Quality of experience in residential care programmes: Retrospective perspectives of former youth participants

This exploratory study examined perceptions of care quality within parent‐pay youth treatment programmes such as therapeutic boarding schools, residential treatment centres, wilderness therapy programmes, and intensive outpatient programmes. Reflecting on their personal experiences as youths, 214 adults reported on a total of 75 different treatment settings. Two indices developed for this study measured participants' perceptions of quality of experience and the totalistic programme characteristics of their care settings. Regression analyses and ANOVA tests of means indicated a negative relationship between totalistic programme characteristics and quality of experience index scores. Significant relationships were not found between quality of experience and forcible transport, intake decade, or the amount of time in treatment.     

Understanding and negotiating identity: Children from cross-community families in public care in Northern Ireland

In Northern Ireland, most research on the impact upon children of living through the ‘troubles’ and in a divided society has assumed that children are from either the Catholic or Protestant community. There has been very little research with children from cross‐community families who have one parent from a Catholic background and one from a Protestant background. It is known, however, that these children are over‐represented in the public care system in Northern Ireland. The study reported in this paper addresses this gap in knowledge by exploring the experiences and views of children from cross‐community families who are in public care in Northern Ireland. The study has key messages for the development of services for looked after children from cross‐community families, if these are to be delivered in accordance with legislative duties in Northern Ireland and in an anti‐sectarian manner.     

Youth and parent perceptions of aftercare supports at discharge from residential care

While much is known about youth struggles after reintegration into the home and community settings following stays in out‐of‐home care, little is known about appropriate supports for aftercare, or parent (see Note ¹ ) and youth perceptions during this critical transition period. This study seeks to begin to address these questions through surveys evaluating youth (n = 48) and parent (n = 48) perceptions of (i) transition planning, family preparedness and aftercare; (ii) youth preparedness for the transition period across major life domains (e.g. education, health care, relationships); and (iii) the importance of specific aftercare supports and services. Results indicate differences between youth and parents on perceptions of need for continued supports, likelihood of participation in aftercare programs; and youth preparedness for success in relationships, family and independent living domains. In contrast, similarities were found on youth and parent ratings regarding the importance of specific services and supports, with both groups indicating supports in education as most important and supports in mental health as least. Study limitations, future research and implications are provided.     

Understanding the experience of moving a loved one to a long-term care facility:family members' perspectives

This project was designed to develop an understanding of family members' experiences of moving a loved one to a long-term care facility and to identify ways in which facilities might help ease this process. Twenty-one semi-structured interviews were conducted with family members who had recently moved a relative into one of three long-term care facilities in Southern Ontario, Canada. Several factors appeared to contribute to the overall experience of the move to long-term care and either served to impede or facilitate a positive transition for families. These factors included: the experience during the waiting process, preparation for the move, ease of the actual move, control over decisions, communication throughout the process, support from others, and family and resident perceptions and attitudes towards the move. Easing the difficult aspects of moving a loved one to a long-term care setting can be facilitated with better preparation and support from facilities and community services.     

“It's better than it used to be”: Perspectives of adolescent siblings of children with an autism spectrum condition

This article reports on the lived experiences of 11 adolescents who have a brother or a sister with a diagnosis of autism spectrum condition. Through semistructured, in‐depth, in‐person interviews, these adolescents shared their experiences and perceptions. These exploratory findings can be used to inform the practice of social workers and other health professionals, and future research. Implications for practice focus on the importance of exploring experiences and perceptions of siblings of children diagnosed with autism spectrum condition to enhance support services for these siblings.     

Hypothesis Testing of CNA Perceptions of Organizational Culture in Long Term Care

This commentary for the special issue on research that went wrong describes a study that explored factors that contribute to variability within Certified Nursing Assistants (CNAs) on organizational safety culture. We know from previous research that CNAs provide most direct care in nursing homes and that direct care workers often experience agency culture differently from agency management (Wolf et al., 2014). We were looking for factors that nursing homes could alter to improve the culture for CNAs, and thus, residents. We conducted a secondary analysis of data collected via a multi-component paper survey of CNAs employed in long term care. We used results from the Nursing Home Survey on Patient Safety Culture and primary shift, type of unit, and years as a CNA to identify modifiable characteristics that would explain variability in the perceptions of patient safety culture. The final sample included n = 106 from three nursing homes. Dimension scores were compared using bivariate tests appropriate to the scale and ordinal logistic regression. Despite support in the literature for the hypothesis, we found few significant differences on the total scale within groups. Differences in perceptions have implications for quality of care and the experiences of residents within nursing homes.     

Birth parents’ perceptions of professional practice in child care and adoption proceedings: implications for practice

This paper explores non‐relinquishing birth parents’ experiences of contested child care and adoption proceedings. It highlights the perceptions and voices of birth parents which are rarely prioritized in dominant discourses of professional practice in this area. The paper reviews previous related research and also discusses a small‐scale empirical study which elicited the perspectives of three birth parents whose children had been made subject to care proceedings and placed for adoption in England. Drawing on previous research and this study, the paper makes range of practice recommendations for sensitive professional practice with birth parents during contested child care and adoption proceedings.     

Getting behind the closed door of care leavers: understanding the role of emotional support for young people leaving care

There have been significant changes in the legislative frameworks and guidance that surround social work practice with young people leaving the care system over the recent years. However, care leavers continue to face a range of challenges, achieve poor outcomes and research has consistently highlighted the insufficient attention paid to sources of emotional support. This paper provides empirical data from a small number of care leavers reflecting on their experiences of transitioning to independence. The findings provide further evidence of the lack of attention paid to emotional support by professionals and highlight the impact that this had on the young people's experiences. The young people identify their changing perceptions and needs as their experiences post‐care change, the complex reasons for why they may have rejected offers of support and make key recommendations for practice. This paper provides valuable insight into the process of leaving the care system from the perspective of care leavers themselves and raises key questions that challenge the structure of the current support systems, the nature of the professional relationship with young people in care and the priorities of current policy initiatives.     

'Seen but not heard'– young people's experience of advocacy

This article draws on two pieces of empirical research undertaken in England with young people in public care. The research examined young people's experiences of a range of advocacy services, and the extent to which the involvement of an advocate facilitated young people's voices being heard in decision-making. The research responded to contemporary concerns about children's participatory rights, citizenship and social inclusion, set in the context of the United Nations Convention on the Rights of the Child. This article examines the strengths and limitations of advocacy for young people in public care and compares the different types of advocacy services that are available to young people and considers the extent to which adult perceptions of childhood and youth frame the services that are offered. It provides a comparison of the outcomes for young people who have had an advocate and those who have not. The concluding discussion argues that young people in public care feel excluded and marginalised from decision-making processes, and that advocacy has a pivotal role to play in placing at centre stage the wishes and feelings of young people.     

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.     

Interpretative phenomenological analysis of young people's lived experiences of therapeutic residential care

Concerns of maltreatment and poor outcomes persist in residential care despite numerous government inquiries and recommendations. Young people in residential care continue to be the most vulnerable and marginalized group in the out‐of‐home care population. Young people's voices are also underrepresented in research. Existing studies predominantly focus on service evaluations in which individual voices of young people are overshadowed by adults' perspectives. Other studies examine the perspectives of young people in out‐of‐home care as a homogenous population, limiting understandings of the subjective experiences of young people in residential care. This study focused exclusively on young people's lived experiences in Australian therapeutic residential care, utilizing interpretative phenomenological analysis. The young people in this study revealed experiences of peer victimization, ambiguous loss and uncertainty during transitions. These findings suggest that more work is required in order to provide safe and healing environments and experiences for young people in therapeutic residential care. Each individual voice captured in this study offers valuable insights into how residential care practitioners can strengthen practice to enhance protection, engagement, connection with families and leaving care support.     

Women's safety service within the Integrated Domestic Abuse Programme: perceptions of service users

This paper draws on the findings of a qualitative evaluation that examines women's perceptions of the services provided to them whilst their abusers attended an Integrated Domestic Violence Programme (IDAP) in one probation area in the UK. Research focusing on domestic violence programmes has mostly concentrated on the experiences of male perpetrators. As a result, less is known about how women feel about such programmes and the parallel safety services they are supposed to receive. This research seeks to address that weakness by exploring the perceptions of 13 women whose abusers are attending one perpetrator programme. The findings of our study suggest that women are generally negative about perpetrator programmes and require more comprehensive and coordinated services than are routinely made available to them. The paper suggests that women value and need direct and assertive support as well as safety services, and this need is especially pronounced in rural contexts where women can be isolated from mainstream services. The implications of the research to practice with victims of domestic violence are discussed to inform further development of IDAP and similar programmes in the UK and beyond.     

Defining Success: The Perspective of Emerging Adults with Foster Care Experience

Youth with experience in the foster care system are often more susceptible to negative outcomes in adulthood due to higher levels of cumulative risk; however, there is little research on perceptions of resilience among this population. This mixed-method pilot study presents results from a modified prototype analysis that examined both qualitative and quantitative aspects of how emerging adults (ages 18–25; n = 18) with foster care backgrounds viewed the concept of “success.” Specifically, the approach involved a demographic questionnaire, modified prototype analysis, Developmental Assets® assessment, and focus group discussion providing valuable insight into the perceptions and experiences of emerging adults who have spent time in the care of foster families. Results share youth's perspectives of how their foster families contributed to resiliency and successful adult development. Findings indicate that the definition of “success” is complex and subjectively defined based on personal goals and that specific Developmental Assets® are important for foster families to promote youth resilience. This deeper insight into perspectives of former foster youth gained through the modified prototype analysis can guide agencies, advocates, and parents, permitting a more intentional promotion of success, and maximizing opportunities for resiliency.     

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.     

Living Close to a Person With Cancer: A Review of the International Literature and Implications for Social Work Practice

To help family caregivers (FCs), social workers need to understand the complexity of FC’s experiences and challenges. For this systematic review, several relevant, multidisciplinary electronic databases were searched. Of 1,643 titles identified, 108 articles met the inclusion criteria and are included in this review. Various experiences, symptoms, and burden related to caregiving responsibilities are described and discussed. The understanding evolving from this study about the FC’s own health risk, caregiver burden, and experiences over time can enhance a social worker’s awareness of an FC’s challenging situation and the potential impact this has on the FC’s ability to provide care to the patient.     

Recommendations for Hospice Care to Terminally Ill Cancer Patients: A Phenomenological Study of Oncologists' Experiences

The aim of this exploratory study was to better understand oncologists' experiences and their perceptions of hospice care as an end-of-life treatment choice for terminally ill cancer patients. To describe this experience, semi-structured qualitative interviews were conducted using phenomenological methods with nine oncologists. Four themes emerged from the data analysis: (a) feelings of discomfort and relief, (b) being different from others, (c) experience with nonhospice patients, and (d) factors influencing the decision to recommend hospice. Future research and a flexible interdisciplinary practice model are suggested to better assist with end-of-life care decision making and recommendations for hospice care with oncologists and their terminally ill cancer patients are presented.     

My life in care: experiences of non-participation in decision-making processes

The extent to which young people are involved in legal decision‐making depends on assumptions and perceptions about their ability to participate in decision‐making in general. This paper draws on research with four young people, looking at their experiences of involvement in a variety of decision‐making processes whilst in the care of the local authority. Through narratives, games and other activities, the thoughts and emotions of the four young people are explored, identifying the development of feelings of helplessness, low self‐esteem and poor confidence that have followed the lack of opportunities made available to them to make decisions about their own lives. The efficacy and tension of corporate parenting is also explored with suggestions from the participants on how the care system could be constructed differently to facilitate their voice and that of much younger children than themselves. Thus, the debate becomes one of adult ability and preparedness to involve young people in decisions about their own lives, rather than whether they are able to participate effectively.     

“Power together”: Professionals and parents of children with disabilities creating productive partnerships

Disparity of power and authority in the relationship between parents and professionals has been shown to be a major challenge in creating a successful partnership in caring for children with disability. The goal of this article was to evaluate workshops attended by professionals and parents of children with disability by raising awareness to barriers related to incompatible expectations and role definitions. The research explored the experiences of the participants in order to identify factors that facilitated or impeded their collaborations. Data were collected from three workshops attended by 22 mothers of children with disability and 24 professionals (most of them are social workers). This qualitative research used interpretative phenomenological analysis to investigate the participants' experiences. Findings showed that parents and professionals joined forces to create a productive working relationship by taking advantage of power over and power together relationships. This mutual process required participants to be aware, empathic, and respectful of one another's needs and limitations; acknowledge the contribution of experiential and professional knowledge; and co‐operate in overcoming the effects of ineffective bureaucratic service systems. Interventions geared to contain emotional burden, acknowledge differential knowledge and experience, and structure the use of power are suggested.     

Problematising Australia's Nanny Pilot Program as evidence‐based policy: A reconstruction of the problem of childcare

In a notable departure from long‐standing childcare policy in Australia, in January 2016 fee relief was extended to nannies providing in‐home care in a 2‐year pilot program. This policy is significant as fee relief is not tied to the meeting of regulatory requirements designed to ensure quality early learning and care for young children. Drawing on Carol Bacchi's approach to policy analysis, this paper extends previous problematising of evidence‐based policy by highlighting the value of first considering how a policy ‘problem’ has been constructed. We propose that the nanny pilot is an ideologically driven policy that has emanated from a construction of childcare that is adult (parent)‐centred and marginalises the needs and interests of young children. Accordingly, certain evidence is privileged while other evidence is ignored, with the ensuing policy focused on economic imperatives rather than quality early learning and care experiences for young children. We draw on an analysis of parent, peak body and researcher submissions to the Productivity Commission's 2013–2014 childcare inquiry, nanny‐focused research, and data from three national surveys to explore the limitations of such a policy approach. The utility of problem reconstruction as a means of disrupting policy‐informed evidence and the legitimisation of purported evidence‐based policy is considered.     

A Collaboratively Designed Child Mental Health Service Model: Multiple Family Groups for Urban Children with Conduct Difficulties

This paper presents preliminary outcomes associated with an experimental, longitudinal study of a Multiple Family Group (MFG) service delivery approach set within thirteen urban outpatient clinics serving children and their families living in inner-city, primarily African American and Latino communities. Specifically, this paper focuses on parent reports of child oppositional behavior and parenting stress over time. MFG is a flexible, protocol-driven approach designed to address the most common reason for referral to outpatient child mental health clinics, childhood behavioral difficulties. The MFG also aims to enhance family-level engagement and retention in ongoing care. Further, the service delivery model was collaboratively developed with intensive input from parents rearing children with conduct difficulties, parent advocates, community-based child mental health providers and services research staff in order to ultimately expand the number of effective service models that can be situated within "real world," urban child mental health settings.