Assessment of problem behaviour by foster parents and their foster children

This study investigates the level of agreement between foster parents and foster children about problem behaviour and how this is associated with the breakdown of a foster care placement. The study took a sample of foster parents and their foster children (n= 60), who were aged 11–17 years, and analysed the severity of problem behaviour displayed by the foster children within 3 months of placement in the foster family and a year and a half later. The level of agreement was established with the intra‐class correlation coefficient, which represents both the differences in scores and the differences in ranking. This coefficient shows that there is a statistically significant difference in the level of agreement on the Internalizing Problems scale of the Child Behaviour Checklist between the placements that broke down and those that continued. The level of agreement is associated with the severity score, which in turn is associated with the outcome of the foster care placement. To avoid placement breakdown, problem behaviour should also be assessed from the perspective of the foster child.     

Placement breakdowns in long‐term foster care – a regional Swedish study

We used a regional sample of children in long‐term foster care to investigate the prevalence of placement breakdown in adolescence, and to assess risk factors/risk markers for placement disruption. The sample consisted of all 136 foster children in the region, born 1980–1992, who on their 12th birthday had been in the same foster family for at least 4 years. They were followed in case files until date of disruption or their 18th birthday. Data on conditions before and during placement were retrieved from case files, and analysed in bi‐ and multivariate models. Results showed that one in four placements broke down in adolescence. The median child who experienced a breakdown was 14 years old, and had been in the same foster home for more than 10 years. Prominent risk factors were (i) being placed after age 2 and (ii) having a birth sibling in the same foster home. We also uncovered strong risk markers that can be viewed as precursors of placement disruption. When the child or the foster parents repeatedly over time expressed dissatisfaction with the placement, this ended with a placement breakdown in 60% of cases. Implications for practice are discussed.     

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.     

The impact of foster children's behavioural problems on Flemish foster mothers' parenting behaviour

Foster children often have behavioural problems. Behavioural problems influence the level of parenting stress and can lead to a breakdown. In this study, parenting behaviour of foster mothers is mapped, and the influence of behavioural problems and parenting stress on the parenting behaviour 2 years later is examined. Data of behavioural problems, family stress and parenting were gathered from 49 foster mothers. Problem behaviour has a direct negative impact on parenting and leads to less support and more negative control. It also results in more parenting stress. Foster parents need to be trained aiming at preventing ineffective parenting. The well‐being of foster parents needs to be guarded. Higher levels of parenting stress lead to less effective parenting.     

Predictors of outcome for unrelated adoptive placements made during middle childhood

This paper reports on a follow‐up to adolescence of two longitudinal prospective studies of children placed from public care with non‐related adoptive families in the UK. Factors associated with outcome are presented for 99 children (one index child per adoptive family) who were between 5 and 11 years of age at placement. Information concerning the children's backgrounds and care histories was obtained shortly after placement (T1), from social workers. Adopters were interviewed at T1 and again at the end of the first year (T2). A further follow‐up was conducted an average of six years after placement (T3). Outcomes at T3 were classified as either disrupted, which was true for 23%, continuing and ‘positive’ (49%) or continuing but ‘difficult’ (28%). Bivariate analyses revealed a number of attributes, related to both the child and the adoptive parents, which were associated with differential outcomes. Logistic regression produced five predictors of placement disruption: age at placement, behavioural problems, preferential rejection, time in care and the child's degree of attachment to the new mother. Differences were found between ‘positive’ and ‘difficult’ outcomes in continuing placements as well as between continuing and disrupted placements. The analysis suggests that adoption should certainly be considered as an option for children over 5 years of age while recognizing the need for both preparation and post‐placement support. Evidence of differential outcome in continuing placements provides support for efforts to reduce the number of placements and returns home that a child at risk experiences.     

Foster parent training programmes for foster youth: a content review

Foster parent training is a well‐recognized component of providing quality care in child welfare. Well‐trained foster parents can improve placement stability, reduce behavioural problems and encourage successful reunification or adoption. A review of the foster parent training programmes can provide a better understanding of the current state of foster parenting training and inform future practice and policy‐making. This review examined published and unpublished research on foster parent training conducted from 1970 to 2014 and provided an overview of the structure and content of 22 foster parent training programmes. Common patterns in the content and structure of foster parent training programmes are identified and discussed, highlighting trends towards multi‐session in‐service training with eclectic content. The development of new training programmes with strong theoretical grounding that train foster parents on specific behavioural skills is recommended.     

KEEP foster-parent training intervention: model description and effectiveness

In this paper, we describe the development and history of the Keeping Foster Parents Trained and Supported (KEEP) foster-parent training intervention. KEEP intervention represents a modified version of the Multidimensional Treatment Foster Care intervention developed by interventionists at the Oregon Social Learning Center and is designed to provide training and support for children ages 5–11 in regular foster care. We also report on the initial findings from a programme of research focused on determining the effectiveness of the intervention. Thus far, the results indicate that the intervention is effective in reducing child behaviour problems and that the effects of the intervention are mediated through changes in parenting behaviour. There is also evidence that the KEEP foster-parent training intervention increases the chances of a positive change of placement (e.g. child reunited with biological parents) and mitigates the negative risk-enhancing effect of a history of multiple placements. We conclude with a discussion of unanswered questions and directions for future research.     

Foster care assessment: an exploratory study of the placement assessment process in Flanders and the Netherlands

Family foster care placement decision‐making has a weak scientific underpinning. The identification of clusters of foster children (groups of foster children with similar characteristics) can help improve decision quality. In this study, we investigated if foster children could indeed be clustered, which problems were identified at the time of placement and what might be the influence of placement history. Two clusters of foster children were found: (i) young children with coinciding parental child‐rearing incapacity and familial problems, and (ii) older children with child problems. At the time of placement, familial problems were more often identified in younger children with a placement history. These findings stress the importance of approaching foster care assessment as part of a dynamic decision‐making process. It is key to finding the most appropriate situation for the child. At the same time, it must be decided how the desired situation can be realized, wherein placement decisions are based on an appraisal of whether or not a foster placement is an appropriate solution. In conjunction with this, it needs to be decided how the parents can be supported towards reunification, or whether or not long‐term foster care is the best option for the child, and if so what conditions need to be met.     

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.     

Factors associated with placement breakdown initiated by foster parents – empirical findings from Germany

This study investigates the effects of covariates on the probability of placement breakdown in non‐kinship family foster care. Breakdowns are distinguished according to the initiator: children, carers, foster parents and the local child welfare authorities. The children concerned had entered foster care at ages ranging from 0 to a maximum of 17 years (n = 14 171). A significantly higher risk of breakdown on the initiative of the foster parents is found in male children, children whose parents receive financial support, children whose parents were removed from the register of carers, children who were between 6 and 15 years old when they joined the foster family, children who had earlier lived in a different foster family or residential care, children from patchwork families and children whose joining of a foster family was the result of disruptive social behaviour. Two‐thirds of the children from non‐kinship family foster care who stay in the foster family was ended on the initiative of the foster parents are subsequently looked after in residential care. That is three times the rate for all terminated foster relationships. Breakdowns on the initiative of the foster parents thus indicate a high risk of unstable care history developing and accordingly necessitate prevention strategies.     

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.     

Searching for effective interventions for foster children under stress: a meta‐analysis

Foster children experience a lot of stress because of their life histories and changes in their family circumstances, such as foster care placement. It is important that foster parents recognize the early signs of stress in foster children and learn how to act in a non‐threatening and understanding manner. Family‐based interventions may help in this. In this paper, we report on a meta‐analysis of studies (n= 19) of the effectiveness of such interventions. All studies used a pre‐test/post‐test design. Both problem behaviour in foster children and the parenting skills of foster parents improved by 30%; however, none of the interventions were specifically intended to help young children (<4 years) to cope with stress. The importance of interventions for young foster children is discussed, as well as the necessary elements these interventions should include.     

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.     

Who returns home? Study on placement outcomes of Flemish foster children

Until recently, Flemish family foster care was a temporary measure with as its most important goal, the reunification of the foster child with the birth parents. To date, nothing is known on the number of reunifications, nor has any study been undertaken into the factors (child, parent, foster parent and foster care process) associated with reunification. Case files of 127 foster children who exited foster care in 2007 were analysed. Dependent variables were type of foster care placement outcome (reunification, successful placement without reunification or breakdown) and place of residence after placement ending (with birth parents, extended family, foster family, residential care or living independently). After placement ending, only 40% of foster children went living with their parents, including foster children who were reunified (26%) and foster children who moved to their parents after a placement breakdown (14%). Characteristics of the foster children, and in particular absence of problem behaviour, were associated mainly with a return home. This may indicate that too much attention is paid to the functioning of the foster child and too little to improving the competencies of the parents and the (future) home environment.     

Breakdown of teenage placements in Danish out‐of‐home care

This study deals with the problem of breakdown in out‐of‐home placements for Danish teenagers. How often are these placements prematurely terminated against the requests and intentions of the child welfare authorities? Which factors seem to increase and decrease placement breakdown? The sample consists of 225 youths and 367 placements during the years 2004–2008. Among the 225 youths, 44% experienced a breakdown, and 33% of the 367 placements ended with a breakdown. A large proportion of the placement breakdowns (20%) occurred before 4 months, and within the first year, 62% of the placement breakdowns had taken place. Replacements took place in 61% of all placement breakdowns. The analysis showed that type of placement and number of youth at the same placement had significant association to placement breakdown, but variables based on the social worker's clinical assessment showed no association to breakdown. However, while the logistic regression model was significant, it explained only 6% of the variance. Earlier studies have indicated that breakdown is a substantial problem of child welfare in several other western countries, Denmark is no exception. These corresponding breakdown rates point out that no child welfare system yet have found a method to reduce breakdown substantially.     

Privatising Foster Care: The UK Experience within an International Context

Foster placements for children in care in the UK are being increasingly provided by non‐governmental organizations. However, although local authorities are purchasing almost one third of their required placements from these external agencies, the UK has not yet followed the examples of other English speaking countries. In parts of the USA and Australia all fostering and other child welfare services have been wholly outsourced or transferred from the public to private and non‐profit organizations. A number of these initiatives have been independently evaluated and some of their findings resonate with what seems to be happening in the UK. This article explores these but also other factors which appear to distinguish the policy and practice of foster care in the UK from those of the USA and Australia. Using theory related to the privatization of welfare and relevant domestic and international research, the article examines the development of external commissioning of foster care in Britain. In the light of changing law, ideology and policy, the article concludes by speculating on how the future of fostering and wider child welfare provision in the UK may look, at a time of political change and economic austerity.     

Mortality after care among young adult foster children in Sweden

This exploratory study looks at mortality after care among 13,100 former Swedish foster children, placed before their teens. Sources used are two national databases, on child welfare interventions and causes of death. Risk ratios of death for foster children are compared with those of their peers in the general population and with a comparison group, consisting of 10,668 young adults from adverse home backgrounds, who never entered foster family care before their teens. Both ex-foster children and the comparison group were young adults (19–26 years old) at time of follow-up. Results show a moderately elevated risk ratio for both groups compared with peers in the general population, mainly due to more frequent unnatural deaths, especially suicides. Time at first placement was not related to mortality among men, but there was a weak tendency of a higher risk ratio for girls placed at age 7–12. Information on time spent in care is used with caution, due to possible problems with reliability. Almost all comparisons between the foster care and the comparison group fell short of statistical significance. For foster children who had spent more than five years in care, the risk ratio tended to be higher than for foster children with shorter care experience, and similar to that of the comparison group. Foster children who had been in care for less then six years thus tended to have a lower risk ratio than the comparison group.     

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.     

Social functioning and mental health among children who have been living in kinship and non‐kinship foster care: results from an 8‐year follow‐up with a Norwegian sample

Studies have shown relatively high rates of emotional and behavioural problems among children living in out‐of‐home care. This study reports the prevalence of social problems at an 8‐year follow‐up for a group of children/young adults. Predictors for prevalence and change in emotional and behavioural problems at the follow‐up are examined. A prospective cohort design with 233 children who had been living in foster care was used. Forty‐eight per cent (n = 111) of those interviewed at baseline were located and interviewed at follow‐up. Mean age was 17.4 (standard deviation = 2.9) years. Mental health symptomatology was measured with Child Behaviour Checklist and Adult Self‐Report. Linear and generalized mixed model analyses were used. Changes in internalizing and externalizing problems from baseline to follow‐up was associated with gender. Boys showed more problems at a young age, whereas girls developed more problems later. Predictors for social problems at follow‐up were mental health at baseline, kinship care and care placement away from the local community.