Residential care: an effective response to out‐of‐home children and young people?

The ever‐growing number of out‐of‐home children in Italy over the last decade has urged an assessment of the available care services. Although foster care is spreading rapidly, many young people are still housed in residential facilities. Reflection on residential care quality has intensified at both a national and an international level. This paper presents the results of a study on residential care facilities for children and young people in the region of Northern Italy (Lombardy). Four dimensions of ‘quality’ are considered: efficiency, effectiveness, participation in planning and intervention, and empowerment of children and their family relationships. The combined effects of these dimensions are defined as ‘relational quality’. The results show that residential care facilities are generally good, while Social Services resources often appear inadequate for interventions aimed at birth families (efficiency). The well‐being of children in residential care facilities is high, even if they tend to move from one facility to another, rarely returning to their birth family (effectiveness). The involvement of children and their families at different stages of the care path is limited (participative approach). Finally, the most critical element is the failure to properly involve birth families (empowerment).     

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.     

“I wish someone would explain why I am in care”: The impact of children and young people's lack of understanding of why they are in out‐of‐home care on their well‐being and felt security

Having a good understanding of one's origins and history is known to be significant in identity development. Drawing on a large‐scale online survey of looked after children's subjective well‐being, this paper demonstrates that a significant number of children and young people (age 4–18 years) did not fully understand the reasons for their entry to care. The paper explores the effect of this lack of knowledge on children's well‐being and on their feelings of being settled in their current placement. The study reiterates the need for professionals to be honest and open with children in out‐of‐home care and the need to specifically address, perhaps repeatedly, why a child is not living with their birth family.     

Child Well‐Being Scales (CWBS) in the assessment of families and children in home‐care intervention: an empirical study

This paper reports research carried out in Italy designed to investigate the usability of Child Well‐Being Scale (CWBS) for the outcome evaluation of home‐care interventions for vulnerable families and children in need. Using a pre‐ and post‐test design, the study traces the changes in 18 vulnerable families and 23 children in need included in a programme of home‐care intervention over a period of 11 months. All the families and children were assessed twice: at intake and at the end of the intervention (after 6 months). Furthermore, 10 families and 11 children had a longer intervention and were assessed three times. Moreover, two focus groups involving 13 home‐care workers and 11 face‐to‐face interviews were used to collect practitioners' points of views on CWBS. The results generally support the idea that families' and children's situation improved over time, as shown by an improvement in almost all of the considered dimensions after 6 months and after 11 months. Specifically, the families improved more on household adequacy in the long term while children on the child performance dimension improved in the short term. Practitioners reported that CWBS was an aid to multi‐professional decision‐making, as the systematic evaluation of the subscales was a practical base upon which to activate shared decision‐making during the casework.     

Daily links between school problems and youth perceptions of interactions with parents: A diary study of school‐to‐home spillover

This study examined how academic and peer problems at school are linked to family interactions at home on the same day, using eight consecutive weeks of daily diary data collected from early adolescents (60% female; M age = 11.28, SD = 1.50), mothers and fathers in 47 families. On days when children reported more academic problems at school, they, but not their parents, reported less warmth and more conflict with mothers, and more conflict and less time spent around fathers. These effects were partially explained by same‐day child reports of higher negative mood. Peer problems were less consistently associated with parent‐child interactions over and above the effects of academic problems that day. A one‐time measure of parent‐child relationship quality moderated several daily associations, such that the same‐day link between school problems and child‐report of family interactions was stronger among children who were closer to their parents.     

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.     

Making a connection: school engagement of young people in care

Intervention to improve educational attainment for children in out‐of‐home care is increasingly being recognized as important for their well‐being and future opportunities. This paper reports on a mixed method study of the school engagement or connectedness of young people in care. The study comprised a survey of 202 young people in care in Queensland, Australia, and a matched comparison group of young people not in care, plus interviews with a subset of 65 young people in care who were surveyed. Both the school environment and the perceived levels of support influenced school engagement, with those who were assisted by carers and caseworkers more likely to be positively connected with school. These young people perceived education as a pathway to achieving work and life goals. The findings suggest that active and focused attention on young people's school engagement should be part of case planning and monitoring as it offers an additional strategy for improving their educational experience.     

The relationship between foster care families and birth families in a child welfare context: The determining factors

Children placed in foster care families usually continue to see their birth parents in supervised and home visits. These children deal with the fact that they belonged to two families in a context where the relationship between the two families is sometimes complex and tense. Based on 45 semi‐structured interviews conducted with foster care families and kinship foster care families, the present study examines the relationship between foster care parents and birth parents in a placement context, and focuses on the factors affecting the nature and quality of this relationship. The results showed that the quality of the relationship dynamics varies according to the following: how well and how often the parent–child visits took place, the birth parents' characteristics, and the foster carers' attitudes. The results also showed that placements in kinship foster care families were more likely to result in conflict and tension between the two parties than placements in regular foster care families.     

Suicidal behaviour in transition‐aged youth with out‐of‐home care experience: Reviewing risk,assessment, and intervention

The rates of suicidal behaviours in youth with out‐of‐home care experience, particularly those who are on the verge of emancipation, appear to be alarmingly high. The purpose of the current study is to highlight the rates of suicidal ideation and behaviour in these youth, illuminating the empirical risk factors that may increase their vulnerability. We offer a review of screening measures and suicide interventions that may hold promise for administrators, practitioners, and researchers who wish to provide comprehensive assessment for transition‐aged youth with out‐of‐home care experiences and effectively treat those who may be at the highest risk.     

Congruence and incongruence in the perception of ‘family’ among foster parents,birth parents and their adolescent (foster) children

Over recent decades, listening to children's voices and viewing children as competent actors has gathered momentum in research as well as in practice. Acknowledging children's perspectives requires sensitive listeners who are willing, deliberately and as realistically as possible, to reconstruct children's ways of seeing. In our study, based in Norway, we investigated the views of 22 adolescents in long‐term foster care and 15 of their birth parents and 21 of their foster parents. Using Q methodology, we explored congruence and incongruence in the perception of ‘family’ among foster parents, birth parents and their adolescent (foster) children. We found three family perspectives among the adolescents. Within two of these perspectives, there seem to be more congruent understandings of the children's perspectives among the parent groups. We discuss some main implications in light of these findings. In Norway, as in many other countries, the policy of child welfare is that children first and foremost should grow up with their birth family. When out‐of‐home placements are necessary, a basic principle is that children should remain in contact with their birth family.     

Characteristics of the Social Support Networks of Maltreated Youth: Exploring the Effects of Maltreatment Experience and Foster Placement

Little is known about the social support networks of maltreated youth or how youth in foster care may compare with those who remain with their parent(s). Social network characteristics and perceived social support were examined between (1) maltreated and comparison youth, (2) maltreated youth who remained with their biological parent, those with a foster parent, or a those with a kin caregiver, and (3) youth in stable placements and those who have changed placements. Data came from a sample of 454 adolescents (241 boys, 9–13 years old at enrollment) who took part in a longitudinal study of child maltreatment. Participants completed three assessments approximately 1 year apart. Results showed that on average, maltreated adolescents named significantly fewer people in their network than comparison adolescents. At Time 2, comparison adolescents reported more same‐aged friends. In the maltreatment group, youth with a foster parent reported significantly more older friends than maltreated youth with a kin caregiver. Fewer maltreated youth named a biological parent on the social support questionnaire at all three time points. More youth in kinship care described their caregiver as supportive than those in foster care. These findings indicate that despite heterogeneous placement histories, social support networks among maltreated youth were very similar.     

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.     

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.     

The turn to optional familialism through the market: Long‐term care,cash‐for‐care,and caregiving policies in Europe

Cash‐for‐care (CfC) schemes are monetary transfers to people in need of care who can use them to organize their own care arrangements. Mostly introduced in the 1990s, these schemes combine different policy objectives, as they can aim at (implicitly or explicitly) supporting informal caregivers as well as increasing user choice in long‐term care or even foster the formalization of care relations and the creation of care markets. This article explores from a comparative perspective, how CfC schemes, within broader long‐term care policies, envision, frame, and aim to condition informal care, if different models of relationships between CfC and informal care exist and how these have persisted or changed over time and into which directions. Building on the scholarly debate on familialization vs. defamilialization policies, the paper proposes an analytical framework to investigate the trajectories of seven European countries over a period of 20 years. The results show that, far from being simply instruments of supported familialism, CfC schemes have contributed to a turn towards “optional familialism through the market,” according to which families are encouraged to provide family care and are (directly or indirectly) given alternatives through the provision of market care.     

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.     

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.     

Needs and availability of support among care‐leavers: A mixed‐methods study

Data are scarce on the long‐term needs of care‐leavers and on the support resources that are available for them in the years after leaving care. This mixed‐methods study presents data on the needs and availability of support of 222 Israeli care‐leavers, suggesting that the most urgent needs of care‐leavers are a lasting need for a stable and available support figure and assistance with educational issues. For some care‐leavers, these needs are fulfilled by their mentors. Parents and other familial figures were found to be the most common support resource for care‐leavers, which highlights the need for the intervention of social workers to improve relationships within families while the children are still in care. Due to high rate of young people who have no support resources and a low rate of services utilization, social services should provide a platform to support this group, using mentors and other supporters. The longitudinal data of up to 4 years after leaving care indicated that the availability of various types of informal support improved over the years, and the reports on difficulties in relationships of the care‐leavers with their parents were significantly fewer 4 years after leaving care than on the verge of leaving care.     

Peer relationships during late childhood in internationally adopted and institutionalized children

The aim of this study was to analyse the interpersonal relationships in the school context of children living in different care settings (adoptive families, residential care centres, birth families). Participants were 76 children between eight and fourteen years of age (M = 10.78, SD = 1.38), belonging to one of three groups: international adoptees, children living in residential care in Spanish institutions, and a comparison sample of Spanish children living with their birth families with no connection with child protection. Sociometric information was collected in the classroom of each child during school hours. Internationally adopted children from Russia showed considerable difficulties in their relationships with peers; they were more likely to be rejected and their peers described them as less prosocial and somewhat more aggressive. With a better sociometric position than the adoptees, children in residential care were rated by their peers as more aggressive and less prosocial than the normative population. Coordination and integrated work between the family, protection centres, schools, and other social services should be a strategic priority in the promotion of healthy social development in these groups of children.     

Foster care in France: children's perception of their own well‐being

Working to improve the welfare of children in care is a priority shared by all French child protection services. However, the means to measure and improve well‐being are limited (Fergeus et al., 2019). Although the trend today is towards a more comprehensive understanding of the point of view of adults involved in the socioeducational process, too little is done to include the children's own perception of their situation and conditions of care. The purposes of this study are to document and analyse the point of view of children in foster families on their subjective well‐being and also to identify contextual factors that influence it. Ninety‐one children living in foster care, aged 13.5 years on average, completed the French version of the Multidimensional Students' Life Satisfaction Scale developped by Huebner, Zullig Runa in 2012. The multidimensional evaluation of well‐being (family, school, self, friends, and living conditions) reveals a moderate life satisfaction within the foster family and a weak one at school. Total life satisfaction levels are directly linked to the number of care orders the child has experienced, their duration, and the type of education received. The implications of these results for professional practices related to children in care will be discussed.