Reconceptualising Residential Care

Thursday 17 April 2025

It’s more than just a Children’s Home: A Pathway to Healing for Children Experiencing Repeated Placement Endings in Foster Care

 

In the ever-evolving landscape of child welfare, the need to reconceptualise residential care as a viable intervention for children who find being in a fostering family overwhelming is more urgent than ever.

For many children, especially those who have experienced significant trauma and adversity, the sudden transition from their family setting, often due to concerns around abuse and neglect, can be fraught with anxiety, fear, and resistance. This can usually be seen in the survival responses and strategies the child has developed to manage to stay within a chaotic and unpredictable care climate within their family of origin.

This article explores the critical need for therapeutic residential care as a preparatory step towards family living, emphasising the importance of harnessing attachment and trauma-informed (ATIC)  residential care.

 

Understanding the Challenge

Children who enter foster care often carry the weight of traumatic experiences—abuse, neglect, instability, and loss—that profoundly shape their emotional and psychological landscapes. For some, the notion of family can elicit feelings of fear and phobia, making the transition to a familial environment daunting. Traditional foster care, while designed to provide nurture and stability, may inadvertently create intolerable experiences for children, leading to placement disruptions and further emotional distress (Cross, 2025). For children who have experienced significant loss and disruption, social care services often face immense challenges. These services, which are often stretched in terms of resources, can be left with what can feel like impossible or difficult decisions when foster placements end unexpectedly. The dreaded 28 days’ notice of having to find a child another home.

How can commissioning teams identify those children who need to have a period of preparation before being asked to navigate a new family living experience? One of the ‘gateways’  that I suggest is the evidence that foster care is not working for a particular child. It may be considered common sense but it’s still not uncommon for social services and fostering agencies to become caught up in a paradoxical situation of moving from placement to placement. This often creates increased disturbance for the child but also often for the foster carers concerned, causing significant lasting impacts in terms of confidence.

Of note here is not the notion that specialist foster care can work for many children. They can often effectively and emotionally hold the children, providing the necessary psychological containment to navigate to a point where there’s stability. This article is about a small group of young children who require early intervention to support a longer-term care journey characterised by stability in relationships.

In this context, specialist residential care offers a unique opportunity to create a therapeutic environment where children can begin to process their trauma, build resilience, and gradually prepare for family life. It is essential to view residential care but as a foundation step in the healing journey. Such services utilise more resources to support children, however, the ‘value’ should be the expectation of the attainment of a successful and positive care journey for children and young people (Demos).

 

The Role of Attachment in Healing

underscores the significance of early relationships in shaping a child’s emotional health. Children who have experienced trauma often struggle with insecure or disorganised attachment styles (Cross, 2025), making it difficult for them to form trusting relationships. Residential care can serve as a bridge, allowing children to attain safety and stability through the experience in the therapeutic milieu, where caregivers are trained to respond empathetically to their needs.

In a therapeutic residential setting, caregivers can cultivate healthy attachments through consistent, nurturing interactions. All within a system of caring that can tolerate the often-painful tsunami of emotions and behaviours which underlie and extremely painful and confusing early developmental experiences.

Therapeutic Care has a long history within the UK and is held by the Therapeutic Communities movement (TCTC & Community of Communities) This knowledge is paradoxically often lost and then re-found, which is often the experience around what we do know about the impact of trauma on developing minds. In part I am seeking to encourage the ‘re-embracing’ of what is known.

This increased level of relational connection provides a safety net for children to explore their emotions and fears without the immediate pressures of a family dynamic. The goal is to help children develop a sense of security and belonging, which will be crucial when they eventually transition to a family setting.

 

Harnessing the centrality of therapeutic relationships in the  Care Environment

Relationships which the child experiences involve a range of crucial elements which require the capacity to create trust, emotional safety, and the ability to receive, digest and give back in a helpful form what the child communicates.

To enhance the use of relational practice, it is crucial for residential care to employ trauma-informed practices that recognise the unique challenges faced by children. This includes training staff to understand the impact of trauma on behaviours and emotional responses, allowing them to respond with empathy rather than frustration.

 

Trauma-Informed Attachment and Recovery Services

The concept of Attachment & Trauma-informed care (ATIC) is integral to reshaping residential care for children transitioning from fostering. A trauma-informed approach recognises the widespread impact of trauma and seeks to create an environment of safety, trustworthiness, and empowerment. This involves not only understanding the child’s past experiences but also actively working to mitigate the triggers that may arise in a new family setting. It’s not the change that creates difficulties, it’s all about navigating and attaining successful transitions.

Recovery services should include therapeutic interventions tailored to each child’s unique needs. By offering a structured and supportive environment, residential care can equip children with the coping skills necessary for family life.

 

Preparing for Family Life

For commissioning bodies and social workers, the value of preparing children for family life after a therapeutic residential care experience cannot be overstated. This preparation should include:

• Parental training: Foster (and adoptive) parents should receive training and develop an understanding on the effects of trauma and the importance of attachment. This knowledge will help them create a nurturing environment that accommodates the child’s needs.
• Gradual transitions: Transitioning to a family setting should not be abrupt. Instead, a gradual process that includes extended visits and involvement in family activities can help children adjust more comfortably.
• Ongoing support: After the transition, families should have access to ongoing support services for both the carers and the child.
• Feedback mechanisms: Implementing feedback systems where children can voice their concerns and experiences can inform both residential care practices and foster placement strategies.

 

Conclusion

As we consider the future of residential child care, it is imperative that we reconceptualise residential care as a vital intervention for children who find family fostering placements overwhelming. By understanding the critical role of attachment and the use of relationally based care environments, and implementing Attachment & Trauma-informed recovery services, we can create a nurturing pathway for healing.

For commissioning bodies and social workers, investing in therapeutic residential care is not merely an option; it’s a necessity for equipping our most vulnerable children with the tools they need to thrive in family life. Through thoughtful preparation and ongoing support, we can help these children transform their fears into trust, trauma into resilience, and isolation into belonging. The future of child welfare depends on our ability to embrace these principles and prioritise the well-being of every child in our care.

Cross, R. M (2025) Affect Regulation, Attachment, and the Developing Social Brain: Implications for Assessment & Treatment of Dissociative Disorders in The Handbook of Complex Trauma and Dissociation in Children: Theory, Research, and Clinical Applications Edited By Ana M. Gómez, Jillian Hosey, Routledge