Limited global evidence on effective Therapeutic Residential Care (TRC) mechanisms is particularly concerning, given recent Portuguese legislation (Decree-Law 39/2025) that reclassified TRC as a Specific Unit pending defined standards. To address this critical gap, our qualitative, cross-sectional study identified key factors for youth improvement and the therapeutic elements of TRC from the perspective of front-line staff. Adopting an established evidence-based framework as a foundational structure for this inquiry, this study explored the perspectives of 13 frontline staff (10 caseworkers and three caregivers), predominantly female (69.2%) and aged 25–48 across five nonprofit facilities in Portugal. Data were collected via questionnaires and semi-structured interviews and analyzed using a manifest content analysis that combined deductive and inductive approaches. Alongside Setting, Staffing, Treatment Approach, and Safety, three additional domains emerged: Milieu Factor, Youth Risk Profile Characteristics, and Job Characteristics. Findings showed staff viewed TRC positively, but predominantly focused on youth risk factors rather than protective factors. While trusting staff-youth relationships were central, enhancing broader Milieu Factor elements, such as peer, family, and community relationships, may be just as crucial. These insights underscore an urgent need for strategic shifts in practice and policy to integrate protective and relational factors within Portugal’s evolving legislative landscape.

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Therapeutic residential care,Qualitative,Staff’s perception and experience,Quality

• Basic Medicine - Medical and Health Sciences
• Clinical Medicine - Medical and Health Sciences
• Law - Social Sciences