Study Review

Kinship care

An alternative to foster care or residential care that means a child can live with a family member or sometimes a close friend

Outcome Overall

This rating shows how effective the intervention is at achieving the evaluated outcome.

Click here for information about how effectiveness ratings are applied.

Strength of

This rating shows how confident we can be about a finding, based on how the research was designed and carried out.

Placement stability Overall effectiveness: 1 (maximum 2) Strength of evidence : 3 (maximum 3)

Headline points

  • This summary comes from the original systematic review: Winokur, M. A., Holtan, A., & Batchelder, K. E. (2018). Systematic review of kinship care effects on safety, permanency, and well-being outcomes. Research on Social Work Practice, 28(1), 19-32
  • Overall, kinship care showed a positive effect on placement stability and this was based on high strength evidence
  • Children in kinship care were more likely than children in foster care to achieve permanence through a court order, less likely to be adopted and less likely to have social and emotional problems
  • There were no clear differences between kinship care and foster care in relation to other outcomes including reunification, length of placement stay or educational attainment

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What is this?

Kinship care is an alternative to foster or residential care. It’s a care arrangement that means a child can live with a family member or sometimes a very close friend. In the UK it can come about from a formal arrangement (i.e. through social work intervention including within court proceedings ) or an informal arrangement made by the family.

How is it meant to work?

Kinship care is thought to have several potential benefits for children. These include letting them live with someone they know and trust, and increasing their feelings of identity and belonging.

There is increasing research looking at different aspects of kinship care, including studies examining how the outcomes for children in kinship care differ from those with other care arrangements.

What are the evaluated outcomes?

  • Placement stability

How effective is it?

The effects of kinship care were reviewed in relation to 23 individual outcomes. Some of these focused on care outcomes, with issues relating to placement stability and permanency. For example, number of placements, length of stay, disruption, reunification, and adoption.

The others focused on other child outcomes, including behavioural development, mental health, educational attainment, family relations, service utilisation and recurrence of abuse and neglect.

Placement stability

Overall, kinship care tended to show a positive effect on placement stability. This is based on high strength evidence.

There is a significant link between being placed in kinship care and having fewer placements and less placement disruption. The odds of having three or more placement settings were 2.6 times higher for children in foster care as compared to those in kinship care.

For example, if 50 per cent of the children in foster care had three or more placements, this would apply to only about 25 per cent of those in kinship care. Children in foster care had 1.9 times greater odds of having a placement disruption.

Permanence outcomes

The odds of those placed in foster care being adopted were 2.52 greater than those placed in kinship care. The odds of achieving permanence through a court order were 3.8 higher among children in kinship care. There was, however, very little difference between the likelihood of family reunification between children in foster care and children in kinship care.

Behavioural and mental health outcomes

Several outcomes relating to child behaviour and mental health were considered. Children in foster care had 1.6 times greater odds of reporting social and emotional problems than those in kinship care. They were also found to have 3.7 times higher odds of experiencing re-abuse.

The odds of children placed in foster care experiencing a psychiatric disorder were two times that of those in kinship care. Children in foster care had 2.4 times the odds of receiving mental health services. The odds of those in kinship care reporting positive emotional health were also twice as great as those in foster care. There were not significant differences found in educational attainment, attachment and the use of health services.

Evidence strength

Kinship care is difficult to evaluate because of the inherent differences between children who use it and those who don’t. This means that the evidence base cannot benefit from some of the more robust research methods (e.g. randomised controlled trials). It is important to note that the differences in outcomes described above cannot always be attributed to kinship care alone; there may be other differences between families that are influencing these findings. The evidence strength reported for placement stability is high, as the review used sound techniques to analyse the quasi-experimental literature.

Where has it been studied?

The vast majority of studies (89 of 102) were conducted in the USA, so further research is necessary to understand how well these findings about kinship care translate to the UK.

Who does it work for?

Decisions to use kinship care were, of course, based on suitable circumstances and the availability of kinship carers.

Therefore the differences in outcomes shouldn’t be attributed to the effectiveness of kinship care alone. There may be other differences between families that result in both appropriate kinship carers being available, and in differences in outcomes.

When, where and how does it work?

Studies have so far focused on the overall relationship between kinship care and outcomes and not on the mechanisms or circumstances that affect them.

Some research investigating the factors associated with positive outcomes would be a natural next step. For example, examining the different characteristics and needs of children entering kinship care, compared to those who enter foster care.

What are the costs and benefits?

There is currently no information on the cost-benefit of kinship care.

How is it implemented?

More qualitative research is needed on how kinship care works and how it might best be supported. We have not included implementation information here because kinship care isn’t a standardised intervention that can be summarised in this way.

Research has shown that arrangements for supporting individual kinship care and special guardianship placements in England vary considerably. Instead we have summarised some key findings from research about factors that affect the success of kinship care placements.

Key findings from research: factors that affect the success of kinship care placements

Research by Selwyn et al. (2013) found that some of the main challenges affecting kinship care placements were:

  • Most kinship carers live in poverty, often as a result of their caring responsibilities
  • 70 per cent of carers had a long-standing health condition or disability
  • Around two thirds of carers were clinically depressed (and many were affected by bereavement)
  • Carers and children often had difficult relationships with the children’s birth parents
  • Coping with children’s emotional and behavioural difficulties (a third of children in kinship care had abnormal levels of difficulty)
  • A lack of support from family members and Children’s Services.

Research on the use of Special Guardianship Orders (SGOs) in England by Wade et al. (2014) has found that these placements are more successful when children already had a stable relationship and emotional bond with their carer before the SGO was made. Children were more likely to experience a disruption if:

  • They were older when the SGO was made
  • Their last placement prior to the SGO was with a stranger rather than a relative
  • They were not already living with the carer to whom the SGO was made
  • The emotional bond between the child and their carer was not strong at the time of the SGO
  • They had experienced higher numbers of placement moves before the SGO.

In summary...

  • Clear differences can be seen in several outcomes of children placed in kinship care compared with those placed in foster care
  • Overall, kinship care showed a positive effect on placement stability and this was based on high strength evidence
  • Children in kinship care were less likely to have emotional and behavioural problems. They were also less likely to use mental health services or to be the victims of further abuse
  • Children placed in foster care were more likely to be adopted than those in kinship care, while children in kinship care were more likely to have relatives assume permanent legal orders for them
  • There were no clear differences to other outcomes including reunification, length of stay in placement or educational attainment, family relations and use of health services.
  • The majority of this research was carried out in the USA

Further resources

This summary comes from an original systematic review called:
Systematic review of kinship care effects on safety, permanency, and well-being outcomes. Research on Social Work Practice. 28(1), pp.19-32
(Winokur, M.A., Holtan, A. and Batchelder, K.E.)
Published 2018