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This paper investigates how children who have experienced instability in substitute family care describe their sense of belonging and relationships with adults who share responsibility for caring for them. Using an interpretive phenomenological methodology, we interviewed twelve children in Swedish foster and institutional care. Our study found that the children craved a close relationship with consistent adults and an opportunity to feel that they belonged somewhere. These needs were difficult for them to receive due to their parents' problematic life histories, instability in care which repeatedly placed them in new care situations and a lack of continuity of social workers. These children endured a repeated disconnection to those adults who were supposed to share the role of raising them and, at the same time, an incredible ability to adapt to new care environments was demanded of them. After continually losing relationships, some children finally decided to ‘hold off adults’ in order to not get hurt. Working with and caring for children who have experienced unstable care puts great demand on adults to develop relationships that children feel will be consistent and that they can trust.

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 process that starts in the discrepancy between the statutory obligations of the social services 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 child’s needs, insufficient 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.

The aim of this dissertation is to investigate the incidence of instability in out-of-home care for children and how children experience this instability. The dissertation consists of two studies. The quantitative study is based on an examination of social work case files of 213 children who began 317 placements in 2005 and 2006. Every placement was followed for a maximum of two years. The qualitative study used interpretive phenomenology as method and is based on interviews with 12 purposively selected children who had experienced placement breakdown at some point during 2011 or 2012.  

The quantitative study shows that the majority of children had experienced problems in their home environments prior to placement. Most commonly reported was parents’ substance abuse or mental health problems. Preschool and schoolchildren were more often placed in care due to neglect whereas adolescents were placed because of their own behavior problems or relational problems. Children in the qualitative study described that the problems they experienced prior to coming into care continued to influence them during their time in care.

The quantitative study indicates that different types of instability are associated with children’s ages. That is, breakdown was most common for adolescents whereas preschool children more often experienced planned placements changes. Children in the qualitative study gave similar descriptions of planned placement changes and placement breakdown. The difficulty with which these children experienced the move from a foster family or group home depended on their relationship to caregivers. Therefore, planned placement changes from foster homes or institutional settings in which children reported being happy were described as more difficult than breakdown in placements from which children wanted to move. In children’s views, breakdown was caused by mismatches between them and caregivers, mistreatment in care settings, and their own behavior problems. However, children explained that when social workers did not listen to them, behavior problems in the form of running away, self-harming or behaving badly, were the only way of ending placements in which they were miserable.

All children in the qualitative study described a wish for close relationships with consistent adults and an opportunity to feel that they belong somewhere. These fundamental needs were difficult for them to have satisfied due to their parents’ problematic life histories, instability in care which repeatedly placed children in new care situations, and a lack of continuity of social workers.

In this paper we present a profile and analysis of children in the out-of-home care system in Sweden. We describe the conditions of three age groups of children and young people prior to their entry into care, the reasons for placement as given by social workers and documented in the children's case files, and analyze their movements in and out of care drawing attention to the issues of placement instability and breakdown. Our analyses reveal that there are important differences between age groups in rationales for placement, that a significant majority of children who returned home from care did so before social workers considered care no longer necessary, and that significant numbers of placements are notable in their instability. This study points to the need to develop participatory frameworks for practice beyond the rhetoric of solidarity and democracy that underlies Sweden's Social Services Act. (C) 2012 Elsevier Ltd. All rights reserved.

This paper analyzes stability in out-of-home care for children in Sweden. The study has focused on placement breakdown but also used planned movements and re-placement to study placement stability. The sample consists of 213 children who started 317 placements during 2005 and 2006. Social work case files were examined to follow every placement for, at most, two years from the day that the placement began. Those children who finished their period of care during the study’s follow-up period were monitored for one year after completion of placement to see if "returns home" were stable or if the child was re-placed in care. The analyses reveal that a significant majority of children who returned home from care did so before social workers considered care no longer necessary. The most common reason for end of a placement for preschool aged children was placement movements and for teenager’s placement breakdowns. This result indicates that type of instability depends on children’s age. As in other research, our study revealed teenagers or children with aggressive behavior had an increased risk of placement breakdown. The risk for re-placement increased if the child’s last placement ended because parents withdrew their consent for placement or if the child was placed in institutional care. This study points to the need to discuss the importance of consent, particularly parents of younger children and with youths themselves. It also indicates that if social service wants to increase placement stability they have to take the age of the child in consideration.