Family relations, adjustment and well-being in a longitudinal study of children in care

The article reports on a longitudinal study of children placed in a children's home during the first two years of the 1980s. The 26 children placed when younger than 4 years of age and staying more than 4 weeks were followed up 3 and 9 months after leaving the children's home and 5, 10, 15 and 20 years later. The children's family relations, including early attachments and later parental relationships and the perception of who is their family, have been one of the predominant themes in the recurrent studies. None of them had lived with both parents after leaving the children's home and 20 of them had been in foster care for periods or permanently. At the time of the last study the children were young adults, aged 20–25. They are categorized in three rather distinct categories, one for those with a ‘good’ and one for those with a ‘moderate’ social adjustment and well‐being and one for those with a ‘bad’ social adjustment and well‐being insofar as involvement with drugs, criminal behaviour and legal sanctions are concerned. Their contacts and relationships with birth parents and foster parents and the perception of who is their family are analysed by use of attachment theory and developmental psychopathology.     

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.     

Positive Connections: a programme for children who have a parent with a mental illness

Mental health professionals working with parents who suffer from a mental illness often overlook the children within the family. Children whose parents are mentally ill face numerous obstacles to their own emotional development and these children are at higher risk for developing mental illnesses than other children. These risks can be decreased if protective or positive interventions are available for the children. This article will describe the development and implementation of Positive Connections, an effective intervention programme specifically designed for children whose parents have been diagnosed with a mental disorder. The effectiveness of this programme has been evaluated using both qualitative and quantitative research strategies, and the results are presented.     

Foster children: a longitudinal study of placements and family relationships

Foster children's family relationships have been one of the themes in a longitudinal study, starting with a disadvantaged group of children, 0–4 years of age when taken into care and placed in a children's home in Sweden. Seven rounds of data collection were carried out; the last two when the children were young adults. This article is about those 20 children in the study group who, in addition to temporary residential care at an early age, have experiences from foster care, either for the remainder of their childhood or before or after a period of reunion. Placement history is put in relation to family relationships, i.e. relationships to birth family and foster family. The categorisation in secure and insecure relationships or attachment patterns is based on interviews with the young adults, with a retrospect of previous relationships. The connection between placement history and family relationship is not obvious in this high-risk group. However, inclusive attitudes from the foster family towards the child's family promote continuity and a sense of security, also in periods of reunion or re-placement, and facilitate foster children's hard work in coming to terms with their family background and finding their own way.     

Worries and problems of young carers: issues for mental health

This paper reports on a research study which explored the worries and problems of young carers in Edinburgh. Sixty‐one young carers took part in the study, conducted between April and June 2002. Findings indicate that young carers identify significant worries and problems in relation to their well‐being, and that these come over and above any ‘normal’ adolescent difficulties. It is suggested that these findings may have important implications for young carers’ mental health, now and in the future, and contain important lessons for child and family social work in general.     

Adult children of parents with mental illness: navigating stigma

The experiences of children who live with parental mental illness are becoming increasingly recognized. However, there remains a limited body of knowledge in relation to an individual's longer term experiences. This study sought adult children's experiences of childhood parental mental illness. It generated reflections of 13 adult children who had lived with parents with mental illness during their childhood. The narrative design of the study facilitated a voice for participants. The paper presents one main theme of the findings. The findings offer a unique insight into childhood awareness of social stigmas and children's behavioural changes to avoid disclosure of parental mental illness. Participants noted that they were aware of social stigmas associated with mental illness during their childhood. This contributed to their fear of disclosure to others that fuelled a culture of familial secrecy, reinforcing the children's own sense of difference. Further work is required to enhance community understanding about the familial journeys of parental mental illness and the impact of negative‐natured stigmas.     

The mental health status of Latino children in the public child welfare system: a look at the role of generation and origin

As the number of Latino children in public child welfare continues to grow, it is necessary to understand how their mental health is faring. The paper examines emotional and behavioural needs among Latino children who had contact with the public child welfare system. The purpose of this longitudinal study was twofold: to examine the severity of emotional and behavioural problems, and to assess the predictive role of generation status and Latino origin. Latent growth models were completed using the National Survey on Children and Adolescent Well‐Being. The predictive model for the externalizing CBCL scale revealed that generation status and Latino origin were significant predictors. At baseline, Puerto Rican children exhibited higher rates of externalizing problems compared with Mexican children. Over time children who were first/second generation tended to have lower scores compared with the third‐plus generation children. Implications for practise are discussed.     

Adult children of parents with mental illness: Family stigma and coping on sense of self

Family stigma is associated with persistent negative outcomes among adult children of parents with mental illness (ACOPMI). Loss of sense of self has been reported by ACOPMI; however, the role of family stigma on sense of self remains unclear. Additionally, research suggests coping behaviour (i.e. adaptive or maladaptive) influences the effect of stigmatization on sense of self. This study investigated the impact of family stigma and coping on sense of self among ACOPMI (N = 134, 63.4% female). As hypothesized, high family stigma was associated with weak sense of self (p < 0.001), and ACOPMI who endorsed adaptive coping demonstrated higher sense of self than those who coped maladaptively (p < 0.001). Further, coping moderated the relationship between family stigma and sense of self (p < 0.001). Unexpectedly, this relationship was only significant for ACOPMI with adaptive coping skills (p < 0.001). At higher levels of stigmatization, post hoc analysis revealed coping styles did not exert an influence on sense of self. Results suggest family stigma contributes to loss of sense of self among ACOPMI, with adaptive coping being protective only at lower levels of family stigma. Findings highlight the need for a systemic approach to eradicate family stigma.     

Young children returning home from care: the birth parents' perspective

While a wide range of literature exists on the experiences of children in foster care or adoption, much less is known about children who return home from care to their birth parents. This paper focuses on the perspectives of a small sample of birth parents of young children who returned home from care. It draws on findings from the Northern Ireland Care Pathways and Outcomes Study that has been following a population ( n  = 374) of children who were under 5 years and in care in Northern Ireland on the 31st of March 2000. As part of this study, interviews were conducted with the foster parents of 55 children, the adoptive parents of 51 children and the birth parents of nine children who had returned home from care. The paper explores the birth parents' views on how they coped while their child was in care, how they were coping after the child had returned home and how their child was faring at home. Results revealed that these parents, and their children, were experiencing multiple difficulties and struggled to cope after the children had returned home.     

Children whose parents misuse alcohol: a study of services and needs

Despite the fact that many children are affected by parental alcohol misuse, both services and research have largely concentrated on adults. Recently, projects have been set up to assist children, but developments have been piecemeal. This article reports on a qualitative study which learned directly from children, their parents and some young adults what they saw as the effects on children of excessive drinking by one or both parents. The most common consequences were distress at witnessing violence to the other parent or to the home; verbal abuse towards the children; feelings of shame; and taking on caring and protective roles. However, the children were not passive victims and usually took active steps to tackle the drinking or modify its impact Those in the sample usually had at least one family member who helped them and was trusted. Nevertheless, many wished they could meet with others in the same position, so they could feel less isolated and learn from each other. The need was identified for access to a network of services with group work, individual counselling, family mediation and educational components.     

Prevalence of mental health problems among children placed in out-of-home care in Denmark

This paper concerns the prevalence of mental health problems among children in family foster and residential care within a Danish context. All children, born in Denmark in 1995, who are or formerly have been placed in out-of-home care ( n = 1072), are compared with a group of vulnerable children of the same age, subjected to child protection interventions but living at home ( n = 1457, referred to as the 'in home care children'), and to all contemporaries who are not child protection clients ( n = 71 321, referred to as the 'non-welfare children'). Prevalence data are established on the basis of national administrative register data, including data on psychiatric diagnoses of the children, and on survey data scoring children in out-of-home care, in home care children, and non-welfare children by means of the Strengths and Difficulties Questionnaire (SDQ). Results show that 20% of children in out-of-home care have at least one psychiatric diagnosis compared to 3% of the non-welfare children. Almost half of the children in care (48%) are, furthermore, scored within the abnormal range of SDQ, compared to 5% of the non-welfare 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.     

‘Not a good person’: family stigma of mental illness from the perspectives of young siblings

The purpose of this paper is to critically examine family stigma as one form of the stigma of mental illness in child and youth mental health. Presented are the outcomes of a thematic content analysis of in‐depth, semi‐structured interviews conducted with seven (n = 7) young siblings, ages 13 to 21 years old, with a brother or sister identified as having a mental‐health issue. The focus of the interviews was on the ways the siblings experienced their other sibling's mental health and how those experiences shaped their sense of self and family. From the analysis, young siblings had predominately negative experiences, struggled with making sense of their brother or sister and the family as ‘flawed’ against the mental illness as ‘bad’ and experienced considerable family stress and overt family stigma. Current practice theories fail to consider the complexity of these factors and, in doing so, fail to adequately explain the nature and extent to which stigmatization occurs for immediate family members. The importance of peer support and understanding stigma in social work practice with children and their families is discussed.     

Negotiating poverty from midlife to pre-old age: a longitudinal study on social assistance recipients in Shanghai

The minimum living standard guarantee (MLSG) programme is part of the social security system in Mainland China designed to tackle urban poverty. To understand how the urban poor manage under this programme, this study interviewed 40 households receiving MLSG assistance in Shanghai. Our findings were as follows: (a) a large proportion of the interviewees who received MLSG assistance from the government were pushed to do so because of the massive layoffs during the economic reform; (b) the MLSG recipients were likely to be trapped in a poverty cycle from middle age up until they reached official retirement age.     

The Development of a Screening Tool for the Adult Children of Alcoholics Traits (STACAT)

In order to develop a valid tool for screening the traits of adult children of alcoholics (ACOA), this study focused on finding common characteristics among ACOA and developing a tool based on those characteristics. An item pool was generated targeting three distinct characteristics discussed in the alcohol literature related to ACOA, and the items were reviewed by a panel of experts. Using data from the sample, a confirmatory factor analysis, t -test and correlation analysis were conducted to gather various validity evidences for the screening tool. Cronbach's coefficient alpha test was used to check the internal consistency of the tool. The evidence of the reliability and validity for the ACOA traits screening tool provide the social work practice with an empirically validated method of measuring these traits in the children of alcoholics.     

Between a rock and a hard place: the role of relatives in protecting children from the effects of parental drug problems

Using qualitative data gathered from 62 problem drug using parents in Glasgow, Scotland, this paper explores the role played by the extended family in protecting children from some of the negative effects of parental drug use. However, the data also indicated that the intervention of the extended family, whilst often critical, was not without its tensions and difficulties for parents, for the extended family and for the children too. What seemed to obtain in most cases was a complex and volatile mix of practical and emotional concerns over children's appropriate care and issues of responsibility and obligation to the child. These in turn were overlaid by expressions of anxiety, worry, anger and disappointment over both the parent's drug problem and its profound effect on the family. Strained family dynamics and a lack of a supportive welfare infrastructure can all compromise the ability of kin to provide a stable, nurturing environment for children over time. In a worst case scenario it can lead to a breakdown of these care arrangements, leaving these already vulnerable children exposed to further rupture, emotional damage and instability. If we are to avoid such outcomes it is crucial that we first identify and then work to rectify those factors that compromise the abilities of extended family carers to look after these children both in the short and the longer term.     

Determinants of outcome in the pathways through care for children hearing voices

Auditory hallucination, or hearing voices, is generally associated with psychopathology. In psychiatry it is inter-preted as a symptom of an illness, with no connection to the individual's life history. Voice hallucinations in childhood occur in a variety of contexts and have variable long-term outcomes. Little is known about the course of the experience. In this study, 80 children and youngsters hearing voices were interviewed on four occasions over a period of three years about the content of the voices and their overall experience of voices, focusing on the determinants for a promising outcome in the pathways through care. The results indicate that the need for care in the context of the experience of voices is associated not only with high levels of problem behaviour and associated negative symptoms of psychosis, but also, independently, with an appraisal of the voices in terms of anxiety, depression, dissociation and frequency of occurrence. In 60 per cent of the participants the voices disappeared during the three-year research period. The relationship between the disappearance of voices and the course of mental health treatment is, however, ambiguous.     

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.     

Age and gender differences in emotional and behavioural problems during the transition to residential treatment: the Odyssey Project

Utilising a national sample of 1,167 young people in residential treatment, this study explored whether the behav-ioural problems exhibited during the transition to residential treatment varied depending upon the age and gender of the youngsters. Specifically, we asked whether those who were admitted to residential treatment centres (RTCs) aged under 12 had a different set of behavioural problems from those who were 12 years and older when admitted, and whether boys had different characteristics than girls. The 11 scales of the Achenbach Child Behavior Checklist were examined. The results revealed statistically significant patterns of associations by age and gender. As populations shift within agencies and across time, knowledge of the behavioural problems associated with age and gender groups can be used to facilitate agency planning and staff training.