From institutional care to family reunification in a post-Soviet country: A qualitative study of challenges and opportunities in restoring child-parent relationships

Abstract

BackgroundFamily reunification is one of the main deinstitutionalization strategies in the Post-Soviet countries, replacing institutional childcare systems. While the family offers a better environment for children, little is known about the challenges and opportunities that children and parents face upon reunification and how multiple traumatic experiences that occurred prior to and during separation affect the family reintegration process. ObjectiveThis qualitative study explores the emotional and interpersonal experiences and difficulties that families experience when they reunite with children following institutional placement.Participants and Setting: Children ages 8–16 with a history of institutionalization and their caregivers (N = 47) were recruited through five child institutions in Azerbaijan. MethodsSemi-structured interviews included questions about children’s and caregiver’s experiences during readjustment to the family environment following deinstitutionalization. Four coders thematically coded the interviews. ResultsChildren and parents were pleased to reunite and return home. At times, upon reunification, children manifested both internalizing and externalizing behavioral problems (i.e., social withdrawal, emotional dysregulation, and overtly aggressive behaviors toward family members). Narratives pointed to relational desires and challenges associated with transition from institutional care to the family environment, including building a better sense of trust and communication, as well as managing role conflict and disparate conceptions of authority in the child-caregiver relationship dynamic, particularly affecting boys. ConclusionsTo improve emotional and psychosocial well-being of reunifying children and their caregivers, deinstitutionalization strategies should incorporate culturally-responsive trauma-informed and attachment-based interventions to heal relational traumas and further equip children and caregivers with coping, stress management and emotional regulation skills.