Out-of-Home-Care

Australian approach, factors influencing, principles, programs to support, First Nations OOHC, after leaving, mental health issues, social work implications, practice approach

Four sections follow:

1. Background Material that provides the context for the topic

2. Suggestions for Practice

3. A list of Supporting Material / References

4. Appendix 1: The S.E.L.F. approach to providing culturally appropriate care

Feedback welcome!

Background Material

The Australian out-of-home care system

Out-of-home care (OOHC) is alternate care for children aged 0–18 who are unable to live with their families or guardians. As of June 2022, there were around 45,400 Australian children living in OOHC, including 19,400 Aboriginal and Torres Strait Islander children. A significant number of children in care are aged between five and 14 years old (61%); around 21% are under five years and 17% are over 15 years old. Most children (70%) are in long- term care arrangements and/or have been in care for more than two years.  The most common OOHC placement types include:

• foster care: in which a child is placed into the care of a foster carer

• kinship care: in which a child is placed into the care of another family member or known adult; and

• residential care: in which a child is cared for in residential facilities by paid staff.

Most children in OOHC in Australia are either in foster (35%) or kinship care (54%) (Miller and Alla, 2024a).

Aboriginal and Torres Strait Islander children are more than 10 times more likely to have contact with the child protection system than non-Indigenous children with these numbers continuing to grow.  In spite of the Aboriginal and Torres Strait Islander Child Placement Principle (ATSICPP), that states all Aboriginal and Torres Strait Islander children in OOHC should be placed with kin or in the care of Aboriginal and/or Torres Strait Islander carers, only two-thirds of Aboriginal and Torres Strait Islander children in OOHC nationally are living with Aboriginal and/or Torres Strait Islander kin, non-Indigenous kin, or other Aboriginal and/or Torres Strait Islander carers (Miller and Alla, 2024a).

There is strong evidence of a social gradient in contact with child protection and OOHC.  More than a third of children who receive child protection investigations are from the most socioeconomically disadvantaged neighbourhoods (Miller and Alla, 2024a).   

The variation in policy and legislation between states and territories means that care leavers in Australia receive different levels of support usually up to 21 years or 25 years of age.  Most young people are expected to leave care at 18 (although this has been increased to 21 in NSW in 2023).  Types of support commonly offered by each state and territory include help to access records and information on services, financial management, accommodation, education and training, employment, legal advice, access to health and community services, and counselling and support services.  However, all states offer only discretionary rather than mandatory post-care support, and most of the funding provided is allocated to preparation or transition (15–18 years) rather than post-care (18–21/25 years) (Campo & Commerford, 2016).

Factors influencing mental health in OOHC

Children’s mental health and wellbeing in OOHC is influenced by experiences and factors that occur prior to children entering OOHC, and factors specific to the OOHC experience.  However, a child will not necessarily experience a mental health challenge as mental health trajectories are determined by interactions between the different risk factors and protective factors over the course of placement (Miller & Alla, 2024a).

Pre-out-of-home care experiences can strongly influence mental health both positively and negatively.  Protective factors include strong attachments, relationships, and social support.  Risk factors include experiences of trauma or adverse childhood experiences, e.g. parental mental health challenges or substance use issues, family violence, housing insecurity and financial stress, abuse (emotional, physical and/or sexual) or neglect.  A history of abuse is one of the strongest predictors of mental illness in children in OOHC (Miller & Alla, 2024a).  A study of how characteristics of children and families prior to a child’s entry to OOHC impact on children’s mental health found:

• Children who entered care early in life and with multiple risk factors showed decreasing mental health over time.

• Children who entered care at an older age (average 7.5 years) showed improvement in mental health over time, despite having poorer mental health on care entry.

• Children with multiple risks on care entry demonstrated the poorest mental health six years after their entry into care (Wade, 2024).

Out-of-home care-specific factors also influence mental health outcomes.  Children who change placement less often tend to have a lower risk for mental health challenges than those who experience more change in placements.  Consistent and supportive relationships with carers, birth families and peers can foster secure attachments and child wellbeing.  Being placed with or continuing to have contact with siblings appears particularly influential for children’s wellbeing.  For Aboriginal and Torres Strait Islander children, connection to their culture and communities, contact with family members, and culturally safe supports and services are critical for social and emotional wellbeing (Miller & Alla, 2024a).

Other factors and experiences can influence mental health and wellbeing.  These include age and developmental status, gender, physical health, and disability; legislation and regulations, discrimination, remoteness of location, cultural connection, access to services and supports, and neighbourhood and community factors.  There is evidence that Aboriginal and Torres Strait Islander children, children of colour, children with disability, and other children from marginal or minority backgrounds have poorer mental health outcomes in OOHC and are less likely to receive adequate support for their mental health and wellbeing while in OOHC (Miller & Alla, 2024a).

Support While In OOHC

Key Principles for supporting those in care                  

There are many programs and initiatives that aim to support the mental health of children in care, but the characteristics and effectiveness of these programs vary considerably.  However, there are some common principles of practice that may be important when supporting children in OOHC (Miller & Alla, 2024b).  

1.     Trauma-informed care           A trauma-informed approach involves understanding the impact that trauma and adverse events can have on children’s developmental and mental health outcomes (trauma-awareness) and an approach which establishes trust and supportive environments with children through a strengths-based focus on resilience and recovery.  Trauma-informed practice is a topic discussed elsewhere on this site – access via the Contents link.

2.     Culturally safe care                   Culturally safe care is critical in OOHC, given that almost half of all children in care identify as Aboriginal and Torres Strait Islander. 

• Cultural safety requires practitioners to acknowledge the historical and continuing impacts of colonisation and racism, ensure they engage respectfully with Aboriginal and Torres Strait Islander peoples, and provide services and supports that are safe and free of bias.  

• Cultural safety in OOHC requires practitioners recognise the continuing impacts of successive government policies of child removals, including the Stolen Generations, and how this contributes to over-representation of Aboriginal and Torres Strait Islander children in OOHC. 

• Supporting the cultural needs of children includes committing to supporting families early and supporting reunification where possible; and ensuring OOHC placements are culturally safe, that children in OOHC have comprehensive cultural support plans, and that they can maintain connections to their family, culture, and communities.

• Maintaining connections to kin and Country are also important components of culturally safe care, and wellbeing support, for Aboriginal and Torres Strait Islander children in OOHC.  All Aboriginal and Torres Strait Islander children in OOHC should be placed with kin and their cultural connections should be maintained.

3.     Strengths-based approaches                Strengths-based approaches should be used when supporting children in care.  A strengths-based approach requires practitioners to shift from a focus on deficits (risks, negative influences, experiences of adversity) or problems, to strengths (resilience, protective factors) and solutions. 

4.     Child-centred practice            Child-centred practice (sometimes called person-centred or client-centred practice) is an approach that places the child at the centre of decision-making and prioritises their needs, preferences, and wellbeing.  Key characteristics of a child-centred approach include respect for children’s autonomy; collaboration, partnership, and shared decision-making; a holistic approach; individualised care; continuity, and child safety.  Child Aware Practice is discussed elsewhere on this site – access via the Contents link.

5.     Holistic and collaborative care            Children in care often face complex problems and have mental health needs that are best supported by a collaborative approach to service delivery.  This approach considers the physical, emotional, social, and developmental needs of each individual child – for example, their family history and circumstances, strengths and challenges (including previous history of abuse or maltreatment), their placement type, and their physical health.  It can include the use of integrated/care teams and comprehensive wrap-around services and supports.

6.     Relationships-focused care                   Relationships-focused care or attachment-based approaches involve building and/or supporting healthy relationships between children and other important people in their lives. Attachment-based approaches are useful to foster strong attachments to caregivers, which in turn can foster a sense of security, trust and emotional regulation.  The relationship between practitioners and children is also critical. It is important for practitioners to build trusting relationships with children by providing regular and consistent communication, coordination, and continuity of staff where possible.

Programs to improve OOHC                    

Carer training and support programs (for foster carers), therapeutic foster care (TFC), and carer-child attachment-based programs have the most published literature with carer and support programs appearing to be the most effective (Miller & Alla, 2024c).

Type	Details	Evidence
Carer training and support programs	Support and training for foster and kinship carers, often aimed at increasing knowledge and skills to improve behavioural outcomes in children. Examples: Parent Management Training Oregon (PMTO), Keeping Foster Parents Trained and Supported (KEEP), Incredible Years.	Carer training and support programs appear to have significant positive impacts on some child outcomes (e.g. mental health and behavioural problems) and mixed outcomes for carers (e.g. mental health literacy, parenting stress). However, effectiveness for kinship carers remains unknown.
Therapeutic foster care (TFC)	Therapeutic foster care is a broad term referring to various approaches in foster care. These approaches often overlap with other program approaches such as specialised training and support for foster carers, and other support for children in foster care. Examples: Multidimensional Treatment Foster Care Model (MTFC), Treatment Foster Care Oregon (TFCO).	There is some evidence of the impact of TFC on improving mental health and behavioural problems. However most studies have weak methodological quality, and significant risk of bias.
Carer-child attachment programs	Programs to improve child-carer relationships and attachment. Examples: Attachments and Bio-behavioural Catch-up (ABC), Child Adult Relationship Enhancement (CARE).	There is promising evidence for the impact of attachment-based intervention on emotional and behavioural outcomes in children. However, reported outcomes vary considerably, most studies are low quality, and many have significant risk of biases.

Other programs with less evidence-based support from research include:

• Child-centred therapies, e.g. Trauma-Focused Cognitive Behavioural Therapy (TF-CBT), Life Story Work.

• School readiness and support programs, e.g. Kids in Transition to School program (KITS), Head Start.

• Restoration support, e.g. Family Treatment Drug Courts (FTDC), Strengthening Families.

• Leaving care and after care programs, e.g. TAKE CHARGE, Independent Living Programs.

• Youth behavioural programs, e.g. Mentoring programs, KEEP SAFE.

• Residential, organisational or system models, e.g. Sanctuary Model, Spiral to Recovery, Attachment Regulation and Competency Framework (ARC).

Keeping First Nations children safe in OOHC

(Commonwealth of Australia, 2021)

As a result of the recommendations of the Royal Commission into Institutional Responses to Child Sexual Abuse, the Commonwealth Government produced a resource to support organisations engaging with Aboriginal children to ensure organisations offer support in a culturally safe way (Commonwealth of Australia, 2021).  For each of the 10 principles, the resource outlines suggestions for executive, middle management, and operational staff.  The following is a synthesis of the suggestions for operational staff.  They reinforce much of the above approach that social workers should adopt when supporting Aboriginal communities, families, adults, and young people.

Engage respectfully with the community (Elders, family, other significant people in the child’s life) to understand and respond to their needs around culturally safe physical and online environments.  It takes time to build trusting relationships, mutual respect and cultural competence.  Attending community events is an initial and important means of engaging with the Aboriginal and Torres Strait Islander community. 

At the Aboriginal and Torres Strait Islander Family Level:

• Behave in a welcoming and culturally safe manner as you listen to what families are saying in formal and informal conversations.

• Understand how to appropriately respond to the concerns and complaints of families.  Keep in mind that Aboriginal and Torres Strait Islander families may find it difficult to complain and may require support to do so.

• Where investigations happen, provide culturally appropriate support to families as the process unfolds.

At the Aboriginal and Torres Strait Islander children and young people’s Level:

• Create an environment that is welcoming and embraces all children regardless of their abilities, sex, gender, or social, economic, or cultural background.  Each child should feel safe to have a voice and participate in programs and activities.  Use culturally appropriate ways to asking to check children feel safe.

• Help children identify trusted adults or friends they can talk to.

• Listen to what children say and reflect on their views to improve activities and processes.

• Understand how to appropriately respond to the concerns and complaints of children.  Keep in mind that Aboriginal and Torres Strait Islander children may find it difficult to complain and may require support to do so.

• Where investigations happen, provide culturally appropriate support to children as the process unfolds.

At the organisational level:

• Uphold and promote the human and cultural rights of Aboriginal and Torres Strait Islander children.  Advocate for these rights, including the right to cultural safety.

• Participate in cultural safety and competency training to create culturally safe, welcoming, and accessible environments.  Implement culturally safe and appropriate services. 

Urban Aboriginal Children Health and Wellbeing

Miller et al. (2020) identified 13 factors that contribute to the health and wellbeing of Aboriginal children in Australian urban areas.  The factors most reported by carers as being necessary for their Aboriginal children to be healthy and well were:

1. Secure and loving family relationships

2. Access and availability of culturally competent healthcare

3. Adequate nutrition and food security

4. Engagement with community and community services

5. Active living

The following factors were also commonly reported:

1. Education for children and families

2. Social and emotional connectedness

3. Physical, emotional, and cultural safety

4. Breaking the cycle of disadvantage

5. Availability and affordability of quality housing

6. Strong culture

7. Positive Aboriginal role models

8. Carer health and wellbeing

Miller et al. (2020) concluded that non-Aboriginal models of child developmental and health do not address the social and emotional needs of Aboriginal children, nor do they sufficiently address the unique structural influences on health including intergenerational trauma, socioeconomic disadvantage, and racism.  Services that support family health, provide health education, enhance access to early childhood and youth services, improve food security and support emerging role models in communities are sorely needed.  So is systemic change.  Without it, structural determinants including racism and socioeconomic disadvantage will continue to contribute to food insecurity, child removals, limited access to culturally appropriate and affordable healthcare, and inadequate housing.

Implications for SW practice                  

The following are common themes in the literature around children’s experiences in OOHC (Miller & Alla, 2024a):

• Lack of information about their care, and limited involvement in decision making, can contribute to feelings of powerlessness and uncertainty.  Children often want more communication about their care or case planning and greater involvement in decision making.

• Feeling safe with carers, having suitable levels of privacy (e.g. having a private bedroom), and the presence or absence of neighbourhood crime or violence are important for a sense of safety.  Stability in placements and care environments, as well as continuity of carers, caseworkers and other professionals adds to this sense of security and safety.

• Maintaining contact with their birth families (particularly siblings), friends and other important people in their lives are a necessary aspect of developing healthy and consistent relationships.  Maintaining connections with family, kin, culture and community are particularly important for Aboriginal and Torres Strait Islander children.  Wade (2024) adds that kin carers must be appropriately resourced to take on the care of the child. Some research suggests that kinship carers are potentially more poorly trained than other foster and adoptive parents, and that children placed with kin may be moved to locations some geographic distance from their original community.

• Peer relationships are important for wellbeing, meaning frequent changes in care arrangements and disruptionsto school and extracurricular activities can be challenging.

Research indicates that children’s mental health in OOHC is negatively impacted by their exclusion from decisions over placement and case planning. It can lead to children experiencing a sense of powerlessness and loss of autonomy, which can perpetuate existing trauma and negatively impact on mental health (Miller & Alla, 2024b).  

Recent findings about improving mental health outcomes for children entering OOHC at school age challenge the assumption and some past research that placing children into care at an older age is risky, and that decisions about child placement and the achievement of permanency need to occur when the child is young (Wade, 2024).

Support After Leaving OOHC

Outcomes for young people leaving care                         

A considerable body of research from small-scale qualitative studies and international research indicate that young people who exit care experience significant social and economic marginalisation and including a range of poor educational and health outcomes:

• homelessness and/or housing instability.

• significantly higher rates of mental illness compared to the general population.

• unemployment/underemployment.

• substance abuse issues.

• involvement in the youth criminal justice system.

• early parenthood.

• low educational attainment (Campo & Commerford, 2016).

Poor educational and health outcomes on leaving care are a result of a complex interaction of factors. These could include their experiences prior to placement, the type of OOHC they are placed in, their experience within OOHC, stability of placement, their connections with family/kin, the age when they transition from care, and their access or use of support services.

• Indigenous care leavers, care leavers with disabilities or mental health issues, and those living in rural and remote areas face additional or multiple difficulties when leaving care. 

• Young women who have spent time in OOHC tend to become mothers at a younger age than their peers. Some of the challenges experienced by young mothers who have been in OOHC include lack of appropriate parenting models; poor understandings of pregnancy and parenthood; difficulty engaging with services; and housing instability/homelessness. General research on young mothers indicates that they experience social isolation, and poverty and economic disadvantage. 

However, not all care leavers experience poor life outcomes.  Children and young people in OOHC can experience supportive and stable placements, and ongoing positive relationships with carers and workers, enabling them to overcome adversities and experience positive outcomes despite previous deprivations (Campo & Commerford, 2016).

The poor outcomes for those leaving OOHC can be viewed from a social development framework where explanations for these generally poor outcomes coalesce around two interrelated factors, namely, the long-term impact of early childhood abuse, neglect, and maltreatment, and the lack of supports available to young people as they exit the OOHC system.  There is now more focus on the developmental needs of young people leaving care (Campo & Commerford, 2016).  For example, the New South Wales Government is now offering additional support for young people transitioning from care until age 21 years (previously support ended at age 18 years).  In addition, programs in the following areas have commenced:

• Housing via Supported Independent Living placements, Foyer Central and the Premier’s Youth Initiative

• Education and employment via Smart and Skilled fee-free courses, targeted traineeships, and scholarship

• Independence and identity through leaving care planning, Transition to Independent Living Allowance, driving courses and life story support.

A ‘staying on’ carer allowance has recently been put in place to provide additional financial support for young people aged 18 to 21 who continue to live with their carer.  Those leaving OOHC from age 18 now receive a fortnightly after care allowance until 21.  The Specialist Aftercare Program, designed to provide support for young people with complex needs has been expanded (NSW Government, Communities and Justice, 2023).

Mental health outcomes of OOHC       

Because children in OOHC have often experienced potentially traumatic events and disrupted attachment with caregivers and other significant people in their lives (e.g. abuse and neglect), they have a higher risk of mental health challenges than their peers who have not experienced OOHC care.  In fact, about half to two-thirds of children in OOHC will experience a mental health challenge of some kind.  Some of the mental health challenges are:

• Trauma related, e.g. stress-related or dissociative challenges (e.g. feeling disconnected from self, managing intense emotions unexpected shifts in mood, depression) and/or other disorders (e.g. post-traumatic stress disorder (PTSD).

• Attachment challenges, such as reactive attachment disorder [RAD] and disinhibited social engagement disorder [DSED].  These arise from disrupted relationships and attachments with caregivers and other significant people,

• Psychological distress, internalising symptoms, and mood disorders, e.g. sadness, anxiety, guilt, social withdrawal, or disordered eating.

• Externalising symptoms—emotions or behaviours that are externally directed or displayed, including aggression and impulsivity (Miller & Alla, 2024a).

There is also strong evidence that children and young people who have been in OOHC are at higher risk for developing long-term psychosocial challenges extending into adulthood, including poor mental health, self- harm and risk for suicide, and substance use and addiction issues. Children who have been in OOHC are also at increased risk for chronic illnesses and of dying prematurely, poor educational and employment outcomes, homelessness, early pregnancy, intergenerational contact with the OOHC system, and contact with the justice system Miller & Alla, 2024a).

Outcomes and challenges for First Nations youth leaving OOHC 

(Walsh et. al., 2023)               

The following outcomes are common when Aboriginal and/or Torres Strait Islander children leave OOHC:

• leaving care ill-prepared and unsupported for independent living due to a lack of transition-to-independence planning

• leaving OOHC with poorly developed social and emotional skills because of pre-care and in-care experiences

• experiencing short- and long-term homelessness because of severe shortages of affordable housing

• leaving OOHC with diagnosed and undiagnosed health issues

• having difficulty achieving success in education and employment

• following a volatile pathway, potentially including drug and alcohol abuse, family violence and involvement in the justice system.

Additionally, female care leavers are more like to become pregnant at an earlier age and be at risk of their own children being removed.

As a result, First Nations youth face several challenges around accessing services, cultural and reunification support, and housing (Walsh et al., 2023). 

Service challenges

• Leaving OOHC with a reluctance to engage with mainstream leaving care services (because of hesitancy to engage with social welfare services due to historical and contemporary removal of children).

• Many services are culturally insensitive, whereas culturally informed care is required.

Cultural and reunification challenges

• Leaving OOHC without a cultural plan (despite the known benefits of cultural planning).  This negatively impacts on their sense of identity, self-worth and belonging.

• Being unsupported in navigating relationships and reunification with family.  Many must travel long distances to return to family and then may find family ill-equipped to welcome them leading to homelessness and isolation.

• Experiences of transgenerational trauma.  The families and communities care leavers return to continue to live with unhealed trauma and socio-economic disadvantage.

Housing challenges

• Finding affordable and culturally appropriate accommodation is a widespread challenge for First Nations care leavers leading a transition to homelessness.

• Mainstream government or public housing does not generally support mobility and the sharing of accommodation for long and short periods with close and extended family and community. When a care leaver finds accommodation, but breaches tenancy regulations specified by government and private housing providers, they are often evicted and so too are the family and community members sharing the dwelling with them.

Suggestions for Practice

There should be a greater investment in out-of-home care prevention through targeted early intervention for young children with two or more risk factors.  For these children, efforts should be made to keep the child at home, through parenting support or temporary placement, while safety is addressed.  This is particularly important for Aboriginal and Torres Strait Islander children, for whom the importance of connections to family, community, culture and Country should be central in considering OOHC (Wade, 2024). 

Establishing trust with children in OOHC is a crucial foundation for trauma-informed practice. Practitioners can build trust and create safety in conversations with children by:

• practicing active listening and being non-judgemental

• communicating information in an age-appropriate, developmentally appropriate, and trauma-informed way

• following up and following through on actions discussed with children

• being clear about confidentiality and mandatory reporting; and

• practising self-reflection (Miller & Alla, 2024b).

Strengths-based practice for children in OOHC may include:

• Using positive and empowering language

• Using motivational interviewing and emotion coaching

• Collaboratively identifying children’s strengths and protective factors for their wellbeing, and

• Encouraging positive coping strategies and celebrating progress towards goals (Miller & Alla, 2024b).

Child-centred practice may include:

• providing information to children in an age and developmentally appropriate, trauma-informed way

• practising active listening

• working collaboratively with children to identify goals and support needs

• ensuring services (including physical environments) are child-friendly and inclusive; and

• engaging children as shared decision makers in their healthcare (Miller & Alla, 2024b).

Placing a child in OOHC: The myView myWay approach

The Practice Approach section of the Child Protection post on this website (https://www.thesocialworkgraduate.com/post/child-protection) outlines an approach that can be used with young people who may be placed in OOHC.  Relying on digital technology and strengths practice the approach enable young people to identify and express views, feelings, and aspirations.  Their responses can form the central focus of care planning and assist in decisions around placing children into OOHC.  You will find it by using the above link.  It fits well with the above suggestions around establishing trust, strengths-based practice and child-centred practice.

Providing appropriate cultural care for children in OOHC

While the Australian National Standards for Out-of-home Care recognise that children and young people should be supported to develop their identity through contact with their diverse cultures, this is not consistently required in legislation.   Casework practice to ensure that children who enter out-of-home care are supported to maintain connections to their diverse cultures is essential.  Elements of good practice include:

• Respectfully Engaging the Children’s Family Members in Cultural Care Planning               Collaborating with birth family members lays the groundwork for the development of a cultural plan that is specific and customised to the family and draws upon the ways they want to contribute towards cultural identity development

• Coaching and Supporting Carers to Promote Cultural Connection          Young people in care have expressed appreciation for carers who are willing to learn about their culture and facilitate opportunities for them to experience aspects of their culture, including communicating in language and sharing food.  Prior to placement carers should be assessed for their receptivity to supporting access to culture, and during placements carers should receive training and support to understand the child’s culture and to connect with culturally and religiously-based organisations and community groups.

• Integrating Culture Into Life Story Work         Life story work assists children with understanding their personal history and making sense of their identity, including how they understand their experiences in out-of- home care.  Documenting information about the child’s culture can contribute to children having a comprehensive record of their lives, which can ultimately support the child’s cultural identity formation.

• Identifying Cultural Mentors       Carers have expressed concerns about how they can maintain a child’s cultural identity in a non-matched placement when they do not have someone within their social network who shares the child’s culture. Pairing a child with a voluntary mentor who shares that child’s culture can provide access to authentic opportunities to learn about and live their culture (Conley Wright et al., 2024).

Support young people leaving out-of-home care

Recent government changes around young people leaving OOHC are a response to research showing there are continuing shortfalls in policy in this area.  Young people continue to face difficulties in the transition period in all three phases: preparation (should begin at 12), the transition itself (between 18 and 21 years) and achieving after-care independence (i.e. finding a home and gaining financial independence).  Three factors may assist people leaving care:

1. Improving the quality and stability of OOHC—research has consistently suggested that stability of care and emotional security are significant predictors of young people’s outcomes after leaving care. 

2. Flexible, well-planned, and supportive transition from care—based on the young person’s needs and with ongoing support rather than abrupt cessation required.

3. Housing assistance and support—homelessness can be a major risk as young people leaving OOHC don’t have access to a family-parental safety net.  Safe, affordable, secure and stable housing options for young care leavers are vital to improving outcomes in employment, education, training and positive social relationships (Campo & Commerford, 2016).

Walsh et al. (2023) provide a more detailed analysis of this issue for First Nations young people.  Research suggests changes can be made in three areas: service practices, cultural practices and housing.

Service practices

• Listen to local First Nations community organisations, Elders and community members. There is no one size fits all approach. Utilise their strengths and ideas. Engage in meaningful and equal collaboration with localFirst Nations people.

• Effective transition planning for First Nations youth should start early and can begin when they are as young as 12 years old. They should include First Nations-specific and mainstream education and employment pathway planning and housing and emphasise a strong connection to culture.

Cultural practices

• Have proper cultural plans in place to build a stronger sense of identity and belonging in care leavers, and this can benefit all other areas of their lives.

• Have a focus on family reunification. A holistic assessment of a First Nations care leaver’s family situation should start when they are in care and include all important First Nations and non-indigenous people in that young person’s life, and possibly family they have not yet met.

• Build service systems and practices that support mobility.  Supporting mobility may involve establishing and maintaining support mechanisms outside the current geographical jurisdiction.

Housing

• Young First Nations people require access to culturally appropriate affordable housing close to family and community support networks. Finding affordable accommodation that can support shared housing with close and extended family members when required is desirable.

Suggestions for social workers

To support the above Walsh et al. (2023) suggest the following:

• At all stages of service provision, try to include the significant people in a First Nations client’s life.  Look for the strengths within First Nations family and community networks. Utilise these strengths to support the First Nations care leaver’s transition planning, cultural planning, leaving care support systems and family reunification.

• Design service practice knowing that a ‘whole of family’ cultural and trauma-informed response is often necessary.

• Be flexible in how, when and where meetings with First Nations young people and their families occur.

• Focus on relationality, be patient and take the time to build trusting relationships with First Nations clients and their families.

• Ensure First Nations young people and their families feel safe and comfortable when interacting with them.

• When talking with First Nations young people, explore what level of understanding the young person really has. Consider asking the First Nations youth if they would like to be accompanied by a significant person.

• A less formal approach is encouraged. Avoid jargon and be very careful to explain the purpose and use of formal documentation clearly.

Supporting Material / References

(available on request)

Campo, M., & Commerford, J. (2016). Supporting young people leaving out-of-home care.  Child Family Community Australia, CFCA Paper No. 41.  https://aifs.gov.au/resources/policy-and-practice-papers/supporting-young-people-leaving-out-home-care

Commonwealth of Australia, Department of the Prime Minister and Cabinet, Keeping Our Kids Safe: Cultural Safety and the National Principles for Child Safe Organisations.  Retrieved from https://childsafety.pmc.gov.au/sites/default/files/2021-06/final-keeping-our-kids-safe.pdf

Conley Wright, A.,  Grace, R., Karatasas, K., Ezekwem-Obi, A., Waniganayake, M., Hadley, F., Blythe, S., Noujaim, G., Ravulo, J., Mitchell M., & Tokunaga S. (2024). Innovative cultural care for culturally and linguistically diverse children in out-of-home care.  Australian Social Work, 77(4), 583-589. https://doi.org/10.1080/0312407X.2024.2379972  

Garsed, J. (2023). Engaging vulnerable young people in planning and reviewing their own care.  Social Work Focus, 8(3), 17-19.  https://www.aasw.asn.au/aasw-news/social-work-focus/

Hall, T., Price-Robertson, R., Awram, R. (2020). Engaging with parents when there are child protection concerns: Key considerations.  Emerging Minds.  https://emergingminds.com.au/resources/engaging-with-parents-when-there-are-child-protection-concerns-key-considerations/

Karatasas, K., Noujaim, Conley Wright, A., & Chapman, J. (2024). The S.E.L.F. framework for keeping children connected to their culture in out-of-home care.  Australian Social Work, 77(4), 567-582. https://doi.org/10.1080/0312407X.2024.2385982  

Millar, H. M. et al. (2020). Parents’ and carers’ views on factors contributing to the health and wellbeing of urban Aboriginal children.  Australian and New Zealand Journal of Public Health, 44(4), 265-270.  doi: 10.1111/1753-6405.12992.  Retrieved from https://onlinelibrary.wiley.com/doi/epdf/10.1111/1753-6405.12992 

Miller, H., & Alla, K. (2024a). Understanding the mental health and wellbeing of children in out-of-home care.  Emerging Minds.  https://emergingminds.com.au/resources/understanding-the-mental-health-and-wellbeing-of-children-in-out-of-home-care/

Miller, H., & Alla, K. (2024b). Practice principles for supporting the mental health and wellbeing of children in out-of-home care.  Emerging Minds.  https://emergingminds.com.au/resources/practice-principles-for-supporting-the-mental-health-and-wellbeing-of-children-in-out-of-home-care/

Miller, H., & Alla, K. (2024c). What type of programs improve the mental health outcomes of children in out-of-home care?  Emerging Minds.  https://emergingminds.com.au/resources/what-type-of-programs-improve-the-mental-health-outcomes-of-children-in-out-of-home-care/

NSW Government, Communities and Justice. (2023). Planning for your future and support after care.  https://www.facs.nsw.gov.au/families/out-of-home-care/children-in-oohc/planning-for-your-future-and-support-after-care/your-future,-your-way-new-aftercare-supports-available-from-early-2023

NYSCP: North Yorkshire Safeguarding Children Partnership.  (2021).  Strength based questions.  https://www.safeguardingchildren.co.uk/professionals/strength-in-relationships-practice-model/sir-tools-and-resources/strength-based-questions-for-the-strength-in-relationship-practice-model/

Paterson, N. (2020). Child participation in decision-making in the child protection system.  Emerging Minds.  https://emergingminds.com.au/resources/childrens-participation-in-decision-making-processes-in-the-child-protection-system-key-considerations-for-organisations-and-practitioners/

Salveron, M., Paterson, N., & Price-Robertson, R. (2020).  Engaging with parents who have children in out-of-home care: Key considerations.  Emerging Minds.  https://emergingminds.frmdv.com/resources/engaging-with-parents-who-have-children-in-out-of-home-care-key-considerations/

Viewpoint Organisation. (2023, February 14). myView myWay: Combining digital technology with strengths-based practice.  https://viewpointorg.com/myview-myway/ 

Wade, C. (2024). What factors predict long-term mental health for children in our-of-home care?  https://emergingminds.com.au/resources/what-factors-predict-long-term-mental-health-for-children-in-out-of-home-care/

Walsh, J., Turnbull, L., Mendes, P., & Standfield, R. (2023). First Nations care leavers: Supporting better transitions (Practice Guide). Melbourne: Child Family Community Australia, Australian Institute of Family Studies.  https://aifs.gov.au/resources/practice-guides/first-nations-care-leavers-supporting-better-transitions 

Appendix 1

The S.E.L.F Framework – Connecting to Culture

Karatasas, K., Noujaim, Conley Wright, A., & Chapman, J. (2024). The S.E.L.F. framework for keeping children connected to their culture in out-of-home care.  Australian Social Work, 77(4), 567-582. https://doi.org/10.1080/0312407X.2024.2385982  

Australia’s demographics are increasingly multicultural, with 1 in 4 Australians born overseas and nearly half with at least one parent born overseas, while nearly 1 in 5 speak a language other than English at home.  Children who are non-Indigenous and non-Anglo Australian are referred to as being from culturally and linguistically diverse backgrounds. Because of data collection varying between states, it is not clear how many children in out-of-home care are from culturally diverse backgrounds.  Placement in OOHC can arise because of culturally different beliefs and expectations around parenting behaviours. Furthermore, the experience of trauma and social isolation among migrant and refugee families can negatively impact parenting practices and attachment.  There are indicators that the numbers of children from diverse cultural backgrounds in out-of-home care are increasing, with reports suggesting they make up to 30% of the out-of-home care population.

The S.E.L.F Cultural Framework

The S.E.L.F. cultural framework provides an approach to explore four key elements that can inform what culture may mean to a child or a family. It guides the collection of information through curiosity questions that seek to better understand what may be important to a child or family and/or what activities may enhance cultural connections. The four cultural elements are Settlement, Ethnicity, Language, and Faith.

Each cultural element has ten prompt questions to guide learning and reflection on the child’s culture. Collectively, the intersectionality of the cultural elements can inform practitioners on what might be influencing a child’s or family’s behaviours, what is considered important to them culturally, and what might need to be further explored to enhance positive experiences for children that nurtures safety, stability, and cultural connections.

The Settlement Journey—the Before, the After and the Now

1. What were the drivers for the family to migrate or seek refuge to Australia? For example, what was happening in their country of origin? Were there any ethnic, social or religious conflicts in their country of origin?

2. What was the individual’s and/or the family’s experiences when they moved from their previous country?

3. What were the circumstances and or experiences in settling in Australia?

4. How was the individual and/or the family received when they arrived in Australia?

5. How long has the child or family lived in Australia?

6. How many of the family’s generations were born and have lived in Australia?

7. What are the family’s cultural expectations of family members’ roles in raising children?

8. How connected was/is the family with their geographic community/neighbourhood?

9. How would the carers view the family’s perceived views on family roles and/or relationships with the local neighbourhood?

10. Which community leader or community member/s could discuss child protection, out-of-home care, and the child’s culture with the family or carer?

    
    

Ethnicity—History, Traditions, Customs, and Social Practices

1. What is the history of the family’s country/ies?

2. Where is the country located on the map? What flag represents the country?

3. What are important national or cultural celebrations?

4. What are the family’s traditional foods?

5. What are the cultural nursery rhymes, songs or music?

6. What can assist the carer to learn about the ethnic traditions important to the child or their family?

7. How is the carer planning to maintain the child’s customs, traditions, way of life, food and diet, music, and celebrations?

8. What are the potential issues for the child being exposed to different practices? What can help them adjust? What can help them feel more comfortable in any transition process?

9. Who has been consulted in the ethnic community to understand cultural issues and how this may impact the child and family members?

10. Where else can information be accessed to build knowledge on the family’s ethnic history and practices?

Language—Exploring Languages, Accent/s, Dialects, and Terminology

1. What is the family’s preferred language or languages? How important is shared language for the birth parents?

2. How fluent is the child in the shared language?

3. What may be the language or communication issues between the birth family and the carer?

4. How fluent are the carers in the birth family’s preferred language/s?

5. How fluent is the social worker in the birth family’s preferred language/s?

6. Who can support communication between the child, family members, carers, and practitioners if assistance is needed?

7. What is the impact on a permanency placement and family relations if the child loses a non-English language through a placement where the carer’s primary language is English, and the birth family’s primary language is not English?

8. What is the impact on a child placed with a kin carer whose preferred language is not English, and the child’s is English?

9. What is the impact of losing language fluency if restoration or reunification is the goal?

10. How does a dialect or a regional accent impact on communication?

Faith—Rituals, Beliefs, Routines, Celebrations

1. What are the religious beliefs held by the birth family members?

2. What are the religious beliefs held by the child?

3. What or how is religion practised within the family?

4. What are the religious beliefs held by the carers?

5. Is there an alignment between the religious practices and expectations?

6. Are there any historical religious issues which may impact the child, birth parent, and carer relationship?

7. Where there are faith-based differences between the child’s birth family and the carers, how may this impact on the child?

8. What are the significant religious calendar events?

9. What are significant religious milestones related to the child’s developmental age?

10. Which faith-based community leader have you consulted with? Why and how?