What Works in Residential Care? Lessons Learned From Implementing, Sustaining and Evaluating the CARE Model

This workshop will discuss the principles, the theory of change, the implementation process, and the research results of the Children and Residential Experiences: Creating Conditions for Change (CARE) program model, designed to develop a therapeutic milieu that supports and expects reciprocal and consistent developmentally appropriate relationships in a trauma-sensitive environment. By incorporating six research informed principles (Relationship-based, Trauma-informed, Developmentally-focused, Family-involved, Competence-centered, and Ecologically-oriented) throughout all levels of an organization and into daily practice, an ethos develops that supports and expects reciprocal and consistent developmentally appropriate relationships in a trauma-sensitive environment (Anglin, 2002; Li & Julian, 2012). The CARE model articulates a theory of change which outlines the causal pathways through which CARE is expected to improve children’s social and emotional development (Holden, 2009; Holden, Anglin, Nunno, & Izzo, 2014). The initial results of a multi-site quasi-experimental study with eleven residential agencies have shown CARE’s potential for reducing aggressive behavioral incidents (Izzo, Smith, Holden, Norton-Barker, Nunno, & Sellers, 2016). A single case study using 12 years of administrative data and a time-series analysis shows significant level, variability, and trend differences from pre to post CARE implementation (Nunno, Smith, Martin & Butcher, 2016).