TST (RES) has been adapted for youth in child and adolescent congregate care settings. The focus of this adaptation is again on creating the delicate balance between appropriate emotional regulation and stable social environment for traumatized youth.
Traumatic triggers can be ubiquitous in residential settings as youth may be consistently confronted with situations that remind them of past traumatic events. In fact, the very nature of having been removed from the family/community and placed in a residence may in itself be a traumatic reminder. In addition, youth in residential treatment are often navigating two social environments, the residential milieu in which they currently reside, as well as the family/community to which they are still connected, and to which they may or may not return.
The goal of TST-RES, therefore, is two-fold. It is both to provide youth with skills to learn to better cope when confronted with such reminders, as well as to provide education and support to staff working in residential settings in order to help them learn to recognize and minimize such triggers; in turn this allows staff to create and maintain a safe and stable therapeutic milieu. Staff are taught to identify patterns of triggers for each youth, as well as to look for signs of potential distress or threat in the milieu overall, which may impact all youth and staff living and working in the environment. Home based care is also a critical intervention in TST-RES, as it helps to address the often difficult transition from residential care back to the home, or to a new community environment.
Agencies that have adapted TST for use in residential milieu treatment include: KVC Health Systems (KS), The Children’s Village (NY), and Lutheran Social Services of the South (TX).