NUMBER 545 • 8 JULY • ALTERNATIVES TO RESIDENTIAL CARE
The decline of residential care was concurrent with policies that were meant to stimulate the expansion of foster care. Foster care has traditionally been preferred for younger children. Indeed, in a number of European countries over recent years, increasing numbers of children who were previously considered unsuitable for family placement have been placed in foster families, and all sorts of new forms of foster care (see Colton and Williams, 1997) have been developed. Family foster care, it was thought, must naturally be better than residential care. Berridge (1994) uses the word blindness to refer to the stubbornness with which foster family care is idealised in places like Great Britain. In support of Berridge’s position, many studies have shown that foster care cannot completely replace residential care, that placement in foster care is not necessarily better or more desirable than residential care for all children and young people, and that the effects of foster care — long-term as well as short-term — are not better than those of residential care (Milligan, 2001).
Day care, too, is seen in many countries as a desirable alternative to residential placement. The number of day-care centres has increased and numerous new forms of day care have been developed, day-care centres that pay attention to supporting the child and family, and to co-operating with the school have become an indispensable link between the family and child welfare in most countries. However, day care is certainly not a valid alternative for the care of children and young people with extremely difficult behaviour, or for children who are seriously abused or in danger of being abused.
In the 1980s and 1990s, family support and family preservation programs were seen as the epitome of child welfare services in Europe and the United States. The balance had tipped from ‘child protection’ to ‘family preservation’: and, indeed, providing services that take account of a family’s strengths and needs, in their own homes, while still protecting children, is an idea that makes sense both in theory and in practice. There were a number of other reasons for the popularity of family preservation approaches:
- Family preservation values, beliefs and intervention processes are consistent with notions of consumer involvement, consumer input and consumer-driven services. In contrast to traditional methods in childcare, they give parents a voice and show collegial co-operation (Kelly & Blythe, 2000).
- Family preservation programs mesh well with community initiatives and cross-system efforts.
- The family’s expertise in addressing its own needs and issues is acknowledged.
- Family preservation programs were expected to be cheaper than residential care. This was a decisive factor for cost-conscious authorities.
Soon, however, the glitter of these programs began to fade, and critical voices were heard. In the United States, where family preservation programs had been thriving since the early 1980s, there was a backlash, in the early 1990s, to the core principles, values and beliefs of family preservation services. The criticisms can be summarized as follows:
- First and foremost, there was model drift and loss of model integrity (Bath & Haapala, 1995; Blythe, Salley & Jayaratna, 1994). Many programmes did not have an identifiable theoretical foundation or well-defined parameters.
- Experts started discussions on the feasibility of such programmes in certain situations: for example, whether they deal sufficiently well with the risk to children whose mothers abuse drugs or have serious mental health conditions. These discussions were stimulated by the media who h8d formerly focused on the scandals in residential care but now blamed family preservation programmes whenever something happened to a child at home (Kelly & Blythe, 2000).
- The evaluation of family-preservation programmes proved to be as complex as that of residential programmes, and it is as difficult to draw conclusions regarding the effects that have been achieved.
- Recent control group studies (Mc Croskey & Meezan, 1997; Rzepnicki et al., 1994) into the effectiveness of family preservation programmes have not found much evidence that they improve family functioning or prevent child placement.
- Fraser et al. (1996) suggests that this kind of intensive and fairly short-term service may be appropriate for some problems but that longer and/or other types of interventions may be necessary for younger children or situations involving serious maltreatment.
There is agreement in the scientific literature that family-based and intensive family preservation services are a significant step in the advancement of children’s welfare, but also that families will always be in need of one or more of the other child welfare services such as day treatment, family foster care, and residential care.
Hellinckx, W. (2002) Residential care: Last resort or vital link in child welfare? In International journal of child and family welfare Vol. 5 No. 3 September 2002. pp. 77-78
Colton, M. & Williams, M. (1997) Overview and conclusions. In M. Colton, & M. Williams (Eds) The world of foster care. An international sourcebook on foster family care systems. pp. 285 - 296 Aldershot: Arena.
Berridge, D (1994) Foster and residential care reassessed. Children and Society, 8, pp 132-150.
Milligan, I (2001) Les dangers de la nouveauté: le dé Fcline de l' internat au Rouaume-Uni. Une analyse des causes de la mauvaise qualite de l'internat specialise pour les enfants et les jeunes. In M. Corbillon (Ed.) Suppleance familale: nouvelles approches, nouvelles pratiques Paris: Matrice.pp 73-85
Kelly, S. & Blythe, B. J. (2000) Family preservation: a potential not yet realized. Child Welfare, 79, pp 29-42
Bathe, H. I. & Haapla, D. A. (1995) Evaluation outcomes of family preservation services and the way ahead: A reply to Littell. Social Services Review, 69 pp. 386-404.
Blythe, B. J. Salley, M. P. & Jayaratna, S. (1994) A review of intensive family preservation services research. Social Work Research, 18, pp. 213-224
Mc Croskey, J. & Meezan, W. (1997) Family preservation and family functioning. Washington, DC: CWLA Press.
Rzepnicki, T., Schuerman, J. R. Littel, J. H. Chak, A., & Lopez, M. (1994) An experimental study of family preservation services: Early findings from a parent survey. In R. P. Barth, J. D. Berrick, & N. Gilbert (Eds), Child welfare research review, Volume 1 pp. 60-82 New York: Columbia University Press.