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  1. 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

  2. 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

  3. 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)

  4. WHAT IS SUCCESS: LT OUTCOMES • Positive outcomes and adaptive adulthoodeg • 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

  5. 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?

  6. 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!

  7. 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”

  8. 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 someambivalence / 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

  9. 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)

  10. 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

  11. 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.

  12. ... 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)

  13. 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)

  14. 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, 1996Wards Leaving Care Study

  15. 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

  16. 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

  17. Figure 7.3Mean 'resilience' scores by source of 'felt' security Figure 7.3 Mean 'resilience' scores by source of 'felt' security

  18. 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

  19. 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 relationship-based practice? (Tilbury, 2008)

  20. 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

  21. 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