Well-Being, Self-Esteem, and Psychosocial Adjustment in Vulnerable Children: A Comparative Study of Residential Care Homes and Child Day-Care Programs✽

Jaime Burón, Ana Pulgar, Raquel Ordiales, Laura García-Alba, Carla González-García, and Amaia Bravo

Received: September 20, 2025 | Accepted: March 26, 2026 | Modified: April 20, 2026

https://doi.org/1.7440/res.12227

Abstract | Psychosocial adjustment is a key indicator of developmental outcomes among children and adolescents receiving child protection services. This study describes the psychosocial profile of participants and compares subjective well-being, self-esteem, and emotional and behavioral symptoms across two programs within the Spanish child protection system: day care centers for children and adolescents (preventive family preservation programs) and residential care homes (for cases involving abandonment or neglect). A total of 194 participants aged 11-18 years were assessed using three standardized self-report instruments: the Strengths and Difficulties Questionnaire (SDQ), the Personal Wellbeing Index (PWI-7), and the Rosenberg Self-Esteem Scale (RSES). Comparative analyses were conducted across the two programs, and associations with gender and age were also examined. Participants attending day care centers showed a more favorable psychosocial profile, reporting significantly higher subjective well-being and a tendency toward fewer emotional and behavioral difficulties. In contrast, adolescents in residential care experienced greater difficulties in peer relationships and held less positive perceptions of their environment, although no significant differences in self-esteem were observed. Correlation analyses indicated that greater difficulties were associated with lower levels of well-being and self-esteem, while the latter two variables were positively associated with one another. Girls showed greater emotional vulnerability and lower life satisfaction, whereas age had only a weak moderating effect. These findings underscore the value of preventive programs that preserve family relationships and foster positive experiences, while also highlighting the need to improve the quality of care through interventions focused on safety, stable relationships, and trauma-informed care. The study also emphasizes the importance of incorporating a gender perspective to strengthen resilience and emotional well-being and provides novel comparative evidence on psychosocial adjustment across two types of child protection services in Spain.

Keywords | day care center; emotional problems; mental health; residential care; self-esteem; subjective well-being

Bienestar, autoestima y ajuste psicosocial en la infancia vulnerable: un estudio comparativo entre hogares de acogimiento residencial y centros de atención diurna

Resumen | El ajuste psicosocial es un indicador clave del desarrollo de niños, niñas y adolescentes (NNA) bajo medidas de protección. Este estudio tiene como objetivo describir el perfil psicosocial y analizar comparativamente el bienestar subjetivo, la autoestima y la sintomatología emocional y conductual entre participantes de dos programas del sistema de protección infantil en España: centros de día para la infancia y la adolescencia (programas preventivos de preservación familiar) y hogares de acogimiento residencial (para casos de desamparo o negligencia). Se evaluó a un total de 194 participantes de 11 a 18 años mediante tres instrumentos autoinformados estandarizados: el Cuestionario de Fortalezas y Dificultades (SDQ), el Índice de Bienestar Personal (PWI-7) y la Escala de Autoestima de Rosenberg (RSES). Se realizaron análisis comparativos entre programas y se exploraron asociaciones con el género y la edad. Los NNA atendidos en centros de día mostraron un perfil psicosocial más favorable, con un bienestar subjetivo significativamente superior y una tendencia a presentar menos dificultades emocionales y conductuales. Los adolescentes en acogimiento residencial presentaron mayores desafíos en las relaciones con sus iguales y una percepción menos positiva del entorno, mientras que no se observaron diferencias significativas en la autoestima. Las correlaciones indicaron que mayores dificultades se asocian con menor bienestar y autoestima, factores que se relacionan positivamente entre sí. Las mujeres mostraron mayor vulnerabilidad emocional y menor satisfacción vital, y la edad presentó un efecto modulador débil. Los hallazgos subrayan la relevancia de programas preventivos que preserven los vínculos familiares y generen experiencias positivas, así como la necesidad de mejorar la calidad del cuidado mediante intervenciones centradas en la seguridad, en relaciones estables y en una atención sensible al trauma. Este estudio destaca la importancia de incorporar una perspectiva de género para fortalecer la resiliencia y el bienestar emocional y, además, aporta evidencia comparativa novedosa sobre el ajuste psicosocial en dos modalidades del sistema de protección en España.

Palabras clave | acogimiento residencial; autoestima; bienestar subjetivo; centro de día; problemas emocionales; salud mental

Bem-estar, autoestima e ajustamento psicossocial na infância vulnerável: estudo comparativo entre serviços de acolhimento institucional e centros de atendimento diurno

Resumo | O ajustamento psicossocial é um indicador fundamental do desenvolvimento de crianças e adolescentes sob medidas de proteção. Este estudo tem como objetivo descrever o perfil psicossocial e analisar comparativamente o bem-estar subjetivo, a autoestima e a sintomatologia emocional e comportamental entre participantes de dois programas do sistema de proteção à criança e ao adolescente na Espanha: centros de atendimento diurno para crianças e adolescentes (programas preventivos de preservação familiar) e serviços de acolhimento residencial (destinados a casos de abandono ou negligência). Foram avaliados 194 participantes, com idades entre 11 e 18 anos, por meio de três instrumentos padronizados de autorrelato: o Questionário de Capacidades e Dificuldades (SDQ), o Índice de Bem-Estar Pessoal (PWI-7) e a Escala de Autoestima de Rosenberg (RSES). Foram realizadas análises comparativas entre os programas e exploradas associações com gênero e idade. As crianças e os adolescentes atendidos em centros de atendimento diurno apresentaram um perfil psicossocial mais favorável, com bem-estar subjetivo significativamente superior e tendência a apresentar menos dificuldades emocionais e comportamentais. Os adolescentes em acolhimento residencial apresentaram maiores desafios nas relações com os pares e uma percepção menos positiva do ambiente, enquanto não foram observadas diferenças significativas na autoestima. As correlações indicaram que maiores dificuldades estão associadas a menor bem-estar e autoestima, fatores que, por sua vez, se relacionam positivamente entre si. As meninas apresentaram maior vulnerabilidade emocional e menor satisfação com a vida, enquanto a idade exerceu um fraco efeito moderador. Os achados ressaltam a relevância de programas preventivos voltados à preservação dos vínculos familiares e à promoção de experiências positivas, bem como a necessidade de melhorar a qualidade do cuidado por meio de intervenções centradas na segurança, em relações estáveis e em um cuidado sensível ao trauma. Este estudo destaca a importância de incorporar uma perspectiva de gênero para fortalecer a resiliência e o bem-estar emocional e, além disso, oferece evidências comparativas inéditas sobre o ajustamento psicossocial em duas modalidades do sistema de proteção à infância na Espanha.

Palavras-chave | acolhimento residencial; autoestima; bem-estar subjetivo; centro de atendimento diurno; problemas emocionais; saúde mental

Introduction

Psychosocial adjustment in children and adolescents is a key indicator of healthy development, as it encompasses emotional, behavioral, and social dimensions. Recent research has shown that psychosocial adjustment during adolescence is closely associated with perceived social support, resilience, and positive affect, factors that in turn predict long-term social integration and emotional well-being (Azpiazu et al. 2024; Rodríguez-Fernández et al. 2016). These resources are not only correlated with well-being but also function as protective mechanisms in the face of stress and adversity. Resilience acts as a psychological buffer that facilitates emotional regulation and recovery from adverse experiences, whereas perceived social support provides a secure framework that promotes the development of social and emotional competencies (Surzykiewicz et al. 2022). Likewise, self-esteem shapes both the interpretation of adverse events and perceived self-efficacy, thereby reducing the likelihood of internalizing and externalizing symptoms (Greger et al. 2017; Ioannidou and Michael 2024).

Difficulties in psychosocial adjustment during childhood and adolescence have also been shown to predict mental health problems in adulthood, including anxiety, depression, and intergenerational relational difficulties (Derdikman-Eiron et al. 2011; Gazelle et al. 2024). In this context, understanding the factors that promote or hinder psychosocial adjustment among children and adolescents has become a scientific and social priority in the study of childhood development. Consequently, emotional symptoms, subjective well-being, and self-esteem are key constructs in the assessment of psychological adjustment in childhood (Casas et al. 2013a; Cummins and Lau 2005; Goodman 2001; Ioannidou and Michael 2024; Ortuño-Sierra et al. 2022; Rosenberg 1965).

Emotional difficulties and strengths constitute important clinical indicators in the assessment of psychological distress (Goodman and Goodman 2012), particularly in contexts of adversity (González-García et al. 2017). It is estimated that between 8.7% and 22.6% of children and adolescents experience emotional problems, while between 2.4% and 14.6% exhibit behavioral problems (Ortuño-Sierra et al. 2016). These rates vary by gender. Evidence suggests that boys are more likely to display externalizing symptoms and tend to report higher scores in the domains of conduct problems, peer problems, and hyperactivity (Derdikman-Eiron et al. 2011; Ortuño-Sierra et al. 2022). In contrast, difficulties among girls tend to manifest as more internalizing symptoms, with higher levels of emotional problems and higher prosocial behavior scores (Derdikman-Eiron et al. 2011; González-Carrasco et al. 2017). Finally, although the evidence remains inconclusive, some studies have reported an increase in emotional and behavioral difficulties with age (Ortuño-Sierra et al. 2016; Rodríguez-Mora et al. 2025).

Subjective well-being is defined as individuals’ evaluation of their own lives and encompasses both affective and cognitive components (Cummins and Lau 2005). In the case of children and adolescents, this construct has been associated with perceptions of safety, relational stability, and a sense of belonging (Blasco-Belled et al. 2023; Casas et al. 2013a). Advancing research in this area requires valid and appropriately adapted instruments capable of capturing their perspectives. Incorporating the direct perspectives of children and adolescents makes it possible to understand the subjective impact of child welfare contexts on their emotional well-being, thereby revealing nuances that may be overlooked in reports provided by professionals or caregivers. In this regard, the present study not only contributes to improving the quality of measurement but also recognizes children and adolescents as competent informants in research concerning their own subjective well-being (Cummins et al. 2008; Llosada-Gistau et al. 2017; Mason and Urquhart 2001).

Self-esteem, in turn, is understood as an individual’s positive evaluation of the self (Rosenberg 1965) and has been identified as a protective factor against the development of both internalizing and externalizing symptoms (Baumeister et al. 2003; Ioannidou and Michael 2024; Orth and Robins 2014). Children and adolescents who have been exposed to situations of vulnerability, such as victimization experiences or adverse life events, tend to report lower levels of self-esteem (Greger et al. 2017; Gullo et al. 2023). Furthermore, gender has also been identified as a risk factor, with several studies highlighting girls’ greater vulnerability to low levels of self-esteem (Derdikman-Eiron et al. 2011; Yang et al. 2025).

Several studies have shown that children and adolescents involved in the child welfare system experience higher levels of psychological vulnerability than the general population, with elevated rates of emotional and behavioral symptoms (Brännström et al. 2017; González-García et al. 2017; Rodríguez-Mora et al. 2025). In this context, the present study examines two programs that form part of the child welfare system in Spain. On the one hand, Child Day-Care programs (CDC) for children and adolescents, which operate within the primary level of care and are organized by the community-level social services, provide daytime care and educational, social, and emotional support for children and adolescents at low to moderate risk. In doing so, they help prevent separation from the family environment (Burón et al. 2025). Their aim is to prevent institutionalization and promote the holistic development of children and adolescents at risk. On the other hand, Residential Care Homes (RCH) constitute a more intensive child welfare measure for children and adolescents who have been placed under protective care due to the loss of parental care and who temporarily reside outside their family home in a structured environment supervised by a team of residential care professionals (Bravo et al. 2022; Castro et al. 2024).

Although both programs are part of the child welfare system, they serve distinct populations and address different needs, raising questions about their differential impact on the psychosocial adjustment of children and adolescents. The profile of boys and girls living in RCH has been extensively studied, and research has consistently found them to be more vulnerable than children and adolescents living with their families of origin. This vulnerability is associated with previous experiences of trauma, disrupted attachments, and exposure to adverse environments. In particular, children and adolescents in RCH have been found to report lower levels of subjective well-being and self-esteem, as well as greater emotional difficulties, compared to their peers living in family or community settings (Delgado et al. 2019; Greger et al. 2017; Montserrat et al. 2022; Rodríguez-Mora et al. 2025; Schütz et al. 2015; Soriano-Díaz et al. 2023).

However, the scientific literature has paid far less attention to community-based resources, resulting in a significant gap in comparative research and a limited body of evidence on CDC (Burón et al. 2025; Hidalgo et al. 2018). Moreover, many studies rely primarily on external indicators or reports provided by professionals and do not systematically incorporate the subjective perspectives of children and adolescents themselves. This omission limits our understanding of the actual impact of child welfare programs on the emotional well-being of the children and adolescents they serve. There is a need to move toward research designs that integrate the voices of children and adolescents as valid sources of information and recognize them as active and valuable participants whose views should be considered in decisions and interventions concerning their own well-being (Sarasa-Camacho and Burón 2025).

For all these reasons, the present study seeks to address this gap in knowledge through a comparative design involving children and adolescents attending CDC and children and adolescents living in Residential Care Homes (RCH) in a region of northern Spain. To the best of our knowledge, this is the first study to systematically examine differences in subjective well-being, self-esteem, and emotional and behavioral symptoms between these two child welfare programs while also incorporating the self-reported perspectives of children and adolescents themselves. The selection of these variables is grounded in both the clinical and social relevance of children’s and adolescents’ own accounts and their potential to inform decision-making in public policy and professional practice. Emotional and behavioral difficulties make it possible to identify risk profiles requiring specialized intervention; subjective well-being provides an assessment of the degree of life satisfaction and emotional well-being experienced by children and adolescents; and self-esteem offers insight into their self-concept and coping capacity.

The main hypotheses propose that children and adolescents attending CDC will exhibit the following characteristics compared to children and adolescents living in RCH: (H1) lower levels of emotional and behavioral symptoms; (H2) higher levels of subjective well-being; and (H3) higher levels of self-esteem. These expectations are based on the assumption that CDC represent a more preventive level of intervention and involve lower levels of exposure to risk within the child welfare system. In these settings, the preservation of family and community ties may facilitate more favorable emotional adjustment. Furthermore, gender (H4) and age (H5) are expected to moderate psychosocial adjustment outcomes. Finally, the three dimensions examined are expected to be correlated with one another (H6), in line with previous evidence showing that subjective well-being and self-esteem function as protective factors against emotional symptoms and buffer the effects of adversity on psychosocial adjustment.

Methodology

This study employs a quantitative, cross-sectional, and comparative design and pursues two clearly defined objectives: (1) to characterize the psychosocial adjustment profile of children and adolescents participating in two distinct programs within the child welfare system, focusing on subjective well-being, self-esteem, and emotional difficulties; and (2) to determine whether significant differences exist between children and adolescents attending CDC and those living in RCH, taking into account gender- and age-related differences. This approach makes it possible not only to describe the psychosocial circumstances of children and adolescents but also to identify relevant implications for improving intervention programs and public policies aimed at children and adolescents in vulnerable situations.

Participants

The sample consisted of 194 children and adolescents subject to child protection measures, aged between 11 and 18 years (M = 14.52, SD = 1.99). Regarding gender, the sample included 103 girls (53.1%), 90 boys (46.4%), and one participant who preferred not to disclose their gender identity.

Participants were divided into two independent groups according to the type of care program they attended. The first group consisted of 110 children and adolescents attending one of the 16 publicly operated CDC in the region under study, which comprise all such centers in that autonomous community. This group comprised 62 girls and 48 boys, with a mean age of 13.83 years (SD = 1.90).

The second group consisted of 84 children and adolescents living in 14 RCH within the same autonomous community: 41 girls, 42 boys, and one participant whose gender was not reported, with a mean age of 15.51 years (SD = 1.68). Although not all residential care homes in the region participated in the study, all residential care modalities were represented, including emergency care, general or non-specific residential care homes, specialized care for unaccompanied migrant youth, preparation for independent living, residential homes for adolescents with moderate emotional and behavioral difficulties, and therapeutic residential care. This strategic sampling approach enabled the study to capture the full diversity of residential care provision across the region while avoiding potential biases associated with the exclusion of specific residential care modalities.

Instruments

To assess the study variables—emotional symptoms, subjective well-being, and self- esteem—three psychometric instruments that have been widely validated and used with child and adolescent populations were administered.

Emotional and Behavioral Difficulties

Emotional and behavioral symptoms were assessed using the self-reported version (S11-17) of the Strengths and Difficulties Questionnaire (SDQ; Goodman 2001). The instrument comprises 25 items distributed across five subscales: emotional symptoms, conduct problems, hyperactivity/inattention, peer problems, and prosocial behavior. Responses are rated on a three-point Likert scale (0 = “Not True”; 1 = “Somewhat True”; 2 = “Absolutely True”).

Both the subscales and the total score allow for the classification of symptomatology using cutoff scores established in the Spanish validation of the instrument. Three levels of symptomatology were distinguished: (a) subclinical (0–15), (b) borderline (16–19), and (c) clinical (20–40), in accordance with international criteria (Goodman 2001). The subscales were interpreted according to the categories of subclinical, borderline, and clinical. Supplementary materials for scoring and interpretation are available on the Youthinmind website (n.d.). In the present study, the SDQ demonstrated acceptable internal consistency (α = .76).

Personal Well-Being Index

Personal well-being was assessed using the Personal Well-Being Index (PWI; Cummins and Lau 2005), adapted for use with children and adolescents. The version employed in this study comprises seven items (PWI-7) assessing satisfaction across key life domains: health, standard of living, personal achievements, sense of safety, belonging to social groups, future security, and interpersonal relationships. Consistent with previous research (Casas et al. 2013b; Gullo et al. 2023; González-García et al. 2024), four additional items specifically relevant to the Spanish context and to children and adolescents subject to child protection measures were included: leisure, body image, family, and care setting.

Responses are recorded on an 11-point scale ranging from 0 (“completely dissatisfied”) to 10 (“completely satisfied”) and are subsequently transformed to a 0–100 scale to facilitate comparisons between groups. Scores between 70 and 80 are considered indicative of average levels of well-being (Cummins et al. 2008); according to this criterion, scores below 70 indicate low well-being, whereas scores above 80 indicate high well-being. Additionally, a standalone item assessing overall life satisfaction (OLS) was included as a complementary indicator. Internal consistency was adequate for both the seven-item version of the scale (PWI-7; α = .85) and the extended version including the four additional items (PWI–11; α = .87).

Self-Esteem

The Rosenberg Self-Esteem Scale (RSES; Rosenberg 1965) was used to assess participants’ global self-esteem. The scale consists of 10 items rated on a four-point Likert scale ranging from 1 (“strongly disagree”) to 4 (“strongly agree”), yielding total scores between 10 and 40. According to the author’s criteria, scores of 25 or below indicate low self-esteem, scores between 26 and 29 indicate moderate self-esteem, and scores of 30 or above indicate high self-esteem. The widespread use of this instrument is attributable to its ease of administration, as well as its strong reliability and validity indices. In the present study, the scale demonstrated adequate internal consistency (α = .84).

Procedure

The samples were drawn from two ongoing independent research projects that were methodologically integrated for the purpose of comparing two forms of intervention within the child welfare system: Child day-care centers for children and adolescents (CDC) and residential care homes (RCH). This integration was motivated by the scientific interest in exploring how the emotional and behavioral profiles of children and adolescents vary according to the type of child welfare intervention they receive. Data collection in the child day-care centers was approved by the Research Ethics Committee of the University of Cantabria (Reference No. 5/2020). In the case of residential care homes, the study was conducted in compliance with all data security and data protection requirements established by the applicable legislation, particularly Regulation (EU) 2016/679 (General Data Protection Regulation, GDPR) and Organic Law 3/2018 on Personal Data Protection and the Guarantee of Digital Rights. Data collection was also approved by the Ethics Committee of the University of Cantabria, as recorded in the minutes of the committee’s ordinary meeting held on July 21, 2022.

Following institutional approval, the technical teams of both programs were contacted to provide information about the study objectives, establish an anonymous coding system, and coordinate data collection. In the CDC, professionals were responsible for contacting birth families, obtaining written informed consent from legal guardians, and securing verbal assent from the children and adolescents. This procedure ensured participants’ understanding of the study, the confidentiality of the data collected, and the voluntary nature of participation. In the RCH, educational staff, acting as legal guardians, were responsible for informing the children and adolescents and obtaining consent in accordance with the same ethical protocol.

Data were collected through face-to-face interviews conducted at the CDC between May 2021 and June 2022 and in RCH between October and November 2023. The instruments were administered in paper-and-pencil format, either individually through interviewer- administered assessments or, in exceptional cases, through self-administration under the direct supervision of the research team. Support was provided whenever necessary to ensure full comprehension of the items. The estimated completion time was approximately 30 minutes. Data collection was carried out by members of the research team, comprising social work and psychology professionals with extensive experience in psychosocial intervention with children and adolescents in situations of vulnerability. In the case of unaccompanied migrant youth, when participants lacked sufficient language proficiency to complete the interview, a cultural mediator assisted in the assessment process.

Data Analysis

Statistical analyses were conducted using SPSS (Version 27). First, exploratory analyses were performed to examine the assumptions of normality and within-group variability among participants in residential care homes, as these encompassed different types of residential care settings. The results indicated that the data did not meet the assumption of normality. In addition, no clear differential patterns were observed across the various types of residential care settings included in the sample. Therefore, this variability did not appear to affect the overall trends observed in the comparison between programs.

Once the nature of the data had been examined, descriptive statistics (mean and standard deviation) were calculated for the scores obtained on the three instruments, distinguishing between the two types of child welfare programs. In addition, the nonparametric Mann-Whitney U test was used to compare score distributions between groups according to the type of placement setting (RCH vs CDC). The magnitude of group differences was estimated using the eta-squared coefficient (η²), with values of .01, .06, and .14 indicating small, medium, and large effect sizes, respectively. In addition to the overall analysis, gender-specific analyses were conducted to examine differences within each form of child protection and to identify distinct patterns between groups.

Subsequently, SDQ, PWI-7, and RSES scores were categorized using the corresponding cutoff scores. These categorical variables were analyzed using the chi-square test (χ²) to examine differences in the distribution of emotional symptoms, well-being, and self- esteem categories between groups. Adjusted standardized residuals (ASRs) and Cramer’s V coefficient were also used to estimate the strength of the associations. ASRs have the same absolute value for RCH and CDC and differ only in the direction of the association, as indicated by their positive or negative sign. For the sake of brevity, only the ASRs corresponding to the CDC are reported in the tables.

Finally, the relationships among the three dimensions assessed (SDQ, PWI-7, and RSES) and age were examined using Spearman’s rank-order correlation coefficient (rho), given the ordinal nature of the data and the violation of the normality assumption. Correlations were computed both for the full sample and separately for boys and girls, consistent with the gender perspective adopted in the study. To determine whether the strength of the associations differed by gender, the procedure proposed by Lee and Preacher was applied. This procedure uses the Z statistic and the corresponding two-tailed p-value to assess whether gender-specific correlations differ significantly from one another. These analyses made it possible to identify patterns of association among the constructs and to provide an integrated view of the psychosocial adjustment of children and adolescents receiving services under either form of child protection.

Results

This section presents the findings derived from the analysis of the three instruments administered: emotional and behavioral difficulties (1; SDQ), subjective well-being (2; PWI-7 and additional variables), and self-esteem (3; RSES), as well as the relevant correlations among these measures.

Table 1 presents the comparative mean scores for the CDC and RCH groups and shows statistically significant differences across several psychosocial dimensions. No significant differences were found between the groups on the overall emotional and behavioral problems scale (1; SDQ). However, significantly higher scores were observed among children and adolescents in residential care on the peer problems subscale (1.4), indicating greater difficulties in social interactions. Across the remaining subscales, a general pattern of greater difficulties and lower scores on positive dimensions was observed in the residential care group, with the exception of the hyperactivity subscale (1.3), on which the CDC group showed slightly higher mean scores. These findings provide partial support for Hypothesis 1 (H1): although most subscales did not reach statistical significance, the peer problems subscale showed a significant difference, and the overall pattern of results favored the CDC group.

Table 1. Comparison of Mean Scores on the Study Measures by Child Welfare Program

	CDC		RCH		U Mann- Whitney	p	η2
	M	SD	M	SD
1. Difficulties (SDQ)	15.27	6.40	16.42	5.52	4514.50	.121	.013
1.1. Emotional Symptoms	4.27	2.49	4.68	2.72	4683.00	.341	.005
1.2. Conduct Problems	3.08	2.04	3.11	1.99	4508.00	.829	0
1.3. Hyperactivity/Inattention	5.49	2.30	5.18	2.23	4096.00	.431	.003
1.4. Peer Problems	2.57	1.99	3.22	1.90	5152.00	.018*	.029
1.5. Prosocial Behavior	8.17	1.58	7.70	1.94	3975.00	.118	.012
2. Well-Being (PWI-7a)	76.67	16.20	67.97	2.53	327.50	.003**	.046
2.1. Healtha	8.30	2.03	6.98	2.32	2987.50	.000***	.089
2.2. Standard of Livinga	8.07	1.97	6.22	2.60	2559.50	.000***	.132
2.3. Life Achievementa	7.48	2.51	6.82	2.59	377.50	.053	.019
2.4. Safetya	7.17	2.66	6.66	2.88	4096.00	.257	.007
2.5. Social Groupsa	8.22	2.25	6.81	2.90	3247.00	.000***	.062
2.6. Future Securitya	6.62	2.93	6.67	2.75	4554.50	.951	0
2.7. Personal Relationshipsa	7.72	2.40	7.36	2.54	420.00	.318	.005
2.8. Family	8.06	2.07	7.25	3.31	424.50	.510	.002
2.9. Leisure	8.81	1.71	6.76	2.72	2393.50	.000***	.162
2.10. Body Image	6.69	3.17	5.96	3.31	3787.00	.119	.013
2.11. Care Setting (CDC /RCH)	8.35	2.32	4.76	3.07	1473.00	.000***	.337
2.12. Overall Life Satisfaction (OLS)	7.68	2.45	6.11	2.75	3044.50	.000***	.082
3. Self-Esteem (RSES)	28.37	6.13	28.21	6.42	4102.50	.914	0

Note: RCH: Residential care home; CDC: Child day-care centers; a items PWI-7; * p < .05; ** p < .01; *** p < .001.

Source: Authors based on the data collected.

Global subjective well-being, as measured by the PWI-7, showed significant differences between the two programs. Children and adolescents attending CDC reported higher overall well-being scores, with a medium effect size (η² = .046). This pattern was also observed across several individual PWI-7 domains, including (2.2) Standard of Living, (2.1) Health, and (2.5) Social Groups. Regarding the additional items included specifically for this study, children and adolescents attending CDC reported higher levels of satisfaction with their (2.11) Care Setting and (2.9) Leisure. The difference in satisfaction with the care setting was particularly noteworthy (η² = .337). Overall Life Satisfaction (2.12; OLS) was also higher among participants attending CDC, consistent with the overall pattern of well-being observed. Although differences in other well-being domains did not reach statistical significance, mean scores consistently favored CDC, with the exception of Future Security, for which participants in RCH reported slightly higher scores. These findings provide full support for H2, with significant differences observed both in overall well-being and across several individual domains.

With regard to self-esteem, as measured by the (3) RSES, no significant differences were observed between programs, making it the dimension with the lowest variability. Overall mean scores were virtually identical across CDC and RCH, indicating a homogeneous distribution of self-esteem between the two groups. Therefore, H3 was not supported.

The gender-based analysis (Table 2) revealed that girls reported higher overall levels of psychosocial symptoms (1; SDQ). This pattern was particularly evident in (1.1) Emotional Symptoms, and differences were also observed in (1.4) Peer Problems. In contrast, for (1.2) Conduct Problems, boys exhibited greater difficulties, reaching statistical significance. No significant gender differences were found for (1.3) Hyperactivity/Inattention or (1.5) Prosocial Behavior, with scores remaining similar across genders.

Regarding subjective well-being, boys reported higher scores across almost all dimensions assessed, including significantly higher overall PWI-7 score (2), as well as higher scores for Standard of Living (2.2), Personal Relationships (2.7), and Leisure (2.9). In addition, significant gender differences were observed across programs in relation to Safety (2.4), Body Image (2.10), and Overall Life Satisfaction (OLS) (2.12), with boys consistently reporting higher scores. With respect to self-esteem, boys scored higher than girls across all groups, making self-esteem one of the dimensions showing the most pronounced gender differences in the study. These findings support Hypothesis 4 (H4), confirming the association between gender and the psychosocial outcomes examined.

Table 2. Comparison of Mean Scores by Gender and Child Protection Program

	Total Sample			CDC			RCH
	Male	Female		Male	Female		Male	Female
	M (SD)	M (SD)	U	M (SD)	M (SD)	U	M (SD)	M (SD)	U
1.Difficulties (SDQ)	14.75 (6.38)	16.63 (5.64)	3334.0	13.96 (6.87)	16.36 (5.84)	976.0 *	15.71 (5.68)	17.03 (5.41)	687.0
1.1. Emotional Symptoms	3.40 (2.49)	5.34 (2.35)	2485.0***	3.17 (2.35)	5.13 (2.25)	707.0***	3.68 (2.34)	5.65 (2.48)	466.0***
1.2. Conduct Problems	3.47 (2.29)	2.76 (1.72)	5189.0**	3.26 (2.26)	2.95 (1.87)	1478.0	3.71 (2.19)	2.48 (1.57)	1100.0**
1.3. Hyperactivity/Inattention	5.23 (2.34)	5.45 (2.14)	4184.0	5.58 (2.39)	5.41 (2.11)	1458.0	4.83 (2.24)	5.51 (2.21)	699.5
1.4. Peer Problems	2.60 (2.07)	3.06 (1.89)	3687.0	2.09 (1.91)	2.93 (1.98)	1034.0**	3.20 (2.10)	3.25 (1.74)	777.5
1.5. Prosocial Behavior	7.79 (1.91)	8.11 (1.60)	4223.5	8.02 (1.66)	8.29 (1.52)	1354.0	7.52 (2.16)	7.82 (1.70)	806.0
2.Well-Being (PWI-7a)	76.98 (16.65)	69.37 (19.74)	5289.5**	80.03 (14.20)	74.14 (17.24)	1619.0	73.71 (18.55)	62.21 (21.27)	1090.5*
2.1. Healtha	8.09 (1.87)	7.38 (2.50)	5249.0	8.62 (1.71)	8.05 (2.24)	1665.5	7.48 (1.88)	6.39 (2.59)	1054.5
2.2. Standard of Livinga	7.66 (2.42)	6.95 (2.41)	5306.0*	8.52 (1.75)	7.74 (2.07)	1742.0*	6.71 (2.71)	5.75 (2.44)	1048.0*
2.3. Life Achievementa	7.57 (2.42)	6.87 (2.65)	5198.0	7.45 (2.58)	7.50 (2.48)	1394.0	7.71 (2.25)	5.95 (2.66)	1191.0**
2.4. Safetya	8.09 (2.13)	5.94 (2.89)	6572.0***	8.35 (1.96)	6.23 (2.77)	2139.0***	7.79 (2.29)	5.50 (3.03)	1218.5***
2.5. Social Groupsa	7.67 (2.69)	7.59 (2.60)	4767.0	8.13 (2.51)	8.30 (2.05)	1451.0	7.14 (2.83)	6.54 (2.97)	965.5
2.6. Future Securitya	6.84 (2.84)	6.48 (2.86)	4942.0	6.52 (2.98)	6.70 (2.91)	1405.5	7.21 (2.66)	6.15 (2.78)	1054.0
2.7. Personal Relationshipsa	7.99 (2.28)	7.21 (2.58)	5446.5*	8.37 (2.07)	7.21 (2.53)	1898.5**	7.55 (2.45)	7.20 (2.68)	917.0
2.8. Family	8.09 (2.40)	7.36 (2.91)	5077.5	8.36 (1.79)	7.84 (2.25)	1603.5	7.78 (2.94)	6.66 (3.60)	965.5
2.9. Leisure	8.38 (2.19)	7.53 (2.56)	5395.0*	9.08 (1.58)	8.59 (1.80)	1693.5	7.57 (2.51)	5.93 (2.73)	1153.0**
2.10. Body Image	8.00 (2.31)	5.05 (3.27)	6663.5***	8.31 (2.15)	5.41 (3.28)	2205.5***	7.62 (2.47)	4.50 (3.23)	1204.0***
2.11. Care Setting (CDC/ RCH)	6.56 (3.33)	7.04 (3.07)	4257.0	8.21 (2.59)	8.46 (2.10)	1478.0	4.67 (3.09)	4.93 (3.09)	835.0
2.12. Overall Life Satisfaction (OLS)	7.71 (2.20)	6.35 (2.93)	5773.0**	8.27 (2.039)	7.21 (2.66)	1761.5	7.07 (2.27)	5.07 (2.88)	1209.5***
3.Self-Esteem (RSES)	29.97 (5.54)	26.85 (6.48)	5307.5***	29.98 (5.23)	27.02 (6.55)	1614.0*	29.95 (5.94)	26.63 (6.47)	1057.0*

Note: RCH: Residential Care Home; CDC: Child Day-Care Center; a items PWI-7; * p < .05; ** p < .01; *** p < .001.

Source: Authors based on the data collected.

As shown in Table 3, the categorization of SDQ scores based on the cutoffs established in the Spanish validation of the instrument revealed a greater concentration of children and adolescents in the borderline and clinical ranges among participants in RCH, whereas subclinical scores predominated among those attending CDC. This pattern was particularly evident for (1.2) Conduct Problems, (1.4) Peer Problems, and (1.5) Prosocial Behavior. The (1.3) Hyperactivity/Inattention subscale showed the opposite pattern, with a higher proportion of clinical scores among participants attending CDC. For the (1.1) Emotional Symptoms subscale, differences between programs were minimal, although the overall distribution indicated a higher proportion of clinical and borderline scores among children and adolescents in RCH.

Table 3. Comparison of Mean Scores on the Study Measures by Child Welfare Program

	Subclinical			Borderline			Clinical			χ²	Cramer's V	p
	CDC (%)	RCH (%)	ASR	CDC (%)	RCH (%)	ASR	CDC (%)	RCH (%)	ASR
1. Difficulties (SDQ)	52.94	41.03	1.6	22.55	29.49	–1.1	24.51	29.49	–0.7	2.56	0.28	.278
1.1. Emotional Symptoms	62.62	62.96	0	13.08	8.64	1	24.30	28.40	–0.6	1.11	0.08	.573
1.2. Conduct Problems	64.81	60.98	0.5	14.81	15.85	–0.2	20.37	23.17	–0.5	0.31	0.13	.856
1.3. Hyperactivity/Inattention	48.60	53.66	–0.7	14.95	15.85	–0.2	36.45	30.49	0.9	0.75	0.06	.689
1.4. Peer Problems	70.75	58.02	1.8	20.75	28.40	–1.2	8.49	13.58	–1.1	3.37	0.13	.186
1.5. Prosocial Behavior	94.55	86.75	1.9	3.64	7.23	–1.1	1.82	6.02	–1.5	3.80	0.14	.149

Note: RCH: Residential care homes; CDC: Child day-care centers; ASRs: Adjusted standardized residuals; * p < .05; ** p < .01; *** p < .001. The ASR reported corresponds to the CDC group.

Source: Authors based on the data collected.

The results of the subjective well-being categorization are presented in Table 4 (PWI-7). Statistically significant differences were found between children and adolescents attending CDC and those living in RCH (χ² = 11.787, p = .003; V = .25). Among participants in RCH, the distribution was concentrated primarily in the low well-being category (54.22%; ASR = –2.1), whereas only 31.3% (ASR = 3.4) were classified as having high levels of well- being, reflecting a less favorable well-being profile for this group.

Table 4. Distribution of Subjective Well-Being Categories by Program Type

High

Medium

Low

χ²

Cramer's V

p

CDC (%)

RCH (%)

ASR

CDC (%)

RCH (%)

ASR

CDC (%)

RCH (%)

ASR

2. PWI-7

46.67

31.33

–3.4

23.81

14.46

1.6

29.52

54.22

2.1

11.787

.25

.003**

Note: RCH: Residential care homes; CDC: Child day-care centers; ASR: Adjusted standardized residuals; * p < .05;** p < .01; *** p < .001. The ASR reported corresponds to the CDC group.

Source: Authors based on the data collected.

The categorization of self-esteem (Table 5) showed a higher proportion of low scores in RCH, whereas CDC displayed a more balanced distribution, with a greater proportion of medium and high scores, although without statistical significance. These data allowed for a more detailed description of how self-esteem is distributed across the different programs and, although it is the dimension showing the smallest differences between groups, important percentage differences can still be observed.

Table 5. Distribution of Self-Esteem Levels by Program Type

High

Medium

Low

χ²

Cramer's V

p

CDC (%)

RCH (%)

ASR

CDC (%)

RCH (%)

ASR

CDC (%)

RCH (%)

ASR

3. (RSES)

4.60

4.24

–1.5

3.69

2.73

1.5

28.71

39.02

0

3.16

.13

.206

Note: RCH: Residential care homes; CDC: Child day-care centers; ASR: Adjusted standardized residuals; * p < .05; ** p < .01; *** p < .001. The ASR reported corresponds to the CDC group.

Source: Authors based on the data collected.

The correlation matrix (Table 6) revealed significant associations among emotional and behavioral difficulties (1; SDQ), subjective well-being (2; PWI-7), self-esteem (3; RSES), and age (4). A significant negative correlation was found between emotional and behavioral difficulties and subjective well-being (r = −.452, p < .001), as well as between emotional and behavioral difficulties and self-esteem (r = −.548, p < .001). In contrast, subjective well-being and self-esteem were strongly and positively correlated (r = .661, p < .001). Age showed only weak associations with the study variables: a positive but non-significant correlation with emotional and behavioral difficulties (r = .128), a significant negative correlation with subjective well-being (r = −.257, p < .001), and a negative but non-significant correlation with self-esteem (r = −.082).

Table 6. Correlations Among the Variables Examined for the Full Sample and by Gender

Association Between Variables	Total r	Boys' r	Girls' r	Z	P Lee and Preacher Test
SDQ – PWI7	–.452***	–.394**	–.444**	.402	.688
SDQ – RSES	–.548***	–.420**	–.643**	2.018	.044
PWI7 – RSES	.661***	.577**	.650**	–.762	.446
Age – SDQ	.128	.157	.097	.392	.695
Age – PWI7	–.257***	–.261*	–.239*	–.154	.877
Age – RSES	–.082	.001	–.115	.757	.449

Note: Statistical significance for Spearman’s rho correlation coefficients (r) is indicated as follows: * p < .05; ** p < .01; *** p < .001. The p values reported in the table correspond to the Lee and Preacher procedure and indicate whether correlations differ significantly between boys and girls.

Source: Authors based on the data collected.

These correlation findings provide partial support for H5, which predicted that greater age would be associated with poorer psychosocial adjustment outcomes. Specifically, lower subjective well-being was significantly associated with increasing age, whereas correlations with the other dimensions were weak. In contrast, H6 was fully supported, as consistent and significant associations were found among the three dimensions assessed. Finally, regarding gender differences in the correlations, the Lee and Preacher procedure revealed statistically significant differences in the association between emotional and behavioral difficulties (SDQ) and self-esteem (RSES). The negative association between these constructs was stronger among girls than among boys, indicating that the strength of the relationship between the variables differed significantly by gender.

Discussion

The findings of this study provide a comprehensive understanding of the psychosocial adjustment of children and adolescents receiving services in two distinct forms of child protection. To the best of our knowledge, this is the first comparative study in Spain to simultaneously examine subjective well-being, self-esteem, and emotional and behavioral difficulties across these two programs while also incorporating the self-reported perspectives of children and adolescents themselves. The approach adopted is particularly relevant because it highlights psychosocial differences between children and adolescents at low to moderate risk who attend CDC, characterized by a preventive and family-preservation approach, and those placed in RCH following the loss of parental care. The institutional trajectories of the latter group are often marked by greater exposure to adverse experiences, disrupted attachments, and the need for more intensive interventions (Bravo et al. 2022; Delgado et al. 2019; Maneiro et al. 2023).

The findings revealed significantly more positive scores across virtually all dimensions assessed, indicating a more favorable psychosocial profile among children and adolescents attending CDC compared with those in RCH. However, the limited body of research examining the psychosocial characteristics of children and adolescents in CDC constrains direct comparisons with previous studies (Burón et al. 2025; Hidalgo et al. 2018). In contrast, there is extensive evidence regarding residential care that is consistent with our findings. Numerous studies have consistently documented higher levels of emotional, behavioral, and relational difficulties, as well as lower levels of subjective well-being and self-esteem, among children and adolescents in residential care compared with their peers in the general population or those with stable family relationships (Brännström et al. 2017; Delgado et al. 2019; Soriano-Díaz et al. 2023).

Regarding emotional and behavioral symptoms, the SDQ results revealed that approximately half of the children and adolescents receiving child welfare services fell within the clinical or borderline ranges, indicating a high prevalence of emotional difficulties. This proportion is consistent with national studies documenting similar clinical profiles among adolescents in residential care and care leavers, with between 45% and 60% experiencing significant emotional or behavioral difficulties (Gullo et al. 2023; Soriano-Díaz et al. 2023). International evidence reports comparable, and in some cases even higher, rates, particularly in contexts of prolonged residential placement. For example, studies conducted in Norway, Sweden, and the United Kingdom have found that 60% or more of children and adolescents in residential care exhibit clinically significant difficulties on at least one SDQ dimension (Brännström et al. 2017; Jozefiak et al. 2016; Lehmann et al. 2014).

Although no statistically significant differences were observed between the CDC and RCH programs across most SDQ subscales, the overall pattern was more favorable for children and adolescents attending CDC, who reported lower scores on the Emotional Symptoms and Conduct Problems subscales. This finding is consistent with previous evidence indicating that maintaining family and community ties functions as a protective factor against emotional distress (Casas et al. 2013b; Montserrat et al. 2015). In fact, the results observed among CDC participants closely resemble those reported by Rodríguez-Mora et al. (2025), who found that adolescents at psychosocial risk who were not living in residential care—whose profile was similar to that of CDC users—showed a prevalence of clinical or borderline symptomatology on the SDQ of nearly 50%. In contrast, research on residential care has shown that caregiver consistency, shared time, and the duration of caregiving relationships can partially mitigate emotional vulnerability (Castro et al. 2024; Pinheiro et al. 2024), although they do not completely eliminate the difficulties associated with disrupted attachments and prior traumatic experiences. Other studies similarly highlight the importance of strong family relationships as protective factors that buffer emotional distress (Morris et al. 2007). This interpretation is further supported by the findings of Molano et al. (2024), who reported that, even within residential care settings, children and adolescents with supportive and collaborative family networks achieved significantly more favorable SDQ scores.

The only statistically significant difference between programs on the SDQ was observed in the Peer Problems subscale, with children and adolescents in RCH reporting greater difficulties. This finding is consistent with previous research linking residential care placements to difficulties in socialization, social isolation, poorer self-concept, and greater challenges in establishing and maintaining relationships within school settings (Gazelle et al. 2024; Greger et al. 2017; Middel et al. 2025). Children and adolescents in RCH often experience disruptions in peer networks and have fewer opportunities for sustained social interaction, which may help explain the concentration of clinical scores observed on this subscale. With regard to gender, the findings reflected the pattern commonly reported in the literature: girls showed higher levels of internalizing emotional symptoms, whereas boys exhibited more externalizing difficulties (Derdikman-Eiron et al. 2011; González-Carrasco et al. 2017).

With regard to subjective well-being, the pattern of more favorable outcomes among participants attending CDC was also evident, with significant differences observed across several dimensions of the PWI-7, including Standard of Living, Health and Social Groups. Perceived standard of living was notably lower among children and adolescents in residential care, a finding consistent with studies suggesting that living in a residential setting may foster perceptions of limited economic autonomy, reduced control over material living conditions, unequal access to material resources, and comparisons with peers living with their families. Together, these factors may contribute to a subjective perception of institutional disadvantage (Delgado et al. 2019; Llosada-Gistau et al. 2017; Montserrat et al. 2022). Similarly, children and adolescents in RCH reported a less favorable perception of their health status. This finding has been documented in previous research and is commonly attributed to histories of maltreatment, neglect, or trauma prior to placement, as well as to the emotional impact of prolonged residential care experiences (Montserrat et al. 2015). Finally, another domain showing substantial differences between the two groups was Social Groups. The findings indicate a weaker sense of belonging among children and adolescents in RCH, which may be explained by the perception of a less emotionally supportive institutional group climate and, above all, by the family and community disruptions and separations that directly affect their sense of identity and limit relational continuity (Montserrat et al. 2022; Sarasa-Camacho and Burón 2025).

The additional items incorporated into the subjective well-being measure (PWI-7) once again revealed significant differences in ratings of the care setting and leisure, with more favorable scores reported by children and adolescents attending CDC. Differences in perceptions of the care setting may be explained by several factors. First, they reflect the distinct nature of the programs themselves. Whereas CDC are exclusively day-care services associated with recreational, leisure, and educational support activities (Burón et al. 2025), residential care settings function as the home environment for children and adolescents. Consequently, evaluations of residential care are influenced by perceptions of safety, the quality of care received, the stability of the educational staff team, and relationships with other children and adolescents in care. In addition, placement instability and multiple moves have been shown to reduce levels of satisfaction (González-García et al. 2024; Gullo et al. 2023). A similar pattern was observed for perceptions of leisure. In residential care, opportunities for enjoyable leisure experiences may be constrained by institutional rules, limited perceived autonomy, and activities that are insufficiently tailored to young people’s interests. Furthermore, difficulties in establishing and maintaining peer relationships may also negatively affect their leisure experiences (Soriano-Díaz et al. 2023).

Our findings indicate that female participants scored lower across all well-being dimensions assessed, a result consistent with recent studies documenting greater emotional vulnerability and lower life satisfaction among adolescent girls, including those living in residential care (Montserrat et al. 2015; Soriano-Díaz et al. 2023). The two domains that stood out because of their consistently significant gender differences were Safety and Body Image. With regard to Safety, studies such as that of Zubieta et al. (2012) suggest that adolescent girls tend to feel less empowered in the face of social pressures, which may affect their perceived sense of control and protection within their environment. This sense of insecurity may be intensified in residential care contexts, where the loss of family and community reference figures can further exacerbate feelings of vulnerability (González-García et al. 2024). Regarding Body Image, previous research has shown that body dissatisfaction among adolescent girls is associated with appearance-related pressures, objectification, and exposure to highly idealized body standards on social media. According to Biolcati et al. (2016), these influences may generate identity-related distress and body-modification behaviors, and ultimately undermine subjective and emotional well-being.

These gender-related dynamics, reinforced by differential socialization processes and cultural stereotypes, may partly explain the differences observed and highlight the importance of incorporating a gender perspective into analyses of adolescent well-being. Consistent with previous studies (Greger et al. 2017; Yang et al. 2025), self-esteem emerged as a dimension with a marked gender difference, with boys reporting higher scores across all groups. Similarly, the correlational analysis showed that this construct was negatively associated with emotional and behavioral difficulties and positively associated with subjective well-being. These patterns are consistent with previous findings emphasizing the protective role of self-esteem in mitigating emotional distress and promoting subjective well-being (Casas et al. 2013a; Gullo et al. 2023). In addition, a modest negative correlation was observed between age and subjective well-being, in line with studies suggesting that later adolescence is associated with greater awareness of personal limitations, increased social demands, and more complex emotional adjustment processes (Derdikman-Eiron et al. 2011; Montserrat et al. 2015).

Limitations

This study has several limitations that should be taken into account. First, the data were collected exclusively from CDC and RCH located in a single region of Spain, which may limit the generalizability of the findings to other contexts. In addition, the residential care group included different types of residential care settings, which may have introduced a degree of within-group heterogeneity. However, no clear differential patterns were identified across these types of settings in the present sample, contrary to what has been reported in the literature. This finding may be related to the relatively small subgroup sample sizes, which limited the statistical power to detect specific differences, as well as to a possible overlap in psychosocial profiles across these forms of residential care. Future studies based on larger samples should further examine potential differences among these types of residential care homes.

Additionally, given the cross-sectional nature of the study design, it is not possible to establish causal relationships or assess changes in psychosocial adjustment over time. This limitation also implies that the differences observed between the two types of programs may be influenced by participants’ prior histories of adversity and child protection involvement, particularly in the case of boys and girls living in residential care, for whom placement outside the family home is often associated with more severe adverse experiences. Future research would benefit from longitudinal designs to examine changes in young people’s adjustment over time and to assess the specific effects of each type of program through repeated measurements. Furthermore, all data were collected through self-report measures, which may introduce biases related to social desirability or age-related differences in comprehension and interpretation. Finally, although the instruments used have been validated for the Spanish population, further adaptations may be required to more accurately capture the specific characteristics of well-being among children and adolescents involved in the child welfare system.

Conclusions and Implications for Practice

The findings of this study make it possible to delineate a clear and differentiated profile of psychosocial adjustment among children and adolescents receiving services in the two child welfare programs examined. Overall, children and adolescents attending CDC displayed a more favorable psychosocial adjustment profile, characterized by relatively low levels of emotional and behavioral difficulties, moderate subjective well-being, and adequate self-esteem. In contrast, children and adolescents living in RCH tended to report higher levels of emotional and behavioral symptoms, with particular difficulties in peer relationships and lower levels of satisfaction in leisure activities. They also showed lower levels of subjective well-being and a greater concentration of participants in the low self-esteem category, although overall self-esteem remained within an adequate range.

Differences between programs were particularly evident in subjective well-being, which emerged as the most sensitive indicator for detecting contextual variations in psychosocial adjustment. Children and adolescents attending CDC reported significantly higher levels of satisfaction in domains such as Standard of Living, Health and Social Groups, as well as in the additional items related to enjoyment of leisure activities and satisfaction with their care setting. In contrast, the only hypothesis that was not supported was that concerning self-esteem. No significant differences between programs were observed on this dimension, suggesting that self-esteem may be more strongly shaped by individual factors and less dependent on the type of child welfare program in which they participate. The high prevalence of emotional and behavioral difficulties in both groups, with approximately half of the children and adolescents falling within the clinical or borderline ranges, underscores the vulnerability of this population and the need for targeted interventions.

Gender inequalities were also identified, with girls displaying greater emotional vulnerability and lower self-reported life satisfaction and self-esteem. These findings highlight the need to incorporate a gender perspective into child welfare programs in order to address the specific needs of adolescent girls. From a practical standpoint, this would involve designing interventions tailored to the particular circumstances of this population, as well as strengthening the training provided to residential care and child protection professionals. Fostering a more gender-equitable environment within child protection settings could contribute to a broader shift in the culture of group living and everyday care practices.

Therefore, from an applied perspective, it is essential to continue advancing toward intervention models that prioritize the strengthening of the relational climate, promoting stability in caregiving relationships, and providing sensitive responses to emotional difficulties in child welfare contexts. The high prevalence of emotional and behavioral symptoms observed in both groups highlights the importance of strengthening systems for early identification and referral to specialized services (Greger et al. 2017; Soriano-Díaz et al. 2023), as well as promoting, through everyday practices, environments that facilitate emotional expression, a sense of belonging, a gender-sensitive approach, and the development of a positive sense of identity (Casas et al. 2013b; Llosada-Gistau et al. 2017; Rodríguez-Fernández et al. 2016).

In this regard, many dimensions of psychosocial adjustment, such as perceived safety, are closely linked to the quality of the relationships that children and adolescents establish with significant adults in their lives (González-García et al. 2024). Consequently, maintaining stable, well-trained, and emotionally available staff may make a substantial contribution to reducing psychological distress and promoting more positive developmental trajectories (Derdikman-Eiron et al. 2011). Likewise, it is important to maintain an inclusive perspective toward families of origin, regardless of their circumstances, in order to support opportunities for collaborative work whenever possible (Delgado et al. 2019; Bravo et al. 2022). In addition, the redesign of physical and relational environments to improve comfort, privacy, and the aesthetic quality of living spaces has also been associated with higher levels of subjective well-being (Llosada-Gistau et al. 2017; Montserrat et al. 2022).

Public agencies and service providers play a key role in creating working conditions that prevent excessive staff turnover and thereby enable the maintenance of meaningful and stable relationships over time, a structural prerequisite for ensuring high-quality care (Soriano-Díaz et al. 2023). In addition, establishing appropriate staff-to-child ratios and promoting high-quality relationships between children and professionals remain recurring recommendations in the specialized literature (González-García et al. 2024). All of these efforts should be accompanied by greater participation of children and adolescents in decision-making processes. Together, these elements constitute cross-cutting pillars for enhancing life satisfaction and fostering a more positive perception of their environment (Casas et al. 2013a; Castro et al. 2024; Llosada-Gistau et al. 2017). In this regard, participation should be structural, embedded in everyday practice, and genuinely influential. It is not sufficient to consult children and adolescents on an occasional basis; rather, institutions must recognize their capacity for agency and create meaningful opportunities for them to influence decisions that affect their lives, beginning with everyday matters such as rules, schedules, activities, placement changes, and other aspects of daily life (Sarasa-Camacho and Burón 2025).

In terms of future research, this study opens new avenues for investigating psychosocial adjustment among children and adolescents involved in the child protection system by incorporating contextual, relational, and cultural variables that may help explain changes in well-being over time. Such research could also inform actions aimed at improving children’s quality of life and well-being through more participatory approaches. Finally, the findings underscore the importance of preventive measures and highlight the value of family-preservation interventions as a means of minimizing negative impacts on well-being and reducing emotional vulnerability. For this reason, further research is needed on community-based programs such as CDC, which have traditionally received less scholarly attention, as well as on the subjective experiences of children and adolescents as active agents in shaping their own well-being.

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✽ This article derives from a research project funded by the Spanish Ministry of Science and Innovation (Project PID2022-112233) and the European Union’s NextGenerationEU fund (Grant No. FUO-EM-22-202). In addition, three of the authors are supported by predoctoral research contracts. Jaime Burón holds a predoctoral contract funded through the competitive grant scheme for doctoral thesis research included in the First Multiannual Research and Human Resources Plan of the University of Oviedo (2022). Ana Pulgar holds a predoctoral contract funded by the Principality of Asturias (Grant No. AYUD0029T01 [BP22-177]). Raquel Ordiales holds a predoctoral contract funded by the Spanish Ministry of Science and Innovation (Grant No. PRE2022-103049). In light of the above, the authors declare that there are no conflicts of interest. The study was conducted in accordance with applicable ethical standards and data protection regulations. Data collection in the child day-care centers was approved by the Research Ethics Committee of the University of Cantabria (Reference No. 5/2020). Regarding residential care homes, the study was carried out in compliance with all data security and data protection requirements established by the applicable legislation, particularly Regulation (EU) 2016/679 (General Data Protection Regulation, GDPR) and Organic Law 3/2018 on Personal Data Protection and the Guarantee of Digital Rights. Data collection was also approved by the Ethics Committee of the University of Cantabria, as recorded in the minutes of the committee’s ordinary meeting held on July 21, 2022.

Author contributions: Jaime Burón, as the lead author, conceived and designed the study together with the research team, led data collection in the child day-care centers, prepared the first draft of the manuscript, and conducted the literature review underpinning the theoretical framework. Ana Pulgar, as the corresponding author, managed all procedures associated with this role, participated in data collection in the residential care homes, carried out the statistical analyses and interpretation of the results, and made substantial contributions to the writing and revision of the manuscript throughout all stages of its development. Raquel Ordiales contributed to data collection in the residential care homes and played a particularly important role in the development of the empirical section and the presentation of the results. Laura García-Alba participated in the study design and critically reviewed the manuscript, ensuring its scientific and editorial coherence, as well as overseeing its translation into English. Carla González-García contributed to the methodological design of the study, particularly in planning the empirical component and selecting the assessment instruments, and critically reviewed the manuscript, providing scientific oversight and substantial contributions to its intellectual content. Amaia Bravo, as Principal Investigator of the project, supervised the development of both the study and the manuscript, participated in the research design, and conducted the final scientific review of the work. The authors declare that artificial intelligence was used exclusively as a support tool for language editing and assistance purposes. It was not used for text generation, data analysis, interpretation of results, or the formulation of conclusions.

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Jaime Burón

Affiliated with the Department of Psychology at the University of Oviedo, Spain. He holds a Ph.D. in Humanistic Research from the University of Oviedo, Spain, and a master’s degree in Juvenile Delinquency and Social Intervention from the University of Granada, Spain. He is a member of the Family and Childhood Research Group (GIFI) at the University of Oviedo. https://orcid.org/0000-0002-0953-8806 | jaimeburon@uniovi.es

Ana Pulgar

Ph.D. student in Psychology, affiliated with the Department of Psychology at the University of Oviedo, Spain. She is a member of the Family and Childhood Research Group (GIFI) at the University of Oviedo. https://orcid.org/0000-0002-2002-0506 | anapulgar@uniovi.es

Raquel Ordiales

Ph.D. student in Psychology, affiliated with the Department of Psychology at the University of Oviedo, Spain. She is a member of the Family and Childhood Research Group (GIFI) at the University of Oviedo. https://orcid.org/0000-0002-9390-1910 | ordialesraquel@uniovi.es

Laura García-Alba

Assistant professor in the Department of Sociology and Social Work at the University of Oviedo, Spain. She holds a Ph.D. in Psychology and Education from the University of Oviedo. She is also a member of the Family and Childhood Research Group (GIFI) at the same institution. https://orcid.org/0000-0003-3105-7272 | garciaalblaura@uniovi.es

Carla González-García

Assistant professor in the Department of Sociology and Social Work at the University of Oviedo, Spain. She holds a Ph.D. in Psychology and Education from the University of Oviedo. She is also a member of the Family and Childhood Research Group (GIFI) at the same institution. https://orcid.org/0000-0002-2431-6734 | gonzalezcarla@uniovi.es

Amaia Bravo

Professor in the Department of Psychology at the University of Oviedo, Spain. She holds a Ph.D. in Psychology and Education from the University of Oviedo. She is also a member of the Family and Childhood Research Group (GIFI) at the University of Oviedo. https://orcid.org/0000-0002-8131-2529 | amaiabravo@uniovi.es