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Practice Profile

Kinship Care for Children Removed from Home for Maltreatment

Evidence Ratings for Outcomes:

Promising - One Meta-Analysis Mental Health & Behavioral Health - Multiple mental health/behavioral health outcomes
Promising - One Meta-Analysis Mental Health & Behavioral Health - Adaptive problems
Promising - One Meta-Analysis Mental Health & Behavioral Health - Emotional wellbeing
Promising - One Meta-Analysis Family Functioning - Out-of-home placement/permanency
Promising - One Meta-Analysis Victimization - Child abuse/neglect/maltreatment
No Effects - One Meta-Analysis Family Functioning - Reunification
No Effects - One Meta-Analysis Family Functioning - Attachment

Practice Description

Practice Goals/Target Population
Child abuse, neglect, or other types of maltreatment often result in the removal of children (under the age of 18) from the home and in their placement in one of several different types of out-of-home-settings, the most common of which is within the foster care system (Winokur, Holtan, and Batchelder 2014). An alternative to traditional foster care placement, kinship care allows children removed from their parents to be cared for by relatives, members of their tribes or clans, godparents, stepparents, or other adults with whom they have a kinship bond (Child Welfare League of America 1994). Kinship care allows children to live with individuals whom they know and trust, reduces the trauma children may experience when they are placed with unknown persons in foster care, and reinforces children’s sense of identity and self-esteem that is often tied to family history and culture (Wilson and Chipunga 1996).

The primary goal of kinship care is either 1) family preservation, in which the permanency goal for children is reunification with their birth parents; or 2) substitute care, in which kinship care is considered to be a long-term arrangement when reunification is not possible, or the permanency goal is adoption or guardianship by kin caregivers (Scannapieco and Hegar 1999).

Practice Components
There are several variations of kinship care, including formal, informal, and private placements. Formal kinship care refers to a legal arrangement in which a child welfare agency has custody of a child and arranges placement with a kin caregiver, who can be licensed or unlicensed (Ayala-Quillen 1998). Informal kinship care refers to when a child welfare agency assists in placing a child with a kin caregiver, but the agency does not seek court action to obtain custody of the child (Geen 2000). Finally, private kinship care is a voluntary arrangement between the birth parents and family members without the involvement of a child welfare agency (Dubowitz 1994).

Meta-Analysis Outcomes

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Promising - One Meta-Analysis Mental Health & Behavioral Health - Multiple mental health/behavioral health outcomes
Aggregating the results from 15 studies, Winokur, Holtan, and Batchelder (2014) found a statistically significant effect size favoring the treatment group (d = -0.33) on measures of behavior problems. This finding indicates that children in kinship care had lower reported levels of internalizing and externalizing behavior problems, such as depression or aggression, compared with children in foster care.
Promising - One Meta-Analysis Mental Health & Behavioral Health - Adaptive problems
Aggregating the results from six studies, Winokur, Holtan, and Batchelder (2014) found a statistically significant effect size favoring the treatment group (d = -0.42) on measures of adaptive problems (i.e., levels of competence). This finding indicates that children in kinship care had higher reported levels of competence, compared with children in foster care.
Promising - One Meta-Analysis Mental Health & Behavioral Health - Emotional wellbeing
Aggregating the results from four studies, Winokur, Holtan, and Batchelder (2014) found a statistically significant effect size favoring the treatment group (OR = 0.50) on measures of well-being (i.e., positive emotional health). This finding indicates that children in kinship care were two times more likely to report positive emotional health, compared with children in foster care.
Promising - One Meta-Analysis Family Functioning - Out-of-home placement/permanency
Aggregating the results from six studies, Winokur, Holtan, and Batchelder (2014) found a statistically significant effect size favoring the treatment group (OR = 0.39) on number of placements. This finding indicates that children in kinship care experienced fewer out-of-home placements, compared with children in foster care.
Promising - One Meta-Analysis Victimization - Child abuse/neglect/maltreatment
Aggregating the results from three studies, Winokur, Holtan, and Batchelder (2014) found a statistically significant effect size favoring the treatment group (OR = 0.27) on institutional abuse (i.e., a substantiated incident of abuse or neglect that occurred in an out-of-home placement setting by either kin caregivers or foster parents but not by the birth or biological parents). This finding indicates that children in kinship care were 3.7 times less likely to experience institutional abuse, compared with children in foster care.
No Effects - One Meta-Analysis Family Functioning - Reunification
Aggregating the results from 13 studies, Winokur, Holtan, and Batchelder (2014) found no statistically significant effect on family reunification. This finding indicates that there was no difference in the rate of family reunification between children in kinship care and children in foster care.
No Effects - One Meta-Analysis Family Functioning - Attachment
Aggregating the results from five studies, Winokur, Holtan, and Batchelder (2014) found no statistically significant effect on children’s attachment with family. This finding indicates that there was no difference in measures of attachment to family between children in kinship care and children in foster care.
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Meta-Analysis Methodology

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Meta-Analysis Snapshot
 Literature Coverage DatesNumber of StudiesNumber of Study Participants
Meta-Analysis 11970 - 201171731798

Meta-Analysis 1
Winokur, Holtan, and Batchelder (2014) conducted a meta-analysis to evaluate the effects of kinship care placement, compared with foster care placement, on the safety, permanency, and well-being of children removed from the home due to maltreatment. Their comprehensive search for studies of kinship care included a keyword search of online abstract and literature databases (such as MEDLINE, PsycINFO, ERIC) and hand searches of volumes of Child Abuse & Neglect, Children and Youth Services Review, Child Welfare, Research on Social Work Practice, and Families in Society: The Journal of Contemporary Social Services, from 2006 and 2007. In addition, they contacted several key authors of studies included in the review for knowledge of other studies not yet identified. The authors also screened the reference lists of published literature reviews for relevant studies.

Literature included in the meta-analysis was current through March 2011. Only the studies that met the following criteria were included: 1) controlled experimental and quasi-experimental studies, in which children placed in kinship care were compared cross-sectionally or longitudinally with children placed in foster care (studies that compared kinship care with more restrictive out-of-home settings (e.g., residential facilities) were not considered for this review); 2) children and youth under the age of 18 who were removed from the home because of abuse, neglect, or other maltreatment, and subsequently placed in kinship care; 3) formal kinship care placements, regardless of whether the kin caregivers were licensed or unlicensed (studies that exclusively examined informal or private kinship care arrangements were not considered); and 4) studies that analyzed child welfare outcomes in the well-being, permanency, or safety domains. Primary outcomes for the review were behavior and adaptive problems, well-being, number of placements, reunification, attachment, and institutional abuse. Appropriate measures of behavior problems, adaptive problems, well-being, and attachment included case records, caregiver reports, teacher reports, self-reports, and standardized instruments. Appropriate measures of the number of placements, reunification, and institutional abuse included child welfare administrative databases.

A total of 102 studies were identified and included in a qualitative synthesis. All but 13 of the studies were conducted in the United States. Of the international studies, four studies were conducted in Australia, two in Spain, two in the Netherlands, and one in each of the following countries: Ireland, Israel, Norway, Sweden, and the United Kingdom. Only 87 of the 102 studies reported data on participant characteristics. The average age at placement for children in both the treatment and control groups was 4 years and 10 months. On average, the study samples were 52 percent female. Of the samples, 45 percent of the children were black, 22 percent were Hispanic, and the race/ethnicity of the other children was not reported. Sixty percent of the children were removed for neglect; however, it was not reported why the other 40 percent were removed from the home. Eighty percent of the children lived in urban settings, 13 percent lived in rural settings, and the settings for the other 7 percent were not reported. The average length of placement for the treatment group in kinship care was 36 months, and the average length of placement for children in foster care was 34 months.

Of the 102 studies included in the qualitative synthesis, only 71 studies were included in the meta-analysis. Standardized mean differences and odd ratios were calculated to measure program effects between the treatment and control groups. Using a 95-percent confidence interval, mean effect sizes were calculated for all eligible studies.
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Cost

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There is no cost information available for this practice.
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Evidence-Base (Meta-Analyses Reviewed)

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These sources were used in the development of the practice profile:

Meta-Analysis 1
Winokur, Marc, Amy Holtan, and Keri E. Batchelder. 2014. “Kinship Care for the Safety, Permanency, and Well-Being of Children Removed from the Home for Maltreatment.” Cochrane Database of Systematic Reviews 1: CD006546.
https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD006546.pub3/media/CDSR/CD006546/CD006546.pdf
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Additional References

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These sources were used in the development of the practice profile:

Ayala-Quillen, B.A. 1998. “The Adoption and Safe Families Act of 1997 Kinship Care Report: An Analysis of Key Areas.” Protecting Children 14(3):12–14.

Child Welfare League of America. 1994. Kinship Care: A Natural Bridge. Washington, D.C.: Child Welfare League of America.

Dubowitz, Howard. 1994. “Kinship Care: Suggestions for Future Research.” Child Welfare 73(5):553–64.

Geen, Rob. 2000. “In the Interest of Children: Rethinking Federal and State Policies Affecting Kinship Care.” Policy & Practice of Public Human Services 58(1):19–27.

Scannapieco, Maria, and Rebecca L. Hegar. 1999. “Kinship Foster Care in Context.” In Rebecca L. Hegar, and Maria Scannapieco (eds.). Kinship Foster Care: Policy, Practice, and Research. New York: Oxford University Press,1–13.

Wilson, D.B., and S.S. Chipungu. 1996. “Introduction.” Child Welfare 75(5):387-95.

Winokur, Marc A., Amy Holtan, and Keri E. Batchelder. 2018. "Systematic Review of Kinship Care Effects on Safety, Permanency, and Well-Being Outcomes." Research on Social Work Practice 28(1):19-32.

Winokur, Marc, Desiree Rozen, Stephen Thompson, Shawon Green, and Deborah Valentine. 2005. Kinship Care in the United States: A Systematic Review of Evidence-Based Research. Social Work Research Centre: Colorado State University.

Winokur, Marc, Amy Holtan, and Deborah Valentine. 2009. "Kinship Care for the Safety, Permanency, and Well-Being of Children Removed from the Home for Maltreatment." Cochrane Database of Systematic Reviews 1.
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Related Programs

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Following are CrimeSolutions.gov-rated programs that are related to this practice:

Baltimore City (Md.) Family Recovery Program Promising - One study
A family drug court designed to serve families involved with child welfare due to parental substance use. The program is rated Promising. There was no difference in the number of cases that reached permanency. However, in cases that did reach permanent placement, they reached it faster. Children whose parents attended the program spent significantly less time in non-kinship foster care. Parents entered treatment more rapidly, and stayed and completed it more often than the non-treatment group.

KEEP (Keeping Foster and Kinship Parents Supported and Trained) Effective - More than one study
This a parent-training intervention for foster and kinship parents with a foster child in the home ages 4 to 12, designed to reduce children’s problem behaviors by strengthening foster parents’ skills. The program is rated Effective. The program was found to statistically significantly improve child problem behaviors, increase parents’ use of positive reinforcement relative to discipline, reduce parenting stress, and increase positive exits from the foster home for children.

Family Finding Promising - One study
This program is designed to find and engage kin and fictive kin to support the needs of foster care youth. The program is rated Promising. There was a statistically significant greater number of kin and fictive kin found and positive attachment figures identified for the intervention group, compared with the comparison group. However, there was no significant difference in proportion of relative placements to total placements, reunification rates, or externalizing and internalizing behaviors.
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Practice Snapshot

Age: 0 - 18

Gender: Both

Race/Ethnicity: Black, Hispanic

Targeted Population: Children Exposed to Violence, Families, Victims of Crime

Settings: Home

Practice Type: Children Exposed to Violence, Victim Programs, Wraparound/Case Management

Unit of Analysis: Persons

Researcher:
Marc Winokur
Research Scientist
Colorado State University, Social Work Research Center, School of Social Work
251 Lake Street Offices, Campus Delivery 1586
Fort Collins CO 80523
Phone: (970) 491-0885
Website
Email

Researcher:
Amy Holtan
Professor
UiT The Artic University of Norway, Regional Centre for Child and Youth Mental Health and Child Welfare
Tromsø
Email

Researcher:
Keri Batchelder
Programs and Services Section Manager, Division of Child Support Services
Colorado Department of Human Services
Website
Email