Resisting your good intentions: substance‐misusing parents and early intervention to support and monitor children in need

Children from substance‐misusing families face elevated risks in growing up well and safe. Early intervention is an opportunity for local authorities to offer support and keep a watching brief on children's welfare. However, the basis upon which agencies voluntarily engage with families in advance of major problems becoming evident is far from straightforward. This qualitative pilot study in Scotland followed professional decision‐making over 6 months (n = 20 professionals) with a small number of families (n = 6) defined as in need of supportive intervention. This support was allied with an intention to monitor the family situation, which, in these data, appeared to affect the willingness of families to engage with services. As services sought to increase their voluntary oversight, sometimes by threatening escalating involvement, so families by various means appeared to resist it. Successful early intervention is reliant on voluntary family participation and thus requires close attention to means of positive and motivated parental engagement to disarm resistance.     

Admission to Nursing Homes in Taiwan

The population of Taiwan is facing a radical ageing process. A proportion of the growing number of people aged 65 and over is expected to need nursing home care. This research concerns the family context of decision‐making in the process of admission to a nursing home in Taiwan. Employing survey data from interviews with elderly people in nursing homes (235 interviews) and their carers/key families (265 interviews), the factors affecting their views about admission were explored. Bivariate analysis and a logistic regression model were also used to examine perceptions of alternatives to nursing home care among family members with elderly relatives in nursing homes. Most elderly people in Taiwan are cared for in their own homes by their families but, in some circumstances, entry to a nursing home seemed inevitable. This research found that the decisions were taken mainly within a family context. The adult children of the elderly people, carers/key families’ preferences and the availability of carers influenced the decision. Apart from the important need factors of elders, families’ views about alternatives to nursing homes were significantly influenced by their preferences. This study has important implications for long‐term care in Taiwan. It is hoped that this will be needs‐led, both by elderly people and their families.     

Stability and change – a 7‐ to 8‐year follow‐up study of mental health problems in Norwegian children in long‐term out‐of‐home care

The aim of the study was to explore stability and change in mental health problems in Norwegian children aged 6–12 years old (n = 70) in long‐term out‐of‐home care. The children's mental health problems were assessed shortly after the placement and 7–8 years later by the caregivers and the teachers on the Revised Rutter Scales. Information on pre‐placement and placement factors were collected from the child welfare workers. At a group level the children's mental health problems had improved significantly over time according to the teachers' reports. According to the caregivers' reports, however, the children's problems were high and stable across time. Analyses aimed at detecting individual changes revealed a great variability in development according to both informants, indicating that treating the placed children as a homogenous group could be misleading. Several pre‐placement and placement variables were associated with the change in the children's mental health problems from the time of placement to the follow‐up time according to both informants' reports. However, all the predictors were accounted for by the strong effect of the children's problem scores when entering care.     

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.     

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.     

Experienced support from family,school and friends among students in out‐of‐home care in a school‐based community survey

Youth in out‐of‐home care have elevated risks for adverse events and detrimental circumstances possibly affecting their development. Responses from 311 students in out‐of‐home care (OHC) were compared with peers living in birth parent care (BPC) and in single birth parent care (sBPC) in a regional school survey, directed to students in compulsory school eighth year and upper secondary school second year. Results indicate OHC students to experience less satisfaction with friends, leisure time, and families. They state less trust in support from friends and families but a more similar level to teachers, counsellors or nurses. OHC students also express being more exposed to abusive experiences online and perceive less sense of security at home and in school. We conclude that welfare institutions need to recognize the components in building trust and safety for students in OHC and that school and other professional institutions have an important role in serve resilience and promote well‐being for children in OHC.     

Attachment‐facilitating interactions in non‐kin foster families

This study aims to analyse the interaction between children in foster care and their main caregivers during a microcoded co‐construction task, focusing on the verbal and non‐verbal behaviours that the adults use to promote a secure attachment in the child. It also examines how children and caregivers' socio‐demographic variables relate to the interaction. The sample is made up of 28 Spanish children between 4 and 9 years old in long‐term non‐kin foster care and their foster families. The building task was administered to 28 dyads, composed of the child and the main caregiver in each family. Our results showed that the caregivers' use of attachment‐facilitating behaviours was frequent during the interaction. Moreover, children tended to display a positive attitude when adults used these attachment‐facilitating behaviours. We also found some differences in the interaction according to the caregivers and children's age, the child's gender and the caregivers' satisfaction with the child's development. These results offer us a better understanding of the functioning of the adult–child relationships in foster families, which helps us make more efficient interventions to improve the caregivers' sensitivity towards the children's needs and difficulties.     

“Nothing goes as planned”: Practitioners reflect on matching children and foster families

Matching children with foster carers is an important step in every nonkinship family foster care placement. Although guidelines for matching are provided in several studies, the case‐specific context of the decision can influence the practitioners' ability to adhere to these guidelines. Therefore, this study answers the following question: “How does the case‐specific context influence the practitioners' decision‐making process regarding matching in family foster care?” Using a qualitative design, 20 semistructured interviews were conducted with practitioners matching children with foster families. Three themes emerged representing different layers of practitioners' everyday decision‐making: matching as planned, matching being tailored, and matching being compromised. The results show that exceptions are part of practitioners' daily work, either due to the belief that it might benefit those involved or because of obstacles presented during the decision‐making process. When the decision is compromised, matching practitioners lower their standards, while at the same time safeguarding the quality of the match. This proves that matching in practice is more than choosing a family, and guidelines are needed to determine what “good‐enough” matching should entail.     

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.     

Exploring approaches to child welfare in contexts of domestic violence and abuse: Family group conferences

This article sets out to explore service provision for families affected by domestic violence and abuse. For most families where there are child protection concerns, there are possibilities for intervention from child welfare agencies and domestic abuse services, but these have been criticised as having distinct and disconnected practice cultures and orientation. Recognising this divergence, in this paper, we advocate for safeguarding children affected by domestic violence and abuse using the family group conference (FGC) model. This offers possibilities for a coherent response that integrates both child‐ and women‐centred concerns in a holistic approach to family safety and well‐being. Furthermore, it is well documented that safeguarding work involves professionally‐led decision‐making that is pre‐occupied with the management of risk. FGCs, however, promote a partnership approach that engages families in a more democratic decision‐making process. As such, FGCs offer families the opportunity to develop their own safety and support plans for the protection and care of children recognising the family's inherent strengths.     

The impact of parental incarceration on children's care: identifying good practice principles from the perspective of imprisoned primary carer parents

Parental incarceration has wide‐ranging impacts on families. One key effect may be disruption to the care and legal custody of children, yet few studies have examined processes and outcomes relating to care planning for children of prisoners. This paper presents findings of interviews with 151 primary carer prisoners in two Australian states which aimed to address this research gap. The study examined care planning for children upon parental arrest, sentencing and imprisonment, stability of care arrangements and primary carer prisoners' involvement and satisfaction with care planning. Around one third of prisoners had discussions regarding children's care arrangements at arrest and imprisonment, although the issue was more commonly raised at sentencing. While there was much variation in the stability of care arrangements, children placed in out‐of‐home care experienced the most instability. A minority of prisoners reported being involved in care planning and decision‐making for children upon imprisonment, and around one third rated care planning process poorly. Prisoners were more satisfied with care planning when there were fewer movements of children, where prisoners felt involved with decision‐making, and when police officers, lawyers and corrections staff inquired about the welfare of their children. Implications for policy and future research are discussed.     

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).     

The Role of Physical Context,Verbal Skills,Non‐parental Care,Social Support,and Type of Parental Discipline in the Development of ToM Capacity in Five‐Year‐Old Children

The aim of this study was to analyze the influence of family context on the performance of 5‐year‐old children (N = 70) in theory of mind (ToM) tasks. The children's performances were assessed during individual sessions held at school. Children's verbal skills were assessed using the Peabody picture vocabulary test (PPVT). Interviews were also conducted with parents in the family home in order to gather sociodemographic data and to assess diverse variables of the family context. In addition to confirming the important role played by children's verbal skills in ToM, the results also supported a potential influence of family context in ToM development through variables, such as quality of non‐parental care or level of social contact and support. The educational implications of these results are discussed in relation to family intervention.     

Participation and health – a research review of child participation in planning and decision‐making

Effective child participation in child protection proceedings has proved difficult to achieve in Norway. Although participation is in principle accepted as a human right and something of benefit to children, when children's health is at stake there is a tendency to view participation in decision‐making processes by children as potentially disruptive to their well‐being. The purpose of this study is to review the research evidence for effects, positive or negative, of participation on health outcomes for children in care. A scoping review of major health and social work research databases was undertaken. Searches in five databases yielded 1830 studies of which 21 were finally included in this review. Studies were included if a relationship between health and participation was evident from the data presented, even if this was not the main objective in the study at hand. We conclude that when participation is successful, it may have beneficial side effects. Chief among these are that participation may improve children's safety, increase the success of care arrangements and increase feelings of well‐being for children involved. Evidence for long‐term effects of successful or failed participation attempts on subsequent health outcomes is however largely absent.     

Adapting the Friends of the Children programme for child welfare system‐involved families

Research has shown the importance of long‐term, caring adults for children in foster care. This paper reviews the Friends of the Children (FOTC) long‐term mentoring programme and how it was adapted to serve children and families with child welfare system involvement. This study's two research questions are (1) How do Friends (FOTC's paid professional mentors) currently work with, and in turn, have an impact on, child welfare‐involved families? and (2) How can Friends better support child welfare system‐involved caregivers and families to promote family stability, permanence, and child well‐being? Data were collected from 21 caregivers (foster and biological), 24 FOTC Friends, five child welfare workers, and five teachers. Qualitative analyses of focus group, interview, and open‐ended survey data revealed a wide variety of ways Friends currently support children and families. In addition, several recommendations were made for strengthening programming. These findings provide valuable insights into providing long‐term mentoring to child welfare system‐involved children and families.     

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.     

Interventions to improve supervised contact visits between children in out of home care and their parents: a systematic review

Although the importance of contact between children in care and their parents, when safe, is accepted, there is limited research about supervised face‐to‐face contact. There is no literature that has systematically critiqued how supervised contact can be best delivered. The aim of this systematic review was to evaluate the evidence for interventions aimed at improving the quality of contact visits between parents and their children who are in out‐of‐home care. Twelve studies were included in this review. Each study was graded and assigned scores according to the presence or absence of each of seven criteria. The studies demonstrated key similarities in the types of interventions provided, although delivery varied across group, individual and educational interventions. Parents reported improved capacity to manage their emotions and parents' satisfaction with the programmes was high. Although there was a lack of large scale, methodologically rigorous studies with long‐term follow‐up, some promising findings were identified: the literature indicates individual family support and group programmes have the potential to improve parent–child relationships and the quality of contact visits. This review suggests that future studies build on current evidence by addressing their methodological limitations and evaluating interventions that can be tailored to meet the needs of individual families.     

“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.