​Throughout Boys Town’s history, one of our most important guiding principles has been to always do what is in the best interests of children or families so they have the greatest opportunity to find healing and success. This is why we developed our Integrated Continuum of Care®. The Continuum includes in-home and community-based programs that allow more children to get the help they need while remaining with their families (whenever possible) or during short-term stays in foster care.

Still, Boys Town knows that these less-restrictive approaches cannot meet the needs of all youth, particularly those with serious behavioral or emotional problems. There will always be children who need more intensive treatment, and research and practice demonstrate that quality residential care is an essential component of any continuum of care for at-risk youth.

Residential care has come under attack recently by policy advocates and system reformers who argue that it should be reduced or eliminated as an out-of-home placement for at-risk youth. Some of these critics contend that foster care and family-based programs can adequately meet the needs of all of these children. They also contend that residential care is costly, and they want to eliminate it in order cut costs and save money.

No one would argue that children who can be safely and successfully served in their own families or in surrogate families should be in residential care. But the debate over residential care vs. less-restrictive options turns in favor of residential care when we are looking at children who have been removed from their families and whose behavioral, emotional, or mental health needs are too challenging for community-based options such as foster care, kinship care, in-home family services, or outpatient therapy.

Some critics, including powerful national foundations, have said it is best to keep these at-risk children in the very programs where they have continually failed. One of their arguments is that children who are placed in residential care have the poorest treatment outcomes. To that, we say: Of course they do; they are the most difficult kids in the system. These are the very children who have failed in outpatient treatment, inpatient treatment, in-home family services, and foster care. These critics fail to recognize this obvious reality.

Sadly, when kids are stuck in a pattern of repeated failure, they are hurt and re-traumatized over and over again by frequent moves to new placements, new caregivers, and new schools, and add even more entries to their resumes of failure.

These are the children who receive care through the Boys Town Family Home Program® and other quality residential programs that use the Teaching Family Model. Yet, these residential programs produce long-term, positive outcomes, even for children who have experienced multiple failures in less-restrictive options. Without quality residential care, these boys and girls would become the “throwaway” citizens of our country.

Over the next several months, we will explore quality residential care and what Boys Town is doing to ensure that it will always be there for children whose serious problems require more-intensive care and who haven’t found the help they need in other care settings.