Impact of perception of safety on outcomes in the context of trauma

•Adults’ perception of safety predicted better program and goal completion outcomes.•Youth perception of safety was related to less likelihood of program completion.•Trauma exposure related to meeting more treatment goals and completing the program.•Traumatized youth had the best outcomes when cared for in safe, low aggression homes. Youth safety is an essential component of trauma-informed services (U.S. Department of Health & Human Services, 2020). Youth perception of safety should be indicative of a healthy care environment and contribute to successful outcomes. It has been shown that trauma impacts an individual’s perception of and response to perceived threat. This study examines the relationship between youth perception of safety, history of trauma, level of aggression, and outcomes in a residential care setting. Data came from the organization’s administrative database and from the care provider certification measures collected during the period of January 2016 through December 2018. Trauma exposure and symptoms, the perceived safety and aggression were used in a mediational path model analysis in predicting goal attainment, program completion, and post-discharge placement. Higher levels of youth trauma were not directly associated with poorer outcomes, and higher percentages of goals met when program supervisor perception of safety was higher. Additionally, trauma symptoms were related to lower rates of program completion when youth perception of safety was higher. Results provide insight into how trauma, perception of safety, and aggression within a residential placement intersect to impact the youth’s treatment progress.