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This research focuses on dinner conversations in family-style group care. Children, who cannot live with their biological families anymore, are given shelter in these family-style group care settings. For the development of an attachment relationship between children and their Professional Foster Parents (PFPs), it is important that the children feel that they are listened to in order to get an affective and intimate relationship with the parents. In this conversation-analytic research we analysed PFPs’ involvement in multiple activities simultaneously, namely listening and eating, which is referred to as ‘multi-activity’. The analyses have shown systematic ways in which PFPs coordinate their involvement in the activities of ‘doing’ listening and eating, which are (i) when parents avert their gaze from the telling child, they break the social rule which states that hearers need to look at speakers during the telling. We found that when averting their gaze, PFPs do head nods and linguistic means or positioning their bodies in the direction of the telling child. This research contributes to knowledge about interaction between adolescents and PFPs. It further contributes to knowledge about how human beings are able to coordinate multiple activities simultaneously. This is the accepted version (post-print) of the article.

Out-of-home placed children or adolescents can be placed in family-style group care, a promising alternative youth care setting. It provides children and Professional Foster Parents (PFPs) with the opportunity to create a continuous relationship. This relationship, in turn, is an important factor in building and maintaining attachment. Scientific literature shows that sensitivity and responsivity are crucial interactional elements for building and maintaining an attachment relationship, but little knowledge is available on how those concepts are displayed in mundane interactions. Therefore this dissertation studies dinner conversations between experienced PFPs and adolescents in family-style group care to find out how sensitivity and responsivity unfold in these conversations. The data consist of 300 hours of videorecordings coming from six family-style group care settings. The method of Conversation Analysis was used to analyse the conversations in detail. On the basis of four studies a better understanding is gained into how the dyadic concepts sensitivity and responsivity are displayed in daily interactions between PFPs and adolescents in family-style group care. The analysis of these specific phenomena disclose the PFPadolescent interaction from different perspectives: the verbal and non-verbal actions of both PFPs and adolescents and how PFPs and adolescents align. In short, this dissertation provides a detailed analysis of interaction and improves the understanding of the dyadic concepts sensitivity and responsivity. It reveals that adolescents are active participants in interactions and shows that PFPs are inventive in their conversations with the adolescents.

Out-of-home placed children or adolescents can be placed in family-style group care, a promising alternative youth care setting. It provides children and Professional Foster Parents (PFPs) with the opportunity to create a continuous relationship. This relationship, in turn, is an important factor in building and maintaining attachment. Scientific literature shows that sensitivity and responsivity are crucial interactional elements for building and maintaining an attachment relationship, but little knowledge is available on how those concepts are displayed in mundane interactions. Therefore this dissertation studies dinner conversations between experienced PFPs and adolescents in family-style group care to find out how sensitivity and responsivity unfold in these conversations. The data consist of 300 hours of videorecordings coming from six family-style group care settings. The method of Conversation Analysis was used to analyse the conversations in detail. On the basis of four studies a better understanding is gained into how the dyadic concepts sensitivity and responsivity are displayed in daily interactions between PFPs and adolescents in family-style group care. The analysis of these specific phenomena disclose the PFPadolescent interaction from different perspectives: the verbal and non-verbal actions of both PFPs and adolescents and how PFPs and adolescents align. In short, this dissertation provides a detailed analysis of interaction and improves the understanding of the dyadic concepts sensitivity and responsivity. It reveals that adolescents are active participants in interactions and shows that PFPs are inventive in their conversations with the adolescents.

Similarities and differences in the (short-term) psychosocial development of children in foster care, family-style group care, and residential care were investigated in a sample of 121 Dutch children (M age = 8.78 years; SD = 2.34 years; 47% female; 59% Caucasian) one year after their initial placement. Pretest and posttest measurements were carried out at the substitute caregivers using the CBCL. The results were examined at group level and case level. At group level, the findings showed no evidence for higher effectiveness in favor to the family-oriented settings (foster care, and family-style group care), as hypothesized. By contrast, some small differences were found between foster care and family-style group care, in favor of the latter. At individual level, a more or less equal number of children (18%) with a clinical pretest score on psychosocial functioning clinically significant improved (behavioral normalization). An important concern is that a number of children without clinical psychosocial problems at the time of admission clinically significant deteriorated (behavioral aberration) in psychosocial functioning (20%). This might indicate a poor match between the risks, needs and responsivity of the child on the one hand and the chosen intervention on the other. Future research on factors that (prior and during placement) positively as well as negatively affect the child’s psychosocial development is needed to further clarify this finding.

To date, no evidence-based criteria are available to place children with multiple psychosocial risks and needs in the most appropriate type of (non-secure) out-of-home care. Due to this, other factors than just the clinical needs of the child and its family are in use, which can heighten the risk of both breakdown (i.e. unplanned terminated placement) and/or poor prognostic placement outcomes. To reduce adverse placement outcomes, insight into the risks and needs of the children at the time of referral can be helpful. To this end, this study explores similarities and differences in child, family and care history context of 200 Dutch school-aged children at the time of admission to foster, family-style group, and residential care. A cross-sectional design was used and data were collected through standardized questionnaires that were completed by the caregivers, substitute caregivers, and behavioral scientists. Case file information was also used. The results showed differences between the three subgroups in all three contexts, which suggest several setting-specific guidelines to promote positive outcome. Biological parents of foster children specifically are in need of support for their individual problems. In family-style group care, specifically, help is required for attachment and trauma-related problems. Residentially placed children are in particular need of specialized care for mental illness, behavioral and school/learning problems. Further research is needed to link the outlined specific characteristics at admission to the developmental pathways of out-of-home placed children. Such research may contribute to the development or refinement of a risk-need-responsivity model to support the decision making regarding out-of-home placement of children with serious psychosocial needs.

When risky child and family circumstances cannot be resolved at home, (temporary) 24-h out-of-home placement of the child may be an alternative strategy. To identify specific placement risks and needs, care professionals must have information about the child and his or her family, care history, and social-cultural characteristics at admission to out-of-home care. However, to date information on case characteristics and particular their similarities and differences across the three main types of out-of-home settings (namely foster care, family-style group care, and residential care) is largely lacking. This review compiles and compares characteristics of school-aged children of average intelligence and their families at the time of each child’s admission to one of the three care modalities. A scoping review technique that provides a broad search strategy and ensures sufficient coverage of the available literature is used. Based on the 36 studies included, there is consensus that the majority of normally intelligent children in care demonstrate severe developmental and behavioral problems. However, the severeness as well as the kinds of defining characteristics present differ among the children in foster care, family-style group care, and residential care. The review also identifies several existing knowledge gaps regarding relevant risk factors. Future research is recommended to fill these gaps and determine the developmental pathway in relation to children’s risks and needs at admission. This will contribute to the development of an evidence-based risks and needs assessment tool that will enable care professionals to make informed referrals to a specific type of out-of-home care when such a placement is required.

The study consisted of a comparative follow-up study with a pretest-posttest design which explored the association between baseline child, family, and care characteristics and the psychosocial development of 121 school-aged Dutch children (M age = 8.78 years; SD = 2.34 years; 47% female; 59% Caucasian) during their first year of placement in foster care (FC), family-style group care (FGC), and residential care (RC). Potential baseline characteristics were collected from both literature data and pretest data, and measured with standardized questionnaires and case file information. The outcome measure (degree of psychosocial development) was based on pretest and posttest ASEBA measurements of substitute caregivers, by calculating the reliable change index (RCI). Based on this, 58% of the children had favorable psychosocial development, with no significant differences across the settings. Results indicated that sets of baseline characteristics were able to distinguish different groups of favorably developing children as well as unfavorably developing children in different settings, whereby unfavorable development could be estimated more accurately. A history of maltreatment proved to be an important risk factor, particularly for family-based settings (FC, FGC). Furthermore, results indicated that specialized treatment is needed for severe individual problems in children in FGC, as these problems were associated with unfavorable psychosocial development for them in particular. With regard to residentially placed children, child mental illness specifically negatively affected their prognosis. Further research is needed to refine the results in order to make them suitable for both supporting decision-making processes and monitoring out-of-home placements.