Journey of Transition Toolkit
Toolkit Home | Implementing | Reintegration of Children into Families
Understanding Child-Centered Case Management
Child-centered case management is an important approach to ensuring that reintegration is done well. The case management process takes reintegration into consideration for all children who are in residential care, regardless of age or special care needs.
Child-centered case management refers to the individualized support provided by professional social workers or trained paraprofessionals who work closely with the children and families during each step of the transition process. This not only provides children and families with a source of consistent and ongoing support, but also provides for the regular documentation of any assessments, records, and other information needed to make sound placement decisions and develop (as well as monitor and update) care plans based on the actual strengths, circumstances, and needs of individual children and families.
The stages of case management prior to, during, and after transition to family include:
- Assessing each child’s development, history, strengths and needs;
- Tracing his or her birth family to determine if reunification is possible and appropriate;
- When reunification is not possible, identifying and assessing alternative family care options;
- Gathering documentation (records, assessments) and providing input into a placement decision;
- Identifying what services are needed by the child and family, and providing the necessary referrals and follow-up;
- With the input of child and family, developing an individualized care plan that builds on their respective strengths to meet their needs, and care plans may be more highly specialized for children who have disabilities, who are coming out of situations in which they are particularly vulnerable, or who are living in fragile or emergency contexts;
- Preparing the child and family for transition; and
- Once the child has been placed in a family, monitoring child and family adjustment and well-being, and identifying additional support or initiating intervention when needed.
While the key steps are common to all, the pacing is specific to the preparation and readiness of each child and family. A child-centered focus aims to engage children in age-appropriate ways, protect them from harm, ensure that case managers make decisions in children’s best interests, and work closely with families and communities.
Case management does not end with placing children in families but continues through monitoring each child’s and family’s adjustment for a period of time. In all care options, consistent case monitoring and effective family-strengthening services are critical to preventing further separation and to ensuring the best possible outcomes for children placed in family care. Even children aging out of residential care or foster care continue to benefit from a case manager who supports their transition to independent living.
Engaging Children and Families
The active participation of children and families is vital to a successful transition and invaluable to the process of accurately assessing specific needs and ensuring an individualized approach to case management. Children and families are the ones most directly impacted by the transition and are often best suited to identify their own strengths, needs, and desires. Children and families alike need to understand what the transition process is about, why it is important, and how they will be engaged and supported before, during, and after placement.
Strategies for child participation in the transition process will depend on each child’s age and developmental capacity. Even young children can participate and express their feelings or concerns through art or play. Older children can often express their own preferences and concerns through one-on-one conversations with a trusted individual, in small group discussions, or through writing. Youth can also speak to larger issues impacting their lives through participation in forums, advisory boards, and group decision making. In all cases, careful consideration is given to protecting the child’s safety and rights to privacy and confidentiality.
Parents and family members are also full partners in the process, providing unique insight into any issues that may need to be addressed to ensure a smooth transition process. They can also help identify the services and support systems that exist or are needed to protect children and strengthen families in their communities. In addition to their individual interviews and assessments, parents and family members can be invited to participate in working groups, forums, support networks, and decision-making processes.
It’s important that caseworkers have (or have the capacity to develop) trusting relationships with the children and families, coupled with a solid understanding of the community context, cultural customs, and local language, so children and families can receive support based on deep understanding of their unique needs.
Conducting Child and Family Assessments
Successful transition to family care depends on the careful and informed consideration of all aspects of a child’s well-being and development. A good assessment process is key to ensuring a child’s safety and protection, avoiding multiple placements, and preparing a child and family.
Conducting formal, individual assessments of all children who will be transitioned into families, as well as the families in which they may be placed, allows case managers to provide information needed for placement decisions (gatekeeping) and to develop individualized care plans based on the unique strengths and needs of each child and family. The assessment process helps to identify any services that may be needed and in what ways these can best be provided. In addition to any previous documentation or records, sources of information for assessment include the child and family, social workers or case managers, current and previous care providers, teachers, health professionals, extended family members, and others who know the child and family well. A sound assessment process always directly and actively engages children and families in the process, affirming their unique strengths, capabilities, and opinions.
The assessment process often begins with tracing a child’s family of origin to determine if reintegration is possible. If reintegration is not safe or appropriate, then alternative care arrangements (such as kinship care, foster care, or adoption) are explored and assessed.
Making Child-Focused Decisions
Procedures that are put into place to prevent unnecessary family separation and to ensure that when separation does occur, ensure each placement decision is based on the best interests of each child, and are often referred to as “gatekeeping”.
Decision-making processes follow two key principles:
- The necessity principle: Ensure that alternative placement is genuinely needed before removing a child from his or her family, and never place a child in residential care unless necessary (seek appropriate alternative family care first).
- The suitability principle: Always seek to match the approach to care and the placement decision to the specific circumstances and individual needs of each child.
These principles require careful assessment and individualized case management to inform decision-making processes at multiple points:
- Before family separation: assessing the circumstances to determine what needs to happen, preventing separation through the provision of services when possible and appropriate.
- After family separation: assessing whether supported family reunification is possible and if not, determining the best alternative care options for each child with preference given to family care.
- After placement in residential care and during the transition process: assessing and determining the best placement options.
How gatekeeping is managed—that is, who is engaged and in what ways—will look different depending on national policies and local practice. In some countries, gatekeeping may involve a judicial process through which a legal placement decision is made. In other contexts, and especially those where a government-mandated system is not yet in place, gatekeeping may be overseen by allied professionals or trained paraprofessionals. No matter what the context, gatekeeping is always a group process that is informed by thorough assessment and the active participation of children, families, and key stakeholders. Gatekeeping always considers which placement option offers the greatest chance of permanency, with preference given to reunification with a child’s family of origin, and to keeping sibling groups together whenever possible.
Preparing Children and Families
The transition to family care can be a complex process for children. Every child and family needs proper preparation to minimize trauma, maximize the experience of positive change, and increase placement success.
Regardless of the type of family placement, all children need to be prepared with special consideration of their age and ability. Preparing children for placement includes adequate opportunities to explain the reason for the transition and to listen to children’s views, hopes, and hesitations. Even for a child who is looking forward to placement, there are aspects of adjustment and loss.
Families need time and resources to prepare for receiving a child, and preparing a family for a child’s placement involves parents, siblings, and others in the household. Families need to know about the child’s background and have a thorough understanding of the placement process and care plan, including identified support services and follow-up visits. They have opportunities to ask questions and share information, and know who to contact to share challenges, problems, questions, and success stories. If the family has never cared for children before or has not parented in a long time, additional training in parenting skills may be necessary, especially to care for children who have special physical, behavioral, or emotional needs.
Placement preparation may include family visits and supported reconnection, counseling and psychosocial support, provision of material support and linkage to basic services (e.g., income, employment, housing), and preparation for community integration (e.g., schooling, day care, rehabilitation services, health services).
Monitoring Child Placements
After a child is placed into family care, regular follow-up visits (or “case monitoring”) allow a trained case worker to monitor the child’s well-being and adjustment. Case monitoring may include assessing family support services to determine if they are meeting needs, engaging with teachers and service providers who can give insights into the child’s adjustment, and encouraging children and family members to share their views and concerns (individually and confidentially to ensure their full views are heard). Any issues will be addressed immediately by appropriate follow-up, such as linking the child or family to relevant services. If serious issues such as child abuse are suspected, the child may be transferred to a short-term placement or foster family until the situation can be more fully assessed and remediated.
A child’s case is “closed” when the goals and objectives, including the permanency goal, of the care plan have been met and the long-term protection and care are reasonably assured, or the child has reached an age of independence and can be reasonably expected to have success living independently (care leaving). As in all other steps, closure includes discussions with other professionals, family members, and the child to ensure that everyone is prepared for and in agreement with the closure, and that there is understanding of where and to whom to turn if help is needed in the future. In many cases specialized services or support can continue. A case can be reopened any time a serious concern is raised and substantiated.
Reintegration of Children with Disabilities
Children with disabilities make up a higher percentage of the children in residential care around the world, and they can face additional vulnerabilities. During the transition, individualized care plans need to include further considerations that support children with learning challenges or physical disabilities. In situations in which discrimination may be an issue, identify people of influence within the community, including faith leaders and school and government officials, in addition to caregivers, who can respond appropriately within the community.
It is important to note that special services, rehabilitation, therapies, and supported school integration are all important aspects of care planning, during all phases of the transition process. Families need to have sufficient community supports in place to care for the children. These may include trauma healing and psychological care, assistance integrating into school, special day services, equipment or physical aids (such as wheelchairs or hearing aids), specialized training for families (such as children’s care or how to communicate through sign language), and respite care for caregivers.
Reintegration of Special Populations and Emergency Settings
Some children transitioning to families may come from unique situations in which they were particularly vulnerable and may require special attention and support. These include children who entered residential care after experiencing trauma or exploitation in the form of trafficking, child labor, street living, natural disasters, conflicts, or forced migration. Family tracing and supported reunification or alternative family care are much more effective responses for decreasing the vulnerability of children than the placement of children in residential care.
Individualized care plans for these children may include trauma healing, psychological care, assistance integrating into school, specialized training for families, or respite care for caregivers, ultimately leading to family care.
Special resources and efforts are needed to assess and reintegrate children who have been separated from their families during emergencies. Temporary foster care or short-term emergency group homes may offer a small-group atmosphere for children to receive assessment and treatment prior to being transitioned into a more permanent option.
In situations in which discrimination may be a serious problem, such as children affected by HIV and AIDS, children who have been sexually exploited, or children associated with armed forces or groups, identifying and responding to stigmas within the community will involve engaging people of influence in the community, including faith leaders and school and government officials, in addition to caregivers.
