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May 2003Vol. 4, No. 4Review Finds Little Evidence to Support Institutional Care

Institutional care is not an essential component of the child welfare system for the majority of children, concludes a recent report. Institutions vs. Foster Homes: The Empirical Base for a Century of Action, by Richard Barth of the Jordan Institute for Families at the University of North Carolina at Chapel Hill, reviews the existing evidence and finds little to recommend group care.

The review considers four outcome measures for children in institutional care and finds:

  • Children in institutional care may experience less risk of abuse or neglect while in care. However, maltreatment rates are low in all forms of care, and children in group care also have fewer opportunities for interpersonal experiences that may enhance well-being.
  • Children who are reunified with their families following group care experience higher re-entry rates than children in other types of settings.
  • Young adults leaving group care appear to be less successful than those leaving foster care.
  • The cost of institutional care far exceeds that of foster care or treatment foster care.

From these findings, the author concludes policy makers and practitioners should emphasize the development of alternative forms of care, such as foster care and therapeutic foster care (rather than residential treatment centers), and receiving centers (rather than centralized emergency shelters). The author did find group care may work as a temporary placement for specific groups of youth, such as youth who have run away from foster care, those who are destructive or self-destructive, or youth "stepping down" from a more restrictive form of care to a family-based setting.

Download the complete report in PDF format from the University of North Carolina at Chapel Hill website at

Related Item

For another view on congregate care for foster children, read "Options for Children in Long-Term Out-of-Home Placements" in the March/April 2001 issue of Children's Bureau Express.