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Child abuse and neglect are common problems across the world that result in negative consequences for children, families and communities. Children who have been abused or neglected are often removed from the home and placed in residential care or with other families, including foster families. Foster care was traditionally provided by people that social workers recruited from the community specifically to provide care for children whose parents could not look after them. Typically they were not related to the children placed with them, and did not know them before the placement was arranged. In recent years many societies have introduced policies that favour placing children who cannot live at home with other members of their family or with friends of the family. This is known as ‘kinship care’ or ‘families and friends care’. We do not know what type of out-of home care (placement) is best for children. This systematic review was designed to help find out if research studies could tell us which kind of placement is best. Sixty two studies met the methodological standards we considered acceptable. Wherever possible we combined the data from studies looking at the same outcome for children, in order to be more confident about what the research was telling us. Current best evidence suggests that children in kinship care may do better than children in traditional foster care in terms of their behavioral development, mental health functioning, and placement stability. Children in traditional foster care placements may do better with regard to achieving some permanency outcomes and accessing services they may need. Implications for practice and future research are discussed. Executive summary/Abstract BACKGROUND Every year a large number of children around the world are removed from their homes because they are maltreated. Child welfare agencies are responsible for placing these children in out-of-home settings that will facilitate their safety, permanency, and well-being. However, children in out-of-home placements typically display more educational, behavioral, and psychological problems than do their peers, although it is unclear whether this results from the placement itself, the maltreatment that precipitated it, or inadequacies in the child welfare system. OBJECTIVES To evaluate the effect of kinship care placement on the safety, permanency, and well-being of children removed from the home for maltreatment. SEARCH STRATEGY The following databases were searched to February 2007: CENTRAL, MEDLINE, C2-Spectr, Sociological Abstracts, Social Work Abstracts, SSCI, Family and Society Studies Worldwide, ERIC, PsycINFO, ISI Proceedings, CINAHL, ASSIA, and Dissertation Abstracts International. Relevant social work journals and reference lists of published literature reviews were handsearched, and authors contacted. SELECTION CRITERIA Randomized experimental and quasi-experimental studies, in which children removed from the home for maltreatment and subsequently placed in kinship foster care, were compared with children placed in non-kinship foster care on child welfare outcomes in the domains of well-being, permanency, or safety. DATA COLLECTION AND ANALYSIS Reviewers independently read the titles and abstracts identified in the search and selected appropriate studies. Reviewers assessed the eligibility of each study for the evidence base and then evaluated the methodological quality of the included studies. Lastly, outcome data were extracted and entered into REVMAN for meta-analysis with the results presented in written and graphical forms. RESULTS Sixty two quasi-experimental studies were included in this review. Data suggest that children in kinship foster care experience better behavioral development, mental health functioning, and placement stability than do children in non-kinship foster care. Although there was no difference on reunification rates, children in non-kinship foster care were more likely to be adopted while children in kinship foster care were more likely to be in guardianship. Lastly, children in non-kinship foster care were more likely to utilize mental health services. AUTHORS’ CONCLUSIONS This review supports the practice of treating kinship care as a viable out-of-home placement option for children removed from the home for maltreatment. However, this conclusion is tempered by the pronounced methodological and design weaknesses of the included studies.

Foster care children are a highly vulnerable population and their experiences in care are considered crucial to their developmental and psychosocial wellbeing. Placement instability has been considered a possible risk factor for developmental difficulties due to its impact on the development of a reparative attachment relationship and sense of relational permanence. The current review synthesises the literature regarding the impact of placement instability on behavioural and mental health outcomes in foster care children. Three major databases and grey literature sources were searched for all relevant quantitative research published by July 2019. Titles and abstracts of 2419 articles were screened following searches, with full texts obtained for 51 studies and 14 included in the final review. All were subject to quality assessment by two independent reviewers. Results indicated that placement instability was a consistent predictor of externalising behaviour in children, although some evidence was counter-indicative in this regard. There was also evidence to suggest a relationship with internalising behaviours, and mental health difficulties, in particular PTSD symptoms. Methodological quality and design varied between studies which limited direct comparisons. Most notably, there was a lack of consensus on how to quantify and measure placement instability and many studies failed to control for potentially confounding care-related variables. The review highlights that instability seems to result in negative psychological outcomes, although the extent of this relationship remains unclear. The review's findings are discussed with reference to research and clinical implications.

This meta-analysis aims at comparing mental health problems of children in foster care to those living with their biological parents while taking in consideration different protective and risk factors. Across 41 studies with a total of 72 independent effect sizes, a significant but small effect size was found between foster care placement and psychopathology (d = 0.19). Children in foster care showed higher levels of psychopathology compared to those from community samples or matched/at-risk samples. They were as likely to show mental health problems as maltreated children living with their biological parents or children from clinical samples. Results showed that foster children’s mental health problems also varied as a function of type of placement and study methodological characteristics. Being placed in kinship care, longer stay in the same foster home and fewer placement disruptions, all acted as protective factors limiting mental health problems of children in foster care.

Youth residing in out-of-home care settings have often been exposed to childhood trauma, and commonly report experiencing adverse outcomes after transitioning from care. This meta-analysis appraised internationally published literature investigating the impact of transitional programme participation (among youth with a baseline age of 15-24 years) on post-transition outcomes of housing, education, employment, mental health and substance use. A comprehensive search of sociology (e.g. ProQuest Sociology), psychology (e.g. PsycInfo) and health (e.g. ProQuest Family Health) electronic abstraction databases was conducted for the period 1990-2014. Search terms included 'out-of-home care', 'transition', 'housing', 'education', 'employment', 'mental health' and 'substance use'. Nineteen studies, all from the United States, met the inclusion criteria and were included in the meta-analysis. Living independently and homelessness were the most commonly described housing outcomes. Rates of post-transition employment varied, while rates of post-secondary education were low. Depression and alcohol use were commonly reported among transitioning youth. Findings of the meta-analysis showed that attention should be given to the potential benefit of transitional programme participation on outcomes such as housing, employment and education. Moderator analyses showed that these benefits may differ based on study design, sample size and sampling unit, but not for mean age or gender. Detailed and rigorous research is needed internationally to examine the characteristics of transitional programmes resulting in more successful outcomes for youth, and whether these outcomes are sustained longitudinally.

Foster and adoptive parents often face challenges while taking care of children who, due to their adverse early life experiences, are at risk of developing insecure attachment relationships, behavior problems, and stress dysregulation. Several intervention programs have been developed to help foster and adoptive parents to overcome these challenges. In the current study, a series of eight meta-analyses were performed to examine the effectiveness of these intervention programs on four parent outcomes (sensitive parenting, k = 11, N = 684; dysfunctional discipline, k = 4, N = 239; parenting knowledge and attitudes, k = 7, N = 535; parenting stress, k = 18, N = 1,306), three child outcomes (attachment security, k = 6, N = 395; behavior problems, k = 33, N = 2,661; diurnal cortisol levels, k = 3, N = 261), and placement disruption (k = 7, N = 1,100). Results show positive effects for the four parent outcomes and child behavior problems, but not for attachment security, child diurnal cortisol levels, or placement disruption. Indirect effects on child outcomes may be delayed, and therefore long-term follow-up studies are needed to examine the effects of parenting interventions on children.

Family reunification is one of the central tenents of the child welfare system, yet research supporting effective practices to promote safe reunifications is limited. As a departure from previous initiatives, the Parent Partner (PP) program enlists as staff mothers and fathers who have experienced child removal, services, and reunification. This study examines outcomes for children served by the PP program. The experimental group includes 236 children whose parents were served by a Parent Partner and a matched comparison group of 55 children whose parents were served by the public child welfare agency in 2004, before the Parent Partner program was established. Cases were examined 12 months following case opening to determine reunification status. Results from the outcome study indicate that reunification may be more likely for children whose parents were served by Parent Partners. Although there are limitations to the data, findings from this study suggest that the Parent Partner model may hold promise as a child welfare intervention designed to support reunification.

Human development theory suggests existence of a series of important transitional periods in cycle. A transitional period is defined as a boundary zone between two more or less defined or structured periods of life [Egan and Cowan 1980]. Consensus exists that transition from late adolescence to early adulthood constitutes a critical period. Using chronological age as an indicator, age span from 17 to 22 demarcates transitional period that immediately precedes early adulthood.Transition to Early AdulthoodTransitional periods are characterized by uncertainties that individuals face in learning to respond to a series of new and unfamiliar developmental challenges. Leaving adolescence and moving into early adulthood readily qualifies as a critical transition. Relationships with parents, family, peers, schools, church, and community institutions are being redefined, modified, or terminated. Matters associated with independent living, such as career directions, personal relationships, responsibility for decision-making, and acquisition of knowledge and skills necessary for adult living must be confronted. At some point, all young people in out-of-home care must leave jurisdiction of child welfare/placement system and enter world of community/adult living. The overriding question is, to what extent are foster wards prepared for self-sufficiency, independence, and effective community living? As yet, independent-living movement is too new for definitive answers. Moreover, child welfare field faces task of fitting independent living into a permanency planning framework. The system focus on family preservation services, family reunification, and family building through adoption makes it difficult for independent living to receive attention. At present time, child welfare field is uncertain about how to best prepare many thousands of foster wards who each year age out of placement.The child-placing system faces a dilemma in attempting to prepare adolescent wards for independent living. To assist young persons to make transition to early adulthood, it is important to encourage behavior associated with self-direction, self-expression, personal initiative, and taking responsibility for one's decisions. For many reasons, including adolescent's personal history and problems, and flaws within placement system, many adolescents are shuttled from placement to placement, suffer frequent school changes, and lose continuity in process of growing up [Timberlake and Verdieck 1987]. The transition from adolescence to early adulthood does not take place in a vacuum. Social competence, self-direction, self-esteem, acquisition of values, standards of conduct, and preparation in life-skills are complex by-products of interactions in families; in school; in workplace; in contacts with peers, friends, and neighbors; and in exposure to community organizations and religious institutions.EmancipationAdolescents in out-of-home care now comprise approximately 40% to 50% of placement caseloads [Lammert and Timberlake 1986]. Most have a permanency plan of preparing for independent living. Wiltse [1978] was one of first in child welfare field to call attention to need for independent-living services. Wiltse noted that the frequency of emancipation as an outcome of foster care suggests that it deserves study in its own right. In years past, when adolescents comprised less than 25% of caseload, and funding for service was automatically cut off at a given age, emancipation and leaving care received little attention. Now that caseload demographics have changed and public concern has produced funding for extended care, child welfare system is expected to facilitate transition of adolescent wards to independent living.Typically, adolescents in care experience numerous, often severe, discontinuities in growing up. Most graduates of placement system need help in making transition from a dependency status to self-directed community living. …

PROBLEM: Adolescents in long-term foster care experience significant health and mental health problems. Little is known about their perceptions of the impact of foster care. METHOD: Seventeen adolescents were interviewed in their foster group homes. Dimensional analysis was used to develop theory on the impact of foster care. FINDINGS: Adolescents in foster care engaged in self-protection strategies secondary to experiences of devaluation and uncertainty in foster care, including guarding foster child status, maintaining a defensive posture, distancing self, and keeping relationships superficial. Self-protection resulted in a veneer of self-reliance and social detachment. CONCLUSIONS: Strategies are suggested to address devaluing experiences and promote positive identity development in foster care.