The Tension Between Flexibility and Standardization: A Study of Therapeutic Residential Care in Norway

This article investigates how care and treatment is practiced in Norwegian therapeutic residential care facilities (TRCFs) for adolescents with severe behavioral challenges. Drawing on Skjervheim’s concept of the instrumentalist mistake and theories of professional discretion and scaffolding, this article investigates how care and treatment is practiced in Norwegian therapeutic residential care facilities (TRCFs) for adolescents with severe behavioral challenges. Particular attention is given to variations in practice and the factors that contribute to these differences. The variations reflect different institutional logics shaped by professional orientation, access to tools and support, and how staff discretion is structured and guided. The analysis identifies two recurring risks: overly rigid standardization that undermines relational engagement, and unstructured flexibility that leads to inconsistency and therapeutic drift. Rather than advocating for or against standardization, this study argues for operational frameworks that support sound professional judgment. The findings have broader relevance for therapeutic care systems seeking to balance structure and autonomy for staff that promote accountable, adaptive, and ethically grounded practice.