Impacts on Children and Young People of Long-Term Placement in Residential Care
Long-term residential care can provide stability, therapeutic structure, and safety for children who cannot live in family-based placements. At the same time, it can carry developmental, relational, and psychological risks if not designed and delivered well. Below is a balanced, evidence-aligned summary.
1. Relational Development and Attachment
Potential Benefits
- Consistent, predictable care teams can give young people a sense of felt safety.
- Therapeutic residential models (e.g., Sanctuary, CARE) can help children build relational skills.
Potential Risks
- High staff turnover disrupts children’s ability to form secure, enduring relationships.
- Multiple adults working shifts can produce a sense of “professionalised care” rather than family-like belonging.
- Young people may develop resistant or pseudo-independent strategies, masking relational needs.
2. Emotional and Psychological Functioning
Potential Benefits
- Access to on-site therapeutic support can reduce behavioural crises and improve emotion regulation.
- Some young people report relief at being in a structured, calm environment after chaotic home or placement histories.
Potential Risks
- Increased risk of institutionalisation, where routines limit autonomy or suppress age-appropriate decision-making.
- Residential settings can amplify trauma-related behaviours, especially without trauma-informed practice.
- Higher prevalence of mental health difficulties, including self-harm, anxiety, and complex trauma symptoms.
3. Social Development and Identity
Potential Benefits
- Peer group experiences can foster belonging, normalise shared experiences, and build social confidence.
- Exposure to pro-social adults (youth workers, educators, clinicians) provides broader modelling.
Potential Risks
- Peer contagion effects: exposure to other young people with high-risk behaviours can escalate vulnerabilities.
- Stigma (“kids from a home”) may shape identity, self-esteem, and expectations for the future.
- Lack of community integration can result in restricted social networks or poor social capital.
4. Education and Cognitive Development
Potential Benefits
- On-site or linked educational support teams can improve attendance and engagement.
- Structured daily routines can help re-establish learning habits.
Potential Risks
- Placement instability within or between residential units disrupts schooling.
- Some residential environments respond to behavioural crises in ways that interfere with learning.
- Young people may be excluded more readily from mainstream education.
5. Health and Safety
Benefits
- Better access to multidisciplinary health services.
- Monitoring of medication, sleep, diet, and risk can improve overall wellbeing.
Risks
- Children in residential care are disproportionately exposed to exploitation, absconding, criminalisation, or online risks, especially in under-resourced units.
- Restrictive practices—if used excessively—can contribute to trauma and distress.
6. Life Skills and Transition to Adulthood
Benefits
- Some units deliver structured independent-living programs that build readiness for adulthood.
Risks
- Over-reliance on staff and systems can undermine autonomy.
- Young people who leave residential care often have poorer outcomes in housing stability, employment, and social support, compared with those leaving family-based care.
7. Cultural, Community, and Family Connection
Benefits
- Good residential programs maintain strong connections to family, culture, and country (for Aboriginal and Torres Strait Islander children in particular).
Risks
- Distance from family or community can weaken identity development.
- Poorly managed contact arrangements can increase distress, behavioural escalation, or emotional withdrawal.
Key Take-Home Messages for Practice
- Long-term residential care can be stabilising or harmful—the difference lies in the model, staffing, culture, and relational environment.
- The most protective factors are consistency, relational warmth, trauma-informed care, low turnover, strong community connections, and meaningful participation for young people.
- The greatest risks come from institutionalised routines, lack of autonomy, weak relationships, and exposure to peers with high-risk behaviours.
- Long-term residential care should always be accompanied by intentional planning, the smallest possible group size, and strong wraparound therapeutic support.
Practice Note: Impacts of Long-Term Residential Care on Children and Young People
Purpose:
To guide practitioners in understanding the developmental, relational and wellbeing impacts of long-term placement in residential care, and to support informed, child-centred practice.
1. Relational and Attachment Impacts
- Long-term residential care can provide predictable structure and a sense of safety.
- Stability is strengthened by consistent staffing, low turnover, and strong relational practice.
- Shifts, rosters and multiple caregivers can make it harder for young people to form secure, enduring attachments.
- Children may develop pseudo-independence, avoiding dependence on adults due to past relational trauma.
Practice considerations: Prioritise continuity of key workers; maintain warm, attuned, reliable relationships; support young people to express relational needs safely.
2. Emotional and Psychological Wellbeing
- Therapeutic care environments can help with emotion regulation, trauma recovery and reducing crises.
- Without trauma-informed routines, residential settings can heighten distress, behaviour escalation or internalising symptoms.
- Institutional routines may limit autonomy and contribute to a sense of powerlessness.
Practice considerations: Use trauma-informed approaches; offer voice and choice; support emotional literacy; ensure therapeutic services are accessible and integrated.
3. Social Development and Identity
- Positive peer relationships and group living can build social confidence and normalise shared experiences.
- Peer contagion is a risk, especially where young people influence one another’s unsafe behaviours.
- Stigma related to being “in care” can shape identity and limit self-belief.
Practice considerations: Support healthy peer dynamics; promote community participation; challenge stigma; build identity-safe environments.
4. Education and Cognitive Development
- Residential care can improve school engagement when routines are structured and supportive.
- Placement moves or behavioural crises can disrupt learning.
- Greater risk of exclusion from mainstream schooling.
Practice considerations: Prioritise educational stability; collaborate closely with schools; use education plans aligned with the young person’s goals.
5. Health, Safety and Risk
- Access to multidisciplinary support can strengthen overall wellbeing.
- Young people in residential care remain at increased risk of exploitation, absconding and criminalisation.
- Overuse of restrictive practices contributes to trauma.
Practice considerations: Maintain strong safeguarding frameworks; minimise restrictive interventions; focus on relational de-escalation and restorative approaches.
6. Transition to Adulthood
- Structured independence programs can prepare young people for adulthood.
- Some young people leave care with limited social networks, employment opportunities or stable housing.
Practice considerations: Build practical skills early; connect young people with mentors and community supports; ensure transitions are planned, gradual and relationally anchored.
7. Family, Culture and Community Connection
- Maintaining connection to family, culture and Country is protective for identity and wellbeing.
- Distance from family or poorly managed contact can increase distress.
Practice considerations: Support safe, meaningful family contact; strengthen cultural belonging; uphold the Aboriginal and Torres Strait Islander Child Placement Principle.
Key Message for Practice
Long-term residential care can either support healing or reinforce harm. The difference lies in consistency, relational warmth, low staff turnover, trauma-informed practice, community connection, and meaningful participation by young people in decisions affecting their lives.