Study title: Mechanisms that promote and support family preservation for children at the edge of care: a realist synthesis
Quick-read summary
How can we support families to reduce the likelihood of children going into care?
Children in care of the state are amongst the most disadvantaged in society. ‘Edge of care’ interventions aim to support families to meet their child’s needs and prevent, or reduce, the likelihood of children going into care.
Whilst it is acknowledged these services are effective, why and how they are effective has not been explored.
This work’s main purpose was to explore existing literature to identify the impact and effectiveness of such interventions.
61 papers were included. Results identified four key factors which promote effective edge of care service operation: family skills training, home-based delivery, dedicated worker time, and rapid response to need.
Who is this evidence useful for?
Researchers, policy makers, local authorities, those working to support families.
What is the issue?
Children in care of the state are amongst the most disadvantaged in society. They have often experienced adverse childhood experiences leading to their care entry including abuse and neglect.
Long-term data suggests that the problems which children in care of the state experience within adolescence, persist into adulthood.
Emerging evidence shows that edge of care interventions can bring about benefits. These interventions support families to meet their child’s needs and prevent, or reduce, the likelihood of children going into care.
However, it is not clear how or why these interventions work. It is important to develop this understanding to inform the development of effective, theory-informed practice to benefit families and children and reduce or prevent children going into care.
Research summary
Evidence synthesis is a way to identify, select, and combine the results of multiple studies.
We reviewed and synthesised published literature to find mechanisms (ways) by which interventions may promote and support family preservation (keeping a family together) for children at the edge of care.
Our synthesis uses a realist approach. A realist approach in qualitative research is method for analysing information that aims to understand how things work, why, and in what context.
This approach enabled us to gain additional insights into the workings of edge of care services, and what it is that makes them effective.
What the research found
Four core mechanisms were found to influence effective edge of care service operation.
- Family skills training. Within a family with perceived parenting skills deficit/low reflective functioning. Viewing the child’s primary carer as the catalyst for change – training facilitated by a family worker, informed by formal service models, supports positive strength and skill development within the family which empowers families and promotes positive social behaviours.
- Home-based response to individual need. In families where the primary context is family need, and care is delivered within the family’s natural home environment. Direct observations by the worker can ensure that the family feels understood and barriers to engagement are reduced – by shifting the power dynamic from the worker to the family, increasing opportunities to promote positive family functioning.
- Dedicated worker time. When families are experiencing multiple issues, and the primary issue is not the parent’s health. Having a dedicated worker equipped to meet the family’s needs working alongside them and providing intensive support, in the form of both practical and therapeutic assistance, and in response to individual family need – builds trust between family and worker and promotes positive effects in reducing potential care entry of the child or children.
- Rapid response. When families are experiencing high stress. Interventions need to provide immediate, action-orientated responses to help families to contain and stabilise the crises without the family breaking down, and to promote positive engagement with services.
Why is this important?
This research has synthesised publish literature to identify and explain how edge of care interventions are able to support families to meet their child’s needs and prevent, or reduce, the likelihood of children going into care.
This detailed understanding can be used to inform the development of effective, theory-informed practice to benefit families and children.
How were people with experience of this issue, involved in this research?
An advisory group consisting of a parent who had previously been in receipt of an edge of care service, referring social workers, service and operational managers and edge of care provision practitioners was brought together.
The group was consulted throughout the research to inform the scope of the review as well as make comment on emerging findings and the findings.
What’s next?
This synthesis was part of a wider research projected which included the evaluation of an edge of care service in the North East of England. Publications from this work will be available soon.
Get in touch about this research
Lead researcher name: Professor Ruth McGovern
Email address r.mcgovern@newcastle.ac.uk
Link to full paper
Funding
This research was funded through the NIHR ARC NENC Open Funding Competition 2021.
It involved researchers funded by the NIHR ARC NENC.