Those involved in decision-making about the ongoing contact that a child has with their extended family after they have been placed in residential settings or with foster carers, adopters, or special guardians, are required by law to put the welfare of the child first. But what do we know about how to ensure that contact arrangements support a child’s well-being? What needs to be taken into account when decisions are made? What factors are associated with positive outcomes? And what needs to be avoided?
This summary highlights the main findings of a review of the existing UK and international evidence, carried out by the National Centre for Social Research (NatCen) and the University of Sussex.
What do we mean by ‘well-being’
The evidence review takes a broad and multi- dimensional view of well-being. It takes into account the subjectivities of feeling good and of functioning well at both individual and interpersonal levels (e.g. Seligman 2011). In this context, we take it to include: mental health, emotional well-being, physical health, behaviour, safety, identity, satisfaction with contact arrangements, and the quality of relationships with both birth and placement families.
Key research findings
The review examined what is known about the implications of contact for the well-being of children and young people who have been separated from their birth parents in public law contexts. This includes children placed in care following family court proceedings, accommodated in care on a voluntary basis, or placed in legally permanent arrangements including adoption or special guardianship.
The review synthesised findings from 49 studies, including international academic and grey literature, published between 2000 and 2020.
The reviewed evidence consistently shows that well-being depends on a differentiated and dynamic approach that takes account of (a) the purposes of contact with important people in a child’s life, and (b) key contextual factors including a child’s age, the nature of placements and questions of permanence.
The key question is not whether or how much contact has a positive impact on children and young people’s well-being, but how best to facilitate positive experiences and the meaningful involvement of the people who matter to the child.
While none of the reviewed studies attempted to establish a causal impact of contact on children’s well-being, the evidence shows that well-facilitated contact is associated with positive well-being outcomes for children and young people in both the short and long term. Conversely, poorly managed contact is associated with risks to children and young people’s well- being. Support for everyone involved in contact—children, carers, adoptive parents and birth relatives—is key, and depends on the investment of time and resources.
Accounting for children’s rights, needs and perspectives
Children and young people want some choice about the people they have contact with. It may not be straightforward for adults to know how children feel about contact— especially younger children. However, when children’s needs and perspectives are not taken into account, it has negative implications for their well-being. Additionally, even when contact is difficult in the short term, it is often still wanted by children and young people. The review found positive long-term outcomes associated with well- facilitated, good quality contact. These included contributing to a sense of identity, mitigating issues around attachment, helping to find a sense of closure, and understanding the reasons for placement.
Adopting a balanced and differentiated approach
Children and young people’s individual situations vary widely depending on their age, their needs and perspectives, and the nature of their placement (including permanence or plans for reunification). Relationships with birth relatives are dynamic and may change over time, for example as a child gets older or a birth parent’s situation alters. Contact may impact differently on various dimensions of well-being, and so can be simultaneously positive and negative. A balanced, differentiated approach involves considering the purpose of contact in an individual child’s situation, structuring arrangements accordingly, and ensuring these arrangements are flexible and responsive to changes over time. Well-being must be understood in relation to children’s everyday lives, their time in care, after leaving care, and into their adult lives.
Accounting for risks and challenges
Contact can carry risks for children and young people’s well-being. It may upset or cause stress for children, and there is also the potential for exposure to further risk of harm. Witnessing conflict between key adults involved in contact (such as birth parents and carers) is associated with higher levels of depression, anxiety and behavioural difficulties for children and young people. Issues related to birth parents’ underlying needs—such as difficult behaviour in relation to contact—can be associated with negative well-being outcomes for children and young people. This includes poorer relationships with placement families, feelings of rejection, stress before and after contact, emotional pain and an increased sense of insecurity.
Managing and supporting contact
To enable positive experiences of contact, support is needed for children, carers, adoptive parents and birth relatives. Contact that has been facilitated by skilled professionals is associated with improved relationships between children and birth parents, placement stability, a return to parental care (when appropriate), improved emotional well-being and a better understanding of identity while in care and in adulthood. Positive experiences do not depend on the frequency of contact, and reviewed studies consistently demonstrate the importance of quality over quantity. Decisions about frequency need to be considered in relation to the purpose of contact, and to account for children and young people’s perspectives, potential risk of harm and the quality of underlying relationships.
Family-centred approaches to contact
A family-centred approach may involve supporting contact through open communication, mutual respect and reciprocal agreements between birth parents and carers or adoptive parents. Across placement and permanency arrangements, the meaningful involvement of key adults is associated with improved child behaviour, better family functioning and greater satisfaction with contact. Family-centred approaches also involve supporting contact with extended family networks. Well-supported contact with siblings is associated with a positive effect on children’s mental health, and can facilitate ongoing relationships with birth families. Well-supported contact with extended family members such as grandparents can provide young people with a sense of security and stability while in care, and reliable support networks after they leave care. Positive connections with siblings and extended networks may have particular importance in cases where contact with birth parents is not possible (e.g. due to risks to the child).
The review identified the following methodological gaps.
- We did not find any studies that directly examined the causal impact of contact on children’s well-being—although there is unlikely to be a simple linear relationship, given the diversity of contact and of children’s lives over time.
- Further longitudinal research is needed to illuminate the complex relationship between contact and well- being over time, and the implications for managing contact.
- Implementation studies are needed to build a differentiated understanding of what approaches to contact might be most beneficial to which children and why, including how best to account for children’s needs and perspectives.
The review also identified the following substantive gaps.
- There is relatively little evidence on contact and well-being for children in special guardianship arrangements, compared to other forms of placement. There are distinctive considerations for contact for children in kinship and special guardianship arrangements, including in terms of permanence, which require further research.
- Several reviewed studies examined the extent to which experiences of contact vary by ethnicity. However, there appears to be a gap in terms of recent, in-depth studies examining differentiated experiences of birth family contact for children from black, Asian and minority ethnic (BAME) backgrounds.
- Some studies indicated the importance of contact with non-family members for children in care, but we found limited research exploring the implications for well-being of contact with friends, carers and carers’ families in former placements (e.g. residential or foster carers and foster siblings). This reflects a wider lack of evidence on the dimensions of contact that matter to children in care.
- More evidence is required to understand the implications of children’s pre-care experiences for managing contact. There is limited research on how to manage the potential harmful effects of contact for some children, including where there is a history of abuse. More evidence is needed in terms of how to support or intervene with birth parents, and to prepare children (and their carers) to manage risk in those relationships, beyond childhood and into adult lives.
- Our parallel review of digital contact and well-being (Iyer et al. 2020) indicated a need for more evidence on the implications of emerging forms of contact in light of changing technology. Key gaps identified included: understanding children’s needs and perspectives; age- appropriate support; and the implications of digital inequalities for children and families.
Adopt a child-centred approach and take account of children’s perspectives
Children and young people’s perspectives should always be taken into account when defining their ‘best interests’. This includes attention to the practical impacts of contact arrangements on everyday well-being, including considerations of comfort and convenience, and minimising disruption to other aspects of children’s lives, such as school. It is important to remember that relationships are dynamic, and children’s needs, feelings and priorities may change over time. Decision-making must therefore be flexible, responsive to the child’s situation and open to review. Overall, it is crucial to achieve a balance between seeking and respecting children’s views, allowing children to feel in control, and not placing inappropriate responsibilities on them to manage the complex decisions and challenges of contact.
Conceptualise contact as ‘safe and meaningful involvement’
Contact alone will not achieve positive well- being outcomes for children. The overall purpose of contact should therefore be understood as enabling the safe and meaningful involvement of the birth family. This approach to contact also involves acknowledging when contact with certain family members is not appropriate because of risk of abuse or re-traumatisation. In these cases, alternative approaches may include temporarily or permanently stopping face-to-face contact or changing to indirect (including digital) forms of contact. It may also be more appropriate to facilitate contact with extended birth family members rather than those who have abused or neglected the child.
Provide active management and support for everyone involved in contact
Skilled professional support is required to manage the multiple, complex factors involved in successful contact arrangements. Well-managed contact is not necessarily supervised contact, but in all cases, it is crucial to facilitate open and respectful communication between birth family members and carers. This needs to be done in differentiated ways according to placement and permanency arrangements. To realise the potential long-term benefits of good quality contact, children and young people need to be supported to deal with the short-term challenges. Birth family members need to be supported to manage the complex experiences of loss associated with child placement. Support for carers and adoptive parents is equally important, to promote understanding and empathy for birth parents’ difficulties, and to understand and respond to children’s complex emotional responses to contact.
Apply a broad and dynamic understanding of family
To determine the ‘best interests’ of the child, it is necessary to acknowledge the fluidity and complexity of family relationships, and to understand contact with ‘family’ as including both birth and placement families. This requires attention to the significance of connections with siblings and extended family, and the potential for maintaining valued relationships with adults or children in former placements. Where contact cannot take place because it is unsafe or unwanted by the child, there is still a need to support children in understanding their family heritage and identities, and to prepare them to manage complex family connections beyond childhood and into their adult lives.
Iyer, P., Albakri, M., Burridge, H., Mayer, M., and Gill, V. (2020). The effects of digital contact on children’s well-being: evidence from public and private law contexts. Rapid evidence review. London: Nuffield Family Justice Observatory.
Seligman, M. (2011). Flourish: a visionary new understanding of happiness and well- being. New York: Free Press.
See the main report for the full list of studies synthesised in the review, screened at full- text level and not included in the review, and studies that informed the review.
- National Centre for Social Research (NatCen)
- University of Sussex