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May 2016Vol. 17, No. 3Reducing the Use of Congregate Care

In order to provide more children and youth in out-of-home care with stable, home-like placements, the child welfare field is moving away from the use of congregate care for long-term placements when possible and appropriate. A policy brief from the Chadwick Center and Chapin Hall examines the field's current use of congregate care, evidence-based practices that can help prevent youth placement in congregate care, the needs of youth who may require intensive interventions, variations in available treatment options, and States' use of congregate care.

Using data from the National Survey of Child and Adolescent Well-Being (NSCAW II), the brief examines the population of youth placed in congregate care as compared to those placed in other out-of-home settings (e.g., kinship care or other foster care). The brief goes on to identify mechanisms for reducing congregate care use—specifically, evidence-based interventions to target youth's needs and services and supports for youth's home-based caregivers. Key findings include the following:

  • Some States rely heavily on congregate care as a first placement, suggesting the need for capacity building for foster homes.
  • Youth placed in congregate care and therapeutic foster homes have significantly higher levels of internalizing and externalizing behaviors than those placed in traditional foster care (suggesting that increased access to services that effectively address internalizing and externalizing behaviors are essential to safely reducing the use of congregate care).
  • Compared to youth whose clinical needs are met through therapeutic foster care, youth placed in congregate care are more likely have externalizing problems (suggesting that strategies for serving these youth in home-based setting should focus on preparing those homes to respond by deescalating difficult behaviors).

Noting that States may use congregate care differently, the brief provides a number of recommendations for reducing the use of congregate care, including the following:

  • Differentiate intensity of treatment from restrictiveness of placement.
  • Incentivize increasing capacity for skilled and/or specialized home-based placement.
  • Support access to evidence-based interventions designed to help stabilize placements and/or enhance clinical outcomes for youth in foster and kin placements.
  • Enhance access for child welfare systems to technical assistance for selecting and successfully implementing evidence-based practices.
  • Develop funding streams that support flexibility in the delivery and intensity of outpatient services.

Access the brief, Using Evidence to Accelerate the Safe and Effective Reduction of Congregate Care for Youth Involved With Child Welfare, at (537 KB).


Related Item

The U.S. Department of Health and Human Services, Administration for Children and Families, and the Children's Bureau published a brief on the use of congregate care in the child welfare system. Access it at