Quality care in therapeutic residential programs: definition, evidence for effectiveness, and quality standards

There are three recent developments in the field of therapeutic residential care (TRC) which provide a major leap forward for new policy and practice directions. These developments further promote TRC as an essential component in the system of care for youth services. First, an international consensus statement provides a definition on what are key elements for the TRC level for the first time. Second, research reviews documenting the effectiveness of TRC practices and models provide a clear base for determining current program quality and establishing future research, program development, and policy directions. Third a public/private partnership involving providers, lead agencies, research leaders and state agencies is establishing new quality standards for out-of-home care in Florida. These standards draw on both the consensus statement and the TRC empirical base and seek to elevate the quality of individual TRC programs as well as out-of-home care statewide. We provide the experience of one agency, which is a national provider of TRC using a model of care with promising research evidence, to suggest that these three developments give practitioners, policy makers, and researchers a fresh perspective on how to fit TRC programs into an integrated continuum of care.