The Care Trajectories and Nature of Care Received by Children Aged 5–11 Who Are in Need of Therapeutic Residential Care

Abstract

A total of 10% of children looked after in residential care in Scotland are aged 5–11. Although there has been a significant amount of information published about the care trajectories of adolescents in residential care, there is limited information about the experiences of younger children. In this paper, we explore the care trajectories and nature of care received by 5–11-year-olds identified as being in need of residential care. Our results show that younger children who enter residential care have significant trauma histories and experience significant levels of emotional and behavioural dysregulation that foster carers find challenging to manage, resulting in recurrent placement breakdowns. Residential care, particularly small-group-sized care that adopts social pedagogical and psychotherapeutic approaches, was considered beneficial for addressing the psychosocial and emotional needs of younger children. Despite these findings, there were concerns about the long-term use of residential care for younger children. Our results highlight that there is a need to improve access to paediatric mental health services for children in family-based placements. There is also a need to invest in better training and support for foster carers looking after children in severe distress. Community-based outreach services and in-home respite services provided by residential care teams are one way this could be achieved. Finally, in order to promote earlier and more timeous use of residential care, there is a need to shift societal views around residential care being a placement of last resort to rather being a place of recovery and healing that should sometimes be used as a placement of first resort.