Evidence-based practice for youth in supervised out-of-home care: a framework for development, definition, and evaluation

Adolescents comprise more than half of the children in child welfare supervised out-of-home care. This article considers the evidence-base for an array of services to adolescents in out-of-home care and evaluates the existing research base for each program. This review advances a framework for considering the critical need to develop, define, and evaluate the essential elements of out-of-home care services for older foster youth. Policy, program, and evaluation recommendations are forwarded.     

Doing competent residential child and youth care work: The normative and experiential dimensions

This article presents two complementary dimensions in competent residential child and youth care. Within the normative dimension, competence in residential work is discussed on the societal, organizational, interpersonal and personal levels. The goal of residential care, according to this dimension, is to enable the child or the youth to return to society as a well-functioning adult. Within the experiential dimension, competent residential care is discussed as it is experienced by both child care workers and their clients. The goal of residential care, according to this dimension, is to focus on the quality of the children's present lives. A possible avenue to integrate these dimensions is presented and implications for policy, program planning, and training are suggested.     

Using the bridges transition framework for youth in foster care: Measurement development and preliminary outcomes

Youth in foster care often undergo multiple transitions before reaching adulthood, and these transitions often create significant stress and can exacerbate emotional and behavioral problems. A measurement instrument (the Youth Experience of Transitions, or YET) was designed to assess foster care youths' understanding of transitions, and this instrument was tested on a group of youth undergoing an intervention program designed to assist them in coping with the stress of these transitions while in foster care. The intervention was based on the Transitions Framework by William Bridges and was implemented in multiple community agencies with funding from the Andrus Family Fund. Using factor analysis, we found that the YET contained two factors representing (1) openness and (2) determination. For youth in the participating foster care programs, growth in openness from baseline to 6 months was linked to a significant decrease in internalizing symptoms; no significant links were found for externalizing symptoms. Implications for foster care intervention programs are discussed.     

Promoting autonomous functioning among youth in care: a program evaluation

Over the past few years, considerable research has highlighted the challenges posed by social reinsertion of youth. For youth who leave an alternative living environment at the outset of adulthood, this integration is all the more difficult on account of psychosocial and health factors and a lack of support in preparing for independent living and employment requirements. Although they possess various qualifications and resources for making this difficult transition, many find themselves relying on public-funded services as they enter adulthood. After a brief outline of the contextual organization of youth protection offered in Quebec, the author presents an intervention program that aims to prepare youth in high-risk categories for social reintegration and independent living. This is followed by a presentation of preliminary results stemming from a three-year pilot study and an outline for intervention and support for troubled youths who are entering adulthood.     

Needs-led child and youth care: Main characteristics and evidence on outcomes

Needs-led child and youth care has three main characteristics: a continuous focus on clients' needs, client participation in the care process (including decision making), and practitioners' displays of needs-led attitudes and skills. The primary aim of this review was to establish whether there is evidence for using a needs-led approach when working with children and families in need. We performed a literature search to find reviews and outcome studies of child and youth care for school-aged children and their families which included the core characteristics of needs-led care, and related them to outcome measures. Only a few studies attributed positive outcomes of care to the attention given to clients' needs and goals. Most studies referred to participation in terms of clients' involvement or engagement. Higher levels of participation were associated with positive changes in child behaviors and parenting stress, client satisfaction, higher completion rates, safety for children, feelings of well-being and empowerment, and better service coordination. Significant professional attitudes and skills included listening to clients and working in active partnership with them. There is some proof for the relevance of core characteristics of needs-led child and youth care, although that evidence is limited by the lack of rigorous studies. This study indicates that needs-led child and youth care can make a difference. Future research should pay attention to the intertwinement of the characteristics of the needs-led approach in care.     

Experiences of youth who transition to adulthood out of care: Developing a theoretical framework

Adverse adulthood outcomes are well documented among youth who age out of foster care. However, not all youth who age out of care experience deleterious adult outcomes, despite struggling with similar challenges during the transition from adolescence to adulthood. Childhood maltreatment, which places youth at greater risk for later maladaptive functioning and psychopathology, may partially explain poor adjustment outcomes in adulthood. Similarly, a history of unstable placements and residing in institutional congregate care settings may also contribute to hardship during this time. However, none of these factors help to explain how some young people aging out of care manage to achieve stability while transitioning into adulthood. This article reviews the literature through the lens of the identity capital framework, and discusses the applicability of this framework to the experiences of youth aging out of foster care.     

Professional challenges experienced by child and youth care workers in South Africa

The goal of the study was to explore professional challenges of child and youth care workers (CYCWs) in the South African context. The study was carried out within a qualitative approach which incorporated a collective case study design. Purposive sampling was used to include a sample of 93 participants representing child and youth care workers from government and non-government organisations based in rural, semi-urban and urban areas across the six provinces of South Africa. An interview schedule was designed by the researchers to collect qualitative data from 11 focus group interviews. With regard to data analysis, the researchers typically followed the following steps as suggested by Miles and Huberman (1994, p. 10): data reduction, data display and drawing and verifying conclusions. The most prominent challenges that the participants have cited are: dealing with client behaviours, lack of tangible and immediate results, poor stakeholder relations, lack of recognition, lack of clarity on the role and title of the CYCW, inconsistent job requirements, lack of professional growth and development opportunities and inadequate working conditions. The conclusion of this study was that CYCWs in South Africa experience a range of professional challenges. Given that the study was situated within an ecological systems theory, the impact of other systems such as poor stakeholder relations in working with individual children (microsystem), working within families (exosystems), working with communities (mesosystem) and working within the broader society (macrosystem) became evident. The researchers overall impression was that the majority of challenges raised emanated from the child and youth care field not yet being fully recognised as a profession at the time the study was conducted. The necessary recommendations to address these professional challenges were made.     

The prevention of gambling problems in youth: a conceptual framework

Despite increased awareness of the need to begin educating young children about the potential dangers of gambling, empirical knowledge of the prevention of adolescent problem gambling and its translation into science-based prevention initiatives is scarce. This paper poses the question of whether or not the common elements of tobacco, alcohol, and illicit drug abuse prevention programs can be applied to gambling prevention. Common risk and protective factors across addictions, including gambling, appear to point to the need to develop a general model of primary, secondary, and tertiary prevention. The authors present the need for science-based prevention initiatives and describe a general adolescent risk-taking model as a basis for science-based prevention of adolescent problem gambling and other risk behaviors.     

The association between perception of relationship with caregivers and behaviours of youth in foster care: a child and caregiver perspective

The transition into foster care can be difficult for children. Research has consistently shown an increased risk for children in foster care to exhibit higher levels of problem behaviours in comparison to youth in the general population. The purpose of this study was to analyse the associations between the youths' perception of their relationship with their caregiver on their perception of their own internalizing and externalizing behaviours as well as the youths' perception of the relationships with caregivers and how caregivers report of youths' internalizing and externalizing behaviours. This study utilized the secondary data from the general release version of the National Survey of Child and Adolescent Well-Being [National Survey of Child and Adolescent Well-Being (2009) Introduction to the wave 1 general and restricted use releases, Nation Data Archive on Child Abuse and Neglect, Ithaca, NY]. Significant relationships between youths' perception of relationship with their caregiver were found with both youth perception of internalizing behaviours and caregiver perception of internalizing and externalizing behaviours. Results are explained with implications for practice, training, research and policy.     

Why youth leave care: Understandings of adulthood and transition successes and challenges among youth aging out of child welfare

Child welfare policies and practices are changing to allow more youth to remain in care beyond age 18. Yet, the majority of youth do not stay. Given recent evidence suggesting that remaining in care may be beneficial, there is a need to understand why youth leave. Using data gathered from in-depth interviews with young people aging out of care, this paper explores this question, relating it to youths' understandings of adulthood and the successes and challenges they face during their transitions. We find that youth leave care because of misunderstanding and misinformation about the requirements for remaining in care, as well as because of a desire for autonomy and independence. Specifically, many youth equated adulthood with independence, and thus felt that they needed to leave care to achieve adulthood. Unfortunately, these efforts to be independent often hinder youths' development of supportive relationships, which they reported to be one of the greatest challenges in their transitions. Based on these findings, we conclude by challenging the conflation of adulthood and independence, as well as of childhood and dependence, calling for connected autonomy as a goal for child welfare involved young people of all ages.     

Building community: a conceptual framework for child protection

This paper proposes a community-building framework as an innovative strategy to begin to re-claim children and families at risk. It is a strategy that identifies a purpose, a value base, knowledge and theoretical dimensions, and methods of practice that present as an approach for child welfare systems to consider shifts in thinking in order to meet what is considered the most important challenge of the next century: that of rediscovering community. Copyright © 2001 John Wiley & Sons, Ltd.     

Diversity training for the community aged care workers: A conceptual framework for evaluation

Older Australians are an increasingly diverse population, with variable characteristics such as culture, sexual orientation, socioeconomic status, and physical capabilities potentially influencing their participation in healthcare. In response, community aged care workers may need to increase skills and uptake of knowledge into practice regarding diversity through appropriate training interventions. Diversity training (DT) programs have traditionally existed in the realm of business, with little research attention devoted to scientifically evaluating the outcomes of training directed at community aged care workers. A DT workshop has been developed for community aged care workers, and this paper focuses on the construction of a formative evaluative framework for the workshop. Key evaluation concepts and measures relating to DT have been identified in the literature and integrated into the framework, focusing on five categories: Training needs analysis; Reactions; Learning outcomes, Behavioural outcomes and Results The use of a mixed methods approach in the framework provides an additional strength, by evaluating long-term behavioural change and improvements in service delivery. As little is known about the effectiveness of DT programs for community aged care workers, the proposed framework will provide an empirical and consistent method of evaluation, to assess their impact on enhancing older people’s experience of healthcare.     

Folk-healing among Mexican-American families as a consideration in the delivery of child welfare and child health care services

If practitioners in cross-cultural services do not understand traditional health beliefs and practices and find ways to incorporate a compatible approach to them in their work, their clients and patients will go their own ways, sometimes with dire results. Practices among Mexican-American families are described.     

Program records as a source for program implementation assessment and youth outcomes predictors during residential care

This study used point card information from a residential program to generate treatment fidelity metrics and determine if the metrics predicted youth outcomes after six months in care. Youth outcomes included staff (n = 52) and youth (n = 143) ratings, youth conduct records kept by the residential program's teaching-family homes and school records. Treatment fidelity metrics included the program components: (a) percentage of positive interactions, (b) number of privileges earned, and (c) a skills taught to interactions ratio. The percentage of positive interactions averaged 90% per youth; 76% of the point cards indicated that privileges were earned; and a variety of life skills were typically taught to the youth (skills ratio = .61). The data from the treatment fidelity metrics supported that the program was implemented consistent with program expectations. The range of implementation quality for each measured component was then used to predict youth outcomes. Increased percent of positive interactions predicted significantly decreased externalizing behaviors as reported by staff (β = − 0.31, p < .001) and youth (β = − 0.30, p < .001), and significantly fewer incidents of non-compliance (Exp(b) = 0.93, p < .001) and school problems (Exp(b) = 0.91, p < .001) as indicated on the program records. The skills ratio indicated similar trends across outcomes, although non-significant at the p < .01 level. Permanent products may be helpful to develop program treatment fidelity metrics, which may be useful for monitoring implementation and may be associated with improved youth outcomes.     

Prevention in child welfare: a framework for management and practice

Development of preventive programs in child welfare has been handicapped by the necessity to serve those in immediate need. A framework defining the role, objectives and techniques of prevention is based on a different perspective for service.     

Voices of pacific youth: Video research as a tool for youth expression

Between 1994 and 1998, UNICEF administered a project to document on video tape the concerns and experience of young people living in the South Pacific Islands. Video was a valuable dual‐purpose medium for this project: it was useful both as a research tool and as a means to communicate sensitive issues across culturally defined borders between young and old. In this article I review the UNICEF produced videos as primary documents about the changing circumstances of youth who live in the Pacific societies. I also examine the challenges of trying to conduct investigations of this sort in cultural environments where young people are inhibited from expressing their views and feelings, and where adolescent perspectives are categorically devalued.     

Transgender children and youth: a child welfare practice perspective

Using an ecological framework, the existing literature and research, and the authors' combined 60 years of clinical practice with children, youth, and families, this article examines gender variant childhood development from a holistic viewpoint where children, youth, and environments are understood as a unit in the context of their relationship to one another. The focus is limited to a discussion about the recognition of gender identity; an examination of the adaptation process through which gender variant children and youth go through to deal with the stress of an environment where there is not a "goodness of fit"; and a discussion of the overall developmental tasks of a transgender childhood and adolescence. Recommendations for social work practice with gender variant young people are presented in the conclusion of the paper.