Editorial Introduction: Residential Services for Children and Adolescents Impacted by Family Violence and Trauma

There are times when our experiences as clinicians, practitioners, and managers align in a moment of enlightenment. This happened for one of us (Pond) several months ago at a meeting of foster parents who have been trained to provide intensive support to particularly vulnerable youth. In my welcoming remarks, I reflected upon some of the challenges associated with working with children whose lives have been impacted by multiple and chronic or recurrent interpersonal trauma, violence and neglect, experiences often referred to collectively as “complex trauma” (see Cook et al. 2005; Spinazzola et al. 2005; Spinazzola et al. 2013). I noted that residential programs see the same population of traumatized youth—often sharing cases and transition plans. We know from consistent federal data that in excess of 100,000 U.S. children and adolescents newly enter out-of-home placements each year (U.S. Department of Health and Human Services 2012). In some instances the determination of whether to place a maltreated child with a foster family versus within a congregate is based upon the acuity or severity of emotional and behavioral difficulties exhibited by these highly vulnerable youth. For example, through analysis of one of the world’s largest child trauma databases, our colleagues at National Center for Child Traumatic Stress (NCCTS) have demonstrated that youth in residential treatment settings constitute the most vulnerable subgroup of children and adolescents victimized by trauma, exhibiting the highest rates of trauma exposure, associated impairment, and need for extensive intervention (Briggs et al. 2012). Just as often, however, out-of-home placement decisions are seemingly “the luck of the draw,” predicated upon local resources and capacity, and in many instances ultimately decided bywhoever happens to be next in line for an available bed. Later during this meeting we had a guest speaker, Hector, a man now in his mid-thirties, who spoke about his life as one of these children who spent years in out-of-home placements. His story is all too common, although his level of insight about the impact of his experiences was exceptional. Hector approached me after the event, and told me that when I spoke about the impact of repeated, familial trauma—physical abuse, witnessing domestic violence, and chronic disruption of placements—“You are talking about me. That’s my story.” Sadly, this disclosure was hardly surprising considering recent research by our NCCTS colleagues establishing that over 70 % of children in foster care have been exposed to complex trauma (see Greeson et al. 2011). Through his entire childhood, Hector witnessed severe domestic violence and suffered frequent physical abuse. The violence escalated; his mother began to beat him to the point that he feared for his life. Even though he had barely turned 13, Hector had the bravery to walk into a social services office and ask that he be put into a safe place. Hector thought this act would be his salvation—what he knew of foster families was from television, and he thought what hewould find would be a family, or other caregivers that would help him and keep him safe. Instead, he experienced further disconnection and continuing loss. For the next 3 years, he was “bounced” from setting to setting, by his count nearly twenty (20) times. He went to nine different high schools. By his account, he was moved nomatter how he behaved. In his mind, if he was good, that was progress, and he was moved on. If he was “bad” he was not making progress, and was moved on. He described himself at 15 as hopeless, and alienated, and angry. Then, just as he turned 16, he met a family trained to provide more intensive support that demonstrated, through A. Pond Justice Resource Institute, Needham, MA, USA