Matching in practice: how to find the right family foster home for the right child

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Ann-Sofie Bergman Stockholm University, Sweden

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Ulrika Järkestig Berggren Linnaeus University, Sweden

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Kristina Engwall Uppsala University, Sweden

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Miia Bask Uppsala University, Sweden

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The concept of matching refers to the process of selecting a family foster home to fit an individual child in placement. Matching is important for the quality of care, as the carers need the necessary resources to meet the child’s needs. Failure in matching can have negative consequences, such as a ‘breakdown’. The aim of this article is to explore the social workers’ practice when matching children and foster carers to ensure the children will receive good care and avoid a placement change. The article uses a qualitative approach and is based on interviews with 31 participants. Social workers and managers at municipal social services, as well as consultants, were interviewed about their work. The professionals reflected on what aspects they perceive as most important in matching and what challenges they encounter that complicate the process. Narratives of successful matches often focused on the characteristics, competence and experience of the foster carers to meet the needs of the children. Some of the challenges highlighted were time pressure and a lack of family foster homes to choose from. This means that professionals have to compromise and prioritise what is most important in relation to the needs of the child.

Abstract

The concept of matching refers to the process of selecting a family foster home to fit an individual child in placement. Matching is important for the quality of care, as the carers need the necessary resources to meet the child’s needs. Failure in matching can have negative consequences, such as a ‘breakdown’. The aim of this article is to explore the social workers’ practice when matching children and foster carers to ensure the children will receive good care and avoid a placement change. The article uses a qualitative approach and is based on interviews with 31 participants. Social workers and managers at municipal social services, as well as consultants, were interviewed about their work. The professionals reflected on what aspects they perceive as most important in matching and what challenges they encounter that complicate the process. Narratives of successful matches often focused on the characteristics, competence and experience of the foster carers to meet the needs of the children. Some of the challenges highlighted were time pressure and a lack of family foster homes to choose from. This means that professionals have to compromise and prioritise what is most important in relation to the needs of the child.

Introduction

In the context of family foster care, the concept of matching refers to the process of selecting a foster home to fit an individual child in placement (Zeijlmans et al, 2017). In the literature review by Haysom et al (2020), matching is understood as the ‘fit’ between children and carers. When social services take over the care of a child from their guardians, the authorities are responsible for compensating so that the child receives ‘good care’, as well as conditions for development. Matching is important for the quality of family foster care, as foster carers need the necessary resources to meet the needs of the children. Professionals involved in matching must be aware of the child’s individual needs and the problems that have led to the need for foster care. The reasons for placement are related to context. Today, the reasons are often related to parental substance abuse, mental illness, violence and other social problems. Children may be placed in family foster care due to their own problems, but most often, it is because of some form of lack of care (Vinnerljung, 2006; Höjer et al, 2012).

Inadequate work with matching may be seen as a contributor to placement failures, which can have negative consequences for the children, such as in the form of a so-called ‘breakdown’ that leads to a change of foster homes (Sinclair and Wilson, 2003; Thoburn, 2016). The term ‘breakdown’ means that a placement is terminated contrary to plans drawn up by the child welfare authorities (Christiansen et al, 2010). This usually leads to relocation to a new family foster home but can also lead to the child moving back home with the birth parents and later to a new family foster home again (Vinnerljung et al, 2004). Research on stability and instability has shown the importance of careful investigation and pre-placement planning before placement. Such planning needs to include a matching process, identification of possible placements and information transfer to and from children, birth parents and foster carers, as well as careful planning before moving the child to the foster home (Tilbury and Osmond, 2014). Failure in the work of matching can also mean that the children are exposed to new risks in the form of lack of care or neglect during their time in care (SOU, 2011; Biehal, 2014). Careful matches are essential for the children’s welfare, both in the here and now and for their future. Mismatches can also lead to foster carers choosing to stop caring for foster children, which means that fewer foster homes are available.

A suitable match between the foster child and the family foster home is thus important for the child to receive good care; however, it is difficult to achieve good matches, as there is a large variation in terms of the children’s needs while, at the same time, there is a lack of family foster homes available (Sinclair et al, 2005). There are also several parties involved – the children, the birth parents and the foster carers – who may have different interests (Zeijlmans et al, 2019). The matching between foster children and foster carers is based on a professional assessment that determines which foster home a child should be placed in. In this assessment, there is always a certain amount of uncertainty. Pösö and Laakso (2016: 307) describe matching as navigating ‘between professional discretion, legal norms and principles, subjective views of the children and their parents, as well as the economic and bureaucratic conditions of the service provision administration in the municipality’. Zeijlmans et al (2017) identify case factors (related to foster children, birth parents and foster carers), organisational factors, external factors, policy and the beliefs and experiences of practitioners as influencing the matching process and placement decisions. Thus, matching in family foster care is a complex process. There are a lot of factors to consider. In their literature review, Haysom et al (2020) concluded that the area of matching foster carers and foster children is under-researched and fragmented, and Zeijlmans et al (2017) conclude that there is a need for in-depth knowledge of which aspects influence matching. An increased understanding of matching could support practitioners in child placement.

Aim and research questions

The aim of this article is to explore professional social work practice when matching children and foster carers to ensure that the children will receive good care in a successful match. The following research question is in focus: what aspects are the most important to consider, and what challenges arise during the matching process, according to the experiences of professionals who work with matching?

The foster care system

In Sweden, the social services in each municipality are responsible for ensuring that children receive the support and protection they need during their childhood. According to the Social Services Act, if the welfare of a child is threatened, social services have the responsibility to intervene in order to provide protection and support to the child, the services of which are offered on a voluntary basis. The law is supplemented with the Care of Young Persons Act, which regulates compulsory care. If it is not appropriate for a child to live with their guardians, the child can be placed in a family foster home or a home for care or residence. The most common form of out-of-home care is foster care. In 2022, 19,200 children and young people lived in family foster homes in Sweden; the majority (65 per cent) were voluntary placements (NBHW, 2023). The first option is that a relative or, if deemed appropriate, someone close to the child will take care of the child (kinship care). If that is not possible, the child can be placed in foster care with new caregivers. In most cases, the aim is to work towards reunification between the child and the guardians. Foster carers are expected to complement the guardians, not replace them. However, if a child has lived in a family foster home for more than two years, transfer of custody to the child’s foster carers should be considered. The decision is made by the court, and the intention of the law is to prevent children from being uprooted from a home where they feel a greater sense of belonging and emotional attachment than in their parental home. After a transfer of custody, the child still has the right to maintain contact with their birth parents if this is in the child’s best interests (Government Bill 2021/22: 178, ‘The best interest of the child when care under the Care of Young Persons Act is discontinued – “Little Sweetheart’s law”’).

When a child is to be placed in a family foster home, the Social Services Welfare Board in the municipality is responsible for investigating and assessing the suitability of foster carers for the task of providing the child with ‘good care’ (Articles 6:1 and 6:6 of the Social Services Act). Prior to the decision on placement in a family foster home, an assessment must be made to determine whether the conditions in the intended home will meet the needs of the child (NBHW, 2020). Social services have responsibility for access to family foster homes. However, it is a challenging task to find suitable homes for all children in need (Swedish Agency for Health and Care Services Analysis, 2016). In many local authorities, foster care social work is organised in specialised units. The social work practice of assessing and matching foster children with suitable family foster homes is carried out by employed social workers working in teams led by a manager, usually an experienced social worker. The final decision to place the child in a family foster home that has been investigated and assessed to meet the child’s needs is taken by the Social Services Welfare Board.

In recent years, private consulting companies and foundations have come to play an increasingly important role in the recruitment of foster carers. They sell services to the municipalities, partly by providing family foster homes and partly by maintaining contact with foster carers who have assignments and offering them support and guidance. Since 2017, permission from the Health and Social Care Inspectorate has been required to carry out such activities (Article 7:1:5 of the Social Services Act). According to the regulations, the staff of these consulting organisations must have a relevant university education, work experience, personal suitability, knowledge of child development, knowledge of the needs of foster children and familiarity with relevant legislation in the field of social services (HSLF-FS 2018: 2, §3). In 2023, about 370 consulting organisations had permission from the Health and Social Care Inspectorate (SOU, 2023: 454).

According to a handbook for social workers, in the work of matching, social workers must consider the principles of closeness and maintaining contact with the foster child’s birth home environment, as well as the possibilities of placement in the child’s network. According to the principle of closeness, care should be planned so that it promotes the child’s connection with relatives and other important persons, as well as contact with the home environment. The principle of closeness can be understood as the need to consider both geography and language, culture, ethnicity and religion (NBHW, 2020: 144).

Foster children’s rights and needs

The contextual basis for the article is children’s rights and needs. What is perceived as sufficiently good care of foster children is contextual; it differs depending on time and place. During recent decades, children’s rights have been strengthened in society. According to the Swedish parental code (PC) (SFS 1949: 381), children have the right to care, security and nurturing and to be treated with respect (PC 6:1). According to the United Nations Convention on the Rights of the Child, which is law in Sweden (SFS 2018: 1197), children have rights to provision, protection and participation. They have the right to express their views in all matters that affect them and have those views taken seriously in accordance with the age and maturity of the child. Bouma et al (2018) suggest that children’s participation includes their ability to express their opinions and wishes, to understand decisions, and to be informed about available options, as well as being supported to do so effectively. A scoping review of children’s participation in decision making in foster care highlights a gap between formal discourse and practice when it comes to children’s participation in the foster care system. Research shows that children’s voices are still minimally represented in the decisions that affect them (Delgado et al, 2023). In a study of children’s experiences of out-of-home care, children describe experiences of mismatching, where they and the foster carers did not fit together. One conclusion is that foster children need to be more involved in the matching process (Skoog, 2013). A study on the involvement of children in the matching process found that children were involved after the birth parents and foster carers had already agreed on the placement. Foster children were involved late in the process and their first meeting with the foster carers could be seen as the beginning of the placement rather than part of the matching process (Zeijlmans et al, 2019).

In order to achieve ‘good care’ for a foster child, it is essential to ascertain the child’s needs. Needs are the necessities for healthy development (Steenbakkers et al, 2018). In addition to the universal needs that all children have, foster children have specific needs as a result of adverse experiences and challenges during childhood, such as maltreatment, instability and other risk factors that compromise their development (Harden, 2004). A systematic review of the literature on the ‘needs of foster children’ found that many articles focus on children’s problems instead of their needs and that the terms are sometimes even used interchangeably (Steenbakkers et al, 2018). The review shows that foster children often have extensive needs, as many of them have experienced broken relationships, trauma and lack of care. The needs identified in the overview are divided into four categories: medical needs (physical health, physical development, treatment and the identification of medical conditions); belongingness needs (needs regarding relationships, attachment and permanency); psychological needs (self-esteem, mental health, autonomy and coping); and self-actualisation needs (needs related to learning, education, leisure and employment) – categories that are closely aligned with Maslow’s (1943) identified areas of need.

The medical needs can be explained by the fact that many children in foster care have health problems, such as incomplete immunisation, vision problems, respiratory problems, allergies and dental issues (Steenbakkers et al, 2018). Belongingness needs means that foster children require continuity in relationships with sensitive and responsive carers who can meet their needs and provide a secure base (Schofield and Beek, 2005). The term ‘secure base’ comes from attachment theory and refers to the idea that during their development, children need a secure base from which to explore the world and a safe haven to return to when the world is perceived as dangerous (Ainsworth et al, 1978; Bowlby, 2010). A placement in foster care means a change of primary caregivers for children and, for younger children, a change of attachment figures. The placement often involves a change in environment, school and friends too. Striving for continuity and stability is of great importance, as many foster children have already experienced discontinuity and loss. Belongingness needs can also be related to continuity with the birth family, peers and other important individuals who can provide support and a sense of continuity. However, contact is not always a positive experience for the child; it may also have detrimental effects (Ruiz-Romero et al, 2022). The literature on self-actualisation needs has, in many cases, focused on education and cognitive development and the importance of meeting foster children’s educational needs. Psychological needs mean that children require the people around them to be sensitive and understanding and that treatment meets their individual needs (Steenbakkers et al, 2018).

Methods

The article employs a qualitative approach and was implemented with interviews with professionals who work with matching children and foster carers. Social workers and managers at municipal social services, as well as staff in private consulting firms and foundations, were interviewed about their work with matching. In the interviews, professionals reflected on what factors they perceived as the most important in matching and what challenges they encountered that complicate the matching process. The study was approved by the Swedish Ethical Review Authority (Dnr 2021-00886; 2022-03017-02).

Sample

The study was conducted in six medium to large municipalities with a geographical spread and socio-economic differences in order to obtain variation, as professional practice may vary between municipalities. One criterion of the selected municipalities was their organisational use of special units, with several employed social workers to handle the cases. When we contacted the social services departments, we requested interviews with one manager and two social workers from each municipality. The participants in the study were those in the selected municipalities who agreed to be interviewed. As the participating municipalities often used consulting organisations when placing children in family foster care, we also decided to conduct interviews with consultants. We contacted the organisations used by the participating municipalities. The participating consultants were those who agreed to be interviewed. The article is based on interviews with 31 respondents, of which 12 were social workers and six were managers within municipal social services, while 13 were consultants from seven consulting firms and two foundations who worked with family foster care. The majority of interviewees (28) were women, while three were men. There was a wide spread of ages from 26 to 67 years; most of them were in their 40s and 50s (the median age was 50 years). A total of 27 out of 31 had a bachelor of science in social work, while four had another university degree, for example, in behavioural science. There was a wide spread in the interviewees’ work experience in foster care: 12 had a maximum of five years, ten had between six and ten years, and nine had more than ten years of experience.

Data and analysis

Before conducting each interview, we asked the interviewees to prepare by thinking about a case they had worked on where the match was successful and a case where the match turned out to be problematic. Most interviews were conducted via video calls due to restrictions during the COVID-19 pandemic. Three interviews were conducted in personal meetings at the interviewees’ workplace. The interviews were recorded on audio files and transcribed verbatim. The length of each interview was approximately one hour. Examples of interview questions were: ‘What are the most important factors to consider when matching?’; ‘Would you like to tell us about a successful match that you have worked with? What went well, and what was important for it to be successful?’; and ‘Do you have an example of a less successful match that you have worked with? What went wrong, and what factors were important in that situation?’. In the narratives, the interviewees described experiences of recognising similar patterns from different cases they had worked with. In the analysis, we used qualitative thematic analysis (Braun and Clarke, 2006). First, the analysis was carried out on a case-by-case basis. We created a table to provide an overview of the interviewees’ responses to the interview questions mentioned earlier. When the interviewees described aspects they considered to be significant for successful matches or mismatches, the statements could contain such words as ‘successful’, ‘good’, ‘great’, ‘important’, ‘alpha and omega’, ‘fundamental’, ‘key factor’, ‘problem’ or ‘challenge’. In the next step, the analysis focused on the entire material. Recurring themes were developed related to experiences of ‘successful’ matches and challenges. Quotes from the interviews were selected to illustrate themes that emerged in the analysis. In the third step of the analysis, the themes were related to the theoretical concept of foster children’s needs (Steenbakkers et al, 2018) and factors that may influence the matching process, such as case, organisational, professional and external factors (Zeijlmans et al, 2017).

Findings

This section presents the findings from the thematic analysis of the interviews with professionals about their experiences of matching. In the first part, experiences of successful matches are described; thereafter, experiences of challenges in the matching process are outlined.

Experiences of successful matches

The following themes emerged in the thematic analysis of narratives about successful matches: characteristics of the foster carers; the competence and experience of the foster carers; participation for children, birth parents and foster carers; and sufficient time and information. The interviewees highlighted the importance of recruiting foster carers who are living in stable relationships. Other desirable characteristics of foster carers that were mentioned are being open-minded, engaged, tolerant, patient, reflective, calm and present, both physically and emotionally. Being physically present can in some cases mean that one parent is expected to be at home full-time, which has financial implications for the foster family. Being emotionally present means, for example, foster carers who ‘open one’s heart’ to the child and have the ability to mentalise and be self-reflective: ‘We talk a lot about mentalising and emotional availability: that you can see the reason for different behaviours, that you can think this step further and that you have … this capacity for emotional availability and reflection and mentalising’ (Social Worker 11). In the interviews, the respondents talked a lot about matching regarding age, which means considering the age of the child, the foster carers and the other children in the foster home. The foster carers should not be too young or too old. The best match regarding age was when the foster child ‘could have been theirs [the foster carers’] in terms of age’ (Manager 5). In cases where there were other children in the foster home, it was considered beneficial if the foster child was the youngest in the group of children. Several respondents expressed the importance of avoiding competition between the children in the foster home:

Then, of course, I matched them with consideration of their own children. This child who was placed became the youngest child in the group of children, so I succeeded with that part. (Manager 6)

I absolutely think that you should check the age among biological children and placed children to see that there is no competition in terms of age. (Social Worker 3)

In the interviews, the respondents talked about the competence and experience of the foster carers. Experience with children in general and previous experience with foster children were highlighted as significant, especially in the case of more difficult placements and when children have extensive needs, for example, a disability:

There was so much that fit. This family showed great care. They had experience with children before, they were cool and calm, and there was not much that could surprise them as parents…. They had been through quite a lot. (Social Worker 9)

The family foster home is a great family foster home…. She has all these things that you need to have. She has experience. She has worked with this target group professionally. She has commitment and will and has just the right personal conditions. (Consultant 2)

Other essential skills that are mentioned in the interviews are the ability to be caring, to cooperate and to communicate. The foster carers are expected to be able to cooperate not only with employees at social services but also with the foster children’s biological parents and other people in their network:

A good condition for it to work is if the family foster home and the biological parents somehow find each other and can work together around the children. Then, it usually turns out very well. So, if the family foster home and the biological parents can meet, as well as have joint conversations and meetings about the child, then the conditions are there for a very good placement. (Manager 4)

The same manager suggested ensuring that birth parents do not feel less valued compared to foster carers: ‘There must not be too much competition; the birth parents must not feel too inferior’ (Manager 4). Communication skills also have implications for matching in relation to culture, religion and language in cases where the children have a foreign background:

Actually, when I think about it, of course you have to match a child with a family foster home where they can understand each other, where they speak, for example, the same language, and that they can communicate with each other so that the child really understands the foster parents. It is obvious. I think that is the alpha and omega, fundamental, that they understand each other and can communicate, that there are the conditions for that. (Social Worker 1)

Matching in relation to culture is also highlighted as significant for the children’s identity:

I have seen benefits when they have roughly the same background. Because the child can keep the food culture the child is used to. There are often TV channels in the child’s home language. It becomes easier to communicate with the biological family. There are many things that make it easier for the child, to be able to recognise what you are used to while being introduced to the new, so that you do not lose part of your identity. (Social Worker 5)

Some respondents highlighted common interests as an important aspect of matching children (especially teenagers) with foster families:

It was a successful match. He was 17 years old, passionate about football and dedicated to his studies. We found a family that we felt was a good match. They were well educated, had stable jobs, and their children were excelling in their studies. Everyone in the family shared his passion for football. It felt like a perfect fit. He became part of their family and continued to live there even after the placement ended. (Social Worker 5)

In the interviews, some respondents talked about the importance of participation in the matching process for children, foster carers and birth parents. In one case, the match was successful when the 16-year-old child was involved, according to a manager: ‘We had several [family foster homes] to choose from. She [the foster child] could meet them, interview them and choose based on which family foster home felt best to her’ (Manager 1). In some cases, the birth parents and their networks were involved in the process of finding a suitable family foster home, as the social workers find it important that the birth parents can accept the selected family foster home: ‘That they feel safe with where we have placed their children’ (Social Worker 11). Some of the social workers talked about involving foster carers by being responsive to their wishes and expectations:

When we investigate a family foster home, we really encourage…. Some of them say something like this: ‘Oh, can one say what one wants?’ They think it is almost a bit rude. But we say: ‘It is super important that you say what you think suits you, what suits your family, what suits your biological children.’ That they are clear about that so that they feel safe with what they are getting into. (Social Worker 11)

According to the interviews with staff working with matching, it is essential to have sufficient time and information about children and foster families to achieve suitable matches:

I think that what usually turns out very well is when there is no rush … when you have time, and where we get a lot of information about the child, which we can then pass on to the foster parents and discuss with them, and also that we can provide very good information to the social services about the family foster home. (Consultant 11)

When the interviewees talked about matches that went well, the narratives often concerned placements of infants and young children without severe behavioural challenges, placements where the birth parents were satisfied with the selected family foster home, and placements where the foster carers closely ‘followed the child’ and entered the process ‘with their heart’, that is, were perceived as committed and emotionally available.

Experiences of challenges in the matching process

In the thematic analysis of narratives about matches that turned out not to be successful, leading to breakdowns and relocations, the following themes emerged: time pressure; insufficient information about the foster child’s individual needs; insufficient information about the family foster home; many factors to consider in the match, which meant a need to compromise and prioritise what was the most important; and a shortage of foster carers to choose from in the task of matching.

In some cases, the interviewees described that time pressure made their work with matching difficult: ‘If you need to make quick decisions, it makes matching difficult’ (Manager 1). One consultant described that time pressure can mean the risk of insufficient information about a case and misunderstandings between the various parties involved, which can lead to placement breakdown in the long run: ‘There was a misunderstanding between the social services and [private company] … at all levels…. It was not really clear what was said [concerning practical details] … it was not really decided; it came out later, which led to the fact that these children had to be relocated’ (Consultant 11).

In the interviews, there were several narratives about the problem with insufficient information about the child’s problems and needs: ‘They [the foster parents] threw him [the foster child] out after only a few days because they thought they had not received enough information [about the child’s behavioural challenges]’ (Social Worker 12). However, there could be different opinions between the parties on the issue of what is ‘enough information’:

I had tried to ‘fish out’ as much information as possible but felt that I had received rather sparse information [about the children’s problems and needs]. But that was not the opinion of the social services, they stated that they had been very clear about it. We had slightly different opinions on that. (Consultant 13)

One consultant highlighted the problem that there are cases where social workers responsible for the placement have not even met the child. This can be explained by the fact that work is often organised in specialised units, where one team is responsible for contact with the child and another for investigating the family foster home: ‘“But you haven’t even met the boy”, those who are investigating the family foster home, they haven’t met the boy, and then I, then I lose hope’ (Consultant 12). In the interviews, several respondents talked about cases of placement breakdowns because the foster carers perceived that they had not received sufficient information. Foster carers could terminate placements, for example, because their biological children were negatively affected by the situation in the home:

We placed the boy there, and it didn’t work at all. It really didn’t work at all because it became an incredibly strange situation for the youngest son in the family, the biological boy. He became completely desperate because I think his whole position in the family was shaken in a way that we hadn’t foreseen, and neither had the parents, the foster mother and the foster father. (Consultant 2)

The work with matching can be especially difficult when there are many factors to consider in the matching process:

There were many factors that needed to be matched, both in terms of the foster parents’ life situation and home situation, but also other things. And what I mean is that it is a challenge when there are a lot of factors to consider; then, there is a risk of missing a point. (Social Worker 1)

Several of the interviewees highlight that there is a shortage of family foster homes to choose from during the matching process, which complicates their work:

It is the shortage of family foster homes that is the big issue; we don’t have much to choose from. Of course, we try to think critically and everything, but we almost always have to compromise on something, and then we have to have thought the right way there, and we notice that we haven’t always done that. We have run into a risk factor which then turns out to be the very one we met even though we had tried to avoid it. So, it is a big problem, the shortage of family foster homes. (Manager 6)

As there is a shortage of family foster homes to choose from, the social workers have to compromise and prioritise what is most essential in relation to the needs of the child concerned, which is a challenge. Compromises could lead to failure with matching; for example, there were children who were placed in foster homes where there were already ‘too many children’:

We had siblings that we placed in a family foster home in a temporary placement. After a month or so, the foster parents said, ‘We like these children a lot, so we want to keep them [for long-term placement].’ And after much discussion, we agreed to it, but we should have thought more because they had too many children there already. (Manager 1)

In this case, the manager said that the situation led to a breakdown and the relocation of the children. A limitation in the number of children in a foster home can be important to avoid breakdowns. In another interview, the respondent talked about a limitation in the number of children in the same home for the reason that all children must have the opportunity to feel included in the family:

I don’t think we should put [many] children into family foster homes; it is enough that they have one placement or that they have two placements. I don’t like when they have many places, they have four places or they have five places or three, but they [the children] should be like part of the family, and there must not be too many children. (Consultant 3)

When the interviewees talked about experiences of mismatches, the narratives often concerned the placement of older children and children with extensive problems and needs. There were also narratives about contracted foster carers that turned out to be unsuitable, indicating that the social service’s investigations were not sufficient. Scarce information about important case factors, regarding both foster children and foster carers, was a recurring theme.

Analysis and discussion

In this section, the findings from the thematic analysis are related to the theoretical concept of foster children’s needs (Steenbakkers et al, 2018) and factors that may influence the matching process (Zeijlmans et al, 2017). Matching is important for the quality of care, as foster carers need the necessary resources to meet the children’s needs. Foster children have universal needs as well as specific needs resulting from adverse childhood experiences and challenges, such as maltreatment and instability. Many foster children have comprehensive needs, including medical, belonging, psychological and self-actualisation needs (Steenbakkers et al, 2018). All these categories of needs were present in the narratives of the social workers, managers and consultants. They talked about belongingness needs in terms of foster children’s need to be attached to emotionally available carers, to feel included as part of the foster family, to be at the centre of carers’ attention and not to have to compete with other children for the attention of adults. Belongingness needs also included the need for continuity in relationships with the birth family and continued contact with them. Respondents mentioned the children’s psychological needs, such as the need not to lose part of their identity, a statement that concerned children from a foreign background who may need continuity in terms of language, culture, religion and food habits. Language was highlighted as particularly important, as it is crucial that the foster child and foster carers are able to communicate and understand each other. This need can also be linked to the need to belong and the importance of feeling included. If the child does not understand the language used by the family in everyday life, this can lead to feelings of exclusion. Another psychological need mentioned in the interviews was the need for autonomy and participation in the process of choosing a foster family. This is not only a need but also a right, as participation is a right for children according to the United Nations Convention on the Rights of the Child, which has been incorporated into Swedish law since 2020 (2018: 1197). Self-actualisation needs were mentioned, with respondents highlighting the importance of an environment that can meet children’s educational and leisure needs. Many children need support with schoolwork and encouragement to engage in leisure activities. Sharing a common interest with others in the foster family can further enhance a sense of belonging. Medical needs were mentioned, as foster children may have extensive needs, for example, due to a disability or challenging behaviour, and these circumstances may require regular interaction with health professionals and adjustments to daily routines, including medication management and treatment.

Based on the children’s needs as expressed in the respondents’ statements, what are the requirements for foster carers to be able to meet these needs, what aspects seem to be the most important to consider and what challenges do the respondents encounter? Respondents are looking for foster carers with previous experience of caring for foster children, that is, carers who understand and can meet the specific needs of the children. In order to make space for the foster child, there should not be too many children in the foster home or children of the same age, so that the children’s needs do not become competing. In their literature review, Zeijlmans et al (2017) conclude that matching is a complex process involving various aspects, including case factors related to the children, birth parents and foster carers, alongside organisational and external factors, as well as those related to the professionals. Respondents’ statements about challenges may be related to these aspects. Organisational factors that were mentioned included the importance of available time for the work with matching. Insufficient time makes the matching process difficult and stressful, potentially resulting in mismatches due to inadequate information about the foster child’s individual needs or the conditions in the family foster home. Insufficient information about children and foster carers may be attributed to inadequate investigations, often caused by time pressure and high workloads among professionals. In order to make good and stable matches between children and foster carers, it is important that knowledge of the child’s specific needs is available during the matching process. Where there are extensive or complex needs, this information must be made available so that the right support can be provided to prevent breakdowns. In Sweden, many municipal social services have a specialised organisation, which in this case means that several professionals are involved in the process. One (or two) social workers carry out the investigation of the family foster home, while social workers from another unit carry out the investigation of the child’s problems and needs. Social services staff are responsible for the placement of the child, while in some cases a consultant from a private company or foundation selects possible family foster homes during the matching process. Some of the professionals involved do not meet with the child in person during the matching process. As a result, important information about the child’s needs, opinions and wishes may be lost in the process.

One external factor constraining matching work was the shortage of suitable foster carers to choose from. The shortage of family foster homes has long been discussed. One explanation for the increased difficulty in finding an appropriate number of foster carers is significant changes in family life over the last half-century. Historically, foster care was mainly undertaken by women, often residing in rural areas. However, since the 1960s, women have increasingly participated in paid work outside their homes, with almost as many women as men now in the Swedish workforce (Institute for Evaluation of Labour Market and Education Policy, 2023). Concurrently, a large portion of the population resides in cities facing housing shortages. These circumstances pose challenges in terms of both time and space, crucial factors for undertaking the role of a foster carer. Limited choices due to a shortage of available foster families are described in several countries (Sinclair et al, 2005; Colton et al, 2008; Zeijlmans et al, 2017).

In the interviewees’ narratives, case factors were discussed in situations where multiple factors had to be considered, leading professionals to compromise and prioritise the most important factors. Matching decisions are ‘characterized by complexity and uncertainty’ (Pösö and Laakso, 2016: 309), but a decision has to be made. The experience of respondents is that it is not always possible to meet all these needs, and then a priority is set. Identifying which needs can be set aside is a delicate task, and the most appropriate course of action is often only apparent in retrospect. Some respondents highlighted the involvement of children, birth parents and foster carers as an important aspect to be considered in the matching process. This is important because foster children have the right to express their views on all matters that affect them. We would also like to emphasise the importance of involving the children already living in the family foster home, as they will also be affected by changes in the family constellation. Previous research has revealed that the presence of other children in the foster home is relevant for stability (Oosterman et al, 2007; Rock et al, 2015; Bergman et al, 2024). Stability for foster children is important for their development, health and relationship building (Vanderwill et al, 2021), while instability risks leading to social problems, school problems, negative self-esteem and reduced trust in carers (Rock et al, 2015; Konijn et al, 2019). Continuous, meaningful relationships with caring adults are essential for the children. However, instability is not always due to mismatching alone. Other factors highlighted by professionals in this study include inadequate support for children and foster carers from sources like schools and child psychiatry. Many children need such services because of academic challenges and experiences of trauma. Both careful matching and sufficient support are essential to ensure that children’s needs are adequately met and prevent children from experiencing repeated moves between homes.

Limitations

A limitation of this article is that it is based on only the professional perspective on matching children and foster carers. There is a need for more studies from different perspectives. Two other ongoing projects related to this research are investigating children’s and foster carers’ views on matching. The aim is eventually to discuss different perspectives together.

Implications for practice

The results of this study underline the importance of professionals involved in matching having access to sufficient information about both the child’s needs and wishes and the conditions in the family foster home. This underlines the need for thorough investigations. Another implication is the importance of involving foster children as well as other children already living in the family foster home early in the process, as changes in the family system affect everyone in the home. It is also important to ensure that both the foster child and the foster carers receive the necessary support to make the placement successful.

Funding

This research was supported by the Swedish Research Council for Health, Working Life and Welfare under Grant Number 2020-00755.

Acknowledgements

Professor Maria Eriksson, Department of Social Sciences, Marie Cederschiöld University, Stockholm, Sweden, is part of the project group and contributed to the development of the research project.

Conflict of interest

The authors declare that there is no conflict of interest.

References

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    • Search Google Scholar
    • Export Citation
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    • Search Google Scholar
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    • Search Google Scholar
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    • Export Citation
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    • Search Google Scholar
    • Export Citation
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    • Search Google Scholar
    • Export Citation
  • Ruiz-Romero, K.J., Salas, M.D., Fernández-Baena, F.J. and González-Pasarín, L. (2022) Is contact with birth parents beneficial to children in non-kinship foster care? A scoping review of the evidence, Children and Youth Services Review, 143: art 106658. doi: 10.1016/j.childyouth.2022.106658

    • Search Google Scholar
    • Export Citation
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    • Search Google Scholar
    • Export Citation
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  • SFS (2018) The United Nations Convention on the Rights of the Child Act, Stockholm: Swedish Code of Statutes, p 1197.

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    • Search Google Scholar
    • Export Citation
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    • Search Google Scholar
    • Export Citation
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    • Search Google Scholar
    • Export Citation
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    • Search Google Scholar
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    • Search Google Scholar
    • Export Citation
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    • Search Google Scholar
    • Export Citation
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    • Search Google Scholar
    • Export Citation
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    • Search Google Scholar
    • Export Citation
  • Tilbury, C. and Osmond, J. (2014) Pre-placement planning: examining continuity and connections, Children Australia, 39(3): 1618. doi: 10.1017/cha.2014.18

    • Search Google Scholar
    • Export Citation
  • Vanderwill, L.A., Salazar, A.M., Jenkins, G., Larwelle, J., McMahon, A.K., Day, A., et al (2021) Systematic literature review of foster and adoptive caregiver factors for increasing placement stability and permanency, Journal of Public Child Welfare, 15(4): 487527. doi: 10.1080/15548732.2020.1760176

    • Search Google Scholar
    • Export Citation
  • Vinnerljung, B. (2006) Fosterhemsvård [Foster care], in V. Denvall and B. Vinnerljung (eds) Nytta och Fördärv: Socialt Arbete i Kritisk Belysning [Benefit and Harm: Social Work in Critical Light], Stockholm: Natur & Kultur, pp 6076.

    • Search Google Scholar
    • Export Citation
  • Vinnerljung, B., Öman, M. and Gunnarsson, T. (2004) Återplaceringar i dygnsvård: hur vanligt är det? [A cohort study of recidivism in Swedish out-of-home care I: how common is it?], Socialvetenskaplig Tidskrift, 1: 5475.

    • Search Google Scholar
    • Export Citation
  • Zeijlmans, K., López, M., Grietens, H. and Knorth, E. (2017) Matching children with foster carers: a literature review, Children and Youth Services Review, 73: 25765.

    • Search Google Scholar
    • Export Citation
  • Zeijlmans, K., López, M., Grietens, H. and Knorth, E. (2019) Participation of children, birth parents and foster carers in the matching decision. Paternalism or partnership?, Child Abuse Review, 28(2): 13951.

    • Search Google Scholar
    • Export Citation
  • Ainsworth, M., Blehar, M., Waters, E. and Wall, S. (1978) Patterns of Attachment: A Psychological Study of the Strange Situation, New York, NY, and London: Psychology Press, Taylor & Francis Group.

    • Search Google Scholar
    • Export Citation
  • Bergman, A., Bask, M., Engwall, K. and Järkestig Berggren, U. (2024) Factors associated with stability for children in family foster care: a study of case files in six municipalities in Sweden, Child & Family Social Work, Early View. doi: 10.1111/cfs.13176

    • Search Google Scholar
    • Export Citation
  • Biehal, N. (2014) Maltreatment in foster care: a review of the evidence, Child Abuse Review, 23(1): 4860. doi: 10.1002/car.2249

  • Bouma, H., López, M., Knorth, E. and Grietens, H. (2018) Meaningful participation for children in the Dutch child protection system: a critical analysis of relevant provisions in policy documents, Child Abuse & Neglect, 79: 27992.

    • Search Google Scholar
    • Export Citation
  • Bowlby, J. (2010) En Trygg Bas: Kliniska Tillämpningar av Anknytningsteorin [A Secure Base: Clinical Applications of Attachment Theory], Stockholm: Natur & Kultur.

    • Search Google Scholar
    • Export Citation
  • Braun, V. and Clarke, V. (2006) Using thematic analysis in psychology, Qualitative Research in Psychology, 3(2): 77101. doi: 10.1191/1478088706qp063oa

    • Search Google Scholar
    • Export Citation
  • Christiansen, O., Havik, T. and Anderssen, N. (2010) Arranging stability for children in long-term out-of-home care, Children and Youth Services Review, 32(7): 91321. doi: 10.1016/j.childyouth.2010.03.002

    • Search Google Scholar
    • Export Citation
  • Colton, M., Roberts, S. and Williams, M. (2008) The recruitment and retention of family foster carers: an international and cross-cultural analysis, British Journal of Social Work, 38(5): 86584.

    • Search Google Scholar
    • Export Citation
  • Delgado, P., Carvalho, J. and Alves, S. (2023) Children and young people’s participation in decision-making in foster care, Child Indicators Research, 16: 42145. doi: 10.1007/s12187-022-09979-5

    • Search Google Scholar
    • Export Citation
  • Harden, B.J. (2004) Safety and stability for foster children: a developmental perspective, The Future of Children, 14(1): 3047. doi: 10.2307/1602753

    • Search Google Scholar
    • Export Citation
  • Haysom, Z., McKibbin, G., Shlonsky, A. and Hamilton, B. (2020) Changing considerations of matching foster carers and children: a scoping review of the research and evidence, Children and Youth Services Review, 118: art 105409. doi: 10.1016/j.childyouth.2020.105409

    • Search Google Scholar
    • Export Citation
  • HSLF-FS (2018) Regulations and Advice from the National Board of Health and Welfare about Consulting Organisations, 2018:2, Stockholm: Socialstyrelsen, https://lagen.nu/hslf-fs/2018:2.

    • Search Google Scholar
    • Export Citation
  • Höjer, I., Sallnäs, M. and Sjöblom, Y. (2012) När Samhället Träder in: Barn, Föräldrar Och Social Barnavård [When Society Steps in: Children, Parents and Child Welfare], Lund: Studentlitteratur.

    • Search Google Scholar
    • Export Citation
  • Institute for Evaluation of Labour Market and Education Policy (2023) Forskning om kvinnor och män på arbetsmarknaden [Research on women and men in the labour market], www.ifau.se/Press/Forskningssammanfattningar/kvinnor-och-man-pa-arbetsmarknaden/.

    • Search Google Scholar
    • Export Citation
  • Konijn, C., Admiraal, S., Baart, J., Van Rooij, F., Stams, G., Colonnesi, C., et al (2019) Foster care placement instability: a meta-analytic review, Children and Youth Services Review, 96: 48399. doi: 10.1016/j.childyouth.2018.12.002

    • Search Google Scholar
    • Export Citation
  • Maslow, A.H. (1943) A theory of human motivation, Psychological Review, 50(4): 37096. doi: 10.1037/h0054346

  • NBHW (2023) Statistics on social service efforts to children and young people in 2022, 2023-9-8737, Stockholm: Socialstyrelsen.

  • NBHW (National Board of Health and Welfare) (2020) Children and Young People in Placement: Handbook for the Social Services, Stockholm: Socialstyrelsen.

    • Search Google Scholar
    • Export Citation
  • Oosterman, M., Schuengel, C., Wim Slot, N., Bullens, R. and Doreleijers, T. (2007) Disruptions in foster care: a review and meta-analysis, Children and Youth Services Review, 29(1): 5376. doi: 10.1016/j.childyouth.2006.07.003

    • Search Google Scholar
    • Export Citation
  • Pösö, T. and Laakso, R. (2016) Matching children and substitute homes: some theoretical and empirical notions, Child & Family Social Work, 21(3): 30716. doi: 10.1111/cfs.12144

    • Search Google Scholar
    • Export Citation
  • Rock, S., Michelson, D., Thomson, S. and Day, C. (2015) Understanding foster placement instability for looked after children: a systematic review and narrative synthesis of quantitative and qualitative evidence, British Journal of Social Work, 45: 177203. doi: 10.1093/bjsw/bct084

    • Search Google Scholar
    • Export Citation
  • Ruiz-Romero, K.J., Salas, M.D., Fernández-Baena, F.J. and González-Pasarín, L. (2022) Is contact with birth parents beneficial to children in non-kinship foster care? A scoping review of the evidence, Children and Youth Services Review, 143: art 106658. doi: 10.1016/j.childyouth.2022.106658

    • Search Google Scholar
    • Export Citation
  • Schofield, G. and Beek, M. (2005) Providing a secure base: parenting children in long-term foster family care, Attachment & Human Development, 7(1): 325. doi: 10.1080/14616730500049019

    • Search Google Scholar
    • Export Citation
  • SFS (1949) Parental Code, Stockholm: Swedish Code of Statutes, p 381.

  • SFS (2018) The United Nations Convention on the Rights of the Child Act, Stockholm: Swedish Code of Statutes, p 1197.

  • Sinclair, I. and Wilson, K. (2003) Matches and mismatches: the contribution of carers and children to the success of foster placements, British Journal of Social Work, 33(7): 87184. doi: 10.1093/bjsw/33.7.871

    • Search Google Scholar
    • Export Citation
  • Sinclair, I., Wilson, K. and Gibbs, I. (2005) Foster Placements. Why They Succeed and Why They Fail, London: Jessica Kingsley Publishers.

    • Search Google Scholar
    • Export Citation
  • Skoog, V. (2013) Barns upplevelser av instabil samhällsvård [Children’s experiences of unstable out-of-home care], Socialvetenskaplig Tidskrift, 1: 3552.

    • Search Google Scholar
    • Export Citation
  • SOU (2023) För barn och unga i samhällsvård [For children and young people in community care], SOU 2023:66, https://www.regeringen.se/rattsliga-dokument/statens-offentliga-utredningar/2023/11/sou-202366/.

    • Search Google Scholar
    • Export Citation
  • SOU (Swedish Government Official Reports) (2011) Vanvård i social barnavård [The Swedish inquiry on child abuse and neglect in institutions and foster homes], SOU 2011:61, https://www.regeringen.se/rattsliga-dokument/statens-offentliga-utredningar/2011/09/sou-201161/.

    • Search Google Scholar
    • Export Citation
  • Steenbakkers, A., Van Der Steen, S. and Grietens, H. (2018) The needs of foster children and how to satisfy them: a systematic review of the literature, Clinical Child and Family Psychology Review, 21(1): 112. doi: 10.1007/s10567-017-0246-1

    • Search Google Scholar
    • Export Citation
  • Swedish Agency for Health and Care Services Analysis (2016) Hittar vi hem? En kartläggning och analys av den sociala dygnsvården för barn och unga [Do we find homes? A survey and analysis of out-of-home care for children and young people], https://www.vardanalys.se/rapporter/hittar-vi-hem/.

    • Search Google Scholar
    • Export Citation
  • Thoburn, J. (2016) Achieving good outcomes in foster care: a personal perspective on research across contexts and cultures, Social Work & Society, 14(2): 115. doi: https://ejournals.bib.uni-wuppertal.de/index.php/sws/article/view/478.

    • Search Google Scholar
    • Export Citation
  • Tilbury, C. and Osmond, J. (2014) Pre-placement planning: examining continuity and connections, Children Australia, 39(3): 1618. doi: 10.1017/cha.2014.18

    • Search Google Scholar
    • Export Citation
  • Vanderwill, L.A., Salazar, A.M., Jenkins, G., Larwelle, J., McMahon, A.K., Day, A., et al (2021) Systematic literature review of foster and adoptive caregiver factors for increasing placement stability and permanency, Journal of Public Child Welfare, 15(4): 487527. doi: 10.1080/15548732.2020.1760176

    • Search Google Scholar
    • Export Citation
  • Vinnerljung, B. (2006) Fosterhemsvård [Foster care], in V. Denvall and B. Vinnerljung (eds) Nytta och Fördärv: Socialt Arbete i Kritisk Belysning [Benefit and Harm: Social Work in Critical Light], Stockholm: Natur & Kultur, pp 6076.

    • Search Google Scholar
    • Export Citation
  • Vinnerljung, B., Öman, M. and Gunnarsson, T. (2004) Återplaceringar i dygnsvård: hur vanligt är det? [A cohort study of recidivism in Swedish out-of-home care I: how common is it?], Socialvetenskaplig Tidskrift, 1: 5475.

    • Search Google Scholar
    • Export Citation
  • Zeijlmans, K., López, M., Grietens, H. and Knorth, E. (2017) Matching children with foster carers: a literature review, Children and Youth Services Review, 73: 25765.

    • Search Google Scholar
    • Export Citation
  • Zeijlmans, K., López, M., Grietens, H. and Knorth, E. (2019) Participation of children, birth parents and foster carers in the matching decision. Paternalism or partnership?, Child Abuse Review, 28(2): 13951.

    • Search Google Scholar
    • Export Citation
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