A critical review of qualitative research into the experiences of young adults leaving foster care services

Published date09 December 2014
Pages263-279
Date09 December 2014
DOIhttps://doi.org/10.1108/JCS-04-2014-0022
AuthorSarah Parry,Stephen Weatherhead
Subject MatterHealth & social care,Vulnerable groups,Children's services
A critical review of qualitative research into
the experiences of young adults leaving
foster care services
Sarah Parry and Stephen Weatherhead
Sarah Parry is a Trainee Clinical
Psychologist and Dr Stephen
Weatherhead is a Clinical
Psychologist, both are based
at Clinical Psychology,
Lancaster University,
Lancaster, UK.
Abstract
Purpose – Due to the emergence of rich personal narratives within recent research, the purpose of this
paper is to review and to explore the experience of transition from care and consider how these accounts
can inform care services.
Design/methodology/approach – This meta-synthesis follows from several quantitative and mixed
method reviews examining how young people experience aging out of the care system.
Findings – Three themes emerged from an inductive analysis: navigation and resilience – an interrelated
process; the psychological impact of survival; and complex relationship.
Research limitations/implications – The findings of a meta-synthesis should not be over generalised and
are at least partially influenced by the author’s epistemological assumptions (Dixon-Woods et al., 2006).
However, a synthesis of this topic has the potential to provide greater insight into how transition can be
experienced through the reconceptualising of the personal experiences across the studies reviewed
(Erwin et al., 2011).
Practical implications – This synthesis discusses the themes; their relationship to existing research and
policies, and suggestions for further exploration. The experience of transition is considered critically in terms
of its often traumatic nature for the young person aging out of care but also the ways in which the experience
itself can build essential resiliencies.
Social implications – Reflections for clinical practice are discussed with importance placed upon systemic
working, accommodating likely challenges and considering appropriate therapeutic approaches for the
client group and their systems.
Originality/value – No review thus far has qualitatively examined the narratives told by the young people
emerging from care and how these narratives have been interpreted by the researchers who sought them
(Hyde and Kammerer, 2009).
Keywords Transition, Resilience, Care services, Attachment, Clinical psychology, Young adults
Paper type Research paper
Introduction
In 2013 there were approximately 92,000 children cared for by local authorities in the UK.
Over half of these young people entered care due to abuse or neglect. The number of young
people entering the care system has risen by 11,413 between 2008 and 2013 (NSPCC, 2014).
The cost of care provisions in 2012 was £2.22 billion (Harker, 2012). Young people in care
can be at greater risk of developing mental illness (Golding, 2003; Mullan et al., 2007; Stein, 2006),
particularly “clinical levels of depression, anger, post-traumatic stress, and dissociation”
(Collin-Ve
´zina et al., 2011, p. 585). Adversities faced have been found to impact their
“self-esteem, self-efficacy and capacity to cope with developmental challenges” (Schofield and
Beek, 2005, p. 1283).
The parenting role assumed by the state could last beyond childhood in terms of the provisions
young people may need once they leave care (Blades et al., 2011). It has been suggested there
DOI 10.1108/JCS-04-2014-0022 VOL. 9 NO. 4 2014, pp. 263-279, CEmerald Group Publishing Limited, ISSN 1746-6660
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JOURNAL OF CHILDREN’S SERVICES
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PAGE 263
are long-term implications of life in care on educational outcome, offending behaviour and
homelessness (Jackson and Simon, 2005; Tyler,2006). One in four of those whotransition out of
care are subject to physical and sexual abuse within eighteen months of leaving care (Courtney
et al., 2001) and continue to be at an elevated risk of social exclusion and loneliness in adulthood
(Jackson and Cameron, 2012; Stein, 2006).
The Who Cares Trust (2012) suggests the care system can leave a young person “alone in the
wilds of adult life”. Difficulties faced in the care system can lead young people into a “double
transition” (Dima and Skehill, 2011, p. 2537) as they experience a simultaneous and sudden
transition from care as a child into the community as an independent adult. This acceleration to
adulthood and independence leaves little psychological opportunity to adjust to significant life
changes over time (Stein, 2006). Additionally, some young people still fall through the gaps
between services (Department of Health, 2007). Whilst the problems are well researched, less is
understood about the resilience that can enable individuals to overcome these adversities
(Walsh et al., 2010).
Windle (1999), cited in Lewis et al. (2011, p. 3), identifies resilience as “the successful adaptation
to life tasks in the face of social disadvantage or highly adverse conditions” (p. 163). In order for
one to develop resilience a number of skills must be learnt first, such as helpful coping skills and
developing social supports (Layne et al., 2007). Further, resilience goes beyond surviving
challenges because it requires one to fully experience and reflect upon challenges (Harvey and
Delfabbro, 2004). Gilligan (2000) has highlighted emotional resilience and practical skills as
essential components of a positive transition.
Positive attachments can play a key part in the development of these features. Sadly,for many of
the children who enter the care system as a result of neglect and abuse, their attachments and
psychosocial functioning have already been damaged (Stovall-McClough and Dozier, 2004).
These authors highlight the importance of early preventative interventions when a foster
placement begins, rather than waiting until difficulties arise. Golding (2003) suggests that the
early experiences of looked after children play a fundamental role in how they relate to their
subsequent carers, which may also impact on their ability to develop other social supports,
emotional resilience and helpful coping strategies.
Rationale for the current review
NICE guidelines for looked after children recognise that transition out of care can be“traumatic”
(2010, p. 9) and recommend that the mental health of looked after children is considered as part
of the young person’s “complex needs” (p. 62). However,there is little explicit national guidance
as to how looked after children in the UK can be served through psychological services.
A number of qualitative reviews have explored the transition from care. For example Spencer
et al. (2010) emphasised the need for services to provide systemic support for care leavers.
Young people transitioning from care often experience difficulties simultaneously, which impact
upon their global ability to cope (Stein, 2006).
Stone (2007) reviewed child maltreatment and foster care experiences presenting conceptual
and methodological considerations for policy review and future research. Hayes (2013) critically
reviewed existing legislation and policy relating to transition. She found in support of other
literature that educational success, social support networks, placement stability, good mental
health and preparation for transition are all important in managing the process well. Importantly,
she highlighted that the choices a young person makes through transition in terms of life course
are particularly crucial due to the limited follow-on resources available throughout their 20s if
they do not remain in education. In a sense, there is no going back for these young people,
which in a society where so many value parental supports throughout their 20s puts foster youth
at an even greater disadvantage.
No review thus far has qualitatively examined the narratives told by the young people emerging
from care and how these have been interpreted by the researchers who sought them (Hyde and
Kammerer, 2009).
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