Supporting Youth in Residential Care: Healing Through Relational Safety  

Today’s guest author is Dr. Claire Cronin RPT-S, LPC, LCMHC, QS. 

Dr. Claire Cronin is the Director of Behavioral Health and Wellness at TGTHR. Claire is passionate about working with the young people at TGTHR. After leaving to attend the University of North Carolina at Charlotte for her Phd in Counselor Education and Supervision, Claire is delighted to be back working at TGTHR. Claire’s clinical and research interests include: social justice in counselor education, adolescent and young adult mental health, resilience within minority communities. Claire is a registered play therapist supervisor, and loves to use art, play and creativity in therapy.

Residential care for youth in the child welfare system is one of the longest-existing systems of care in the United States. Residential programs can offer systems of caring professionals that support youth that have been removed from their homes for a variety of reasons, most through no fault of their own. Youth in residential care have often suffered from abuse, neglect, attachment ruptures, and other complex trauma that lead to a cumulation of adverse childhood experiences (ACEs). Even the act of separating youth from their caregivers and community is immensely traumatizing. The cumulation of ACEs has been linked to poor health outcomes later in life, including higher heart disease and cancer rates. In addition to ACEs, youth in the child welfare system have often been impacted by other forms of systemic oppression. BIPOC and LGBTQ+ youth are disproportionally represented in the child welfare system. Given the unique needs of this population, it has always been imperative to focus on buffering trauma and providing opportunities for healing.

At the non-profit TGTHR, based in Colorado, we provide life-changing opportunities to youth ages 12-25 via a continuum of care. TGTHR was established in 1966 by a group of concerned citizens with the mandate to provide ‘attention, not detention’ to displaced youth. Since then, TGTHR has served over 11,000 young individuals as they become healthy, productive members of our community. Our services support youth in the child welfare system and those experiencing homelessness. We partner with local child welfare systems to offer our Qualified Residential Treatment Program (QRTP). The QRTP system is a massive step forward nationally, resulting from the federal Families First Act, which prioritizes prevention, in-home intervention, and family preservation when possible. When this is not possible, youth are supported through QRTPs which work with youth struggling with psychological, behavioral, and/or substance use issues to provide services that may fall outside the scope of a typical foster care placement.

One theme that has existed since our founding is our deep belief in the power of youth to grow, heal and change. We have proudly been a no-touch facility for our entire existence, and this is what we attribute many of our positive outcomes from youth to. Focusing on building safe, secure, and consistent relationships is the first step in providing trauma-responsive care, where youth can learn to live in relationships again. Our staff all engage in Youth Staff Relationship Training (YSRT) which explores trauma, adolescent development, and relational healing. YSRT is based on Child Teacher Relationship Training and is modified to be developmentally appropriate for adolescents.

Most importantly, this training focuses on the power of the relationship- that creating the right emotional environment provides opportunities for healing and growth. Staff spend time in the training exploring their thoughts and beliefs about youth/adult relationships and are challenged to reframe their thinking about our youth participants. We are constantly looking for the innate strengths and talents in all of our youth participants- what we like to call “focusing on the donut, not the hole.” A deep respect for a youth’s autonomy is the cornerstone of this training, and the YSRT training focuses on helping youth learn decision-making and independence.

TGTHR’s staff seek to “walk alongside” youth during their time in our program and trust the youth to take the relationship where they need it to go. We never use restraint or seclusion for a myriad of reasons. Many of our youth come to our programming after experiencing seclusion, restraint, and physical punishment, which has led to severe trauma. Using these approaches would only lead to further re-traumatization, which is in complete opposition to our mission. We also recognize that isolation, restraint, or physical punishment often leads to further escalation, which increases the likelihood of placement instability or, worse, law enforcement engagement and interaction with the juvenile justice system.

Thirdly, we recognize that staff trained on and asked to engage in isolation, restraint, or physical punishment report higher levels of compassion fatigue and burnout, leading to higher staff turnover. When youth are not supported by consistent, well-trained, engaged, and emotionally regulated staff, they are less likely to get the care they need to heal. Our purpose at TGTHR is that we want to live in a society where every young person can lead a fulfilling life. And we won’t stop until every young person is valued, empowered, and safe. We believe standing up against seclusion and restraint is vital in accomplishing this mission.

If you or your organization are looking for support or technical guidance in becoming a trauma-responsive program that utilizes a no-touch approach, don’t hesitate to contact Dr. Claire Cronin at

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