In residential care, evidence matters. The CARE (Children and Residential Experiences) model—developed at Cornell University’s Residential Child Care Project—is far more than an idea. It’s a meticulously tested, research-based program that transforms institutions through relationship, reflection, and respect.

What Is CARE? Core Principles & Structure

CARE is built on six guiding principles:

• Developmentally Focused
• Family-Involved
• Relationship-Based
• Competence-Centered
• Trauma-Informed
• Ecologically Oriented

These principles shape daily practice, staff development, and agency culture. The model uses reflective practice, data-informed decision-making, and participatory management over a typical 3–4 year implementation process, guided by local Implementation Teams and Cornell consultants. CEBC for Child WelfareUVic Journalsbpr.sprc.org

Evidence That CARE Works

Behavioral Incident Reductions

• A quasi-experimental, multi-site study in North Carolina found CARE implementation produced monthly reductions in behavioral incidents—3–5% in initial trials and up to 8% in broader evaluations. RCCPScienceDailyPMC
• Caregivers noted reductions in physical restraints and violent behaviors as the agency culture shifted toward a therapeutic, supportive atmosphere. ScienceDaily
• The landmark 2016 Prevention Science study by Izzo et al., titled “Intervening at the Setting Level to Prevent Behavioral Incidents in Residential Child Care: Efficacy of the CARE Program Model”, offers a peer-reviewed validation of CARE’s efficacy. PMC

Relationship Quality Improvements

• A 2020 evaluation across 13 group care agencies used a stepped-wedge design to measure CARE’s impact on youth-staff relationships. Children reported significant improvements in relationship quality post-implementation. RCCP

Safety & Trust in Care Environments

• A 2020 study (Sellers et al.) found that youth feelings of safety were deeply tied to the quality of their relationships with direct care staff. Agencies fostering these relationships enabled children to feel safe—an essential foundation for healing and growth. ResearchGate

Organizational Change & Broader Recognition

• In 2019, Holden & Sellers outlined CARE’s evidence-based implementation process, emphasizing how structured leadership, training, and reflective practice can embed therapeutic responses across institutions. RCCP
• CARE holds a “Promising Research Evidence-Based” rating (Level 3) in the California Evidence-Based Clearinghouse for Child Welfare. UVic JournalsPMC

Summary: What the Research Shows