‘She was like a mother and a father to me’: searching for the ideal mentor for youth in care

Recent studies of youth in out‐of‐home placements have indicated that a successful mentoring relationship in care is associated with better emotional, educational and behavioural outcomes in adulthood. The goal of this exploratory qualitative study is to describe the profile of a staff member who is able to establish a meaningful relationship with youth in care through the perspectives of 20 young adults aged 21–26 who left care in Israel. Findings revealed that the staff member who formed meaningful relationships with youth was the staff member who was available to the youth and familiar with their personal backgrounds, who was able to see them as positive and trustworthy and to provide guidance and support from a non‐judgmental approach. One of the study's conclusions is that staff members who were able to transform their connection with the youth into mentoring relationships were those who were able to make the youth feel as if they were the staff member's own children, and as a result feel cared for deeply and loved. The discussion addresses the barriers in forming a mentoring relationship with a formal professional and the ways to utilize these mentoring relationship components more effectively within the care system.     

Instability and caregiving in the lives of street‐involved youth from foster care

A large proportion of youth who become street‐involved have experience in foster care, and our sample of 92 street‐involved youth, aged 14–18 years, all had foster care experience. We report on (i) instability of guardians and home from birth to street involvement; (ii) the connection between perceptions about foster care and measures of well‐being; and (iii) the implications of these findings for understanding street‐involved youth and the role of foster care in their life. The average number of transitions per youth from birth to mid‐teens was nine. Youth with experience in permanent care first lived away from biological parents at age 8.5 years, and for those with temporary care experience, it was age 10 years. Foster care was one of many living situations and one of several sources of caregivers. If participants were satisfied with foster care, they were more likely to be currently hopeful and happy. Participants who experienced positive influences from at least one long‐term caregiver tended to have other positive caregiver experiences, and those with negative influences were more likely to also have a positive relationship with a female caregiver. Foster care was one of several ‘way stations’ in their lives, one whose meaning needs further study.     

Harmful care. To what extent is terminology from medicine and clinical psychology applicable to out‐of‐home care?

Research concerning outcomes for children who have been placed in out‐of‐home care has indicated that the care may have unwanted consequences. However, there has been no coherent terminology for differentiating between different types of such unwanted consequences. In this article therefore, we attempt to disentangle different aspects of potentially harmful care for looked after children, as well as to discuss potential pathways to more systematically approach and report adverse events for this group. In this endeavour, we turn to two adjacent disciplines, medicine and psychology, where these issues have received more interest. The applicability of the concepts used in these fields is discussed, and it is concluded that although they provide some help in categorizing different aspects of harmful care, the complexity of out‐of‐home care makes existing models difficult to adopt without adjustments. This has consequences for the possibility of evaluating care in research, as well as for monitoring adverse events in practice. Importantly, the causality will often be unknown. We therefore suggest that it is essential to shed more light on how decisions should be made about when to intervene or not in out‐of‐home care, despite limited information.     

Post‐secondary transitions of youth emancipated from foster care

This study investigated the extent to which KnowHow2Go (KH2Go), a national college access campaign developed for first‐generation students in the USA, would resonate with youth who had aged out of foster care. Interviews were conducted with 27 youth who were enrolled in a post‐secondary programme following emancipation from foster care. We found KH2Go to have a close fit with the experiences of youth who had been in foster care. Four topics emerged as particularly important for youth in our study: money management, work, parenting and transportation. Finally, the study identified attributes these youth demonstrated that contributed to their resilience during the transition process. This study and the data presented pertain to youth living in the south‐eastern USA.     

The Economic and Gender Consequences of South Africa's Home‐based Care Policy

South Africa's approach to care provision in the era of HIV/AIDS is home‐ and community‐based care, but in reality care for ill people in the home is provided on an unpaid basis, predominantly by women. But how much do they spend on this care work, in time and money? And what economic consequences does this policy have, particularly for poorer women? This article is based on findings from a study that focuses on unpaid care provision within the home for those in late‐stage HIV/AIDS in KwaZulu‐Natal, South Africa, and specifically on the costs of such provision. The findings show that female caregivers are bearing the bulk of the costs of care provision for ill people within the home on an unpaid basis. Home‐based care is cost‐effective for the provincial government but not for unpaid caregivers who are subsidizing the provincial economy. While hospital care for people with HIV/AIDS has been capped, home‐based care services have not been increased to a commensurate level. Unpaid caregivers and ill people within the home are largely disconnected from the health system. The analysis clearly shows that the home‐based care policy is not resulting in appropriate or sufficient support for these individuals in need and needs to be revised.     

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.     

The effects of autonomy support and psychological capital on readiness for independent living through personal growth initiative among youth in out‐of‐home care

This study explored the effects of the factors on independent living readiness among youth under out‐of‐home care. Specifically, this study focused on the effects of caregivers' autonomy support and psychological capital on independent living readiness through personal growth initiative. A total of 215 youth who were expected to be discharged from caring institution within three years were gathered for the survey, and the final sample was 194 after excluding incomplete responses. Structural equation modeling with Mplus (version 7) was used to test research model and hypotheses in the study. Results showed that the research model was appropriated with several fit indices satisfied and that all the hypotheses were supported. Also, direct and indirect effects of independent variables were fully supported. However, the indirect effect of psychological capital was marginally significant. The results implicate that both caregiver's autonomy support and psychological capital are important for increasing personal growth initiative and that personal growth initiative served as a motivation to facilitating the readiness for independent living among children under institutional care.     

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.     

Expanding the scope of research with transition‐age foster youth: applications of the social network perspective

The support and resources embedded in social networks may be especially important for youth aging out of child welfare custody, such that foster youth support network characteristics influence the degree to which individual risk factors translate to poor outcomes during the transition from care. To examine the extent of this network influence on youth outcomes, social network analysis can be used to measure the interconnected relationships in the service network of caseworkers, foster parents and other providers, and in the personal network of biological family and community supports. By assessing these patterns of relationships, researchers can identify social network characteristics associated with particular subpopulations of foster youth who experience relatively successful or unsuccessful transition outcomes. This paper applies social network concepts and related methodology to frame foster youth transition support from a network perspective and to promote the generation of network‐informed hypotheses that could expand the scope of research with this important population.     

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.     

Into adulthood: a follow-up study of 718 young people who were placed in out-of-home care during their teens

In this study, national register data were used to analyse long‐term outcomes at age 25 for around 700 Swedish young people placed in out‐of‐home care during their teens. The sample consisted of 70% of all 13‐ to 16‐year olds who entered out‐of‐home care in 1991. Results revealed a dividing line between young people placed in care for behavioural problems and those placed for other reasons. Young woman and men from the first group had – in comparison with peers who did not enter care – very high rates of premature death, serious involvement in crime, hospitalizations for mental‐health problems, teenage parenthood, self‐support problems and low educational attainment. Young people who were placed for other reasons had better outcomes, but still considerably worse than non‐care peers. Young women tended to do better than young men, regardless of reasons for placement. Very high rates of hospitalizations for mental health problems were found among young people placed for behavioural problems. Breakdown of placement was found to be a robust indicator of poor long‐term prognosis.     

Foster children as young adults: many motherless, fatherless or orphaned: a Swedish national cohort study

We examined prevalence of parental deaths among former out‐of‐home care youths at age 18 and 25, and odds of parental loss compared with peers from similar socio‐economic childhood backgrounds. The study utilized Swedish national register data for 12 entire birth cohorts (1972–1983), 35 550 former out‐of‐home care youths and 1 138 726 cohort peers without out‐of‐home care experiences. Logistic regression models were used to compute odds ratios for parental loss through death. It was especially common among former residents of long‐term out‐of‐home care to be motherless (11%), fatherless (11–13%) or orphaned (3–4%) at age 18, compared with non‐foster care peers (1%, 3% and 0.03%). Twenty‐six per cent had lost at least one parent (4% among non‐foster care peers). At age 25, the figures had increased considerably; 36% had lost at least one parent, compared with 7% in the majority population. Adjusted odds ratios for parental loss among long‐term care youth were strikingly high, particularly for having a deceased mother. In short‐term and intermediate care, most youths with deceased parents had suffered parental loss before entering foster care. For youth from long‐term care, parental death after start of placement was most common.     

Building home on a fault line: Aging out of child welfare with a serious mental health diagnosis

Youth aging out of foster care are at high risk for homelessness. This research explains how and why homelessness occurs among youth with serious mental health struggles after aging out of residential and transitional living programmes. Using a longitudinal constructivist grounded theory design, we analyse 20 in‐depth interviews exploring youth's transition experiences and perceptions of transition success within 4 months of emancipation and at 6 and 12 months postemancipation. Monthly 15‐min check‐ins prevented attrition. A three‐phase transition process was observed driven by participant desires and actions to cultivate psychological home through establishing physical home alone away from social networks. Pre‐emancipation, the promise of home was privacy and opportunity for self‐redefinition. Shortly after emancipation, home became a physical and social space to be, a valuable resource to share and a demonstration of personal transition success. However, later in the year postemancipation, maintaining physical home proves nearly impossible given the risk context. Findings speak to how and why youth aging out appear overly self‐reliant upon emancipation. Cultivating a psychological sense of home has practice implications for child welfare providers who aim to prepare youth to live independently postemancipation.     

Incorporating self‐determination into substance abuse prevention programming for youth transitioning from foster care to adulthood

Youth transitioning from foster care to adulthood are at higher risk for alcohol and substance abuse disorders than general population youth. At the same time, these youths are often recipients of strong clinical intervention, often at levels considered unnecessary, for other mental health or behavioural challenges. Because of this, there is sometimes resistance from providers to offer services such as substance abuse prevention programming as it may be seen as contributing to youths' overclinicalization, stigmatization, or retraumatization. Using thematic content analysis, this qualitative study analysed focus groups with community stakeholders providing recommendations on support services for youth transitioning from foster care to adulthood to derive strategies for delivering substance abuse prevention programming in a way that enhances youth self‐determination. Findings were organized by self‐determination theory's 3 key psychological needs: autonomy, competence, and relatedness. All three needs were represented in stakeholder recommendations, which were translated into strategies for bolstering youths' achievement of each need. Strategies include a mix of those already present in motivational interviewing‐based brief substance abuse prevention interventions as well as more unique strategies that are much less frequently employed but that may better meet the needs of youth with foster care experience.     

Parental empowerment and child behavioural problems during youth care involvement

The aim of this study was to examine changes in parental empowerment and child behavioural problems during a period of youth care and how changes are related to the kind of services provided. We compared a preservation service that was family‐centred (FCS) with out‐of‐home services that were primarily child‐centred (CCS). The sample consisted of 621 families who were supported by FCS (n = 434) or CCS (n = 137). Information about parental empowerment and child behavioural problems was gathered at the start and end of youth care. Significant changes during treatment were identified with t tests and effect sizes. Significant improvements emerged on all empowerment scales for FCS but only on the behavioural control subscale for CCS. Moreover, significant improvements emerged on all child behavioural scales for both FCS as CCS. Cross‐lagged analysis showed that the kind of service, in favour of FCS, predicted parental empowerment but not child behavioural problems. Parental empowerment and child behavioural problems were negatively related. This paper discusses the potential for parental empowerment and FCS elements in CCS out‐of‐home care and the need for follow‐up research on this subject.     

Putting the child at the centre of inter‐professional cooperation in out‐of‐home care

A large part of most children's childhood is about taking part in educational and leisure‐time activities together with other children across various contexts. However, children in out‐of‐home care do not always have easy access to these possibilities for participation. In general, parents coordinate their children's everyday lives, but in the case of children in out‐of‐home care, the responsibility of care is distributed between several professionals and institutions. Research often recommends that inter‐professional cooperation should put the child at the centre and be more child focused. But what does that mean? The paper investigates theoretical understandings of ‘child centredness’ in inter‐professional cooperation. It also includes an empirical example taken from a research project that followed four children in their everyday lives in two residential homes in Denmark. The research explored how professionals work together across contexts in order to support children to take part in school and leisure‐time activities. The overall reasoning leads to the point that for children in out‐of‐home care, the possibility of exercising personal agency in their everyday life constitutes a difficult but vital issue. How children in out‐of‐home care learn how to conduct their everyday lives, is closely related to the ways professionals cooperate across contexts. It points to the need for close inter‐professional cooperation in order to encourage and support children's initiatives and engagements in activities in communities with other children.     

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.     

Older Persons’ Views on Using Cash‐for‐Care Allowances at the Crossroads of Gender,Socio‐economic Status and Care Needs in Vienna

The article aims to contribute to understanding social inequalities resulting from familization (or de‐familization) tendencies among cash‐for‐care beneficiaries in a Conservative welfare state. It highlights justifications for choices in accessing and using care in a cash‐for‐care scheme from the perspective of care recipients aged 80 years and older in Vienna. Along key dimensions characterizing care recipients’ experiences, we identify four different user groups, which reflect recipients’ individual characteristics, particularly gender, socio‐economic status (SES), and care needs, and the respective care arrangement. The groups are dubbed: (1) the self‐confident; (2) the illiterate; (3) the dependent; and (4) the lonely. Narrative interviews with 15 frail older people were held in 2014 and analyzed using the framework analysis method. Results show that familiarity with support structures associates with higher SES, while those who depend on others for acquiring information or organizing care express ambivalence in choosing between formal and informal care. Engagement in deciding which care type to use is limited among people of lower SES or with complex care needs, but own experience as informal caregiver for a family member increases care recipients’ long‐term care (LTC) system literacy. Gender differences among care recipients were limited, yet middle‐class female recipients often expressed normative claims for family care from female relatives. We conclude that unconditional care allowance schemes may reinforce existing gender relations, particularly among informal caregivers, as well as underpin socio‐economic differences among LTC users in old‐age. Results also partly question the assumptions of choice and empowerment implicit in many cash‐for‐care schemes.     

Dialogic literary gatherings and out‐of‐home child care: Creation of new meanings through classic literature

Research on out‐of‐home child care has revealed that foster care programmes focused on educational attainment and reading have the potential to improve the academic outcomes of children in care. However, no studies have examined which elements of these programmes positively benefit children's emotional well‐being. This article presents evidence of the positive effects of implementing a successful educational action, dialogic literary gatherings, in a children's residential care institution. A qualitative study using a communicative‐oriented methodology was conducted and involved five participant observations and eight daily life stories with children in out‐of‐home care in Catalonia (Spain). The children's reflections demonstrated that reading classic books, such as Dickens' Oliver Twist, deeply influenced their feelings and self‐conceptions and created new and exciting meaning in their lives.