Barriers to the Reunification of Youth in Intensive out-of-Home Placements: Systemic and Agency Factors

Background & Purpose: Few studies have documented the experiences of foster youth who are transitioning from intensive out-of-home settings back into their homes and communities. This study begins to address this gap by presenting the findings of a qualitative evaluation of a unique pilot program designed to help foster youth with complex mental and behavioral health needs successfully reunify with their families. Specifically, this study seeks to understand the barriers to successful reunification of these youth.

Methods: Semi-structured interviews were conducted with a small sample of youth, their family caregivers, CPS caseworkers, and pilot program staff who were interviewed about their experiences with the reunification process and the services provided through the pilot program. Additional case history data were obtained from structured reviews of the youths' CPS files. Participants included six youth and six caregivers, nine CPS caseworkers, and two program staff (N=23). The majority of youth and caregivers in the study were African American and Hispanic. Youth ranged in age from 10-18, while caregivers ages ranged from 33-67 years old. Caregivers for the youth included two grandparents, two birthparents, one adoptive parent, and one fictive kin. All of the youth were placed in at least one residential treatment setting while in foster care. The youth resided in residential treatment settings between eight months and six years.

Results: Results of this study highlight the importance of the following: 1) assessing the overall readiness of youth and caregivers for reunification; 2) adequate preparation of the youth and caregiver to ensure the successful transition of youth back into the community; 3) providing program staff with adequate time to engage with the youth and caregivers prior to reunification; 4) CPS caseworkers taking a more active role in determining the youths' readiness for discharge; 5) need for CPS caseworkers and residential treatment staff to receive cultural competence training in order to better serve the needs of youth and families of color, and 6) facilitating frequent visitations between the youth and caregiver prior to the reunification. Program staff emphasized the need for collaboration with staff in the youths' residential placement settings to prepare the youth for reunification. The staff also identified a number of logistical barriers to their efforts to assist in the youth's preparation for the reunification, including difficulty working with CPS caseworkers to coordinate visits between the youth and their caregivers and accessing the youth to develop rapport prior to the reunification. Caregivers also stressed the importance of not using the youth's behavior as a reason for withholding visitation. Overall, caregivers were very satisfied with the support the pilot project provided prior to and following the reunification.

Conclusions and Implications: The utilization of community-based services following discharge is of critical importance to ensuring the successful reunification of youth in intensive out-of-home placements back into the community. Participants in the study provided important insights regarding how services are utilized, as well as systemic and agency-level barriers to the successful reunification of youth with severe mental and behavioral health needs back into the community.