Therapeutic residential care in Spain. Treated profiles, mental health problems and therapeutic coverage

The scientific literature has been showing a high prevalence of mental health problems in the population of children and youth placed in supervised homes. For more complex cases, different specialized resources have been... [ view full abstract ]

The scientific literature has been showing a high prevalence of mental health problems in the population of children and youth placed in supervised homes. For more complex cases, different specialized resources have been generated that can be encompassed under the term of therapeutic residential care. A recent international review (Whittaker, Del Valle & Homes, 2015) has shown a great diversity in the types of intervention carried out and in the referral criteria of cases to these specialized resources. The goal of this work is to describe the profile of the cases that are attended to in therapeutic residential resources in Spain, as well as their mental health problems and the therapeutic care they receive. The sample is made up of 215 youths, of whom 93 are in therapeutic resources and 122 in homes with autonomy programs for adolescents. The instruments used were the "Sistema de Evaluación y Registro en Acogimiento Residencial" (SERAR; in English, System of Assessment and Registry in Residential Care; del Valle & Bravo, 2007) and the Child Behavioral Checklist (CBCL; Achenbach & Recola, 2001). Bivariate analysis and logistic regression were performed. The main results indicate that the cases referred to therapeutic resources had passed through a larger number of centers, although they had been placed in these resources for a shorter period of time than the comparison group. The group in therapeutic placement also showed greater substance consumption, and there was a greater percentage cases within the clinical range on the scale of Attentional and Aggressive Behavior Problems of the CBCL. The logistic regression shows that the variable that most modifies the probability of being referred to therapeutic resources is substance abuse. With regard to treatment received, there are no significant differences in the percentages of those receiving some kind of therapeutic treatment, although the group in therapeutic residential placement receives more psychiatric and pharmacological treatment. These results are discussed with regard to prior research and its practical applications.