Transcript Outcomes for Young People Leaving Care : WHAT DO WE KNOW

CHILDREN’S VIEWS,
EXPERIENCES and OUTCOMES:
Child Welfare and Out-of-home Care
Judy Cashmore
University of Sydney Law School
and
Centre for Children and Young People
Southern Cross University
Families SA
July 2009
KEY QUESTIONS
• What is the evidence re the outcomes of care?
• Disentangling pre-care and in care aspects
• What do children and young people say about
their experience in care?
• Implications for policy and practice
WHAT IS SUCCESS: OUTCOMES
• What outcomes?
• What is ‘success’?
• Relative to age-peers? In general population?
• Children are happy, they are loved in a way that does
not threaten their attachment to their families, their
behaviour improves and their school reports are
positive (Sinclair & Wilson, 2003)
WHAT IS SUCCESS: LT OUTCOMES
• Positive outcomes and adaptive adulthood eg
• Educational engagement and attainment
• Aim : Employment
• Positive relationships – peers, partners, as parents
• Physical and psychological health and well-being
• Perceived security and life satisfaction, meaning
CHILDREN AND YOUNG PEOPLE
IN CARE AND AFTER
“Playing a poor hand well”
• Under what circumstances can children recover
from a poor start?
• How effective is intervention at various stages in
a child’s life – in relation to socio-emotional,
educational and health outcomes?
OUTCOMES of
Out-of-Home Care: Context
• Better than the alternative?
• Child’s view
• Research findings
• In care vs ‘reunified’ or ‘remain’ at home
• Adopted vs foster ?
• Significant problems but not all bad!
Better off in care?
or left with your family?
Consistent findings re children’s and young people’s
views: Happy in care or better off in care?
•
Canada: Kufeldt, Armstrong & Dorosh, 1996: 89% children
•
UK : Shaw & Who Cares? Trust : 75% of 2000 chn happy
•
UK: Ward et al (2005) : 72% of 242 “good thing in care”
•
Selwyn et al (2008) – 85% in care of UK private provider
•
But understandable ambivalence re birth family, and “if
things were different”
Better off in care?
or left with your family?
Cashmore & Paxman (1996, 2006)
12 months after discharge from wardship:
• 78 % better off in care but some ambivalence / wish other
•
options or treated with more care
18 % wished left in their own homes or not sure
4 - 5 years after left care
•
•
•
46 % more positive – “understand more now”
18 % more negative – “they didn’t care”
36 % same or both +ve and –ve
OUTCOMES
• In care vs ‘reunified’ or ‘remain’ at home
• Generally children did better in care than those returned
home – methodological issues
• Australia: Barber, Delfabbro & Cooper (2003) , Barber &
Delfabbro (2005) - if in stable care
• UK - recent review by Forrester et al (2009)
• US: Taussig, Clyman & Landsverk (2001) : Wald et al (1988)
• France: Dumaret & Coppel-Batsch (1998)
OUTCOMES
Children did well in care for 2 main reasons:
• Poor home circumstances they left – and returned to
• Relationships
• Importance of stability and security
• Continuing relationships with :
Carers
Workers and
Birth family
Most strikingly, in many studies there were descriptions of
foster carers and social workers, residential carers and
managers, who form relationships and work tirelessly to ensure
that the children they are responsible for thrive. It is easy to
miss these success stories in the general perception that care
fails. Often the institutional arrangements that surround care
are inadequate.
• Forrester et al. (2009). What is the impact of public care on children's
welfare? A review of research findings from England and Wales and their
policy implications. Journal of Social Policy, 38, pp 439-456.
• ... broadly positive picture of care did not
extend to leaving care provision. The leaving
care system tended not to work well for most
children. In effect, it often undid the positive
impact of care for many children. (Forrester, et
al, 2009)
PREDICTING POSITIVE OUTCOMES
AFTER LEAVING CARE
• Employment* (ever employed?) *
• Living arrangements
• Mobility
• Never homeless after leaving care *
• Education (completed high school?)* further education
• No problems with drugs / alcohol *
• Mental health – suicidality *
• Criminal behaviour – self-reported*
• Relationships
• Contact, unresolved family issues
• Partner, domestic violence
* (Domains of Resilience
• (Cashmore & Paxman,2005)
McGloin & Spatz Widom, 2001)
ACTUAL STABILITY
Long-term placement for > 75 % time in care
→ fewer schools
→ more years of schooling
→ report better school progress
→ get on better with peers
→ fewer workers
→ more willing to ask for financial,
emotional support esp from foster carers
Cashmore & Paxman, 1996 Wards Leaving Care Study
SENSE OF SECURITY
Coded as positive, negative, medium:
•
•
•
•
•
•
Was there anyone ever feel loved you?
Anyone ever feel secure with?
Feel as if listened to?
Miss out on things other kids had?
Miss out on affection?
Grow up too fast – bad thing?
Cashmore & Paxman , 2005
PREDICTING RESILIENCE /
POSITIVE OUTCOMES *
• Perceived emotional security in care
• Social support after care
• Positive family contact
• Positive foster family support
• Church, community affiliation
• Completing high school before leaving care
• Total number of moves after leaving care
• Stability did not add to model over this BUT
Continuity /stability  felt security and emotional
connectedness
* Cashmore & Paxman 2005
6
5
4
3
2
1
0
Family and carer Carer
Worker
Family
No-one
Figure 7.3 Mean Figure
'resilience'
scores by source of 'felt' security
7.3 Mean 'resilience' scores by source of 'felt' security
How do children define good carer/worker?
CONSISTENT THEMES ... RECOGNITION
and RESPECT
• Someone who listens to me, not just tells me ...
• Sits down with you – not lots of questions
• Try to be their equal, not their master (McLeod, 2008)
• Not just a job, but cares about me
• Kind, approachable, reliable - “follows thr”
• Provides real help – art lessons example
POLICY AND PRACTICE
IMPLICATIONS
• Importance of stability and security
• How do you turn stability into security?
• What support is necessary/effective in supporting
reunification?
• What is the function of contact in care?
• Perceived benefits, problems, issues
• Long-term outcomes?
• What is needed in standards to promote relationshipbased practice? (Tilbury, 2008)
POLICY AND PRACTICE
IMPLICATIONS
• RELATIONSHIPS
• Managing transitions into, in, and out of care
• Shared care?
Extended respite care, “Aunties and Uncles” enduring relationships and a sense of belonging in
most extended natural family structures.
eg Heath Ducker (2009) A Room at the Top
POLICY AND PRACTICE
IMPLICATIONS
• Child’s motivation – follow though on child’s “choices”
• Continuity and relationship with agency workers
• Importance of school links / continuity
• Focus on early stages eg first / second placements
• Supporting family contact and stability
• “Family for life” where possible
– financial and emotional support beyond 18