WHAT INTERVENTIONS IMPROVE OUTCOMES FOR KINSHIP CARERS AND THE CHILDREN IN THEIR CARE

Systematic review

What interventions improve outcomes for kinship carers & children in their care

Highlights

  • This systematic review reports findings from twenty-one studies looking at the impact of programmes designed to support kinship carers and the children in their care, as well as findings from six studies on the experiences of kinship families and practitioners in relation to a programme in the UK.
  • Overall, findings from the systematic review show that kinship families have unmet needs, and that different types of programmes can meet these needs.
  • The findings show positive impact of programmes that help kinship carers to navigate services and support (known as ‘kinship navigator programmes’) on the likelihood of children being placed in kinship care and on stability for children in kinship care.
  • The review also found positive impact of financial support to kinship carers who enter legal guardianship for the children in their care in promoting permanence, which is the rates at which children move into adoption and guardianship.
  • The qualitative evidence from the UK highlighted the importance of, peer support, practitioners building relationships with kinship carers, and being beneficiary-centred both in the design and implementation of interventions.

This systematic review informed the development of the Kinship Care Practice Guide, setting out the best available evidence for senior leaders in local authorities on how to improve services for kinship families.

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Summary

The number of children and young people placed in the care of family or friends rather than unrelated foster carers is increasing. This form of care, known as kinship care, can lead to better outcomes for children, despite kinship carers facing additional challenges compared to other foster carers.

This systematic review sought to examine the evidence of programmes and policies to improve the outcomes of kinship carers and the children in their care. Where possible, the review aimed to understand the elements of effective programmes and assess differential impact for groups of carers. The review also explored carer and practitioner perspectives on how interventions can best serve them.

Aims

We aimed to assess the effectiveness of programmes that improve outcomes for kinship carers and the children in their care and to understand the implementation considerations involved in delivering such programmes.

This review aimed to answer five research questions:

  1. What interventions for kinship families improve the outcomes of children in kinship care (e.g., safety, permanence, and wellbeing) and for kinship carers (e.g., wellbeing, confidence in parenting, relationship with child in care)?
  2. Are there interventions / programmes that are particularly effective with different groups of carers and children (e.g., disabled or carers or children from minoritised ethnic backgrounds)?
  3. Are there common elements shared by effective interventions?
  4. What are the enablers and barriers to successful implementation of interventions for kinship carers and children in kinship care?
  5. What are the perspectives of kinship carers and children in kinship care on the acceptability and usefulness of different interventions?

Method

The systematic review followed established evidence synthesis methods to identify published and unpublished evidence that describes outcomes for children in kinship care and their caregivers from robust impact evaluations of interventions, policies, and programmes using experimental and quasi-experimental designs.

Key Findings

Of the studies included in this review, 21 looked at the impact of programmes, and six looked at the experiences of kinship families and practitioners in relation to a programme in the UK. Overall, the studies included in this review emphasised that kinship families have unmet needs, and that different types of programmes can meet these needs. These programmes can ultimately help to improve the outcomes for children in care, such as behaviour, wellbeing and placement stability, and kinship carers, such as parenting skills, wellbeing, and access to support.

The six studies that looked at the experiences of kinship families and practitioners showed that support designed specifically for kinship families is both needed and welcomed. The research highlighted the value of trust, peer support and relationship building in programmes for kinship families.

Overall, this review adds to growing evidence looking at how best to support kinship carers. The studies of measurable outcomes indicate that programmes specifically designed for kinship families show promise in helping to improve the lives of kinship caregivers, and the children in their care. The evidence suggests that this is particularly true for three types: programmes that help kinship caregivers navigate local and national services, parenting programmes for kinship carers, and financial support guardianship for kinship carers.

To better understand who these programmes work for, and in what contexts, future work should be coordinated to fill gaps in the evidence. Specifically, researchers looking at programmes for wider populations such as foster carers or parents of children with behavioural issues should report outcomes for kinship families separately.

Implications for Policy

Based on studies reporting positive findings for ‘kinship navigator’ programmes, this approach holds promise and should be continued to be funded and delivered in areas where it is present and rolled out and evaluated in areas where assistance to navigate needs is not present (e.g., informal carers). It is important to understand how ‘navigation’ type programmes currently operate in the UK and how this evidence maps onto them.

There is clear commitment by governments to kinship care including Championing Kinship Care: The National Kinship Care Strategy (2023), and a commitment of kinship carers to the children and young people in their care. Kinship care is generally a long-term relationship, and services should be attuned to this. As highlighted in the qualitative evidence, it is important for programme developers and practitioners to work with kinship carers to establish accessible services and to develop a level of trust where kinship families will be willing to ask for, and receive, assistance. When such assistance is provided, it’s important that services are caregiver-centred; this means ensuring that they are timely, convenient, and that they map onto their needs and those of the children in their care. The included studies in this review also suggest that programme developers and practitioners should be cognizant of their role and the differing perceptions of statutory services and third-sector organisations when providing support to kinship families.

Implications for future research

Although the findings for placement in kinship care and placement stability are promising, kinship navigator programmes need further research in the UK context to understand its impact on caregiver and child well-being outcomes. Further randomised controlled trials and quasi-experimental design evaluations are also needed for other kinship care interventions such as parenting programmes, peer support groups, financial support, and mentoring for children in kinship care.

Literature supporting the efficacy of programmes, policies, and interventions for kinship carers – and the confidence of the researchers in individual studies as well as meta-analyses – has been limited due to challenges such as the use of non-rigorous study designs and implementation standards for evidence-based programmes. This review did not seek to answer questions about the needs of kinship carers, so future research should continue to examine this topic with both quantitative and qualitative methods and align services with need.

Future research with a data equity lens would also be beneficial for the kinship care evidence base. As this review demonstrated, kinship caregivers hold diverse and intersecting identities and programming for this population should align with and support their continuum of experiences and needs. It is likely that kinship care interventions have differential efficacy for caregivers based on factors such as ethnicity, socio-economic status, and age. Additionally, research is needed to examine differences in outcomes based on informal or formal kinship care arrangements.

The qualitative research findings from this review offer revealing insights into caregiver perceptions about what makes kinship care interventions beneficial. Additional qualitative research could explore children’s perspectives of the services they or their kinship carers receive and further explore the caregiver-practitioner relationship from both perspectives to surface recommendations regarding service accessibility and acceptability. Greater and more diverse research is needed to understand the variation of experiences for this diverse group.

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