Search any placement portal and nearly every children's home is "therapeutic". The word has become a market signifier, and when everything is therapeutic, nothing is. Commissioners know this, which is why the label increasingly triggers scepticism rather than confidence.
The sector now has a serious answer to the definitional problem. The Royal College of Psychiatrists' College Centre for Quality Improvement publishes the Therapeutic Child Care Standards, now in their second edition (2025), which set out, in auditable detail, what a genuinely therapeutic residential service involves. Not an ethos statement: a specification.
The substance is demanding, and that is the point. A therapeutic home in any meaningful sense has a coherent model of practice that every member of staff can articulate and apply: trauma-informed, attachment-aware, and consistent across shifts, because a child cannot heal in a home where the rules change with the rota. It has qualified clinical input woven into the life of the home: informing formulation and care planning, supervising the staff team's practice, and supporting staff with the emotional impact of the work. Not a therapist who visits on Tuesdays while the home runs on behaviourism the rest of the week. It treats daily life (mealtimes, bedtime, conflict, repair after rupture) as the primary therapeutic medium, on the long-established insight of the therapeutic community tradition that children recover through relationships and routine, not despite them. And it measures change: baseline and repeated outcome measurement, honestly reported, including when progress stalls.
Almost none of this is visible in a brochure. All of it is visible in a home within an hour, and in a provider's documentation within a day: the practice model in writing, the clinical staffing structure, the supervision records, the outcomes data.
So rather than asking providers whether they are therapeutic (a question that has never once received the answer "no"), commissioners might ask better questions. Which model, and where is it written down? Who provides the clinical input, at what sessions per week, doing what? How do you know it is working, child by child? What happened the last time it wasn't?
Providers who can answer those questions have nothing to fear from being asked. The word "therapeutic" should be earned annually, in evidence. Should the sector go further and treat external accreditation against published standards as the norm rather than the exception?
