Improving outcomes for children in out‐of‐home care: the role of therapeutic foster care

How best to support children and young people in foster care remains a challenge for child welfare. There has been little Australian research on the outcomes for children and young people placed in therapeutic foster care (TFC). This article aims to address this knowledge gap, presenting the evaluation of a state‐wide model of TFC known as the Circle Program operating in Victoria, Australia. Data sources for the study were case assessment analysis; surveys of foster carers, program workers and other stakeholders in the sector; and both focus groups and individual interviews with foster care workers. The evaluation found that the Circle Program lessened the number of unplanned exits of children from foster placements compared with generalist foster care. Another important finding was that the Circle Program positively influenced foster carers' decisions to stay in the carer role. Key components perceived as contributing to outcomes of the Circle Program included enhanced training of foster carers, intensive carer support, specialist therapeutic support to the child and carer, therapeutic service to family members and a network of services to provide support to the child.     

Foster care placement breakdown in the Netherlands and Flanders: Prevalence,precursors, and associated factors

Family foster care is the option of choice for children in need of out‐of‐home care in Flanders and the Netherlands. Foster care is however a vulnerable intervention, and questions can be raised as to its efficacy. Although the literature on placement breakdown has made significant progress during the last years, empirical knowledge regarding breakdown in Flanders and the Netherlands remains scant. Consequently, this study aimed at investigating prevalence and precursors of breakdowns in long‐term foster care, the duration of placement before breakdown, and the association of child and placement characteristics with breakdown. Case files of 271 Dutch and 309 Flemish foster children were analysed with a coding scheme designed for this study. After 6 years, 398 placements had terminated: 169 placements broke down and 229 placements ended positively. Placements broke down mainly because of behavioural problems of the foster child, foster parents' parenting problems, and conflicts between birth and foster parents. Foster children with behavioural problems, older foster children, foster children denied treatment, and foster children in care because of sexual abuse were more at risk of breakdown. Assessing these factors is important when evaluating the appropriateness of a family foster care placement.     

The Association of Team Composition and Meeting Characteristics With Foster Care Placement Recommendations

ABSTRACT

Research shows that changing foster care placements is associated with negative outcomes for children. This study examines the extent to which Team Decision Making (TDM) can influence placement recommendations for children currently in foster care. Using administrative data from three sites, logistic regression models are fitted to estimate the association of team and meeting characteristics with placement recommendations. Controlling for demographic differences across sites, results show that caregiver attendance significantly reduces the likelihood that a child will be recommended to change placements, specifically, to less restrictive and more restrictive placements. Implications for practice and future research are discussed.     

THE RELATIONSHIP OF FAMILY BACKGROUND AND CASEWORK INVOLVEMENT TO PLACEMENT STABILITY

Stability of foster family placements is viewed as a function of the types of families foster children come from and the involvement of caseworkers in the children's cases. Two groups of children (N = 30) whose foster care histories differed in the number of placements they had experienced were compared. The identification of children prior to their first placement as "at risk" for instability in foster care is recommended, with the targeting of intensive casework activities on those children to follow as a means of lessening the likelihood of later placement changes.     

Research into unaccompanied refugee minors in family foster care: Promoting adaptive functioning?

Unaccompanied Refugee Minors (URMs) are at high risk for trauma and maladaptive functioning. Although foster care is best suited to come forth to their needs, obtaining a better understanding of the strengths and flaws of foster care for URM can help to improve their development and psychological wellbeing. Twenty-seven URM cared for in family foster care filled in questionnaires measuring trauma, behavioural difficulties, resilience and contact with persons from the home and host country, whilst their foster care workers assessed the quality of the living environment. URMs had more trauma symptoms than other immigrants and Belgian adolescents. Furthermore, compared to Belgian counterparts, levels of resilience were low. However, URM did not have more behavioural problems. The quality of the living environment in kinship care was worse than the quality in non-kinship foster care, and social support and cultural sensitivity were protective factors. This study found evidence for developmental risks for URM in foster care. Integration, social support and a connection with the home culture were protective factors. Contrary to other studies, no evidence was found of kinship foster care being preferential.     

The relationship between foster care families and birth families in a child welfare context: The determining factors

Children placed in foster care families usually continue to see their birth parents in supervised and home visits. These children deal with the fact that they belonged to two families in a context where the relationship between the two families is sometimes complex and tense. Based on 45 semi‐structured interviews conducted with foster care families and kinship foster care families, the present study examines the relationship between foster care parents and birth parents in a placement context, and focuses on the factors affecting the nature and quality of this relationship. The results showed that the quality of the relationship dynamics varies according to the following: how well and how often the parent–child visits took place, the birth parents' characteristics, and the foster carers' attitudes. The results also showed that placements in kinship foster care families were more likely to result in conflict and tension between the two parties than placements in regular foster care families.     

Love and money: payment, motivation and the fostering task

Although the payment of foster carers has attracted greater attention in recent writing and research, coverage of the issues has been limited. In this study, based on interviews with 20 female carers, the place of payment within foster care is explored in greater depth. The focus is on charting how carers perceive their task as ‘parenting’ or ‘job’, whether and how they experience payment as compensation or as an appropriate reward for their skills. Also examined are the ways in which payment may impact upon the practice of foster care, for example in decision making over the taking or ending of placements and the provision of aftercare support for care leavers. The study highlights the distinctive nature of foster care as an institution that straddles the public and private domains, and examines the resulting complexities. It concludes by suggesting that while payment issues provide important threads that run throughout foster care, their influence is ultimately limited by the latter's base within the family.     

Congruence and incongruence in the perception of ‘family’ among foster parents,birth parents and their adolescent (foster) children

Over recent decades, listening to children's voices and viewing children as competent actors has gathered momentum in research as well as in practice. Acknowledging children's perspectives requires sensitive listeners who are willing, deliberately and as realistically as possible, to reconstruct children's ways of seeing. In our study, based in Norway, we investigated the views of 22 adolescents in long‐term foster care and 15 of their birth parents and 21 of their foster parents. Using Q methodology, we explored congruence and incongruence in the perception of ‘family’ among foster parents, birth parents and their adolescent (foster) children. We found three family perspectives among the adolescents. Within two of these perspectives, there seem to be more congruent understandings of the children's perspectives among the parent groups. We discuss some main implications in light of these findings. In Norway, as in many other countries, the policy of child welfare is that children first and foremost should grow up with their birth family. When out‐of‐home placements are necessary, a basic principle is that children should remain in contact with their birth family.     

How do placements in kinship care compare with those in non‐kin foster care: placement patterns,progress and outcomes?

As the use of kinship care is set to rise in England, it is important that policy and practice developments are based on firm evidence about kin placement outcomes and how these compare with those in stranger foster care. The research reported in this paper was based on case file reviews of 270 children, half in kin placements and half in stranger foster care, and on interviews with a sub-sample of 32 kin carers, social workers, children and parents. Kin carers were found to be significantly more disadvantaged than stranger foster carers: more kin carers were lone carers, with health problems, living in overcrowded conditions and had financial difficulties. The children, in contrast, were remarkably similar in the two kinds of placement. The main differences between the children in the two settings are examined in the paper. The children's progress and outcomes in terms of placement quality and disruption were very similar in the two settings, but kin placements lasted longer, mainly because fewer were planned as interim placements. However, because kin carers persisted with very challenging children and yet received fewer services than stranger foster carers, they were more often under strain. The implications for policy and practice are examined.     

Analysis of care and education pathways of refugee and asylum‐seeking children in care in England: Implications for social work

There are currently 4,560 refugee and asylum‐seeking children in care in England, but little is known about their care histories and educational outcomes. This study analysed the educational outcomes of unaccompanied refugee and asylum‐seeking children in care at age 16 (n = 167) in 2013, using secondary data analysis. It compared their care histories and educational experiences with other children in care and those in the general population. Secondly, it used linear regression to determine what factors predict educational outcomes. Refugee and asylum‐seeking young people in care faced fewer difficulties than their peers in care or those in need, but they lagged behind children in the general population. Age at entry, placement type, Strengths and Difficulties Questionnaire scores, school type and mobility predicted attainment. Special educational needs (SEN), number of placements and absences did not. Better care planning and a greater understanding of SEN are required to enhance the well‐being of this population.     

'The past, the present, but never the future': thematic representations of fostering disruption

The paper discusses some of the findings of a small-scale explor-atory research project which analysed the dynamics involved in substitute family care placements for young people, and assessed the processes demonstrated in fostering breakdowns in terms of the interactions, negotiations and adjustments between the re-spective parties over time. The paper concentrates on three core and interlocking themes: first, the perception of foster placements as 'second best'; secondly, the 'images of family life' permeating placements; and finally, the 'nature vs. nurture' debate which affected the ability of users and carers to sustain placements. These themes were selected for their significance in the development of an explanatory framework for understanding the interactional dynamics involved in placement disruption. The paper concludes with a discussion of the key implications for social work practice, considering foster carer training, sustaining placements, and part-nership arrangements between the young people, their natural families, foster carers and social work professionals.     

Breakdown of teenage placements in Swedish foster and residential care

This article deals with the problem of breakdown in different types of out‐of‐home care (foster care/residential care) for Swedish teenagers. How often are such placements prematurely terminated against the wishes and intentions of child welfare authorities? Which factors appear to increase or decrease the risk of placement breakdown? The sample consists of a national cohort of 776 youths who started 922 placements during 1991. Every placement was followed in municipal case files for a maximum period of five years. Between 30 and 37% of all placements were prematurely terminated, the exact figure depending on whether a narrow or wide definition of breakdown was applied. The lowest rates of breakdown were found in kinship care and secure units, the highest in non‐kinship foster homes. Teenagers who display antisocial behaviour and/or have mental health problems constitute a high‐risk category for most types of out‐of‐home care, but especially in non‐kinship foster homes. Risk factors in relation to breakdown were analysed in the four main forms of Swedish out‐of‐home care separately (foster homes, privately/publicly run residential care and secure units). The analysis pointed out that risk factors are not the same in all types of care, but antisocial behaviour at time of placement increased the risk in most forms of care. Prior research indicates that placement breakdown is a major problem of child welfare in other countries, and this study found that Sweden is no exception.     

Relative foster care: An emerging trend in foster care placement policy and practice

Abstract

Increases in the foster child population, at a time when terminations in foster care placement have decreased along with a decline in the number of non‐related foster parents, has resulted in an increasing use of relative foster care placement. Relative care as an emerging trend in foster care placement, is not without controversy. Its merits, however, should be assessed in terms of its benefits to the children in care, the fiscal and organizational costs, and the problems it creates for the child welfare system. This paper reviews what is known about the characteristics of relative caregivers and the children in their care. Federal and state policies that affect the use of relatives as an alternative placement resource for children are described. The available data regarding the length of time in placement, number of placements, physical, mental health and educational and permanency outcomes for children placed with relatives are discussed. Implications for practice are drawn and areas for further research are suggested.     

Carers and Professionals' Perspectives on Foster Care Outcomes: The Role of Contact

This study investigates the association between the contact of children or young people in care with their family, and the foster care placement evaluation (positive or negative) in Portugal. According to the perspectives of foster carers and service professionals' perceptions regarding children and young people's reactions, during and after the visits, are measured. Utilizing a quantitative approach, two fostering services teams and 140 foster carers completed questionnaires, which had 212 children in common. Results indicated that despite the importance of continued contact, especially for children and their parents, it was not determined to be essential to long-term placement. On one hand, there was the perception that a high percentage of children expressed positive reactions during and after the visit, while on the other hand, this didn't influence the perception of placement success. This study also showed significant differences between foster carers' and the professionals' perceptions on several dimensions of foster care, especially the children's reactions during visits. These differences need to be further analyzed in future research and the outcomes used to help improve contact management.     

The functional patterns of adolescent mothers leaving foster care: Results from a cluster analysis

Few studies have explored the outcomes of adolescent mothers leaving foster care, especially using person‐oriented methods. The current study employed a cluster analysis to identify unique patterns of functioning among adolescent mothers aged 19 (n = 777). Data from the National Youth in Transition Database and the Adoption and Foster Care Analysis and Reporting System were utilized. Findings revealed five subpopulations characterized by distinct constellations of outcomes at age 19. The largest group (43%) exhibited competent functioning across all the domains studied—its members were connected to school and/or employment and did not experience homelessness, substance abuse referrals, or incarceration during the past 2 years (i.e., “resilient”). A relatively small group (12%) exhibited challenges across all the above‐referenced domains, whereas the remaining groups presented challenges in some domains, but not in others. Follow‐up analyses revealed that adolescent mothers classified as resilient at age 19 had the lowest rates of congregate care placements and the highest rates of nonrelative foster care placements at age 17. Moreover, they had lower placement instability and higher rates of extended foster care as compared with members of the other clusters. Implications for practice, policy, and research are discussed.     

Father's involvement in the lives of children in foster care

Limited understandings exist about non‐resident fathers' views of their involvement with their children in foster care placements. Guided by the ecological systems framework, the purpose of this exploratory study was to gain insights into fathers' perceptions of their involvement with a child in foster care. Data were collected from demographic questionnaires and two focus groups with 17 men. Fathers expressed how kinship compared with non‐kinship placements affected their involvement. Fathers were also in agreement that their financial hardships were a significant factor affecting their involvement. Several fathers also reported how they experienced discrimination in the child welfare system as men. Surprisingly, uncommon to findings from other studies, few men viewed the child's mother as being a barrier to their involvement. The findings provide insights into factors requiring attention to help non‐residential fathers become involved with their children.     

Contact between birth parents and children in kinship care in a sample from Spain

Within the context of kinship care, the main objectives of this work are to study the characteristics of contact between foster children and their birth parents, and their relationship with key variables of fostering, the children and their kinship caregivers. The sample included 189 children from Spain and their kinship families. A semi‐structured placement interview and two scales relating to the child–caregiver relationship and child's psychological adjustment were used with the kinship families. The results revealed a significant percentage of foster children who had no family contact. Various visit types, frequencies and durations were described. Kinship care with contact, compared with placements without contact, was frequently characterized by the absence of professional supervision, and an affectionate child–caregiver relationship; moreover, children with contact were perceived to have fewer serious behaviour and socio‐emotional problems and a greater probability of family reunification. The regression analysis showed that the main predictors for how caregivers assessed contact were the children's emotional reaction during visits and the quality of the relationship between the kinship families and the birth parents. These results suggest the need for further research about contact, which will certainly have a major impact on professional intervention with these families.     

Nonfamilial kinship carers—Who are they and what support do they need to nurture children?

There is a growing body of literature about kinship care in the Western world; however, much of it focuses on grandparent care. A lesser known aspect of kinship care is the care of children by nonrelatives known to the child or their family. What little research exists about this group suggests that such placements are less stable than familial kinship care. This article reports a research study in Victoria, Australia, that explored nonfamilial kinship care through analysis of administrative data, interviews with young people and carers, and focus groups with kinship care support workers. It emerged that current administrative databases are not yet able to reliably identify the carer relationship, and thus the extent of such care arrangements cannot accurately be determined. Interviews and focus groups revealed that nonfamilial kinship care is diverse and qualitatively different from familial kinship care, bearing some similarities to foster care yet managed very differently. It is suggested that policymakers need to pay more attention to conceptualizing nonfamilial kinship care within kinship care policy frameworks and that greater attention is needed to the individual support needs of children in such placements and their carers.     

Growing up in foster care: providing a secure base through adolescence

As the UK Government White Paper, Care Matters: Time for Change , suggested, foster children need the care system to provide them with good quality foster family care that will help them through childhood to success and fulfilment of their potential in adult life.
This paper draws on the third phase of Growing Up in Foster Care , a longitudinal study of 52 children in planned, long-term foster care (1997–2006). It aims to increase our understanding of the transformational power of foster family relationships over time and particularly in adolescence. It shows how a secure base parenting model, using concepts from attachment and resilience, can be applied to foster care of adolescents. The paper uses case material to demonstrate each dimension of this secure base model and to emphasise how, even when adolescents have had stable and effective placements, they are likely to need support through into adulthood.