Child Welfare Care Research Articles

Dynamics of Social Work Approach in Childcare; An Analysis of Integration of Islamic Kafala Theory and Bowlby’s Attachment Theory and Application Thereof in Childcare in Saudi Arabia

This paper explores the dynamic integration of Islamic Kafala theory and attachment theory within the context of childcare and welfare in Saudi Arabia. Despite the growing recognition of diverse cultural and theoretical frameworks in social work practice, there is very limited research on how specific theories are integrated and applied in childcare, particularly within Islamic contexts. This study aims to fill this gap by analyzing the application of these theories in enhancing child welfare and social work practices in Saudi Arabia. Utilizing a mixed-methods approach, the research draws on qualitative data from surveys of child welfare professionals and families engaged in the Kafala system, supplemented by case study analyses in various Muslim countries. The findings reveal that the integration of Islamic Kafala theory and attachment theory offers a culturally sensitive and effective framework for improving childcare practices, promoting the emotional and psychological well-being of children in care. The study highlights practical implications for social workers, suggesting strategies for the successful incorporation of these integrated theories into child welfare practices in Saudi Arabia. It also identifies challenges and limitations within the current system, offering recommendations for policymakers to enhance child welfare services. This research contributes to the theoretical and practical knowledge of childcare and welfare, advocating for a more nuanced and culturally informed approach to social work in Saudi Arabia.

Predicting successful placements for youth in child welfare with machine learning

Out-of-home placement decisions have extremely high stakes for the present and future well-being of children in care because some placement types, and multiple placements, are associated with poor outcomes. We propose that a clinical decision support system (CDSS) using existing data about children and their previous placement success could inform future placement decision-making for their peers. The objective of this study was to test the feasibility of developing machine learning models to predict the best level of care placement (i.e., the placement with the highest likelihood of doing well in treatment) based on each youth’s behavioral health needs and characteristics. We developed machine learning models to predict the probability of each youth’s treatment success in psychiatric residential care (i.e., Psychiatric Residential Treatment Facility [PRTF]) versus any other placement (AUROCs > 0.70) using data collected in standard care at a behavioral health organization. Placement recommendations based on these machine learning models distinguished between youth who did well in residential care versus non-residential care (e.g., 80% of those who received care in the recommended setting with the highest predicted likelihood of success had above average risk-adjusted outcomes). Then we developed and validated machine learning models to predict the probability of each youth’s treatment success across specific placement types in a state-wide system, achieving an average AUROC score of >0.75. Machine learning models based on risk-adjusted behavioral health and functional data show promise in predicting positive placement outcomes and informing future placement decisions for youth in care. Related ethical considerations are discussed.

Narratives from non-citizen former youth in child welfare care fighting crimmigration and deportation

Narratives from non-citizen former youth in child welfare care fighting crimmigration and deportation

Recommendations for child welfare care reform in the global south: Perspectives of 542 adults who were separated from parental care during childhood in 12 nations

A robust literature has outlined the risks to children separated from parental care. Recently, there has been an effort to reform services to this population. However, the research driving reform has often neglected the voices of adults with care experience, especially those from the Global South. The current research explored recommendations for care reform from 542 adults who had experienced alternative care during childhood in 12 nations in the Global South. Data revealed three themes to improve care: (1) child focus and participation, (2) the need for family placements, and (3) the importance of support services. Implications are discussed.

An Intersectionality-Based Policy Analysis of Canadian Child Advocate Reviews of Infants, Children and Youth with Prenatal Substance Exposure and Fetal Alcohol Spectrum Disorder in Child Welfare Care

Background and Objective Care providers in the child welfare system often support children with Fetal Alcohol Spectrum Disorder (FASD). Women who give birth to children with FASD face many multi-dimensional socio-structural challenges, including prenatal substance use, that lead to their children being placed in care. Alcohol use disorders have strong associations to trauma histories, psychiatric problems, adverse experiences in life, and other substance use. Children with FASD experience abuse and neglect along with other forms of adversities in childhood and adolescence at higher rates than other children, and are often kept in the care of the child welfare system. Risks of harm for children and youth with FASD exist due to distinct vulnerabilities associated with the disability. Even with child welfare intervention, adverse outcomes remain for children and youth with FASD. Our objective was to examine reports generated from Child Advocate offices in Canada on deaths and serious injuries where FASD was identified to gain a deeper understanding of the experiences of this population in the child welfare system. Material and methods We employed an intersectionality-based policy analysis (IBPA) framework to analyze child welfare reports from 1989 to 2019 available online publicly from Child Advocate (or equivalent jurisdiction) Offices across Canada. An underpinning theoretical framework in this research was life course theory, as it is critical to recognize the connection that exists between early decisions made for infants and children with FASD and later outcomes in life. Reports were included when there was evidence of FASD or prenatal substance exposure in the report. Sequential Excel spreadsheets were employed for data extraction, and individual word documents were generated for each report specific to the IBPA framework. Thematic analysis was employed to identify themes related to serious injuries or deaths in child and youth, report summaries, and recommendations. Results A total of 61 reports were reviewed, and deaths of 17 children or adolescents with FASD were reported. Four categories of reports existed, including investigative death reports, investigative serious injury reports, special reports, and annual reports. Key themes from these reports for this population included: (1) challenges to stability and permanency, (2) challenges to FASD-informed service provision, (3) over-representation of Indigenous children and youth, and (4) presence of concurrent mental health challenges. Recommendations within reports addressed needs of individuals, families, care providers, systems, and policies. There were many consistencies across time and jurisdictions. One notable concern was that FASD, while possible, was often not diagnosed, and therefore supports and services specific to this disability were not provided. It is critical to note that these reports served to document both a child's history and make key policy and practice recommendations to inform a differential response in the child welfare system in the case of FASD. Conclusion This analysis illuminated the risks and vulnerabilities for this population in the child welfare system and has implications for assessment, diagnosis, and practice interventions in responding to the needs of this population. This analysis also identified that many opportunities exist to improve practice and service delivery for individuals with FASD and their families. It is critical to recognize that a connection exists between early decisions made for infants and children with FASD and later outcomes in life.

The Reflective Fostering Programme\u2014improving the wellbeing of children in care through a group intervention for foster carers: a randomised controlled trial

BackgroundThe needs of children in care are a government priority, yet the evidence base for effective interventions to support the emotional wellbeing of children in care is lacking. Research suggests that supporting the carer-child relationship, by promoting the carer’s reflective parenting, may be an effective approach to improving the wellbeing of these children.MethodsThe study comprises a definitive, superiority, two-armed, parallel, pragmatic, randomised controlled trial, with embedded process evaluation and economic evaluation, and an internal pilot, to evaluate the effectiveness, and cost-effectiveness, of the Reflective Fostering Programme. Randomisation is at the individual level using a 1:1 allocation ratio. The study is being conducted in local authority sites across England, and is targeted at foster carers (including kinship carers) looking after children aged 4 to 13. Consenting participants are randomly allocated to the Reflective Fostering Programme (intervention arm) in addition to usual support or usual support alone (control arm). The primary outcome is behavioural and emotional wellbeing of the child 12 months post-baseline, and secondary outcomes include the following: foster carer’s level of stress, quality of life, reflective capacity, compassion fatigue and burnout, placement stability, the quality of the child-carer relationship, child’s capacity for emotional regulation, and achievement of personalised goals set by the carer.DiscussionA feasibility study has indicated effectiveness of the Programme in improving the child-carer relationship and emotional and behavioural wellbeing of children in care. This study will test the effectiveness and cost-effectiveness of implementing the Reflective Fostering Programme as an additional aid to the support already available to local authority foster carers.Trial registrationISRCTN 70832140.

Experiences and well-being among Indigenous former youth in care within Canada

BackgroundResearch indicates that a healthy cultural identity is associated with positive outcomes including increased self-esteem, academic achievement, and higher reports of satisfying family interactions. ObjectiveThis retrospective study explored the experiences of intergenerational trauma, cultural connections, and identity among Indigenous former youth in child welfare care of the Ontario government. Participants and settingParticipants self-identified as Indigenous (First Nations, Status and non-Status; Metis; Inuit), had a history of being in child welfare care and had never been adopted. Each participant in this research study reflected on the influence of intergenerational trauma and being in child welfare care in the development of their cultural identities. MethodsThis study utilized a blend of traditional grounded theory, constructivist grounded theory, relational worldview model and a two-eyed seeing approach. ResultsOverall findings indicate the importance of cultural connections, having a purpose and meaning in life that links to cultural identity and spirituality as critical elements in the pathways from trauma to well-being. These findings reflect Indigenous reclamations of traditional belief systems, practices, languages, and cultures in order to overcome personal experiences and problems. ConclusionsMany Indigenous communities are taking active steps to find children lost in the child welfare system, to care for these children, and to rekindle cultural identity for them. With the goals of healing, reconciliation and cultural restoration, it is imperative that child welfare agencies support the development of positive cultural identity, spirituality, and connection to cultural communities for Indigenous children, youth, and their families.

Mental disorders among adults formerly in out-of-home care: a systematic review and meta-analysis of longitudinal studies

While children and adolescents placed in child welfare or juvenile justice out-of-home care show higher prevalence rates of mental disorders compared to the general population, it remains unclear whether this pattern persists into adulthood. A quantitative synthesis of existing studies is lacking. The aim of this meta-analysis was to estimate the prevalence rates for mental disorders among adults with a foster or residential child welfare or juvenile justice care history, comparing them where possible to rates among the general population. PubMed, PsycInfo, EMBASE, and Web of Science were systematically searched for epidemiological studies published up to 28 October 2020. Nineteen studies, totaling 604,257 participants, met our inclusion criteria. Random-effects models were used for prevalence rates and odds ratios (OR) of mental disorders, and study quality was rated. A prevalence rate of 30% [95% CI (23.36, 37.36)] for any mental disorder in adults with a child welfare care history was found (3–17% for specific disorders). A prevalence rate of 45% [95% CI (42.38, 47.38)] for any mental disorder was found in adults with a juvenile justice care history (6–66% for specific disorders). For out-of-home placement history, adult mental disorders were significantly higher than in the general population (OR = 1.33–2.76). Studies differed in terms of methodology and the disorder groups considered, so heterogeneity between effect sizes ranged from low to high. Our findings suggest that the high risk that mental health issues will persist in adults with an out-of-home placement history needs to be taken seriously in the transition from adolescence to adulthood. The care systems involved need to collaborate and to be aware of these risks.

Measurement invariance of the short Warwick-Edinburgh Mental Wellbeing Scale and latent mean differences (SWEMWBS) in young people by current care status

PurposeStudying mental wellbeing requires the use of reliable, valid, and practical assessment tools, such as the Short version of the Warwick-Edinburgh Mental Wellbeing Scale (SWEMWBS). Research on the mental wellbeing of children in care is sparse. The current study aims to: (1) examine the unidimensionality of SWEMWBS; (2) assess measurement invariance of SWEMWBS across children and young people in care compared to their peers not in care; and (3) investigate the latent factor mean differences between care status groups.MethodsWe used data from the 2017 School Health Research Network Student Health and Wellbeing (SHW) survey, completed by 103,971 students in years 7 to 11 from 193 secondary schools in Wales. The final data include a total of 2,795 participants (46% boys), which includes all children in care and a sub-sample of children not in care who completed the SWEMWBS scale fully and answered questions about their living situation.ResultsConfirmatory factor analysis supported the unidimensionality of SWEMWBS. The SWEMWBS is invariant across groups of young people in foster, residential and kinship care compared to children and young people not in care at configural, metric and scalar levels. Findings from latent mean comparisons showed that young people in care reported lower mental wellbeing than their peers, with those in residential care reporting the lowest scores.ConclusionsFindings suggest that SWEMWBS is a valid scale for measuring differences in mental wellbeing for young people in care similar to the population.

Attempting to operationalize a multi-dimensional definition of permanency in child welfare practice: results from a demonstration project

ABSTRACT Permanency has been a cornerstone concept in child welfare since the 1960s. Despite its endorsement as a best practice principle in promoting the wellbeing of children in child welfare care, debate persists about the key elements of the concept and their effects, particularly in relation to the emphasis on legal permanency when children in care cannot be reunited with their parents. This article describes results from a demonstration project using a Family Finding service model. It aimed to operationalize a multi-dimensional permanency definition where most of the children served were Indigenous.

Comparing outcomes of children and youth with fetal alcohol spectrum disorder (FASD) in the child welfare system to those in other living situations in Canada: Results from the Canadian National FASD Database.

The current study aimed to explore differences in adverse outcomes between youth and adolescents with fetal alcohol spectrum disorder (FASD) living in child welfare care (i.e., foster care or group home) with those living with their biological parent(s) or with adoptive or other family member(s) in Canada. Data gathered from the Canadian National FASD Database were used for analysis. A total of 665 youth and adolescents with a clinical diagnosis of FASD under the age of 18 living in child welfare care, with biological, adoptive or other family members, were included in the sample. Key areas examined included living situation, legal problems, experience of sexual or physical abuse, mental health (anxiety, conduct disorder, mood disorder and post-traumatic stress disorder) and suicidal ideation. Descriptive statistics and chi-square comparisons were utilized to explore these differences. Results revealed a significantly higher rate of reported sexual and physical abuse among individuals in child welfare care compared with those living with biological parents or with adoptive or other family member(s). Rates of difficulty with the law were also higher among those in child welfare care compared with adoptive/other family members. Conversely, the rate of mood disorders was significantly higher among those living with adoptive/other family members compared with child welfare care. Results highlight similar rates of reported suicidal ideation/attempts across all living situations, as well as mental health concerns. Results offer rare insight into the lives of youth and adolescents under age 18 with diagnosed FASD who reside in child welfare care in contrast to those living with biological parent(s) or with adoptive or other family members. These findings increase our awareness of the complexity of mental health concerns and suicide risk across all living environments. Results have further implications for policy, practice and clinical intervention.

Subjective Well-Being of Children in Care: Comparison Between Portugal and Catalonia

The subjective well-being (SWB) of children in out-of-home care is crucial to assess their potential quality of life today and in the future. This study aims at comparing SWB of children in residential care and in foster families in two European territories or jurisdictions: Portugal and Catalonia (Spain). This study used a sample of 551 children, aged between 11 and 15, being 39 in foster care and 145 in residential care in Portugal, and 41 and 326 respectively in Catalonia. SWB was measured with the Personal Well-being Index-School Children (PWI-SC9) and other variables were evaluated, such as happiness with the placement, relationship with carers, satisfaction with school, and perceptions about themselves and their lives. Results indicate that children in residential care have a lower SWB, as well as lower scores in most of the other variables, compared to children in the foster care groups in the two territories. These results should challenge public policymaking for children to change from an attitude dominantly favourable to institutionalisation to a more successful approach based on family foster care. This can provide the opportunity for children in out-of-home care to grow up with higher SWB and, probably, a better life trajectory.

The Effects of Self Harming Behaviours of Youth in Child Welfare Care

This paper considers the clinical issue of self-harming behaviours, defined as intentional self-injury that results in tissue damage. It is distinct from a suicide attempt, as self-harm does not occur within the context of a conscious wish to die. Self-harming behaviours among children and youth is a recent area of research. To date, studies indicate that in community samples, self-harming behaviours occur in as many as 35% of youth who are sampled (Gratz, 2001). Alarmingly, very little is known about self-harming behaviours among children and youth within the child protection system. This study, drawing from data gathered through a government-mandated reporting procedure of all children and youth in care,attempted to explore self-harming behaviours of children and youth in welfare care. While analyses did not focus explicitly on Aboriginal children and youth, it does consider differences in self-harming behaviours among minority and non-minority children and youth in care of the Children’s Aid Society of Toronto. Approximately half of all child welfare cases that go through the child protection system in Toronto fall under the responsibility of the Children’s Aid Society of Toronto. Although minority status was not significantly related to the number of self-harming attempts or threats, results suggested that minority children and youth in care were less likely to use puncture-type behaviour (cutting, scratching, stabbing) as a means of serious self harm. Results suggest that although self- harm may be a universal phenomenon, culture may affect how children and youth in care engage in self-harming behaviours. Direction of future research should consider between-cultural effects and more importantly, how these culture-specific differences may impact on children and youth’s self-harming behaviours.

THE FINAL WORD: After the Residential School Apology: Why All Canadians Should Care about a Racial Equality Case Before the Canadian Human Rights Commission

cblackst@fncfcs.com There is no way around it – if you are a First Nations child on reserve in Canada you simply get less government funding for statutory child welfare services than other children even though there are more First Nations children in child welfare care now than at the height of residential school operations. The federal government has failed to fully address the inequalities even after leading experts, including the Auditor General of Canada, have called for action. The Department of Indian Affairs (INAC) has publicly acknowledged that it’s outdated funding formula results in growing numbers of First Nations children being removed from their families and placed in child welfare care. The Auditor General recently found that the federal government’s new child welfare funding approach also fails to ensure equity.

Meaning and Essence of Child Well-Being According to Child Welfare Professionals

Many foster youth demonstrate poor outcomes in multiple domains of functioning, including behavioral, cognitive, physical and psychosocial. Because child well-being is a central aim of the child welfare system (with safety and permanency), it is critical to better understand well-being in order to properly measure, promote and intervene to secure the well-being of children in care. Child welfare professionals play a central role in the experience of children and families in care, thus their perspective on well-being is key to its conceptualization. Twenty-nine child welfare professionals participated in in-depth interviews to discuss their understandings of well-being, as well as barriers and facilitators to well-being in their practice experience. After iterative coding of the entire data set, data related to defining well-being was analyzed using phenomenology in a qualitative secondary data analysis. Results include two central domains that organize findings about the essence of well-being in child welfare: (1) a practice approach for professionals and (2) the lived experience of well-being for children. Across both domains were shared clusters of meaning identified as humanization, fulfilling connections with a responsive adult, and a long-term, hopeful future orientation. The article concludes with discussion of implications for practice, policy and future research, particularly the role of this new understanding in improving child well-being.

Mental well-being among children in foster care: The role of supportive adults

ObjectivesFew studies have examined predictors of positive development among children currently in foster care. We examined associations between perceived support from adults in three developmental contexts (home, school and neighbourhood) and mental well-being (life satisfaction, self-concept, optimism) among grade four children living with foster parents in British Columbia (B.C.), Canada. MethodsThe sample was comprised of children who completed the Middle Years Development Instrument (MDI) in B.C. schools between 2011 and 2016 and who reported living with a foster parent (N = 211). Hierarchical linear regression analysis was used to examine individual and joint associations between adult support variables and mental well-being indicators, controlling for gender, age and ESL status. ResultsResults showed that perceived support from adults at home and school were both individually, positively associated with all three well-being indicators, while perceived support from adults in the neighbourhood was not individually associated with any mental well-being indicators. ConclusionThis study indicated that perceived support from adults at home and school are individually associated with mental well-being among children in foster care during middle childhood. Policy aimed at improving the well-being of children in care should be considered for both in child welfare and school systems.

Parental availability of support and frequency of contact: The reports of youth in educational residential care

Social work policies emphasize the importance of encouraging parent-child contact to enhance the well-being of children in care. However, there is little research on the frequency and quality of contact between adolescents in residential care settings (RCSs) and their mothers and fathers. Research based on the self-reports of youth in RCSs is also limited. This study was based on a random cluster sample of 1409 youth, aged 13 to 20, in Israeli educational RCSs designed for youth from underprivileged backgrounds. It examined the youths' self-reports of the perceived availability of support from their mothers and fathers and their in-person and phone contact with them. A range of correlates and the moderating role of marital status in the link between gender and contact were examined. Adolescents completed a structured questionnaire. Multivariate regression models with a moderation effect between gender and family status were used to test the correlates of contact. Overall, adolescents reported more perceived support and more frequent contact with mothers, though fathers were perceived to be involved fairly highly in their lives. Adolescents from divorced-parent families and those whose parents lived farther away from the RCS reported less frequent and supportive contact. Boys reported more parental support. Parents' education was linked positively with most measures of contact. Overall, immigrant adolescents reported less frequent contact. Among youth from divorced-parent families, boys reported significantly higher levels of support and phone contact with fathers, but among adolescents from intact families, the gender gap was insignificant. Identifying groups of youth at risk for poorer contact with parents has implications for pre-placement decisions and for designing interventions to enhance child-parent contact while in care.

A Study on the Family Reunion Experience of Adults Discharged from Childcare Welfare Facilities - Grounded Theory Approach -

A Study on the Family Reunion Experience of Adults Discharged from Childcare Welfare Facilities - Grounded Theory Approach -

Barriers to childcare in Children's Homes in Ghana: Caregivers' solutions

The care of children in need of alternative care is a matter of concern to government, nongovernmental organisations and international communities. Understanding the barriers to childcare and knowing the measures to overcome them are important in ensuring the safety and wellbeing of children in alternative care. Few studies exist on caregivers' suggestions of solutions to overcome barriers to childcare in Children's Homes in Ghana. Drawing on in-depth semi-structured interviews with 37 caregivers in two Children's Homes in Ghana, this study sought to explore caregivers' suggestions of solutions to barriers in childcare. This study adopted a phenomenological approach, reporting findings in participants' own words. The study findings revealed ensuring gender balance, the need for staff and interdisciplinary teams, and financially motivating caregivers as measures to overcome barriers in childcare. Professionals working with children in alternative care and policymakers should pay attention to these solutions to ensure the safety and wellbeing of children in care.

Psychotropic Medications for Youth in Child Welfare: Developing and Pilot-Testing A Field Guide for Team Decision-Making

ABSTRACTHigh rates of children involved with the child welfare system are prescribed psychotropics. In response, federal legislation has mandated state child welfare agencies to develop policies to improve the coordination and oversight around the use of psychotropics. This project aimed to support such policies by developing and pilot-testing a field guide for team discussions and decision-making related to the use of psychotropics among youth in child welfare. We used a community-based participatory research (CBPR) framework to engage a team of local stakeholders, including former youth in foster care and parents, in the research. We developed a field guide to facilitate team discussions and decisions around the individual needs and preferences of youth and families, and we pilot-tested the field guide with child welfare staff, parents, and care team members in seven team meetings. Parents and care team members, in particular, highly valued the guide and found it useful to increase knowledge and improve practices such as side effect monitoring and information sharing. Child welfare responses were more mixed, and some reported feeling burdened by the additional tasks. More work is needed to integrate the guide into routine child welfare practice and reduce burden on staff.