Critical issues for practice in residential treatment: the view from within.

A large proportion of children in residential treatment engage in extreme acting-out behavior and suffer from severe attachment disorders and abuse reactivity. At the same time, practice is increasingly alienated from theory and public policy. The challenges to practitioners posed by these difficulties are described and illustrated by vignettes, their impact on residential group care practice is discussed, and their implications for the redesign of practice and for the development of a new theoretical base are examined.