Select Page

Session 9/13

Page 2/5: Introduction: Placement types and care quality

Introduction: Placement Types and Care Quality


Group care is often compared to family based solutions: foster and kinship care, and support programs to help parents and communities avoid placement. But what are really the positive and negative effects of group and family based placement?

In 2009 UNICEF urged governments to close all orphanages in favour of foster and kinship care. The main reasons were that worldwide, eight out of ten children have live parents who sent them to orphanages because of poverty to give them better lives. Also, research in extremely bad Eastern Europe orphanages had shown devastating effects of institutionalisation. In some developing countries, criminal organisations used children for trafficking, child labour, and stealing children from parents to be sold for adoption.

These negative effects mainly happened because most governments provided little or no support, education and quality control for institutions. A final reason is that in industrialized countries, work hour legislations cause many shifts in caregivers during the day and week, making continuity in relations between caregivers and children very difficult to provide.

The positive sides of group care have been overshadowed by this policy. Group care staff are more often professionally educated and more able to provide long term care for mentally and physically disabled children, as well as children with severe attachment and behaviour problems. In many developing countries foster care is unknown and children without blood relatives rarely get the chance to be placed in a foster family. Research shows that foster families very often break down or expel these children, due to emotional stress. Another fact is that due to disaster, migration, war and drug epidemics, the huge numbers of children without parents makes anything but group care impossible for authorities.

The global de-institutionalisation process takes place very fast in some countries and creates enormous pressure on foster care systems. In many Eastern Europe countries, unprepared foster parents received eight to fourteen children placed from closed institutions, and there are still governments that have not built any kind of support, control, or special needs education systems for family based care. Recruiting foster families is a major challenge. Children who have returned to parents often run away because they still have dysfunctional parents, or are rejected by their community. What does research say about placement?


Children younger than three years tend to attach as successfully to foster parents as to parents. For this reason European legislation places all babies and toddlers in foster care.

The older children are and the more deprived they were before first placement, the more professional group care is to be prefered – half of foster care placements for this age group break down before planned.


There is no scientific evidence that foster care produces better outcomes than group care (McCall, Bryderup, a.o.). Sixty years of international research shows five simple principles that caregivers in any placement type must provide:

  • A long term relation to one or two adults – preferably also after leaving care. Care-leavers are more successful if they leave at age 23 instead of age 18. Other studies show that the more children shift placement, the poorer their lives as adults.
  • The child must be an accepted member of a long-term group of peers. The peer group must be guided by adults to avoid negative group development.
  • Daily child group size should be less than five in foster care, and less than eight in group care. Small groups with the same caregivers have lifelong benefits, and institutions can be divided into small group home units.
  • Children must have supervised and trained caregivers with relevant knowledge. The more foster parents and staff lack this, the more frequent conflict, force and abuse is.
  • Absence of conflict between those the child is attached to, or who can take decisions about its life. Agreement between parents, between foster parents and case manager, between staff and staff leader, school and home, etc.


In Denmark only 36% of children in placements pass 9th grade exam and education because of society´s challenges in fulfilling these five principles. In SOS Children’s Villages, children have one SOS mother while they grow up in groups of four to ten, and learn to see each other as lifelong siblings. This is the main reason why 80% of 51.000 village children pass 9th grade, and 14% have academic careers. A secure base has enormous significance for learning.

How can we enhance continuity in our mind-sets, daily practices and work plans?

How can we guide and enhance healthy peer group relations in our work?

In this session, there are two important group dialogues: a practical one about promoting stable and long-term relations between children and adults, and a dialogue concerning committing relations between staff and children/youth and in the group of children in care.