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Methods
This study draws on in-depth qualitative interviews with adult survivors of institutional child abuse in youth residential care, including therapeutic boarding schools, wilderness therapy programs, residential treatment centers, troubled teen boot camps, and behavior modification programs. Participants were recruited through advocacy organizations, legal and youth-serving organizations, social media, and word of mouth. Survivor-scholars were involved in all aspects of the project, including leadership, research design, interviewing, data analysis, and validation of findings. Data were analyzed using an iterative, comparative approach. Coding focused on identifying recurring patterns across cases and examining how participants linked adolescent institutional experiences to later developmental outcomes. Findings are preliminary and reflect ongoing analysis of a larger dataset.
Results
Four consistent themes emerged reflecting long-term developmental and life course disruption. First, relational distrust and threat sensitivity persisted into adulthood. Participants described difficulty trusting others, particularly authority figures, along with chronic vigilance and an expectation of harm in relationships. Second, identity disruption and constrained autonomy were widely reported. Participants described a diminished sense of self, difficulty making independent decisions, and enduring patterns of compliance and self-suppression. Third, developmental disruption was evident in damaged family relationships, loss of normative adolescent experiences, and inadequate preparation for adulthood. Participants linked placement to estrangement from family, missed developmental milestones, and limited acquisition of practical and relational skills. Fourth, altered engagement with systems and services reflected a durable pattern of avoidance and mistrust. Participants described reluctance to seek help and difficulty engaging with providers, particularly in institutional or authority-driven contexts. Across themes, participants linked these trajectories to institutional conditions, including coercive control, restricted communication, humiliation, and deprivation of autonomy.
Conclusions & Implications
Institutional child abuse in adolescence is associated with patterned disruptions in life course development, not isolated or time-limited harm. The findings show that institutional conditions shape enduring trajectories across relational functioning, identity formation, developmental progression, and engagement with systems. For social work, this requires a shift in how maltreatment in congregate care is understood and addressed. Assessment and intervention must account for developmental disruption linked to institutional environments, not just individual trauma symptoms. At the policy level, these findings show the need for greater scrutiny of residential care models that rely on control, compliance, and restriction, particularly where such practices interfere with normative development. This study strengthens the empirical basis for recognizing institutional child abuse as a developmental and life course issue and supports trauma-informed approaches that account for institutional experiences in practice and policy.