Kinship Care for the Safety, Permanency, and Well‐being of Children Removed from the Home for Maltreatment

Child abuse and neglect are common problems across the world that result in negative consequences for children, families and communities. Children who have been abused or neglected are often removed from the home and placed in residential care or with other families, including foster families. Foster care was traditionally provided by people that social workers recruited from the community specifically to provide care for children whose parents could not look after them. Typically they were not related to the children placed with them, and did not know them before the placement was arranged. In recent years many societies have introduced policies that favour placing children who cannot live at home with other members of their family or with friends of the family. This is known as ‘kinship care’ or ‘families and friends care’. We do not know what type of out‐of home care (placement) is best for children. This systematic review was designed to help find out if research studies could tell us which kind of placement is best. Sixty two studies met the methodological standards we considered acceptable. Wherever possible we combined the data from studies looking at the same outcome for children, in order to be more confident about what the research was telling us. Current best evidence suggests that children in kinship care may do better than children in traditional foster care in terms of their behavioral development, mental health functioning, and placement stability. Children in traditional foster care placements may do better with regard to achieving some permanency outcomes and accessing services they may need. Implications for practice and future research are discussed. Executive summary/Abstract BACKGROUND Every year a large number of children around the world are removed from their homes because they are maltreated. Child welfare agencies are responsible for placing these children in out‐of‐home settings that will facilitate their safety, permanency, and well‐being. However, children in out‐of‐home placements typically display more educational, behavioral, and psychological problems than do their peers, although it is unclear whether this results from the placement itself, the maltreatment that precipitated it, or inadequacies in the child welfare system. OBJECTIVES To evaluate the effect of kinship care placement on the safety, permanency, and well‐being of children removed from the home for maltreatment. SEARCH STRATEGY The following databases were searched to February 2007: CENTRAL, MEDLINE, C2‐Spectr, Sociological Abstracts, Social Work Abstracts, SSCI, Family and Society Studies Worldwide, ERIC, PsycINFO, ISI Proceedings, CINAHL, ASSIA, and Dissertation Abstracts International. Relevant social work journals and reference lists of published literature reviews were handsearched, and authors contacted. SELECTION CRITERIA Randomized experimental and quasi‐experimental studies, in which children removed from the home for maltreatment and subsequently placed in kinship foster care, were compared with children placed in non‐kinship foster care on child welfare outcomes in the domains of well‐being, permanency, or safety. DATA COLLECTION AND ANALYSIS Reviewers independently read the titles and abstracts identified in the search and selected appropriate studies. Reviewers assessed the eligibility of each study for the evidence base and then evaluated the methodological quality of the included studies. Lastly, outcome data were extracted and entered into REVMAN for meta‐analysis with the results presented in written and graphical forms. RESULTS Sixty two quasi‐experimental studies were included in this review. Data suggest that children in kinship foster care experience better behavioral development, mental health functioning, and placement stability than do children in non‐kinship foster care. Although there was no difference on reunification rates, children in non‐kinship foster care were more likely to be adopted while children in kinship foster care were more likely to be in guardianship. Lastly, children in non‐kinship foster care were more likely to utilize mental health services. AUTHORS’ CONCLUSIONS This review supports the practice of treating kinship care as a viable out‐of‐home placement option for children removed from the home for maltreatment. However, this conclusion is tempered by the pronounced methodological and design weaknesses of the included studies.