Children referred to foster care, family-style group care, and residential care: (How) do they differ?

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.