abstract: Youth who turn 18 in the foster care system often face the difficulty of transitioning to adulthood without traditional emotional and financial supports. Early experiences of trauma impact their mental health and receipt of services both while in care as well as decisions whether to continue services after leaving care. Using the behavior analytic model, this dissertation explores the challenging and supportive situations former foster youth experience with mental health services while transitioning to adulthood. Qualitative interviews and focus groups inform the development of a quantitative instrument in a mixed methods, sequential exploratory research design. The resulting instrument identifies the most intense and frequently encountered situations former foster youth experience, related to their mental health and transitions to adulthood. Results indicate the most challenging situations foster youth experience during the transition are related to overwhelming expectations, receiving mixed messages from professionals, feelings of isolation, and a lack of voice and choice with regard to mental health services. Young adults in this study also emphasized the importance of responsive engagement, self-efficacy, and consistency in relationships both formally and informally. This research provides important implications for social work practice, policy, and education. Acknowledging the voice of foster youth gives them a choice in services and allows for realistic transition planning. Developing problem-solving skills and a support network beyond foster care are necessary strategies of preparation to age out. Finally, practitioners should recognize the impact of trauma and other contextual factors when conducting assessment and treatment, to promote positive outcomes. / Dissertation/Thesis / Doctoral Dissertation Social Work 2015

Problem. Approximately 400 000 children are in the year 2018 living in foster care in South Africa. Many of these children have wounds from neglect and abuse from their original family. Even though foster care is intended to be a safe haven many of the children instead end up drifting from one foster home to another, waiting to be placed in a permanent family. Because of the deficiencies in foster care it is of importance to investigate the social workers’ views of a suitable family, since we believe this will affect the assessment, which in the end will affect the child. This thesis explores what conceptions social workers at a child protection organization in South Africa have of a suitable family for vulnerable children. Method. We interviewed seven social workers at mentioned organization, working with formal foster care and reunification with parents or relatives. We use theme analysis to process our findings which we thereafter analyze using Maslow’s hierarchy of needs. Result. Our findings reveal that the emotional needs of the child are considered most important by the social workers, followed by the physiological needs. Criminal behavior and poor values and morals are thought to make a family unsuitable. Conclusion.  We found that there are some differences in the social workers’ conception of a suitable family for vulnerable children, although they all underlined the same factors as most important. They also state that these children are thought to have the same needs as any other child; it all comes down to what they consider is the best interest of the child. Regardless which values the individual social worker has, what they look for in every family is that the child will feel safe and loved. / Problem. Cirka 400 000 barn lever i fostervård i Sydafrika år 2018. Många av dessa barn är påverkade av den försummelse och våld deras familj har utsatt dem för. Även att syftet med fostervård är att det ska vara en fristad är det många av barnen som flyttar från familj till familj och hela tiden väntar på att komma till en permanent familj. På grund av bristerna i fostervården är det viktigt att undersöka socialarbetarnas syn på en passande familj, eftersom vi anser att detta kommer påverka utredningen, vilket i slutändan kommer påverka barnet. Den här uppsatsen utforskar vad socialarbetare på en barnskyddsorganisation i Sydafrika uppfattar som en passande familj för utsatta barn. Metod: Vi intervjuade sju socialarbetare på nämnd organisation, som arbetar med formell fostervård och återförenande med föräldrar eller släktingar. Vi använder tematisk analys för att bearbeta vårt undersökningsresultat vilket vi sedan analyserar med Maslows behovstrappa. Resultat. Våra undersökningsresultat visar att socialarbetarna anser att de emotionella behoven hos barnet är de viktigaste, vilka sedan följs av de fysiologiska behoven. Kriminellt beteende och olämpliga värderingar och moral tros utgöra en opassande familj. Slutsats. Resultatet visar att det är vissa skillnader i socialarbetarnas uppfattning av en passande familj för utsatta barn, samtidigt som de alla betonar samma faktorer som mest viktiga. De menar också att dessa barn anses ha samma behov som vilket annat barn som helst; allt handlar om vad de anser är det bästa för barnet. Oavsett vilka värderingar den individuella socialarbetaren har, vad de letar efter i varje familj är att barnet ska kunna känna sig säkert och älskat.

Studiens syfte var att få bidra med en ökad kunskap om och förståelse för hur nu unga vuxna, biologiska barn, upplever att ha föräldrar som har haft familjehemsuppdrag och vilken betydelse det haft för dem. Syftet var också att undersöka om dessa barn haft behov av stöd samt vilket stöd de fått. I studien genomfördes fem kvalitativa intervjuer med unga vuxna som har vuxit upp med föräldrar som haft familjehemsuppdrag. Studiens resultat analyserades med Schultz Jørgensens familjeplansteori. Resultat och tolkningar visade att biologiska barn upplever sig delaktiga i familjehemsuppdraget och beskriver relationen till sina fostersyskon som syskon och vän. Biologiska barn beskriver att de hade lättare att skapa relationer till de yngre fostersyskonen än till de som är tonåringar eller jämngamla. Resultatet visade att informanterna upplever fler fördelar än nackdelar med att ha fostersyskon. De biologiska barnen beskriver också att de kände att de saknade möjligheten till stöd från socialtjänsten. / The purpose of the study was to help create a greater knowledge and understanding for now young adult biological children's experiences of having had parents being foster care parents and the meaning of it. The purpose was also to examine if these children had need of and what kind of aid they got. This study was based of five qualitative interviews with now young adults that’s been growing up with parents that were foster parents. The result in the study was analysed with Schultz Jørgensens familyplanetheory. Results and interpretations showed that biological children experience a participation in the foster care process and describes the relation to the foster children as that of a sibling and friend. Biological children describe that they have an easier time creating relations to younger foster siblings than to teenagers and children in the same age. The results showed that the informants experience more positive feelings than negative feelings with having foster siblings. The biological children also describe that they felt a loss of opportunities of aid from the social services.

A presente dissertação teve como objetivo cartografar o campo de intervenção do Programa Família Acolhedora (PFA) do Rio de Janeiro, com o intuito de perceber máquinas da gestão das menoridades operadas por políticas públicas neste recorte, pelo PFA. Para tal, foram realizados grupos com as famílias de origem, famílias acolhedoras e crianças e adolescentes acolhidos, além de entrevistas com duas famílias de origem e diversos encontros e discussões com uma equipe técnica. A partir do referencial teórico da Análise Institucional francesa e do método cartográfico, a defesa da convivência familiar preconizada nos discursos que sustentam programas de acolhimento familiar foi posta em análise, evidenciando práticas-discursivas que naturalizam modelos de família e cuidado, operando certa gestão da infância que, em última análise, visa à neutralização de uma parcela da população tida como potencialmente perigosa através da inserção ou manutenção em unidades domésticas. A análise das tensões postas nas negociações travadas no cotidiano do Programa explicita o tensionamento da proteção que tutela, inerente à intervenção. A emergência de dinâmicas, como a gestão da solidariedade e da retórica da gratidão, permitiu analisar um campo de relações enunciativas e agenciamentos de posições que produzem os sujeitos em relação e agenciam possibilidades de negociação. Através da discussão do trabalho com grupos e da desmontagem de dois casos, discutimos experiências de famílias de origem e acolhedoras no Programa. Foi possível perceber como as famílias e as equipes técnicas se apropriam do Programa, apesar do caráter impositivo como prática disciplinar de governo, criando linhas de fuga e mantendo algum grau de autonomia, não se confirmando nem rebeldes, nem coitadas. / The present dissertation had the goal of charting the field of intervention of Rio de Janeiros Programa Família Acolhedora (PFA), in order to comprehend the tools of management of minorities operated by public policies in this case, the PFA. In order to do this, groups were conducted with families of origin, foster families and foster children and adolescents, and interviews with two families of origin and several meetings and discussions with technical staff. From the theoretical framework of the french Institutional Analysis and the cartographic method, the defense of family life advocated in speeches that support foster family programs was put under review, showing discursive-practices that naturalize models of family and care, operating certain childhood management that ultimately aims neutralizing a portion of the population considered as being potentially dangerous through the insertion or maintenance in households. The analysis of tensions placed on the negotiations held in the Programs quotidian explains the tension of the protection that tutorizes, which is inherent to the intervention. The emergence of dynamics, such as management of the solidarity and rhetoric of gratitude, allowed the analysis of a field of enunciative relationships and negotiation of positions that produce the subjects in relation and work the possibilities of negotiation. Through the discussion of the work with groups and the dismantling of two cases, we discuss experiences of families of origin and foster families in the Program. We could see how families and technical staff appropriate the Program to themselves, despite the impositive character as a government disciplinary practice, creating vanishing lines and maintaining some degree of autonomy, not affirming themselves as rebellious or pitiful.

A presente investigação tem como objetivo estudar sobre o futuro do adolescente abrigado no imaginário coletivo de psicólogos. Justifica-se na medida em que, abordando um grupo profissional atento à importância da adolescência, no percurso da vida pessoal, pode contribuir para um debate sobre a condução de vítimas de sofrimentos sociais a abrigos. Articula-se, do ponto de vista metodológico, por meio da realização de entrevistas individuais, estruturadas a partir do uso do Procedimento Desenhos-Estórias com Tema, com oito psicólogos. Tais encontros foram registrados sob forma de narrativas transferenciais que, conjuntamente com os desenhos e as histórias, foram consideradas à luz do método psicanalítico. Por esta via, foi possível chegar à produção interpretativa de três campos de sentido afetivo-emocional ou inconscientes relativos: Fadado ao fracasso, Salvo por mágica e Com ajuda e boa vontade. O quadro geral revela uma tendência dos participantes a considerar que o adolescente abrigado dificilmente escapará a um futuro infeliz. Assim, fica claro que se posicionam de modo crítico à realidade dos abrigos, concebendo-os como instituições que não chegam a dar conta satisfatoriamente de sua função social / This research intends to study the future of adolescents in foster care within the collective imaginary of psychologists.The study can contribute to the debate over the conduction of the victims of social suffering to foster care shelters by addressing a professional group aware of the importance of adolescence during the personal life. This approach consists, from the methodological point of view, in structured interviews conducted with eight psychologists using the story-drawing procedure with a theme. Such meetings were registered under the form of transferential narratives, which, along with the drawings and the stories, were considered through the psychoanalytical method. This way, it was possible to reach the interpretative production of three affective-emotional meaning fields or relative unconsciousness: Bound to fail, Saved by Magic and With help and will. The general framework reveals a trend of the participants to consider that the sheltered adolescent will hardly come off from a miserable future. Thus, it is clear that these professionals position themselves critically to the foster care shelter reality, conceiving them as institutions that are not able to fulfill their social function satisfactorily

Reintegração familiar é o termo utilizado no âmbito jurídico para se referir ao processo de crianças/adolescentes que retornaram às suas famílias de origem (natural ou extensa) após terem passado por acolhimento institucional ou familiar. Documentos jurídicos que regulamentam a reintegração e a literatura sobre esse tema enfatizam a necessidade de se investir na família para viabilizar o retorno seguro ao convívio familiar, mas não indicam como isso deve ou pode ocorrer na prática. Pautando-se na perspectiva da Rede de Significações, esta pesquisa objetiva investigar o processo de reintegração familiar de crianças de 0 a 7 anos e seis meses que estiveram nos serviços de acolhimento institucional, em Ribeirão Preto, durante o período de Setembro/2008 a Setembro/2010. Para tal, foi realizada a caracterização dessas crianças, de suas famílias e de sua trajetória de acolhimento - reintegração familiar, a partir de 50 autos processuais na Vara da Infância e Juventude do Tribunal de Justiça e dos prontuários institucionais, cujos dados foram analisados quantitativamente, através de estatística descritiva. Ressaltam-se alguns resultados: o número de participantes foi de 50 crianças, dentre as quais havia 13 grupos de irmãos, totalizando 36 famílias. Sobre as crianças, 25 são meninas e 25 meninos; 66% foram registradas pelos pais juntos; 34% tinham até seis meses de idade; 62% são brancas; 88% têm irmãos; 86% têm outros parentes além da família natural e 14% vivenciaram acolhimento(s) anterior(es). Sobre as famílias, encontrou-se uma significativa ausência de informações; famílias dirigidas por mulheres; pais com idade entre 17 a 39 anos, predominantemente solteiros e separados, com baixa escolaridade, desempregados ou com trabalhos que exigem pouca qualificação e oferecem baixa remuneração. Com relação à reintegração familiar, há um desencontro de \"com quem estava a criança antes do acolhimento\" e \"para quem ela foi após reintegração\", a maioria estava com os pais, sobretudo com as mães, e foi reinserida na família extensa, prevalentemente com as avós. Ademais, foi notória a participação da família materna neste processo. Os acolhimentos foram breves: 76% das crianças permaneceram até 75 dias na instituição, as mais velhas foram reintegradas mais rapidamente, principalmente aquelas que faziam parte dos grupos de irmãos e os bebês (0 a 6 meses) permaneceram acolhidos por um período maior (2,5 meses a 3 anos). Os principais motivos do acolhimento registrados foram: o uso abusivo de álcool e/ou drogas pelos pais (76%), negligência (66%), abandono (34%), falta temporária de condições, moradia e problemas socioeconômicos (30%). Intervenções que visam à reintegração resumem-se, basicamente, a entrevistas com as famílias e visitas domiciliares, realizadas pela equipe técnica das instituições e do judiciário. Notou-se, ainda, a ausência de informações sobre o acompanhamento pós-reintegração. Observou-se a coexistência entre novas leis e velhas práticas: \"cultura de institucionalização\" x acolhimentos - reintegrações breves; (re)inserções na família extensa; presença do PIA e de guias de acolhimento/desacolhimento nos autos e prontuários. Tais resultados revelam a importância de pesquisas que mostrem como o trabalho de reinserção vem sendo feito na prática a fim de embasar as necessárias adequações nas políticas públicas e no trabalho em rede. / Family Reintegration is the legal term used to refer to the process in which children/teenagers have returned to their original family (natural or extended), after a period of institutional or family foster care. Legal documents that regulate reintegration and the literature regarding this subject emphasize the need for investing in the family to facilitate a safe return to a family environment, however, they do not indicate how it should or may occur in practice. Based on the \"Network of Meanings\' perspective, this study investigates the process of family reintegration of 0 to 7 years 6 months old children who have been in residential care in Ribeirão Preto, from September/2008 to September/2010. With this aim, we did a characterization of these children, their families and their institutional trajectory and family reintegration, based on 50 court processes of the Child and Youth Justice Court and their respective records. The data was analyzed quantitatively using descriptive statistics. Some results are hereby highlighted: the number of participants was 50 children, among which there were 13 groups of siblings, on a total of 36 families. 25 children were girls and 25 were boys; 66% were registered by both their parents; 34% had up to 6 months of age; 62% were Caucasian; 88% have siblings; 86% have other relatives besides the close family; and 14% have experienced previous hosting(s). Regarding the families, a significant lack of information was observed; families headed by women; parents aged 17-39 years old; predominantly unmarried and separated; with low education; unemployed or with jobs that requires few skills and offer low wages. With respect to family reintegration there is a mismatch on \"with whom the child was before hosting\" and \"to whom it was after reintegration\"; the majority was initially with their parents, specially the mothers, and were reinserted in the extended family, prevalently with the grandparents. Furthermore, the maternal family participation in this process was evident. The hosting period were brief: 76% of children stayed in the institution up to 75 days, the oldest children were quickly reintegrated, especially those who belonged to groups of siblings. On the other hand, babies (0-6 months) remained upheld for longer periods (2,5 months to 3 years). The main reasons for the recorded hosting were: the abusive use of alcohol and/or drugs by the parents (76%), negligence (66%), abandonment (34%), temporary lack of financial conditions, housing and socioeconomic issues (30%). Interventions that aimed at reintegration are basically interviews with families and domiciliary visits, conducted by the technical staff of the institutions and the judiciary. It was also noted the absence of information on the follow-up after reintegration. The study pointed to the coexistence of new laws and old practices: \"institutionalization culture\" versus quick reintegrations, but in the extended family; the PIA (plan of work with each child/family) and guidelines for fostering and reintegration begin to appear in the records and files. Those results point to the importance of research showing how the reintegration work has been done in practice in order to support the necessary adjustments in public policy and networking.

Kandidatuppsatsen består av en kvalitativ forskningsstudie med innehållsanalys som metod. Syftet är att genomföra en jämförande studie över hur vuxna som tidigare varit familjehemsplacerade som barn ser tillbaka på sin tid som placerad. Variabeln som eftersöks  att undersöka är om det finns skillnad i uttryck om sin placering hos de som hade kontinuitet i sin placering i jämförelse med de som haft ett sammanbrott i sin placering vid minst ett tillfälle. Intervjuerna genomfördes med hjälp av en semistrukturerad metod, vilket innebär att att intervjuerna utgår flexibelt från en färdigställd mall, detta innebär att respondenten har friheten att utrycka sig fritt samtidigt som att intervjun får en viss inriktning för att underlätta analysen av materialet. Det insamlade materialet från intervjuerna bearbetades sedan genom transkribering, kodning och kategorisering. För att kunna behandla det bearbetade materialet konstruerades en forskningsöversikt för att kunna begripliga det insamlade materialet. Det framtagna resultatet antyder att personer som har haft sammanbrott i placering upplever större svårigheter att skapa kontaktnät, svårare skolgång samt belyser ett mer utåtagerande beteende. Vidare visar  även studien på att ålder vid placering är en viktig faktor för den placerades upplevelse av inkludering i familjehemmet.

Among girls in foster care, 48% become pregnant at least once by age 19 (Dworkey & Courtney, 2010). Teen moms are less likely to graduate from high school and their children also are more likely to be placed in foster care due to abuse or neglect (Hoffman, 2006). Furthermore, 50% of 21-year-old men aging out of foster care report they have gotten someone pregnant, compared to 19% of their peers not involved in foster care (Courtney et al., 2007). Youth in or at-risk for foster care (YFC) report limited knowledge about, access to, and use of condoms; ambivalent attitudes toward teen parenting; and participation in other risky behaviors. For the current study, we adapted and supplemented an evidence-based sexual health program called SiHLE, using a systematic adaptation framework (ADAPT-ITT, Wingood & DiClemete, 2008), to address these unique and targeted needs of YFC. Thirty-six youth participated in four sessions of SiHLE-YFC during their stay at a temporary shelter. Four 90-minute sessions focused on increasing sexual health knowledge, improving attitudes toward and self-efficacy of condom use, and developing core skills such as problem-solving and communication. As hypothesized, youth showed high satisfaction with the intervention and significant improvement in sexual health knowledge from pre to post. At one month follow-up, youth continued to show significant improvement in sexual health knowledge, along with a significant reduction in risky sexual behaviors. Though not significant, there were moderate effect sizes for changes in attitudes toward teen pregnancy and condoms. There were no changes in attitudes towards teen parenting. Taken together, findings suggest that sexual health education directly targeting the unique needs of YFC may improve sexual health knowledge and behavior, and are discussed in the context of challenges associated with intervention and research with this population.

US Foster Care is already known to be an under researched and complex topic, and the literature that is done tends to focus on the need for more investigation to improve this ineffective system. Foster care has even been described as “one huge experiment that has been conducted on children”, at a “cost of untold billions of dollars” (Courtney, 2000). This comment doesn’t seem too far off—there is a consensus that more work needs to be done in the realm of child welfare services, and some studies have even questioned whether removals and placements by foster care are beneficial at all (Doyle, 2006). In order to improve foster care and decisions in treatment (as these decisions have significant impact on children’s safety and well-being), we need to be more effective in using our resources and understanding the needs of the population, and the trends that might be influencing foster care. On that note, research by the US Department of Health and Human Services has shown a clear relationship between parental substance abuse and child abuse, and a study reported by Economic Inquiry (Cunningham, 2013), investigates this in terms of foster care. Cunningham’s study investigates the impact of methamphetamine abuse on admissions in foster care, and reports a significant causal relationship. This interesting report motivated me to investigate this further, and in terms of the recent opioid epidemic in the US. In this study, I adapt Cunningham’s strategies to investigate the effect of the opioid epidemic on US Foster Care, at a more recent time period. Surprisingly, I find different results for the opioid epidemic than the meth shocks, despite many variations of the model to proxy opioid use. My results show a negative relationship from opioid use on foster care admissions, while also confirming Cunningham’s study with a positive relationship with methamphetamine use and foster care at a more recent time period. This study will explain the methods that attain these results, as well as the reasons driving the results in the discussion. While contributing to Cunningham’s study, this study also contributes new research to a topic (the opioid epidemic) frequently mentioned in recent news. This study also considers the impact of this epidemic on individuals it might impact most, and addresses the gap in literature that exists regarding US Foster Care.

Many homeless youth come from foster homes, group homes, and other forms of substitute care. For young people in the child welfare system, elopement represents a major problem as it places them at risk for a number of troubling outcomes. Three studies were undertaken examining elopement among young people living in substitute care in Canada and the United States. The first study explored strengths and needs in a sample of 5,011 children and youth housed in a variety of substitute care settings including foster homes, group homes, residential treatment centres, emergency shelters, and juvenile justice facilities. Results indicated that needs, but not strengths, predicted running among children, while both needs and strengths predicted running among adolescents. Problems with school attendance, substance abuse, and delinquency also predicted running among both children and adolescents, with the exception of young children, for whom substance abuse was not a significant predictor. The second study explored the relationship between trauma, strengths, and elopement in a sample of 2,296 adolescents living in substitute care. Sexual abuse, physical abuse, school violence, and traumatic grief/separation were found to predict elopement. In addition, family violence and community violence predicted running among younger but not older adolescents. Educational strengths predicted a lower risk of running away for all adolescents, while well-being and relationship permanence predicted a lower risk of running among younger and older adolescents, respectively. The impact of strengths on the relationship between trauma and elopement was evaluated, with results suggesting that elopement was not predicted by an interaction between strengths and trauma. The third study was qualitative in nature and explored the perspectives of youth who had run away from substitute care at least once in their lifetime. Youth provided information about their experiences as well as suggestions designed to reduce the prevalence of running away among youth in substitute care. Findings for all three studies were discussed in relation to the literature with implications for research and prevention.