40 years of research on the Teaching-Family Model suggest that high-quality residential programs have high levels of youth and family engagement and consistently demonstrate positive outcomes.

Most arguments against residential care do not differentiate between poor-quality and high-quality residential care, or even recognize the possibility of quality residential care.

One oft-cited consensus statement argues, “In addition to compromises in virtually every domain of development, including structural and functional brain abnormalities (Nelson, Bos, Funnar & Sonuga-Barke, 2011), young children raised in group settings are especially vulnerable to disturbances of attachment (Nelson, Fox, Zeanah, 2014; Zeanah, 2000).” It should be noted that all three citations studied Romanian orphanages where the “group setting” was characterized by “profound sensory, cognitive, linguistic, and psychosocial deprivation” (Nelson, Bos, Funnar, & Sonuga-Barke, 2011), which obviously does not reflect high-quality residential care like that offered by Teaching-Family Model agencies.

Failing just one high-risk youth can cost society $3.75 million dollars (Cohen, Piquero, 2009).

Boys Town’s analysis suggests that every $1 dollar spent on residential services has the potential to save $198 – $340 dollars in long-term societal costs.

In addition, Teaching-Family Model agencies are often community-based and take advantage of services already offered in the community in order to use resources as efficiently as possible.

Critics argue that “In a majority of cases, these problems can be safely and effectively treated in the community” (Dozier, et al. 2014), through prevention programs.

This is likely true, and many Teaching-Family Model agencies offer in-home services and parent training, adapted from Model systems and proven effective, to avoid the removal of children from the home.

But we also believe it is naïve to expect that these prevention programs will completely eliminate the need for the foster care system, or that those who do enter the system will have their needs met in foster care.

Residential providers offer children 77 hours per week of care at a rate of $28 dollars per hour, which is difficult to provide in the community alone. It is our view that quality residential care will continue to be a necessary part of the foster care system to ensure that children’s needs are met and costs to society are minimized.

17 of 18 recent meta-analytic studies, and research out of a Teaching-Family Model agency – Boys Town – have shown no negative peer contagion effects in quality residential care.

High quality residential care programs foster healthy relationships and a positive peer culture.

Trauma-informed care and group care are not mutually exclusive.

In fact, the original standards of the Teaching-Family Model align closely with the principles of trauma-informed care.

The Teaching-Family Association has also added a trauma-informed standard that overlaps with many other standards to emphasize its importance in agency reviews.

Often, children who are on a trajectory towards residential care can be identified early based on average daily incidents with foster parents. These incidents lead to repeated removal from care in the foster care system, which increases the traumatic damage of the system.

The belief that residential care should be a last resort means many of these children are continually placed in and removed from settings where they are likely to be removed and traumatized again by that removal. In quality residential care like Teaching-Family Model agencies, these incidents do not result in removal.

We also know that trauma damages the hippocampus, and that caring relationships can reverse this process of damage, but the reconstruction and healing process can take 90 days to even begin, and these connections need to continue to be strengthened past 90 days. The value of residential care is the sustained, durable relationships kids can receive in a stable setting.