ABSTRACT
This chapter discusses that the residential care and treatment remain essential but, nonetheless, controversial components in an overall continuum of child welfare services. It argues that elsewhere in the text, creation of an accurate, comprehensive, national, up-to-date database for all children and youth in residential group care remains a critical requisite for any serious service reform efforts. As a result of inattention to group care, model development, treatment innovations, development of treatment and training protocols, and controlled empirical studies of residential group care have all languished. The chapter discusses children and youth who are dually diagnosed: severely emotionally disturbed and delinquent and major involvement in sexual abuse and substance abuse. Children in residential placement are in care as well as treatment. The decision to place a child in residential treatment is presently a high individualized matter based on a complex set of idiosyncratic factors defying categorization.
