Children and Youth Services Review 107 (2019) 104525 Contents lists available at ScienceDirect Children and Youth Services Review journal homepage: www.elsevier.com/locate/childyouth Legal professional perspectives on barriers and supports for school-aged students and families during reunification from foster care T Jacqueline Huscroft-D'Angeloa,⁎,1, Alexandra L. Trouta,1, Christine Henningsena,2, Lori Synhorsta,1, Matthew Lamberta, Irina Patwardhanb,3, Patrick Tylerb,3 a University of Nebraska-Lincoln, USA b Boys Town National Research Institute, USA ARTICLE INFO ABSTRACT Keywords: Backgroud: Supports following reunification play an important role in successful transitions from out-of-home Reunification care to home and school settings for children and their families. There are several stakeholders who play critical Foster care roles supporting families during this transition. One key role is tied to legal professionals, who often work closely Aftercare with the child or family while in care and then continue to monitor family progress during the transition from Attorney foster care to the home setting. Although work has been conducted to understand what supports other stake- Legal professional holders feel children and families need during this transition, little is known about the perspectives of legal professionals. Objective: This exploratory study gathered perspectives from legal professionals regarding the challenges these youths and families face and necessary supports to promote successful reunification. Three research questions guided this work: (1) How prepared do legal professionals feel youth and families are for the reunification period? (2) What do legal professionals perceive as existing barriers for youth and families during reunification? and (3) What services do legal professional perceive as necessary to promote successful reunification and the effectiveness of existing supports? Methods: Participants (N= 1 3) completed a brief survey including demographic items and questions on re- unification supports following departure from foster care. Participants also engaged in a focus group using the nominal group technique to address two primary questions that addressed challenges faced by families during reunification and necessary supports or services to promote positive youth and family outcomes. Results: Participants felt that families were not well prepared for reunification and that current supports were somewhat effective to support this transition period. They also indicated supports in the mental health domain to be most important. A total of 36 independent barriers were generated for the first question and 27 supports were identified for question two. Conclusion: Establishing effective and accessible supports for families during reunification is necessary for po- sitive family outcomes. This study highlighted barriers in preventing successful reunification, namely limited access to resources and supports in preventing successful reunification and the importance of mental health support for the entire family in promoting successful outcomes. 1. Introduction Information Gateway, 2016). Although children and families meet specified goals to work towards permanency, the initial phase during Approximately 443,000 children (one out of every 184 children) are this transition period presents many challenges (i.e., educational, en- served each year in foster care (AFCARS, 2018; CWIG, 2016) and more vironmental, behavioral, social, emotional, health, existing services, than half will reunify with caregivers (AFCARS, 2018; Child Welfare and preparedness for transition; Basca, 2009; Child Welfare Information ⁎ Corresponding author at: Academy for Child and Family Well Being, University of Nebraska-Lincoln, 247D Barkley Memorial Center, Lincoln, NE 68583-0732, USA. E-mail address: [email protected] (J. Huscroft-D'Angelo). 1 Academy for Child and Family Well-Being, University of Nebraska-Lincoln, USA. 2 Center on Children, Families & Law, University of Nebraska-Lincoln, USA. 3 Boys Town National Research Institute, Boys Town, NE, USA. https://doi.org/10.1016/j.childyouth.2019.104525 Received 30 May 2019; Received in revised form 1 October 2019; Accepted 2 October 2019 Available online 15 October 2019 0190-7409/ © 2019 Published by Elsevier Ltd. J. Huscroft-D'Angelo, et al. Children and Youth Services Review 107 (2019) 104525 Gateway, 2011; Foster & Gifford, 2005; Geenen & Powers, 2006; Life/Better Futures) and those ageing out of foster care (19 years and Ogongi, 2012; Pecora, 2012; Zetlin, Weinberg, & Kimm, 2004). Chil- older) (e.g., Transition to Independence Process). Thus, little is known dren may return to home environments that continue to be affected by about effective strategies and supports that address the broad chal- poverty, substance abuse, domestic violence, and mental illness (Foster lenges faced by reunifying school-aged children departing foster care &Gifford, 2005; Zetlin, Weinberg, & Kimm, 2004). Caregivers also face settings. To change the trajectory of outcomes for this population and ongoing difficulties with issues of shame, guilt, resistance to service better understand comprehensive needs, it is necessary to identify providers, and mistrust with schools (Child Welfare Information supports or services that foster a path towards success. Gateway, 2011; Ogongi, 2012; Stukes Chipungu & Bent-Goodley, An initial step in this process is to gather to the perspectives of 2004). numerous stakeholders (i.e., service providers, children, families, In addition to their caregivers, school-aged (elementary, middle, caseworkers, legal professionals) on necessary child and family sup- and high school) children in particular, may also face significant edu- ports and potential barriers that prevent success during this period. cational, behavioral, social, and emotional challenges during the period Although limited, some literature exists examining perspectives of from foster care back to the home and school setting. Foster care pro- certain stakeholder groups (service providers, caseworkers). While gramming differs based upon local oversight and state agency guide- there are numerous stakeholders involved during this transition pro- lines, generating extreme variability as to what children in foster care cess, one group that plays an integral role in many of the identified risk will experience pertaining to therapeutic or educational support (Burns areas during and following the reunification period are legal profes- et al., 2004; Committee on Early Childhood, Adoption, & Dependent sionals. Yet, there are no existing studies that capture insight from this Care, 2002; Leslie, Hurlburt, Landsverk, Barth, & Slymen, 2004). It is stakeholder group. Although there are several kinds of legal profes- also common for school-aged children to move several times following sionals, each serves the child or family in specific capacities at different placement before finding a stable foster home, further decreasing the times during the transition (prior to, during, and following). Moreover, likelihood that they will receive the necessary supports to address in some states, legal professionals may even serve in multiple legal roles educational, social, behavioral, or health needs (Olin et al., 2010; for the child or family (e.g., legal counsel and guardian ad litem [GAL]). Turnball, Turnball, Erwin, & Soodak, 2015). Therefore, many school- For example there are prosecuting attorneys who represent the interests aged children depart foster care and enter the reunification period with of the State; attorneys who represent the child welfare agency; attor- many of the same risks that were present when they were removed from neys who represent the parents or guardians; and GAL(s) serving the the home. This consists of a multitude of problems including poor children who are the subjects of the petitions. A GAL may be an at- physical and mental health, poor academic functioning, limited school torney or Court Appointed Special Advocate (CASA) who investigates engagement, poor relationships, and delinquency (Basca, 2009; Geenen the needs of the child andmakes recommendations in the best interests & Powers, 2006; Pecora, 2012). of the child (42 U.S.C. 5106a(b)(2)(A)(xii)). As each legal professional These risks result in re-entry rates between 21 and 38%, with rates role is unique, individuals provide varied perspectives on how prepared on the higher end among subsets of children in foster care (e.g., school- families are for the transition, necessary supports during this transition aged [grades K-12th]; Hatton & Brooks, 2008; Kids Count Data Center, period and barriers that exist for school-aged children and families. 2017; Wulczyn, Hislop, & George, 2000). For families, re-entry con- Understanding the diverse perspectives from each type of legal pro- tributes to increased parental stress, poor family functioning, and fessional can provide a more comprehensive picture of what is needed strained parent-child relationships (Child Welfare Information to promote youth and family success. Gateway, 2011). For school-aged children, re-entry negatively affects The American Bar Association has adopted standards for legal social and emotional well-being, peer relationships, and education. professionals who represent children (ABA, 1996) and parents (ABA, Follow-up studies of children served in the foster care system reveal 2006) in cases of abuse and neglect and lawyers representing child that nearly half will fail to graduate high school with their peers welfare agencies (ABA 2004). These standards require attorneys to take (National Foster Youth Institute [NFYI], 2018), only 11% attend col- a role in case planning, advocate for appropriate services, and take lege, and a mere 3% complete college (Barrat & Berliner, 2013; Child reasonable steps to ensure that court orders are complied. This includes Trends Data Bank, 2015; Ryan & Bauman, 2016; U.S. Department of (a) identifying the circumstances that led to child or youth placement Education, 2015). As such, these children demonstrate continued risks into care; (b) monitoring court involvement including court-ordered into adulthood resulting in unemployment, financial instability, pov- treatment for parents, tracking visits that occur between the youth and erty, and homelessness (Courtney & Heuring, 2005; Dworsky, 2005; family, and making recommendations to judges on behalf of the family Park, Metraux, & Culhane, 2005; Pecora et al., 2006). Thus, while re- regarding services and progress (Guggenheim, 2016; Krinsky, 2010; unification is the desired outcome for families, unsuccessful reunifica- Sankaran, 2010); and (c) monitoring “red flag” behaviors of school- tion can result in many costly and adverse consequences (Hatton & aged children across several domains (e.g., academics, behavior, social, Brooks, 2008; Kids Count Data Center, 2017). emotional, health) which put them at risk for involvement in a juvenile One method for preventing this cycle of failure is to provide effec- justice case or possible re-entry to care. Given that school-aged children tive and comprehensive supports following reunification. This includes have elevated rates of re-entry to care, legal professionals likely provide services or supports that are designed to address the transition period, support and advocacy for extended periods of time during the transition facilitate family reunification, improve family stability, address social, period. This high-level and diverse involvement in each of the proposed emotional, health, and academic domains, and prevent children from challenge areas (e.g., educational, environmental, behavioral, social, returning to foster care (Pecora & English, 2016; Trout et al., 2012). emotional, health) experienced by school-aged children and families This support often requires the ongoing involvement of numerous sta- provides legal professionals with a unique perspective to identify unmet keholders including service providers, educational, and legal profes- needs and necessary supports during reunification. sionals. While comprehensive evidence-based programs exist to support Given the unique and varied roles that legal professionals play in the the transition home for children in other out-of-home settings (e.g., reunification process, it is hypothesized they will provide pivotal in- residential care; On the Way Home, Trout et al., 2012), there are no formation to fill in some of these existing gaps related to preparedness, similar programs for school-aged children departing foster care and necessary supports, and potential barriers. Thus, the goal of this ex- transitioning to home and school settings. Existing programs for chil- ploratory study was to address the following research questions: (1) dren departing from foster care are often time limited and focus on a How prepared do legal professionals feel children and families are for specific area of risk (e.g., family functioning, substance abuse; the reunification period? (2) What do legal professionals perceive as Children’s Bureau, 2014; English, 2007; Zetlin, Weinberg, & Shea, existing barriers for children and families during reunification? and (3) 2006) or focus on younger children (birth through preschool) (e.g., My What services do legal professional perceive as necessary to promote 2 J. Huscroft-D'Angelo, et al. Children and Youth Services Review 107 (2019) 104525 successful reunification and the effectiveness of existing supports? Trout and Epstein, 2010). In step 1, individuals independently gener- ated as many ideas as they could on notecards to the presented ques- 2. Method tion. The notecards were placed in the middle of the table and collected by members of the research team. Each idea was recorded anonymously 2.1. Procedures onto a word document and projected onto a large screen (step 2). Next, the group went through each idea and discussed an overlap in ideas The University’s institutional review board (IRB) approved all study along with clarification of presented ideas (steps 3 and 4). Then as a procedures. Potential participants were legal professionals (N = 39) group any ideas that needed to be eliminated due to overlap and a lack recruited from one state in the Midwest who attended a four-hour of clarity were removed (step 5). The group then came to an agreement continuing legal education (CLE) training by the state bar association on the final list of independent themes and ideas (step 6). Finally, using on re-entry planning for children. For 90 min of the CLE, attendees were the the remaining items, participants independently selected the ideas invited to complete a brief survey and participate in a focus group on that were the most important to them and placed each on idea onto aftercare or reunification needs for children departing out-of-home care separate notecards. A member of the research team then used scripted and asked to rank (1 = most involved to 3 = least involved) their ex- and systematic approach to have participants rank order the ideas they perience with children in three different settings (residential care, foster selected from the list in order of importance (5 = most important to care, and juvenile justice). Participants were grouped according to their 1 = least important; step 7). highest rated experience area. The present study focuses solely on the perspectives of those with the most experience with children and fa- 2.2. Data analysis milies involved in foster care. Thirteen legal professionals ranked their experience as highest with Data for each question of the survey were entered into an excel foster care and were invited to attend the foster care focus group and sheet, cleaned, and verified. Descriptive data from the demographic and complete a brief survey. Participants were informed of the time com- four-item surveys were calculated. Items from the focus group were mitment and efforts for participating and consent was collected. tallied for each question to indicate the frequency of receiving a ranking Participants then completed six demographic items that included items score of 5 = most important to 1 = least important based on individual on gender, age, ethnicity, race, education level, and legal professional participant perceptions. Next, each item was summed to provide a total role. To gather additional information on key areas of the transition score based on the ranking scores indicated by participants. Finally, process and service provision, participants were also asked to complete frequencies were tabulated to identify the how often an idea was four additional items. These four items were used in a previously de- ranked by the participants as a top five idea. veloped, comprehensive survey assessing the aftercare needs of school- age children departing residential care (Huscroft-D'Angelo et al., 2013; 3. Results Trout et al., 2014). The items used in this version were modified to reflect reunification and foster care versus aftercare. Participants were 3.1. Participants asked to provide their perspectives on the transition period including caregiver preparedness for transition (very prepared, somewhat pre- Based on the information reported in the demographic portion of pared, not at all prepared), youth’s preparedness for transition (very the survey, approximately 53.8% of the participants were male (n = 7), prepared, somewhat prepared, not at all prepared), effectiveness of 92.3% were Caucasian (n = 12), and 7.7% were Asian (n = 1). Their existing services (very effective, somewhat effective, not at all effec- average age was 42.31 years (SD = 12.09). All participants had a pro- tive), and the importance of services in eight critical domains (e.g., fessional degree with an average of 9 years of experience. Participants education, mental health, physical health) identified in previous re- were asked to identify what they felt was their primary role in serving search (Huscroft-D'Angelo et al., 2013; Trout et al., 2014). Items were children in foster care, more than half (n = 8; 61%) perceived their rank ordered by importance with 1 being the most important to 8 being primary role during reunification as serving as a dual role of GAL and the least important. Following completion of the survey, participants legal counsel (e.g., youth, family, state, agency). One participant engaged in a systematic focus group approach to address two primary (n = 1; 8%) indicated legal counsel, and three (n = 3; 23%) indicated questions: (1) What are the primary challenges/obstacles that you see other, but identified as counsel for the parent. Finally, one participant faced by school-aged children and their families during the reunifica- (n = 1; 8%) identified as a child advocate for CASA, which is not an tion period? and (2) What services or supports would you recommend attorney, but may be appointed by a judge in a child welfare case. Of for these school-aged children and their families to promote school and note, in the state where the study was conducted, GALs serve a dual role home stability? as counsel for the child and best interest attorney. Nominal group technique. Participants responded to the two questions in a 90-minute focus group using a modified version of the 3.2. Preparedness, effectiveness, and importance nominal group technique (NGT; Delbecq, Van de Ven, & Gustafson, 1986). The NGT process was used for each target question. NGT is a Participants were asked to provide their perceptions on how pre- structured procedure that uses both qualitative and quantitative pared they felt families and children were to experience reunification, methods to collect consumer feedback in a timely manner. This ap- how effective they felt existing services were in preparing children and proach was selected because it has been widely used in the identifica- families for this transition period, and to rank the importance of sup- tion of consumer needs and opinions across broad populations. It has ports in key domains related to reunification. None of the participants also been identified as an important initial step in the development of reported families to be “very prepared” for the reunification period, interventions and programs (Trout and Epstein, 2010). The NGT 23.1% (n = 3) felt families and children were not at all prepared for the questions focused on understanding barriers to the reunification process transition period following a stay in foster care. Similarly, the majority and identifying necessary supports for school-aged children and fa- (n = 11; 84.6%) reported that existing services are somewhat effective milies following reunification. NGT procedures involved the completion in supporting this transition, and the remainder (n = 2, 15.4%) re- of seven steps: (1) brainstorming and silent generation of ideas, (2) ported that services were not at all effective. None of the participants reading aloud, recording, and display of generated ideas, (3) group indicated that existing services were “very effective” for families. discussion for clarification, (4) categorization of ideas into themes, (5) a Participants were also asked to rank order the importance of receiving preliminary vote to identify high priority ideas, (6) group discussion of supports in critical domains of reintegration (see Table 1). Overall, preliminary vote, and (7) a final vote of ideas (Delbecq et al., 1986; participants felt supports in the mental health domain to be most 3 J. Huscroft-D'Angelo, et al. Children and Youth Services Review 107 (2019) 104525 Table 1 3.4. Question 2: Services and supports to promote stability Importance of supports and services in critical domains (N = 13). For question 2, participants generated 27 unique supports or ser- Domain M SD vices that they perceived as important to promote school and home Mental health supports 1.91 1.3 stability for reunifying children and families in steps 1–6. Of those, 24 Family supports 2.18 1.07 were rated in participants’ top five supports or services (step 7). Educational supports 3.81 1.72 Supports that were ranked highest amongst the group were mental Relationship supports 4.36 1.57 Safety supports 4.91 2.25 health services for the entire family; consistent sharing of information Physical health supports 5.82 1.89 between key stakeholders; access to a resource hotline, including in- Independent living supports 6.45 1.69 formation on availability and how to use it; having a consistent case- Legal supports 6.54 1.29 worker; parenting supports; and educating school personnel on ways to work with child-welfare involved students. Table 3 displays all 24 Note. Items were ranked with 1 = most important to 8 = least important. items, the total score each item received in the ranking process, and the number of times the item was ranked in the top 5. important (M= 1 .91; SD = 1.30) and legal domain to be the least important (M= 6 .54;SD = 1.29). 4. Discussion 3.3. Question 1: Challenges and obstacles preventing successful Legal professionals play a critical role in all aspects of child welfare reintegration involvement. This includes removal from the home, monitoring while in care, identification of permanency plans, preparation for discharge, As part of the NGT process, participants were asked to generate as and monitoring reunification for children and their families following many examples of challenges or barriers that families face which hin- placements in foster care. Ultimately, this level of continuous involve- ders successful reunifications. Overall, 36 independent barriers were ment offers unique insight into potential barriers and needs of families identified during steps 1–6 and 29 of those were rated in the partici- to promote long-term stability. In many cases, the judge and other legal pants’ top five rankings (step 7). Most notably, participants were con- professionals may be the only individuals who have been involved in cerned about the perceived lack of desire by parents to implement long- the case for its entire duration. As such, the legal professional has an term changes; limited access to services in rural communities; limited intimate knowledge of the facts surrounding the case, and insight into access to resources such as family support, counseling, and vouchers; what services should be provided to enable a successful transition back challenges with reintegrating into educational systems; a lack of con- into the family home. tinuity of services upon reentry; and limited access to relationships children formed while in care. Table 2 displays all 29 rated items, the 4.1. Preparedness for reunification and effectiveness of current supports total score each item received in the ranking process, and the number of times the item was ranked in the top 5. When asked about perceptions of preparedness for reunification, none of the participants felt that families were “very prepared” and just Table 2 Participant ratings for barriers preventing successful reunification for youth and families following a stay in foster care (N = 13). Item Sum Score # Times Rated in Top Five 1. Lack of desire by parents to implement long term changes 24 6 2. Limited access to services and supports in rural communities 17 4 3. Financial resources such as family support, counseling, vouchers are immediately cut off to both the child and parents 14 4 4. Reintegration into educational systems 11 4 5. Lack of continuity of support services upon reentry 11 3 6. Youth no longer have access to supportive relationships formed in care 11 3 7. Lack of caseworker continuity 10 4 8. Mental health support for youth 8 3 9. Quality family support workers and caseworkers who understand family challenges and needs 8 2 10. Lack of follow through by probation officers or caseworkers 8 3 11. Maintaining stability (physical/mental health) youth and caregiver 7 2 12. Follow through by parents 7 2 13. Lack of ability finding to address special needs 6 2 14. Increased stress/instability once direct care supervision needs 6 2 15. Access to substance abuse treatment 5 1 16. Appropriate transition plan for families and children 5 2 17. Re-entry into the community form where they were taken, where there are temptations such as friends, drugs, illegal behavior 5 1 18. Family does not have skills to support youth returning 5 3 19. Obtaining support within the school system to provide needed services within the school setting 4 1 20. Parents admitting there is a problem that needs fixed which leads to removal 4 1 21. Lack of support for parents to use skills they have learned 3 1 22. Lack of parental involvement in services/supports provided for their child 3 1 23. Continued support by the system (HHS, Foster care, etc.) 3 2 24. Lack of discipline leading to a return of old habits 3 1 25. Change of environment stressors 2 2 26. Lack of knowledge of follow up care resources 2 1 27. Youth struggle with the less rigid structured environment of home 1 1 28. Rebuilding of relationships 1 1 29. Getting reconnected with friends and others in the neighborhood 1 1 Note. aIndividual items were generated by participants and then ranked from 5 = most important to 1 = least important. bThis column represent the number of times the item was in a participant’s top five rankings. 4 J. Huscroft-D'Angelo, et al. Children and Youth Services Review 107 (2019) 104525 Table 3 Participant rankings for necessary supports or services to promote home and school stability (N = 13). Item Sum Score # Times Rated in Top Five 1. Mental health services for the whole family 25 5 2. Consistent sharing of information between key stakeholders (caseworker, parent, school) 16 7 3. Access to a resource hotline and education on availability and how to access it 16 7 4. Consistent case-workers versus revolving door of caseworkers (turnover prevention) 14 3 5. Parenting supports such as homework support and respite services 12 4 6. Educating school personnel on special needs/ways to work with students who are in the system (helps reduce stigma) 11 3 7. Linking both youth and parents to mentors in the community 10 3 8. Access to counseling for parents and youth 9 2 9. Continued health checks 8 2 10. Providing ongoing support/mentoring efforts of the parents' skills 8 3 11. Non-judicial family follow through from caseworkers/ supports 8 3 12. Peer support groups for reintegrating youth and for caregivers 7 2 13. Implementation support of parenting class curriculum for generalization purposes 7 2 14. Youth involved in extra-curricular activities 7 2 15. Continues parent education offerings 6 2 16. In home therapy for parents/youth 5 2 17. Continuity in in-home &school family support 5 3 18. School mentors for youth 4 2 19. Tutoring services in school 4 1 20. Substance abuse treatment for family and children 4 1 21. Home visits consistently performed by one person 4 2 22. Scheduled case worker follow up 3 1 23. Engage and educate parents on the special education process 1 1 24. Improve Guardian Ad Litem training 1 1 Note. aIndividual items were generated by participants and then ranked from 5 = most important to 1 = least important. bThis column represent the number of times the item was in a participant’s top five rankings. over a quarter felt families are not at all prepared. Therefore, the ma- (Courtney & Heuring, 2005; Dworsky, 2005; Pecora et al., 2006). Al- jority (77%) felt that families and children are only somewhat prepared though there are varying degrees of foster care (i.e., family, treatment, for the reunification transition period. Similarly, when asked about the or kinship foster care), children in foster placements are not con- effectiveness of current supports, none of the participants reported that sistently provided therapeutic services. Therefore, children enter the supports were “very effective.” Given that between 21% and 38% of reunification period with continued mental health difficulties that will reunifying children return to care (Hatton & Brooks, 2008; Wulczyn require attention to be successful both in the home and at school (Burns et al., 2000) and findings that re-entry results in significant negative et al., 2004; Committee on Early Childhood, Adoption, & Dependent community (e.g., increased costs), family (e.g., wellbeing), and youth Care, 2002; Leslie et al., 2004). The results from this study convey the (e.g., social emotional, educational, financial) outcomes, it is not sur- importance of mental health supports for both children and parents as a prising that attorneys working with this population feel that that fa- primary and important need during reunification. This finding sheds milies are ill-prepared and lack effective services to successfully support light for legal professionals as an area of focus when considering the families and children during reunification. needs of necessary supports or services that are critical to youth success. 4.2. Importance of targeted aftercare domains 4.3. Barriers for successful reunification When asked to rank the importance of supports in targeted domains With respect to legal professionals’ perspectives regarding chal- of aftercare, participants identified ongoing mental health supports as lenges or barriers that families face during reunification, participants most important. This was not surprising given that legal professionals rated a perceived lack of desire by parents to change as the most sig- often become involved with these families when the child is initially nificant barrier. This perception may stem from the fact that legal removed from the home (Krinsky, 2010; Sankaran, 2010). Initial re- professionals often become re-engaged with children and families in moval is frequently a result of ongoing abuse, neglect, or maltreatment child-welfare when families are in crisis and potentially facing addi- related to parental substance abuse or mental illness (Annie E. Casey tional legal ramifications. Unfortunately, there are many barriers pre- Foundation, 2014; Foster & Gifford, 2005; Krinsky, 2010; Zetlin et al., sent for caregivers following reunification that likely prevent them from 2004), and parents are often court-ordered to participate in therapeutic wanting to engage in service. This includes their own difficulty with the services and reach targeted goals prior to reunification. However, de- child welfare system, feelings of inadequacy, mistrust of schools, spite reaching these goals, stressors during reunification can reignite challenges navigating school systems, and low levels of parent self-ef- many of the original problems that caused the child to be removed from ficacy (Hoover-Dempsey et al., 2005; Ogongi, 2012; Olin et al., 2010; the home (Child Welfare Information Gateway, 2011; Ogongi, 2012). Turnbull, Turnbull, Erwin, & Soodak, 2015). The availability of therapeutic supports for parents during the re- A common underlying theme across the remaining top-rated bar- unification period may better prepare caregivers to manage the stres- riers (e.g., limited access to services and supports in rural areas; fi- sors attributed with reunification and assist families through the nancial resources to assist with resources; reintegration into the school changing family dynamics. As part of the team of individuals in this systems; a lack of continuity of services) included access to supports process, legal professionals could provide a sound voice in advocating which may also affect perceptions of an unwillingness on the part of the for these services to be in place during and following reunification. parents to change. Parents are more likely to engage in services if they For children, removal from their parents is traumatic and although are empowered and confident in their ability to navigate services foster care is intended to provide a temporary, safe environment free (Zhang & Bennett, 2003; Zimmerman, 2000). It appears that the results from adverse caregiving conditions, the accumulation of bad experi- from this study indicate some barriers may exist that contribute to ences leave children vulnerable and at high-risk for mental illness parents’ lack of desire to change. Legal professionals could focus on this 5 J. Huscroft-D'Angelo, et al. Children and Youth Services Review 107 (2019) 104525 with parents when preparing them for reunification and proactively caregivers with an individual (e.g., counselor, school social worker) discuss this with the reunification team as a priority. For example, if who could explicitly teach them strategies to navigate the school en- services are not readily available, what motivation is present for parents vironment and use online school portals to monitor academic risks. to access services when they are available? Furthermore, if services are These simple steps can remove barriers related to youth engagement present there must be a mechanism for parents to engage in the service. and promote greater rates of youth school success. These strategies can If there is a feeling of intimidation or inadequacy to access a service, also help facilitate ongoing communication between caregivers and this may prevent parents from wanting to engage in a service that has schools and contribute to empowering caregivers to be involved in their the potential to serve as a behavioral change agent (Hoover-Dempsey child’s education. et al., 2005). Future research should examine programs or practices that exist which are successful at engaging parents and changing behavior to 5. Limitations reduce the barrier of lacking the desire to changing parenting behavior. Although the overall purpose of this exploratory study was to 4.4. Top-rated reunification supports identify potential barriers and strategies for supporting successful re- unification in children served in foster-care, the findings should be Participants in this study rated mental health supports for the entire considered in conjunction with several potential limitations. First, the family as the top-rated service or support for families to receive to participants in this study were recruited from one training agency lo- promote successful reunification. This was not surprising given that cated in the Midwest. Although the participants represented several they rated mental health to be the most important domain in which firms and legal positions, the size, available resources, and services families should receive services (see Table 1). Legal professionals place offered to families may influence their perspectives. Thus, barriers emphasis on addressing and providing mental health support for this discussed or supports identified may differ based on where the firm is population and should collaborate with other stakeholders to ensure located (e.g., suburban, rural) and the clients it serves limiting the these supports are in place for children and families during the re- generalizability. A second limitation is the small sample size in this unification period. Closely following mental health supports, the re- study and the inability to examine data by legal professional subgroups. maining top-rated supports linked to general themes of consistency and Future research exploring aftercare needs, barriers, or consideration for parent training/support and provide important insight into supports or intervention development in children departing foster care and re- services that could better support children and their families during unifying with their families should consider expanding to multiple reunification. states and including even more diverse settings (i.e., urban), include Legal professionals likely recognize that families involved with child other key stakeholder groups, and with bigger samples of legal pro- welfare require specific and systematic attention and intervention, fessionals to examine differences between each type (i.e., GALs as op- particularly those who are repeatedly involved with the system. The posed to parent attorneys, agency attorneys, or prosecuting attorneys). importance of consistency and stability for these families was evident Third, as with any self-report or interview data, there could be bias, due across participant recommendations and could be accomplished to social desirability, based on experience, inaccurate recall, or ability through systematic approaches to preparing for and supporting re- to respond to questions. unification efforts. As an example, legal professionals could advocate for establishing standard methods for sharing information and file 6. Conclusions transfers among all involved stakeholders (e.g., caseworkers, school personnel, therapists, medical providers). This would ensure that all Results from this study offered insight from one key stakeholder stakeholders have access to pertinent information and prevents the group working with families who are involved with reunification. Re- need for parents to continuously restate content, increasing frustration entry is an ongoing challenge for children in foster care and those in- with the system. Moreover, shared information allows for increased dividuals working to prevent recidivism. The perspectives of experts collaboration, shared responsibility, and data informed goal setting to working to meet the needs of these families is integral to understanding better support and meet the needs of the child and family. This process and making progress in developing a comprehensive approach to meet should begin once the family enters the legal process of removal and child and family needs during and following reunification. These results follow the family through reunification to promote success post re- highlight the unique perspectives offered by those involved with the unification. legal side of child welfare. There are several practical implications from An additional theme across the top-rated supports involves explicit these findings that can be generalized to various professionals sup- training with parents on how to access readily available resources (e.g., porting these families during the reunification process. First, it remains national or local hotlines, respite services) or implementing supports necessary to recognize the importance of mental health needs with both with the home (e.g., homework support, parenting strategies). Legal caregivers and children during the reunification process. Reunification professionals conveyed the value this may add in supporting parents to can present elevated caregiver stress, which can exacerbate contexts in experience positive reunification evidenced by several of the generated which family violence, substance abuse, mental illness, and child abuse items and those that appeared in the top-rated items. If legal profes- occur or escalate, and lead to decreases in family functioning, educa- sionals could take extra time to show parents available tools or re- tional success, and stability (Cronin, Becher, Schmiesing-Christians, sources, along with how to use each resource, it may ensure parents can Maher, & Dibb, 2015; Patnaik, 2014; Sutherland & Miller, 2012). En- access and use services that already exist. For example, there are na- couraging caregivers to access mental health services and conveying the tional crisis hotlines available to parents and children (e.g., Boys Town importance of mental health care should remain a priority when sup- National Hotline). However, if parents are not aware of the hotlines, porting reunifying families. This may include helping caregivers to es- their effectiveness as a resource, or how to access the information, these tablish a mental health provider, educating them on the importance of resources provide little support. medication adherence, and providing them with tools or resources that Finally, it is well documented that monitoring of student perfor- will foster positive mental health well-being. mance, the provision of academic opportunities, school and family Second, participants identified several barriers that hinder suc- support, educational goal setting, and overall school engagement are cessful reunifications. Several of the identified barriers can be ad- critical factors in the prevention of school failure and dropout dressed from those implementing services or supports to the family (Randolph, Fraser, & Orthner, 2004; Reschly & Christenson, 2006; including establishing systems that incorporate consistency among Sinclair, Christenson, & Thurlow, 2005), an outcome too prevalent in providers when speaking with caregivers, transferring or sharing in- children placed in foster-care. Legal professionals could connect formation, and supporting common family goals among team members 6 J. Huscroft-D'Angelo, et al. Children and Youth Services Review 107 (2019) 104525 to reduce several of the top-rated barriers identified in this study. These American Bar Association. (2004). Standards of practice for lawyers who represent child systems can also ease the frustration of caregivers who may already welfare agencies. Retrieved from https://www.americanbar.org/content/dam/aba/ administrative/child_law/agency-standards.authcheckdam.pdf. have negative perceptions of services providers and contribute to the American Bar Association. (2006). Standards of practice for attorneys representing par- potential that caregivers will access supports that promote positive ents in abuse and neglect cases. Retrieved from https://www.americanbar.org/ reunification outcomes. content/dam/aba/administrative/child_law/ParentStds.authcheckdam.pdf. Third, while children are an integral component of the reunification Annie E. Casey Foundation. (2014). What is foster care? Retrieved from http://www.aecf. org/blog/what-is-foster-care/. process, participants in this study identified the ongoing need for con- Annie E. Casey Foundation. (2017). Kid count data center. Retrieved from https:// sistent and explicit supports aimed at caregiver needs. Caregiver in- datacenter.kidscount.org/. volvement, positive parenting, and caregiver self-efficacy are important Barrat, V. X., & Berliner, B. (2013). The invisible achievement gap, Part 1: Education out- comes of students in foster care in California’s public schools. San Francisco, CA: WestEd. factors in a child’s social/emotional and educational success (Bronstein, Basca, B. (2009). Providing effective prevention services to youth in foster care. Ginsburt, & Herrera, 2005; Jones & Prinz, 2005; Kim & Schneider, Prevention Brief, 4(2), 1–12. 2005). For children in foster care, these constructs are particularly Bronstein, P., Ginsburt, G. S., & Herrera, I. S. (2005). Parental predictors of motivational important because reunification presents many challenges for care- Aordioelnetsacteinocne ,i n4 ,e 5a5rl9y– a5d7o5l.e scence: A longitudinal study. Journal of Youth and givers, including balancing their own needs with those of their child Burns, B. J., Phillips, S. D., Wagner, R., Barth, R. P., Kolko, D. J., Campbell, Y., & (Child Welfare Information Gateway, 2012). Thus, legal professionals Landsverk, J. (2004). Mental health need and access to mental health services by youths involved with child welfare: A national survey. Journal of the American can convey the importance of implementing strategies to improve these Academy of Child and Adolescent Psychiatry, 43, 960–970. constructs as a mechanism to promote home and school stability. If Chacko, A., Wymbs, B. T., Arnold, F. W., Pelham, W. E., Swanger-Gagne, M., Girio, E. L., caregiver are equipped with the skills they need to engage in positive &O’Connor, B. (2009). Enhancing traditional behavioral parent training for single- mothers of children with ADHD. Journal of Clinical Child and Adolescent Psychology, parenting behavior, it is favorable for positive child outcomes (Chacko 38, 206–218. https://doi.org/10.1080/15374410802698388. et al., 2009; Zhang & Bennett, 2003; Zimmerman, 2000). Child Trends Data Bank. (2015). Foster care: Indicators on children & youth. Retrieved Finally, as noted, very little is known about comprehensive re- from Child Trends website: http://www.childtrends.org/databank/. unification supports for this population. As such, research is needed to Child Welfare Information Gateway. (2011). Family reunification: What the evidence shows. Washington, DC: U.S. Department of Health and Human Services, Children’s both replicate and extend the present study. For example, replication is Bureau. necessary with various stakeholder populations (e.g., foster parents, Child Welfare Information Gateway. (2012). Supporting reunification and preventing youth, school personnel, caseworkers, mental health providers) as each reentry into out-of-home care. Washington, DC: U.S. Department of Health and Human Services, Children’s Bureau. provides varied insight as to the reunification needs of caregivers and Child Welfare Information Gateway. (2016). Statistics. Retrieved from https://www. children. Moreover, it would be beneficial to replicate this study within childwelfare.gov/topics/systemwide/statistics/?hasBeenRedirected=1. the various levels of foster care (e.g., therapeutic foster care, respite, Children’s Bureau. (2014). Child maltreatment 2014. Retrieved from http://www.acf.hhs. short-term, specialized) as needs and barriers may differ slightly de- gov/cb/resource/child-maltreatment-2014. Committee on Early Childhood, Adoption, & Dependent Care. (2002). Health care of pending upon services offered and approaches used within the settings. young children in foster care. Pediatrics, 109, 536–541. Further evaluations of perceived barriers and needs will help to develop Courtney, M. E., & Heuring, D. H. (2005). The transition to adulthood for youth aging out and implement effective reunifcation supports and tailor appropriate of the foster care system. In W. D. Osgood, M. E. Foster, C. Flanagan, & G. R. Ruth (Eds.). 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