Parent–Child Visits in Foster Care: Reaching Shared Goals and Expectations to Better Prepare Children and Parents for Visits

Abstract

This study presents descriptive findings from a project designed to understand different perspectives about family visits, to pilot a guidebook tool to help participants reach shared goals, and implement best practices. A sample of 133 parents, children, foster parents, and social workers reported their reactions to the tool. Findings revealed that, depending on the role played in visits, there was variation in perceived goals of visits and ideas about handling difficult visits. After using the tool, parents reported feeling better able to manage their emotions during visits, children reported believing their feelings about visits were more normal, and foster parents were more open to discussing parent no-shows with children. Implications for practice are discussed.

Experience and research have established beyond any further question that parental visiting of placed children is essential to the resolution of the function of placement in each family’s problem. It loses much of its value as a crucial treatment instrument, however, if it is not used flexibly in a carefully and continuously planned process. (Hess 1988, p.311).

The above quote was written over two decades ago, yet still applies today as much as it did then. Parent–child visits remain at the heart of reunifying foster children with their families, but there is a dearth of tools or guidance to enhance them as a “treatment instrument.” Ideally, the child welfare system will support the visiting process by simultaneously engaging everyone who is involved, using a consistent message about visiting goals and providing parents with tools and information that promote meaningful and productive interactions with their children during visits. In foster care, visits not only provide a venue for parents to transition back into parenting and heal the relationship with their children, but in the process, they can help children feel that they have not been abandoned (Boss 1999; Roberts 2002; Samuels 2008). However, social workers, foster parents, and parents are not always given the same information about visits and may not share the same goals and understanding about the purpose of them (Kapp and Propp 2002). If all the involved parties do not routinely communicate with each other about visiting, it can be difficult to understand and respect the perspective of the others.

The research literature reveals scant information about effective tools or information to improve the quality of visits. Moreover, documentation and accountability of visits tends to be minimal, making it challenging to learn from prior visits (Hess 1988). Parents, children, and foster parents need resources to help them understand each other, their respective roles, and how they can make the most of visits. In response to these concerns, the Familyconnect pilot project created a visiting tool designed to improve parent–child visiting experiences. This paper presents findings from the evaluation of the Familyconnect project and offers implications for practice.

Literature Review

Family visits are the primary child welfare intervention used to sustain the parent–child connection which is critical for successful family reunification (Haight et al. 2005; Hess 1988). Recognizing the value of visits, the Child Welfare Act of 1980 (P. L. 96–272), explicitly requires family visits as a key part of family preservation efforts. Children with more frequent and consistent visits tend to be better adjusted during placement, to have shorter placement durations, and are more likely to reunify with family at discharge than other children (Benedict and White 1991; Davis et al. 1996; McMurty and Lie 1992; McWey and Mullis 2004; Perkins and Ansay 1998). The frequency and quality of visits are impacted by preparation and efforts toward accountability. The quality of the visits, in turn, can affect the child’s experience of loss, attachment, and behavior.

Loss and Attachment

Removing children from their homes and placing them in foster care can be traumatic under the best of circumstances. Children naturally form attachments with their custodial parent, regardless of whether that parent maltreats them (Ainsworth 1989). When children do not have regular access to their parents, they can suffer from ambiguous loss, the experience of grieving someone who is physically absent but psychologically present (Boss 2006; Samuels 2008). With ambiguous loss, there is no closure, such as what one might achieve from attending funeral for a loved one who died. For children in foster care, they know their parents are present in the world, yet inaccessible to them.

Quality parent–child time is important in alleviating anxiety and fear of abandonment as well as nurturing the attachment relationship (Hess 1988; Poulin 1992; Roberts 2002; Samuels 2008). The more frequent and consistent the visits, the more connected the children will feel to their parents and the less anxiety they may experience while waiting to return home (Poulin 1992; McWey and Mullis 2004). Frequency of planned visits varies widely, but monthly visits are common while weekly visits are much harder to coordinate. Even weekly visits can feel inadequate to children who long for daily affection and attention from their parents. Long waiting periods between brief visits can cause significant anxiety and prolong grieving (Boss 2007; Lee and Whiting 2007; Samuels 2009).

Child Behavior

Children who are less anxious and children who have stronger attachments to parents tend to exhibit fewer behavior problems (McWey and Mullis 2004). Cantos, Gries, and Slis (1997) studied children in family foster care and found, controlling for time in care and number of placements, that children who were visited regularly had significantly lower behavior problem scores on the Child Behavior Checklist than children who were not visited or who were visited irregularly. The children who were not visited at all had more internalizing behavior problems than those visited regularly.

How child behaviors are interpreted may affect whether future visits are encouraged or limited. Because parents, foster parents, social workers, and children all view visits from a different vantage point, they likely attribute observed emotions and behaviors near visiting time to different causes. In-depth interviews with child welfare workers, foster mothers, and biological mothers about visits revealed that each group tended to focus on different aspects of visiting (Haight et al. 2005). Parents attended to grief and loss, foster parents to preparing children and their transitions, and caseworkers discussed the complexities of supporting emotionally close parent–child interactions while monitoring and assessing parental behavior during visits.

If a child acts out after visits, it is the foster parent who must deal with that behavior and who may report to the social worker that the visit was not good for the child. The social worker may then conclude that the visits are not healthy for the child, or succumb to foster parent pressure to reduce visit frequency (Browne and Maloney 2002; Hess 1988). On the other hand, it is also plausible that the foster child’s behavior is not a result of the interactions during the visit but rather of separating at the end of the visit. In this instance, sometimes social workers will find that an increase in visits might reduce the child’s anxiety (Hess 1988).

Documentation and Accountability

Despite federal policy and empirical research espousing the value of routine visits, planning for visits, and attending to the needs of visiting participants, visits can at times receive a low priority over other placement activities both in local policies and practice. In a study of state foster care visiting policies, fewer than one-third of the states required that the visit participants be tracked and even fewer required documentation of the visit frequency, length, location, problems during visits, why they did not occur, or observed interactions (Hess 2003). This also surfaces in discussions of other research on visiting. Several researchers who endeavored to assess visiting practices and outcomes reported that the documentation of visits was minimal or disorganized (McMurty and Lie 1992; Perkins and Ansay 1998; White et al. 1996).

The absence of documentation greatly limits accountability toward assuring that appropriate efforts are made to establish visits, leaving many decisions at the discretion of the individual caseworker. In Hess’s (2003) study, although 62 % of the states did identify agency staff responsibilities with visiting, only 40 % stated the responsibilities of parents or caregivers in visits. In fact, that is what has been observed in the few studies to examine the issue. White et al. (1996) observed that social worker efforts to establish visits were minimal shortly after admission and declined from that point forward. Social worker efforts to establish a visiting schedule diminished substantially over time among longer-staying children, leading to infrequent visits. Family visits conducted through a visitation center with the sole task of coordinating visits have been found to yield significantly higher visiting rates than when the task is left to individual caseworkers (Perkins and Ansay 1998).

Preparation

Preparing children ahead of time so they are emotionally ready for visits, and giving parents tools to help them connect with their children during their time together are important in encouraging natural and positive interactions (Loar 1998; Kapp and Propp 2002). When a parent inconsistently attends visits, it can be painful to witness a child’s disappointment—something the foster parent is most likely to be faced with. A natural and common response is to withhold information from the child about upcoming visits to prevent disappointment if the parent fails to arrive. Withholding visiting information may be even more tempting if the child acts out when a parent does not come to a planned visit. This presents a conundrum. The risk of withholding information is that one cannot prepare a child for a visit if he or she does not know it is scheduled, thus suspending the opportunity to face the reality of the situation.

…withholding information may elicit, maintain, or exacerbate ambiguous loss. In such cases the foster children may have difficulty processing their grief and forming attachments to new caregivers…when we deny our foster children information we may exacerbate the feelings of disempowerment and helplessness so pervasive in these children. (Lee and Whiting 2007, p. 427).

Parents too need to prepare both for their own emotions that may surface during visits, and to help their children cope with closure of visits. Interviews with mothers who visited their children in foster care revealed that the mothers were anxious prior to visits and distressed by the pain of separation at the end of them, especially when the children clung to them and begged them not to leave (Haight et al. 2001). The irony in this situation is that the very mechanism designed to heal the parent–child relationships and move toward reunification requires that mothers disregard their maternal instinct to continue comforting their children and instead leave them behind.

A Case for Visiting Tools

While research in the field has demonstrated the primacy of consistent parental visits for children in foster care, there is scant information about what preparation should be made to enhance the quality of visits and even fewer tools to guide preparation. A comprehensive review of the research literature revealed no tools or interventions that simultaneously prepared everyone involved, the parents, the children, and the foster parents, or provided them with consistent information.

The present study is an evaluation of a visiting tool, Familyconnect, designed and piloted by a small private non-profit foster care agency in Minnesota, Family Alternatives, Inc., (“the agency” here forward). The tool was conceived and project was led by the project director, Wendy Negaard.

The Pilot Project

Familyconnect was a two-year effort to develop and pilot a coordinating set of guidebooks for foster parents, parents, and foster children aimed at helping them work together toward carefully planned and productive visits with common goals.

The Visiting Guidebook Tool

The agency developed the guidebook tool based on what is already known about the importance of preparation and emotional connections, with direct input from children, parents, foster parents, and social workers. The guidebooks are short, readable in a single sitting, easy to use, and avoid technical jargon. They provide information and self-reflection activities addressing five tenets of best visiting practices:

• 1. Preparation—planning ahead for visit activities and feelings that might arise during visits.

• 2. Communication—promoting open communication between children, parents, foster parents, and social workers.

• 3. Emotions—recognizing how strong emotions unrelated to the visit itself can influence visits.

• 4. Connection—using visiting time to intentionally enhance the parent–child connection.

• 5. Transition—easing transitions into and out of visits, for both children and parents.

Separate versions were developed for foster parents, parents, and children aged seven and older. The social workers were asked to become familiar with each version and encourage their use.

The children’s guidebook conveyed messages about the five tenets using cartoon characters representing foster children with varying storylines and different coping styles. It offered a variety of activities, for example: asking children to make a list of questions for their parents for the next visit, check-box lists of possible reactions to visiting scenarios, and questions to consider. There were also puzzles, games, and places to draw pictures. The children’s guidebooks were designed to be used with the assistance of foster parents and sometimes parents, particularly for those children with limited reading skills or ability to understand the concepts.

Within the context of the tenets, the parent guidebook had three prevailing themes: 1) the importance of attending visits, 2) that they are not alone in their feelings, and 3) guidance in setting aside negative feelings about the foster parents or child welfare system during visits in order to focus on the children. It asked parents to explore their emotional reactions to visits and to consider the impact of those reactions on their children. It provided ideas on how to make the most of their time with their children and use it to build stronger connections.

The foster parent guidebook emphasized the role that visits can play in tempering the trauma children experience from separation. It asked foster parents to consider the implications of how they talk to the children about their parents and how they interact with the parents in front of the children. It offered an opportunity to explore how they felt about the visits, especially in light of child behavior before and after visits. Finally, it provided tips on how to prepare children for visits and how to help children cope with disappointment when parents did not show up for a planned visit.

Methods

The reactions to the Familyconnect guidebooks were assessed using two groups: reviewers who read the materials and provided immediate reactions, including their perceived potential for future use, and a pilot group that tested the materials and then provided feedback on their experiences with them.

Sampling

The Familyconnect project was conducted in two large Minnesota counties. The reunification and reentry rates for both counties were similar; one had a reunification rate of 67 % and the other 69 %. Reentry rates within 12 months among all exiting children were similar as well, 17 and 16 %, respectively (Children’s Defense Fund 2007).

Pilot Group Sampling

Parents were invited to participate if their children met the following criteria. The children: (1) were 7–17 years old, (2) placed in foster care in one of the two participating counties, (3) had a permanency plan for reunification, and (4) had a visitation schedule established with at least one parent. All the social workers in both counties were asked to invite qualifying parents to participate. Parents were also invited as they checked in at two visitation centers. Once parents indicated an interest in the study, the foster parents and social workers associated with the child were invited, as well as the child.

Review Group Sampling

There were many foster parents and social workers who did not currently have children who met the pilot group sampling criteria, but worked with such children in the past and future. To capture their opinions on the tool as well, the county supervisors asked these social workers to review the materials. This sample was important because whether or not the guidebooks were used hinged to some extent on the initial reaction when the guidebooks were first introduced. This was highlighted during preliminary interviews in which several foster parents and social workers pointed to a large county visiting manual and remarked that they found it too daunting and uninviting to use. If they did not find the guidebooks appealing, relevant, to have potential, or if they perceived them to be time-consuming, the chances were slim that the materials would be used.

Procedures

The initial procedures were the same for both the review and pilot groups. Participants from both groups attended a brief training conducted by the Familyconnect project director. The training began with a presentation about best visiting practices and a summary of the research that supports those practices. The training then presented the intended purpose of the guidebooks and how they were meant to be implemented. After the training, the procedures differed for the two groups.

Pilot Group Procedures and Measures

Data was collected at two time points: immediately prior to the training and two months later after using the guidebooks. The measures included both a written questionnaire and an in-person interview. Because most families had weekly or biweekly visits planned, two months permitted a minimum of four visits in which the guidebooks could be employed. Interview locations were at the discretion of the participants; most occurred in participant homes.

The pilot group read the guidebooks and individually rated their satisfaction, using a Likert-type five-point scale. These items addressed utility, perceived ease of use, relevance of subject matter, and stylistic appeal. The group also rated their satisfaction with the amount of time it took to use the guidebook and to what degree it built on their existing knowledge.

The foster parents reported their observations of any anxious or acting-out behavior of the child before and after visits. The child questionnaires were simpler and more tailored toward their experiences. Instead of a five-point answer set, children were given options of “no,” “yes,” “sometimes,” or “I don’t know.” The children were asked how prepared they felt for visits, whether they believed their feelings about visits were normal, if they communicated their feelings to others, and how they perceived their own behaviors before and after visits.

The open-ended interview questions explored why participants rated the tools as they did and how they used them. The interview topics included:

• Specific topics or sections of the guidebooks that stood out as helpful or unhelpful.

• Guidebook activities that they used with the children or themselves and their reactions to them.

• Barriers to the guidebook effectiveness.

• What potential, if any, they saw the guidebooks as having toward improving visits.

Review Group Procedures and Measures

There were separate review groups for social workers and foster parents. They met once, first attending the training as a group and then assessing the materials individually. Social workers were given 90 min to review all three versions of the guidebooks. Foster parents were asked to review the foster parent and child guidebooks in a 60 min session. They were asked to rate their satisfaction in the same areas as the pilot group: utility, perceived ease of use, relevance of subject matter, and stylistic appeal. They also provided open-ended reactions to the materials.

Limitations

The study does not include a comparison group that would speak to the impact of the tool on child welfare outcomes relative to those who did not use the tool. Attrition introduces some bias as well. Foster parents who did not participate in the post-pilot interview were more often relatives of the parents than not, and were more likely to cite new tensions with the parents as a reason for declining post-pilot participation. Therefore it is possible that this sample under-represents those with the most strained relationships. Finally, the small sample size within each subgroup (parents, children, etc.) limited the analysis primarily to descriptive statistics.

Participants

There were a total of 133 individuals who participated in the study, 72 in the pilot group and 61 in the review group (Table 1). Fifty-three of the pilot group participants completed the post-pilot interview, representing a 74 % retention rate. The review group was comprised of 22 foster parents and 39 social workers.

Table 1 Participant sample

The 23 children enrolled in the pilot group ranged in age from 7 to 14 years old, averaging 9 years (Table 2). Sixty-one percent were African American, 26 % White, 13 % Native American, and 9 % Asian. There were more girls (61 %) than boys (39 %). Thirty-nine percent of the children had previous foster care spells. In their current spell, the children had resided in an average of slightly less than two homes. At the time of their first interview, the children had been in their current spell an average of 4.6 months.

Table 2 Placement characteristics (n = 23)

At the start of the study, 35 % of the children were in kinship placements and 65 % in non-kin homes at the start of the study.

Findings

Guidebook Use

All the pilot participants indicated using the guidebook at least once, most using it three or more times (92 %). Most of the parents (90 %) reported that they began using the guidebooks within the first few days of receiving them, whereas the foster parents were more likely to wait until a visit was approaching before they turned to the books. Foster parents had been asked to help the children with their books. When the children were asked with whom they used the book, 80 % said they worked with it alone. Foster parents confirmed that they left the children to work on them by themselves, seldom, if ever, reminding them about it. The children who had help, received it from siblings. Nevertheless, in post-pilot interviews, the children pointed out multiple pages they had read or on which they had completed activities. The children used the guidebooks both before and after visits.

Satisfaction with the Tool

All 61 review group members and 53 pilot group members provided satisfaction ratings, for a total of 114 ratings. Table 3 presents the ratings that foster parents and parents gave to the guidebooks that were designed for them. Both the foster parents and parents rated the guidebooks with scores close to 4.0, “satisfied.” They rated the usefulness, ease of use, style, time required, and adding to knowledge close to 4.0 as well. The lowest mean rating pertained to how much parents felt the topics related to their concerns, at 3.6. The most common topic they wanted added was legal information. This was intentionally omitted because it is so case-specific.

Table 3 Mean guidebook satisfaction ratings: foster parents (N = 39) and parents (N = 10)

Overall, the children liked the guidebooks (Table 4). They liked the activities and the characters the most (64 %). The most consistent complaint was the amount of text, especially among less fluent readers.

Table 4 Child guidebook ratings (N = 15)

Social workers rated the child guidebook between neutral and satisfied (Table 5). While the relevance was rated quite high with a mean of 4.3, ease of use was rated closer to unsatisfied on average. In the open-ended responses, they revealed that their primary concern was that the child books were too dense with text, consistent with the children’s responses.

Table 5 Social worker mean ratings of all guidebooks (N = 51)

The social workers rated the parent guidebooks positively with all the ratings averaging in the satisfied to very satisfied range. Social workers on the whole were satisfied with the foster parent guidebooks as well, though less so than the parent books. Relevance of the topics was rated at 4.5 out of 5.0. They scored closer to neutral on the ease of use for foster parents and appeal to foster parents, though foster parents themselves were satisfied with those qualities.

Pilot Group Reactions: Visiting Perceptions, Practices, and Experiences

The 53 pilot participant reactions to the guidebooks are organized here into the following categories: coping with powerful emotions, perceptions about the purpose of visits, understanding each other’s perspectives, communication, and preparation.¹ These are not discrete or mutually exclusive; each overlaps to some degree with the others, and they include both quantitative and qualitative results.

Coping with Strong Emotions

As anticipated, the participants reported that visits can be an emotionally charged time for both parents and children. The most pervasive theme during the parent interviews was their dual challenge of coping with their own powerful feelings while also dealing appropriately with their children’s emotions. Exacerbating the situation was the added stress parents felt because they were being observed. They expressed fear of making a mistake in the eyes of the observer. There was much guesswork on the part of the parent to determine what interactions and what kinds of emotions were acceptable versus “red flags.” Many of the parents discussed feeling a sense of relief when they read in the guidebooks that other parents shared their turmoil around visits.

I think I cried the first time I read [the guidebook] just because it made me feel I was not alone and it had some of my favorite quotes from people I admire. I love some of those quotes like from Eleanor Roosevelt and you know, Aristotle. I thought it was a great idea and it helped us get started on the right side. Especially [husband] who’s not a talker. So this book was really helpful.

In the initial interview, many parents expressed concern about how to cope with their own feelings and their children’s feelings as visits drew to a close. Figure 1 depicts their responses when asked about their coping skills regarding ending visits. The scores shifted on average, from a neutral position—neither agreeing nor disagreeing—toward agreeing that they were able to cope with their and their children’s emotions at the end of visits. This positive result was not reflected in the children. A smaller proportion of the children reported feeling they were able to handle their emotions at the close of visits (46 %) two months later than at the onset of the study (64 %). Some explained that they missed their parents more intensely as time passed. Even more pronounced, fewer children felt they had someone to talk to about visits after two months, dropping from 65 to 29 %. This is consistent with the report that foster parents did not engage the children with the visiting tool, even though they committed to it for the study.

Fig. 1

Parent perceived ability to cope with child’s and own emotions

An area of improvement was the children’s sense that their feelings about visits were normal (Fig. 2). Before using the guidebooks, 57 % of the children thought other children in foster care shared their feelings, increasing to 69 % at the end of the study.

Fig. 2

Child’s sense of normalcy

When asked if their feelings about visits were normal, the change was substantial. Sixty-five percent of the children thought their feelings about visits were normal at the start of the study, a figure that increased to 92 % at the second interview. Children’s anxiety and acting-out behavior near visits as reported by foster parents, was low both at the start and end of the study.

Understanding the Perspectives of Others

Changes in perceptions of others was reflected most in the open-ended responses. The parent guidebook encouraged parents to recognize that foster parents were not their adversaries simply because they were caring for their children. For foster parents, the guidebook discussed how painful the situation was for parents and encouraged them to reach out to parents even when it was difficult. One foster parent shared how the tool helped her understand the parent better,

…a lot of this helped me out because I’d go back and figure like gee, why can’t the parent show up here instead of me having to come to the school and the day care? Why can’t the mom come meet them here? The first few visits were really hard for her to come here so a lot of this helped me out because I’d read some of the answers [in the guidebook]… If I knew a visit was coming up, I’d go through the book and think about what happened last time, and what could help me make things different this time. Especially after they had a few visits and I knew their reactions just before their visits and right after. I knew better what to do.

Many foster parents initially viewed their role as one that involved exclusively the children. After using the guidebooks, some began to hold a broader view of their responsibility that included nurturing the parent–child bond and helping the parents move toward reunification.

At first I thought it was most important that I take care of the kids as best as I could. Now it is most important to me to make sure they know who their parents are and keep that connection and make myself not be the enemy for the parents. That is a really hard barrier to get past.

All the parents reported grief about the separation from their children and most described anger toward both the foster parents and the child welfare system. They shared that it was difficult to move beyond those emotions during visits. Several parents remarked that until they read the guidebook, it had not occurred to them that complaining about foster parents or social worker in front of their children could make the children ill at ease and interfere with their opportunity to connect with each other.

When I really read [the guidebook], I didn’t expect that I would be able to be eased into being able to just see her for only a small period of time. Afterwards I would cry and cry and complain about everything. This wasn’t right and that wasn’t right and I was mad at this person and it was everybody else’s fault. Then I saw I had to stop pointing the blame and take the time that I am spending with my daughter.

For many parents, it was a new experience to step outside their own grief and anger to consider what their children wanted from visits and the impact that a visit with an angry, complaining parent could have on a child.

Communication Between Parents, Foster Parents, and Children

At the start of the study, participants from all groups observed a lack of open communication. At the end of the study, the most notable changes occurred with communication between two pairs: parents with their children and foster parents with parents.

Many parents remarked that the guidebook helped them recognize that being open with their children about their feelings positively affected communication and understanding. This led to calmer and more open interactions.

This section right here “Communication,” is the main one we used because it was a common thing that caused disagreements between me and her…She wouldn’t tell me what was going on with her, how she was feeling on the inside about things, what was happening at school. Once we started talking about that and I started pointing things out in the guidebook, I said to her, ‘Ok, we have to do this in order to get back on track. So me and you need to start opening up to each other so we don’t be mad at each other and go down each others’ throats.’ She thought it was good. In her book she was able to relate and understand what I had been saying to her.

For some of the parents, this was the first time they had ever attempted to communicate honestly with their children about their feelings. They reported feeling relieved when they read in the guidebook that stress and tension are normal. These parents described a new motivation to work toward more peaceful interactions.

Like with the “Communication” piece where they say how you talk to your child—that sometimes you might be yelling, sometimes you might scream at each other. The way they explain it that at first it is typical and a normal reaction because of all the chaos that’s going on. But as you continue on and you start to resolve issues and see how each other is really feeling, then you get a bigger picture and you can work on it and go from there.

The guidebook recommended using play to get children to reveal their feelings. One parent, despite initial skepticism, tried some of the suggestions to spark conversation with her children. She described her surprise at its success.

At first … I didn’t think the book was all that good. I thought, “oh come on, please. This doesn’t relate to me.” I didn’t really get into it until a month later and so like in the book, we started playing games at the visit and lo and behold, the games opened up the door for other conversation. We would laugh and talk and we would work out problems and I thought, “ok, all this from just starting a game. Who knew?” Say for instance, we would play Sorry! and once we started playing the game, they would get into that mode, and things would come up and I’m like, “Aha! There it is!” And I’m like, all this from just doing a game?

Communication between foster parents and parents was also described as improved. At the start of the study, the foster parents found communication with the parents to be strained. They indicated that they used the new information from the guidebook to convey clearer boundaries to parents about visits in their homes and to impart more information to parents about the children’s progress. Some discovered new insights about why there was tension with the parents.

The part [in the guidebook] about stuff between the foster parent, the parent, and the child. “Communication” it was, I guess… that’s where most of the problems are. You got someone else parenting your kid, they aren’t ever going to really do it right. I mean if someone took your daughter, if she was taken away and put in a home, you probably wouldn’t be happy with everything they did.

Parents indicated improvements in their communication with foster parents (Fig. 3). Before using the guidebook, parents were, on average, undecided on whether or not they knew what kinds of information they were permitted to ask of the foster parents and how to handle disagreements with them. After using the guidebooks, on average, the parents agreed or strongly agreed that they knew how to handle these situations.

Fig. 3

Parent communication with foster parents

Social workers also found the communication component of the guidebooks to be useful. Nearly all the social workers remarked that a tool to help convey consistent messages was valuable for families.

Anytime we are opening up communication, talking about expectations before, or at the beginning of placement, there is great potential for improvement at all levels. Additionally with these guides, all parents, all kids, and all foster parents get the same information rather than varied information based on the social worker they get.

All the social workers spoke positively and with enthusiasm about the tool. One social worker commented that the guidebooks “…have one hundred percent positive potential. It facilitates discussion between all members involved to promote discussion and open and honest communication.”

Perceptions About the Purpose of Visits and Informing Children

Overall, the foster parents tended to describe the purpose of visits as a way to provide safe contact between the parent and child or observe the adequacy of the parenting skills. After using the guidebooks, the foster parents spoke more about the importance of building the parent–child bond and their role in helping the parents connect better with their children.

If I use [the guidebook] and learn something about how to work with the kids, then I can share that with the parent…If I learned some way of doing things works best with them, then I want her to know that, so she can take what I’ve learned and apply it. Isn’t that really the point?

Another foster parent had never considered that her role in the visits should involve anything more than safety and transportation. The guidebook introduced her to the idea that visits offer an opportunity to teach parenting skills.

I think it is an interesting idea that visits could be training opportunities for parents. Because I never considered it that way…that was the big eye-opener for me. What sank in the most for me is…that visits are traditionally for getting them there, keep them safe, and getting them home, as opposed to a chance so the birth parents can get something they don’t have out of the visit, more than just contact, but training.

Preparing Children for Visits and Transitions

Prior to using the guidebook, the foster parents generally believed that it was best not to let children know a visit had been scheduled. There were two reasons cited for this practice: (1) if children did not anticipate a visit, they would not be disappointed when a parent failed to arrive, and (2) to avoid difficult behaviors believed to be linked to anxiety around an impending visit. After using the guidebook, foster parents were significantly less likely to agree that scheduled visits should be concealed from children (Fig. 4). After using the guidebooks, foster parents still disagreed, but to a lesser extent, that negative behaviors after a visit might indicate a need for more parent–child time.

Fig. 4

Foster parent change in beliefs about visits. t-test *p<.05

Although the parents were less directly involved with preparing the children for visits, they employed guidebook suggestions including asking the children what they wanted to do during the next visit, making family scrapbooks with the children, and asking children at the end of visits what they should bring the next time. Preparing for transitions at the start and closure of visits was primarily the parents’ responsibility. One parent was at first reluctant to use visiting time to prepare the child for separating, but later saw the benefit of it,

I learned to spend that time calming down, cleaning up, and then talking about what are you going to be doing this week and stuff like that so he leaves mellow instead of keyed up or ‘oh we got to leave. Bye’ where he leaves highly emotionally charged. Because that was one of the things they were trying to say [as a criticism] is that he’s emotionally charged after he sees me.

Another parent reported that the guidebooks helped her to understand the value of using the transition time to “calm down and take time to just cuddle.” It was a simple action such as snuggling with the child that appeared to make the transition out of visits smoother for both the parent and the child.

Discussion

This study examined perceptions about, and experiences with, parent–child visits for children in foster care and the utility of a tool to improve the quality of visits. The findings highlighted two important features regarding visits: (1) foster parents, parents, social workers, and children hold different perceptions about visiting goals and practices, and (2) providing consistent information and self-reflective tasks to everyone involved in visits may help achieve shared child-oriented goals and a better understanding of each other’s perspectives.

The concepts presented in the guidebook tool are not new, nor are they complex. It is the presentation of the concepts in a user-friendly and interactive format, applied simultaneously to all the key visiting players that makes it unique. The tool addressed an important gap; while there were other lengthy text-like volumes addressing visitation issues available to the social workers and foster parents, there was nothing that was brief and inviting to use, and very little designed specifically for parents and children. The participants responded quite favorably to the tool, most indicating that they would like something like this to be readily available, and that they would recommend it to others without reservation.

The findings emphasized the variety of influences on visits. It is often the perception that the success of parent–child visits rests on the shoulders of the parents; in particular, they must show up for scheduled visits and display appropriate parenting behaviors during the visits. However, these findings suggest that foster parents, social workers, and children wield important influence over visits as well. Bringing parents into the fold of discussions around visiting goals and helping them better prepare may reduce some of the mystery they feel about what is expected of them and lead to a better appreciation of foster parents’ efforts to care for their children. When parents only learn their mistakes after the fact, it likely contributes to their anxiety. The findings here revealed that foster parents had an interest in using visits as a time to share parenting skills and tactics that worked with the child; they just had not realized they could use the time for that purpose. Encouraging such exchanges may create new opportunities for teaching and learning.

It is worth noting that the participants who displayed the strongest motivation to use the guidebooks, the parents and children, arguably the hold the least power over visiting decisions and had the lowest access to information about visits. The study results point to the need for resources specifically aimed toward parents and children. All the parents appeared to be yearning for information. Every parent participant reported that they read their guidebooks cover-to-cover, shortly after receiving it, and sometimes repeatedly. The children, even those who were not proficient readers, worked on the guidebooks despite the lack of foster parent engagement. The foster parents, who had much less at stake with visits, reported the lowest use of the guidebooks and no engagement of the children with their books. If a similar tool or technique was to be employed in the future, it is recommended that this be encouraged, if not required, of foster parents.

Communication between foster parents and parents requires opportunities for mutual contact. Keeping foster parents and parents apart is a common way of avoiding conflict, at times by holding visits outside the foster home, having separate entrances to visiting centers for foster and birth parents, or using a third party to transport children to visits. This study suggests that, given the chance, parents and foster parents can come closer to appreciating each others’ perspectives and can begin to openly share ideas and information about parenting the child when encouraged to do so. Better communication and more interaction between the foster and birth parents may reduce anxiety some children feel about dual allegiances.

Being open and honest with children is important as well. While it may be easier in the short run to withhold information from children about impending visits, it only postpones the inevitable. If their parents repeatedly do not attend scheduled visits, at some point the children will know the parent is not able or willing to commit to spending time together and they will still experience disappointment and abandonment.

Such a tool does not come without challenges. Any tool intended for use in the home by families will require some means of encouraging their use. Social workers and foster parents were initially wary of the time and effort that the guidebooks might make on their busy schedules. However, several social workers disclosed that if they could get all the parties actively using the tool, it could free some of their time by preventing conflicts before they surface.

While the observed changes after using the guidebooks cannot explicitly be attributed to their use without a comparison group, the interest and enthusiasm reported by pilot and review group participants can hardly be overstated. The guidebooks offered a tool that is not to be in lieu of other existing tools, but rather in the absence them. The specific details of these guidebooks might be changed and still be successful as long as the basic tenets remain intact that focus all parties on thoughtfully considering preparation, communication, connection, emotions, and transitions in parent–child visits.