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Care leavers are more often unemployed, have lower annual earnings and live in inferior housing circumstances than their peers in the general population. International research has extensively studied and discussed these outcomes. However, in Flanders (the Dutch speaking part of Belgium), no previous quantitative studies are known. This study therefore explores and predicts outcomes on employment, income and housing circumstances of care leavers in Flanders and investigates if these outcomes improve in the years after leaving care. Associations with placement factors are explored to support recommendations to the clinical field. The current study involves 175 care-leavers (both family foster care ( n = 105) and residential care ( n = 70)). Data was collected using a self-reporting questionnaire touching multiple domains. The participants of the study (49 male, 126 female) are between 18 and 27 years old. Care leavers are employed at younger ages but are also more often unemployed than their peers from the general population, they earn significantly less than peers and are more often homeless. On all domains, no significant differences were found between foster- and residential care leavers. Placement characteristics are more declaratory than only the type of care. In the current study, most outcomes improve during the years after leaving care, this supports the theory of emerging adulthood. Although we cannot infer causal effects, care leavers who experienced fewer placement changes and received individual therapy during their time in care tend to have better outcomes in the current study. The same applies for care leavers who were prepared for leaving care and supported after leaving care. Policy makers should focus on increased support regarding breakdown prevention and individual mental health support during the time in care. Preparation for placement ending and aftercare should be provided.

This article describes how 27 foster children aged 12 to 18 years old, placed in Flemish long-term family foster care, experience life in their foster family and how they cope with their feelings. Evidence from a combination of the children's selection of visual images displaying different emotions (emoticons) and semi-structured interviews shows that they mostly express positive feelings, such as happiness and pride, but simultaneously experience difficult emotions like sadness, anger and confusion. Positive feelings are mostly related to being able to feel like an ‘ordinary’ kid and negative ones to strained relationships with birth parents. Investigations into how the children cope with these emotions distinguished two groups: those who talk about their feelings with friends and other supportive figures and those who hide them. The latter group needs to be provided with strategies to better comprehend and express their feelings; among those suggested were activities that offer tranquility, consolation or distraction and having a private place for themselves. More attention to the emotional experiences of foster children and the ways they cope with their emotions is recommended in policy, practice and research if children's well-being is to be enhanced.

This chapter explores the child protection systems in Belgium. The complex structure of Belgium’s three communities has implications for the child protection system, most of which are related to child maltreatment. The regulation and legislation addressing help for child maltreatment differ between the Flemish Community, the German Community, and the Walloon Community. Additionally, child abuse and neglect (CAN) are treated as a criminal act at a federal level. The Belgian child protection systems emphasize the protective function of the government with a more social democratic approach of defamiliarization policies. The characterization of CAN depends on social structures, attitudes, values, norms, and laws.

Research consistently shows that both foster- and residential care leavers achieve lower levels of educational qualification in comparison to the general population. However, in Western society, education remains an important gateway to success in employment, income and housing opportunities. This study explores and predicts educational achievement of care leavers in Flanders and investigates the effect of educational attainment on other outcomes (employment, income and housing). The study involves 220 care leavers (both family foster care ( n = 138) and residential care ( n = 82)). Data was collected using a self-reporting questionnaire touching multiple domains. The participants of the study (77 male, 143 female) are between 21 and 27 years old. Both foster- and residential care leavers achieve significantly lower qualifications, earn less and more often experience homelessness than their peers from the general population. Residential care leavers achieve lower qualifications and are more often unemployed than foster care leavers. Multiple regression analyses indicate that the level of qualification is a key factor in determining the results on employment, income and education. More placements and less support during the time in care are significantly associated with lower educational achievements. This lower qualification brings significantly higher risks of unemployment, financial- and housing obstacles in the long term. It is therefore important to support young care leavers in attaining their qualification, therefore providing equal opportunities in our society. Policy makers should focus on increased support regarding education during the time in care. School- and placement changes should be minimized, and society ought to invest in psychological support during placement.

Dit kwalitatieve onderzoek, uitgevoerd in Vlaanderen, beschrijft hoe 27 pleegkinderen, tussen 12 en 18 jaar oud, geplaatst in perspectiefbiedende pleegzorg – waarbij het de bedoeling is dat een pleegkind langdurig in een pleeggezin zal verblijven – het leven in een pleeggezin beleven en hoe zij omgaan met hun gevoelens. Uit de analyses blijkt dat pleegkinderen vooral positieve gevoelens, zoals blijheid en trots, koppelen aan het leven in een pleeggezin. Tegelijkertijd ervaart de meerderheid ook lastige gevoelens, zoals verdriet, boosheid en verwardheid. De positieve gevoelens zijn vooral gerelateerd aan het zich ‘gewoon’ voelen en de lastige gevoelens aan de verhouding tot hun ouder(s). Met betrekking tot coping worden twee groepen onderscheiden: pleegkinderen die daarover praten met vrienden en andere steunfiguren (bijvoorbeeld pleegmoeder), en pleegkinderen die hun gevoelens verbergen. Die laatste groep heeft er behoefte aan adequate strategieën aangereikt te krijgen waarmee gevoelens geuit kunnen worden.Activiteiten die rust, troost of afleiding bieden en het hebben van een eigen plek helpen om met die gevoelens om te gaan. Meer aandacht voor de emotionele beleving van pleegkinderen is nodig, zowel in toekomstig onderzoek als in de praktijk.

Foster children are known to be at high risk for developing attachment problems. Moreover, their associated behavioural problems can be a burden for the foster family and increase the risk of placement breakdown. A sensitive parenting style promotes a secure attachment which, in turn, can reduce the chance of difficulties arising and protect against placement disruption. Interventions using video-feedback of parent–child interactions offer a method of increasing parental sensitivity and improving the quality of the parent–child attachment. The intervention discussed in this article was part of a wider initiative, Video-feedback Intervention to promote Positive Parenting and Sensitive Discipline (VIPP-SD), fashioned to promote sensitive parenting, secure attachment and a reduction in children’s behavioural problems. Its effectiveness has been shown for a variety of target groups. A variant of the approach was developed specifically for foster and adopted children, Video-feedback Intervention to promote Positive Parenting and Sensitive Discipline – Foster Care/Adoption (VIPP-FC/A). This article discusses the design and delivery of the intervention and illustrates these with case material.

This study, performed in 2019, examined which factors influenced recognition of child abuse and the need to intervene of school staff of primary schools in Flemish rural areas. One hundred and fifty staff members of primary schools filled out the Questionnaire Assessment of Situations of Child Abuse and answered for each vignette questions regarding recognition and perceived intervention need. Although school staff recognized most of the situations of child abuse, cases of emotional abuse were recognized less often. Compared to European victims, vignettes involving non-European victims were considered as more severe, and the need to involve professional help and to call in judicial authorities was greater. School personnel’s number of years of experience in education was positively associated with recognition, but negatively with the need to involve judicial authorities. The number of students in a school was associated with lower severity assessment and more children with low socio-economic status with a decreased likelihood of referral to a Confidential Center of Child Abuse and Neglect. Awareness of the fact that characteristics of the victim, staff characteristics and context characteristics influence detection and perceived intervention need of school personnel may result in more equal treatment for all victims.

This article describes the results of a narrative literature review on empirical research examining the outcomes and/or experiences of unaccompanied refugee minors in family foster care. The limited research, in which only 17 references were identified, suggests that family foster care is an important type of care for this group and is associated with better health and psychosocial outcomes compared to other types of care. Nevertheless, breakdown of family foster care placements is a cause for concern. Four groups of factors that influence the course of family foster care placements are discussed, namely, foster family characteristics, differences in expectations between foster parents and refugee youth, cultural differences, and contextual factors. Furthermore, practical implications and suggestions for further research are described.

Background: It is likely that the circumstances during the COVID-19-lockdown in Belgium increased the incidence and prevalence of child abuse and neglect (CAN) due to exacerbated risk factors and new COVID-19-related stressors. However, traditional reporters had less contact with children which could lead to undetected cases of CAN. Objective: Gain insight into the number and profile of CAN reports filed to the Brussels Confidential Center of Child Abuse and Neglect (CCCAN) during the COVID-19-lockdown. Participants and setting: A dataset comprising 536 CAN reports from periods before (N = 442) and during the lockdown (N = 94). Methods: Characteristics about the report, reporter, victim and his/her family, perpetrator(s) and the trajectory with the CCCAN were registered. The number and characteristics of reports during the lockdown were compared to those of reports before the lockdown. Results: The number of advisory questions (p =.506, d =.377) and allegations (p =.095, d = 1.206) remained unchanged. During the lockdown, the risk assessment of advisory questions was higher (p =.011, d =.280), they evolved more into social exigency investigations (p

Background:Foster children often experience school problems and perform less well than average. This may result in failed school careers and compromised future career paths. Nonetheless, few studies have focused on the perspective of foster children regarding education.Method:Semi-structured interviews were conducted with 27 foster children (M = 14 years, range = 12–18 years) placed in long-term family foster care about their experiences regarding “school.”Results:A thematic analysis distinguished four main themes: (1) the importance of school for foster children; (2) the impact of the foster care placement on the school performance (3) support foster children receive with regard to their functioning and performance at school; and (4) the fear of stigmatization.Discussion:Foster children attach a great importance to school and receive support from different persons. Yet, many foster children are confronted with school difficulties, such as bullying, hindered concentration, and negative reactions to being placed in foster care. Interventions should be developed to support this group and improve their performances. Furthermore, actors who get in touch with foster children should be better acquainted with foster care.

This study examines the prevalence of placement breakdown in family foster care for unaccompanied refugee minors (URM). Furthermore, it investigates which foster child, foster family and case characteristics are associated with breakdown. Case files of 107 URM who were placed in 2016 in Flemish family foster care (Dutch speaking part of Belgium) were analyzed. In a research window of 2.5 years, 62 placements (57.9%) had terminated: 32 placements broke down (29.9%) and 30 placements ended positively (28.0%). An ongoing asylum procedure and lying or cheating were associated with an increased likelihood of breakdown. Contacts with birth parents, on the other hand, was a protective factor for placement disruption. Therefore, legal authorities should limit the term of asylum procedures, foster care services and guardians must facilitate contacts between the URM and their parents, and the building of trust between youngsters and foster carers should be a central theme in the support process.

Background An important responsibility of the child welfare system, is taking decisions on the reunification of children with their birth parents after the children have lived in foster families. We currently lack evidence-based knowledge to guide the reunification decision-making process. Objective The present study uses concept mapping as an exploratory method, to identify themes that seem to be used by two groups of professionals in their judgement and decision making on reunification. Method First, we consulted 78 foster care workers and studied 172 legal cases to examine criteria important for reunification. Next, unique criteria were grouped and rated by 35 foster care workers and also by 12 family judges separately. The data was analysed with multidimensional scaling and cluster analysis which resulted in a concept map for each group of professionals. Results Both foster care workers and family judges suggested the following themes in the reunification decision-making process: (a) birth parents’ functioning and parenting abilities, (b) birth parents’ acceptance of support, and (c) the child’s functioning, developmental needs and wishes. Besides parallel themes, both foster care workers and family judges also seem to consider unique themes. Conclusions The suggested similarities and differences between the two groups of professionals possibly reflect different professional frameworks. The foster care workers’ considerations seem to have an orientation towards permanency planning while the family judges’ considerations seem to be linked to the legal framework. Gaining insight in the perspective of different groups of professionals involved in the process of reunification, is a small but important step towards reaching consensus through discussion in order to achieve the optimal implementation of the decisions considered in the best interest of children’s future.

In Flanders, family foster care is increasingly the option of choice when out-of-home care is needed. However, foster care is a complex and challenging intervention and meeting all expectations by foster parents is frequently hampered by the severity of the mental health problems of foster children and conflicts with birth parents. Moreover, these problems result in high support needs and low satisfaction of foster carers, ultimately leading to placement disruption. This study aims at identifying characteristics of foster children, foster parents and foster placements associated with low satisfaction and high support needs. Support needs and satisfaction from 1216 Flemish foster parents were mapped with the Support Needs and Satisfaction Questionnaire–Foster Parents. Foster parents had rather limited support needs and high satisfaction scores. More behavioural problems of the foster child and shorter time between two visits was associated with more support needs regarding dealing with the birth parents and with support needs regarding parenting the foster child. More behavioural problems of the foster child, less non-professional support and non-kinship care were associated with lower satisfaction. As breakdown and discontinued fostering are linked to dissatisfaction and lack of support, foster placements of children with more behavioural problems, with non-kinship parents and with foster parents with less non-professional support should be considered at-risk placements needing intensive support.

Concept mapping was used to identify the needs of nonkinship foster parents from Caucasian ethnicity who care for unaccompanied refugee minors (URM) in Flanders (Dutch speaking part of Belgium). Nonkinship foster parents (n = 30) described their needs in response of the question: “What do you need to be a good foster parent for the unaccompanied refugee minor(s)?” Next, 50 unique responses were sorted by 15 foster mothers, and analyzed using multidimensional scaling and hierarchical cluster analysis. Furthermore, foster mothers indicated the degree of importance of each statement. Fifty unique responses were grouped into eight clusters. In descending order of importance these clusters referred to parenting skills and a good fit of the URM into the foster family, good parenting conditions and personal skills, a tolerant society and information about options for reunification, support for the URM and certainty about the future, information on and open attitude for the background and friends of the URM, preparation of the URM and reassuring contacts with the biological family and others, support and fellow contacts for foster parents, and support from the context. Their needs resemble the needs of normal foster parents, with the exception of some specific needs, such as the preparation of URM for the placement, information about the options for reunification and certainty about the future, experienced foster care workers, specialized psychological support related to trauma, openness to and information about culture, religion and language.

Since the entry into force of the foster care decree in Flanders (01/01/2014), a distinction is made between short-term and long-term family foster care. In short-term foster care, a foster child is placed in a foster family for at most one year with the aim of reunification, or, if this is not possible, clarifying the child's future (long-term family foster care or residential care). The present study is the first to examine reunification rates and characteristics associated with reunification decisions in Flemish short-term foster care. Case files of 125 short-term foster care placements that started after 01/01/2014 and ended before 31/12/2015 of all Flemish foster care agencies were analyzed. Short-term foster care resulted in 27% of the cases in a reunification. Bivariate analyses showed that seventeen variables were significantly associated with a reunification. Inclusion of these variables in a logistic regression model resulted in a significant model that explained 52% of the variance, with the only predictive variable being the pedagogical skills of the mother at the end of the placement. This is promising. It implies that in developing a methodology to promote reunification, improving the pedagogical skills of mothers must be given a prominent place.

In 2015, 523 reports of suspected child abuse and neglect (CAN) were brought to the attention of the Confidential Center of Child Abuse and Neglect (CCCAN) of Brussels. Around 38% of these reports came from school personnel. This study investigated which factors affect the recognition of CAN by school personnel of Dutch-speaking primary education in Brussels and their intervention need. Two hundred seventy-nine staff members of 16 schools professionally working with children, filled in a Questionnaire Assessment of Situations of CAN. The instrument consists of 24 vignettes describing CAN. Respondents were asked questions regarding recognition and intervention need about each vignette. Detection, severity assessment, the need for professional help, the need for referral to a CCCAN and the need to involve judicial authorities were mainly associated with case characteristics. Although most situations of CAN were detected, situations of emotional abuse were less often recognized. Situations involving non-Western victims were considered to be more severe and the perceived need for involvement of professional help, CCCAN and judicial authorities was larger. Ethnic stereotypes affect the actions undertaken in case of CAN. Awareness of these reactions may result in equal treatment for all victims. Staff characteristics were little associated with detection and intervention need.

In Flanders, family foster care is increasingly the option of choice for children in need of out-of-home care. Foster care is however an assailable intervention as is shown by the high number of placement disruptions. Knowledge regarding breakdown in Flanders remains scant. This study aimed at investigating the incidence of placement breakdown in Flemish long-term foster care and exploring the association of breakdown with foster child, foster family and case characteristics. Case files of 309 Flemish foster children were analysed. After 6 years, 208 placements had terminated: 90 placements broke down and 118 placements ended positively. Foster child's behavioural problems, conflicts between birth and foster parents and parenting problems of the foster parents were the main causes of placement disruption. Foster children with behavioural problems at admission, older foster children and foster children who denied treatment were more at risk of breakdown. Consideration of these factors is important in view of the appropriateness of family foster care placements.

Foster care is one of the most far-reaching interventions targeted at children who are abused or neglected by their parents, or who are engaged in anti-social behavior (Lindquist & Santavirta, 2014). The large number of children in foster care and the high cost of child welfare, makes the outcomes of former foster youth a trending topic in research. However, research that combines results on different extents (education, employment, wages, housing, mental health, substance abuse and criminality) is sparse. Using the PRISMA method, the outcomes of 32 original quantitative studies were compared. The studies were categorized into two groups reflecting on the child welfare orientation of the country: child protection vs. family service (Gilbert, Parton, & Skivenes, 2011). The results are clear as well as troubling. In both systems, children who leave care continue to struggle on all areas (education, employment, income, housing, health, substance abuse and criminal involvement) compared to their peers from the general population. A stable foster care placement, establishing a foothold in education and having a steady figure (mentor) who supports youth after they age out of care seem to be important factors to improve the outcomes.

Foster children often had negative experiences in the past, which can contribute to attachment problems. In their meta-analysis, van den Dries et al. found that foster children were more often disorganized attached when compared to the general population. It is to be expected that the quality of attachment between the foster children and their foster parents is related to various factors. However, research into which factors are associated with the development of secure attachment is scarce. Using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses method, a total of 13 articles were included in this review. This review provides an overview of the associated characteristics with the quality of attachment between foster carers and foster children. In the articles included in this review, the foster carers’ characteristics were often described as more important than characteristics of the foster child and placement when it comes to developing a secure attachment. The most consensus, although not unanimous, existed on the finding that a positive, sensitive parenting style of foster parents was positively related to a secure attachment between the foster children and their foster carers.

Concept mapping was used to identify characteristics of successful foster families in Flanders (Dutch speaking part of Belgium). A sample of 97 (out of 505) foster care workers from all foster care agencies were asked to answer in writing the question: “What characteristics does a successful foster family have?” Sixty unique characteristics were identified by three researchers. In a second phase, 50 foster care workers individually grouped together the statements that according to them covered the same topic. Furthermore, they were asked to indicate the degree of importance of each response on a seven-point scale. Multidimensional scaling and hierarchic cluster analyses identified eight clusters of successful foster family characteristics: willingness to cooperate with all stakeholders (foster care worker and birth parents), emotional-affective characteristics, characteristics that are conditions for stability, a child-oriented motivation supported by the whole family, adaptability, social-cognitive characteristics, social and material circumstances that are conditions for foster care, and good parenthood. Although sometimes differently grouped or named, the characteristics mentioned by foster care workers were almost entirely in line with findings from other research. Identification of these characteristics can contribute to the development of a foster family profile. Such a profile increases the chance of screening of quality foster families, enables training of families that don’t meet certain conditions, and contributes to standardized decision-making.

Background The aim of this Flemish study (Dutch speaking part of Belgium) is to evaluate the efficacy of an intervention based on the social learning theory for foster parents who take care of a foster child (ages 3–12) with externalizing problem behaviour (a borderline or clinical score on the externalizing broad-band or on one of the externalizing problems scales of the Child Behaviour Checklist), with respect to breakdown, foster children's externalizing problems and foster mothers' parenting stress. Methods A randomized controlled trial was used to compare, at baseline, post-intervention and three-month follow-up, an intervention group (n = 30) with a treatment as usual control group (n = 33) consisting of foster parents of new placements recruited via a routine screening or on-going placements signed up by their foster care worker. The intervention consists of 10 home sessions. Results The intervention had significant small short-term en large long-term effects on externalizing problems and medium short-term and long-term effects on parenting stress. No significant effects were found on the breakdown rate. Conclusions Giving the evidence for its effects on foster children's externalizing and foster mothers' parenting stress, implementation of this foster parent intervention might increase the effectiveness of foster care.

Objective: The aim of this study is to evaluate a training in non-violent resistance (NVR) for foster parents who take care of a foster child (ages 6-18) with externalizing problem behavior. Methods: A randomized controlled trial was used to compare an intervention group (NVR, n = 31) with a treatment as usual control group (TAU, n = 31). The NVR-intervention consists of ten weekly home sessions. Measures regarding behavioral problems in foster children, parenting stress and parenting practices in foster mothers, and the size of the supportive network were assessed before, after treatment, and at three months follow-up. Results: NVR showed to be an acceptable approach that lead to an increase in experienced support and some promising changes in parenting stress and parenting practices. Conclusion: Implementation of this intervention might increase the effectiveness of foster care. More longitudinal research using a Multitrait-multimethod-approach is however needed.

This qualitative research describes how 27 foster children, aged 12–18 years placed in long-term family foster care, experience the concept ‘family’. Foster children had a pragmatic and open-minded view of the concept ‘family’, transcending the conventional definition of kinship. In general, they were remarkably satisfied with the foster family and considered them as real family. They often believed that they fared better in their foster family than in their family of origin. The presence of other children in the foster family was usually perceived as positive. The relationship with their birth family was complex. Although sometimes considered as no longer belonging to their family, foster children in general spoke about their parents with loyalty and eagerness to forgive. But they were also concerned, sad, and angry. During visits often fun activities were done, although frequently overshadowed by conflicts and problems. Siblings had a prominent place, although the foster care placement sometimes troubled contacts between siblings. Creating a context in which foster family and family of origin can contribute to a positive development of the foster child is an important task for foster care workers.

Self-determination theory (SDT) has been applied to several domains. SDT-research in parenting focuses on parents’ perception of satisfaction or frustration of basic psychological needs (BPN) of autonomy, competence and relatedness. BPN satisfaction is considered a necessary condition for parenting high on autonomy support, structure and involvement, which in turn promotes emotional, behavioural and academic functioning of children. Although many studies supported the SDT-model in parenting situations, SDT has not been investigated in foster care. This study aims at examining if processes proposed by SDT are supported in a foster care sample. 97 Flemish foster mothers filled in questionnaires measuring BPN satisfaction and frustration in general, BPN satisfaction in relationship with the foster child, parenting and functioning of the foster child. BPN satisfaction was associated with autonomy support, structure and involvement. BPN frustration was associated with controlling parenting. Contrary to our expectations, autonomy-supportive parenting did not impact significantly the functioning of the foster child, suggesting a direct association of BPN satisfaction and frustration with the foster child’s functioning. Only BPN satisfaction in relationship with the foster child and psychological control were associated with problem behaviour, and only BPN satisfaction in relationship with the foster child was associated with prosocial behaviour. Although research in parenting in many studies confirmed hypotheses inferred from SDT, in this study SDT was not univocally supported. Several explanations are proposed and discussed.

Background: Medically unexplained symptoms (MUS) are common among children and adolescents and may be highly impairing. Even after long diagnostic and/or therapeutic trajectories, many of these children and their parents feel dissatisfied with the advice and therapies they were given. Objectives: After a 2-week hospitalisation for somatic and psychiatric reassessment, children and their families were given recommendations for further treatment. This study evaluates which of these recommendations were carried out (primary outcome measure) and which factors influenced the (non-)adherence to therapeutic advice. Methods: Parents of 27 children aged 7–17 with impairing MUS took part in a structured telephone survey to assess adherence to and perceived effectiveness of therapeutic recommendations (cross-sectional study). Influencing factors were analysed retrospectively. Results: Psychotherapy was recommended to all 27 patients and their families; 19 of them (70.4%) carried out this advice. When physiotherapy was recommended, adherence proved lower (6/22 children; 27.3%). No influencing factors were found to have a statistically significant correlation with adherence. Effect sizes may be indicative of clinically relevant influential factors, but should be considered cautiously. Conclusion: Results suggest that more efforts need to be made to ensure adherence to therapeutic recommendations. Known risk factors for non-adherence to treatments for chronic somatic disorders may not apply for children with somatoform disorders.