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.     

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.     

Examining individual‐level academic risk and protective factors for foster youth: School engagement,behaviors, self‐esteem,and social skills

Students' school engagement is widely regarded as critical for positive school adjustment and overall academic success. Foster youth persistently face poorer educational outcomes than peers and demonstrate lower levels of school engagement and higher levels of academically threatening behaviors. The goals of the present study were (a) to explore relationships amongst various child‐level correlates of school engagement and problem behaviors—namely, self‐esteem and social skills—and (b) to respectively investigate the protective potential of self‐esteem and social skills in the association between school engagement and behavior problems that threaten educational trajectories. Results indicate significant associations between school engagement and problem behaviors, as well as between self‐esteem, social skills, and school engagement. Further, self‐esteem mediated the association between school engagement and both youth‐ and foster parent‐reported externalizing behavior, and social skills mediated the association between school engagement and both youth‐ and foster parent‐reported externalizing behavior. Implications for future practice, research, and policy are discussed.     

A systematic review of interventions to support looked‐after children in school

A systematic review of interventions to support looked‐after children in school included interventions that aimed to improve attainment, or prevent drop‐out or exclusions, and those that aimed to reduce absenteeism in the care population. Studies were critically appraised and their results were considered. No study was found robust enough to provide evidence on effectiveness, but promising interventions were identified. The review highlights the lack of evidence in an area that has received a lot of policy attention in the past few years. Future evaluations need to be underpinned by lessons learned from existing evaluations, clearly defined theories and definitions, and by the views of professionals, researchers, policy‐makers and young people in care.     

We care about care: advice by children in care for children in care,foster parents and child welfare workers about the transition into foster care

Twenty children in foster care, ages 8 to 15 years, provided advice to children in care, foster parents and child welfare workers about ways to assist service delivery during the transition into foster care. The children discussed the importance of tending to experiences such as foster home expectations, the importance of time and information, the new foster/parent–child relationship, coping with stress, the ability to be engaged in decision‐making, the benefits of foster care and the need to build a trusting and personal relationship between children in care and their caregivers. The importance of listening to children's experiences of the transition into foster care and incorporating their advice into future research, policy and practice will be discussed.     

Looking for best practice in caring for disabled children: a case of socialized foster care in China

This study focuses on the problems associated with caring for children with cerebral palsy (CWCP) in Chinese State Children's Welfare Institutions (SCWIs). It considers how to place these children with foster families and also provide them with the best rehabilitation services. In a pilot project, one SCWI trained foster parents as rehabilitators and provided services to CWCPs living with foster families in selected rural communities. The practice was very successful over the last decade, and more than 600 CWCPs in these communities are growing up happily. Hence, specialized foster care projects could be a solution for all SCWIs in China, where most of the institutionalized children are disabled.     

Helping foster youth find a job: a random‐assignment evaluation of an employment assistance programme for emancipating youth

A primary task for youth aging out of foster care is finding and maintaining a job. In recognition of the challenges that foster youth face, employment assistance has become an important part of child welfare agencies' efforts to prepare youth for emancipation. The current study uses random assignment to evaluate the impact of an employment assistance programme for foster youth on the rate of employment, income and other self‐sufficiency outcomes among a group of adolescents in substitute care in Kern County, California. Data were collected via multi‐wave, in‐person interviews of 254 foster youth. At the second follow‐up interview, only two‐fifths of the sample report being employed. However, three‐quarters of the sample are either working or attending school, and a quarter reports both working and attending school. Nevertheless, significant minorities report experiencing financial hardships and receiving financial assistance. No statistically significant impacts of the evaluated programme are found on any measured employment or self‐sufficiency outcome. Implications for child welfare policy are discussed.     

Foster carers' experiences of a paired reading literacy intervention with looked‐after children

Previous studies have shown that paired reading, a structured literacy intervention, is a promising method for improving looked‐after children's literacy skills. The aim of this study was to explore variations in foster carers' experiences of conducting the intervention. Interviews were carried out with 15 Swedish foster carers with varying experiences in programme compliance and of practicing the method. Findings suggest that the intervention process starts with getting carers involved, which seems to be dependent on a positive carer attitude. Integrating the reading training in the everyday life is another important aspect, which evolves around motivating the child and prioritizing the reading sessions. Furthermore, the results emphasize the need of having a flexible approach when delivering the intervention. The results suggest that it is possible to engage foster carers in literacy training for looked‐after children and that paired reading can provide a model for competent reading and also result in improved child/carer relations. However, participants need support, and in some cases adjustments in the day‐to‐day delivery of the intervention are required.     

“Helping teenagers in care flourish: What parenting research tells us about foster care”

In this article, I review a range of theoretical and practical issues that are relevant to the foster care of teenagers. I argue that topics such as the recent research evidence from neuroscience regarding brain development in adolescence, as well as control, the promotion of autonomy, and resilience, all have major implications for the provision of appropriate care for teenagers. I outline some of the key conclusions reached by researchers on these pertinent topics and then go on to consider the implications from this evidence for the training of foster carers.     

The social networks of young people in Ireland with experience of long‐term foster care: some lessons for policy and practice

This paper presents findings from the first study of the social networks of a group of young people in Ireland who have experienced long‐term foster care. The study group was composed of two groups of young people, a group who were currently in care and a group who had left the care system. The central focus was to examine the impact of foster care on the social network experience of the young people. Findings indicated that foster care impacts on the young people's social network experience in the following ways: losing contact with extended family; a greater challenge in making and sustaining friendships; an impact on education; and an inability to maintain contact with groups and activities that are of significance. This paper also presents recommendations in relation to policy and practice, including the raising of awareness of the importance of a social network approach in working with young people with care experience.     

The relation between parents' mental state talk and children's social understanding: A meta‐analysis

Though there is empirical support for the relation between parents' mental state talk to children and children's social understanding, including false belief understanding (FBU) and emotion understanding (EU), effect sizes range widely. The current meta‐analysis focused on the relation between parents' mental state talk and children's social understanding and moderators of this relation: parents' mental state talk content (e.g., cognitive vs. emotion talk), quality (e.g., appropriate vs. inappropriate), and context (e.g., book vs. reminiscing). Data from 22 studies examining FBU and 18 examining EU were examined. Participants included 2,298 children (<7 years). Analyses yielded a significant effect size for parents' mental state talk and children's FBU and EU. These relations were stronger under certain circumstances, particularly for children's FBU. For example, in terms of content, cognitive state talk was a stronger predictor of FBU and EU compared to talk about desires and emotions. For FBU, the strongest relations were present when parents' mental state talk was: (a) appropriate and explanatory compared to inappropriate and (b) in a book or self‐report context compared to reminiscing. The results of this study further refine the social constructivist view of social understanding and point to future avenues for research aimed at improving children's social understanding.     

Challenging behaviour in out‐of‐home care: use of attachment ideas in practice

Children in out‐of‐home care that demonstrate challenging behaviour are often thought of as ‘attachment disordered’. Our understanding of what this might mean for practice is not well developed. In this study, 92 South Australian stakeholders were interviewed about how they understood extremely challenging behaviour amongst school‐age children in out‐of‐home care. Participants consistently described behaviour as arising from attachment difficulties. Despite this, there were a variety of ways that a child's attachment needs were conceptualized, which appeared to be inconsistent with contemporary attachment theory. Thematic analysis yielded four implicit views about children's attachment: attachment as capacity that is limited, attachment as skill that children can learn and transfer to other relationships, attachment as unachievable for some children and an idealized view of attachment as a close and trusting relationship. These possible misconceptions about attachment and attachment needs and their relationship to the development of challenging behaviour are discussed in terms of attachment informed research and theory. The possible implications for placement practice and policy for children in out‐of‐home care are discussed.     

Experienced support from family,school and friends among students in out‐of‐home care in a school‐based community survey

Youth in out‐of‐home care have elevated risks for adverse events and detrimental circumstances possibly affecting their development. Responses from 311 students in out‐of‐home care (OHC) were compared with peers living in birth parent care (BPC) and in single birth parent care (sBPC) in a regional school survey, directed to students in compulsory school eighth year and upper secondary school second year. Results indicate OHC students to experience less satisfaction with friends, leisure time, and families. They state less trust in support from friends and families but a more similar level to teachers, counsellors or nurses. OHC students also express being more exposed to abusive experiences online and perceive less sense of security at home and in school. We conclude that welfare institutions need to recognize the components in building trust and safety for students in OHC and that school and other professional institutions have an important role in serve resilience and promote well‐being for children in OHC.     

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.     

Securing permanence for children in care: A cross-country analysis of citizen's view on adoption versus foster care

If children in child protection cannot be cared for by their natural parents, should they be adopted or live in foster home? Results from a study of representative samples of populations (n = 12 330), in eight European countries—Austria, England, Estonia, Finland, Germany, Ireland, Norway and Spain—and California, USA, reveal that people would recommend adoption over foster care, if a child in public care cannot grow up with their natural parent(s). There are cross-country differences between populations, and examining if institutional context such as type of child protection system explains differences, we find that child maltreatment-oriented systems are more supportive of adoption than other types of systems. Citizens having little confidence in the child protection system were only weakly correlated with preference for adoption. In conclusion, people prefer adoption as placement options for children in care are more than foster homes, and possible this finding reflects a sort of refamalialization of children into the private sphere.     

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.     

You matter to me: important relationships and self‐esteem of adolescents in foster care

This study examined the extent to which relationships with biological mothers, foster parents and peers influenced the self‐esteem of adolescents in foster care. A subsample from the National Survey of Child and Adolescent Well‐Being of adolescents in long‐term foster care was used for this study (n = 188). The findings indicated that when considering relationships with biological mothers, foster parents and peers and controlling for demographic characteristics in one regression model, relationships with peers had the greatest impact on self‐esteem of adolescents. Implications for child welfare and clinical work are discussed.     

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.