Arranging stability for children in long-term out-of-home care
Introduction
When children who are in the care of local authorities cannot return home in the foreseeable future, it is the task of the authorities to ensure a good care situation in childhood and adolescence. The success of the public authorities in carrying out this task is mostly assessed on the basis of two different criteria: i) how the child is progressing with regard to development and well-being, and ii) whether the child receives a placement and a care situation characterized by stability (Kelly, 2000, Leathers, 2006, Sinclair & Wilson, 2003, Ward & Skuse, 2001). The achievement of the latter – placement stability – is generally regarded as a prerequisite for the first criterion — the positive development of the child. This may be the reason why stability, in both research and practice, is often used as the focal measurement of the success of a placement.
Another reason for reliance on the stability factor may be that stability appears to be easier to assess than the child's development. The emphasis on stability is probably also accounted for by the fact that research in a number of countries shows that a large proportion of children in public care experience a shifting life, moving from one care arrangement to another (see Oosterman et al., 2007, Unrau, 2007). It is a matter of concern that the lack of continuity and stability in the child's home, prior to the placement, is followed by the lack of continuity and stability in public care. This remains the situation despite the fact that for several decades stability has been a prioritized goal for the child welfare services (CWS). In this study we will explore what is understood by stable and unstable placements, based on an interview material regarding 70 Norwegian children who have had long-term out-of-home placements.
As in many other countries, family foster care is the preferred care arrangement for long-term public care in Norway. Approximately 80% of all children placed out-of-home live in foster care (Statistics Norway, 2009). Adoption occurs rarely (Thoburn, 2000). The foster carers are expected to offer the child a daily life and care that are as similar as possible to that experienced by most children. The carers, together with the child's birth family, are expected to give the child a sense of belonging and relational continuity. Some children, primarily adolescents, spend parts of their childhood and adolescence in residential units (Tjelflaat, 2003). When a residential stay promises to be long-lasting, efforts will also be made within the residential setting to ensure that the child/youth experiences stability and continuity regarding the place of residence and relations to key adult caregivers.
A number of studies have investigated stability in out-of-home care. However, there are considerable variations in the criteria applied for assessing stability. A diversity of terms is used to describe placement stability and instability. These include placement ‘changes’ (Connell et al., 2006), ‘moves’ or ‘movements’ (Barber & Delfabbro, 2003, Hyde & Kammerer, 2009, James et al., 2004, Unrau, 2007, Ward, 2009), ‘trajectories’(Wulczyn, Kogan, & Harden, 2003), ‘history’ (Strijker, Knorth, & Knot-Dickscheit, 2008), ‘pattern’ (Usher, Randolph, & Gogan, 1999), ‘pathway’ (Fernandez, 1999); placement disruptions' (Leathers, 2006, Oosterman et al., 2007), ‘breakdowns’ (Berridge & Cleaver, 1987, Egelund & Vitus, 2009, Minty, 1999), and ‘permanence’ (Sinclair, Baker, Lee, & Gibbs, 2007). The variation in the use of terms reflects the variation in what is being studied and how the studies are designed. For example: does the study focus on moves generally, or breakdowns in particular? What placement changes are included in the different terms? What age group is chosen and how long is the study interval? Are cross-sectional or longitudinal designs applied? The considerable variation makes comparisons and summaries of the field difficult (James, 2004, Minty, 1999, Munro & Hardy, 2007, Oosterman et al., 2007, Unrau, 2007, Webster et al., 2000).
The research on stability has centered around long-term foster care and adoption, and to a lesser degree on residential placements (Egelund & Vitus, 2009, Vinnerljung et al., 2001). This is presumably related to the policy that residential care shall ideally be utilized as a transitional measure or for cases where a solution within a family is not possible. There is a danger of overlooking the fact that a considerable number of children, especially teenagers, spend years of their childhood and adolescence in residential units (Whittaker, 2004).
Despite variations among the studies, it is usual to interpret ‘breakdowns’ as placements that are terminated contrary to plans drawn up by the child welfare authorities (James, 2004, Sallnäs et al., 2004, Strijker et al., 2008). Triseliotis (2002) observes that “the overall breakdown rates noted in a number of key studies of long-term fostering, for all groups between 2 and 5 years after the placement was made, are around 43%” (p. 24). Oosterman et al., 2007, Egelund, 2006 reach the conclusion that, although the findings vary considerably, a total of 20–50% of placements are unplanned.
An important research aim has been to acquire knowledge of the factors that increase or reduce the risk of moves and breakdowns. Such studies have generally searched for correlations between different factors and the incidence of breakdowns (Egelund, 2006, Oosterman et al., 2007, Triseliotis, 2002). Special focus has been directed towards the characteristics of the children, of the carers and care arrangements, and of the child's birth family. According to such analyses the factor that most clearly increases the risk for breakdowns is children's behavioural problems. Many studies also find that the risk of breakdown is greater for older children/adolescents than for younger children, and that the risk increases when there are children in the foster family who are of the same age or younger than the foster child. Most studies find that placement with relatives reduces the risk of breakdown. Fewer investigations have been carried out to assess children's views on being in care, but qualitative studies in particular reveal that the children's attitude is a key factor (Hyde & Kammerer, 2009, Rushton & Dance, 2004, Sinclair & Wilson, 2003). Some studies have included system factors (Berridge & Cleaver, 1987, Egelund, 2006, James, 2004, Sallnäs et al., 2004), such as characteristics of the professionals and their handling of the case. Other studies have included parenting practice and the interaction between carer and child in their analyses (Schofield et al., 2000, Sinclair & Wilson, 2003).
Even though the individual studies identify significant risk factors for breakdowns, the findings are often ambiguous or contradictory when comparisons are made or meta-analyses are conducted. A main conclusion is that placement breakdowns are often a consequence of an interaction between several factors, and that they most often constitute the end point of a process rather than being a sudden occurrence (e.g. Oosterman et al., 2007).
There is a general consensus that placement breakdowns and repeated moves exert a negative influence on children's well-being and development. At the same time, a number of researchers point out that a breakdown should not automatically be regarded as dramatic. There is a case to be made that if the child's development and well-being are the principal goal, the consequences of a breakdown may be looked at in a differentiated manner (Barth, 1999, Biehal, 2009). For instance, the impact may vary according to whether the child's need was ‘a family for life’ or ‘a safe refuge’, ‘a substitute family’ or a ‘care facility’ (see Rowe et al., 1984, Schofield et al., 2000, Sinclair et al., 2007, Thoburn et al., 2000). Clearly the significance and consequences of a care breakdown can be reduced if other important relationships are preserved, — relationships with friends, school, or the original family (Jackson, 2002, Sinclair et al., 2007).
Within a prospective research design, the purpose of the present analysis is to examine long-term out-of-home placement histories, and to gain knowledge of important factors that affect stability as reported by children, parents, and social workers.
Section snippets
Methods
Our analysis is based on interviews from “The Norwegian Longitudinal Study on Out-of-Home Care” (Christiansen & Anderssen, 2010). This prospective study recruited a national sample of 109 children aged six to twelve when they were placed in out-of-home care in the period from September 15th 1998, to December 31st 1999. Qualitative and quantitative data regarding the children and their cases were collected for the first time within a few months of the placement (T 1). Follow-up studies were
Moves
We have mapped the children's moves between different care arrangements under the auspices of the child welfare services. This does not incorporate the initial move from home. A reunification or a move to independent housing is only included if followed by a new move to a care arrangement.
A total of 70 children experienced altogether 180 moves after the initial placement — 2.5 moves on average (see Table 1). While 10% had only lived in one placement (foster care), just under one-third had moved
Discussion
The starting point for this analysis has been the widespread concern about the considerable percentage of children in public care who experience repeated moves and a lack of opportunity to settle down. Drawing on the longitudinal design of this study and having access to the stories and explanations of the central actors, we found that knowledge both of the purpose of the individual placement and of the explanations for why the placement had been terminated was essential. This enabled us to
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