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John Pinkerton ( j.pinkerton@qub.ac.uk)

International Symposium on Life Course Studies NUI Galway October 2014

not ‘outcomes’ but ‘indicators of coping’ with the life course ?

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The case of youth transitions from out of home care

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My aim

Express some reservations about ‘outcomes’

• dominating organising concept in British evidence informed policy, service design and practice

Sketch an open system social ecology of

childhood• youth transitions from out of home care illustration

• from ‘outcomes’ to ‘indicators of coping’

Ask whether ‘life course’ adds values ?

STRATEGIC DIRECTION+

Legislation+

Regulation & Guidance+

Local Policies & Procedures+

Research based understanding+

Enhancements in Practice

= Good Outcomes

Not dismissive of outcomes teaching slide; involvement in drafting strategies; setting the agenda

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membership forum

Promoting an approach to children’s services that is outcomes-focused, evidence-informed and children’s rights-based

‘Outcome’ speak part of EiP which is making a positive contribution

• Confident: “The concept of EBP, so long under development,

with its regularly changing brand names, seems now to have found

its time” (p66) {‘evidence informed’}

• Clear: “Evidence-based social care is the conscientious, explicit and

judicious use of current best evidence in making decisions “ (p68)

• Specific: “takes the form of well-explicated, well organised procedures

usually carried out in a stepwise manner and designed to achieve relatively

specific goals “ (p69)

• Accountable and respectful of service users• Theory based and experimentally tested

(Sheldon & McDonald 2009 The Textbook of Social Work Ch 4)

Resonates with where childhood and youth studies are in general and where the study of youth transitions from out of home care is

• Childhood and youth studies consolidated internationally as a disciplinary hybrid, convergent identity, drawing together scholars from across disciplines with their varied conceptual frameworks, methodologies and data

• Focus on children and young people’s ‘well-being’ along with their ‘well-becoming’ and their rights - expressed as concern to maximize children/young people’s engagement, optimize investment in c/yp , and increasingly alleviate / manage c/yp poverty.

• Establishing own institutionalized presence. Promoting an approach to children’s services that is : outcomes-focused, evidence-informed

children’s rights-based

UK research provides good holistic (joined up), process aware (dynamic) description: “accelerated and compressed transition”

Leaving Care

In CarePre care After Care

• low engagement by social workers • bureaucratic decision making • not enough attention to education • placement instability • difficulty with identity &

relationships• role family and friends not valued

• residential care• low educational attainment• ineffective preparation

• return to family• housing insecurity• economic insecurity• unemployment • no training • no further education

• early parenthood• loneliness

adolescents

7Mike Stein 2012 Supporting Pathways to Adulthood

Childhood: dependence

Youth: exploratory independence

Adulthood : chosen interdependence

Family position Personal space within and apart from family

Partner Own family

School Training, further and higher education (un)employment

(un)Employment

Friends Peer group Chosen friends and social networks

Home neighbourhood Personal territory Householder in chosen locality

Ascribed identity Developing identity Own identity

Impact of globalisation, socio-economic group, ethnicity, gender, disability and sexual orientation.

Recognise it as a variation of youth transitions

Anticipate the probability of certain outcomes (international evidence)

Housing insecurity Low educational attainment Unemployment Loneliness Young parenthood Dependence on state benefits In trouble with the law Involved with psychiatric services

Find their own way Need supported to make

itCan’t get it together

INTRAC (www.lboro.ac.uk/research/ccfr/INTRAC)

NOT A SINGLE PATHWAY

Well on our way to delivering good outcomesthrough EiP service design ?

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Young people leaving out of home care – what works ?Lessons for Cape Town mentoring project ?An Evidence informed Practice challenge ...

Similar messages from earlier US reviews

(Collins 2001, Lemon et al 2005, Montgomery et al 2006)

• Few formal evaluations exist

• Support services may have a beneficial effect (education,

employment, parenthood, housing)

• Urgent need for rigorous design and evaluations

• Importance of assessing the needs of different groups

Systematic review in support of NICE/SCIE programme guidance on improving the physical and emotional health and well being outcomes for Looked After children and young people (2010). From 171 potentially relevant papers, 7 were included (6 US + 1 UK)

http://guidance.nice.org.uk/PH28/SupportingEvidence)0

Recognise the range of types of outcomeexpressing complexity of cause and effect

• Different Types – Final outcomes

– Intermediate outcomes

– Client based outcomes

– Service based

outcomes

• Cause and Effect• Contingent

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COPING

INDICATORS

Ongoing Research at Queens University Belfast• Transitions & Outcomes for Care Leavers with Mental Health

&/or Intellectual Disabilities’ NI Public Health Agency• Moving On ? Young people’s experiences of transitions from

custody Youth Justice Agency• Thematic Review of Child Sexual Exploitation relating to 22

care experienced young people Safe Guarding Board

“A universal finding in all studies of both physical and psychosocial adversity is that there is huge heterogeneity in outcome . . . some individuals have a relatively good outcome despite suffering risk experiences that would be expected to bring about serious sequelae.” Rutter quoted in Davidson et al 2010 ‘The Impact of Adversity in Childhood on Outcomes in Adulthood’ Journal of Social Work

We have a very joined up, dynamic description … but do we know how it all works ?

No theoretical explanation of what it is we are intervening in …

?INTERVENTIONS COPING

Poverty of Theory

“Although there is a growing body of international empirical work on young people aging out of care, very few of these studies have been informed by theoretical approaches.”

Set in the context of social exclusion, this paper explores three perspectives : attachment theory; focal theory; and resilience.

“But these are not the only theoretical possibilities ... for example, life course theory to explore transitions.

the relationship between developmental perspectives, including a life span approach, and the three selected

are they conceptually and theoretically integrated or distinct?

Stein, M. (2006) 'Young people ageing out of care: the poverty of theory', Children and Youth Services Review, Vol 28, No. 4, pp. 422-434

Recognise importance of thinking about trajectories - young people’s ‘care career’ (continuum / pathway / journey)

Leaving Care

In Care

placement types

Pre care After CareA B

Preparation for leaving

Informal

FormalSupervised/ supported

Self managing

“A process

not an event”

Dependence Interdependence

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Key decisions and time periods

Position ?

Needs ?

Supports ?

Recognise importance of thinking holistically and systemically - “whole child / whole system”

Self confidence

identity

Adult support

Social competence

Peer support

Neighbourhood belonging

health

employment

education

Income support

accommodation

training

Material ‘Spokes’

Social and Emotional ‘Spokes’

securing the spokes is a multi agency

challenge

‘Rim’ of shared expectations, choices, rights and responsibilities 16

Leaving Care ‘Coping Wheel’ Motion

metaphor

An open system social ecology of youth transition Bronfrenbrenner (1979) The Ecology of Human Development: Experiments by nature and design

• MICROSYSTEM

• MESOSYSTEM

• EXOSYSTEM

• MACROSYSTEM

• CHRONOSYSTEM

Extended Family

Friends / Neighbourhood

Formal Organisations Statutory / Voluntary / Community/ Commercial

National Social, Economic, Political Legal Institutions

Immediate Family

YOUNG PERSON Achieving Rights & Meeting Needs

Shifts focus from matching needs to services (technical) to providing resources to enhance capacity to cope (relational) and emphasises developmental change over time

GLOBAL INSTITUTIONS & PROCESSES

Move from closed to opens systems thinking: from ‘logic models’ to ‘theories of change’

• Social ecology• Functionalist• Deterministic• Manageable

Social, political and economic ecology

Conflictual Power plays Unintended consequences

“It is helpful to think about youth transitions in general and leaving care in particular not as the achievement of a set of completed outcomes for a phase of the lifecycle, but as an ongoing developmental process of coping in acceptable and unacceptable ways with the changing physical, psychological and social circumstances of uneven and fragmented transitions ... Linked with chronological age but more dependent on levels of formal and informal support, structures of opportunity and personal agency”

Pinkerton J (2011) ‘Constructing a global understanding of the social ecology of leaving out of home care’ Children and Youth Services Review 23, 12,

In the black box : a globalised social ecology of care leaving?

Leaving and Aftercare

Interventions

COPING CAPACITYFOR YOUTHTRANSITION

Care Leaver’s Social Capital

Care Leaver’s Resilience

Local Social Ecology ofSupport

Pinkerton J ‘Constructing a global understanding of the social ecology of leaving out of home care’ Children and Youth Services Review 23, 12, 2011, pp2412-2416.

INTERNATIONAL

NATIONAL

Conceptual plugs and disciplinary sockets

• Social exclusion: social policy• Attachment theory: psychology (psycho dynamic)• Focal theory - psychology (developmental)

• Resilience – child & family social work (psychiatry)• Social capital: sociology

Integrative Cross Disciplinary• Bio-psycho-social ecology of the life course ??

In the black box : a globalised social ecology of care leaving underpinned by the ‘life course’

Leaving and Aftercare

Interventions

COPING CAPACITYFOR YOUTHTRANSITION

Care Leaver’s Social Capital

Care Leaver’s Resilience

Local Social Ecology ofSupport

AGENDA: shared language / horizontal systems linkage longitudinal studies / biographical narrative methodologies.

INTERNATIONAL

NATIONAL

LIFE COURSE

Some references

• Bronfenbrenner U (1979) The Ecology of Human Development: Experiments by Nature and Design Massachusetts :Harvard University Press

• Collins ME (2001) Transition to Adulthood for Vulnerable Youths: A Review of Research and Implications

Social Services Review 75, 271-291

• Lemon K, Hines AM and Merdinger J (2005) From foster care to adulthood: the role of independent living programs in suporting sucessful transitions Children & Youth Services Review 27, 251-270

• Montgomery P, Donkoh, Underhill K (2006) Independent living programs for young people leaving the care system: The state of the evidence Children and Youth Services Review 28 1435-1448

• Mills S and Frost N (2007) Growing Up in Substitute Care: Risk and Resilience Factors for Looked After Young People and Care Leavers in Coleman J and Hagell A (eds) Adolescence, risk and resilience: Against the odds Chichester:Wiley

• Pinkerton J (2011) Constructing a global understanding of the social ecology of leaving out of home care’ Children and Youth Services Review 23, 12, pp2412-2416

• Pinkerton J and Dolan P (2007) Family support, social capital, resilience and adolescent coping Child and Family Social Work 12, pp 219–228

• Stein, M. (2006) 'Young people ageing out of care: the poverty of theory', Children and Youth Services Review, 28.4, pp. 422-434

• Stein M (2012) Young People Leaving Care : Supporting Pathways to Adulthood London:Jessica Kingsley