Foster care placement breakdown in the Netherlands and Flanders: Prevalence,precursors, and associated factors

Family foster care is the option of choice for children in need of out‐of‐home care in Flanders and the Netherlands. Foster care is however a vulnerable intervention, and questions can be raised as to its efficacy. Although the literature on placement breakdown has made significant progress during the last years, empirical knowledge regarding breakdown in Flanders and the Netherlands remains scant. Consequently, this study aimed at investigating prevalence and precursors of breakdowns in long‐term foster care, the duration of placement before breakdown, and the association of child and placement characteristics with breakdown. Case files of 271 Dutch and 309 Flemish foster children were analysed with a coding scheme designed for this study. After 6 years, 398 placements had terminated: 169 placements broke down and 229 placements ended positively. Placements broke down mainly because of behavioural problems of the foster child, foster parents' parenting problems, and conflicts between birth and foster parents. Foster children with behavioural problems, older foster children, foster children denied treatment, and foster children in care because of sexual abuse were more at risk of breakdown. Assessing these factors is important when evaluating the appropriateness of a family foster care placement.     

How do placements in kinship care compare with those in non‐kin foster care: placement patterns,progress and outcomes?

As the use of kinship care is set to rise in England, it is important that policy and practice developments are based on firm evidence about kin placement outcomes and how these compare with those in stranger foster care. The research reported in this paper was based on case file reviews of 270 children, half in kin placements and half in stranger foster care, and on interviews with a sub-sample of 32 kin carers, social workers, children and parents. Kin carers were found to be significantly more disadvantaged than stranger foster carers: more kin carers were lone carers, with health problems, living in overcrowded conditions and had financial difficulties. The children, in contrast, were remarkably similar in the two kinds of placement. The main differences between the children in the two settings are examined in the paper. The children's progress and outcomes in terms of placement quality and disruption were very similar in the two settings, but kin placements lasted longer, mainly because fewer were planned as interim placements. However, because kin carers persisted with very challenging children and yet received fewer services than stranger foster carers, they were more often under strain. The implications for policy and practice are examined.     

Relative foster care: An emerging trend in foster care placement policy and practice

Abstract

Increases in the foster child population, at a time when terminations in foster care placement have decreased along with a decline in the number of non‐related foster parents, has resulted in an increasing use of relative foster care placement. Relative care as an emerging trend in foster care placement, is not without controversy. Its merits, however, should be assessed in terms of its benefits to the children in care, the fiscal and organizational costs, and the problems it creates for the child welfare system. This paper reviews what is known about the characteristics of relative caregivers and the children in their care. Federal and state policies that affect the use of relatives as an alternative placement resource for children are described. The available data regarding the length of time in placement, number of placements, physical, mental health and educational and permanency outcomes for children placed with relatives are discussed. Implications for practice are drawn and areas for further research are suggested.     

The Association of Team Composition and Meeting Characteristics With Foster Care Placement Recommendations

ABSTRACT

Research shows that changing foster care placements is associated with negative outcomes for children. This study examines the extent to which Team Decision Making (TDM) can influence placement recommendations for children currently in foster care. Using administrative data from three sites, logistic regression models are fitted to estimate the association of team and meeting characteristics with placement recommendations. Controlling for demographic differences across sites, results show that caregiver attendance significantly reduces the likelihood that a child will be recommended to change placements, specifically, to less restrictive and more restrictive placements. Implications for practice and future research are discussed.     

Assessment of problem behaviour by foster parents and their foster children

This study investigates the level of agreement between foster parents and foster children about problem behaviour and how this is associated with the breakdown of a foster care placement. The study took a sample of foster parents and their foster children (n= 60), who were aged 11–17 years, and analysed the severity of problem behaviour displayed by the foster children within 3 months of placement in the foster family and a year and a half later. The level of agreement was established with the intra‐class correlation coefficient, which represents both the differences in scores and the differences in ranking. This coefficient shows that there is a statistically significant difference in the level of agreement on the Internalizing Problems scale of the Child Behaviour Checklist between the placements that broke down and those that continued. The level of agreement is associated with the severity score, which in turn is associated with the outcome of the foster care placement. To avoid placement breakdown, problem behaviour should also be assessed from the perspective of the foster child.     

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.     

No place like home: lessons learned and lessons forgotten –the Children Act 1948

The Children Act 1948 emphasizes foster care as the alternative provision for children who cannot be cared for by their own families; it also underlines the responsibility of the state to provide good alternative homes where necessary. The Act reflects contemporary developments in psychological thinking about the importance of attachment relationships, and a recognition, derived in part from the experiences of evacuation, of the harmful effects on children of separation from their families. However, greater awareness, from the 1970s on, of the deficiencies of the state as parent and the complexity of relationships between children, their birth parents and foster families led to the promulgation of 'inclusive' and 'task-centred' models of foster care, reflected in the shift of nomenclature from foster 'parenting' to foster 'caring'. These approaches may, however, be in danger of minimizing both the attachment needs of many children and young people within the foster placement and the parenting role which is appropriate in many placements. A model of foster care, derived directly from the first Children Act, which stresses these core relationships, should be developed alongside that which emphasizes task-centred, time-limited provision.     

Placement breakdowns in long‐term foster care – a regional Swedish study

We used a regional sample of children in long‐term foster care to investigate the prevalence of placement breakdown in adolescence, and to assess risk factors/risk markers for placement disruption. The sample consisted of all 136 foster children in the region, born 1980–1992, who on their 12th birthday had been in the same foster family for at least 4 years. They were followed in case files until date of disruption or their 18th birthday. Data on conditions before and during placement were retrieved from case files, and analysed in bi‐ and multivariate models. Results showed that one in four placements broke down in adolescence. The median child who experienced a breakdown was 14 years old, and had been in the same foster home for more than 10 years. Prominent risk factors were (i) being placed after age 2 and (ii) having a birth sibling in the same foster home. We also uncovered strong risk markers that can be viewed as precursors of placement disruption. When the child or the foster parents repeatedly over time expressed dissatisfaction with the placement, this ended with a placement breakdown in 60% of cases. Implications for practice are discussed.     

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.     

Indicators for Placement in Foster Care

Summary In order to develop a typology of indicators for long-term treatmentin foster care, a cluster analysis has been carried out on theitems of a standardized questionnaire which is used by fostercare centres in the province of Zuid-Holland. Two types of indicationfor placement have emerged from the present study. In combinationwith the foster child's age, these two types discriminate effectivelybetween unsuccessful, prematurely terminated placements aftereighteen months and continued placements. It is claimed thatthe employment of this procedure can effect a reduction in thenumber of unsuccessful, prematurely terminated placements.     

Who returns home? Study on placement outcomes of Flemish foster children

Until recently, Flemish family foster care was a temporary measure with as its most important goal, the reunification of the foster child with the birth parents. To date, nothing is known on the number of reunifications, nor has any study been undertaken into the factors (child, parent, foster parent and foster care process) associated with reunification. Case files of 127 foster children who exited foster care in 2007 were analysed. Dependent variables were type of foster care placement outcome (reunification, successful placement without reunification or breakdown) and place of residence after placement ending (with birth parents, extended family, foster family, residential care or living independently). After placement ending, only 40% of foster children went living with their parents, including foster children who were reunified (26%) and foster children who moved to their parents after a placement breakdown (14%). Characteristics of the foster children, and in particular absence of problem behaviour, were associated mainly with a return home. This may indicate that too much attention is paid to the functioning of the foster child and too little to improving the competencies of the parents and the (future) home environment.     

Foster care assessment: an exploratory study of the placement assessment process in Flanders and the Netherlands

Family foster care placement decision‐making has a weak scientific underpinning. The identification of clusters of foster children (groups of foster children with similar characteristics) can help improve decision quality. In this study, we investigated if foster children could indeed be clustered, which problems were identified at the time of placement and what might be the influence of placement history. Two clusters of foster children were found: (i) young children with coinciding parental child‐rearing incapacity and familial problems, and (ii) older children with child problems. At the time of placement, familial problems were more often identified in younger children with a placement history. These findings stress the importance of approaching foster care assessment as part of a dynamic decision‐making process. It is key to finding the most appropriate situation for the child. At the same time, it must be decided how the desired situation can be realized, wherein placement decisions are based on an appraisal of whether or not a foster placement is an appropriate solution. In conjunction with this, it needs to be decided how the parents can be supported towards reunification, or whether or not long‐term foster care is the best option for the child, and if so what conditions need to be met.     

Research Review: Sibling placement in foster care: a review of the evidence

This research review was undertaken to explore the current evidence pertaining to sibling placement in the foster care system. The review specifically addresses the following questions: (1) Which theories inform research on siblings in foster care? (2) Which designs and methodology are used to study brothers and sisters in out of home placement? (3) How do researchers define ‘siblings’ when investigating child placement? and (4) What are the findings of studies pertaining to siblings in the foster care system? This review suggests that incorporation of theory into research regarding siblings in foster care is quite limited. Additionally, few studies clearly state how siblings were identified and defined. A major strength of the research, however, is the diversity of design and methodology used. Overall, the evidence presented in this review strongly supports keeping sibling groups intact unless there is a compelling reason for separate placements.     

'The past, the present, but never the future': thematic representations of fostering disruption

The paper discusses some of the findings of a small-scale explor-atory research project which analysed the dynamics involved in substitute family care placements for young people, and assessed the processes demonstrated in fostering breakdowns in terms of the interactions, negotiations and adjustments between the re-spective parties over time. The paper concentrates on three core and interlocking themes: first, the perception of foster placements as 'second best'; secondly, the 'images of family life' permeating placements; and finally, the 'nature vs. nurture' debate which affected the ability of users and carers to sustain placements. These themes were selected for their significance in the development of an explanatory framework for understanding the interactional dynamics involved in placement disruption. The paper concludes with a discussion of the key implications for social work practice, considering foster carer training, sustaining placements, and part-nership arrangements between the young people, their natural families, foster carers and social work professionals.     

Outcomes of permanent family placement for children of minority ethnic origin

The paper explores the outcomes of permanent family placement for children of minority ethnic origin, using a sample of 254 placements drawn, in the main, from a cohort of 1165 British children placed between 1980 and 1985. Statistical techniques are used to explore the relationship between 'success' (defined, for the purposes of this paper, as the placement not known to have broken down) and a range of variables, including the characteristics of the child, the birth parents and the adoptive parents, and the type of placement. In most respects, the findings are consistent with those of similar studies. Age at placement is found to have an important effect, with success least likely for children placed in the middle age range. Lack of problem behaviours in the children at the time of placement is also found to be associated with success. Variables which are found to have no effect on the probability of success include ethnic origin of the child, whether it is an adoptive or permanent foster placement, and whether contact with birth parents continued after placement. There was an interesting gender effect in that boys did better in 'transracial' than in 'matched' placements, but the opposite was the case for girls.     

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

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

Who Takes Care of Education? Looked after children's perceptions of support for educational progress

This paper documents the views of a sample of 80 children and young people, aged 10–18 years, living in foster and residential care placements in England, regarding their educational experience whilst being looked after. The children were interviewed as part of an ongoing evaluation of the Taking Care of Education project, a development programme designed to facilitate improvements in the education of looked after children, co‐ordinated by the National Children's Bureau and funded by the Gatsby Charitable Foundation. Interviews with the sample asked children to assess their current educational progress and identify individuals who supported or hindered their education, as well as the availability of educational support in care placements. Teaching staff were frequently mentioned as providers of support, whilst social workers were often associated with hindering educational progress. Children and young people had access to a range of educational supports in care placements, and these were more widely available in residential settings than in foster care. Children offered a range of pertinent suggestions as to how the educational experience of those in the public care system might be improved.     

Predictors of outcome for unrelated adoptive placements made during middle childhood

This paper reports on a follow‐up to adolescence of two longitudinal prospective studies of children placed from public care with non‐related adoptive families in the UK. Factors associated with outcome are presented for 99 children (one index child per adoptive family) who were between 5 and 11 years of age at placement. Information concerning the children's backgrounds and care histories was obtained shortly after placement (T1), from social workers. Adopters were interviewed at T1 and again at the end of the first year (T2). A further follow‐up was conducted an average of six years after placement (T3). Outcomes at T3 were classified as either disrupted, which was true for 23%, continuing and ‘positive’ (49%) or continuing but ‘difficult’ (28%). Bivariate analyses revealed a number of attributes, related to both the child and the adoptive parents, which were associated with differential outcomes. Logistic regression produced five predictors of placement disruption: age at placement, behavioural problems, preferential rejection, time in care and the child's degree of attachment to the new mother. Differences were found between ‘positive’ and ‘difficult’ outcomes in continuing placements as well as between continuing and disrupted placements. The analysis suggests that adoption should certainly be considered as an option for children over 5 years of age while recognizing the need for both preparation and post‐placement support. Evidence of differential outcome in continuing placements provides support for efforts to reduce the number of placements and returns home that a child at risk experiences.     

Maintaining Sibling Relationships--Neglected Dimension in Child Care Practice

Correspondence to Marjut Kosonen, 80, Grove Road, West Ferry, Dundee DD5 1LB, UK Summary This article describes some of the findings of a study undertakento evaluate all foster and adoptive placements in one localauthority social work department in Scotland. The numbers, characteristicsand care experiences of children in foster and adoptive carewere considered. The study found that for the majority of childrenplacement in foster care led to separation from siblings. Thechildren were most vulnerable to separation at points of entryand leaving care. Separation from brothers and sisters can havelifelong consequences for the child and his or her siblings,as few of the children were found to have plans which includedreunification with their siblings. A fragmented picture emergedconcerning siblings' living situations. Children were foundto have siblings living in a variety of situations, both inand outwith the care system. Social workers lacked full informationabout the family composition where contact with parents waslost or siblings had moved from the area. Children were mostlikely to be placed with siblings in temporary and relativefoster placements.