RUNNING HEAD: Types and Settings for Foster Care Visitation and Placement
Joanne M. Cannavo, MSSA, LCSW-R, PhD Student
University at Buffalo, School of Social Work
Review of the Empirical Literature on Types and Settings for Foster Care Visitation and Placement
Funded by Center for the Development of Human Services
June 28, 2005
Types and Settings for Foster Care Visitation and Placement
Abstract
Foster care placement consists of many different types. In addition, the setting and type of
visitation, supervised versus unsupervised, varies as well. This paper is an exploration of the
empirical literature on the benefits and limitations of various types of foster care placements, as
well as a review of the literature for supervised visitation settings.
Placement types are defined,
factors regarding successfulness related to each type are reviewed, selected major empirical studies
are reviewed to assess the successfulness of each. Alternatives to each type of placement are
compared, as well as types of visitation: supervised visitation will be of focus towards the later
portion of this paper. There was very little empirical research on supervised visitation, therefore,
findings for much of what exists in the literature are provided. Review of placement outcome
studies reveals that kinship care and treatment foster care have found the greatest successes for the
children involved, compared to traditional foster care and group home residential placement.
Finally, recommendations for policy and practice are suggested.
Key Words
Visitation, placement, treatment foster care, specialized foster care, therapeutic foster care,
supervised visitation, kinship foster care, congregate care, permanence, reunification.
The purpose of this paper is to review the types and settings for foster care visitation and
placement, as well as aspects of each type that contributes to their success or reveals their
shortcomings. After defining each type, and reviewing the factors regarding successfulness related
to each type, several major empirical studies will also be reviewed to assess the successfulness of
such. Alternatives to each type of placement are compared, and placements describing supervised
versus unsupervised visitation will be presented. There was very little empirical research on
supervised visitation, therefore, findings for much of what exists in the literature is provided, yet
2
Types and Settings for Foster Care Visitation and Placement
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cannot be reviewed per placement type due to the lack of literature in this area. Finally,
recommendations for policy and practice are suggested. Because of the breadth of the subject
matter, the complexity of the placement types, and vast amount of literature that exists for such, this
paper represents only a general overview of a fair selection of the empirical literature on settings
and types of placement in foster care. It is not intended to be an exhaustive review.
Types and Settings for Foster Care Placement and Visitation
Placement of children out of home is not a new phenomenon. Since the beginning of
recorded history there have been examples of children being cared for and raised by both kin and
non-kin. More recently, according to data from 2001, there were approximately 542,000 children in
the United States foster care system (Child Welfare League of America, 2004). There are many
reasons for foster care placements. It is commonly known that an increased prevalence in violence
and delinquency over the past several years has originated from various social problems. These
include child abuse and neglect, substance abuse, youth conflict and aggression, and involvement
with sexual activity at an early age, many of which contribute to problems in a family that result in
a child’s separation from their parent or parents through an out-of-home placement (Chamberlain,
1998). Length of stay in foster care placements is concerning. Research has indicated that the
younger the child is when he or she enters foster care, the greater likelihood that child will spend a
large portion of childhood in the foster care system (Goerge & Wulczyn, 1998). Children average a
duration of 33 months in foster care (U.S. Department of Health and Human Services,
Administration on Children, Youth and Families, 2004). It has also been established that the longer
the child spends in foster care, the more placements the child is likely to have including traditional
foster care homes or residential treatment facilities (Rubin et al., 2004). Federal government has
identified five discrete modes for duration in foster care:1-5 months, 6-11 months, 12-17 months, 34 years, and 5 or more years (U.S. Department of Health and Human Services, Administration on
Types and Settings for Foster Care Visitation and Placement
4
Children, Youth and Families, 2004). Further, once children are in the system as adolescents, they
tend to age out of the system rather than find a permanent home. It has been estimated that yearly
as many as twenty thousand youths mature out of foster care at the age of eighteen and facing
independent living with little in the way of resources or support. As a result, they struggle with
employment, homelessness, and lack of education, and problems with living arrangements (Reilly,
2003). Children are better off spending less time in foster care, especially considering that the
average age of a child in foster care is about ten years old (U.S. Department of Health and Human
Services, Administration on Children, Youth and Families, 2004). However, the public policy laws
mandating such acts as foster care do not necessarily yield the most successful outcomes. Statistics
indicating the numbers of children in foster care as well as duration in foster care reflect its
enormous impact on the lives of children.
Foster care placement consists of many different types. In addition, the setting and type of
visitation, supervised versus unsupervised, varies as well. An exploration of the empirical
literature on the benefits and limitations of various types and settings for foster care visitation serves
several functions. First, it may inform practice, from judges to the county services, of different
placement options that exist given needs of foster children and the successfulness (or lack of) those
options. Secondly, the review in this area of benefits and limitations will reveal the outcomes and
impacts to the foster children based on each format for placement. Lastly, it will shed light on the
potential areas for policy and practice to address the needs in child welfare and strengthen certain
aspects of foster care placement and type of visitation that could contribute to greater success for
the children as well as the others involved.
Placement and Visitation
Many invested people in child welfare, from researchers to policy makers, from clinicians to
social services workers, are invested in ensuring success for foster children in the appropriate foster
Types and Settings for Foster Care Visitation and Placement
5
care placement while they work towards the goal of reunification. Programs that contribute to the
reunification accentuate this along with the child welfare professionals. However, it is also
supported by the federal legislation, namely the Adoption Assistance and Child Welfare Act of
1980 (PL 96-272) which requires regular visitation to take place between parents and their children
when they are in foster care. Further, the Adoption and Safe Families Act of 1997 (PL 105-89)
purports that family reunification remains the primary goal for the majority of foster children and
puts a limit on the time that a child may spend in foster care, being 15 of the last 22 months. The
literature indicates that visitation plays a key role in improving the parent-child relationship that
will largely enable reunification (Fanshell, 1978; Haight et al., 2003). Such invested professionals
should ensure their cognizance of the developmental needs of children (Goldstein, Freud & Solnit,
1979) that can partially be accomplished through visitation of foster children with their parents.
Specifically, this included the emotional and psychological needs of the children, as opposed to
solely the physical needs (Goldstein, Freud & Solnit, 1979). There is a preoccupation with the
physical location or residence of the child which contributes to forgetting essential concerns about
the welfare of the children. These include promoting healthy child development in a safe and
fostering environment, and improving family functioning, both of which should be goals for public
policy (Whittaker & Maluccio, 2002). It is a delicate task in placing the law in the position of
designating another person or organization in the role of ‘parent’ when a child’s own parent fails
them. In doing so, the invested professionals must consider not just the physical safety of the child,
but the psychological well-being as well. The question of how well the law can ensure both of these
aspects of development through management of the child’s physical environment becomes a key
concern (Goldstein, Freud & Solnit, 1979), and is reason to examine the successfulness of various
settings and types of placement and visitation on behalf of the children.
Types and Settings for Foster Care Visitation and Placement
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Decision-Making
Despite that decision-making is crucial regarding placements and visitation for children in
out-of-home care, little published empirical research exists to address the topic. As was mentioned
previously, visitation is viewed as an effective reunification method that may help with decisions to
reunify more quickly (Leathers, 2002). Exploring unsuccessful decisions was examined by Rossi,
Schuerman, and Budde (1999), who found that foster care workers made two types of mistakes in
decision making. They failed “to remove children from their families when it is called for and
…(removed) children when it is unnecessary” (Rossi, Schuerman, & Budde, p. 579). In addition,
foster care workers are responsible for making placement decisions for foster children, but may not
actually be the most knowledgeable to assess the children and their behaviors (Courtney, 1998;
Goldstein et al., 1986). Treatment foster care homes have increased over time as placement options
in addition to the usual foster care homes or kinship foster homes. Therefore, foster parents or
residential treatment counselors may be better able to assess foster children and the appropriateness
of placement decisions but such information is not sought (Courtney, 1998). Furthermore, when
making such placement decisions, Courtney (1998) found that certain characteristics such as child
age, behavior problems, and placement history, had a strong correlation with the increased
likelihood that a child welfare worker would seek to find a treatment foster care or group care
placement for a child as opposed to a regular foster care home or kinship foster care home. Glisson
(1996) found that child age, gender, frequency of times in custody and problem behaviors as
assessed by the child’s caregiver were associated with the degree of restrictiveness of the child’s
placement setting in out-of-home care. This addresses the concern of ensuring an appropriate
placement which would only then enable successful visitation with such a good fit. Interestingly,
Brittner and Mossler (2002) found that professional group membership, as opposed to aspects such
as age or ethnicity of the foster child or the persistence of abuse, explains the varied patterns of
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7
prioritizing and utilizing information when making decisions for community-based training and
intervention efforts are considered. For example, when making decisions about foster care
placements, mental health providers and social workers reportedly depend on data about the
seriousness of and pattern of abuse, on information about services offered historically, and the
parents’ reaction to such services. Judges and guardians ad litem depend more closely on
information about the likelihood of reoccurrence of maltreatment and the child’s capability to give
an account of the abuse. CASA volunteers in this study relied on data about the stability of the
family (Brittner & Mossler, 2002). Finally, Goldstein, Freud and Solnit (1979) suggest using
psychoanalytic theory to create relevant guidelines to child placement that give a foundation for
evaluating and revising the process as well as influencing court decisions and statutes. Overall,
there is a need for research that explores differences between successful and unsuccessful decisionmaking in placements, visitation, and reunification.
Settings for Foster Care Placement and Visitation
Traditional ‘Non-Relative’ Foster Care Versus Kinship Foster Care
Traditional foster care, what is commonly known as regular, non-therapeutic foster care
placement that is not with relatives, is at a shortage and such foster placements continue to lessen in
availability (Barth et al., 1994). Simultaneously, kinship foster placements are quickly increasing
as a result of increasing caseloads and also due to the lack of traditional foster home placements
(Berrick, 2000).
Kinship care, defined as the placement of children who are in state custody in to the care of
their relatives, is well-established, highly utilized and largely accepted in child welfare as an out-ofhome placement. It has moved from being an informal placement option to a more formalized one,
from structure as a placement option to supports from the legal system including funding for
caretaking of their relative foster children (Hawkins & Bland, 2002). It qualitatively differs from
Types and Settings for Foster Care Visitation and Placement
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traditional foster care. Kinship care is viewed as a form of family preservation that ensures that
children are preserved in the extended family system (Berrick, Barth, & Needell, 1994). In essence,
traditional foster family caregivers are most often strangers to the foster child in care (Berrick,
2000).
Further, it is also important to view the demographic outline and attitudes of kinship foster
parents versus traditional foster parents. Kinship foster parents tend to be older, more likely to be
unmarried, and more likely to work outside the home than nonkin foster parents (Berrick et al.,
1994; LeProhn,1994).
Dubowitz et al (1993) found that 43% were employed either full or part-
time, the median age of kinship caregivers was approximately 48 years of age, and that about 38%
of these caregivers were married and living with someone. They also found that the foster children
in kinship care are largely African American (90%); kinship caregivers tend to be grandparents in a
majority of cases (Poehlmann, 2003) as well as aunts in over a quarter of the cases (Dubowitz et al.,
1993). They also report poorer health, have less education, and do not extensively receive services
from child welfare agencies when compared to nonkinship foster placements (Berrick et al., 1994;
LeProhn, 1994). Dubowitz et al. (1993) found that over half of the kinship caregivers had not
completed high school.
Regarding traditional or nonkin foster caregivers, Downs (1986) surveyed licensed foster
parents in eight states and also found that they tend to be over 40 years of age. There were largely
more Caucasian foster parents than African American (68% versus 32%), 82% of the foster mothers
were married, and approximately half of these nonkin foster homes had incomes under $15,000. In
addition, African American homes were more likely to have taken related foster children in than the
traditional foster families. Further, in Gebel’s (1996) study of 140 randomly selected nonrelative
licensed foster parents, when compared to kinship caregivers, he found that kinship caregivers have
more positive views about the children placed in their care than nonkin caregivers, and thus
Types and Settings for Foster Care Visitation and Placement
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supports the value of extended family. Despite random selection, it should be noted that the
demographic traits of the caregivers may be different in the southeastern state where the study was
conducted. Gebel (1996) also found that foster care case workers had a lower level of contact with
kinship caregivers than traditional foster parents, which Berrick et al. (1994) found as well.
Traditional Foster Care
Foster care is provided to children in families, institutions or group homes by public child
welfare service providers who have custody of such children who must live separately from their
parents. Reasons for separation include abuse, neglect, or other extenuating circumstances
(Kadushin & Martin, 1988).
Barber, Delfabbro and Cooper (2000) and Fanshel and Shinn (1978)
have found that referrals into traditional foster family care are generally correlated with positive
outcomes. Festinger (1983), in her longitudinal study of foster children in New York, found that
most of the 227 children sampled who had been in foster care developed into functional, lawful
citizens by the start of their early adulthood years. Further, it has been found that in the Australian
study of 235 children entering foster care over a period of one year, one quarter had successfully
returned home within four months. Those who remained in foster care beyond that period showed
improvements in psychological status and behavioral functioning (Barber, Delfabbro & Cooper,
2000). However, other findings contradict this, as Barber et al. (2000) found that over half the
foster children in their study had not stabilized in their placement within four months. Further,
foster children referred for placement at a younger age, such as younger than age ten, are more
likely to develop positively than older foster children (Minty, 1999). However, entering before the
age is ten is not always reality. Further, some foster children age out of the foster care system
through adolescence (Courtney & Barth, 1996). Barber, Delfabbro and Cooper (2001) found that
adolescents with mental health issues or behavioral problems were not very likely to achieve
placement stability or to positively adjust psychologically in foster care. They therefore suggest
Types and Settings for Foster Care Visitation and Placement
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that this lack of adjustment indicates that traditional foster care is not suitable for adolescents.
Other literature raises concerns of the effectiveness of traditional foster care as well, fueling the
interest in examining the effectiveness of other placement options. Such concerns experienced by
foster children include placement disruption, lack of compliance with parental visitation, and
concerns of general well being indicated by study findings (Barber & Delfabbro, 2003a). Lastly,
hard-to-place children contribute to further reasoning to examine placements that are found to be
appropriate based on need. Issues and circumstances such as having a disability, being a male,
African American, and an older child when entering care have often yielded a hard-to-place status
that Avery (2000) found contributed to an average of 11.8 years spent by foster children waiting for
placement.
Kinship Care
Trends show that placements in kinship care are quickly increasing as child welfare funded
out-of-home care placements. They are increasing faster than foster care in some states, and
essentially out of need (Gleeson, 1995). They are expected to continue to increase since more
children are entering foster care than exiting and the quantity of available foster homes is waning as
was mentioned (Barth et al., 1994). Previous research suggests that children have longer stays in
kinship care with relatives than with nonrelatives. Wulczyn (1990) found that 88% of the children
in kinship care were still in care after nearly two years compared to only 40% of the children in
traditional foster care. The ability to be discharged home from kinship care is an advantage of outof-home placement with relatives. The biological parents may be more inclined to maintain
contacts with their children when they are in the care of their own family members, which makes
the goal of returning home from foster care a viable option (Link, 1996) and increases the frequency
of visitation (Berrick, 2000). Further, children in kinship care experience less placement changes
during their stays in foster care. Berrick et al. (1998) found that 53% of children under six who had
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been in traditional foster care for four years had experienced a minimum of three placements as
compared to only 30% of children in kinship placements experiencing the same quantity of
placements. In addition, Berrick et al. (1998) found that children in kinship care report being
happier than foster children in traditional foster care, and that placement in kinship care is
associated with more successful reunifications and less of a likelihood of re-entry into foster care.
Although kinship care may be viewed to be a more attractive placement option for foster
children due to the family component being maintained, much of the literature suggests that
relatives are not willing to adopt their kin (Child Welfare League of America, 1994). Kinship
families largely do not adopt their relative foster children. However, that trend may be starting to
change. Regardless, the process of kin adopting their relatives in foster care becomes complicated
as it requires the termination of parental rights of their relatives who are the biological parents to the
children whom they seek to adopt. In addition, depending on the state where kinship care takes
place, kinship caregivers are paid equal to what traditional foster parents are paid, but in other states
they are paid the equivalent of welfare payments (Berrick, 2000). Such issues that continue to
emerge about the financial expense of kinship care, suitability of the kinship home and agency
supervision continue to put kinship care in the forefront for evaluation (Iglehart, 1994).
Attachment and Kinship Care
It seems that many social and environmental factors determining reunification become
weighted differently depending on focus of importance at the time of assessment, again,
contributing to the attractiveness of the kinship placement option. Of such factors as attachment,
permanence, and kinship, Hegar states that “one is often traded off for another” (Hegar, 1993, p.
367) when deciding on placement options if reunification possibly may not take place. Hegar
(1993) discusses the importance of children’s attachment bonds to parents and surrogates as a goal
in foster care placement. She indicates that permanence, which included relationships that continue
Types and Settings for Foster Care Visitation and Placement
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throughout time, whether in a biological family, kinship, through adoption, in stable guardianship or
an extended family foster care arrangement, is the primary focus of child placement practice.
Kinship, or the perception of family, is viewed as a very old concept in the placement of children
but is the most recent of these three factors to attract a respectable degree of professional attention.
Hegar summarizes in her review that attachment, permanence, and kinship are weighted towards
making decisions which are made about placement for foster children. They are presented in such a
manner so as to examine all options for placement of children (Hegar, 1993) particularly if
reunification may not be an option.
Additional Factors Contributing to Kinship Foster Care Placements
In addition to the bond that may exist between family members and foster children
supporting kinship placements, the literature has explored the factors experienced by foster children
that lend to the likelihood of having a kinship placement. Beeman et al. (2000) found that older
children, children without disabilities, children of color, children court ordered into placement, and
children whose explanation for placement was parental substance abuse were more likely to be
placed in kinship foster care. This study examined the relationship of child and case characteristics
to placement in kinship and nonkinship foster care of more than 2,000 foster children in a
Midwestern urban county. The increase in kinship placements is due to several reasons. There is
an increased quantity of children needing out-of-home care. The number of available traditional
foster care homes has decreased. In addition, there is a growing validation of kinship placements as
an out-of-home resource (Child Welfare League of America, 1994).
Kinship Foster Care and Family Foster Care Studies
Although kinship can be defined in a number of ways, it typically considers caregivers to be
related to the foster child. However, some placements are considered family foster care, which
includes single or multiple parent homes that consist of caregivers that are either relative or
Types and Settings for Foster Care Visitation and Placement
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nonrelative and are licensed to provide care for foster children (Pecora & Maluccio, 2000). The
literature on kinship foster care has recently increased, but of particular focus is the examination of
the outcomes for children placed in kinship foster care (Benedict & Zuravin, 1996; Berrick, Barth,
& Needell, 1994; Courtney & Needell, 1997; Hawkins & Bland, 2002; Iglehart, 1994; Link, 1996;
Wulcyyn & Goerge, 1992). Outcomes for family foster care are of interest as well (Fanshell &
Shinn, 1978; Stein, Gambrill & Wiltse, 1978; Wulczyn, Zeidman & Svirsky, 1997).
Wulcyyn and Goerge (1992) discuss the foster care placement trends as a result of the
substantial increase in children in placement nationwide, which has drawn national public attention
to the concern. The trends include caseload growth, a large decline in age of children entering
traditional foster care, and increased placement of children into kinship caregiver homes. They
used administrative records for children entering kinship care in New York City and Cook County,
IL from 1987 to 1989 examining length of stay in care. They found that in New York, 88% of those
foster children in kinship care and 50% of those in non-kin care were still in care in 1990. In
addition, in Cook County, 45% of those foster children in kinship care and 40% of those in non-kin
care were still in care by 1990.
Berrick, Barth, and Needell, (1994) did a comparison of kinship foster homes and family
foster homes, and examined implications for family preservation. They studied 246 kin caregivers
and 354 non-kin caregivers from California through a cross-sectional mailed survey. This was a
descriptive study that examined the qualities of foster caregivers and of foster children in care.
Results indicated that over half of the children placed with kinship caregivers saw their parents
more than once per month versus 32% of foster children in traditional placements who had the same
visitation frequency. Only three percent of children in foster care saw their parents on an ongoing
basis, and 19% of the children in kinship care saw their parent at least once weekly.
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Courtney & Needell (1997) completed an outcome study in kinship care, examining children
who entered care in 1988. They were predominantly placed with kin, and the sample size was
4,644 foster children. Information was derived from administrative data, and odds of being
reunified were compared to staying in long-term foster care. Outcomes found that African
American children were less likely to reunify versus Caucasian children, and slightly less likely
than Hispanic children. In addition, neglected children living with kinship caregivers are
approximately 25% less likely to be reunified than physically or sexually abused children placed in
kinship care. Furthermore, kinship caregivers who are eligible for AFDC are approximately onethird les likely to reunify compared to kinship caregivers whose children are not eligible for AFDC.
Lastly, 85% of children initially placed in kinship care stay steadily in the same placement. If they
are moved, they typically move to the home of other kin.
Iglehart (1994) examined data from a Los Angeles County study where she compared 352
adolescents in kinship care to 638 adolescents in non-relative family foster care on the variables of
placement history, placement adjustment, and agency monitoring. Further, 160 foster adolescents
with legal guardians were studied. Results found that kinship placements have greater stability and
that adolescents in the care of a related foster parent have less of a likelihood to have a serious
mental health problem. She found that initial kinship placements seem to reduce the number of
subsequent placements. However, kinship care teens are not doing any poorer than adolescents in
family foster care, despite that both groups of adolescents do still experience struggles. Iglehart’s
study also suggests that child welfare professionals should ensure that services are provided to both
groups equally, as such efforts will act to reduce multiple placements.
Benedict et al. (1996) completed an outcome kinship study which examined associations
between the type of placement held by foster children in kin versus nonkin homes, and specific
adult outcomes of such children. Benedict et al. (1996) conducted interviews with 214 former
Types and Settings for Foster Care Visitation and Placement
15
foster children, 40% of whom were previously in kinship care. They reported on adult outcomes
such as aspects of current functioning from education to employment, as well as physical and
mental health, stresses and supports and risk-taking behaviors. Social services records reported
significant differences in functioning of children when comparing kin versus nonkin placements
during youth, however, few differences were found in adult functioning. (Benedict et al., 1996).
Link (1996) presented a longitudinal study of permanency planning for foster children in
kinship care in Erie County, New York in 1991. The county’s philosophy to favor relatives as the
desired placement for children requiring out of home care contributed to their success in enforcing
this practice well before the 1989 enactment of the New York State law stipulating that child
welfare agencies seek to use kin as foster care placements (Link, 1996). The data collected in the
1991 Erie County study completed by the State Task Force on Permanency Planning served as a
baseline for Link’s (1996) study and included 336 cases involving 664 children. The large majority
of these children (525) were placed with kin or a resource family, defined as a close friend of the
family, godparent or neighbor; 139 were siblings at home or in traditional foster care.
Demographically, 73% of the biological mothers were African American, 23% were Caucasian, and
2% were Latino. After examination of all 525 children placed in kinship foster care in Erie County
in 1991, this longitudinal study found that many children were adopted by their kin or were living
with kin towards the goal of adoption. Contrary to other trends discussed in the literature, kinship
families largely do adopt foster children in their care whom they are related to. In addition,
interestingly and consistent with the prior literature, this study found that the children who were in
the care of their relatives were in placement longer than those in traditional foster care. In sum,
more children are moving towards permanency in kinship care since families are starting to have a
greater willingness to adopt those children to whom they are related (Link, 1996).
Methodologically, although the access to data longitudinally is valuable as well as the relationships
Types and Settings for Foster Care Visitation and Placement
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noted in some instances, the more sophisticated systematic statistical review of such data could play
an important role in understanding what characteristics and experiences of foster children and
kinship foster families contribute to the success or lack of for their kinship placements, and possibly
explain why kinship families choose to adopt their kin foster children.
In yet another study, Hawkins and Bland (2002) discussed their program evaluation of
the Comprehensive Relative Enhancement Support and Training (CREST) Project supporting the
effectiveness of kinship care as an approach to permanency planning. The CREST project was
designed to address needs of the relatives acting as kinship foster parents and strengthen those
placements. It was to promote safety, permanency and the well-being of foster children who were in
the care of their relatives. CREST provided formal group training, case management and some
financial assistance to the kinship foster parents. The study was both qualitative and quantitative,
and had as its strength the triangulation of data sources to prevent possible bias by respondents.
However, it used an available-subjects sample composed of the kinship caregivers as well as the
CREST project caseworkers. The three year evaluation consisted of 304 relatives providing care to
579 foster children. They indicate that this model project improves functioning of relative
caregivers and decreases the expense of out-of-home care (Hawkins & Bland, (2002).
In regards to family foster care studies, Fanshel and Shinn (1978) completed a longitudinal
study of children placed in family foster care in New York City. It was the first longitudinal study
of foster children to take place, and identified the importance of parental visiting as a predictor of
discharge of children from foster care and therefore considering the welfare of the child. The
sample studied 624 foster children entering foster care in 1966 and were followed for five years.
Over one-third were still in foster care after five years, over half were not visited by their parents
during their care. Those who were visited by biological parents had more positive functioning, had a
Types and Settings for Foster Care Visitation and Placement
17
greater likelihood of returning home, and were found to reunify sooner than those who were not
visited.
Stein, Gambrill and Wiltse (1978) also completed a family foster care study around the
same time as Fanshel and Shinn (1978). They completed an evaluation of a demonstration project
designed to increase the permanency planning outcomes for foster children who were in placement
in Alameda County, California. Participants received housing, intensive case management services,
and financial aid, all of which was provided within a goal and time-oriented structure. It was also
contractually outlined in an arrangement with the parents, the case worker and the project director.
The design was quasi-experimental, and used 56 experimental group cases, and 40 control group
cases. Results indicated that significantly more (26%) experimental group cases were closed
through return home, guardianship or adoption when compared to the control group cases (18%).
Further, 79% of the experimental group foster children were either discharged from foster care or
were awaiting discharge, versus 40% of the control group foster children.
Later, Wulczyn, Zeidman, & Svirsky (1997) examined family foster care through the Home
Rebuilders project, a family reunification demonstration program aimed at achieving permanency
planning outcomes for children placed in New York City. There were many criteria excluding
participants, which added control to the study. Participants who were excluded included children
ages 12 or older, children in foster care for less than 90 days, children with a previous foster care
placement or those who previously had siblings in foster care, children who were placed in training
schools, state hospitals or institutions for the severely developmentally delayed, children who were
from adoptive residences, and children whose parents were paying for the total expense of
placement. Agencies received a predetermined sum that was to meet all expenses for three years.
Case load sizes were reduced, and foster children were randomly selected into the experimental and
control groups. Upon the conclusion of the first year, 79% of the Home Rebuilders children were
Types and Settings for Foster Care Visitation and Placement
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still in care compared to 85% of the control group. Further, 380 Home Rebuilders foster children
returned home, as opposed to the 224 children who would have returned to their homes using a
projected baseline rate.
Treatment Foster Care and Alternative Types of Residential Treatments
Treatment Foster Care is also known as specialized or therapeutic foster care; they are often
used interchangeably (Chamberlain, 2000). However, there are distinct differences. In treatment
foster care, treatment parents are the primary change agents and are used in a clearly defined
treatment plan. Parents, as the change agents, supply treatment services to children with emotional,
behavioral and/or medical problems. This program recognizes treatment parents as components of
a treatment team. Treatment parents from the community are enlisted and provided instruction and
support services to create and employ interventions for children in their home (Chamberlain, 1998).
Parents help children access community resources to aid in their development and transition from
the program. Mental health professionals are accessed by the treatment parents as consultants only
(Bryant & Snodgrass, 1992; Galaway, 1989).
‘Treatment foster care’ has been used broadly to exemplify programs that offer specialized
and / or treatment foster care programs (Reddy & Pfeiffer, 1997).
Although specialized foster care
is also called treatment foster care in some instances, there is a qualitative difference as was
mentioned. In specialized foster care, mental health professionals are the primary change agents.
Therapy and intensive family-based community-based services are presented to children who
necessitate out-of-home placement. Parents are afforded training to produce a nurturing therapeutic
environment in their own home. Treatment parents implement individualized interventions devised
and moderated by mental health professionals. Mental health professionals function in a primary
role in the development and implementation of interventions. They are also usually employed by
the program (Chamberlain & Reid, 1991; Snodgrass, 1989).
Types and Settings for Foster Care Visitation and Placement
19
Treatment foster care initially was created by the Oregon Social Learning Center (OSLC) in
1983 for severe and chronic juvenile offenders as an alternative to institutionalization in residences
and group homes (Chamberlain, 1998), and has been increasing in utilization ever since
(Chamberlain, 2000). It has become one of the most widely used placement methods for out-ofhome care for children and youth who are severely emotionally and behaviorally disturbed, and is
considered the least restrictive form of residential care (Kutash & Rivera, 1996; Stroul, 1989).
Since the program’s inception, this model has served over 300 youth (Chamberlain, 1998). In
treatment foster care, the exposure to other delinquent youths is minimized, so as to lessen the
potential of creating bonds between the teens and modeling further delinquent behavior.
Adolescents are placed individually or at times in pairs, in a family setting (Chamberlain, 1998).
This is viewed as an advantage, as well as that children are placed in the normalizing setting of the
family environment (Chamberlain, 2000). Adolescents receive a structured, individualized program
that builds on their strengths and provides limits, rules and expectations (Chamberlain, 1998).
Regardless of the differences denoted, treatment, specialized or therapeutic foster care has found
increasing favor in a number of states (Needell, Webster, CuccaroAlamin, & Armijo, 1998). Terms
will be used interchangeably from this point onward but will be identified as per how each author
has chosen to do so for that particular study.
It is also important to specify a definition of ‘residential treatment,’ as it is widely used
without a universally accepted definition. The terms ‘group home’ and residential facility are often
used interchangeably. However, group homes are generally designed to supply basic needs of its
residents, from food to shelter to daily care. Residential facilities or treatment centers provide such
needs, but specifically focus on delivering therapeutic services to its residents. Unfortunately, the
differences between these types of facilities are often unclear (Bates, English, Kouidou-Giles,
1997).
Types and Settings for Foster Care Visitation and Placement
20
A review of the outcomes studies for treatment foster care reveals that the intervention is
practical as well as economically beneficial particularly compared to alternative residential
treatment programs. Further, it has yielded better results for children and families (Chamberlain,
1998). Although there are over three hundred treatment foster care programs operating in the
United States and Canada, a selection of treatment foster care program outcome studies will be
reviewed in this paper.
Hudson, Nutter, & Galaway (1992) used snowball sampling techniques to categorize 1,255
potential North American specialist foster care programs from a mailing list seeking those that meet
their criteria defining themselves as such.
Among the criteria, this ‘treatment foster care program’
also meets the description for specialized foster care, given the training and support services
provided to the treatment foster care parents who are intervening with foster children, as well as
that the foster parent is a part of a team with mental health professionals providing services to the
youth as well. The authors admit the lack of consensus and true label for the term. Questionnaires
were sent to programs in the United States and Canada and were returned by 824 programs, 430
which were eligible due the remainder only providing program identification data. After meeting
the criteria, 293 ‘treatment’ foster care programs were evaluated for general program data, length of
stay, and intervention techniques utilized. Findings suggest that program processes are mostly
unknown, which is due to programs failing to document such. Over half of the people in care were
adolescents, 55% were male, most referrals came from the child welfare system with a minority of
referrals coming from juvenile justice and mental health. The average length of stay for children
and youth discharged from the program was approximately 12.8 months; 63% of discharges were
planned, and two-thirds were to a less restrictive level of care. Further, 75% of the programs placed
a maximum of 3 persons per foster home.
Types and Settings for Foster Care Visitation and Placement
21
Cross, Leavey, Mosley, White and Andreas (2004) describe the results from an outcome
measurement in a services network that administered specialized foster care to children who were in
custody of child protective services. Classified as a specialized foster care program because of the
collaborative clinical treatment team involved and providing services, this program was considered
a step down from more intensive, residential treatment. The Specialized Foster Care program was
part of the Family Reunification Network (FRN), a managed delivery system providing services to
youth and their families in child protective services custody in Boston. The dataset called
‘SOURCE’ was the FRN dataset examined. This study involved 384 foster children who were
discharged from specialized foster care from July 1995 to March 2000.
The participants in the
sample included mostly adolescents with a moderately sized group of grade school and preschool
children. The children averaged more than four problem areas. Half had a history of sexual abuse
and a psychiatric diagnosis. Three quarters had a history of some trauma. A small portion had been
sexually abused, involved with substances or promiscuous sexual behavior. Two-thirds suffered a
major loss as well as struggled with aggressive behavior. When examining outcomes for child
behavior, slightly less than half showed comprehensive improvement. Less than half of those who
identified with promiscuous behavior or substance abuse improved. In addition, less than half of
the children improved on running away behaviors within a 24 hour period, destroying property, and
lessening negatively symptomatic behaviors related to parental visitation. The authors admit that
the outcome survey lacked standard psychometric data, and that therefore, assessing internal
consistencies as well as interrater or test-retest reliability is difficult.
Evans and Armstrong (1994) examined results for emotionally disturbed youth, ages six to
twelve, who were seriously emotionally disturbed and placed in treatment foster care. Results were
compared to a similar group of children who remained at home and whose families received
intensive case management. The Client Description Form for Children and Adolescents (New York
Types and Settings for Foster Care Visitation and Placement
22
State Office of Mental Health, 1991) and The Child Behavior Checklist (Achenbach, 1991) were
used to assess client demographics, behavioral and functioning status, treatment history, strengths,
unmet needs of each child and family, and child behaviors. The study used a positive, controlled
randomized design where children were referred to either the Family Based Treatment – treatment
foster care program or the Family Centered Intensive Case Management (FCICM). After referral
and randomization, 39 children were enrolled in either the FCICM (N=15) or FBT (N=24) program.
Findings concluded that home placement children did as well as the children in treatment foster
care. However, treatment foster care youth did not receive family therapy as part of treatment foster
care their program. In addition, the small sample size may possibly have limited the statistical
power of this study.
Chamberlain’s (1998) review of four studies (Chamberlain, 1990; Chamberlain & Reid,
1991; Chamberlain, Moreland, and Reid, 1992; Chamberlain and Reid, 1998) done in Eugene,
Oregon through the Oregon Social Learning Center (OSLC) indicated the successfulness of the
treatment foster care model. The first study used a matched comparison design where the
adolescents were matched on age, sex and date of commitment to the State training school. This
study examined the quantity of days that the adolescents were incarcerated during the initial two
years following treatment as well as the program completion rates for the sample of 32 youth. The
youth spent substantially fewer days incarcerated which also demonstrated a savings of $122,000
for the program in incarceration costs. There were also fewer incarcerations of the adolescents after
treatment (Chamberlain, 1990). Although a larger sample would have been desirable, procedurally
matching participants lends strength to the design.
Chamberlain and Reid (1991), in the second Oregon Treatment Foster Care study, examined
the treatment foster care program model for children and adolescents leaving the state mental
hospital. Although there is a strong emphasis on ensuring the shortest possible hospital stays, such
Types and Settings for Foster Care Visitation and Placement
23
short term stays are not always possible due to the lack of treatment foster care program facilities,
among other services such as residential facilities and short term respite care facilities. The
shortage of such facilities creates problems such as long waiting periods for such facilities. This
adds pressure to such places like specialized foster care among others since insurance companies
will only financially support children’s hospital stays if the level of care is warranted (Bronfman,
1999). Chamberlain and Reid (1991) studied 20 youth, ages nine through eighteen, and examined
the effectiveness of treatment foster care to community group home living. Cases were referred
from the hospital as youth were ready for discharge. A random assignment design was used;
treatment foster care was compared to the control group of youth who utilized the community group
home. The status with psychiatric symptoms, problem behaviors, and occurrence of
rehospitalizations were examined. Youth were placed in the Treatment Foster Care from the
hospital at a high rate. Over the seven month follow up period, one-third of the control group youth
continued in the hospital because of the lack of availability at viable discharge placement options.
No differences were found in rates of rehospitalization or self-reports of psychiatric symptoms.
However, treatment foster care youth had a significantly better status with behavioral problems as
reported by observances from adults (Chamberlain & Reid, 1991). Despite the reliance on selfreports for status of psychiatric symptoms, the random assignment and presence of a control group
clearly strengthens the design of the study. However, the small sample size supports the need for
further research as well as questions the ability to rely on the findings.
Continuing study through the OSLC, Chamberlain, Moreland, and Reid (1992) created
three groups of foster parents and placed provisions in the groups to assess how the provisions
affected disruption rates for children in traditional foster care. The three groups included:
assessment only, where parents did not receive pay or training for their participation; payment
only, where parents were paid for their participation but did not receive additional training; and
Types and Settings for Foster Care Visitation and Placement
24
enhanced training and support, where parents did not receive payment but did receive enhanced
training and support. Random assignment of the 70 foster parents to the three groups took place.
The individualized daily program from the OSLC treatment foster care program was taught to the
enhanced training and support group, including methods for assessing frequencies of child behavior
problems as well as disruption in foster care. In comparing the groups, fewer enhanced training and
support participants dropped out. Regarding the adolescent results, treatment foster care youth
whose parents participated in the enhanced training and support group had less disruptions in their
placements and three months following the study, youth from this group had the largest decrease in
the frequency of problem behaviors. Again, the random assignment and presence of a control group
adds strength to the design of the study.
The positive outcomes from these studies (Chamberlain, 1990; Chamberlain & Reid, 1991;
Chamberlain, Moreland, & Reid, 1992) lead to the full-scale clinical trial to assess the effectiveness
of the OSLC treatment foster care program. Thus, Chamberlain and Reid (1998) examined the
relative efficacy of group care and multidimensional treatment foster care through a comparison in
regards to their impact on criminal offending, rates of incarceration, and program completion results
for 79 males, ages twelve to eighteen. These residential placement options are viewed as an
alternative to incarceration, as the juvenile delinquents would result in incarceration without such
other options The adolescents had a history of ongoing and serious juvenile delinquency, and they
averaged 13 offenses. A significantly greater number of treatment foster care youth completed the
program than those in the group home program. In addition, treatment foster care youth were
incarcerated for 60% fewer days during the one year follow up period than the adolescents in group
home care. Further, more treatment foster care youth were released from out-of-home care to return
to their families.
Types and Settings for Foster Care Visitation and Placement
25
Group home placements and residential treatment facilities have been met with mixed
success (Barker, 1988; Chamberlain & Reid, 1998; Festinger, 1983; Jones & Moses, 1984, Pecora
et al., 1992), partly due to the poor post-discharge adaptation (Curry, 1991; Pecora et al., 1992).
Treatment outcomes from such residential programs have been found to reduce effectiveness from
programs that have focused on juvenile delinquency (Oswald et al., 1991) and emotionally or
behaviorally disturbed children (Harding et al., 1978). Research suggests that children from foster
family care are more likely than children who have been in residential care, such as group homes or
institutions, to develop into well-functioning adults. Various social indicators have indicated this,
such as high school completions, criminal activity, substance usage, marital success, and general
satisfaction with life (Festinger, 1983; Jones & Moses, 1984). In addition to the support already
suggested for treatment foster care, the literature indicates that interventions such as this are more
cost effective than group home and similar residential care facilities (Chamberlain, 2000).
Treatment foster care programs require one-fifth to one-third less funding than residential facilities
(Kutash & Rivera, 1996). Lastly, depending on the age of the children who are served, specialized
foster care programs as well as residential facilities can supply older children in care to placement
in independent living centers where they will learn life skills of all types preparing for the
independence of adulthood (Hoge & Idalski, 2001).
Given the general review of all such placement types, it can be seen that more research in
the field is necessary. However, review of placement outcome studies reveals that kinship care and
treatment foster care have found the greatest successes for the children involved, compared to
traditional foster care and group home residential placement.
Supervised Visitation
Supervised visitation is defined as “providing an opportunity for contact between a child and
an adult, typically the non-custodial parent, in the presence of a third party. This third person is
Types and Settings for Foster Care Visitation and Placement
26
responsible for ensuring a safe environment for the individuals participating in the visit” (Perkins &
Ansay, 1998, p. 253). Supervised visitation is used when there is believed to be a risk to the child.
(Strauss & Alda, 1994). Supervised therapeutic visitation is when a parent is supervised by a third
party trained person, such as a clinician, who has a graduate health and human services degree.
They are viewed to be best able to therapeutically intervene and to manage conflicts and clinical
issues when they arise (Tuckman, 2005).
Visitation is a common part of the case plan for parents seeking to recapture custody of their
children (McWey & Mullis, 2004). The Adoption Assistance and Child Welfare Act of 1980 also
stipulates visitation and that placement must be arranged for a foster child to reside within a
reasonable proximity from the biological parent(s). In many states, a judge determines if
supervised visitation is required between parent and child. The decision is based on circumstances
such as type of abuse, the severity of abuse, and abuse history in the family. Following an order for
supervised visitation, the case worker involved may possibly plan and observe the visits, or the
family may be referred to a supervised visitation center (Perkins & Ansay, 1998).
Supervised
visitation programs often consist of established centers where visits take place between dependent
children and the non-custodial parent who is supervised by a trained observer. Such visitation
centers generally provide such services as arranging visits among family members, observing visits
and child exchanges, as well as, in some instances, provide parenting classes and support groups
(Strauss & Alda, 1994). Visits commonly take place at agency or county case worker’s office or at
foster families’ homes (Davis, Landsverk, Newton, & Ganger, 1996). The caseworker’s office may
not be perceived as welcoming and may actually increase family tensions. Visiting at foster
families’ homes may also yield tension between foster parents and biological parents as a result of
anxiety and loyalty to the children (McWey & Mullis, 2004). This struggle is exemplified, as
Straus and Alda (1994) refer to visitation as ‘child access’ since many visiting parents object to the
Types and Settings for Foster Care Visitation and Placement
27
use of the term visitation. They discuss programs and practical issues related to supervised
visitation, and reveal the delicate nature of the supervised visitation process. For example, tension
among parties exists for many reasons. A child may witness abuse resulting in their traumatization
from this experience (Johnston & Straus, 1999; Straus & Alda, 1994); fathers who previously were
not invested in visiting or having contact with their child wish to initiate contact with their child for
whom they pay child support. These sensitive issues are intricate in the modalities of how to
address them. However, supervised visitation is an intervention that provides a neutral and safe
environment for both parents and children to have access to one another for evaluation and
assessment, as well as the opportunity to strengthening the parent-child relationship (Straus &
Alda, 1994).
Ultimately, supervised visitation is to provide a safe, friendly surrounding that functions to
support the parent-child relationship (Perkins & Ansay, 1998). Although Horrwitz (1983)
discusses arguments regarding whether or not it is in the best interests of the child for the court to
force visitation with the non-custodial parent or for the court to provide the custodian with the
authority to assess the conditions of visitation or perhaps deny it, Levy (1982) suggests supporting
the supervised parent and emphasizing the positive bond and history that may exist between the
child and the visiting parent should resistance arise in the child. Regardless, it is commonly
accepted that visitation plays a key role in improving the parent-child relationship that will largely
enable reunification (Fanshell, 1978; Haight et al., 2003). In addition, due to the advantages for
children who would not have had a great degree of time with their non-custodial parent, supervised
visitation programs are being looked upon very favorably by the courts which utilize them, by the
parents who feel more included in the process and lives of their children, and by the greater
community (Newton, 1997).
Types and Settings for Foster Care Visitation and Placement
28
There was very little empirical research on supervised visitation, as well as a small amount
of literature in regards to articles and professional papers (McWey & Mullis, 2004). Further, “the
effectiveness of supervised visitation centers in conducting visits has not been systematically
researched” (Perkins & Ansay, 1998, p. 253).
Given the limited literature in this area, findings for
much of what exists in the literature is provided, yet cannot be reviewed extensively or per
placement type due to the considerable lack of literature in this area.
There is a large body of literature that supports the need for visiting between parent and
child towards enhancing that relationship and towards achieving the goal of reunification (Davis,
Landverk, Newton and Ganger, 1996; McWey & Mullis, 2004). In addition, there is much research
that indicates that children who are visited in foster care have a more positive emotional and
behavioral status when compared to those children who are not visited in foster care (Cantos &
Gries, 1997, Fanshel & Shinn, 1978). In addition, although this study did not look at supervised
visitation, Davis, Landverk, Newton and Ganger (1996) found that parental visiting plans were
more frequent for both visiting mothers and fathers in kinship foster homes than in traditional foster
homes. They also found that parents who visited their children in foster care at the court
recommended levels had significant reunification rates. Browne and Maloney had the similar
finding where they concluded that parental access and frequent visiting positively affects the foster
child (2002). In addition, there are studies that have examined the effects of having a trained home
visitor enter the home of vulnerable families towards the goal of child abuse prevention (Barlow et
al., 2003; Davis & Spurr, 1998). However, the body of literature on the benefits and necessity of
visitation have largely examined unsupervised visitation such as these examples. There is a great
need for the study of the effects of supervised visitation, are there are few studies that have
examined its effects.
Types and Settings for Foster Care Visitation and Placement
29
Perkins and Ansay (1998) provide information about the effectiveness of a supervised
visitation program at preserving the relationship between parents and their children who have been
adjudicated. Families involved in a visitation center in a city in Florida (N=48) were compared with
those families who did not participate (N=35). Their visits took place under the supervision of a
caseworker, who also scheduled the visits. The data utilized was retrospective in format, and the
authors indicate that such was chosen due to ethics. Further, although random assignment of
families to the visitation centers did not take place, again because it was not possible or ethical,
threats to internal validity were minimized by families in both groups being exposed to the same
conditions in their environment. These included agency protocol and politics. They found that the
families involved in receiving visits at the visitation center had a much greater likelihood to have
visits take place, as well as to have many visits, when compared to non-participating families.
Ansay and Perkins (2001) completed a preliminary study of foster care children receiving
supervised visitation in a visitation center to assess the quality of attachment. Retrospective reports
from observations from visit supervisors assessed degree of attachment by tallying the negative and
positive comments indicated as the measure of attachment. They present a conceptual model that
attaches a numerical value to aspects of the parent-child relationship for utilization in supervised
visitation, and the authors admit that the model has yet to be tested. After examination of 43
families, a small sample size, they found that African American children displayed stronger levels
of attachment to their biological parents than the Caucasian children did. Further, greater
attachment levels were derived if the mother was the specified perpetrator of maltreatment instead
of the father.
McWey and Mullis (2004) also assessed attachment in 123 foster children who were
receiving supervised visitation at a Family Visitation Center. Two bachelors level personnel along
with the principal investigator administered and completed the Attachment Q-set (AQS) after
Types and Settings for Foster Care Visitation and Placement
30
observations of the visitation of the foster children and their parents. The AQS has fair reliability
and validity, however, reliabilities at follow-up spanned into a low range (.67 to .98). Findings
indicated that for families who have reunification as a goal, children who have regular, frequent
contact with their biological parents have stronger attachment quality than children who have less
frequent contact. In addition, foster children who have a stronger attachment quality had fewer
problem behaviors, were less likely to take psychiatric medications, and were less likely to be
categorized as developmentally delayed when compared to children with negative attachment
levels.
Pearson and Thoennes (2000) described a representation of families who receive supervised
visitation services due to custody, visitation or family violence issues. They reviewed agency files
from 590 cases dealt with by one of four programs, including three visitation centers and one victim
assistance center, among various states in the nation. The study drew a large sample who was
largely referred from the courts. They were from four large-scale programs serving divorced
parents, those never married, and those with a history of domestic violence. In addition, they
interviewed 201 parents who were involved to learn of the services received, to assess their
experiences and outcomes. The study found that these programs successfully serve a wide
assortment of families and were viewed to be highly satisfactory from the users. However,
approximately half leave the program without proper closure. Families that chose to drop out
receive fewer court hearings and assessments for the issues that lead to their admission into the
program, indicating that they may have felt disregarded or mistreated. For those who completed
and formally left the program, the visitation conditions got better with time. However, those
parents who were interviewed reported mixed feelings about their visitation circumstances after
departing the program.
Types and Settings for Foster Care Visitation and Placement
31
Further information from an article on a model program providing supervised visitation are
not empirical reviews reveals additional information, from proposed models, to key issues in
supervised visitation. Hess and Mintun (1992) describe a Model program created in 1989, ‘The
Family Connection Center,’ (FCC) which is proposed as an innovative visitation program center for
supervised visitation and other types of visitation. The FCC has provided visitation services for
approximately 2,000 children, the majority of whom were in placement. The FCC is designed to
enhance family relationships, empower parents, give family members chances to exercise new
behaviors, as well as monitor family advancement. The program operates on the premise of
visitation being a planned intervention that is essential to the reunification process. It has as its
foundation planned case goals, and assesses family functioning and risks to the child.
Recommendations for Shifts in Policy and Practice
Avery (2000) found that the hardest to place children wait years for placement largely because of
their status of having a disability, being a male, African American, and an older child when entering
care. However, she reported that foster care caseworkers and agency screening practices restricted
placement opportunities for foster children. Child welfare practice should recognize such potential
biases and more objectively consider viable options, seeing progress and possibilities where they
exist. It is commonly known that an increased prevalence in violence and delinquency over the past
several years has originated from various social problems. These include child abuse and neglect,
substance abuse, youth conflict and aggression, and involvement with sexual activity at an early
age. Researchers and policy makers suggest that the development of effective interventions for
juvenile delinquents should be based on research that addresses the development of aggression and
antisocial behaviors. Therefore, it is believed that expert study of interventions, such as treatment
foster care, should evaluate the successfulness of the intervention and contribute sound information
that can guide the development of interventions in the future (Chamberlain, 1998).
Types and Settings for Foster Care Visitation and Placement
32
Kinship foster care supports one of the main goals of the child welfare system, which is to
support families in their efforts to protect children. Child welfare agencies should recognize the
need and challenge to develop policies and support services for children and their related caregivers
to enhance their experience in foster care (Berrick, 2000). In addition, Gebel (1996) found that
foster care case workers have a lower level of contact with kinship caregivers than traditional foster
parents. This raises a concern and indicates a recommendation for practice. Increased attention
needs to be directed towards kinship caregivers towards the goal of providing permanency for the
foster children in kinship placements. Measures must be taken to ensure that the quality of care is
monitored and that they are receiving the level of support necessary to assist them with meeting
their related foster children’s needs.
Link (1996) indicated that more research will be necessary to truly learn what the motivating
factors are that lead families to adopt their kin. Such information can be acquired through surveys
and interviews, and she suggests that achieving independence from the social services as well as
fiscal considerations may be possible motivating factors for increasing adoptions (Link, 1996).
Further, Lorkovich et al (2004) suggested needed shifts in philosophies and policies, including
practice strategies to promote permanence in kinship homes. They suggest learning from projects
that have been successful, such as the Kinship Adoption Project (KAP) in Cuyahoga County, Ohio.
KAP was an exploratory study that sought to identify the obstacles and catalysts in kinship
adoption, and created a social service program to minimize the obstacles so as to enable kinship
adoption to take place. They suggest considering the perspectives of KAP kinship providers so as
to gain insight into what may help achieve permanence for children today. The realms of practice,
philosophy and policy should all examine the best permanency option for children, and the needs of
the family should determine the services provided to kinship caregivers and their children. In
addition, kinship caregivers need social support and services that should be made available to them
Types and Settings for Foster Care Visitation and Placement
33
and not be blocked due to obstacles such as paperwork, limited office hours, or transportation
issues. They also need financial assistance for the foster child’s basic and special needs, as well as
adequate health insurance. Support groups for themselves and the children who they are taking care
of is another necessity. Further, kinship caregivers need complete and detailed information about
the children entering their home.
Finally, Berrick and Barth (1994) comment on ensuring that kinship is a not a cheap
alternative to traditional foster care or another form of care, which would then create a hierarchy.
Instead, putting money, training and support into kinship families would ultimately address the
welfare of the child. Further, permanency plans should not end should foster children remain in
foster care for extended periods followed by emancipation. Therefore, the development of more
satisfactory independent living services is necessary, as well knowledge of resources to ensure that
guardianship and adoption are successfully achieved. Lastly, research with foster children should
seek to have more comparison groups and repeated measures to more comprehensively assess the
field.
Lastly, engaging families and having them increase investment in the visitation process
towards improving the parent-child relationship and considering the welfare and the development of
their children in foster care is another considering that needs continued attention (Dawson & Berry,
2002; Fanshel & Shinn, 1978; Haight et al., 2003). This important factor was identified early in the
first longitudinal research (Fanshel & Shinn, 1978) and has been identified as a key component
throughout the literature ever since (Haight et al., 2003). In addition, Clement (1998) discusses the
need for increased supervised visitation services, as the quantity of children at risk and in need of
such services is rising beyond the existing supervised visitation services. Further, although
supervised visitation is necessary in some instances (Clement, 1998), child welfare professionals
must ensure that children are assisted with achieving or maintaining a positive focus of the
Types and Settings for Foster Care Visitation and Placement
34
supervised visitation experience and the parent involved. They should be conscious of the fact that
supervised visitation acts to undermine the parent who is being supervised (Tuckman, 2005). If
resistance arises by the child towards visitation, emphasis should be placed on the positive bond and
history that may exist between the child and the visiting parent (Levy, 1982). Parents should be
made aware of the developmental needs of their children which can possibly be fulfilled during
visitation, and the rejection and abandonment issues that can result from the lack of the parent-child
relationship in their child’s life (Goldstein, Freud, & Solnit, 1979). Tuchman (2003) suggests that
future research should focus on the impact of attachment issues on young children experiencing
supervised visitation. Such an emphasis would enable appropriate services and interventions to be
created and employed to support the parent-child relationship and more suitably develop supervised
visitation services that address the needs of the children being visiting. In addition, efforts should
continue to ensure that a child is receiving the proper placement at the least restrictive level of care
(Goldstein, Freud, & Solnit, 1979). However, child welfare professionals should ensure that the
focus on placement considers both the safety and psychological well-being of the child (Goldstein,
Freud, Solnit, 1979; Whittaker & Maluccio, 2002).
Types and Settings for Foster Care Visitation and Placement
35
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