Youths in coercive residential care: attitudes towards key staff members’ personal involvement, from a therapeutic alliance perspective

Abstract

A strong therapeutic alliance between staff and juveniles (residents) in institutional settings is considered to be important for a positive treatment outcome. The article focuses on residents placed in coercive care in Swedish residential treatment centres (RTCs), and the aim is to explore obstacles and opportunities for establishing a therapeutic alliance between key staff members (KSMs) and residents in a one-year perspective. The key question is how residents view their KSMs’ personal involvement and active participation in their treatment process. Semi-structured interviews were conducted with twenty-thre girls and twenty-three boys placed in ten different RTCs, and follow-up interviews were conducted after one year. In accordance with the theoretical approach, it is hypothesized that the residents’ view of KSM involvement will be more positive in the one-year follow-up. Results from the first data collection show that more than half of the adolescents perceived their KSMs’ personal involvement as mainly negative. Between the two interviews, several had developed a more positive view of the KSMs’ personal involvement, while a large group did not display any change in attitude. Positive and negative institutional conditions and processes affecting the prospects for the development of a therapeutic alliance between residents and KSMs are discussed.

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