From walls to homes: Child care reform and deinstitutionalisation in Ghana

In 2006, the Ghanaian government, in partnership with the United Nations Children's Fund (UNICEF), began to reform the child welfare system. The main aim of this reform was to provide a sustainable and culturally appropriate system of care for children without parental care by shifting from an institutional‐based model to a family and community‐based one. Drawing on existing peer‐reviewed and grey literature, this article provides an overview of the major components of the reform, including reintegration with the extended family, foster care and adoption. In addition, the article discusses the prospects and challenges involved in achieving the reform's intended component. Key Practitioner Message: ● Use community development techniques to raise the resources needed to provide family support services for vulnerable families; ● Social work practitioners partner with non‐governmental organisations to train community members as para‐social workers; ● Social workers, especially in developing countries, understand the challenges they face when embarking on deinstitutionalisation.     

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.     

Placement characteristics and stability: a longitudinal analysis of Norwegian children in foster homes

This paper investigates how enhanced support for foster parents, such as covering fees and providing consultants and relief, may reduce the number of replacements experienced by children in foster care. It also investigates the extent to which replacements are associated with family (kin) vs. non‐family foster parents, or with legal characteristics of the placement (i.e. forced administrative decisions vs. relief measures agreed upon by the parents). Statistical analyses of administrative data from Norway investigated the longitudinal relationships between these characteristics and the number of replacements at two levels – children (N = 16 109) and municipalities (N = 418) – over 5 years (2007–2011). The results reveal modest associations between enhanced support and fewer replacements; for example, replacement rates are lower for children placed in homes of kin than in non‐family homes. Replacements also tend to be fewer when the placement is forced rather than consensual.     

Early outcomes for young adults transitioning from out-of-home care in the USA

This paper describes the well‐being of participants in the Midwest Evaluation of the Adult Functioning of Former Foster Youth (n = 603), a study of youth leaving out‐of‐home care in the USA, at the point where they have been ‘young adults’ for about 1 year. Although some of these young adults are in stable situations and either moving forward with their education or employed in promising jobs, more of them are having significant difficulties during the early stages of the transition to adulthood. Too many are neither employed nor in school, have children that they are not able to parent, suffer from persistent mental illness or substance use disorders, find themselves without basic necessities, become homeless, or end up involved with the criminal justice system. They are doing worse than other young adults across a number of important dimensions. Most of these young adults continue to maintain relations with members of their family of origin, with many finding themselves living with family at age 19. Importantly, those young people who chose to remain under the care and supervision of the child welfare system experienced better outcomes than those who either chose to or were forced to leave care.     

High‐frequency family contact: a road to nowhere for infants

Understanding the practices which support the best interests of infants when placed in out‐of‐home care in the first year of life is a significant challenge. A study based in Victoria, Australia, explored the practice by the Children's Court of ordering high‐frequency contact (4–7 days a week) with the infant's mother and father when they are placed in care in the first year of life. A literature review revealed little attention to the issue of frequency of family contact for infants. An audit of case files of all infants in care in mid‐2007 showed that at 1 year follow‐up, there was no difference in the reunification rate for children with a period of high‐frequency contact and those with less contact with their mothers and fathers. Focus groups revealed deep divisions of opinion about high‐frequency family contact which are played out in the adversarial Children's Court system in Victoria. The study highlights the complexity of understanding and supporting the attachment relationships at this critical period in the infant's life.     

“The Persistence of Parent Repayment” and the Anticipation of Filial Obligations of Care in Two Thai Provinces

With an accelerated and sustained decline in fertility and an increase in life expectancy, Thailand has entered its aging phase at a rapid pace. This raises an important question of who should care for the increasing elderly population. Using a survey of adults aged 16–64 years (n = 742) in two provinces in the north‐east (Kalasin) and south (Phang Nga) of Thailand, this paper explores the expectations that individuals have from their children when they become very old. Only one‐third of the respondents expected to live with their children in old age and only one‐fifth anticipated financial assistance. Less than half of them expected personal care and practical care from their children (43% and 38%, respectively). The expectations varied substantially by the number of children and income, with those with higher income reporting lower expectation. Those living in Kalasin, a much poorer province than Phang Nga, had greater expectations from their children in old age. This suggests that, for those with less financial resources, children remain the main care provider for the elderly.     

Residential care: an effective response to out‐of‐home children and young people?

The ever‐growing number of out‐of‐home children in Italy over the last decade has urged an assessment of the available care services. Although foster care is spreading rapidly, many young people are still housed in residential facilities. Reflection on residential care quality has intensified at both a national and an international level. This paper presents the results of a study on residential care facilities for children and young people in the region of Northern Italy (Lombardy). Four dimensions of ‘quality’ are considered: efficiency, effectiveness, participation in planning and intervention, and empowerment of children and their family relationships. The combined effects of these dimensions are defined as ‘relational quality’. The results show that residential care facilities are generally good, while Social Services resources often appear inadequate for interventions aimed at birth families (efficiency). The well‐being of children in residential care facilities is high, even if they tend to move from one facility to another, rarely returning to their birth family (effectiveness). The involvement of children and their families at different stages of the care path is limited (participative approach). Finally, the most critical element is the failure to properly involve birth families (empowerment).     

Foster care in France: children's perception of their own well‐being

Working to improve the welfare of children in care is a priority shared by all French child protection services. However, the means to measure and improve well‐being are limited (Fergeus et al., 2019). Although the trend today is towards a more comprehensive understanding of the point of view of adults involved in the socioeducational process, too little is done to include the children's own perception of their situation and conditions of care. The purposes of this study are to document and analyse the point of view of children in foster families on their subjective well‐being and also to identify contextual factors that influence it. Ninety‐one children living in foster care, aged 13.5 years on average, completed the French version of the Multidimensional Students' Life Satisfaction Scale developped by Huebner, Zullig Runa in 2012. The multidimensional evaluation of well‐being (family, school, self, friends, and living conditions) reveals a moderate life satisfaction within the foster family and a weak one at school. Total life satisfaction levels are directly linked to the number of care orders the child has experienced, their duration, and the type of education received. The implications of these results for professional practices related to children in care will be discussed.     

A comparison of youth resilience across seven South African sites

The resilience of children and youth is an increasingly important area of research. Young people growing up in distressed communities, characterized by poverty, crime and family troubles, are particularly vulnerable. Resilience can assist these young people in navigating through these challenges towards independent living, particularly as they transition out of adolescence and into young adulthood. Children in South Africa are almost universally vulnerable, but children growing up in residential care facilities and children from poverty‐stricken communities are particularly in need of resilience. This quantitative study of 575 South African children compared their resilience in terms of individual, family and community protective factors across seven sites, including child and youth care centres, schools in poor communities and schools in middle‐class suburban communities. Contrary to expectations, the study found that children in one of the children's homes and one of the poor communities had the highest levels of resilience. Moreover, all but one of the sites scored very high on at least one of the resilience variables, suggesting unique profiles of resilience across the sites. Practice implications for child and family social work are discussed.     

Caregiving in Transition in Southern Europe: Neither Complete Altruists nor Free-riders

In the framework of the SOCCARE Project, focusing on families dealing with a double front of care for children and frail elderly people, similarities can be found in Italy, France and Portugal beyond their different welfare regimes. The comparison of family histories and caregiving strategies, by the methodology of case‐matching, gives an interesting overview of the relationship between the debate on social care and that on the intergenerational contract. The paper aims to understand which are the available combinations of family, informal and institutional resources making a heavy burden of care “acceptable and still normal”: this focuses both typical situations of each country and common features through the countries. The results show how changes in the representations of obligation and duty in the intergenerational pact produce different outcomes and demands in welfare systems. The analysis of shifting boundaries between the public and private spheres in care provides useful policy recommendations, aimed at improving choices and “sustainable” responsibilities of individuals, families and social networks. Sustainable policies seem to be more dependent on family and structural types and resources of networks than on different welfare and services support.     

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.     

Child of two worlds: How foster care workers perceive their skills in dealing with worldview differences in foster care

Foster children often encounter worldview differences between their foster family and their birth family, for example, when participating in religious activities and practices. Foster children not only have a right to continuity in upbringing but also consistency in worldview, culture and language. Good co-parenting relationships are important for their identity development. For these reasons, foster care workers are entrusted with the task of supporting the triadic relationship of the foster child, birth parents and foster parents in dealing with worldview differences. Based on in-depth interviews with foster care workers (n = 16) six skills in dealing with worldview differences can be distinguished: (1) basic knowledge of worldviews and identity formation; (2) empathizing with the other; (3) inquisitiveness to discover what is essential for the other; (4) initiating worldview conversations and keeping them going; (5) fostering self-reflection in worldview; and (6) manoeuvring between and monitoring all interests. It is helpful if birth parents are well-informed in advance about the impact of worldview differences and if foster care workers and foster parents are aware of the identity and developmental needs of foster children to explore the worldview of the foster family and the birth family.     

Reimagining child welfare outcomes: Learning from Family Group Conferencing

This article reports on a qualitative study, which sought to retrospectively understand the contribution family group conferencing (FGC) makes to longer‐term outcomes for children at risk of entering State care and their families. Eleven case examples of FGC were studied from five local government areas across Scotland. Each example included the perspectives of different stakeholders in the process: children, their parents/carers and extended family (n = 32), and professionals (n = 28) involved with them. The study found a number of interconnecting issues in relation to FGC outcome contribution. First, the personal experience of process matters to the service user and his/her opinion of the outcomes they achieve. Second, what professionals do and how they do it can impact the outcomes of people requiring support. Thus, the relationship between professionals and service users is central to understanding why and how families achieve longer‐term outcomes. Finally, who defines outcomes and to what purpose is significant when understanding outcomes. This article reports on two sets of FGC outcomes identified within the study: personal and professional. Arguing for a more nuanced understanding of outcomes in child welfare this article begins to explore, and challenge, the manner in which outcomes are identified and valued in child welfare.     

Research Review: Parents' service experience – a missing element in research on foster care case outcomes

A large body of child protection literature focuses on termination of parental rights, family reunification, and children's re‐entry into care as outcomes for children in foster care. Studies have investigated child, placement, family, and parent variables as predictors of case outcome. However, one important group of variables remains largely unstudied: factors related to parents’ service experience. Parents’ service experience includes parents’ perceptions of and involvement in the various services in which they must participate in order to recover their children from foster care (e.g. mandated treatment programmes such as substance abuse rehabilitation, parenting skills classes, etc.). The parental perspective on the foster care process is a critical element in the life of a child protection case, and its influence on case outcome must be explored. A brief review of the current literature on case outcome predictors is provided and parents’ service experience is highlighted as an area in need of investigation. Suggestions for the measurement of parents’ service experience are also offered.     

Complex home care: challenges arising from the blurring of boundaries between family and professional care

Over the last 50 years, increasingly complex care (such as tracheostomy management, dialysis or enteral feeding) has shifted from hospital to home, with a concomitant rise in patient self-management and care given by family members. Recognition of the importance of the contribution of family care to the health system is also growing. This article reports the findings of a New Zealand study which explored the experiences of family carers who manage technical health procedures at home. It then draws attention to some broader issues raised by shifting complex care from professional management in hospital settings to family care at home, namely the ways in which complex home care blurs the boundaries between professional and family care (creating the ambiguous position of the expert carer) and questions of safety and responsibility in family care. We also discuss the implications for policy around family caregiving in New Zealand. Given the potential physical and mental health impacts of caring, it is time for renewed consideration of what family carers should be expected or allowed to manage and how the health system can support them in their important role.     

Peer relationships during late childhood in internationally adopted and institutionalized children

The aim of this study was to analyse the interpersonal relationships in the school context of children living in different care settings (adoptive families, residential care centres, birth families). Participants were 76 children between eight and fourteen years of age (M = 10.78, SD = 1.38), belonging to one of three groups: international adoptees, children living in residential care in Spanish institutions, and a comparison sample of Spanish children living with their birth families with no connection with child protection. Sociometric information was collected in the classroom of each child during school hours. Internationally adopted children from Russia showed considerable difficulties in their relationships with peers; they were more likely to be rejected and their peers described them as less prosocial and somewhat more aggressive. With a better sociometric position than the adoptees, children in residential care were rated by their peers as more aggressive and less prosocial than the normative population. Coordination and integrated work between the family, protection centres, schools, and other social services should be a strategic priority in the promotion of healthy social development in these groups of children.     

What is a family? Constructions of family and parenting after a custody transfer from birth parents to foster parents

The subject of stability for children in long‐term foster care is an emerging field within social work with vulnerable children. In Sweden, the adoption of foster children is not a common occurrence. Instead, when a child has been placed in foster care for 3 years, the local social welfare committee will consider whether the custody of the child should be transferred to the foster parents regardless of the circumstances of the birth parents, in order to secure stability and a sense of family belonging. Consequently, custody transfers raise questions such as “who is family?” and “who is a parent?” This qualitative interview study with custodians and young people who have experienced custody transfer highlights that who counts as family and as a parent is ambiguous. This article draws attention to how negotiations about family and parenthood revolve around biological, emotional, and relational dimensions. Furthermore, we show that stability for children in care has to be understood in terms of processes over time and not as the result of a single decision of custody transfer. Consequently, social workers need to take several aspects into account when they assess family belonging and stability for children in foster care.     

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.