Every year an estimated 20,000 adolescents “age out” of the foster care system and find themselves on their own (Courtney and Piliavin 1998; Courtney et al. 2001; Courtney et al. 2004; Westat 1991). In 2005, according to the Adoption and Foster Care Analysis Reporting System (AFCARS), there were 24,407 adolescents who “aged out” of the foster care system into independent living (U.S. Department of Health and Human Services 2006). These foster youth often lack support from family and social service systems and may often experience a more difficult transition to independent living than non-foster youth (Courtney et al. 2004; Hardin 1988). The federally funded Independent Living Program (ILP) was enacted through the Consolidated Omnibus Budget and Reconciliation Act and Title IV–E Social Security Act of 1985 to assist foster youth in the United States to make the transition from foster care to independent living. In order to increase ILP financial entitlements and housing resources, while decreasing the age of eligibility to 14 years, and expanding Medicaid eligibility for foster youth, a subsequent Foster Care Independence Act of 1999 was passed (Children’s Defense Fund 1999).

ILP was designed to enable foster youth to transition to adulthood and focuses on life skills needed for basic living. Despite the array of policy tools to promote transitional support to foster youth, little is known about the effectiveness of ILP (Montgomery et al. 2006). This article summarizes the results of ILP studies to date for the purposes of better informing direct service delivery. Prior reviews of ILP have focused on implications for research (Montgomery et al. 2006) and policy (Collins 2001) but have not primarily addressed practice implications.

Children in out-of-home care cannot rely on their families so they must depend on child welfare agencies to provide opportunities for them to acquire life skills. Youth transitioning out of foster care experience multiple risk factors and difficulties including: school failure, employment, obtaining medical care, housing, homelessness, violence, teen parenthood, and high rates of involvement with the criminal justice system (Biehal et al. 1994; Courtney and Barth 1996; Courtney and Piliavin 1998; Courtney et al. 2001; English et al. 1994; Montgomery et al. 2006; Reilly 2003). Because youth who are transitioning to independent living are extremely vulnerable and experience many negative outcomes, it is imperative that researchers make it a priority to provide practitioners with guidelines for providing effective independent living services. Without this, practitioners will continue to provide independent living services without any empirical evidence of effectiveness. The purpose of this literature review is to summarize and provide practice implications of studies that examine independent living outcomes.

Study Selection

The first step in the literature review was to search academic, electronic databases of articles written between 1990 and 2006. The key words used were: independent living programs, life skills, older foster youth, transitional living, aging out of foster care, and independent living services. These keywords were applied in the following databases: Social Work Abstracts (42 records found), Social Services Abstracts (164 records found), EBSCO (25 records found), and PsycINFO (215 records found). Next, the 446 abstracts found in the electronic databases were reviewed by the authors. From these abstracts, articles that reported on outcomes for foster youth, independent living programs and emancipation readiness were located and reviewed. Following the abstract review, four criteria were created in order to clearly establish which articles would be included. Studies were included if they (a) reported on independent living programs designed to increase readiness for independent living, (b) reported on educational attainment, employment, housing, mental health, employment and placement, (c) were published in English in a peer-reviewed journal, and (d) discussed transitional services including independent living programs. Based on these inclusion criteria, 19 articles were chosen for review.

The most frequent outcome measures fall into the general domains of education, employment and housing. While all of these outcomes may be predictors of readiness for independent living, it is clear from the variation among the outcomes measured that there is no uniform method to measure readiness for independent living. In order to better serve youth transitioning to adulthood, practitioners must provide evidence-based services that effectively meet the needs of youth. Based on this review, research in this area is growing, but more work needs to be done to bridge the gap between service delivery and evidence-based practices.

This review has a number of limitations. First, the generalizibality is limited because no studies outside of the U.S. and U.K. were identified; therefore, the impacts of ILP programs elsewhere are unknown. Second, many of the studies are dated, however, useful information can still be gleaned but may not be relevant for today’s programming. Finally, the review is limited by the methodological weaknesses of the studies, most importantly a lack of uniform outcome measures across studies.

Search Results

This section reviews four frequently measured domains used as indicators of readiness for independent living and provides practice implications for each based on the study authors recommendations. These domains include: housing, educational attainment, placement (i.e. foster family homes, group care facilities, living with relatives) and employment. A section on additional implications is followed by a discussion of practice, research and policy recommendations. Table 1 provides summaries for all 19 studies.

Table 1 Reviewed ILP studies
Full size table

Housing

Three of the 19 studies used housing status as an outcome measure (Biehal et al. 1994; Lindsey and Ahmed 1999; Pecora et al. 2006). Lindsey and Ahmed (1999) looked at housing outcomes one to three years after leaving care. They found that 68% of ILP youth (N = 44, n = 30) were living independently and 41% of non ILP (N = 32, n = 13) were living independently. Both groups had high rates of one or more episodes of homelessness since leaving care. Among ILP youth, the rate was 52% (n = 22) and 53% (n = 17) among non ILP youth. In addition, 30% (n = 13) of ILP and 19% (n = 6) of non ILP youth experienced difficulties paying all of their housing expenses.

Pecora et al. (2006) examined homelessness as an outcome measure. In their sample of 659 youth, they found that one in five alumni experienced homelessness for one day or more within a year of leaving foster care. Biehal et al. (1994) also examined homelessness. They found that 15% (N = 183, n = 27) of their sample, all of whom participated in ILP, were homeless within three to nine months of being discharged from care.

Practice Implications Include

  • (Lindsey and Ahmed 1999) The study revealed high rates of housing instability. Social service agencies should pursue state funding for the development of transitional living programs to subsidize rent and provide for ongoing counseling and assistance by ILP staff.

  • (Pecora et al. 2006) Foster youth should be encouraged to develop and maintain long-term relationships with foster parents and other supportive adults so that they have a place to live during difficult times.

  • (Pecora et al. 2006) Social service agencies should work with local Sect. 8 landlords to allocate apartments for low-income foster youth who leave care. Former foster youth would benefit from a housing service delivery model that provides not only housing subsidies, but also home-based case management or other adult guidance.

  • (Biehal et al. 1994) Transitional living programs should concentrate on building links with local housing providers in the public and voluntary sectors to develop a range of housing options for youth leaving care.

Educational Attainment

Eleven of the studies reviewed included educational issues as an outcome measure. Nine studies looked at educational outcomes at various points in time. Mallon (1998) and English et al. (1994) looked at youth upon discharge who did not already receive ILP skills training. In Mallon’s (1998) sample of 46 youth, he found that 26% (n = 12) had less than a high school diploma. Thirty-one percent of youth (n = 14) obtained a General Equivalency Diploma (GED) and 26% (n = 12) had a high school diploma. Of those with a high school diploma, 17% (n = 8) had some college education. English et al. (1994) found that 54% (N = 500, n = 270) of the youth were in school and 36% (n = 180) were attending special education classes. Of those in school, 76% (n = 380) were performing at grade level, and 24% (n = 120) were one or more years behind. One in five youth had completed a high school diploma or a GED.

Two studies (Georgiades 2005; Lindsey and Ahmed 1999) compared youth who had received ILP training to youth who had not. Georgiades (2005) found that 8% (n = 1) of the non ILP group compared to 16% (n = 8) of the ILP group had no high school diploma or GED. No members of the non ILP group had a college education as compared to 31% (n = 15) of the ILP group who did. Lindsey and Ahmed (1999) found that 1–3 years after leaving care, 16% (n = 7) of ILP youth were in college, compared to 0% of non ILP youth. Thirty-seven percent (n = 16) of ILP youth had completed high school or a GED as compared to 18% (n = 6) of non ILP youth. Twenty-one percent (n = 9) of ILP youth completed a technical/vocational program as compared to 0% of non ILP youth, and 46% (n = 20) of ILP youth were currently enrolled in an educational program as compared to 34% (n = 11) of non ILP youth.

Four of the studies (Cook 1994; McMillen and Tucker 1999; Pecora et al. 2006; Reilly 2003) used samples of former foster youth who had been discharged from foster care. Pecora et al. (2006) found that 56.3% (n = 371) of youth had completed high school, 30% (n = 198) had earned a GED, 42.7% (n = 281) had any type of education past high school, 18% (n = 119) completed college or more and 20.6% (n = 136) completed any degree/certificate beyond high school. In interviews with 810 former foster youth, Cook (1994) found that 54% (n = 437) of the youth completed high school, compared to 78% of 18–24 year olds in the general population. In interviews with 105 former foster youth, Reilly (2003) found that 50% (n = 52) of youth left foster care without a high school degree, 69% (n = 72) were obtaining a high school degree and 30% (n = 31) were attending or had attended college. McMillen and Tucker (1999) found in their sample of 252 former foster youth, 67% (n = 168) had not graduated from high school before leaving care, and 5.6% (n = 14) had received their GED prior to exiting care. Overall, 11% (n = 28) of youth did much worse than expected, 25% (n = 63) did somewhat worse, 26% (n = 65) did somewhat better than expected and 7% (n = 18) did much better than expected.

One study, Biehal et al. (1994) used a sample of youth some who were leaving care and those who had been living independently some time prior to their legal discharge from care. They found that two-thirds of the sample had no qualifications. They also found an association between moves in care and educational attainment. Three quarters of those who had experienced four or more moves in care had no qualifications.

One study (Blome 1997) examined the high school and post high school experiences of a group of foster youth (N = 167) and a matched group of youth living with at least one parent. Blome found that 37% (n = 62) of foster care youth compared to 16% (n = 27) of the matched sample dropped out of high school. In addition, two years after high school, 13% (n = 22) of foster care youth were taking college courses, as compared with 29% (n = 48) of the non foster care group. Five years after leaving high school, 23% (n = 38) of the former foster youth had not received a diploma or certificate, as compared with only 7% (n = 12) of the non foster youth.

Practice Implications Include

  • (Blome 1997) Social workers should observe whether teachers expect lower achievement from foster youth.

  • (Blome 1997) Social service agencies should increase attention to homework and school by training foster parents to monitor the youth’s daily school performance, expect workers to track the youth’s progress in school and facilitate birth parent involvement in school functions and educational decisions even if reunification is no longer a goal.

  • (Blome 1997) Social service agencies may want to train social workers to consider the impact of a school disruption when contemplating a change of placement. Possibly, youth should be allowed to finish the year in a school, and teachers could be helped to understand the multiple transitions in the youths’ lives.

  • (Pecora et al. 2006) Foster care programs should encourage youth to obtain a high school diploma, not just a GED.

  • (Pecora et al. 2006) Foster youth should be encouraged and supported to go to college.

  • (Pecora et al. 2006) Child welfare practitioners should increase access for foster youth to educational services and tutoring by minimizing the number of school changes.

  • (Reilly 2003) Closer connections need to be forged between schools and child welfare agencies to monitor the educational progress of foster youth.

Placement

Four studies (Biehal et al. 1994; Courtney and Barth 1996; McMillen and Tucker 1999; Mech et al. 1994) used placement issues as outcome measures. Courtney and Barth focused on types of youth placements before discharge from care. They found that in a sample of 2,653 foster youth, 38.3% (n = 1,016) were in foster family homes, 24.5% (n = 649) were in group care facilities, 25.2% (n = 668) were in kinship foster homes and 12.2% (n = 320) were in court-supervised guardianship placements. Biehal et al. (1994) examined where youth lived upon leaving care. They found that upon leaving care 43.5% (n = 80) of youth moved to temporary accommodation, 23% (n = 42) returned to or remained in the family home and 26% (n = 48) moved to permanent accommodations. McMillen and Tucker (1999) examined youth placement status before and after discharge. Pre-discharge they found that 26% (n = 65) of youth were living with relatives, 22% (n = 54) were living in their own apartment, a college dorm or military barracks, and 12% (n = 29) were runaways or had unknown situations. Post-discharge, they found that 26% (n = 66) of youth left care due to refusing further services, 20% (n = 50) achieved their goals and were living on their own and 10% (n = 26) left due to unplanned reunification, while 11% (n = 29) ran away and 6% (n = 14) turned 21 years old. Using a 50-item multiple choice instrument to measure life skills knowledge, Mech et al. (1994) examined youth life skills across foster care placements. They found that life-skill scores among youth in foster-boarding placements were higher than among youth in group home and/or residential/institutional placements.

Practice Implications Include

  • (Courtney and Barth 1996) This study found a large proportion of the foster youth return to their families at final discharge. Thus, child welfare practitioners should place an emphasis on the assessment and maintenance of kinship ties for long-term residents of foster care, instead of solely focusing on the youth’s acquisition of independent living skills. In addition, practitioners should be familiar with the youth’s family resources and how those match with the youth’s needs. Practitioners should continue to explore the resources in the youth’s biological families, even if the goal is “independent living.” There should be an increase in the development of ILP programming for group homes, as many of the youth who reside in these homes have a higher level of emotional and behavioral disturbances than in other types of out-of-home care.

  • (Mech et al. 1994) Since this study found that life-skill scores among adolescents in foster homes were higher than among youth in group homes, one practice implication is that securing home-based placements for youth may be more beneficial than placing them in group care. This may mean more aggressive recruitment of foster families in order to create better opportunities for foster home placements, or an increased effort to work with biological families to avoid removal.

  • (McMillen and Tucker 1999) This study showed that a sizeable percentage of foster youth who leave out-of-home care unite with their relatives regardless of the determination of the child welfare system. The practice implications of this study include that the focus of ILPs should not solely be on the acquisition of independent living skills, but also on preparing youth for independent living with their families. These families may be experiencing serious challenges such as poverty, mental illness and addiction. Moreover, youth who do exit the system should continue to receive services voluntarily until age 21.

Employment

Ten studies used employment as an outcome measure. Five of the studies examined youth who were discharged from foster care. McMillen and Tucker (1999) found that 38% (n = 96) were employed and 29% (n = 73) had never had a job. Pecora (2006) found that the employment rate was 80.1% (n = 528), substantially lower than the national average at the time of 95% for youth ages 20–34. In a sample of 18–24 year olds 2.5 to 4 years after discharge, Cook (1994) found that the employment rate was 49% (N = 810, n = 397), as compared to 60% in the general population. In addition, the median weekly salary for youth who held a full time job was $205, as compared to $261 in the general population of 16–24 year olds. Biehal et al. (1994) found that 13% (n = 24) were employed full time, 36% (n = 66) were unemployed within a few months of leaving care and 10% (n = 18) were not working because they were caring for children. In their sample of 732 youth, Courtney et al. (2005) found that 47.7% (n = 349) had ever been employed and 35.1% (n = 257) were currently employed. In addition, 27.6% (n = 95) of youth worked 11–20 h a week, 30.2% (n = 104) worked 21–30 h and 23.8% (n = 82) worked 31–40 h.

Three of the studies examined youth who were still in foster care. English et al. (1994) found that 48% (n = 207) had been employed for more than 12 months, 44% (n = 190) had entry level or semi-skilled (23%, n = 99) jobs, and 46% (n = 198) held more than one job. Mallon (1998) found that 72% (n = 33) had full-time employment at discharge, 7% (n = 3) had part-time and 21% (n = 10) were not employed at discharge. Iglehart (1994) found that 14% (n = 21) never worked and 17% (n = 26) worked 40 h a week.

Two of the studies compared outcomes post-discharge for youth who had participated in ILP with youth who had not. Lindsey and Ahmed (1999) found that 59% (n = 26) of the ILP participants were employed either part or full time, as compared with 44% (n = 14) of nonparticipants. In addition, 81% (n = 26) of non ILP youth experienced unemployment for more than one month since leaving care, as compared to 63% (n = 28) of ILP youth. Georgiades (2005) found that 8% (n = 1) of the non ILP group and 22% (n = 11) of the ILP group were employed full time, while none of the non ILP group and 51% (n = 25) of the ILP group were employed part-time. In addition, 92% (n = 17) of the non ILP group was unemployed, as compared to 27% (n = 13) unemployment for the ILP group.

Practice Implications Include

  • (Iglehart 1994) Employment training may not be enough if it does not include actual employment for the foster care youth.

  • (Iglehart 1994) Programs may need to develop agreements with employers so that foster youth can easily gain access to employment opportunities.

  • (Iglehart 1994) Opportunities should be created for real world application of ILP training while the foster youth is in care.

  • (Biehal et al. 1994) Social service departments should consider the policy and practice implications of the high level of unemployment and the low levels of income on which many young people have to manage.

  • (Pecora et al. 2006) Practitioners should provide foster youth who are exiting from care with concrete resources to help them conserve and build their resources and compete in the employment market.

Additional Implications

Practice implications, which are not included in the above domains are listed below. The studies in this review address other areas that are important for foster youth transitioning to adulthood. However, these implications are not based on outcome measures, and address a variety of areas including sexuality, comprehensive and individualized ILP service delivery, services for foster youth with special needs, mental health, mentoring and goal planning associated with transitioning to adulthood.

  • (Georgiades 2005) The practice implications are that programs should focus on social support, interpersonal skills, money management, job seeking and maintenance skills as potentially being more challenging to address. In addition, ILP did not increase positive outcomes for sexual-risk prevention outcomes or parenting competence. One practice implication is that ILPs may not be adequately addressing sexuality issues, which may put foster youth at high risk for disease, victimization and unwanted pregnancies.

  • (Pecora et al. 2006) Youth should be involved in developing a comprehensive transition development plan that includes planning for supportive relationships, community connections, education, life skills assessment and development, housing, employment, physical and mental health. Foster care services should be extended to age 21 and independent living services to age 25.

  • (Biehal et al. 1994) The practice implications include highlighting the need for comprehensive planning that includes all of the service professionals and other adults involved in a foster youth’s care (e.g., social workers, residential workers, foster parents, probation officers). In addition, the study emphasized the need for follow up once youth are discharged from care. This follow up care should include access to stable housing, educational resources, assistance with gaining employment and general financial assistance.

  • (Mallon 1998) Transitional programming for foster youth should be highly individualized and able to provide services tailored to the developmental level of a particular youth.

  • (English et al. 1994) The study found that over half of the foster youth had one or more disabling conditions. The practice implications include that practitioners should consider the effects that physical, psychological or emotional disturbance and other disabling conditions may have on youth who are exiting care. Without fully understanding the youth’s developmental functioning, ILPs may not be delivered in a manner that youth can understand and translate into their own lives.

  • (Iglehart 1994) Developing specialized services for foster youth with mental health challenges is necessary to assist them in achieving positive outcomes.

  • (Courtney et al. 2005) Foster youth who were transitioning experienced challenges in the following domains: mental health, victimization, early pregnancies, educational deficits and economic insecurity. These are all domains, which ILPs should address in order to meet the needs of youth transitioning from care.

  • (Cook 1994) The practice implications include that services are most effective in improving outcomes when they are targeted to meet specific goals and include the teaching of concrete skills. In addition, other persons in contact with the foster youth should be taken into consideration with ILP, as foster parents, teachers, child advocates, and social workers were also a major part of preparation for adulthood.

  • (Reilly 2003) Practitioners must develop ongoing relationships with effective supports including mentoring programs.

Practice, Policy and Research Implications

By improving the quality of ILP research, researchers can offer practitioners’ ways to improve services to youth who face a myriad of challenges upon discharge from the foster care system. The studies reviewed here offer such recommendations, based on empirical findings. Recommendations made in this section focus on ways to improve ILP practice, policy and research. Further recommendations are made to improve independent living programs and child welfare practices with foster youth. The recommendations in this section reflect this article’s authors opinions based on research, policy analysis and practice wisdom.

Suggestions for improving ILP training extend across practice, policy and research domains. Practice suggestions include: (1) ILP practitioners should start recruiting youth and working to assure that they are engaged in ILP training and attend consistently; currently, youth lack consistent attendance in ILP sessions (Naccarato 2005); (2) create a standardized curriculum that is used across states; and (3) put in place mechanisms to ensure that youth’s needs and skills are matched to the interventions offered.

Policy suggestions include to: (1) provide input from youth and practitioners to policy makers in order to update outdated legislative goals and objectives of ILP and give practitioners and youth a hand in shaping the legislation; and, (2) create a system where all states are able to adhere to the legislative mandates relating to ILP.

Research suggestions include to: (1) conduct further research to find out which ILP medium is most effective for youth (e.g. classroom, group, individual, online); and, (2) develop standardized outcome measures to adequately measure ILP (Naccarato and DeLorenzo, in press). Standardized outcome measures must be used to accurately quantify how effective ILP services are improving outcomes for youth.

The suggestions for improving independent living programs include to: (1) create highly tailored ILPs with clear goals and outcomes; (2) provide aftercare services such as case management and crisis intervention to youth post-discharge; (3) collaborate with caregivers and other professionals responsible for providing services to the youth; (4) strengthen housing programs, for example working with landlords to help allocate apartments for low income foster care alumni; (5) encourage youth to not only earn a GED, but also attend college; (6) do not prejudge foster care youth as not being able to succeed; and, (7) share information among ILP coordinators about what strategies are effective for working with youth transitioning to independent living.

The suggestions for child welfare professionals working with youth transitioning from care include to: (1) examine closely if youth should have been removed from their families to begin with, and work to return youth to their families in a more timely manner because so many youth return to their families after discharge from care; (2) emphasize engaging and encouraging youth to participate in ILP services because the research indicates that youth who participate in ILP have generally better outcomes than non ILP participants in the areas of education, employment, housing, health and life skills; (3) minimize the number of school disruptions; (4) recognize that the intrusive nature of out-of-home placements may have caused trauma and problems for the youth; and, (5) give youth more control over where they live and how they spend their time and money. Expanding and improving the evidence base for research on independent living, in conjunction with providing practitioners with concrete ways to deliver effective independent living skills to youth, will help improve outcomes for these at-risk youth transitioning to independent living.

Conclusion

Among the studies included in this review, there was great variation in how independent living was measured across studies. In each study, the participants and methods varied across several domains. Specifically, the sample sizes, demographics, placement histories, support networks and outcome measures were different across each study.

One way to uniformly measure ILP is to create a national database with input from researchers and practitioners in the field, in order to design the most functional, rich information system possible. Without uniform measurements, there is no way to determine how effective ILPs are, and whether or not there should be practice changes or reprioritization of funding goals.

Specific suggestions for a federal database include collecting service data, having a comparison group that does not receive the ILP intervention and collecting post-discharge data. Practitioners collecting service data is something that is sorely lacking for the population of youth exiting foster care at the agency level. Service data should include the frequency, dates and number of ILP sessions that each youth received. In addition, outcome measures must be standardized, or comparisons will not be able to occur with any reliability. Practitioners collecting post-discharge data is also extremely important, as it is lacking in the current research, and it would be informative and necessary to improve practice. Finally, using a control group that does not receive the intervention would create a comparison point for youth in each state. Doing this, along with using scales of measurement, and not simply just collecting dichotomous/binary variables, will allow for the use of more rigorous statistical models.

With the current emphasis on social work interventions integrating evidence-based practices, once again measuring outcomes emerges as a research, policy and practice challenge. Without addressing this challenge, research findings will continue to not be generalizable and practitioners will not know to what extent and how to redesign and improve ILP programs. Without this knowledge, practice will be empirically uninformed, making recommendations for future service delivery impossible. Since ILP has the important charge of helping vulnerable foster youth transition to adulthood, the ability to improve upon practice is essential, or these youth will continue to lag in important life skill domains.