs for older youth, and works to reunite children with their families of origin whenever possible. Bruce lives with his wife Judy in the mountains of Western North Carolina.
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Transcript:
Colby: 0:00
Welcome to the Secure Start podcast.
Bruce: 0:04
I think it’s a huge mistake to break up sibling groups when that may be the only part of their family that they’re still in touch with on a regular basis. I think the record that I know of was a young man at the age of 15 had been in 35 different placements 35 different placements, and if you think about what that does to your life, it’s just. I mean educationally, socially every way you can think of.
Bruce: 0:37
I think the issue is a matter of finding a fit between a particular child, that child’s history and an environment that’s going to work for that child, and I think residential care needs to be one of the options. I don’t think we need to pit different kinds of care against each other. I mean, you can find good and bad versions of every kind of care. And the question, the real question, is quality, the quality of the care, and it comes back to that every single time and to a large degree, the question of quality is a question of building relationships. If in fact, there’s a good chance of going back to the family of origin, residential care is kind of a neutral place to go.
Bruce: 1:18
The evidence is that we lose foster care families at a rapid rate and I think it’s oftentimes because of that insensitivity about the nature of that child. I don’t think residential care should be the norm for kids who need care. I think it’s gonna be relatively rare, but it needs to be one of the options. The last resort notion came from a belief that residential care was inherently bad for children. But if you ask a large number of alumni of residential care about their experiences and they tell you. They had good experiences and they never would have preferred foster care. You’ve got to give some attention to that.
Colby: 2:08
Welcome to the Secure Start podcast. I’m Colby Pearce, and joining me for this episode is the author of perhaps the most comprehensive review ever of the research evidence in relation to children’s residential care. Before I introduce my guest, I would like to acknowledge the traditional custodians of the lands that I come to you from the Kaurna people of the Adelaide Plains, and acknowledge the continuing connection the living Kaurna people feel to land, waters, culture and community. I’d also like to pay my respects to their elders, past, present and emerging. My guest this episode is Bruce Henderson.
Colby: 2:55
Bruce is Professor Emeritus of Psychology at Western Carolina University and is a child psychologist with a PhD from Minnesota, whose research until 2018 focused on the development of curiosity and memory in children and on teaching in higher education. Since then, most of his writing has been about children’s residential care. His book Challenging the Conventional Wisdom About Residential Care for Children and Youth A Good Place to Grow is a critical appraisal of the research on residential care and a defence of high quality residential care for children who need it. For over 35 years, bruce has been involved with the Black Mountain Home for Children, youth and Families, an organisation that provides residential care but also has foster care and adoption services, transitional and independent living programs for older youth and works to unite children with their families of origin whenever possible. Bruce lives with his wife, judy, in the mountains of western North Carolina. Welcome Bruce.
Bruce: 4:14
Thanks for having me, Colby.
Colby: 4:16
Yeah, and you quiped a little bit earlier about speaking to someone in the future, which probably the laugh that it got from me probably would have if we’d been recording. It would have blew out a few eardrums if we included it in the podcast recording. But yes, it’s nice to be here too. It’s Thursday for you and Friday for me.
Bruce: 4:41
And don’t give me the lotto numbers. I don’t need them.
Colby: 4:44
You don’t need them, you’re doing okay. Well, that’s good to know. Yeah, yeah, in my neck of the woods, professor Emeritus means that you’ve retired. Is that the same in America?Bruce: 4:58
Yes, it means I retired from teaching and committee work and you’re given access to your computer and to your email and you can sit on dissertation committees and things like that.
Colby: 5:14
But yeah, I basically retired from teaching in 2020 after 42 years, 42 years, and look, and I was going to uh make the point that it doesn’t really look so much that you, like you, have retired as such my, my brother calls it a faux retirement a faux. Yeah, that’s probably a good yeah, that’s probably a very good term to use yeah anyway, as long as you still enjoy it, why not?
Colby: 5:42
that’s right and that’s right yeah, and particularly brain active yes, yes, I can imagine myself writing, you know, until I can no longer write, I would in fact, I’m looking forward to retiring. I’ll probably do a faux retirement myself, in terms of I’ll retire from certain activities and free up a bit more time for reading and writing in the area.
Bruce: 6:06
Well, my job was at a regional comprehensive university we call them here, not a research university and so when you did research and writing, you had to find bits and pieces of time. So I find it quite a luxury to have a good deal of time to write. It’s been fun.
Colby: 6:26
Yeah, yeah. So, as I read out in your bio, your work activities until relatively recently were very much focused on teaching and training and you were interested in children’s curiosity and memory from a research point of view. But you have also had this longstanding connection to residential childcare, wondering if you’d tell us a little bit more about how that came about.
Bruce: 6:58
Well, my wife talked me into doing that. I didn’t really want to do it, but she had visited the Black Mountain home and at that time in 1989, the home was in a good deal of difficulty. Their leader had died unexpectedly. He had actually fallen back behind the times and really had needed to retire years before he died, and there were lots of problems and I didn’t really like what they were doing there. And so I went on the board and at that time met with other board members trying to find a way to gracefully close the place down. And it had become. It wasn’t serving very many children and it wasn’t, in my opinion, serving them very well. But instead of closing it down, we hired some effective leadership and that turned the place around.
Colby: 7:59
And that was, as you say, 35 years ago, in the early 1990s. Yeah, yeah, as you say, 35 in the early 1990s, yeah, yeah, what was it that you noticed?
Bruce: 8:12
where had it gone? Gone awry? From your perspective, I think, uh, they hadn’t kept up. Come up, uh, come along with new ideas about child care. They, they were still using almost a barracks kind of situation and they didn’t have cottages, they didn’t have enough house parents, the physical facilities had gotten old and dilapidated, they didn’t have a good education support. There were lots of things that needed to be fixed and they didn’t really have good relationships with the children’s families, and all of that needed to change.
Colby: 8:50
Well then, tell us a little bit about how that happened, how it came to be turned around.
Bruce: 8:57
Well, I think it’s almost always leadership, and we hired two leaders. It was a couple and the man had been involved in mental health he was a Presbyterian minister and he’d been involved in mental health and his wife was a child welfare lawyer and so they brought some skills that were really well applied in the child care situation well applied in the in the child care situation, and having having a lawyer around was quite useful in trying to help kids navigate the legal system.
Colby: 9:33
That oftentimes is pretty oppressive, and having that that kind of background really helped a lot and I was impressed to read that not only is Black Mountain these days a therapeutic residential child care facility, but it also has fostering activities associated with it. It has some endeavour around looking after young people who are entering adulthood who have been in out-of-home care, and also reconnection or strengthening connection with birth family.
Bruce: 10:13
Yeah, I think that what you see at Black Mountain is increasingly common with good programs. They often call it a continuum of care. I like to call it an array of services, because I don’t think continuum is an accurate description. But you know, children are complex. They’re as complex as they’ve ever been. Families are as complex as they’ve ever been, and so I think the programs need to have the flexibility to assess what’s going on with a kid or a family and then use whatever services are needed at that time, and you know that can change over time. It’s different for every child and family. Every child and family and we are at Black Mountain, like a lot of places, we’re dealing with kids who’ve had just awful experiences. I think the record that I know of was a young man at the age of 15 had been in 35 different placements, and if you think about what that does to your life, it’s just I mean educationally, socially, every way you can think of that’s insane.
Colby: 11:30
And so those are the kinds of situations we’re often dealing with arises that you see the young people with that level of well, that type of history, largely because of residential care being seen as an option of last resort, so that definitely has an impact.
Bruce: 11:58
So what? What has often happened to these young people is that they’ve been in foster situations that didn’t work, or even even, sometimes, adoption situations that didn’t work, or even, sometimes, adoption situations that didn’t work, and then they’re put in residential care and the pressure and this is not just true in the United States, it’s true all over the world there’s pressure to get the young person out of the residential care as fast as they can and oftentimes it just leads to another bad foster placement that doesn’t work and the kids suffer for it.
Colby: 12:33
So I guess what I wonder with what you’re saying is that sometimes children may even yo-yo in and out of residential care or between foster situations and residential care.
Bruce: 12:46
Some of the histories are amazing. I mean, you look at it and you say how can that happen to any child?
Colby: 12:52
Yeah, well, as it happens, I work therapeutically with children in the out-of-home care sector primarily, and I have a young person that I see at the moment who’s been through 50 5-0 placement that’s unbelievable, unbelievable yeah, yeah. So, um, the option of last resort, um, how does that sit with you?
Bruce: 13:24
Well, you know, I think the issue is a matter of finding a fit between a particular child, that child’s history and an environment that’s going to work for that child, and so the idea that you’ve got a hierarchy of placements makes no sense if you think in terms of fit, because there may be children the very first thing that would be best for them would be in residential care, and I’m not talking about being in residential care the rest of their lives.
Bruce: 13:57
Oftentimes, what they need is a period of time. It may be six months, it may be a year period of time. It may be six months, it may be a year, a year and a half, two years. It varies. And there’s another situation that is common and that is sibling groups.
Bruce: 14:11
And oftentimes sibling groups in the United States and I know other places get broken up because their foster families don’t want to take more than one child, and I think it’s a huge mistake to break up sibling groups when that may be the only part of their family that they’re still in touch with on a regular basis.
Colby: 14:33
Yeah, if you stop and think about it, and this is part of the problem, certainly in many jurisdictions, and what I’ve heard from many people talking on this podcast is that practice is dominated by a set of, I guess, principles or ideals or beliefs, indeed, one of those beliefs being the best place for children to grow up is in a family environment. The best place for children to grow up is in a family environment, and if that’s your paramount decision-making standard, then you get those sorts of situations where children are separated from their siblings, because if it’s a large sibling group, it’s very rare or difficult to find a family-based placement where they can all be together, and it comes with complexities when you do put siblings together as well that I think child welfare authorities often worry about.
Bruce: 15:43
Well, I think you’re right about the concept of family has, I think, been used in an unfortunate way, because sometimes what these kids need is a home. They need a place that is a home, and sometimes your biological family isn’t home, or at least it isn’t for a period of time.
Colby: 16:02
until it can become a home, you need another home yeah, yeah, I often and you made a very good point in there I I think the language we use is really important. I I strongly encourage child welfare authorities to um use the word, use the that’s not a word unless you make it one but use could not, instead of cannot be safely cared for at home. Because you see kids who tally up a huge number of placements over in their teens by the time they reach their teens and they’re still writing that the young person cannot be cared for at home, but no one’s really assessed that for years and years and and so much damage is being done in the meantime with, with, through failed placement endeavors. Uh, in family-based care.
Colby: 16:56
You see, black mountain is interesting for a number of reasons, not least of which is you have those, at least those four streams of endeavour that I talked about children’s residential care, the foster care, the transition from care and the family reconnection. I think. I mean it sounds like an absolutely ideal model service to me From your point of view view. You’ve talked about fitness and I think I think fitness is a a really key concept here, because fit in a struggling child welfare system, fitness goes out the window. They’re just looking for a bed, right, right, yeah, that’s right. But I also wonder about what your thoughts are about the relative standing of residential care alongside family-based foster care or adoptions, which you do in America.
Bruce: 18:02
Well, my view is that what we need are options because of the fit fit question, and I think residential care needs to be one of the options. I don’t think we need to pit different kinds of care against each other. I mean, you can find good and bad versions of every kind of care, and the question, the real question, is quality, the quality of the care, and it comes back to that every single time and, to a large degree, the question of quality is a question of building relationships, and one real problem with the last resort notion is that oftentimes the children are placed with the expectation they will not build relationships because they’re going to get yanked out soon, and that’s, I mean that that’s becomes a self-fulfilling prophecy if you, if you say, well, um, you know that here’s the, here’s the care of last resort. Therefore, don’t build relationships, and then in, in fact, it’s bad care, it’s bad care by circumstance, and you said you talked a little bit earlier.
Colby: 19:12
You mentioned that for some children it may be the first resort, the option of first resort, and this is something that is very much in my mind at the moment and I’ll just just just very quickly. The reason being is that my, my long-held view or observation of children, young people, who find their way into out-of-home care, the trauma that they’ve experienced is relational trauma. It’s happened at the home, it’s happened, you know, with their parents and they come into care with. Well, I would say it’s uh for people, because people don’t easily think of it in this way. I would say it’s akin to a phobia, where the phobic object is there is a relationship, is relationship or relational connection.
Colby: 20:03
Now it’s, I would say it’s more than akin to a phobia. It is a phobia and that phobia has, you know, probably relative degrees of difficulty for the young people, a challenge for the young people and there are, there are probably young people, there are undoubtedly young people who come into care that perhaps the worst place to put them is in the family environment, where they’re really challenged by relational closeness and the expectations of the adults in those environments. And again, I think that comes back to what you were saying about fitness. I wonder have you got any comment you’d like to make about that?
Bruce: 20:48
Well, you know, I think something that goes with that is that we often think in terms of these children who’ve had traumatic experiences in their families, all in terms of parent-child attachment.Bruce: 21:04
But as kids get older, it’s their peer group that’s increasingly important.
Bruce: 21:09
And unfortunately, there has been a mythology that’s built around the idea that if you put kids in residential care, they’re just around other troubled kids and that’s just more trouble, when in fact I don’t think the research supports that.
Bruce: 21:24
And I think that if you have high quality care, as kids get older certainly when they’re by the time they’re 12 or 13, their peers are becoming increasingly important and that peer group can be a powerful form of relationship and, under the guidance of sensitive adults, that can be an important part of their therapy. And the idea that you’ve always got to go back to the infant-child attachment model I think is a mistake. Now, the infant-child attachment model works in the sense that every social relationship is about kids sending off signals and needing to get sensitive responses back from those they send the signals to, but it doesn’t have to be a parent and it doesn’t even have to be an adult yes, in fact, um children will continue to make relationships that we would we would refer to as attachment relationships throughout their throughout their growing years and even as adults as well.
Bruce: 22:30
And I don’t want to, you know, put down the parent-child relationship, because I mean, if it had worked in the first place, the kids would have been a lot better off. But the other thing I know is I’ve rarely met a child who wouldn’t go back to their family if they possibly could. I mean that that that is fundamental, and even when they’ve been mistreated, and even when they know it’s not a good situation in their heads, they would love to be able to go back to that. And so I don’t want to suggest that’s not an important relationship.
Colby: 23:05
it is yeah, and I think it’s something that it should be aspirational in terms of our endeavors, that we, we, we do endeavor to try and return them, and part of the part of my reasoning around this is that children form multiple attachment relationships, but their overall attachment style is a is influenced by all of those relationships.
Colby: 23:31
So one of the reasons why placements, foster placements break down, not least of which is that the children are challenged, potentially overwhelmed, by the expectation of the foster carer around relational closeness, is that they’re carrying around all this attachment baggage for want of a better term from their relationships with their parents and that impacts their capacity to form a new attachment form, an attachment to their current carers, and also it impacts their overall attachment style and those two things interplay with each other.
Colby: 24:12
So you know, I call it the secure ideal. Child protection authorities seem to be relentless in trying to pursue this idea of attachment security, but in the process they often neglect these historical relationships or they may still be contemporary, but they may also be unrepaired, and those relationships do hamper our efforts, I think significantly, to achieve an outcome where children and young people approach life in a well-adjusted way, well, cognitive psychologists would call it mental models or schemas, and that’s how we interpret our worlds, and these kids often have mental models that are distorted in important ways, and partly what therapy is about is working on those mental models and providing new models.
Bruce: 25:09
And uh, and you can’t provide new models.
Colby: 25:12
If kids are changing situations over and over and over again, they, they never get a chance to form them yeah, yeah, and if they’re just putting transference into all of those, there’s a lot of transference going on into all of those new relationships and too often unhelpful counter transference. But one other thing I think you touched on. I just wanted to ask you, before we move on, do you think that residential care, children’s residential care, could be an option of first resort, and under what circumstances do you think Well, I think there are a couple of situations residential care, children’s residential care, could be an option of first resort, and under what circumstances do you think?
Bruce: 25:50
Well, I think there are a couple of situations. You know. If in fact there’s a good chance of going back to the family of origin, residential care is kind of a neutral place to go compared to having to get a brand new family and starting all over again. And residential care under those circumstances might be the best place for kids to be while their family’s getting their act together.
Bruce: 26:17
And so I think that’s one. Another one is the sibling situation, and at Black Mountain I’ve seen situations where we’ve taken in three or four kids at a time and they, for those kids, those sibling relationships, are the most important relationships in their lives, and so that that, I think, is sometimes a good reason to put children in a residential care as a first resort. There may have, you know, there are also, I think, red flags. There are red flags in some kids especially, you know, adolescent, young adolescents, where it’s clear that they don’t want another family and that you’re really putting not only them at risk but the poor foster family at risk. The evidence is that we lose foster care families at a rapid rate and I think it’s oftentimes because of that insensitivity about the nature of that child. And you know, I feel for social workers, social workers around the world they’re too young, they’re too inexperienced, they don’t last think, I think they’re in incredibly difficult situations.
Colby: 27:29
But I think we’ve created some of that difficulty by doing things like saying um, well, residential care is last resort yeah, when indeed it as we’re talking, I mean we’re highlighting some of the, you know, the manifest strengths of residential care, and I know from reading some of the you know the manifest strengths of residential care and I know from reading some of your writing you’ve talked about stability and resources as strengths Wonder if you might tell us a little bit of your thoughts about that.
Bruce: 28:02
Well, you know, this gets complicated because it’s related to what I think has been the stereotype of residential care that has kind of ruled the literature over the last 30 or 40 years. And I think that what they look at is they say that residential care is inherently unstable because the caregivers are coming and going Well in high quality care. That’s not true. In high quality care, where you’re compensating your house parents, for example, well and you’re making their jobs doable and attractive, then you can get long-term stability in relationships. So I think that stereotype has worked against it. If, in fact, the residential care is not providing stability, it is not high quality by definition. It’s not able to provide high quality care Resources.
Bruce: 29:07
I think the most important resource we’ve talked about relationships and those are the most important resources. But I think also there are resources like specific forms of therapy for some kids with particular traumas, but also just basic things like education. One of the things that happens to these young people who’ve been through dozens of placements is they’ve not only changed families, they’ve changed schools, they’ve changed neighborhoods, they’ve changed playgrounds. They with the same group of children and adults is just. For some of them that’s the first time that’s ever happened to them in their lives.
Colby: 29:54
Yeah, yeah, I think you speak compellingly about these aspects of residential care that are strengths and often overlook strengths.
Bruce: 30:07
You’d have to say when the dominant, when the dominant view is that residential care is is the lowest standard of care and the option of last resort well, even related to to foster care, one of the one of the advantages we have at Black Mountain is we we have a campus and we have resources there, and one of the advantages we have at Black Mountain is we have a campus and we have resources there, and one of the things we can do for foster parents is provide them with resources. And one reason that foster care places don’t make it is because the foster parents don’t get enough support. So we’re careful about identifying the parents in the first place, but then we also support them. It may be if it’s very young children.
Bruce: 30:51
it may be something as simple as diapers, providing them with diapers, which are very expensive, or it foster children that they wouldn’t have otherwise, and now they’re getting some of the same experiences as the residential kids are getting and we can also work with them in terms of things like educational planning, vocational planning, and that really helps those foster parents.
Colby: 31:26
Yeah, and what you’re describing is a is a community, a therapeutic community that’s right, that’s right. Yes, that’s that’s right, and you know a lot of, I guess, even just from my own jurisdiction, where I’m most familiar a lot of these things that that we’re talking about just don’t exist in residential care yeah, that’s right, that’s right and so residential. I want to get on to talking a little bit about the research in a moment, but it’s probably worth mentioning beforehand that residential care is a heterogeneous group, just as families are.
Bruce: 32:02
That’s right and worldwide it’s incredibly heterogeneous and some of it’s good and some of it’s bad, and I will say that I have tended to focus on private residential care. I am not in the sense that I’m not sure for profit residential care. I don’t know how you can make a profit in this business. I don’t know how you do it and make a profit, and I haven’t looked closely at for-profit care. I read the newspaper too, and I read the stories about a lot of problems in for-profit residential care, but I just don’t, unless your government is supporting it well or you’re a private, uh organization that has extra support from, from donors. I don’t know how you do it, yeah it’s definitely an.
Colby: 32:59
What we’re talking about is expensive care or at least someone taught me the task about this about whether you call it extensive, sorry, expensive or high cost, though, and no, he was arguing that it’s high. When it’s done well, it’s high cost, expensive kind of has connotations of not being really value for money, but just for image, I guess.
Bruce: 33:26
But yeah, I think the key, key word is value. Uh, I mean, it’s a question of values. Uh, you know, the united states spends billions and billions of dollars on aircraft carriers that float around the the world and in the sea. Uh, we spend enormous amounts of money on betting, on sports activities and lottos and so forth. And it’s a question of you know, where are you putting your money? I don’t think residential care should be the norm for kids who need care. I think it’s going to be relatively rare, but it needs to be one of the options.
Colby: 34:10
And I guess when you say the norm, are you saying that children? Probably it’s not the best place for children to grow to independence so that they spend all their time in care, in residential care.
Bruce: 34:25
Well, again, it depends on the child and the environment, and when we get new youth, when they’re 14 or 15, it may, in fact, be the best place for them to grow to independence. Because we can, we can provide the support in terms of training and support. You know, for years and years in many states in the United States, when a child turned 18 in foster care was basically by it’s been nice knowing you, and for most 18 year olds, the idea that you’re going out on your own without any support, I mean could you have done it? Could I have done it? I mean I can’t imagine it and so that idea was just crazy. So I think the changes in recent years to provide more support for older kids it may be a 15 year old. They need to stay in residential care until they get the skills to be independent. But yes, certainly there are situations where it’s going to be a lot cheaper, more effective, to find a forever home for children, whether it be a really good foster situation that’s going to remain stable or adoption.
Bruce: 35:37
Now I have concerns about adoption. In the United States. We’ve had a tendency to rush to adoption in too many cases and I don’t like the idea that families of origin can be cut off quickly. That shouldn’t happen. If they need to get their act together in order for their child to come back to their house, give them some time for it, because one of the naive aspects of some of the changes that occurred in the last decade was the idea that you can fix families real quick and then send the kids home. I mean that I don’t know who told them that could happen as a psychologist.
Bruce: 36:17
That’s crazy to me yeah, yeah.
Colby: 36:21
So so the issue with residential care, or the I guess the point sorry that we’re that is being made is that, um, there, there needs to be an ongoing, perhaps, assessment of what is the best care arrangement for this person. So, um, so that that can happen at the beginning when children come into care. And what I’m hearing you say is that there shouldn’t be a distinction in relative status between residential care and a family-based care environment. They’re just all part of the care options and they have equal standing and merit because they cater to children who have different needs, the variability of needs, and then, as a child travels through the remaining years of their growing up, their childhood, there can be a continuing assessment of fitness and what is, what is the best placement environment for them. And we need residential care to have the same standing as an option as, uh, as those family-based options.
Bruce: 37:44
That’s what what I’m, I guess, to summarize, yeah the last resort notion came from a belief that residential care was inherently bad for children, and what got me going on and looking at the research was that a law that was passed in the United States in 2018 that said that no federal funds could be used for residential care. And I was the chair of the board of directors at Black Mountain at that time and a reporter called me up and said you know, you’re going to lose significant amount of money here. What are you going to do about it? Now, black Mountain is a faith-based organization and I said we’re a faith-based organization. We’ve been working with kids for a long time. We’re going to find a way to work with these kids and meet their needs.
Bruce: 38:39
Well, I got attacked immediately by a lobbyist in Washington DC who said you people who are spreading this notion about good residential care, that’s phony and I’ve got the research to support it. And he argued that he had three pages of citations of studies that showed that residential care was inherently bad for kids. Well, there I was, a child psychologist and somebody with research background and research methodology and I thought, well, I’m going to take a look at those citations. And that got me in looking at the whole literature. Now it turned out that those three pages of citations didn’t have a single one that supported what he was saying, but it got me into that literature to look at what actually was going on I’m going to come to that in a moment.
Colby: 39:36
But what I would say I mean we, because we’re going to have people who listen to this podcast. Perhaps. Perhaps we’ll get a lot of people who listen who are kind of thinking similarly, but we’re going to have a proportion of people who think that this is nuts. You know, talking positively about residential care. And there is and I know I’ve had, I’ve put, I remember a post I put up about residential care some time ago on LinkedIn and I didn’t get any comments, but one where the person who commented basically said that residential care was basically a repository for adults who engage unlawfully with young people, and they weren’t as vague about it as I just was.
Colby: 40:32
But I think to those people, to those people who are concerned about residential care, I would say that my understanding of what we’re talking about, the message is this that in some instances and for some children, residential care is not a good option. So, in some instances, because residential care is not always the same and there are residential care programs or facilities that do not meet the needs of the children and young people and for other children and young people, that’s not what they need at this time. They need to be, they’re ready and they need to be in a caring family option, or they need to go home to their parents a parent or parents? Yeah, I think so, and I think, think so. It’s a good time to go to the next part of our conversation with the. What does the research actually say about children’s residential care, including in comparison to other care options in out-of-home care?
Bruce: 41:50
Well, you know, I think I started off the book with an early chapter on research methodology, because I think you need to think carefully about this research.
Bruce: 42:03
It’s a messy area and there’s some things that we can’t know, and I think it’s important to keep that in mind.
Bruce: 42:12
I do not think there’s any way to prove that residential care is inherently bad or that it’s good, because of what you were talking about earlier the range of different things we’re talking about, and so definitional issues are really important and I’ll just say up front that I think there’s certain forms of residential care that seem to have consistently been poor, and that’s correctional juvenile justice forms of residential care that seem to have consistently been poor, and that’s that’s correctional, juvenile justice forms of residential care, and I think that’s because they rarely, if ever, use a developmental model, they never really understand the way kids work, and so that all over the world you know juvenile justice interventions in residential care have not worked.
Bruce: 43:03
Now I think that when you look at the research that says residential care is inherently bad, a problem with making that statement is all you have to do is find one, one residential care situation that isn’t bad and then that blows the inherent out of the water, it’s not by its nature, it’s, again, the quality of the care. So, anyway, when I started looking at the literature, it became clear to me that there’s a handful of studies, research studies that have had an enormous impact on the view of residential care, and the single most important one is the study of the so-called Romanian orphans who by?
Bruce: 43:47
the way were not orphans at all. But that study, the Bucharest Early Intervention Project, has just dominated all the talk about residential care for almost 30 years now.
Bruce: 44:06
And it appears over and over and over in the statement, and that was a situation where there was lots of money for research and American researchers, including good researchers from Harvard University, were involved in the research. They’ve published dozens and dozens of journal articles out of it and indeed the care that was given in Bucharest was horrible care and it should never be repeated. But what’s happened is that that research has been generalized. It was, it was research on infants and very young children, and yet it has been generalized to all forms of residential care, for all kinds of different kinds of residential care, for kids of all different ages and backgrounds, and that’s a. That’s a research. No, no ages and backgrounds. And that’s a research? No-no, you don’t generalize from one kind of research to completely different situations, different majors, different kids. I mean it’s just amazing to me that it has been applied so naively. And there are a handful of other studies that have the same problems, have the same problems. There was one that was funded by the Annie Casey Foundation that basically looked for kids or adults who had grown up in bad residential care and interviewed them and said residential care is terrible. I mean it just frankly. It’s researchers not following their own rules.
Bruce: 45:45
Now, on the other hand, I think there’s evidence that it’s not proof. It can’t be proof, but I think there’s strong evidence that good residential care has positive effects. And some of it is just simple survey research, which tends to be. You know, researchers tend to look down their nose at survey research. But if you ask a large number of alumni of residential care about their experiences and they tell you they had good experiences and they never would have preferred foster care, you got to give some attention to that. If you look at simple pre-post studies, kids come in and you look at them when they come in, you look at them when they leave and they get better consistently. Now, that’s not going to prove that it was the program that made them better, but it all suggests that it’s not making them worse. That’s not going to prove that it was the program that made them better, but it all suggests that it’s not making them worse. It’s not.
Bruce: 46:46
So I you know what I did in the book was to was to kind of look at both sides and I looked very critically at both sides and I and I and there is no perfect research. There’s not going to be perfect research, but the evidence is that if you do it well, kids thrive, they do grow. And then in the book I focused on two very different models of residential care the teaching family model, which has behaviorist roots and a lot of people I work with don’t like behaviorist roots but I don’t think the actual application of the behavioral psychology and the teaching family model has been. It’s not Watsonian or Skinnerian, they found out very, very early relationships mattered and that family systems model I think works well.
Bruce: 47:44
And the other is the care model. And, uh, the care model is the out of cornell, out of the uh, uri bronford brother center, and the care model is what fit, uh, what we were doing at black mountain, and so, uh, we adopted that and became one of the care model programs and I think they do a wonderful job. I think they have a very sophisticated theory that combines James Anglin’s work, attachment theory, vygotsky’s work, and they do it in a very sophisticated way and I think that it’s had a power, powerful, positive effect on residential care all around the world, including in australia.
Colby: 48:26
Yeah, yeah, what you were saying there put me in in mind very recent guests, which was, uh, dr laura stickley, who, um you, you would, you would know, who in fact put us together in contact with each other.
Colby: 48:44
And, yeah, she talked about exactly the same thing that when you interview alumni of residential care, more often than not they’ll say that they have a positive opinion of it, and even if they’ve also been in foster care, they’ll report comparatively more positively about their residential care experiences.
Colby: 49:08
It would have to be said, though, that that data may be influenced by the circumstances in which they left foster care and went into residential care, and I think this is it’s that, it’s that level of and I think this is probably what you were, you, you have were saying about just be aware of basic research methodology, and and you had that early in your, you have that early in your book which is that we, we, we need to, to be, we need to be able to critically appraise the research. That um and not not everyone can do that, and that’s why I guess it it’s helpful to have people like you who can do that. To spell it out, um for people, but, um, you know even just what, what I just said, that you’ve got to, you know, understand the circumstance, or turn your mind to the circumstances under which a child might have left foster care to go into residential care, or young person.
Bruce: 50:08
Yeah, you’re really not talking about discrete effects. You’re not talking about what we would call discrete, independent variables. You’re talking about packages. It’s much like studying cultural differences when you’re comparing kids from one culture to another culture. You can’t identify something discrete about those two cultures because you’re dealing with packages. And that’s certainly the case in terms of residential care. And the other thing I think you have to be careful about is the quality issue, because that’s what comes back over and over again is as more important than the site of the care is the quality of the care, and kids can have bad care in every single different situation, and what we need to do is make sure you’re assessing that quality of care is. Make sure you’re assessing that quality of care.
Colby: 51:02
Yeah, yeah, you’ve mentioned your book a number of times. You’ve mentioned I don’t mean that in a bad way, but you’ve mentioned it. It’s one of the reasons why I was really keen to speak to you. What can people expect to get out of reading uh, access and reading the book, and how? How do you think it would influence practice in this space?
Bruce: 51:30
uh, you know I I did not push the book for the first year and a half because the hardback version was ridiculously expensive.
Bruce: 51:38
So I didn’t suggest anybody buy it, and so now it’s in paperback and you can buy it on sale sometimes and it’s more reasonably priced. But I think some of the other things I’ve written in journal articles would get the message across, and I often just give references to open access articles because they can get the basics. James Anglin, who has had a big influence on me, and anybody who knows residential care knows James’ name, and James said that the main purpose for my book should be that anybody writing a grant proposal to get support for residential care should put it in the appendix, and that’s basically why I wrote it. I wrote it because I felt like those who do residential care, those who see it as having a positive impact, were getting a bad press and I wanted to clear that up. And so you know, I think the major purpose of the book was to make that point. Now I do think that and this happened to me when I talked I was giving in Calgary, canada, last year a young woman came up to me and had actually bought the expensive hardback and she said that she she had, she was running a program there in Canada and she said what she had picked up from the book and which I was delighted to hear, was a better idea about what quality care is, and I think if people can can read that book and take that away.
Bruce: 53:21
I’m delighted because I think that’s such an important issue. It is the issue, the issue of providing quality care, and I think the reason you know, I don’t think there’s a mystery here. I think the research shows what high quality care is. It’s a matter of picking the people who are going to provide it carefully. It’s a matter of training them carefully, it’s a matter of supporting them carefully, providing the resources they need and the kids need, and then providing that stability. And I think that if you do that, you can provide quality care. Now it’s easy to provide bad quality care. There’s so many different ways of doing it and you do have to go into it. I think, thinking that this is an expensive form of care. And I say in the book, in the conclusion of the book, one of my conclusions is that residential care is expensive and it should be. We owe it to these kids. Society has not supported these kids well up to now and we’re going to pay for it and we should pay for it.
Colby: 54:30
I think that’s a really good point and it puts me in mind of an earlier guest who came into residential care from economics and who was very interested in human capital, the notions of human capital Graham Kerridge was his name, if you wanted to look back and I think that residential care done well, I think that residential care done well, just as is the case with other forms of out-of-home care, is an investment not only in the future of that young person, but their children and their children’s children. That’s right, and I do think that when you view residential care as an option of last resort, I wonder whether you know, like I wonder, whether a certain amount of that argument comes from the funders. Because of the cost yes, because of the cost they don’t want kids to be in residential care.
Bruce: 55:37
It’s bad for them, which also confounded with with the fact that it is also expensive yeah, there’s no question about that, that that happens, and and I think that, um, one of the reasons they get legislators on board for, uh, pulling the support from residential care is exactly that. And they said you know, it’s cheaper to keep kids in families. Well, no kidding. But the question is what’s the long term impact and what’s it going to cost society in the long term if we’re not careful? One of the things that’s happened because of the last resort thinking is that and the lack of foster care placements is there’s some strong stress on keeping kids in their families of origin, sometimes to the point where that’s dangerous.
Bruce: 56:34
And they’re doing it in situations where that’s dangerous. So there’s a writer, Naomi Riley, who writes about this regularly and what she’s pointed out is that when you increase the number of kids who are going back to their families of origin, abuse and deaths go up. Yeah.
Colby: 56:54
Well, that’s sobering.
Colby: 56:57
As a practitioner myself for 30 years working in child protection and related endeavor, one of the one of the the challenges that practitioners like me have is is that the state is a is a relatively poor carer and it’s a bit of a case of out of the frying pan into the fire for a lot of our young people, unfortunately, and I think you know, our legislators and our services have got a big job ahead of them to address the quality this, the quality of, of all forms of out of home care I mean state care, or the care if you’re in the care of the state. That should be a haven, that should be a sanctuary for the children that should be a safe place to grow up and too often we owe that to them yeah, yeah, have you ever said
Bruce: 57:58
that no, you go well, I, I think you know the foster, foster parent situation is we we don’t give, typically, we do not give nearly enough support to foster parents. Um and and if, if you’re serious about making uh, foster care work, we’ve got to do a better job of supporting foster parents.
Colby: 58:19
Yeah yeah, yeah, bruce, it looks like the sun’s going down where you are, the it’s getting darker and darker. It’s getting dark. You’re right. I don’t know if you wanted to pause for a moment and put a light on I can put, I can put a light on does that help? That’s different. We’ll wait for that. There you go.
Bruce: 58:45
Now the camera is focusing in on you again well, I I was going to do this outside on my, on my deck, overlooking the mountains, but, uh, they were predicting, uh, um, thunderstorms, so I I decided to go inside.
Colby: 58:57
I I well, we talked last time. You, I think you were out on the deck.
Bruce: 59:02
Oh was I.
Colby: 59:02
Yeah, there were thunderstorms predicted then too. You were in a very stormy place, it seems. Yes, yeah, I can predict that, on the basis of N equals 2. Both times I’ve spoken to you.
Bruce: 59:13
Well, we live in what’s known as a temperate rainforest.
Colby: 59:18
Yes.
Bruce: 59:18
And we are in the wettest portion of the United States east of the Mississippi.
Colby: 59:24
Wow, yeah, yeah, well, there you go. Well, there you go. I mean, my prediction was true based on a sample there you go. Sometimes it works. Bruce, if you were sitting down in front of legislators, what would you say to them about residential care?
Bruce: 59:42
in a nutshell, Well, we’ve talked about some of the things I would say to them. In fact, I have written to to as a written witness, to a number of of legislative groups and what I, what I say, is good residential care needs to be available and it needs to be an option, and not an option of last resort, but an option that takes into consideration the child’s needs. And one of the problems we’ve had in the United States and I’ve told legislators this over and over again they use the term family first and I think that’s wrong. I think the Danes have it correct. In Denmark, they don’t say family first, they say children first.
Colby: 1:00:32
And.
Bruce: 1:00:32
I think that’s the attitude that we need to take, and so what we need to do to have children thrive. They’re the ones that don’t have the power, they’re the ones that don’t have the voice, they’re the ones that get pushed around, and when you say family first, and what you really mean is parents, adults first, that’s not a good approach.
Colby: 1:00:55
No, no, yeah, finally, I’ve asked you a lot of questions, bruce. Was there anything that you’d like to ask me before we wrap up?
Bruce: 1:01:06
yeah, um, um. Australia was a place a few years ago that said we’re going to do away with all residential care. That’s the dream, and the dream’s been realized, and then things seem to have turned around pretty quickly. What’s your take on what happened?
Colby: 1:01:27
Well, I can’t really speak authoritatively for what’s happened in other states of South Australia. I’m in South Australia. We had what’s called a Royal Commission in our political environment, which is based on the British one, a Royal Commission and I’m probably not going to give a great description of it, but it’s like a very high level judicial inquiry into an issue. It’s called by the government of the day, it tends to take a period of time and it’s an investigation of an issue of great importance to the body politic, and then recommendations are made and it’s usually around things that have gone wrong. We had one in relation to child protection systems and an outcome of that was that, well, one of the things that flowed on from that was there was this idea reinforced that residential care is inherently bad, excuse me. And so we did have congregate residential care units. They’ve been closed down. Residential care units they’ve been closed down. I think almost all of them have been closed down, at least the state-run ones.
Colby: 1:02:48
And there was pressure in the last few years to move children out of residential care arrangements and, in particular, temporary residential care arrangements, which they were referred to as emergency care.
Colby: 1:03:05
And there remains this um, this idea that that residential care is bad and and that we should have all children out of residential care. And indeed our minister, or her staff has, has, you know, talks in posts on social media about we funded this program or that program and we saved children from residential care. I can’t quote you the figures, but residential care hasn’t gone away, and though the state or the government-run child protection agency tried to divest itself of residential care to independent providers, they have ended up having to maintain their own residential care program. I don’t know if it’s expanding or static. I don’t know if it’s expanding or static, I just know that it’s not been successfully gotten rid of. And I think you won’t. You won’t, and I think there’s very good reasons, as we’ve outlined in this conversation, for why residential care needs to be part of the picture. So it’s almost like the tail wagging the dog, in a way.
Bruce: 1:04:23
Yeah, yeah.
Colby: 1:04:28
The need is right in front of people’s faces. There needs to be this option. You can’t get rid of it. What you, rather, should be focused on is how do you make it better? How do you improve?
Bruce: 1:04:44
it. Quality is the issue. Quality of care is what it’s all about. I know that the people at Cornell in the care model have spent a lot of time in Australia and a lot of Australian programs have adopted the care model and I think that’s a real positive outcome because I think if you really do take the care model seriously, you can provide high quality care. Yeah, yeah.
Colby: 1:05:22
Well, Bruce, it’s been a real privilege to be able to have tracked you down and had this conversation.
Bruce: 1:05:27
Well, I have a low social media presence and that’s intentional, but I’m not hiding from anybody I know.
Colby: 1:05:34
But look to be honest. Last weekend it’s Father’s Day here tomorrow, tomorrow, sunday’s Father’s Day here tomorrow. Tomorrow, sunday, it’s Friday here, but one of my sons is going away tomorrow. So we celebrated. Last weekend. I barely picked up my phone and looked at social media and, gee, it was nice to do that. But thank you for taking the time to speak with us.
Bruce: 1:06:00
I’ve enjoyed talking with you. It’s been a fun conversation, awesome, thank you.
