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The purpose of this article is to advance knowledge concerning outcomes among the former residents of therapeutic children's homes, especially those located in England.

In total, 16 young adults who had been resident in one of seven therapeutic homes took part in interviews.

It appeared, from the information they gave in these interviews, that their outcomes were good in terms of their emotional and behavioural well‐being, physical health, accommodation, and absence of early parenthood and substance use. Some of the young adults also had good outcomes in respect of their education and absence of criminal convictions. A small number of the young adults did less well on these latter two measures but few of them were particularly poor in either of these respects. The young adults had limited contact with their family members.

The evidence from this research is that young adults who have been in therapeutic residential care can have good outcomes.

In the desire to improve outcomes for children in care, the issue of those individuals placed by local authorities in residential establishments run by external agencies has become especially salient. In addition to questions of quality and value for money, there are concerns about children becoming detached from local services, especially as many of the placements selected are outside the local authorities' geographical boundaries. This study looks at 262 children so placed in eight English local authorities. It was found that although there were common presenting problems, such as a need for specialist therapy or to reduce difficult behaviour, the children's circumstances varied and four distinct groups of children with common needs were identified. The use of such placements also varied across the authorities and did not mirror their numbers of children in care. The factors associated with the use of externally purchased residential placements and differences between those placed internally and externally are explored. A framework for developing new approaches for difficult adolescents and suggestions about fruitful service development are offered.

The SECURE STAIRS framework for integrated care is a trauma-informed approach to supporting staff and young people within the Children and Young People’s Secure Estate (CYPSE) in the UK. Within secure settings, therapeutic climate is a concept that encapsulates an individual’s perception of safety, connectedness with others and level of support within the environment. To support evaluation of the SECURE STAIRS framework, a Secure Children’s Home (SCH) within the North East of England examined therapeutic climate for staff and young people annually using the Essen Climate Evaluation Schema (EssenCES) over a three-year period. This paper aims to present the findings.

Over the three years, a total of 71 young people and 214 staff EssenCES questionnaires were administered. Between 2020 and 2021, the setting also experienced significant changes resulting from the COVID-19 pandemic. Numbers of young people also decreased within the setting over the three-year period.

Results indicated a positive trend for therapeutic climate sub-scores. For example, Experienced Safety for young people significantly increased from 2020 to 2021. Additionally, therapeutic hold for staff was significantly higher in 2020 and 2021 in comparison to 2018.

Findings are discussed in relation to implementation of the SECURE STAIRS framework and providing trauma-informed care for vulnerable young people within secure settings. Implications for practice are explored.

In this chapter, I examine stories that foster care youth tell to legislatures, courts, policymakers, and the public to influence policy decisions. The stories told by these children are analogized to victim truth testimony, analyzed as a therapeutic, procedural, and developmental process, and examined as a catalyst for systemic accountability and change. Youth stories take different forms and appear in different media: testimony in legislatures, courts, research surveys or studies; opinion editorials and interviews in newspapers or blog posts; digital stories on YouTube; and artistic expression. Lawyers often serve as conduits for youth storytelling, translating their clients’ stories to the public. Organized advocacy by youth also informs and animates policy development. One recent example fosters youth organizing to promote “normalcy” in child welfare practices in Florida, and in related federal legislation.

Secure Children’s Homes are safe environments where many of the most troubled children in British society are resident. These children are from either a criminal background or referred for protection of themselves and others from harm. There is often a history of drug use and diagnoses of mental health problems before admission. The purpose of this paper is to examine one Secure Children’s Home to determine the level of drug use prior to admission compared to surveys of children not in this environment and to examine the veracity of the mental health diagnoses.

This paper is a retrospective examination of case notes for admissions from 2014 to 2015.

The study found much higher levels of drug use than in the general population at similar age and a wide diagnosis of mental health problems prior to admission.

Levels of harm from traumatic childhood events need to be recognised by referrers as maybe leading to attachment disorders and not mental health problems. More research is needed into the outcomes form Secure Children’s Homes in the long term.

The children in these homes do have as anticipated much higher levels of drug use than in the general population and high levels of mental health diagnoses which are not always borne out during their admission to the children’s home.

This is an examination of a special population of young people indicating high levels of drug use and mental health problems.

The purpose of this paper is to test whether incorporating a 20-week Kundalini yoga programme into a residential home for children improves well-being outcomes.

This is a mixed methods feasibility study. Feasibility was assessed through recruitment and retention rates as well as participants’ self-report perceptions on social inclusion, mental health and well-being and through semi-structured interviews on the benefits of the study. Mutual recovery entailed that children in care (CIC), youth practitioners and management participated together in the Kundalini yoga sessions.

The study initially enrolled 100 per cent of CIC and 97 per cent (29/30) of eligible staff. Attendance was low with an average rate of four sessions per participant (SD=3.7, range 0-13). All the participants reported that the study was personally meaningful and experienced both individual (e.g. feeling more relaxed) and social benefits (e.g. feeling more open and positive). Pre- and post-yoga questionnaires did not show any significant effects. Low attendance was associated with the challenges faced by the children’s workforce (e.g. high levels of stress, low status, profile and pay) and insufficient consultation and early involvement of stakeholders on the study implementation process.

Because of the chosen research approach (i.e. feasibility study) and low attendance rate, the research results may lack generalisability. Therefore, further research with larger samples including a control or comparison group to pilot similar research questions is mandatory.

This study has generated a number of valuable guiding principles and recommendations that might underpin the development of any future intervention for CIC and staff working in children’s homes.

The concept of togetherness and mutuality within residential spaces is discussed in the paper.

The effects of Kundalini yoga have not been reported before in any peer-review publications. This paper fulfils an identified need (i.e. poor outcomes among CIC and residential staff) and shows how movement and creative practices can support the concept of mutual recovery.

The purpose of this paper is to inform readers and researchers about the use of a “lived experience” of therapeutic community work as an effective intervention for severely emotionally troubled children.

An explanation of the main developmental influences and how the Mulberry Bush School is continuing to incorporate new theories and approaches.

How the Mulberry Bush as a specialist therapeutic residential provision can bring about excellent outcomes for severely emotionally troubled children.

The paper explores the work and legacy of the school's founder Barbara Dockar-Drysdale and of her collaboration with Donald Winnicott to create a lived experience of community as an agent of therapeutic change. The paper also provides descriptions and a case study of the current multi-disciplinary work of the school, including how neuroscientific research is influencing the evolution of the therapeutic task with traumatised children.

The paper shows how a highly evolved model of integrated provision can support excellent outcomes for traumatised children and young people.

To broaden and deepen knowledge about the use of therapeutic community principles in the treatment of severely emotionally trouble children and young people.

Hippotherapy is an emerging area of paediatric occupational therapy practice in Ireland. It is a treatment strategy used by specially trained occupational therapy practitioners, physical therapists and speech language pathologists as part of the intervention programme to facilitate functional gains. This paper aims to explore parents’ perspectives on children’s participation in home-based occupations following hippotherapy treatment.

Qualitative, semi-structured interviews were conducted with eight participants. Interviews were audio-recorded and transcribed verbatim. In accordance with thematic analysis, line-by-line coding was completed to identify codes. Codes were organised into categories, which were grouped to develop themes.

Three core themes were identified: lack of knowledge regarding hippotherapy as an occupational therapy intervention; children’s increased participation in home-based occupations secondary to improved physical, psychological, communication and social skills; and the unique hippotherapy environment as a motivating factor for children to engage in occupational therapy intervention.

Findings from this study support the growing body of evidence that hippotherapy is an effective means of intervention for increasing physical, psychological, social and communication skills. The participants report positive effects following hippotherapy on their children’s participation in home-based occupations. It highlights a link between the unique hippotherapy environment and children’s increased engagement in occupational therapy. Given that no published hippotherapy-specific literature related to occupational therapy exists in the Irish context, and given that hippotherapy is an emerging area of practice in Ireland, this paper contributes to the knowledge base.

This paper aims to explore an integrated therapeutic care approach for a group of children and young people who have experienced chronic and enduring interpersonal trauma.

This paper aims to emphasise the need to routinely assess for that which could have been relationally traumatic, as this is the context in which many looked‐after children's and young people's developmental experiences occur. In particular, it explores the need to have trauma‐informed assessments, clinically effective interventions based on this knowledge, and the need to ensure that a therapeutically enabling environment and organisational functioning is maintained, in order to improve outcomes. It builds on existing work on trauma systems theory, both within an organisational context and within a holistic completely integrated (therapy/assessment, care, education) residential child care treatment process.

This research raises consideration of the manner in which interpersonally traumatic experiences with the child's primary attachment figures (accommodation complex) may create the context in which children employ dissociative coping. This also may have possible helpful connections for those working with adults diagnosed with borderline personality disorder.

The paper provides a systemic model based on three strands of understanding, namely trauma, attachment and dissociation, which can provide an underpinning assessment and interventions model for children in residential care.

This article focuses on group work with children using a board game format. Combining the principles of group work and board games helps to engage and motivate children and adolescents to address and work through their difficulties. Lifegames are a series of six therapeutic board games developed for group work with children and adolescents who encounter adversity in their life as a consequence of bereavement, family break up, poor relationships, bullying, chronic illness or obesity. The games facilitate the understanding and disclosure of the complex feelings experienced by children and young people when they are confronted with traumatic life events. The games encourage and assist the participants to obtain and maintain behavioural change. Lifegames are a means to assist professionals in their group work with children and adolescents.