Adolescents' psychological adjustment and quality in residential care

In Portugal, more than 8000 Portuguese children and youngsters are currently in Residential Care (RC) and a large number of them are adolescents (56.1%) aged 12 to 17 years. The lack of studies on the quality of RC in... [ view full abstract ]

In Portugal, more than 8000 Portuguese children and youngsters are currently in Residential Care (RC) and a large number of them are adolescents (56.1%) aged 12 to 17 years. The lack of studies on the quality of RC in Portugal, and the scarce information about how far the available services meet the real characteristics and needs of young people in care, makes it imperative to carry out research on RC quality. The use of an Empirically Based Assessment is crucial, since it enables the design of effective clinical interventions that are also empirically based. The Achenbach System of Empirically Based Assessment (ASEBA) allows the collection of information in several contexts (e.g. school, family) with more than one informant (e.g. caregivers, adolescents). This is a quick and cost-effective way to perform a complete assessment of the problem(s) presented by this population.
Five RC centres for children and young people were visited within an exploratory study of a nationwide assessment on the quality of the Portuguese RC system. Sixty-one youngsters (64% are female) living in those settings participated in this study. Data on RC quality was collected using the ARQUA-P and youngsters filled the YSR.
The present study is part of a larger study, and it aimed to: a) characterize behavioural and emotional problems displayed by 61 adolescents, as reported by themselves; b) examine gender differences in youngsters to the scales of YSR; c) examine the correlations between the evaluation of the adolescents in care and specific dimensions of the context (number of adolescents and ratio caregiver/adolescent).
In relation to the characterization of the behavioural and emotional problems displayed by youngsters, YSR revealed scores that highlight the presence of psychological problems and psychosocial difficulties that may indicate psychopathology in much higher rates than those found in normative population. The female youth present more psychopathology and more behavioural problems than male youth, as is corroborated by the literature. With regard to the context variables, the Total Problems and Internalizing Problems of YSR present significant negative correlations with the number of adolescents and also with the caregiver/adolescent ratio: decreasing number of adolescents per home is associated with increases in the difficulties and problems they present and adolescents living in homes with a lower ratio display more psychological maladjustment. These correlations are not supported by the literature and appear to contradict the theoretical assumptions and evidence of research. A plausible explanation for this result is the fact, in this study, that the smaller RC centres show willingness to accept adolescents who are not always accepted in other institutions, given their personal characteristics, life history and the severity of the problems previously experienced.
In Portugal, as in other countries, the prevalence of mental health symptoms and psychological problems is much higher in adolescents in RC. This fact deserves further validation and has implications for future policies regarding the RC and for the management and practices of the RC centres. Given these results, measures to ensure the creation of more units of specialized care should be prioritized, as well as the integration of a greater number of Psychology professionals in RC. Furthermore, more refined screening processes and psychological evaluation should be developed and specific continuous training to all caregivers should be provided.