Purpose– The purpose of this paper is twofold: first, to report results from a quasi-experimental study of outcomes of a leaving care project for youth placed in secure unit care and second, based on the (zero) results, to analyse and discuss the interplay between organisational boundaries, social work and the target group when implementing a project such as the one studied.

Design/methodology/approach– The outcome study had a quasi-experimental design. The young people in the leaving care programme were compared with a matched reference group who did not get the special leaving care services. Data were collected (structured Adolescent Drug Abuse Diagnosis-interviews) when the young people entered secure units and on follow-up (registered crime and re-entry into care).

Findings– The outcome study showed that the leaving care project had no effect on the young people's situation at follow-up regarding re-offending and re-entry into secure unit care. This is understood and discussed in relation to the poor implementation of the leaving care project along with an inbuilt conflict between state and local municipality that overshadowed the good intentions of the project.

Research limitations/implications– The effect study has a quasi-experimental design, and hence differences between the project group and the comparison group at T1 cannot be fully precluded, although nothing is pointing in such a direction. The unclear content of the intervention makes it difficult to decode how the variation in the support given to the young people eventually impacted the results. The zero-results apply to group level, but that may not be valid for each and every one in the project.

Practical implications– According to earlier research, a key person following young persons through different phases of the care trajectory may be of importance. Learning from the CoC project, one can conclude that such a key person should preferably take the role of advocate for the young person, and not be an administrator mainly concerned with coordinating other professionals. Further, when planning and financing is split between organisations, that split hinders efforts to actually mobilise support for young people leaving secure unit care.

Originality/value– Few leaving care services are designed for youth with severe behavioural problems and hence, the research is scarce. This study contributes with important knowledge about leaving care interventions for the target group.

In Sweden, the recent debate on youth crime has focused on strengthening repressive measures. At the same time, government work is underway to strengthen children’s rights. Young people who are placed for the purpose of care in secure youth care (locked institutions) are placed at the intersection of these two trends. Starting from a critical children’s rights perspective, we explore how young people understand rights in a secure care environment and discuss how these understandings relates to central principals, laws and conventions. We start from the concrete situations and contexts in which rights are to be realized in order to contribute to a better understanding of the importance of rights in a secure care environment. The empirical data consists of 15 youth interviews, at four institutions. Three understandings of rights are identified; rights as tokens where rights are seen as something symbolic and without meaning, rights as self-responsibility where rights are seen as conditional on the young people’s actions and, rights as fundamental value where rights are understood as respect for one’s own and others’ human dignity, regardless of their actions. The three understandings of rights can be linked to different care contexts and to the relationship between staff and young people. Taken together, the young people’s understandings highlight the importance of basic principles of dignity and respect on equal terms, as well as the right of children deprived of their liberty to be helped to reintegrate into society. Implications for the operation of secure youth care are highlighted.

In this paper we present a comparative analysis of out-of-home care in Australia and Sweden. We compare the age structure of the out-of-home care population and the types of out-of-home care services provided to children and young people in both countries. Our analysis reveals that in Australia the out-of-home care service system is focused mainly on children who are deemed to be abused or neglected within their families, while in Sweden the majority of the out-of-home care population are teenagers who cannot live with their families for emotional or behavioural reasons. These population differences intersect with variations in the forms of service provision in both countries, with a much greater reliance on home-based care in Australia than in Sweden, while there is more extensive use of residential care in Sweden. We envisage that this paper will demonstrate how the age structure of the out-of-home care population, though rarely considered in international comparative child welfare research, reveals much about the assumptions on which State intervention with children and young people is based. We intend that this analysis will assist social workers to better understand and address the gaps in the quality and comprehensiveness of out-of-home care service provision to children and young people in both countries.

In recent decades, Swedish out-of-home care has been criticised for a number of reasons. In this article, based on research and public debate, we discuss this criticism as well as the institutional responses that have been evoked. We use the concepts of risk, control and trust to structure the analysis, which outlines three core issues portrayed as problematic: a) certain principles of the Swedish child welfare system with relevance for the placement of children and adolescence, b) the quality of out-of-home care and c) the privatisation of out-of-home care and the possibility of generating profits on such services. The institutional response to the criticism has mainly been increased control measures, but the development is not uniform - trust and control-oriented responses are often combined. We conclude the article by relating Swedish out-of-home care to international child welfare trends, discussing the institutional responses and the implications for social work practice.

I artikeln presenteras en undersökning av hur barn som är placerade i dygnsvård upplever sin situation. Det visar sig att de allra fl esta är nöjda men att det finns grupper som inte trivs i sin vårdmiljö. Särskiltmissnöjda är flickor i institutionsvård. Barns upplevelser av vården diskuteras också i förhållande till andra sätt att mäta kvalitet och utfall.

The inner core of child protection – on coercive placement motivated by abuse or neglect

This article is about emergency placement due to child abuse or neglect. Empirical data consists of judgements on coercive care in three administrative courts (n=211). Motives for placements are analysed against the background of the discursive changes that have taken place with regard to definitions of child abuse as well as today’s strong focus on risk and risk assessments. Results show that there were a number of motives to justify the court’s decision in each individual case. However, the broadening of the concept of abuse in research and in general discourse is evident in the judgements. We raise the question whether this matter, in practice, has resulted in more children being cared for because of an expansion of the concept of violence. As for risk assessments, two types of causal reasoning can be identified: situations where the child has been abused or neglected and where the risk assessment is about the probability that the problems will continue, and situations where the child has not been harmed but risks being harmed in the future. However, risk assessments are not that elaborate and systematic as presupposed in legislation. Taken together, the findings call for a discussion both within the justice system and in social work.

Familiepleje I Denmark by Bryderup, Engen and Kring (2017) is a very ambitious piece of work. The book has more than six hundred pages, and includes a Danish national empirical study of foster carers and foster children, the historical and socio political context of this type of care, a comparative sub study of care in Norway, Sweden and England in relation to Denmark, as well as an extensive review of research on foster care and children in placement. According to the authors, too little is known about the foster care system and the children in it. Therefore, the overall aim of the book is to bring knowledge to a field with big knowledge gaps.

Hvb, hem för vård eller boende, är kanske det fält inom välfärdsområdet där privatiseringarna gått som längst. Avkastningen är mycket hög, 20 procent. En siffra som sticker ut.

Under rubriken ”Ungdomshem en guldgruva”, kunde Dagens Industri för fem år sedan konstatera: ”Boende för barn och ungdomar är en lönsam nisch för vårdbolag. Miljonvinsterna fortsätter att rulla in även om ett stundande vinstförbud hänger som ett mörkt moln över branschen”. Idag kan vi konstatera att något mörkt moln inte längre hänger som ett hot, vinstbegränsningar har i det stora hela försvunnit från den politiska dagordningen. Men hur är det då med själva vinsterna? Den frågan och hur det gått till när hvb-vård blivit ett fält för privata företag diskuteras i den här artikeln.

Denna artikel tar utgångspunkt i ett socialpolitiskt perspektiv och analyserar hur barnavårdsproblem över tid kopplats till klass, kön och etnicitet. Hur har dessa faktorer behandlats i officiella texter om barnavård under 1900talet och hur framstår de i offentlig statistik?

This article investigates siblingcontact among Swedish fostered children in foster and residentialcare. The study also examines a potential link between siblingcontact and psychosomatic status. Highly structured interviews were conducted with 240 young people (13–18 years) in out of homecare. Results show unfulfilled desire for siblingcontact among children in Swedishout-of-homecare. Nearly 40% of the children interviewed see their siblings more seldom than monthly and a good half of the children—more girls than boys—want more siblingcontact. The longer the time the children have spent in care, the greater is the risk of being without contact with brothers and sisters; and the more seldom the children see their siblings, the more they crave contact. The Swedishfamilyservicesystem is obviously no guarantee of fostered children keeping their desired contact with brothers and sisters. Thus, an important task for social workers and others involved in the life of separated children is to open opportunities for contact—if the children want it. From achildren's rights perspective, it is fundamental to facilitate siblingcontact among fostered children according to their own wishes.

Utvärdering av en förstärkt vårdkedja för ungdomar som vårdats vid SiS-institution, är en forskningsrapport som skildrar försöket med förstärkt vårdkedja för ungdomar som lämnar särskilda ungdomshem. Bakgrunden till försöket är de svårigheter som ungdomar står inför när de avslutar vårdperioden vid SiS. En central del i vårdkedjeprojektet har varit de särskilda samordnare som haft till uppgift att utgöra en länk mellan ungdomarna, deras familjer och inblandade myndigheter. Vårdkedjeprojektet omfattade placeringar från 15 kommuner och bestod, utöver tillsättande av samordnare, av en subvention på dygnsavgiften till SiS.

För att undersöka resultatet av samordnarnas arbete har ungdomar med eller utan samordnare jämförts. Utfallet har undersökts med hjälp av tre datakällor: (1) ungdomarnas uppgifter om hur de har det cirka ett år efter utskrivning, (2) hur många som återinskrivits ett år efter att de lämnat institutionen och (3) brottslighet två år efter utskrivning. Dessutom har samordnarna fyllt i enkäter om innehålleti sitt arbete.

Den samlade slutsatsen pekar på att ungdomar som tagit del av satsningen med samordnare inte fått en bättre situation än jämförbara ungdomar med ”vanliga insatser”. Denna förhållandevis säkra slutsats begränsar sig dock till återfall i brottslighet och återinskrivningar till SiS.

The field of residential care for children and youth in Sweden is often termed unstable and turbulent. During recent decades the field has been subject to many changes. In this study, the development and changes in the field of residential care for children and youth in terms of ownership structure and treatment ideas will be analysed. The study is particularly focused on the changes in ownership structure that have taken place during the 2010s. It also analyses changes in treatment ideas, and discusses how these may relate to transformations of ownership structures as well as to dimensions of institutional logics, such as legislation and other types of normative pressure from the environment.

The result reveals that of the approximately 450 treatment oriented residential care units (excluding homes for refugee children), close to 80 % are today run by private companies and to a growing extent by large for-profit corporations. Parallel – and possibly related – to the changes in ownership structure, the dominant treatment ideas have changed over time. The changes in the field can be summarised as a transformation from small-scale establishments with a family logic, to large-scale establishments with a professional logic, or more specifically from a domination of small family run units with milieu therapy to big business and a focus on evidence based interventions.

This article analyzes the transformation of Swedish residential care homes for children from a regionally coordinated, public social service system into a thin, but highly profitable, national spot market in which large corporations have a growing presence. Marketization and privatization are theorized as complex processes, through which the institutional structure and logics of this small, but significant, social policy field changed profoundly. Using official documents, register data, media reports and existing research, three consecutive phases in the development of the children’s home market are identified since the early 1980s. Change was driven on one hand by policies inspired by New Public Management, which shifted public authority horizontally to the private sector, and vertically to local authorities (funding) and to the state (regulation). On the other hand were responses of local authorities and private actors to the changing incentives that policy shifts entailed. During the first two phases, both the proportion and size of for-profit providers increased, and the model of family-like care was replaced by a professional model. Cutting across the trend of privatization in the third phase was establishment of a parallel system of homes for unaccompanied refugee children – mostly in public ownership. Similarities with privatization in the English system of children’s care homes are noted. By showing how the Swedish market for residential care has been created by policy and by actors’ responses to those reforms, the article provides a foundation for thinking through how the predictable, significant and well-documented problems of such care markets might be addressed.

Foster care is the most common intervention for children who are placed in out-of-home care. At the same time, there are recurrent discussions about difficulties in recruiting foster homes. The preconditions for recruitment have changed and today, there is an increased competition for foster homes between municipalities and private businesses, stricter requirements placed on foster parents and changes in the needs of children placed in care. The aim of the article is to analyse the recruitment of foster homes in light of these changed preconditions. Empirically, the article is based on a survey targeting Swedish municipalities. The findings show, that although a majority of the municipalities have employees particularly responsible for recruitment, small municipalities often lack such resources. Further on, almost three quarters of the municipalities state that it is difficult or very difficult to recruit foster homes. For example, answers to the survey’s open questions demonstrate that competition from other municipalities and private companies affects recruitment. Further on, the municipality’s reputation is considered an important factor for attracting new foster homes. Finally, it appears to be difficult for municipalities to recruit a varied supply of foster homes and, in particular, homes that can care for children with special needs. The findings are discussed in relation to previous international and Swedish research. Finally, suggestions regarding how recruitment may be improved are presented. 

The study presents an overview of the historical growth and deve-lopment of residential care for children and youth in Sweden as well as an analysis of the present-day structure and organisation. The empirical material consists of official statistics, government reports and data from a questionnaire addressed to all registered residential homes in the child welfare sector at the end of 1995. The history of residential care for children and youth is marked by a period of establishment and expansion in the first decades of the last century, followed by a process of major de-institutionalisa-tion in the period after the Second World War. A third phase was introduced with the Social Service Act of 1980, which laid down new premises for child welfare. Traditional concepts of children’s homes were replaced in the legislation by the “HVB-home” and the dividing line between institutions and foster homes became blurred. The study shows that contrary to what was intended, a growing part of out-of-home placements during the 1980:s and 1990:s where into residential care. In fact, residential care has taken over “market shares” from foster care in Sweden. Analysis of the range of alternatives shows that residential care today is relatively small-scale and that nearly all of the smaller units are privately run. Approximately half of the homes have teenagers as their target group and most homes work with longer-term pro-grammes of treatment and care. Educational background among staff varies considerably, but in general the level of educational is low. So far, no professional forces have proved strong enough to organise the field on a mutually knowledgeable, normative ground. A problem is the lack of unanimous concepts and a common language with a terminology that can be used for a systematic de-scription of the care or treatment given. What is clear, however, is that a new form of residential care can be identified – so-called hy-brid homes that are somewhere in between extended foster homes and small institutions – and that these homes have gained a con-siderable position in the field.

The field of residential care for children and youth in Sweden is fragmented; there is a diversity both in terms of ownership and in terms of therapeutic content. This article analyses how decisions regarding therapeutic content are made in residential care settings. The data consists of interviews with representatives of different types of residential care organisations. The results indicate that the field is impacted by different logics as well as multiple actors and environmental elements shaping the prerequisites for decisions about therapeutic content. Local managers have substantial discretion in deciding which models and treatments that should be used in their settings and they can in that capacity be viewed as key actors in the field. The decisions of managers are influenced by a mix of professional and market logics, but there are also some traces of a family logic. Signs of a professional logic can be discerned in claims about models and treatments viewed as evidence-based and/or locally evaluated, but such claims are also perceived as competitive on the market. A gap between descriptions of models and treatments and actual practice is acknowledged by managers and believed to be fuelled by procurement processes and market considerations.

Privata aktörer har en framträdande roll inom flera av socialtjänstens verksamhetsområden, något som påverkar förutsättningarna för arbetet. Forskningen har pekat ut flera problem som är förknippade med den typ av marknadsförhållanden som råder på socialtjänstområdet. En försvårande omständighet är att de som direkt berörs av socialtjänstens insatser är en socialt selekterad grupp med svag samhällsposition och med starkt begränsade möjligheter att utöva någon form av konsumentmakt. I kapitlet diskuteras privatiseringens omfattning och konsekvenser, samt i vilken riktning man ska tro att utvecklingen går i framtiden.