The use of institutional placement in juvenile justice, mental health, and child welfare continues to be widespread. Yet there is little information about the decision-making processes connected with the choice of this alternative for adolescents. Focus groups were held with administrators, staff, and youth in a variety of institutional placements. The discussions of these groups were qualitatively analyzed for content regarding the factors that motivated reliance on placement in institutional care and the effects of policies to regulate this practice. Agreement about the diversity of adolescents in institutions, the difficulties of (but necessity for) preventive interventions with families, and possible causes for reliance on institutional care emerged. Differences about the risks and benefits of institutional placement were noted.
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