NUMBER 685• 17 FEBRUARY • RESIDENTIAL PLACEMENT
American sentiment toward residential placement for troubled youths is increasingly suspicious, pessimistic, and even hostile (Morganthau et al., 1994; Pecora, Whittaker, Maluccio, & Barth, 1992; Wells, 1991; Wolins, 1974). Yet many families are too dysfunctional to warrant keeping their youths at home and alternatives are scarce (cf., Weisman, 1994). Foster families are simply unavailable for many of the estimated 840,000 children who will require out-of-home placement by 1995 (Select Committee on Children, Youth, and Families, 1990). The most empirically supported criticism of residential placement is its limited positive influence on postplacement problems such as delinquency (Jones, Weinrott, & Howard, 1981; Pecora et al., 1992; Quay, 1986). Yet the most highly touted alternatives to placement (family preservation services and treatment foster care) have not been shown to be superior in this regard. Furthermore, the widespread negative sentiment appears to primarily involve issues pertaining to life within placement. Specifically, lay and professional persons alike appear to believe that, once in placement, life for troubled adolescents inexorably worsens. There is extensive current scientific evidence showing that, before placement, these youths' lives are filled with failure and misery (Eisikovits & Guttman, 1988; Small, Kennedy, & Bender, 1991). But scientific evidence pertaining to life within placement is in short supply.
This knowledge void appears to have been filled by negative beliefs based on older, mostly descriptive literature (e.g., D'Amato, 1969); McEwen, 1978; Polsky, 1965; Schur, 1973; Trieschman & Whittaker, 1972; Trieschman, Whittaker, & Brendtro, 1969), older, precedent-setting court cases (e.g., Donaldson vs. O'Connor, 1974; Morales vs. Turman, 1974), and a combination of theoretical orientation, ideology, media influences, and personal experiences. Among the most prominent of these negative beliefs are those pertaining to the delivery of helpful treatment, relationships with supervising adults, isolation from friends and family, and sense of control.
Delivery of Helpful Treatment. A primary purpose of placement is to provide treatment, yet it is widely believed that youths receive bad treatment, little treatment, or no treatment at all. There are at least three sources of this belief. The first is startling early accounts of life in placement (e.g., Polsky, 1965; Schur, 1973) suggesting treatment of youths was often negligent and/or abusive. The second is the well-documented problem with incongruities between treatment prescribed in residential programs and treatment delivered (Jessness, Allison, McCormick, Wedge, & Young, 1975; Kazdin, 1985; Quay, 1977). In fact, a National Academy of Sciences panel, commissioned to evaluate evidence on the efficacy of rehabilitation programs for offenders, concluded that most evaluation studies were of limited value because little treatment was delivered and the treatment that was delivered often had little resemblance to the treatment prescribed (Martin, Sechrest, & Redner, 1981; Sechrest, White, & Brown, 1979). Landmark court cases mandating a right to treatment are a third source of belief that treatment has often been lacking in residential placements (e.g., Donaldson vs. O'Connor, 1974; Morales vs. Turman, 1974).
Relationships with Supervising Adults. A common belief is that the relationship between youths in placement and their supervising staff is adversarial, servile, or collusional. The source of this belief is partly in the notion of an inmate counterculture which was portrayed in Goffman's (1961) classic work Asylums, predicted in the theoretical work of Sykes (1958), and dates back at least to the work of Clemmer (1940). Some articles have also concluded that most children entering residential programs often already have negative perceptions of authority and that the deprivation of their liberty instigates resistance rather than cooperation (e.g., Empey & Stafford, 1991). These perspectives emphasize how enforcement of rules can undermine the relationship between children and those who provide their daily care (cf. Lundman, 1984; Polsky, 1965).
Isolation from Family and Friends. Other common beliefs are that residential placement produces an inexorable sense of isolation from family and friends (Eisikovits & Guttman, 1988; Empey & Stafford, 1991; Kiesler, 1982). These beliefs have at least two sources. The first is in the logical conclusion that the all-encompassing nature of residential life and the presence of institutional barriers to outside contact can cause a sense of isolation. The second source is from case descriptions and first-hand accounts of life in residential settings that emphasize isolation and disconnection from family and friends (e.g., D'Amato, 1969; McEwen, 1978; Polsky, 1965; Schur, 1973; Trieschman & Whittaker, 1972; Trieschman, Whittaker, & Brendtro, 1969).
Sense of Control. The last common belief of concern here is that residential placement limits the youths' development of a sense of personal control (Empey & Stafford, 1991). When youths are forced to live away from their homes, families, and friends, their sense of control is at risk (Gold & Osgood, 1992; Sykes, 1958). Pessimistic belief pertaining to this risk has expanded over the years due to media-based illustrations of loss of control during and following placement in institutional settings (see for example, the movie American Me). The importance of this belief is underscored by research showing that reduced sense of control has a strong relationship to maladjustment within placement (Gold & Osgood, 1992; Martin & Osgood, 1987; Osgood, Gruber, Archer, & Newcomb, 1985).
The impact of residential placement on feelings of control has special clinical and theoretical importance for programs that use external reinforcement systems (e.g., token economies). An influential line of research has suggested that such programs decrease intrinsic motivation to engage in the prosocial behaviors that the programs intend to promote. The key support for this conclusion is research showing performance decrements following removal from external reinforcement systems (Deci & Ryan, 1985; Lepper & Green, 1978). Although this concern is widely cited in criticisms of behaviorally oriented programs, there have been few tests of the applicability of this research beyond laboratory settings. Only by directly comparing youths in and out of placement can we determine whether external reinforcement actually interferes with their sense of control.
That these five beliefs may be valid for some current programs is not in question here. But the beliefs have a pervasive nature that suggest they are universally valid. In the past 20 years, however, some programs have made changes in their methods and goals with an eye toward improving life in placement. These programs have moved away from the traditional training school format with mostly custodial shift-work staff and moved to a smaller group-home format with a family-type atmosphere and trained staff who live with the youths (e.g., Christian, Hannah, & Glahn, 1984; Fixsen et al., 1978; Lerman, 1975; Lundman, 1984; National Institute of Mental Health, 1971; Small & Alwon, 1988; Wolf et al., 1976). Thus the programs purport to correct past problems (problems that presumably have contributed to the negative beliefs mentioned above - cf. Daly & Dowd, 1992).
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