The Implementation of Evidence-Based Practices in Residential Care: Outcomes, Processes, and Barriers

Using data from a U.S. survey of residential care providers on the utilization of evidence-based practices (EBPs) in residential care, this study examines outcomes, processes, and barriers related to the implementation of EBPs. Descriptive data on 115 EBPs implemented in 66 residential care agencies were analyzed with regard to multiple domains of implementation outcomes, such as the adoption, appropriateness, fidelity, and sustainability of EBPs. Study results showed that residential care programs are primarily implementing EBPs that target specific client problems and populations and address prevalent problems of trauma and emotional disorders. A low rate of utilization of milieu-based program models, which were specifically designed for residential care, was noted. Child care staff were mostly excluded from the training and delivery of EBPs. Although providers reported that implementation of EBPs yielded desired results, considerable barriers persisted. Fidelity data raised questions about the degree to which agencies are in fact implementing EBPs. Findings from this exploratory study are meant to encourage further inquiry of the conditions necessary in residential care programs to foster openness toward the implementation of EBPs and to achieve sustained success.