Examining “Family-Like” Care
By Kurt Jensen, Communications Director, Teaching-Family Association
The actual evidence suggests that foster care could be just as risky as residential care, but we have this dualism that people don’t recognize there. We have the idea, then, of the family being natural, and residential care is unnatural, and obviously – the idea of the homely versus the institutional. So we have these dualisms, I think, which run through, in a sense, some of the ideology around residential child care which we need to unpick.
Is foster care necessarily more “home-like” than residential care? This was an assumption made by the Chapin Hall policy brief we previously summarized – and it’s an assumption Teaching-Family Model agencies constantly have to overcome in marketing and advocacy efforts. What does it mean – and, how do we explain – that the Teaching-Family Model is “family-style” care?
But it’s also a question that’s highly relevant inside the Teaching-Family Association. How does being “family-style” relate to youth perceptions and outcomes? Does using shift staff necessarily preclude a Teaching-Family Model agency from providing “family-style” care?
Back in July of 2015, Virginia Home for Boys and Girls shared a panorama on Facebook of one of their homes, captioned: “What do you think of when you hear the words ‘group home’? Our homes are built exactly like your home! Our youth have dinner with their teaching parents around the kitchen table, they watch TV in the living room, and they even (reluctantly) do chores to help keep the house clean!“
I loved this post when I saw it, because as much as I love words – and as much as you Teaching-Family Model practitioners are experienced in giving detailed, specific descriptions – a picture really does say a thousand words. And for youth, a home-like environment like this one really does make a difference.
Across the pond, a professor of residential child care at the University of Strathclyde, Glasgow School of Social Work, Andrew Kendrick, gave a presentation in 2009 examining “the family metaphor” as it relates to perceptions of residential care as well as children’s perceptions of relationships and relatedness.
His presentation – which you can listen to and follow along with, below – addresses from several angles how children in care often describe residential staff members “like family” in a positive way, and how and why these positive relationships, and a family-like environment, contribute to quality care.
Relationships are a key standard of Teaching-Family Model care for a reason – strengths-based, positive relationships are vital to the provision of quality care, and so argues Kendrick. Citing Berridge (2002), Kendrick quotes, “Several of the studies of residential homes explained successful residential care according to the quality of the interaction between young people and adults. Terms used include: empathy; approachability; persistence; willingness to listen and reliability.”
Over time, a deeper understanding of attachment theory and resilience theory have simply highlighted the centrality of these relationships in quality care, Kendrick argues. But you know that – it’s a huge part of what Teaching-Family Model agencies do everyday.
But what, exactly, characterizes these positive relationships in care? Citing “Working in Children’s Homes: Challenges and Complexities” by Whittaker, Archer and Hicks (1998), Kendrick lists:
Being ready to listen, both to the evidently momentous and to the apparently mundane
Being sensitive to a young person’s readiness, or not, to talk and to share feelings and experiences
Combining non-verbal or symbolic forms of caring with verbal, explicit ones
Noticing good or admirable behaviour and crediting a young person for it
Marking special occasions in a young person’s life with a celebration.
These elements of relationships create the perception of “relatedness” for children and youth, Kendrick argues, and this perception is a large part of what Jim Anglin described as a “sense of normality,” vital to the youth’s sense of well-being:
I’m not saying that the relationships with care staff take the place of relationships with family members… but what I’m arguing is we need to be looking at how children and young people see these relationships with staff in the context of the complexity of relationships that they have within families. Jim Anglin talks about a sense of normality – “It would appear that creating a ‘sense of normality’ for the residents without attempting to pretend that a group home setting is either ‘normal’ or ‘normative’ is vital for their sense of well-being.” In a sense, that sense of normality is about relatedness and relationships and how children and young people conceptualize those.
Central to Kendrick’s argument, as it relates to the dualism in popular perceptions of residential and foster care, is that residential care – even assuming shift staff – and positive, “family-like” relationships are not mutually exclusive.
Beyond relationships, he lists environmental factors creating the same sense of relatedness and normality:
Routines, rhythms and rituals of daily living
Sharing of food
[Staff] involvement in cultural and leisure activities
The living space and the environment
These are essential elements of what it means for the Teaching-Family Model to be “family-style,” and all of these elements can be achieved by the Model – regardless of setting or staffing particulars.
In fact, data from Betsy Farmer’s study of Teaching-Family Model group homes found a negligible difference in youth outcomes between shift staff and Teaching Parent couples. Why? I’ll speculate – because the Model’s systems foster accountability and facilitate smooth transitions in care between shifts, and perhaps because the Teaching-Family Model provides family-style care, no matter how you slice it.
Kendrick’s presentation was particularly interesting to me for two reasons:
It reminds us that “family-style” care is related to positive outcomes and client perceptions, and it gives us specifics to observe and measure what it means to provide “family-style” care.
It gives us a new paradigm to explain how the Teaching-Family Model provides “family-style” care.
Maybe Kendrick’s work here could help TFA and TFA agencies in future advocacy or marketing efforts – and though a picture might say a thousand words, it still could use some evidence behind it.
What do you think? Leave a comment below!
Kendrick also quotes several studies supporting residential care, generally, in his presentation:
A recent review and meta-analysis of research on residential child care concludes that children and young people, on average, improve in their psychosocial functioning (Knorth et al, 2008).
The limited research on residential child care also found that generally children did better following time in residential care than they were doing beforehand (Forrester, 2008).
When the nature of the aims of placements is taken into account, foster placements and residential placements were equally successful in achieving their specific aims (Kendrick, 1995).
If one takes account of behaviour, age and age at entry, children’s homes are not significantly ‘less successful’ than other placements (Sinclair et al., 2007).