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Effectiveness conditions in residential care for children and adolescents: results from an Italian study


The present contribution focuses on the analysis of the "community microsystem" and its ability to endorse wellbeing and to set off change processes in the developmental trajectories of adolescents.
From the attachment theory we know that the possibility of constructing a meaningful relationship with new adults is, for abused or deprived children, an essential condition for dealing with a profound change in the representation of the self, the significant other and one's own internal working models. Nevertheless, the analysis of the quality and stability of the dyadic care relationships is necessary but not sufficient in evaluating the overall capacity of the microsystem to constitute an effective care context. The notion of therapeutic environment refers to the importance of the living environment as a place designated to creating the reparative and therapeutic intervention. In particular, everyday life takes on specific value in growth processes because it is repetitive and foreseeable, it is familiar and therefore reassuring, it concerns the here and now, it is easily representable on a mental level and constitutes a shared and inter-subjective reality (Emiliani 2008). When rules, routines and rituals become the basis for the shared construction of social and affective gestures, behaviours and meanings they do indeed act like a scaffolding in a supportive and positive sense for development. Thus they become protective factors, that is elements capable of modifying the developmental trajectory undertaken by a subject under risky conditions.

In the present study, we analyze the relational climate inside the community as it is perceived and evaluated from adults and adolescents in terms of 1) quality of relationship between them and 2) daily routines that organize life in the homes. We hypothesize that these indicators are a good predictor of the efficacy of residential care.
Data were collected by means of self-report questionnaires distributed in 19 residential communities in Italy with a number of residents between 6 and 10.
The residential communities involved cater for children who present developmental and relational delays and the consequences of maltreatment and abuse. Some of these communities host young offenders, as well as unaccompanied foreign children.
We gathered data from 59 adolescents (33 males and 26 females) who had been living in the communities for at least a year. Self-report questionnaires were also distributed to the entire residential staff (73 participants).

Key findings
The investigation confirms that there are better outcome indices where the everyday organization aims to enhance the routines that regulate encounters and relationships fostering good levels of coexistence, and where there is good, open communication with at least one reference adult.
The results also clarify the specific relationships between dimensions of the intervention and dimensions of the outcome. While the actual possibility of sharing activities and dialogue with the adult reflects on the satisfaction and wellbeing of the adolescent, improvement from a psychosocial adaptation point of view is linked to the meaningfulness of the routines proposed in the community. Lastly, for adolescents to profoundly rethink their life experience, it is also crucial to forge meaningful relationships with adults.

The results of this study not only confirm the theoretical hypotheses on the link between the relational climate in the community and the effects of the intervention, but also question the idea that residential care can be conceived, and therefore evaluated, merely as an array of facilities, procedures or services without identifying the theory on which this set of resources and their organization is supposed to bring about the desired change.

Key references
Bronfenbrenner, U. (1979) The ecology of human development. Experiments by nature and design. Cambridge: Harvard University Press.
Cicchetti, D., and Cohen, D.J. (eds) (1995) Developmental psychopathology. New York: Wiley-Interscience.
Emiliani, F. (2008). La realtà delle piccole cose. Psicologia del quotidiano. Bologna: Il Mulino.

Contact details
Laura Palareti, Department of Psychology, University of Bologna, Italy.
Email: laura.palareti2@unibo.it

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