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DOI: 10.1177/1473325012474017
2014 13: 255 originally published online 14 February 2013 Qualitative Social Work
Evelyn Khoo and Viktoria Skoog
surrounding the unexpected ending of a child's placement in their care
The road to placement breakdown: Foster parents' experiences of the events
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DOI: 10.1177/1473325012474017
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Article
The road to placement
breakdown: Foster parents
experiences of the events
surrounding the unexpected
ending of a childs placement
in their care
Evelyn Khoo and Viktoria Skoog
Umea University, Sweden
Abstract
Placement breakdown is a frequently occurring phenomenon in the context of out-of-
home care. Although research has pointed to the many problems associated with
placement instability and breakdown, less is known about foster parents experiences.
We carried out deep interviews with foster parents to investigate connections between
their caring experiences and experiences of placement breakdown. Results of our study
demonstrate that breakdown is a complex process rather than a single event a pro-
cess that starts in the discrepancy between the statutory obligations of the social ser-
vices toward the foster home and the foster parents perceptions of the kind if
information and support they actually receive from the social services. High demands
are placed on foster parents ability to provide care and offer a loving home to children
who have been raised in difficult environments and who have behaviour problems. The
road to breakdown also included a lack of knowledge about the childs needs, insuffi-
cient understanding of the placement process, a difficult relationship with the social
worker, and a lack of individualized service with the right supports at the right time.
Although the placement may have ended in breakdown, foster parents described a
continuing relationship between their families and child which was of lasting significance.
Keywords
Children, experiences, foster carers, placement breakdown
Corresponding author:
Evelyn Khoo, Deptartment of Social Work, Umea University, SE-90187, Umea, Sweden.
Email: evelyn.khoo@socw.umu.se
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Introduction
When children cannot grow up with their parents, society has an overall respon-
sibility for ensuring that they have access to the support and protection they need.
In Sweden, this responsibility ultimately falls to the social service system. Every
year, thousands of children and young people nd themselves placed in out-of-
home care. While the overall numbers of children in care have varied over the
years, the use of care placements have been a stable part of the child welfare
system since its foundation. Placements of children and young people may be in
either foster care or institutional settings although most, regardless of age, are
placed in foster care settings. Foster care is often seen as the optimal care envir-
onment because it is meant to give children an ordinary family life until they either
return home or are ready for independent living. How well the system succeeds in
this task has long been open to question with research showing that there are
serious and frequent problems and adverse outcomes for children who have been
placed in public care (Vinnerljung and Sallna s, 2008).
One problem shared by child welfare systems across the western world is place-
ment breakdown the unexpected, unplanned and sudden termination of a childs
placement, whether in foster care or in another care arrangement (Unrau, 2007).
A review of the literature has shown that placement breakdown is a frequently
occurring phenomenon, occurring in between 2040 percent of placements
(Egelund, 2006; Oosterman et al., 2007). Research has also shown a connection
between placement breakdown and poorer outcomes for children in both the short
and long term. They often experience increased behavioural problems and emo-
tional diculties (Newton et al., 2000) and have generally poorer long-term prog-
noses (Vinnerljung and Sallna s, 2008).
In Swedish child welfare, the child is at the centre of care planning whereas
responsibility for the child is shared between the social services, carers and parents
(in so-called three-party parenting). If a placement does break down, it impacts not
only the child but often also biological parents, social workers, and foster parents.
Although studies of placement breakdown are numerous, they have often focused
on its frequency, risk factors or causes and consequences to children. Few studies
have included foster parents; and when they have, the focus has been on foster
parents view of childrens problems and not on their own experiences of break-
down (Brown and Bednar, 2006).
To address this knowledge gap, we designed this study to investigate how
Swedish foster parents described and understood placement breakdown and the
care context in which it occurred. It is part of a larger study including the experi-
ences of foster children, biological parents, and social workers. We sought answers
to the following research questions:
. How do foster parents describe their reasons for becoming, and their lives as,
foster parents?
256 Qualitative Social Work 13(2)
. How do they describe the circumstances surrounding children being placed in
their care?
. How do they describe the circumstances surrounding placement breakdown?
A better knowledge of how this phenomenon is experienced in relation to the care
process as a whole may help us to better deliver services for the sake of all involved
in child welfare placements.
Children in care in Sweden
In Sweden, the states responsibility for children is subsidiary to the parents, as
long as parents themselves can give their children a good upbringing (Sundell et al.,
2007). Child welfare is, thus, a combination of controlling and family supportive in
nature (Wiklund, 2006) and is legislated through the Social Services Act (SoL). The
law is goal oriented (Andersson, 2001) and states that the Social Welfare Board
should, on the bases of democracy and solidarity. . . work to ensure that chil-
dren and youth grow up in a safe environment (SoL chapter 5 1). Services are
to be provided in cooperation with parents and may include the placement of a
child in out-of-home care. Parental consent is always required when children are
placed outside their homes under the SoL. If the child is aged over 15, the childs
consent is also required. Foster care is considered preferable to residential care and
children should, if possible, be placed with a relative or other close adult
(Andersson, 2001).
Children and youth may also come into care on a compulsory basis
under the Compulsory Care of Young Persons Act (1990: 52) (LVU) if
there is substantial risk that the childs health or development will suer
due to conditions in the home environment or because of the young persons
own behaviour and if care cannot be given on a voluntary basis. When a child
receives care under LVU, parents remain legal guardians although their dis-
cretionary powers are curtailed. In Sweden, regardless of whether placements
occur under the legal mandate of SoL or LVU, when children and young
people are placed in out-of-home care, it is regarded as a support and
temporary measure where family preservation remains the guiding principle.
Although custody of a child in care for longer than three years can be trans-
ferred to the foster parents, this is an option that is rarely exercised
(Andersson, 2006).
Placement breakdown
The nature of placement breakdown
The phenomenon of placement breakdown has been studied since the 1960s.
Given the poor outcomes associated with placement breakdown, research has
Khoo and Skoog 257
focused on identifying risk factors associated with breakdown (Rostill-Brookes
et al., 2011) and studies have, to a large extent been based on the examination of
social work case les (Egelund et al., 2010; Unrau, 2007). Risk factors have most
frequently been connected to the children in part because case les most often have
information about children and their parents, leaving other potential risk factors
dicult to discover. Swedish and international research on placement breakdown
has shown that older children (Smith et al., 2001), the presence of behaviour prob-
lems (Newton et al., 2000; Park and Ryan, 2009; Sallna s et al., 2004; Ward, 2009)
and previous moves within the care system (Oosterman et al., 2007; Vinnerljung
et al., 2001) are associated with a signicantly higher risk of breakdown. Research
also indicates that caregivers, social services and biological parents, inuence the
breakdown process but ndings from these studies are not consistent. These
approaches in quantitative research risk, as Engelund et al. (2010) explain, positing
placement instability as a single event rather than a process and that risk factors for
placement breakdown become reduced to qualities within individuals instead of
being seen as something that is shaped in the interaction between people and
context.
Breakdown and foster parents
Even in qualitative studies of placement breakdown, foster parents often cite
childrens behaviour problems as a reason for breakdown. Foster parents
describe the safety of the family due to the childs physically or verbally aggressive
behaviour as one reason for placement breakdown (Brown and Bednar, 2006;
Gilbertson and Barber, 2003). However, interviews with foster parents have
shown that it is not just the childs behaviour that is an important consideration
but rather it is in combination with system failures including a lack of pertinent
information about the child prior to placement and a lack of supports to foster
families when they asked for help that placements, which otherwise could be
saved, end up in unnecessary breakdown (Gilbertson and Barber, 2003). From
foster parents perspectives, placement breakdown occurred if the child had
needs or behaviours that the foster parents could not meet or manage, if their
own health became problematic or if the circumstances of the family changed
(Brown and Bednar, 2006). The stress that can come with being a foster parent,
for example coping with hyperactivity in a child, diculties in their relations with
the biological parents, and problems in contact with social workers can lead to an
increased feeling of stress and thus increase the risk of placement breakdown
(Farmer et al., 2005).
Foster parents decisions to terminate placements are preceded by a substantial
period of weighing alternatives (Wilson et al., 2000) and regardless of the reasons
given, placement breakdown is described as a dicult experience, marked by guilt
and a sense of failure in trying to make a dierence in a childs life (Rostill-Brookes
et al., 2011). Placement breakdown signicantly increases the chances that a foster
parent will decide to end their role as a foster parent (Wilson et al., 2000).
Methodology
This study is informed by interpretive phenomenology and explores the experi-
ences of the participants from their own perspective but moves from a descrip-
tive level to interpretation (Cederborg and Gumpert, 2010). Our focus is thus
on the meaning that our respondents give to events preceding and surrounding
placement breakdown rather than on risk factors associated with this phenom-
enon. In this study, we carried out deep interviews with foster parents to
understand how they experienced placement breakdown (phenomenology) and
how they make sense of and apply meaning (interpretation) to their experience.
The method is based on two aims. The rst one tries to understand the par-
ticipants world and describe it with focus on the participants experiences of
placement breakdown. The second aim is to analyse and interpret these nd-
ings in relation to the wider social and cultural context (Larkin et al., 2006)
in this case in the context of social services and the provision of out-of-home
care. Our approach is based on our interpretation of placement breakdown as
an experience immediately and directly connected to the context of caring in
which it occurs.
We recruited a purposive sample of traditional foster families (no previous
relationship to the child) to participate in this study. Using the conceptualiza-
tion of placement breakdown developed by Sallna s et al. (2004), we have included
those placements that end because of a social workers displeasure with the place-
ment, the foster parent refuses to continue to provide care, the child runs away or
refuses to remain in the placement, or because the parent withdraws consent to
placement.
Respondents and procedures
Potential respondents were identied via a network of social workers
who work with foster care in seven municipalities. Respondents were
contacted through an information letter sent to all foster parents in these munici-
palities. Those who met the inclusion criteria and who wanted to participate in
the study contacted the primary researcher. In total, eight foster parents
participated in this study. All respondents had biological children. Respondents
experiences as foster parents varied from one year to thirty years. The number of
children they had looked after varied with two presenting patterns: four foster
families had had fewer than ve children and four had over ten. All respondents
received children placed via municipal social services. Some foster families were so-
called specialized foster homes and were formally employed by for-prot care
agencies.
Data was collected through semi-structured interviews with foster parents
in their homes. Respondents were asked about their thoughts about being foster
parents generally and about their experiences of placement breakdown. Those who
had experienced more than one placement breakdown could choose themselves
Khoo and Skoog 259
which experience to talk about. Interviews ranged from 32 minutes to one hour and
44 minutes. All interviews were audio recorded and transcribed verbatim. Two
researchers analysed the interview material and engaged in analytical comparisons.
Analysis was assisted using NVivo 8 software. Similarities and dierences in
respondents stories were documented. And, from this information, categories
were shaped (Patton, 2002) that were relevant to the studies aims, and were
grouped into relevant themes.
Findings
Foster parents descriptions depict placement breakdown as a consequence of a
long series of events preceding children actually leaving their care. In the
text following, we report on this path to placement breakdown beginning
with a description and analysis of foster parents motivations and then an explica-
tion of their mission, the childs arrival and everyday life in the foster home and
ending with foster parents depictions of the breakdown and of conditions
afterwards.
Ordinary family motives meet extraordinary circumstances
Some respondents contacted social services themselves to become foster parents
while others had previous contact with social services and eventually had foster
children placed in their homes. Regardless of these dierent starting points, our
respondents described wanting to care for a child, to do a good deed and, most
importantly, to oer a family. To be able to help a child. I think we had a stable
family to oer, a good environment so (. . .) our own two girls had grown so they
could take care of themselves and it felt like I wanted to give more. The caring
perspective of wanting to support, protect and nurture a child was a recurring
theme in many descriptions of their views of the purpose of foster care and motives
to become foster parents. The terms help and save were frequently used. The
purpose has to be to save, to save many or We are a shield; if we arent their shield
who else is going to be? Respondents also described wanting to shape independent,
well-functioning citizens. There was also a clear awareness of the importance of the
childs biological parents and of not wanting to split up families. The best thing
would be if we would let children have four parents.
After years of experience, fostering had become a lifestyle for some. Weve had a
lot [of children] over the years. I mean we werent expecting it but it has been
continuous the whole time or, Now so many children and young people have come
and gone that it isnt strange for anyone in the family if a new child arrives. So I think
its become a lifestyle.
Becoming foster parents was complicated upon the arrival of a foster child into
their families. Arrival was often marked by its acute nature, sudden decisions and a
lack of information. The initial placement of a child was often acute and hasty.
It just went a day or so, then suddenly they would come here with her. It was
extremely dramatic when she arrived because she was screaming and hitting people
and we couldnt ever get her in here or They called at 9 oclock in the morning and
she was here by twelve (. . .) I told them to drive slowly so that I could get the room
tidied up and it all went so fast.
In addition to these quick placements, foster parents describe the problem of
not having enough information about the childs diculties. But these were com-
pletely unknown little people that we had taken in and we clearly had our share of trial
and error (. . .) I remember things that I hadnt expected like for example one was a
bed-wetter and that kind of thing or Maybe not even social services knew how bad
things were with her. There wasnt a lot that agreed with what they had described,
though maybe they didnt know more either (. . .) we received a girl who we thought
just had problems with her parents and didnt have problems herself. Those foster
parents who described reasons for a lack of information named connections
between the kind of nancial compensation they got as foster parents, rules
around condentiality, and social workers lack of knowledge about certain
kinds of problems.
The ordinary family meets the extraordinary child
Foster parents ideas of why children are placed and of the problems they exhibit,
revealed children coming from dicult home environments who largely also have
behaviour problems themselves or show other signs of doing poorly. In particular,
adolescent risk behaviour put high demands on some foster families:
She was depressed and was supposed to take medication for it and everything but it
wasnt any better. She tried to take her life several times and things like that (. . .)
When those people at Child and Youth Psychiatry told me after, that she had tried to
take her own life and was in the ER and everything and that we should keep a close
eye on her an ordinary little family, like we are going to sit awake every night and
watch over her the whole time thats not going to work either but thats what they
expected us to do.
Even younger childrens behaviour took a toll of foster families:
He was feeling terrible in other ways. He was like a wagon behind me also
bit by bit (. . .) he followed me everywhere and almost never left my side. Here
inside he could spend time in his room but if we went anywhere or, as he said
himself Im like your wagon. When he didnt see me he went directly looking for
me and trying to nd out where I was (. . .), I was very, I dont know, isolated I was
going to say.
The childs biological parents and contact between the child and parents was
described by some as an asset and by others as a strain. That was the problem all
these years that she wouldnt leave them in peace. They never set roots here (. . .) we
Khoo and Skoog 261
would have to start over in some way after every contact they had with their mother
and over time they slowly drifted away from us. It could also be described as a relief.
So then she went and stayed with her mother and I could leave her there. It was a bit
of a respite for me at that moment. Even the foster parents descriptions of the
childrens parents spanned the range of seeing their relationship as working well to
seeing it as a great source of stress. For example, biological parents could be
threatening or have negative views of the foster home. In one case, the threat
was so signicant that the foster parents had security alarms installed and had a
direct number to the police. We were supposed to be oered an attack alarm and
we were supposed to have contacts with the police. I even had my own phone number
to the police so that I really could get through to them.
A cry for help
A number of patterns emerged in how foster parents described contact with social
workers. They described having diculty establishing and then having very little
contact with their social workers. They would have to telephone or email with
specic questions as a way of guaranteeing an answer or, develop independence
in seeking support from other services for example the childs school or the local
child and youth psychiatric unit. However, they also expressed an understanding of
the diculties faced by social workers who have too much to do and too little time:
For the most part it is I who calls and talks, tells them things and ask questions (. . .)
I mean they are supposed to follow up every six months and so more than half a year
can go by and they realize that we need to meet to do a review. (. . .) but I mean I know
they have a lot of work to do and everyone thinks that their issue is the most import-
ant (. . .) so I guess I understand that they dont always have time for someone and
some things.
A recurring theme was the desire for more support or guidance in their role as
foster parents. This need for support was connected to a desire that a child be
referred to additional treatment services (e.g. child and youth psychiatry (CYP)).
She did go to CYP a few times but CYP said that she was doing too poorly and was
too unstable to continue there and with that my contact with CYP ended too. So, then
I had no contact at all and I didnt have anyone to talk to either. In another case, the
child was described as being passed back and forth between social services and
CYP which led to neither the child nor the foster parents getting the supports they
wanted. Social services directed me to CYP and CYP directed to social services and
they cant work together.
Where support and contact with social services was described positively in spite
of placement breakdown, the consistent element in these descriptions was that the
social worker kept in contact and responded immediately when a foster family
requested help. The social worker was sitting in some meeting so I left a message
saying it was somewhat urgent. I dont even think it took a minute for her to call me
back. I really appreciated that someone dealing with things when you really need it.
Satisfaction at getting support quickly did not necessarily mean that a problem was
solved quickly or even that the social worker could deal with the situation directly.
Rather, their immediate response left a positive feeling in the foster home.
Cutting ties experiencing breakdown
In our study, placements broke down for a variety of reasons. Foster parents or
children initiated it themselves, social services ended the placements, or parents
withdrew consent to out-of-home care. In those cases where breakdown was
initiated by social services, the decision to move/return a child was given suddenly
a quick telephone call and the placement ended. In one case, the foster parent
received a telephone call regarding a child who had been placed for six years and
that the child, who was on a home visit with their biological mother, would not be
returning to care. Then the social services called and called us into question and then
they just told us, the child is not coming back to you (. . .) everything became one
big. . ., I still think back and wonder what happened (. . .) we never really had any kind
of ending where we like sat together and talked about what happened that day.
Where foster families initiated the breakdown, they described how they were
overwhelmed by the childs needs. It was so dicult and I was so tired and nished
because he took so much of my strength and energy all the time (. . .) so one day after
I had taken him to school I just broke down or We didnt get any help from anywhere
and (. . .) when he tried to kill himself for the third time in a week it was just too
much. In one case, the foster parents described how their biological children were
being negatively impacted by the placement. It started having an eect on our own
child. He started getting very demanding and copying (. . .) and we knew then that it
wasnt worth it.
Regardless of the reasons for the placement breakdown, foster parents stories
shared a theme of wanting more support. We called and called but we never got any
support. They didnt have time. I mean that might be true but we really called for
help. When foster parents described having a good relationship to the social
worker they did not describe placement breakdown in as negative terms as the
other foster parents. These foster parents described how the social worker actively
dealt with the breakdown and were clear: I think Susan who was our social worker
at the time did a super clear job in this case.
The determining factor for how foster parents experienced placement break-
down was not connected to who initiated breakdown. The description of their
feelings surrounding the breakdown were described in similar ways by those who
themselves initiated the breakdown and those where someone else initiated it. All of
the respondents descriptions of the experiences of breakdown are permeated with
more or less hard feelings where they use such words as: terribly dicult and that
they felt upset, oended, angry and sad. Breakdown was described as creating a
large sore and discomfort as well as feelings that the foster parent was about to
break apart or go mad. Three foster parents described their hurt feelings and
Khoo and Skoog 263
connected them to the failure of their mission. I mean they must think of us as huge
traitors and thats what has hurt me the most that they feel like we somehow aban-
doned them, or Somehow it feels like we gave up even if that wasnt our intention. It
feels that way now looking back or maybe it was a failure (. . .) that I didnt manage
to give her a lasting home in that way. . .
These negative emotions connected to breakdown were not just described
as feelings held by the foster parents but something shared by relatives, bio-
logical children and other placed children. The person hurt the most was
Sandra. These were her sisters so it was terrible and she felt really bad because she
had already experienced dicult separation and she felt like these really were her own
sisters.
Three of the families describe how the experience of placement was so dicult
that they were drained of energy. Afterwards, I mean we had been feeling terrible for
a long time and we both felt like it was too much. (. . .) In some way it leaves a trace,
a long, long time afterwards, or You are completely at your end because you, I mean
she has demanded so much of your (. . .) In a way its like youve been burnt out by
this whole period. Two foster parents describe a return to energy as something
positive that happened after a child was moved. It took for sure a month or more
before I felt what enormous energy she had sucked out of me because it was then that
I started getting my energy back.
In all cases, placements ended as suddenly as they had begun. I think they could
have said this like that, ok now Alfred is going to move home and then decide that he
can come back and visit during a school break or something but there was nothing just
*demonstrating a scissors cutting* just gone and so I think its pretty bad that there
isnt any plan. Just quick, out, and thats it.
Foster parents described with dissatisfaction the level of support they received
after placement breakdown. It was minimal at best with the only measure oered
being a termination meeting with social services. Some declined this closing meet-
ing because they were dissatised about how the whole situation was handled and
really wanted a meeting with the child. We never did have an ending with social
services. I really missed that and think we should have seen each other afterwards.
They felt their need for support was not acknowledged or provided by social ser-
vices. I dont go around talking about it with anyone but it can be tough and I cant
say that weve had any help with it.
Most foster parents said that they believed breakdown could have been avoided
in some circumstances: if they had received clearer information about the child
prior to the placement, if they had received support and relief during the place-
ment, and if all parties to the placement sat down and discussed alternatives prior
to a placement ending. Emotional scars were left upon foster parents as well as
inuencing their attitudes toward future foster caring. They did not want to take
the risk of having a child with emotional or behaviour problems because of the
risks involved to the placement. And, they did not want to take younger children
for fear of becoming attached to and then possibly losing them. This could be a
grief too profound to live through one more time.
Strong connections to children silence from social services
Placement breakdown did not lead to a complete cessation in contact between the
foster parents and children. All had maintained some kind of contact although the
relationship clearly had changed. Contact ranged from sporadic, for example,
sending birthday wishes, to regular and frequent communication. Contact contin-
ued regardless of who initiated the breakdown, even in cases where foster parents
could no longer cope with a childs negative behaviour. But it is kind of nice
because I have contact with her and she calls from time to time so actually weve
found our way back to staying in contact. Several families described how a child is
always welcome to visit them and that one child requested to remain in contact
after a breakdown. In all her mails she says that she wants to come and visit and
I always tell her that she is welcome because she is. If ever anything happened and
Linda needed something, wed be there for her and I think she knows it. Contact
between foster parents and their previous foster children took place without the
planning or support of the social services. She still wanted to visit us and could do it
sometimes. We were told that we could be her contact family (. . .) It wasnt any-
thing written down anywhere but I have actually seen Anna every month (. . .) I tried
to contact social services. I dont know how many times I tried to call them and left
messages but she never got back to me.
Placement breakdown was followed by a sudden silence from social services.
Weve never had an ending and I havent heard a word since we took some of the
childs things back home. And it was a bitter ending. I think that its bad on the
social services because they went and did things this way and then they dump the
foster family and dont care about them anymore. I mean, youve taken on the respon-
sibility [to be foster parents] and they could at least be in touch.
Analysis and discussion
Placement breakdown needs to be understood as a complex process rather than a
single event starting in the contrast between foster parents vision of their mission
and that of the social services. At least in the perception of these foster parents,
there is a discrepancy between the statutory obligations of the social services
toward the foster home and the foster parents perceptions of the kind of informa-
tion and support they actually receive.
The caring perspective, described as a desire to oer a caring and protective
home, to act as substitute parents, and to raise children so that they will grow into
well-functioning adults is, in many respects, the same goal that parents have for
their own biological children. However, the children placed with them are, at a
group level, dierent from other children, and this may make it more dicult to
normalize the parenting role of foster parents. Children in care in Sweden have
largely experienced both signicant problems in their home environments and have
had serious behaviour problems before being placed in out-of-home care (Khoo
et al., 2012). At the same time and as described in previous research (Rostill-
Khoo and Skoog 265
Brookes et al., 2011) the foster homes ability to prepare itself for childrens needs
is often limited by the quick process involved in placing children as well as a lack of
information received by the foster parents about the child prior to placement. This
deprives foster parents of the possibility to assess their own abilities and makes it
more dicult for them to develop strategies to meet the childs needs. Foster par-
ents also described how the environment in the foster childrens home of origin and
their own behaviour problems often and signicantly aected their own familys
everyday life. Their view of fostering as a form of substitute parenting can become
problematic as they are parenting children with dicult life experiences and often
complex needs. Their substitute parenting is further complicated by contact with
the childs biological parents who often have their own problems in the form of
substance abuse or poor mental health (Khoo et al., 2012).
High demands are placed on foster parents ability to provide care and oer a
loving home to children who have been raised in dicult environments and who
have behaviour problems. The foster parents in our study, however, describe
aggression and emotionally labile behaviours from another perspective. For
them, it is not the behaviour as such but rather the social services care planning
(or lack thereof) and insucient support and relief that lead to placement
instability for children with behaviour problems. Our results are supported by
Hyde and Kammerers (2009) study where children in care experienced changes in
placement because of behaviour problems connected to dicult life situations
prior to coming into care and foster parents uncertainty around how to
manage their behaviour. Given that teenagers with behaviour problems comprise
the largest age group of children in care in Swedish child welfare and almost
40 percent of their placements end in breakdown a dialogue needs to take place
around how to best meet the needs of children and young people entering into
out-of-home care.
In light of these challenges, support and relief are two prerequisites that foster
parents say are necessary to handle their responsibilities. Our ndings suggest that
foster parents are treated as a normal family without being oered relief and that,
to a great extent, they are left on their own to look after and handle the children in
their care. A lack of continuing support means that the road leading to giving a
child care and security is travelled in the dark and without signposts.
Our study is supported by previous research (e.g. Christiansen et al., 2010)
which indicates that the success of the mission of a foster parent is made
possible through the provision of information and support about the child
and the foster parent role, having a good relationship to a social worker,
and receiving individualized support at the right times. At the same time,
our study is about foster parents own perceptions and cannot say anything
about the kinds of supports that social services actually oered. In spite of the
intentions of social services, the foster parents experienced a lack of informa-
tion and communication and a failure to receive support and relief. Placement
breakdown is experienced negatively and is strongly perceived as a failure
leaving long-lasting and strongly felt emotions. If they enter into this role
believing that they are surrogate parents until children are grown up, foster
parents certainly risk feeling like they have failed in their parenting role.
Placement breakdown was an experience characterized by its suddenness and
unplanned nature beginning and often ending with a lack of planning. A childs
problematic behaviour could be used as an explanation for the problem of instabil-
ity in out-of-home care when it may be a lack of planning on the part of social
services that has contributed to the problem. In this sense, a failure to attend to
structural problems may lead to children being even more marginalized in the care
system. One risk is that placing a child in care is, by itself, seen as the solution to an
individual childs problems. This may leave the child at risk of rejection and may
result in a child re-living the same kinds of problems experienced in their families of
origin. In these circumstances, fostering may become an unmanageable role with
goals that are impossible to full and posing signicant risks to both the foster
family and the children themselves. In spite of this studys limited scope, foster
parents are an important source of knowledge about the foster caring experience
and the need to improve care provision. From their perspective, they point to the
need for:
1. More involvement of foster parents in the matching process; including that
foster parents need complete information to decide, for themselves, if they are
the right family to meet the needs of specic children.
2. Care planning that includes the needs of carers for specic supports and relief
during a childs placement.
3. When a placement ends abruptly, do not terminate contact with foster parents
equally abruptly. Include them in the childs care review in order for all to
understand why the placement ended and to determine if and how contact
may continue between the child and the foster home.
Foster parents describe how these children are a part of their families and that
placed children, in many cases, grow up as siblings to other children in the family.
Foster parents, foster siblings and other relatives have become signicant others
for these children. Although the foster placement may have ended in breakdown,
the relationship between the foster family and child was and may continue to be of
lasting signicance.
Funding
We wish to thank the Childrens Welfare Foundation Sweden and The Swedish Council for
Working Life and Social Research for nancing this study. Many thanks also go to the
foster parents in this study who opened up their hearts and homes and shared their experi-
ences with us.
References
Andersson G (2001) The motives of foster parents, their family and work circumstances.
British Journal of Social Work 31(2): 235248.
Khoo and Skoog 267
Andersson G (2006) Child and family welfare in Sweden. In: Gary C and Freymond N (eds)
Towards Positive Systems of Child and Family Welfare: International Comparison of Child
Protection, Family Service, and Community Caring Systems. London: University of
Toronto Press.
Brown J and Bednar L (2006) Foster parent perceptions of placement breakdown. Children
and Youth Service Review 28(12): 14971511.
Cederborg A-C and Gumpert C (2010) The challenge of assessing credibility when the
alleged victims have intellectual disabilities. Scandinavian Journal of Disability Research
12(2): 125140.
Christiansen , Havik T and Anderssen N (2010) Arranging stability for children in long-
term out-of-home care. Child and Youth Services Review 32(7): 913921.
Egelund T (2006) Sammenbrud i anbringelser: En forskningsmssig belysning [Placement
Breakdown: A Research Overview]. Copenhagen: Socialforskningsinstituttet.
Egelund T, Bo cker-Jakobsen T, Hammen I, Olsson M and Hst A (2010) Sammenbrud i
anbringelseraf unge [Breakdown in Youth Care]. Copenhagen: Socialforskningsinstituttet.
Farmer E, Lipscombe J and Moyers S (2005) Foster carer strain and its impact on parenting
and placement outcomes for adolescents. British Journal of Social Work 35(2): 237253.
Gilbertson R and Barber J (2003) Breakdown of foster care placement: Carer perspectives
and system factors. Australian Social Work 56(4): 329339.
Hyde J and Kammerer N (2009) Adolescents perspective on placement moves and congre-
gate settings: Complex and cumulative instabilities in out-of-home care. Children and
Youth Services Review 31(2): 265273.
Khoo E, Skoog V and Dalin R (2012) In and out of care: A profile and analysis of children
in the out-of-home care system in Sweden. Child and Youth Services Review 34(5):
900907.
Larkin M, Watts S and Clifton E (2006) Giving voice and making sense in interpretative
phenomenological analysis. Qualitative Research in Psychology 3(2): 102120.
Newton R, Litrownik A and Landsverk JA (2000) Children and youth in foster care:
Disentangling the relationship between problem behaviours and number of placements.
Child Abuse and Neglect 24(10): 13631374.
Oosterman M, Schuengel C, Wim Slot N, Bullens R and Doreleijers T (2007) Disruptions in
foster care: A review and meta-analysis. Children and Youth Services Review 29(1): 5376.
Park JM and Ryan JP (2009) Placement and permanency outcomes for children in out-of-
home care by prior inpatient mental health treatment. Research on Social Work Practice
19(1): 4251.
Parkinson P (2003) Child protection, permanency planning and childrens right to family
life. International Journal of Law, Policy and the Family 17(2): 147172.
Patton M (2002) Qualitative Research and Evaluation Methods. London, UK: SAGE.
Rostill-Brookes H, Larkin M, Toms A and Churchman C (2011) A shared experience of
fragmentation: Making sense of foster placement breakdown. Clinical Child Psychology
and Psychiatry 16(1): 103127.
Sallna s M, Vinnerljung B and Westermark PK (2004) Breakdown of teenage
placements in Swedish foster and residential care. Child and Family Social Work 9(2):
141152.
Smith DK, Stormshak E, Chamberlain P and Whaley RB (2001) Placement disruption in
treatment foster care. Journal of Emotional and Behavioural Disorders 9(3): 200205.
Sundell K, Egelund T, Andre e Lo fholm C and Kaunitz C (2007) Barnava rdsutredningar. En
kunskapsoversikt [Child Welfare Investigations. A Review]. Stockholm: Gothia.
Unrau Y (2007) Research on placement moves: Seeking the perspective of foster children.
Children and Youth Service Review 29(1): 122137.
Vinnerljung B and Sallna s M (2008) Into adulthood: A follow-up study of 718 young people
who were placed in out-of-home care during their teens. Child and Family Social Work
13(2): 144155.
Vinnerljung B, Sallna s M and Kyhle Westermark P (2001) Sammanbrott vid tonarsplacer-
ingar [Breakdown of Teenage Placements]. Stockholm: Socialstyrelsen.
Ward H (2009) Patterns of instability: Moves within the care system, their reasons, context
and consequences. Children and Youth Services Review 31(10): 113118.
Wiklund S (2006) Den kommunala barnavarden om anmalningar, organisation och utfall
[Municipal Child Welfare on Reporting, Organisation and Outcomes]. Stockholm:
Stockholms universitet, institutionen fo r socialt arbete.
Wilson K, Sinclair I and Gibbs I (2000) The trouble with foster care: The impact of stressful
events on foster carers. British Journal of Social Work 30(2): 193209.
Khoo and Skoog 269

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