Background/Aims: Children and young people in residential care often exhibit complex emotional and behavioural needs. Attachment theory is frequently used to explain these difficulties, whereby a young person's early experience can influence their internal representations of relationships and their subsequent interactions within the residential milieu. Thus, residential childcare staff have a fundamental role supporting young people, to facilitate therapeutic change and mitigate poor long-term outcomes. Policy and research often recommend staff training and attachment-informed care, yet there is very limited understanding of how this translates into practice or influences outcomes. Therefore, this thesis aimed to systematically review literature on the types, measurement and effectiveness of residential staff training, focussed upon psychosocial outcomes. It also aimed to construct an explanatory theory of how residential staff make sense of, and use, attachment theory in practice. Methods: Research aims are addressed in two studies. Literature on residential staff training was systematically reviewed in Journal Article 1. This was conducted through a search of electronic databases, quality assessment of included studies, and subsequent narrative synthesis. Journal Article 2 used qualitative methodology in the form of constructivist grounded theory. Semi-structured interviews were conducted with twenty residential staff members through an iterative process of data collection and analysis, and theoretical sampling, until theoretical saturation was achieved. Results: Eighteen studies were included in the systematic review. Results highlight heterogeneous staff training, often evaluated through measurement of staff knowledge, skills and/or attitudes, and/or child behaviour frequency. Findings offer tentative support for the positive impact of training upon staff skills but other outcomes remain unclear. Results from Journal Article 2 indicate that staff had difficulty articulating attachment theory and often did not have a coherent narrative to describe attachment theory to practice links. Instead, they focussed upon a natural process of building relationships within a challenging context, with attachment theory only coming to the forefront when deemed relevant. Conclusions: The effectiveness of residential staff training remains unclear due to the methodological limitations of included studies. Significant improvements are identified for future evaluations of training to address this issue. Future staff training may benefit from limiting jargon, developing theory to practice links, and facilitating staff reflective function. Recommendations of attachment-informed care must also recognise the complexity of the residential system; and the current disparity between attachment theory narrative within policy and research, and practice.

Children around the world need care outside their families for a variety of reasons including poverty, war and epidemics such as HIV/AIDS. The majority of these children live in developing countries where there are limited resources to care for them. As a result of concerns about the effects of institutional care on children, and following trends in the developed world, there is a movement in developing countries to replace large residential institutions with a system of adoption, foster care and small group homes. The aim of this study is to examine the experience of orphan, abandoned, and neglected or abused children who grew up in residential institutions in the Caribbean nation of Trinidad and Tobago, to learn the positives and negatives of residential care in order to contribute to developing a model of care suited for high need, low resource countries. Oral history methodology was used to collect the stories of 24 alumni (12 men and 12 women) from seven homes in Trinidad and Tobago. The homes were categorized as 1) state— partially funded by the state but managed by the Anglican and Catholic dioceses, 2) faith-based— run by religious communities, and 3) community homes run by individuals in the community. The findings of the study show that overall experiences were positive. For poor and working-class children, life in the home was better than their life would have been if they had remained with their families. However, discharge and transition from the homes were less favourable. Alumni from the state-funded homes experienced more difficulties than the faith-based and community homes as a result of poor planning and a lack of post-departure supports. Women suffered more hardships than men, often leading to sexual exploitation. The findings also show that being admitted with siblings and staying at the same home over the duration of care—as was the norm—correlated positively with educational outcomes for the majority of alumni. Some life-long relationships were maintained with volunteers and with friends made among peers at the homes. The study concludes that large group care is not necessarily harmful for children. It may be even beneficial and may be cost effective—a factor that is very important for low resource countries. An aftercare plan, with planning beginning at admission might ease the transition process and gender must be considered in discharge and transition policies. / October 2016

Background: Since the 1980’s incidents of workplace violence have been recognised as a serious problem within social care. It has been found to be particularly rife within residential settings and children’s homes in particular have been found to be one of the most violence-prone settings. And yet, there is a lack of literature on the prevalence and psychosocial impact of workplace violence on staff in residential units for looked after and accommodated children (LAAC). Method: Given the limited literature on residential childcare workers a systematic review was conducted on research of violence towards social workers in child and family services to achieve a better understand of violence within child and family social care generally. An empirical study was also conducted with staff of Local Authority residential units within Central Scotland. The aim of the empirical study was to explore staffs’ experience of workplace violence perpetrated by LAAC in residential settings, using the qualitative methodology Interpretative Phenomenological Analysis (IPA). Results: The systematic review showed that studies were mostly of medium methodological quality; verbal aggression towards social workers in child and family services was common place; physical violence was comparatively rare; and that all forms of violence impacted on wellbeing and practice. The empirical study had similar findings, but also provided new insights into how staff cope with workplace violence, particularly in the context of young peoples’ life experiences. Conclusion: Violence perpetrated by LAAC in residential units appeared to be lessening and a move towards more behaviour management was aiding staff to better understand the roots of violence. This in turn was found to help staff cope better with the emotional impact of violence. Management need to be mindful of the impact violence has on staff and continue providing training programs to better equip staff to understand violence and support LAAC to manage their aggression.

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Residential childcare has had an image which, at the very least, is not a positive one. It has been blamed for weakening family links and leading to poor educational and health outcomes for children (Biehal et al. 1995; Mendes and Moslehuddin 2004; Stein 2002). However, children and young people enter residential care institutions for a variety of reasons, and by examining the experiences of children and young people in Bangladesh, we can see that residential childcare has the potential to offer a positive option for many disadvantaged children and young people. UNICEF estimates that there are more than 49,000 children in residential care in Bangladesh (UNICEF 2008), but this figure fails to include thousands of children who live in madrasahs. There is neither a uniform childcare policy nor formal aftercare support provision in Bangladesh; instead, the government, Non-Governmental Organisations (NGOs) and madrasahs all have their own approaches and methods and there has been no research conducted on young people in and after care. The aim of this study was to explore the experiences of residential care from the perspectives of a group of young people who had lived in residential childcare institutions in Bangladesh with a view to making improvements in residential childcare in the future. Qualitative methods were employed for data collection, using in-depth semi-structured interviews with 33 young people (aged between 12 and 26) who had left the care system and observation of the four institutions where they had lived: one run by an NGO, two run by the government and one madrasah run by the religious community. All of the fieldwork was conducted and transcribed in Bangla. The findings of this study show that young people had mixed feelings about their lives in care, preparation for leaving care, and aftercare support; moreover, their experiences were diverse. Overall, most said that they had benefited from being in care and the institution had had a largely positive impact on their lives. However, the experience for those who had been evicted was much less favourable; these young people suffered a range of hardships after leaving care. The findings also show that there was a connection between the in-care experience and the success of a young person in the outside world. The type of institution, its culture, systems and practices, the amount of care received and socio-cultural-religious influences all played a part. The research further indicated that although some young people developed a measure of resilience to face the problems of their everyday lives, they were not fully able to overcome them due to societal discrimination. Those who did best where those who had developed positive attachments with at least one trusted adult, who acted as a mentor and strengthened their commitment and self-motivation. The findings demonstrate that aftercare support varied from institution to institution, but overall, was informal in nature. The study concludes by setting out implications for building better residential childcare policy and practice in Bangladesh. It identifies a number of avenues for further research, suggesting that lessons for the minority world may be learned from this study, namely the notion that the whole community should take responsibility for its children; and attention should be paid to faith and religious beliefs in children’s upbringing. The study has also demonstrated that improving financial resources may not necessarily lead to better outcomes from children and young people. Instead, building relationships with adults, peer groups, parents, and community offer the best chance for good outcomes.