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Gathering PACE 2017

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Gathering PACE 2017

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Gathering PACE 2017

  1. 1. Gathering PACE 2017 16 November The Lighthouse, Glasgow #GatheringPACE
  2. 2. Welcome and introduction Professor Jennifer Davidson Executive Director Inspiring Children’s Futures #GatheringPACE
  3. 3. Address by the Minister MareeTodd MSP Minister forChildcare and EarlyYears #GatheringPACE
  4. 4. Setting the scene Jason Leitch National Clinical Director (Healthcare, Quality and Strategy) Scottish Government #GatheringPACE
  5. 5. Nina Biehal Department of Social Policy and Social Work University of York nina.biehal@york.ac.uk
  6. 6.  What do we mean by permanence for children accommodated away from home?  Need to consider both  Objective permanence • Physical and legal stability  Subjective permanence • Involves child’s emotional security and sense of belonging • ‘Perception of permanence is key’ (Lahti 1982) • Do children and caregivers both view the placement as permanent? 6
  7. 7. A definition from English government guidance ‘Permanence is the framework of emotional permanence (attachment), physical permanence (stability) and legal permanence (the carer has parental responsibility for the child) which gives a child a sense of security, continuity , commitment and identity. The objective of planning for permanence is therefore to ensure that children have a secure, stable and loving family to support them through childhood and beyond. (My italics) Children Act 1989 Guidance and Regulations: Care Planning, Placement and Case Review (2010) 7
  8. 8. 1. Findings from University of York study Belonging and Permanence: compared children in foster care (including kinship foster care) those adopted  Compared objective permanence  Compared mental health and educational progress of children on different pathways  Explored subjective perceptions of permanence for children in long-term foster care 2. Will briefly introduce our ongoing Permanently Progressing? study in Scotland 8
  9. 9. Belonging and Permanence study (2010)  In 2001 we identified 196 children who had been  in same foster placement for 3+ years or  adopted from care  By 5 year follow-up (2006) there were 3 groups  39% adopted from care  32% in stable foster care (in same placement 7-12 years) • 1/3 of these were in kinship foster placements  23% experienced unstable care (1 or more moves since previously stable placement)  Methods  Postal surveys of children’s social workers and foster carers or adoptive parents  Focus groups with social workers, team managers, adoptive parents and foster carers 9
  10. 10.  Higher disruption rate for foster placements, even for apparently stable placements  28% of the previously stable foster placements disrupted  11% of children placed for adoption/adopted  Other studies have found  High disruption rates for foster care: 17-50% (depending on age at placement and other factors)  Very low disruption rates for adoption (Selwyn et al 2012) • 3.2% of 37,335 adoptions disrupted over 12 years • Disruption mainly occurred in adolescence • Varied a lot by local authority 10
  11. 11. Children accommodated at a younger age were more likely to be adopted  Age when last entered care (Belonging and Permanence study)  Adopted 1.6 years  Stable foster care 3.8 years  Unstable care 4.9 years  Late admission reduced children’s chance of adoption  59% children adopted by strangers entered care before age 1  But fewer children adopted by carers entered before age 1  Late admission increased the risk of placement instability 11
  12. 12. Mix of child, foster carer and agency factors (B & P study) The child  Later admission to care - longer exposure to abuse, neglect, other adversities at home may have impact on emotional & behavioural development  Child may be more difficult to care for if enters care when older The foster carer  Circumstances changed – some gave up fostering due marriage breakdown, bereavement, domestic violence  Lack of legal permanence - no legal commitment to child when carers’ circumstances changed The local authority  Response to emerging placement difficulties?  Support to placement? 12
  13. 13.  Used a standardised measure of emotional and behavioural difficulties (SDQ) to compare mental health of the 3 groups  completed by adoptive parent or foster carer  Scoring above clinically significant threshold no different for children adopted or in stable foster placements  Stable foster care 36%  Adopted 35%  Unstable care 54%  General population 10%  ‘Unstable’ group at higher risk of mental health difficulties  At least 50% of disruptions triggered by behaviour problems  Impact of delay on mental health: those who entered placement after age 4 had higher scores on SDQ 13
  14. 14. 14  Scores from 5 years earlier were available for 82 children  Those whose index placements subsequently broke down (unstable group) already had higher SDQ scores beforehand  No significant change in scores over past 5 years  Lack of change suggests emotional and behavioural difficulties are strongly influenced by pre-care adversity  Unstable care group entered care much later  Had longer exposure to adversity • Other studies show that this reduces ability to recover from impact of abuse and neglect 14
  15. 15. 15  Measured carers’ and adopters’ parenting style  Measures of child orientation, family integration, rejection (completed by foster carers/adoptive parents)  Ratings of parenting (social workers)  Foster carer scores for family integration/rejection correlated with social worker ratings of parenting  Children with higher SDQ scores less likely to be perceived as integrated into the foster family (by carers)  Rejection scores for previous carers of unstable group (in 2001) higher if children had high SDQ scores then (i.e. before last placement disrupted) 15
  16. 16. 16 Interaction of child disturbance and parenting style  Behavioural and attachment difficulties can make child more difficult to care for  May elicit carer rejection  Can lead to downward spiral: rejection or lack of warmth/responsiveness to child may reinforce emotional and behavioural difficulties  Carer commitment to the child was key 16
  17. 17. Combined measure of school progress, attendance, exclusion and behaviour showed:  Better overall integration and progress for children in permanent placements  Stable foster care as well as adoption  Unstable care group doing worse on overall measure  More likely to be excluded or truant in last 6 months  Children likely to be doing worse if they  Had high scores on SDQ (esp. if high for hyperactivity)  Were disabled 17
  18. 18.  Other comparative studies at York have highlighted risk of impermanence in foster care and also its potential  Study of 595 children in foster care found impermanence sometimes due to repeated attempts to return child home even when not in their best interests (Sinclair et al 2005)  Study of 149 children accommodated due to abuse/neglect, and either reunified with parents or remained in foster care  2/3 reunified children returned to care 1, 2 or more times, foster care group was more settled  Outcomes more positive for those who remained in foster care  Children in foster care were more likely to have positive wellbeing and less likely to be involved in crime or substance misuse than those reunified with families (Wade et al 2011; Biehal et al 2014). 18
  19. 19. 19 Subjective permanence was important too  Interviewed 37 children in Belonging and Permanence study and their foster carers or adoptive parents  Used a range of methods to explore  Relationships with adoptive and foster families  Relationships with birth parents  Perceptions of permanence – a family for life?  Child’s sense of belonging  Some findings in relation to children in stable foster placements………………
  20. 20. 20  Ideas about ‘family’ and ‘belonging’ were complex and could shift over time  Some children were preoccupied with birth parents  ½ of stable foster care group, ¾ of unstable care group  A key factor in sense of belonging was how child located the foster family in relation to the birth family  Feelings of hurt, anger, ambivalence about parents sometimes linked to ambivalence towards carers  ‘Chemistry’ between child and carer and carer’s love/ commitment to child despite difficulties were also key  also found in fostering studies by Ian Sinclair, Gill Schofield, and Mary Dozier
  21. 21. 21  Some parents physically present (in contact), but unreliable or rejecting, so their psychological presence was troubling  How far can fostered children mentally process their experience and knowledge of parents?  How does their ‘story’ explaining parents’ past and current actions represent their parents - and themselves – to them?  How far can they resolve complicated feelings about parents who have harmed or rejected them, and settle for permanence in another family?  Can they find a way to identify with and ‘belong’ to both families?
  22. 22. 22  Children who felt they ‘belonged’ to the foster family and thought it would be a ‘family for life:  Could reconcile belonging to two families OR  Were physically and/or emotionally distanced from parents  Contact with parents relatively unproblematic (or no contact)  Where negotiating the boundaries between the two families was difficult for children:  They were often ambivalent about parents and/or  Pre-occupied with unreliable, rejecting or dangerous parents  More difficult for these children to identify with foster family and feel emotionally secure  Were more troubled about where they belonged
  23. 23.  Foster care can provide stability, but often fails to do so  For 1/3 of children, placements broke down even after 3 years  But where foster care is stable  chance of positive outcomes similar for fostering & adoption  Need to avoid delay in admission and permanent placement  Late admission to accommodation may mean lengthy exposure to abuse/neglect other adversities  increases risk of placement instability and poor mental health  reduces chance of adoption  High levels of need for many fostered and adopted children  continuing support needed to ensure stability and child wellbeing  Important to help children in long-term foster placements make sense of their location between two families  support their sense of belonging to their foster families (as well as to their birth families). 23
  24. 24.  A collaboration between University of Stirling (Dr Helen Whincup and others), University of York and AFAS (Dr Margaret Grant)  Builds on Belonging and Permanence study, but in Scottish context  Investigating decision-making, permanence, progress, outcomes and belonging for children in Scotland placed permanently away from their birth parents  October 2014 – October 2018 24
  25. 25. Following up large sample of children who were under 5 years old when accommodated (during the year 2012-13)  Pathways study: pathways over 4 years for all 1,836 children under 5 who became accommodated or looked after at home in 2012-13  Analysis of data from CLAS and SCRA (all local authorities)  Outcomes study: Histories, decision-making and outcomes for 416 adopted or fostered children, 3-4 years after accommodated  surveys of social workers and foster carers/adoptive parents (19 local authorities)  Qualitative study of children in 16 adoptive or foster families  Interviews with adopters, foster carers and some children  Policy and decision-making study  Interviews and focus groups with children’s and family placement SWs, CHS panel chairs/members and others (9 authorities) 25
  26. 26.  Findings will be presented at conference in Stirling on September 19th 2018  Please join us! 26
  27. 27. Nina Biehal, Sarah Ellison, Claire Baker and Ian Sinclair (2010) Belonging and Permanence. Outcomes in Long-term Foster Care and Adoption. London: BAAF. Nina Biehal (2014) A sense of belonging: meanings of family and home in long-term foster care, British Journal of Social Work, 44, pp. 955-971. Nina Biehal, Ian Sinclair and Jim Wade (2014) Reunifying abused or neglected children: decision-making and outcomes, Child Abuse and Neglect, 49, pp.107-118 Jim Wade, Nina Biehal, Nicola Farrelly and Ian Sinclair (2011) Caring for Abused and Neglected Children. Making the right decisions for reunification or long-term care, London: Jessica Kingsley Publishers Ian Sinclair, Claire Baker, Kate Wilson & Ian Gibbs (2005) Foster Children. Where They Go and How They Get On. London: JKP. 27
  28. 28. Poster session Make your way to the poster number on your badge. Once the presentation is finished, move in a clockwise direction to the next poster. #GatheringPACE
  29. 29. The legislative landscape Donald Henderson Head of Care, Protection and Justice Scottish Government #GatheringPACE
  30. 30. Reflections on morning Michael Chalmers Director of Children and Families Scottish Government #GatheringPACE
  31. 31. Round table discussion 1. What do you think is working well with PACE? 2. What would be even better if… ? #GatheringPACE
  32. 32. Poster session #GatheringPACE Poster session Make your way to the next poster from the last session. Once the presentation is finished, move in a clockwise direction to the next poster.
  33. 33. Round table discussion 1. What do you think is working well, in meaningfully involving children and their families – or carers – in providing services in your area of work? 2. What would be even better if… ? #GatheringPACE
  34. 34. Closing comments Michael Chalmers Director of Children and Families Scottish Government #GatheringPACE