Reducing Trauma in Residential Direct Care Staff

Considered the most intensive level of out-of-home care for youth (James et al., 2012), residential treatment was initially developed in the 1940s as a response to the needs of the most seriously emotionally disturbed youth (Lieberman, 2004). A residential treatment center (RTC) is defined as a facility operating 24/7, which is not licensed as a hospital, offering mental health treatment programs for seriously emotionally disturbed children (Connor et al., 2002). The youths entering RTCs typically have multiple-placement disruptions, neuropsychiatric diagnoses, chronic traumatic experiences, and multiple-attachment disruptions (Connor et al., 2003). These treatment centers strive to address the developmental, psychological, behavioral, and relationship needs of the youth through therapeutic services and reliance on the therapeutic milieu as an intervention (Lieberman, 2004). Residential direct care staff have the most direct contact with these youths. Residential direct care staff are those staff who reside with youth in shifts, and are responsible for meal planning, hygiene, oversight of homework/learning activities, crisis management, household therapeutic and entertainment activities, and general emotional support to the youth, many of whom have limited contact with family or others outside the residential treatment center (Eastwood & Ecklund, 2008; Seti, 2008). The work can be emotionally taxing and by its nature expose these residential direct care professionals to both direct and indirect trauma. More specifically, research has shown that those working in the field of child welfare have a greater risk of developing a form of indirect trauma called “secondary traumatic stress” than do others within