The moderating roles of childhood adversity on program outcomes in residential care in a diverse sample

ABSTRACT

A better understanding of how childhood adversity (CA) patterns influence the effectiveness of Trauma Informed Care (TIC) for youth in residential programs is needed. Utilizing a longitudinal design, the study examined how CA patterns influenced aggression and self-injurious behavior during treatment and emotional and conduct outcomes for 1,343 racially diverse adolescents in a TIC residential program. Latent class analysis identified five CA patterns. Subsequent mixed, two-factor ANCOVAs indicated youth from all CA patterns experienced parallel decreases in emotional problems from intake to discharge while changes in conduct problems during this same period differed by CA pattern. Likewise, Hierarchical Linear Modeling revealed that youths’ self-injurious behavior and aggressive behaviors over the first 12 months of the program also differed by CA pattern. Some demographic differences based on sex and race were found, which are discussed in turn. Findings indicate that while the program is functioning as TIC, more tailored support is needed for youth with specific CA patterns and demographics.

Practice Implications

• Trauma-informed practices are important for improving emotional well-being in residential care.

• Tailored interventions for youth with specific trauma histories may help reduce self-injurious behavior and behavior problems.

• TIC programs may better serve youth with a variety of trauma histories by incorporating interventions that target social development.

KEYWORDS:

• Residential treatment
• Trauma
• Emotional problems
• Aggression
• Self-injurious behavior

Disclosure statement

Dr. Gordon, Mr. Ringle, Ms. Ende, and Dr. Tyler are all researchers at the same institution which houses the evaluated residential program. Several measures were taken to mitigate this potential conflict of interest including utilizing a priori hypotheses and statistical plans, collaborating with colleagues/authors outside of the program institution, and utilizing rigorous statistical techniques based on sound scientific support.

Supplementary material

Supplemental data for this article can be accessed online at https://doi.org/10.1080/0886571X.2023.2266987.

Additional information

Funding

The work was supported by the Eunice Kennedy Shriver National Institute of Child Health & Human Development of the National Institutes of Health [T32HD101392].