Using a Theory of Change to Guide Purposeful Programming

When considering the significant trauma, adversity, loss and neglect that bring children and young people into residential care, children and families deserve and require high quality programming to achieve positive outcomes. The role of the direct care worker is essential to help children learn, change and grow in residential programs.

By first understanding the purpose of residential care, direct care staff have a shared understanding that therapeutic care is about providing a safe setting to learn and practice new skills.

With a common ground for purpose for care, a theory of change can be used to illustrate the process and pathways that lead to trauma sensitive environments and improved child outcomes. They can be used purposefully to design and implement programs so that adults can create the experiences children need in order to achieve the desired outcomes. The use of a developed theory of change can help staff practice with fidelity to an evidenced based model and provide consistency and congruence across the organization as all individuals see their role in the therapeutic process.

Using a positive developmental relationship with children, staff can create a therapeutic milieu. As staff see their role to support youth to take risks to learn and practice skills, the importance of daily programming and predictable routines becomes more significant. These daily tasks, simple routines and engaging activities are pivotal in contributing to a sense of safety and helping children learn and develop.

This workshop will not only explore these concepts but provide an opportunity for participants to apply these concepts to their own programs and individual practice.


Andrea Turnbull, LMHC

TCI Program Manager , Cornell University


Rich Heresniak

CARE Implementer , Cornell University


William Martin, MHSA

Instructor , Cornell University


James Hatfield

Youth Residential Supervisor , Waterford Country School