Young People In Residential Care Research Articles

Placement Instability Among Young People Removed from Their Original Family and the Likely Mental Health Implications.

BackgroundYoung people in out-of-home care are more likely to experience poorer mental and physical health outcomes related to their peers. Stable care environments are essential for ameliorating impacts of disruptive early childhood experiences, including exposure to psychological trauma, abuse and neglect. At present there are very few high quality data regarding the placement stability history of young people in out-of-home care in Australia or other countries.ObjectivesTo undertake the first systematic census of background, care type and placement stability characteristics of young people living in the out-of-home care sector in Australia.MethodsData was collected from four non-government child and adolescent community service organisations located across metropolitan Melbourne in 2014. The sample comprised 322 young people (females 52.8%), aged between 12 – 17 years (mean age=14.86 [SD=1.63] years).ResultsMost young people (64.3%) were in home-based care settings (i.e., foster care, therapeutic foster care, adolescent care program, kinship care, and lead tenant care), relative to residential care (35.7%). However, the proportion in residential care is very high in this age group when compared with all children in out-of-home care (5%). Mean age of first removal was 9 years (SD=4.54). No gender differences were observed for care type characteristics. Three quarters of the sample (76.9%) had a lifetime history of more than one placement in the out-of-home care system, with more than a third (36.5%) having experienced ≥5 lifetime placements. Relative to home-based care, young people in residential care experienced significantly greater placement instability (χ2=63.018, p<0.001).ConclusionsPlacement instability is common in the out-of-home care sector. Given stable care environments are required to ameliorate psychological trauma and health impacts associated with childhood maltreatment, well-designed intervention-based research is required to enable greater placement stability, including strengthening the therapeutic capacities of out-of-home carers of young people.

The characteristics of children and young people in residential care in Wales

ABSTRACTCare for children in residential settings is popularly characterised as the last resort for children who have had multiple failed placements and often high levels of need, requiring therapeutic help. It is often assumed that children will leave residential care for independent living. Using administrative data for a six-year period (2008–2014) for children “looked after” in Wales, univariate and bivariate analyses were conducted to provide a characteristic profile of the residential child care population. Of those placed in a residential setting, the vast majority of children were voluntarily placed and the most common reason for leaving residential care was going home. A similar number of children left residential care to move back to a family setting as entered residential care from a family setting, which challenges the assumption of residential care as necessarily the final destination in a troubled care history. The fact that large numbers of children are placed voluntarily in residential care might suggest some potential for preventing some of these placements and keeping children at home with support. Appropriate measures are needed to support children returning from residential care to live with birth families, as well as support for independent living.

A Qualitative Exploration of Coordinators' and Carers' Perceptions of the Healthy Eating, Active Living (HEAL) Programme in Residential Care

Internationally, there are few studies that have trialled structured intervention programmes designed to prevent excessive weight gain or combat existing overweight/obesity for young people living in out‐of‐home care. The Healthy Eating, Active Living (HEAL) programme was designed to address this limitation and is, to our knowledge, the first programme that simultaneously encourages young people and their carers to engage in a healthy lifestyle. This is the second of two papers presenting the HEAL evaluation. The aim of this study was twofold: first, to explore the experiences and opinions of key stakeholders regarding the intervention programme; and second, to understand the key enablers and barriers to successful implementation of the HEAL programme in residential care. Seventeen carers and ten programme coordinators participated in semi‐structured interviews. Findings demonstrated that HEAL was considered a valuable adjunct to the residential care programme, and was successful in raising awareness about the importance of leading a healthy lifestyle. Positive behaviour change among the young people and carers' dietary, physical activity and sleeping habits, and the development of independent living skills were described. Barriers to implementation included leadership support and professional development of carers. Recommendations are made to improve implementation, particularly around the importance of increasing stakeholder ‘buy‐in’. Copyright © 2017 John Wiley &amp; Sons, Ltd.Key Practitioner Messages There is a need to address the lifestyle habits of young people in residential care. Raising awareness is an important first step, but must be supplemented with supportive environmental change to enable lasting, healthy outcomes. Carer capabilities need to be strengthened so that they can effectively manage challenging behaviours, yet still address the lifestyle habits of young people in care. Stakeholder ‘buy‐in’ and a programme champion are critical to implementation of healthy lifestyle programmes in residential care. ‘The first programme that simultaneously encourages young people and their carers to engage in a healthy lifestyle’

Conceções de aprendizagem de adolescentes em acolhimento residencial

The current study focused on the analysis of learning conceptions of 3rd cycle students in residential care. Literature indicates that learning conceptions are expressed and materialized in different learning situations, leading to the achievement of qualitatively different learning outcomes. The available data on the school situation of children and young people in care have been identifying various school fragilities. Fifty-five adolescents who lived in residential care institutions in Porto and Braga participated in this study. Semi-structured interviews were conducted, with a script focused on the various questions about learning (Gracio, 2002). School performance of the participants was also collected, which proved to be mostly consistent with a situation of school failure. Results point to an identification of learning conceptions, mainly of the reproductive type. We also perceive that these young people conceptualise learning as a means to achieve a better future, in which one learns from others and from mistakes. Data reinforce the relevance of the active role of students in their learning and of the development of studies in the domain of education of young people in residential care.

Children and young people’s right to participate in residential care in South Africa

ABSTRACTThe South African Children’s Act accords the right to participate in all matters to every child of sufficient maturity. This article examines the Guidelines for the Alternative Care of Children to analyse the extent of the right in residential care and the degree that this right is realised in South Africa. South Africa’s laws and policies include detailed commitments to ensure that children and young people participate in professional assessments; judicial procedures; decisions about daily care and the governance of residential facilities. However, even the most perfectly crafted legal framework is no guarantee of the fulfilment of rights, therefore, it is critical to assess practice and outcomes.The government of South Africa routinely collects administrative data on the number of children and young people in residential care but no data that measure participation or even the statutory decision-making processes. The only information available comes from two cross-sectional studies of child and youth care centres (residential facilities). A review of the results suggests that the critical decision-making processes are not happening, and consequently children and young people lack opportunities to comment on their care or influence what happens to them. The article concludes that the state needs to train professionals on children’s rights and the Children’s Act and include protection and participation indicators as part of monitoring instruments. Monitoring will not be sufficient to create the conditions for participation to happen; however, it will begin to shed light on where efforts need to be increased.

To be or not to be a rights holder: Direct and indirect effects of perceived rights on psychological adjustment through group identification in care

This study explores how young people in residential care perceive their rights and the relationship with their adjustment, through the role of group identification. Data from a non-random sample of young people (N=356; aged 11–18years) in Portuguese residential settings was analysed and a set of mediation effects was found. Findings revealed a set of mediation effects on the relationship between Participation and Protection and Positive Self and between Respectful system practices and behaviours and Emotional Distress, Anger Control and Antisocial Behaviour. Higher scores of these rights perceptions were associated with lower psychological problems, through the indirect effect of group identification (i.e., the sense of belonging to the group in residential care). These findings are discussed based on social and developmental insights together with empirical evidence on residential care. These results provided important practical implications in residential care, namely, assuring the young people's participation, the promotion of professional practices based on the respect for young people and their families, non-discriminatory behaviours and equal opportunities.

Adolescent Attachment Style in Residential Care: The Attachment Style Interview and Vulnerable Attachment Style Questionnaire

Attachment frameworks are increasingly used to understand human development and used by social workers in care planning for children and young people in care. To date, there have been few assessment tools that social workers can use easily and therefore little sustained use of attachment assessment by practitioners in residential care. This paper describes the use of the Attachment Style Interview (ASI) for adolescents and the Vulnerable Attachment Style Questionnaire (VASQ) self-report in a pilot study of young people in residential care in the UK and Isle of Man. The aim was to test these relatively new measures in practice contexts administered by practitioners, and to determine rates of insecure and disorganised attachment style to compare with other studies. Results show around half of the young people had disorganised (or mixed) attachment styles using either measure, with avoidant attachment styles more common than anxious ones. Secure style was rare. There was some difference in young person and carer ratings, with young people rating slightly less disorganised style and more anxious style, but simplified classifications were similar. The implications for assessing attachment style in residential care to improve identification of interpersonal risk and aid with care planning are discussed.

Young People in Residential Care, their Participation and the Influencing Factors

ABSTRACTIn 1992, Ireland committed to the right of children to participate in decision-making that impacts on their lives. The extent to which this right is upheld for young people in the care of the State who live in residential childcare centres is unknown. A small qualitative case study was carried out in four such centres in the West of Ireland in 2012 which aimed to establish young people's level of participation and the factors which influence it. The findings show that they were relatively satisfied with decision-making in everyday matters though this was fraught with difficulties because of control battles. They had limited involvement in decisions about admission to residential care and the process of admission, family access, education/training and their future plans. These young people were unfamiliar with their right to participate and the majority of social care workers in the study had not received training on participation. Factors were identified as enabling participation or creating obstacles to it. They include the value placed on the voice of the child, the capacity of young people to participate, their access to effective advocates and the nature of the available participatory spaces. The knowledge, skills, values and personalities of relevant professionals were key determinants of youth participation.

Governance of the table: Regulation of food and eating practices in residential care for young people

Abstract This paper explores how food and eating practices are governed in residential care for young people and who or what governs the table in residential care centres. The governance of everyday food and eating practices in residential care is multifaceted and conducted on multiple levels by external and internal authority and regulation. This paper draws on Coveney’s 2008 theory on ‘the government of the table’ that builds on the Foucauldian perspective of governmentality to explore the interplay between internal and external regulation, which in turn highlights the tensions between institutional and homely aspects of residential care. The approach taken involves an exploratory, sequential mixed-methods design of focused ethnography in five centres, a survey of ninety-two social care practitioners working in the field and a review of Health Information and Quality Authority inspection reports.

Do sibling relationships protect adolescents in residential care and traditional families from developing psychopathologies?

ABSTRACTThe transition of young people to residential care is caused, usually, by the need for removal from a dysfunctional environment, which can poten tially disrupt their healthy development and put them at a higher risk. Sibling relationships have been identified as critical to adapting to the developmental process. The present study analyzes whether sibling relationship quality can protect from the development of certain psychopathologies among adolescents from traditional families, as well as institutionalized adolescents. We also intend to analyze the differences in sibling relationship quality and psychopathological symptoms, according to the adolescents' family structure, gender and age. The sample consisted of 387 adolescents, 215 from traditional families and 172 in residential care, aged from 12 to 18 years old. The results show that siblings can play an important role in the prevention of psychopathological symptoms. Young people in residential care appear to have higher psychopathological symptoms; nevertheless, they also present higher levels of pro-social behaviors with siblings.

Identification and treatment of tobacco dependence among young people in residential homes during the statutory annual health assessment: a retrospective case-note review

BackgroundRates of tobacco smoking are substantially higher among young people accommodated in residential homes than in the general youth population. Public health guidance from the National Institute for Health and Care Excellence (NICE) recommends that all smokers should be identified, advised to quit, and offered treatment for tobacco dependence during health-care consultations. Opportunities to address tobacco dependence are available for young people in residential care through the annual statutory health review assessment (HRA). However, little is known about the extent to which HRA is used to address tobacco dependence among this population. We aimed to assess smoking-related recording and clinical practice during the HRA. MethodsA retrospective review of the statutory health assessment forms of all young people accommodated in residential homes by an English local authority in the East Midlands between June 1, 2013, and May 31, 2014, was conducted. Practice was assessed with standards developed from statutory and NICE guidance relating the recording of smoking-related information during annual health assessments. Descriptive statistics were used to summarise the characteristics of the young people and the level of smoking-related recording. Associations between categorical variables were analysed with χ2 tests, and one-way ANOVA was used to assess continuous data. Ethics approval was provided by the Families, Young People & Children Clinical Audit, Standards, Effectiveness and Research Group of Leicestershire Partnership NHS Foundation Trust, and data were accessed under Section 251 of the NHS Act. Findings31 young people were included in the review, of whom 30 (97%) had completed a statutory HRA. Inquiries about smoking were made in 23 (77%) instances. 12 (52%) of those who had participated in the HRA and who were asked about smoking were identified as smokers. Nine (75%) of these smokers engaged in discussions about their smoking and were offered treatment for tobacco dependence: two (22%) accepted a referral for treatment. The reasons for declining support for smoking cessation were documented in two (17%) cases. InterpretationOpportunities to address tobacco dependence among young people in residential homes are being missed during the HRA. Further research should explore clinician practice and attitudes to addressing tobacco dependence during the HRA and the perceptions of these young people in relation to receiving smoking cessation advice and the treatment offered. FundingThis study was funded by a UK Centre for Tobacco and Alcohol Studies PhD studentship.

Estudar e aprender em instituições de acolhimento: o papel de variáveis individuais e contextuais

The recent literature has pointed out the existence of fragilities, in the school and learning dimensions, in children and young people in residential care. The current study aimed to analyse and understand the processes of studying and learning in institutions, of 2nd and 3rd cycle and secondary students, examining the role of individual and contextual variables on self-regulated learning processes. The sample included 248 children and young people living in 20 residential care settings from the north of Portugal. The instruments were the following: a personal and academic data instrument, the Inventory of Self-Regulated Learning Processes (Rosario et al., 2010), and an instrument of characterization of the institution. Results showed significant differences in the self-regulated learning, according to gender and grade retention, also emphasizing the importance of self-efficacy, value of learning, and educational aspirations. The study site and study time, as well as the reported difficulties in studying, were relevant in the self-regulated learning processes. The size of the institution did not assume relevance. Implications of these results in promoting better education and learning in residential care contexts are discussed.

Review: Residential Child Care

Young people in residential care are often the most vulnerable amongst the already very vulnerable group of 'looked after children.' There has been a significant policy focus on the needs of looked after children in recent years including reforms to the Hearings system, changes to child protection guidance, strategies for foster and kinship care and, more broadly, the gradual establishment of the Getting it Right for Every Child approach to children's services. The Scottish Parliament's Education and Culture Committee is currently on its second inquiry this session in this area. There has been a considerable amount of activity often linked to the broader policy theme of early intervention and preventative spend. While there has been substantial policy work done on residential childcare (in particular the National Residential Childcare Initiative) it has not had the same level of attention as has foster and kinship care. Partly this reflects the fact that relatively few children are in residential care, but it also reflects a preference for care in a family setting where possible. This book is therefore a useful reminder of the place of the diverse types of residential care within the range of placements for looked after children and a plea for a more strategic, positive approach to its use.

Seeking to prevent residential care for young people with intellectual disabilities and challenging behaviour: examples and early outcomes from the Ealing ITSBS

Purpose – The purpose of this paper is to present early outcomes and case examples from the Ealing Intensive Therapeutic and Short Break Service. Design/methodology/approach – The service was piloted over a period of 3.5 years during which clinical data were collected for young people at risk of a move to residential care. Findings – There were positive outcomes for young people with intellectual disabilities and challenging behaviour who were seen through the service with residential placements prevented in the vast majority of cases. Originality/value – These early outcomes highlight the importance of providing intensive therapeutic intervention with short breaks in order to prevent family placement breakdown.

Learning basic employability competence: a challenge for the active labour insertion of adolescents in residential care in their transition to adulthood

The teaching of basic employability competence from a very early age is of preventive value in the transition of young people in residential care to adulthood. The present research relates employability competence (finding and holding down a job and gaining promotion in the labour market) with positive career outcomes and employment opportunities. In this study, conceptual methods for understanding employability are analysed and some existing international studies of employability skills are reviewed, although all of these are deemed partial approaches to the needs of children and young people in residential care. Our proposal, the IARS (Infancia y Adolescencia en Riesgo Social [Children and Young People at Social Risk]) Employability Competence Framework, developed by means of a collaborative and integrated approach with experts, provides a complete picture of how employability competences are important for preparing young people in residential care not only for active labour insertion but also in terms of their comprehensive development. A selection of a cluster of eight employability competences (self-organisation, decision-making and problem-solving, teamwork, communication, perseverance, professional project development, flexibility and responsibility) and their components are presented, as well as its educational implications within children's homes.

Investigating the Scale of the Problem of Children in Residential Care in the UK Being Exploited by External Agents for Sexual Purposes

This research is an exploratory study of the potential problem of children and young people in residential care being groomed and sexually exploited and abused by people from outside care without the involvement of care staff. A postal questionnaire was sent to all Chairs of English Local Safeguarding Children‟s Boards (LSCBs). 38 responses were received, covering a range of types of local areas. 40% of respondents reported cases of this problem, 9.4% in relation to asylum seeking children. 17.1% recorded more than 15 cases in the previous 2 years. Respondents were split almost equally with regard to whether the current law was adequate to deal with this problem or not. Only 3% of LSCB areas felt this was a declining problem. LSCBs felt that the most available existing resource to deal with the problem was professional knowledge, and the least was available physical resources. Given the size of the sample caution needs to be exercised in generalising from these results, but it seems that further investigation of this area would be helpful to aid the development and improvement of child protection services.

The “Key” to Successful Transitions for Young People Leaving Residential Child Care: The Role of the Keyworker

In the absence of mandatory planning and support to assist all young people who leave care in Ireland, after-care provision is a “neglected” area of service provision and has been criticised for being inconsistent and ad hoc. The benefits of keyworker support for young people making the transition out of care is more clearly articulated within the literature and across policy statements and is firmly embedded as a model of good practice in working with young people in residential care. The study reported here sets out to conduct an in-depth exploration of the concept of keyworking. This is achieved by engaging young care-leavers, residential care providers and after-care support workers in qualitative interviews. By asking young people and care providers about their experiences of keyworking, it attempts to drill down into both the benefits and possible downsides of this practice model. The findings and discussion presented here are based on the pilot stage of this study, and although the findings can only be regarded as tentative in nature some important issues have emerged from the pilot stage as reported here.

Identifying speech, language and communication needs among children and young people in residential care

There are claims that elevated levels of speech, language and communication needs (SLCN) exist among looked-after children and young people, and that their needs remain largely undetected and unmet. Scarce empirical evidence exists to support these assertions. To investigate whether elevated levels of communication impairment exist among children and young people in residential care; to begin to explore the nature of any communication impairment indicated, including social and pragmatic difficulties; to consider the extent to which communication impairment may be undetected and unmet; and to consider the suitability of the Children's Communication Checklist 2 (CCC-2) as a screening tool in this context. In four local authority areas in Scotland residential care workers completed the CCC-2 on children and young people well known to them, and provided information about previous concerns and/or referrals regarding communication. Results are presented for 30 children and young people ranging in age from 11;01 to 17;01 years (133-205 months, mean = 172.57, SD = 19.97 months). CCC-2 scores indicated impairment in 19 out of 30 cases. In eight of those 19 cases profiles were suggestive of autistic spectrum disorder (ASD), while for the remaining eleven cases impairment was indicated in other aspects of speech, language or communication. The general trend was towards greater severity of impairment in both ASD and non-ASD profiles. Information regarding previous concerns and/or referrals was available for ten of the 19 cases whose profiles indicated impairment: in nine out of these ten cases there had been no concerns, and in the final case no referrals had been made despite concerns. This study indicates the presence of high levels of SLCN among individuals in residential care, much of it severe and pervasive in nature, and in large part unsuspected. The CCC-2 has the potential for use as a screening tool for this population. There is a compelling case for speech and language therapy services to address issues of awareness and access with regard to this population. This preliminary research supports the need for further investigation on a larger and wider scale.

Victim or troublemaker? Young people in residential care

Young people who live in residential care are caught between discourses of being a victim of abuse and inadequate care or being a troublemaker by their own conduct. Both discourses are rooted in the reasons for placement, and they will offer subject positions that are experienced as troubled. Repeated interviews with young people living in residential care provided by child protection services demonstrate how the youths position themselves within such prevailing discourses and negotiate social claims and expectations of appropriate development. While some try to normalise their problematic behaviour and thereby reject being a troublemaker, others insist that they are victimised as a result of the placement and thus displace the cause of their troubles. The study shows that, in this negotiation of possible subjectivities, some youths manage to take advantage of the placement in surprising ways, while others get blocked in their own developmental efforts.

Special Protection: Article 20, Special Protection and Children's Rights Training in the Developing World?

AbstractArticle 20 of the UNCRC entitles young people in residential care to 'special protection.' This presents a challenge to States Parties concerned with how such protection can be achieved. It is suggested that one way to do this is through the establishment and delivery of meaningful training in children's rights. This paper describes the authors' experience of delivering a training programme on children's rights for staff working in Social Protection Centres in Vietnam. It provides a critical reflection on the broad emphasis of current children's rights training in the developing world and argues for more targeted research in this area.