Dyadic and systemic trauma-informed care in adolescent residential settings: A systematic review of outcomes for staff, youth, and relationships.

OBJECTIVE

This systematic review evaluated the effectiveness of dyadic and systemic approaches to trauma-informed care (TIC). The study aimed to identify TIC-based models in adolescent residential care and evaluate their effects on staff development, youth well-being, and the quality of staff-youth relationships.

PARTICIPANTS AND

SETTING

The studies focused on adolescents aged 10-19 years in residential care settings and the staff responsible for their direct care.

METHODS

Following PRISMA 2020 guidelines, a comprehensive search across 12 databases and two registers yielded 19 eligible studies. These studies were appraised using the Mixed Methods Appraisal Tool (MMAT).

RESULTS

Findings suggest modest but promising effects of trauma-informed care (TIC) interventions on staff development, youth well-being, and adult-youth relationships. Interventions that integrated dyadic strategies (e.g., emotional attunement, reflective functioning) with systemic support (e.g., supervision, organizational coherence) showed the most consistent improvements. However, methodological quality was generally low, and only higher-quality studies demonstrated sustained outcomes.

CONCLUSIONS

This review supports a shift toward relationship-centered practice models that align daily care with organizational coherence and reflective structures. While promising patterns are evident, more robust, theory-driven research is needed to clarify mechanisms and long-term impacts across diverse residential care settings.