Residential care for young people in Sweden : homes, staff and residents

Abstract

This thesis studies residential care for young persons (13-18 years of age) with emotional and behavioural problems. An overall aim is to examine and describe different aspects of residential care. The thesis consists of five papers based on two different studies. Papers I and II use data from a survey of residential care for young persons in Sweden. Papers III, IV and V use data from a research study concerning a single treatment home. In Paper I different settings in residential care in Sweden are compared according to the problems of the youths in care, the mean length of stay in care, staff characteristics and aspects of the care and treatment provided. In Paper II different approaches to residential care are identified and related to characteristics of the home, the staff and the type of care. Paper III explores careworkers’ perceptions of treatment. Paper IV explores adolescents’ experiences of living in residential care. Paper V illustrates and illuminates how relationships between careworkers and young persons in residential care can be perceived. It was found in Paper I that institutions run by the public sector have better educated staff and a higher staff-resident ratio than privately run institutions. Despite this, they were more restrictive in their intake and had youths with fewer problems, especially delinquency and other antisocial behaviours. In Paper II it was possible to identify five different approaches to care and treatment. These approaches did not exclude each other but were agreed with to different extents by different homes. The approaches were found to be related to the variety within residential care. In Paper III six different intentions in the care delivered could be identified. The distribution of each careworker’s statements created a pattern that illustrated the careworkers’ general treatment perceptions. This pattern made it possible to study and compare different careworkers’ perceptions of treatment. Paper IV shows that living in the same institution during the same time period does not mean sharing the same experiences. In retrospect, the experiences of the six young persons were very different from each other. Three of them, the girls, expressed great discontent with the stay. The three boys were more positive. Paper V shows that relational factors can play a great part in how young persons experience their stay in a residential institution. The mutual trust between the young person and the careworker can be an important foundation for the treatment process. Likewise, difficulties in the relationship between the young person and the careworker can contribute to mistrust and dropout from care. In conclusion, diversity in residential care was found on multiple levels in the studies in this thesis: on the individual level, the interactional level, and on contextual levels such as settings and approaches to treatment. It was also found that some of these differences, for example careworkers’ perception of treatment and institutions’ approaches to treatment, are not only possible to describe but also to “measure”. Key words: Residential care institutions, youth, staff, settings, approaches to treatment, experiences in care