Unraveling Trauma-Focused Residential Treatment for Families Experiencing Complex and Multiple Problems: Practitioner-Reported Practice and Program Elements

Families experiencing complex and multiple problems (FECMP) face severe, chronic, and intertwined problems across multiple areas of life, increasing their risk of child maltreatment and complex trauma. An innovative approach to helping FECMP and preventing child out-of-home placement is to treat entire families together in an out-of-home setting. This study examined the content and provision of such a program for traumatized FECMP in daily practice. We conducted a qualitative content analysis of practitioner-reported care reports and treatment goals for 12 families who completed the program, using the Taxonomy of Interventions for Families with Multiple Problems (TIFMP). A total of 9288 practice elements were coded, including their intensity, mode of delivery, recipients, and alignment with families’ treatment goals. The results show that elements focusing on promoting change (e.g. working on communication and trauma) and maintaining practitioner-family collaboration (e.g. talking about expectations) were most frequently reported, whereas elements focusing on activating social and professional networks were least frequently reported. Most practice elements targeted parents and involved practicing and psychoeducation. There was considerable alignment between family treatment goals and reported practice elements. This study highlights the value of using a taxonomy to gain detailed insights into residential treatment, allowing for a better understanding of care outcomes.