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.     

Obstacles to involving children and young people in foster care research

ABSTRACT Despite increasing recognition of the importance of including the perspectives of children and young people in care in alternative care research, in practice this is not always a straightforward matter. This paper describes the recruitment of disruptive young people in care under the jurisdiction of the South Australian statutory authority to three studies on placement instability. Non‐response rates of 72.5% and 82% are reported. A large number of subjects were excluded because agency social workers did not cooperate with the project, and more subjects were excluded for reasons which suggest high levels of distress in this population. The dilemma of providing a voice to distressed subjects when distressed subjects are excluded from research is discussed, and the appointment of an independent representative for children in care to review research proposals and to negotiate research access to children is proposed.     

Why one goes to school: what school means to young people entering foster care

In this interpretative childhood study of 17 boys and girls aged 13–16 years placed in foster families, the experiences and attitudes towards school are explored. The importance of school as an arena for both learning and socialization is emphasized. Data were collected through interviews, network maps and text answers via mobile phone (‘beepers’). Their educational improvement was based on their understanding of scholastic achievement as meaningful for their future, stability in daily routines and the involvement and support of family, peers and teachers. Access to peers at school is important, and group activities facilitate this. Because of their background, foster youth can also be exposed to bullying from peers. Both learning and socialization at school affect their self‐esteem.     

Intergenerational pathways leading to foster care placement of foster care alumni's children

This study examined a path model that postulated intergenerational relationships between biological parent psychosocial functioning and foster care alumni mental health, economic status and social support; and from these to the likelihood of children of foster care alumni being placed in foster care. The sample included 742 adults who spent time in foster care as children with a private foster care agency and who reported having at least one biological child. A full pathway was found between poorer father's functioning to greater alumni depression, which was in turn associated with negative social support, and then a greater likelihood of child out‐of‐home placement. Other parent to alumni paths were that poorer father functioning was associated with alumni anxiety and post‐traumatic stress disorder (PTSD), and poorer mother's mental health was associated with PTSD; however, anxiety and PTSD were not implicated as precursors of foster care placement of the child. Findings support the need for increased practice and policy support to address the mental health needs of parents of children in or at risk of foster care, as well as the children themselves, as family history may have a lasting influence on quality of life, even when children are raised apart from biological parents.     

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.     

Supporting unaccompanied asylum‐seeking young people: The experience of foster care

Although research on the experiences of unaccompanied asylum‐seeking young people in the UK has grown steadily in recent years, their experience of fostering and of the role played by foster carers in helping their adjustment have been neglected. This paper reports findings from the first UK study into these experiences, describing issues arising from initial assessment and preparation for fostering and the ways in which young people and foster carers adjusted to their lives together. It assesses the progress made by young people during placement, the strategies that appeared helpful to relationship building, and the extent to which young people had become integrated within the wider network of family relationships. Given that most young people first arrive as teenagers, it also considers the ways in which foster carers and social workers helped young people prepare for adult life in the context of uncertainties arising from the asylum process.     

Providing a secure base for LGBTQ young people in foster care: The role of foster carers

The experiences and needs of lesbian, gay, bisexual, trans and queer/questioning (LGBTQ) young people in care have been overlooked in England, in both policy and research. This paper reports on findings from the first study of LGBTQ young people in care in England and focuses on the nature of foster carers' experiences and perspectives on caring for LGBTQ young people. Qualitative interviews regarding the fostering role in caring for LGBTQ young people were conducted with a sample of foster carers (n = 26) and analysed thematically. Foster carers described the importance of offering LGBTQ young people not only the nurturing relationships that all children in care need but also availability, sensitivity and acceptance to help young people manage stigma and other challenges associated with minority sexual orientation and gender identity. The Secure Base caregiving model provided a framework for analysing the different dimensions of these relationships. Understanding caregiving roles and relationships for LGBTQ young people in care has important implications for recruiting, training, matching and supporting foster carers to care for LGBTQ young people effectively.     

Substance use among older youth transitioning from foster care: Examining the protective effects of religious and spiritual capital

Among older youth transitioning from the foster care system, this longitudinal study examined the association of religious and spiritual capital to substance use in the past year at age 19. Participants consisted of African American (N = 179) and White non‐Hispanic (N = 133) older youth in foster care. Drawing from social capital theory, it was posited that religious service attendance (a proxy for religious capital) and belief in a spiritual force (a proxy for spiritual capital) would be inversely associated with substance use. Multiple logistic regression results indicated support for the first and second hypothesis for White foster youth only. Among White foster youth, more frequent religious service attendance and greater belief in a spiritual force were associated with a lower likelihood of illegal substance and polysubstance use. No association between religious or spiritual capital and substance use was found among African American foster youth. The findings underscore the importance of conducting spiritual assessments to help ensure older foster youth who have strong religious or spiritual orientations are in environments where they are accommodated and supported.     

Network governance among actors involved in the government’s contracting out of foster care services: A case study in China

The government's contracting out of foster care services in Guangzhou, China, introduced the possibility of partnerships between nongovernmental organizations (NGOs) and government-led human services. To understand network governance among actors involved in contracting out foster care services, service funders, service providers, and service users were interviewed. A thematic analysis of interviews combined with a critical review of archival data was conducted. Drawing from the policy network governance analytic framework, we found that network governance conditions in contracting out foster care services were characterized by close interdependence among actors, moderate standardization in work duties, but nonreciprocal patterns of interactions, and low to modest levels of autonomy, along with strong power in the government but limited self-governance among NGOs and foster families. Our findings indicate that network governance was not fully achieved among actors involved in the contracting out of foster care services. Implications for practice and research are discussed.     

Contact visits between foster children and their birth family: the views of foster children,foster parents and social workers

It has been argued that contact visits between foster children and birth parents can help maintain attachment bonds and support the child's development. However, some research suggests that such visits can be detrimental. This study analyses the characteristics of contact visits and examines children's perceptions of the emotional relationship they have with foster carers and their biological parents. Participants were 104 non‐kinship foster children and their respective foster carers and social workers. Fifty‐six of these foster children had contact visits with their birth parents. Foster children rated the quality of their relationship with foster carers and birth parents using the Affect Scale. Foster children, foster carers and social workers all completed the Evaluation of Contact Visits Questionnaire. Results showed that (i) a high proportion of children had no contact visits; (ii) the contact agreement was often not fulfilled; (iii) many visits were rated as poor quality; (iv) foster carers' evaluation of visits was more negative than that of both foster children and social workers; and (v) children who experienced poor‐quality visits and perceived less warmth and more criticism/rejection from their parents. These results highlight the need to improve contact visits by developing intervention strategies targeted at all those involved.     

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.     

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.     

Impacts of media on sexual behaviour and relationships among youth in foster care

Youth in foster care (YFC) are at high risk of negative reproductive and other health outcomes and may be especially vulnerable to negative impacts of media due to early adversity and a lack of stable caregiver relationships. The aim of this project was to explore how access and exposure to media impacts YFC in order to inform future research in this realm and promote resilience in this understudied population. We conducted semistructured interviews with YFC ages 15–21 (n = 22) and focus groups with foster caregivers (n = 86). We used thematic analysis to analyse data for themes related to media. Youth and caregivers described four main themes: (a) impacts of media on youth norms and attitudes, (b) impacts of media on youth behaviour, (c) impacts of youth exposure to pornography, and (d) caregiver monitoring and mediation of media. Data from this study indicate that media has unique, important effects on YFC norms and behaviours, including sexual behaviours. Foster caregivers encounter multiple barriers to monitoring and mediating media use for YFC. Further research is needed to explore differential effects of media on YFC versus non‐YFC in order to develop effective interventions and mitigate potential negative effects of media.     

Family contact in foster care in Portugal. The views of children in foster care and other key actors

This is a pilot study on the sensitive issue of how children and young people experience family contact in foster care, and the views of key adults in their lives on the same issue. There is a special focus on the children's experiences, opinions, and feelings. The study is a response to the relative scarcity of literature on family contact based on the experiences of children and adults in caring roles. This is a qualitative and exploratory study, with a sample of 10 children and young people in care in the district of Porto, aiming to identify key issues and areas for further examination. The results allow us to conclude that the possibility of maintaining contact is positively evaluated. However, perspectives on the relationships involved, and on the reactions to and difficulties associated with visits, revealed considerable disagreement among the actors. A possible set of implications drawn from the findings pointed out to the importance of developing a monitored cooperation that improves communication processes in order to take into account the children's and young people's views in the decision‐making process; and to develop more attentive and open working relationships with parents throughout the foster care placement.     

Assessing the educational achievements of adults who were formerly placed in family foster care

Case records and interviews concerning educational achievements of 1087 foster care alumni are presented. Youth were served by a voluntary agency in 23 communities across the USA between 1966 and 1998. Because the alumni were older than most foster care follow‐up studies, a more extensive picture of educational achievement was possible. High school graduation and college enrolment rates were comparable to or even greater than those of the general population, but the number of alumni completing high school with a Graduate Equivalency Diploma and the college dropout rates were a concern. Predictors of high school completion while in foster care, such as fewer placement changes, extracurricular activities and independent living training, are presented, along with recommendations for improving educational and vocational preparation.     

Interventions to improve supervised contact visits between children in out of home care and their parents: a systematic review

Although the importance of contact between children in care and their parents, when safe, is accepted, there is limited research about supervised face‐to‐face contact. There is no literature that has systematically critiqued how supervised contact can be best delivered. The aim of this systematic review was to evaluate the evidence for interventions aimed at improving the quality of contact visits between parents and their children who are in out‐of‐home care. Twelve studies were included in this review. Each study was graded and assigned scores according to the presence or absence of each of seven criteria. The studies demonstrated key similarities in the types of interventions provided, although delivery varied across group, individual and educational interventions. Parents reported improved capacity to manage their emotions and parents' satisfaction with the programmes was high. Although there was a lack of large scale, methodologically rigorous studies with long‐term follow‐up, some promising findings were identified: the literature indicates individual family support and group programmes have the potential to improve parent–child relationships and the quality of contact visits. This review suggests that future studies build on current evidence by addressing their methodological limitations and evaluating interventions that can be tailored to meet the needs of individual families.     

Effective services for improving education and employment outcomes for children and alumni of foster care service: correlates and educational and employment outcomes

Outcomes for youth from foster care have been found to be poor. The education and employment outcomes of youth and alumni of foster care served by transition programmes located in five major US cities were examined. Data were collected by case managers and reported to evaluators quarterly on 1058 youth from foster care for over 2 years. Job preparation, transportation, child care, education support services and life skills were the most common services provided to youth. During the 2‐year study period, 35% of participants obtained employment, 23% obtained a General Education Development or diploma, and 17% enrolled in post‐secondary education. It was found that the longer the youth were enrolled, the more education and employment outcomes they achieved. Further, job preparation and income support services were associated significantly with achieving any positive education or employment outcome. Results indicated that certain services provided over an extended period of time can improve outcomes for youth placed in foster care. For youth to achieve positive outcomes as they transition to adulthood, additional services are necessary. Other implications are discussed.     

Traditional kinship foster care in northern Ghana: the experiences and views of children, carers and adults in Tamale

Surveys were employed to explore the experiences of children in care and their carers about traditional fostering. They also examined the perspectives of randomly selected adults in the community about the practice of traditional foster care in the Tamale area of northern Ghana. The 74 participants responded to closed- and open-ended interview questions about traditional foster care. Frequencies and thematic grouping of qualitative responses showed that the need to keep family ties alive was the key reason for placement of children with family and kin. Majority of the children expressed satisfaction with living in foster care, even though they had experienced physical and emotional abuse and intimidation. Although most carers were not formally employed and had little personal income, they were positive about having the care role, but faced challenges in providing for many children in a difficult economic situation. The report highlights the role of reciprocity, altruistic and socio-cultural factors in quality of care, and the potential for the traditional kinship foster care to provide suitable avenues of placement for children as recommended by the Ghana child rights law. It also identifies the need for education for carers around children's needs and Ghana's child rights law.     

Nowhere to go: Housing pathways of college students with foster care and homelessness experience

This study builds on previous research to understand longer term housing experiences in late adolescence and early adulthood for vulnerable college students. Using a biographical, qualitative method, we study high school and college housing and family circumstances for 27 students with homelessness or foster care experience enrolled in 4-year colleges in Georgia. We identified three different housing pathway types in high school—family homelessness, unaccompanied youth and foster care. Housing instability and frequent moves were common in high school among all housing pathway types. In college, students who were able to find low or no-cost housing and those who identified a foster care pathway in high school achieved greater housing stability. Others students experienced a continuation of housing instability that began in high school. Additional funding to cover the cost of on-campus housing would likely contribute to increased stability. Additional strategies, such as rental assistance programmes tailored for college students, may be needed to address housing instability for vulnerable college students. More research on the unmet housing needs and the consequences of housing instability during college for homeless and foster youth is needed to further a housing policy agenda that focuses on practical solutions.     

Supporting foster and kinship carers to promote the mental health of children

The majority of children and young people removed from the care of their parents by the state of Victoria, Australia, reside in foster or kinship care. These children have experienced a broad range of adverse conditions and are up to 4 times more likely to experience problems with mental health than their mainstream peers. This paper draws on the perspectives of foster and kinship carers, describing the disconnection between their role as mental health advocates and their interest in early intervention in a field which is dominated by crisis and the historic marginalisation of foster and kinship carers. Thirty‐one foster and kinship carers across greater metropolitan Melbourne, Australia, contributed to this study through interviews and focus groups. Participants demonstrated a practical understanding of mental health and an ability to identify a range of conditions that have an adverse impact on the mental health of children and young people in their care. The paper concludes that there is a lack of systemic support and even a range of barriers that affect the capacity of foster and kinship carers to promote the mental health and well‐being of the children and young people in their care.