‘Well, it’s up to me now’ – young care leavers’ strategies for handling adversities when leaving out-of-home care in Sweden

Abstract

This qualitative longitudinal study of 20 young Swedish care leavers investigates their subjective experience of and strategies for handling adversities when being in the process of leaving out-of-home care. The empirical data is based on two sets of interviews, the first conducted at time 1 (T1) when they were still in care but the moving out process had begun, the second (T2) 6–10 months later when the vast majority had left care. The thematic analysis based on resilience theory showed that the majority of the informants over time developed process-oriented strategies, which in our categorization emanated either from the inner world of the informants (e.g. through re-framing of experiences and an emerging self-reliance) or from their outer contextual world (e.g. through a restructuring of the social network). The results are discussed from a resilience theoretical perspective in which the informants’ strategies are illustrated by the conceptual pair of ‘navigation’ and ‘negotiation’, used to make sense of their inner and outer world-oriented strategies.

Keywords:

• Leaving care
• longitudinal studies
• resilience
• young people
• handling adversities

Introduction and previous research

A strong body of research shows the vulnerability of young people making the transition from public care to independent adulthood (Courtney and Dworsky 2006; Crawford and Tilbury 2007; Hjern, Vinnerljung, and Lindblad 2004; Stein 2012). Young people in care have been shown to originate from socially disadvantaged families in terms of class, gender and ethnicity (Egelund 1997) and often lack access to support from their families during the process of transition (Biehal and Wade 1996; Lundström and Sallnäs 2009). Compared with young people in general their moving out process is described as ‘accelerated and compressed’ (Biehal and Wade 1996; Stein 2012) and as representing ‘instant adulthood’ (Rogers 2011) because their transition to adulthood is shorter and occurs at a younger age compared with their peers (Höjer and Sjöblom 2014; Stein 2005, 2012). Quantitative studies show that care leavers face problems with instability in housing (Courtney et al. 2011), unemployment (Courtney and Dworsky 2006) and poor school performance (Berlin, Vinnerljung, and Hjern 2011), and an increased risk of: being involved in crime, suffering from mental health problems (Vinnerljung and Sallnäs 2008) and committing suicide (Hjern, Vinnerljung, and Lindblad 2004). Qualitative studies report care leavers’ fear of being socially isolated and their lack of practical and emotional support after leaving care (Höjer and Sjöblom 2010, 2011, 2014). To sum up, these findings show both poor outcomes and risk factors for young people leaving care.

However, longitudinal studies with focus on care leavers’ subjective experiences show more diversity in the outcomes over time (Andersson 2008; Mølholt 2017). Research has also focused on supportive factors that can help vulnerable groups of young people and care leavers to be resilient and cope with adversities. In a comprehensive international research review on young people with antisocial behaviour (Rutter, Giller, and Hagell 1998) resilience was associated with: a warm and secure relationship with at least one parent or parent-like person, positive experiences of education, ability to plan for the future, a sense of being in control of their life, experiences of positive relationships with peers, and the possibility of achieving a positive turning point in life. Another literature review, focusing the transitions in challenging life situations for young people in general, reported resilience to be associated with ‘the capacity to re-frame adversities so that the beneficial as well as the damaging effects are recognized’ (Newman and Blackburn 2002, 2). This implies a way of understanding challenges not merely as obstacles, but also as opportunities to develop coping and problem-solving skills. Newman and Blackburn also report the importance for young people of having a feeling of mastery and a conception that their own effort has an impact on what is happening in life as a factor for promoting resilience (Newman and Blackburn 2002). Research focusing specifically on resilience during the transition out of care for young people has reported results in line with previously mentioned studies on resilience among young people in the general population. Studies on care leavers have shown that resilience is promoted by stability in care (Jones et al. 2011; Stein 2012), opportunities for a delayed transition to adulthood (Wade and Dixon 2006), participation in decisions concerning one’s own future (Stein 2012), and access to formal and informal social support (Wade 2008).

In this study we focus on care leavers’ subjective experiences. The aim is to investigate young care leavers’ subjective experiences of handling adversities when leaving out-of-home care. Which strategies do they use to handle challenges they face during different phases in their transition from care to adulthood? To what extent do these strategies promote resilience?

Theoretical approach

Resilience is a relevant theoretical perspective when studying young people in vulnerable situations handling obstacles. Resilience can be described as ‘overcoming the odds’ and finding ways to handle adversities and exposure to different risk factors (Stein 2005).

In a review of the development of resilience research over the last 50 years, Masten (2007) concludes that the focus has changed from the individual to the system in which the individual develops. Using a ‘system approach’, Rutter (1987) argues that promoting resilience means focusing on processes and mechanisms rather than on personal characteristics. This can open a broader scope for exploring resilience-promoting processes and mechanisms located both within and outside of the individual (Rutter 1999; Schofield and Beek 2005), i.e. involving both internal reflective and external contextual capacities. According to Schofield (2001), a child’s inner world processes can be illustrated by the capacity to reflect on a failure in a school assignment, and the outer world processes by the child actively looking in the surroundings for help with the next assignment.

Ungar (2008, 2011) argues for an ecological and process-oriented definition of resilience by proposing the conceptual pair of navigation and negotiation. Ungar suggests an agency-oriented view, in which navigation occurs towards psychological, social, cultural and physical resources in the surrounding community and negotiation takes place to make these resources meaningful. This suggests claiming active agency in one’s own life, a resilience- promoting factor in itself (Newman and Blackburn 2002), but it also suggests orienting towards support from the surrounding system.

The concept of resilience allows us to study both inner and outer worlds, thus increasing the understanding for complex processes in human lives (Schofield and Beek 2005) such as transition out of care. Fergus and Zimmerman (2005) likewise make the distinction between outer and inner worlds by referring to assets for promotive factors residing inside the individual (self-efficacy, coping skills, competence, etc.) and resources for promotive factors external to the individual (parental support, adult mentoring, the social network, etc.).

This theoretical point of departure provides the opportunity to understand young care leavers’ experiences, not only of adversities, but also of how they navigate and negotiate to overcome these adversities during their transition to adulthood.

Method and analysis

The data is based on two sets of interviews from a qualitative longitudinal study in which 20 Swedish care leavers (aged 16–21) were followed from December 2014 to January 2017. A purposeful sampling strategy (Patton 2015) was used to recruit informants who could provide substantial information regarding the research questions. We contacted 60 social workers who had a professional relationship with young people matching the inclusion criteria, which were: having experienced at least 1 year in placement in public care, having started the process of moving out of care, and age 17–20. ¹ The social workers forwarded the initial question of participation to potential informants. The majority of those interested had their contact information forwarded through the social worker to the first author and a few contacted the first author directly. At the first contact with the researcher they were informed about the purpose of the study and ethical issues such as confidentiality, voluntariness and the right to withdraw from the study at any time. Signed informed consent was obtained from all participants. The study was approved by the Swedish regional ethical committee (2014/213; www.epn.se).

In total, 27 young care leavers matching the inclusion criteria were requested to participate in the study, 24 of whom participated in the first interview (at T1). Reasons for dropout at T1 were not wanting to tie themselves up in a longitudinal study (n = 2) and travelling abroad (n = 1).

Twenty care leavers participated in the second interview at T2, and constitute the sample for this article. The reason for dropout between T1 and T2 was not having the time or desire to continue participating (n = 2), or not responding (n = 2). Those not responding had at T1 been in placement several times for severe drug abuse and criminality and one explanation for their failure to respond could be a lifestyle with continuous severe problems, a well-known obstacle to participation among vulnerable groups (see, e.g. Liamputtong 2007). On the other hand, these kinds of troubles were also experienced by several of the care leavers who did participate in both interviews. Therefore, the participating informants did not seem to be less plagued by problems than the non-participants. However, as the informants had initially been selected through previous contact with social workers there is a risk that data could have been ‘biased’ towards more successful narratives of leaving care. Furthermore, we cannot preclude that those asked who refrained from participating would have reported different experiences. Nevertheless, we consider the thick descriptions of the informants’ narratives as relevant in assessing the transferability of our findings. The narratives give us a profound insight into their subjective experiences and can, as such, constitute important data that can be evaluated by other researchers and that can possibly be ‘transferred’ to other contexts (cf. Lincoln and Guba 1985).

There is an overrepresentation of men (65%) in the sample, which corresponds with national statistics on adolescents in out-of-home care (63%) (Swedish National Board of Health and Welfare 2015). However, the majority of the informants (60%) had been in residential care compared with only 30% on a national level, where the most common form of out-of-home care being foster care (70%). Time in care in our sample ranged from 1 to 15 years (3.6 years on average).

The most common pattern of accommodation at T2 was to have moved from care to a rented apartment (n = 11). Other living options after care were having moved in with the family of origin (n = 4) or into a halfway house (n = 2), or being homeless (n = 1). Two informants were still in care. Regarding work/education, half of the informants were still in upper secondary school (n = 9), while the other half were entering working life as full or part-time employed (n = 5), had been enrolled in government unemployment projects (n = 2), were unemployed (n = 3), or were on general sick leave (n = 1). At T2 the majority were still in contact with the social services (n = 13).

Both at T1 and at T2, semi-structured interviews were carried out by the first author with the overarching purpose of getting thick descriptions (Patton 2015) of the informants’ subjective experiences of their transition out of care. The first interview was carried out face to face when the informants were still in care but the moving out process had begun. It was guided by the aim to obtain narratives on six overarching themes: subjective health; being in placement; the present life situation; planning for the transition to independent life; availability of social support; and future plans. Besides questions covering background information (e.g. age, and time in and reason for placement), both interviews mainly contained open-ended questions, such as ‘How would you describe your life situation today?’ The second interview was conducted by phone 6–10 months after the first interview, by which time the vast majority of informants had left care; it addressed the same themes as at T1 with the addition of the themes transition from placement; challenges and support during the transition; and establishment in adult life. Both interview guides were inspired by and developed from earlier research projects aimed at similar informants yet adapted to the theoretical and longitudinal aspects of this specific project. The second interview constitutes the primary data for this article, and later guided the analysis of interview one. The first interview lasted about an hour (range 45–75 min) and the second, half an hour (25–35 min). Both interviews were recorded and transcribed in full.

The transcripts were analysed using thematic analysis (Braun and Clarke 2006) with the purpose to condense the content and seek recurrent patterns. Thematic analysis differs from comparable pattern-seeking qualitative analytical methods such as interpretative phenomenological analysis (Smith and Osborn 2003) and grounded theory (Corbin and Strauss 2015), by not being bound to a theoretical framework or a fixed epistemological position (Braun and Clarke 2006). The analysis was conducted in five phases in accordance with Braun and Clarke (2006, 87):

(1)	Familiarizing with data – a thorough reading of the transcribed interview (at T2).
(2)	Generating initial codes – the analysis started with a general coding of subjective experiences of hindering and supportive factors identified in the second interview (T2).
(3)	Searching for themes – looking for a way to group and combine different codes into potential themes.
(4)	Reviewing themes – a thorough reading of the themes and checking whether they work with the grouped codes, and breaking down of the themes into sub-themes. The theory-laden perspectives of the inner and the outer world formed overarching themes and illuminated the informants’ different strategies for handling obstacles and adversities.
(5)	Refining theme names and merging themes and sub-themes together. These themes then guided the reading of the first interviews (performed at T1) in order to study different phases over time.

The first two phases were conducted by the first author. The remaining phases were conducted by all three authors and included interpretation of data and discussion of the compilation of themes until consensus was reached (see, e.g. Lincoln and Guba 1985).

Results

The results are based on the informants’ stories of their strategies for handling adversities during their transition from care. The results are structured, in accordance with the two main perspectives, into personal or inner world strategies, and contextual or outer world strategies. The themes and sub-themes of each perspective generated in the analysis are presented below.

Inner world strategies

In Table 1 the main inner world themes Re-framing of experiences and Increased self-reliance, are broken down into six sub-themes. Three sub-themes were generated from the main theme Re-framing of experiences: a re-evaluated and positive retrospective view on the time in placement; experiences of being reborn as a result of the received care; and a new gratitude, not previously recognized, towards society for providing another chance in life. The other main theme, Increased self-reliance, generated the three sub-themes becoming an active agent in one’s own life; increased trust in one’s ability to handle adversities and experienced preparedness to take on the challenges of being an independent adult.

Table 1. Themes and sub-themes describing the informants’ inner world strategies.

Themes	Sub-themes
Re-framing of experiences	Retrospective positive view of placement
	Experience of ‘being reborn’
	Gratitude towards society
Increased self-reliance	Becoming an active agent in life
	Increased trust in self
	Preparedness for adult life

Re-framing of experiences

One important, sometimes implicit and unarticulated, strategy reported by the informants was the process of re-framing the experience of the extraordinary life event that an out-of-home placement constitutes. At T2 more than half of the informants (n = 12) in retrospect gave a positive evaluation of their time in placement. Another group (n = 5) maintained a negative view both at T1 and at T2 and considered the time in placement a waste of time, while some (n = 3) had a positive perception of their placement at both T1 and T2. However, the main pattern was that the time in placement made sense to them and was seen as necessary in their lives. It was common, at both T1 and T2, to report that this positive view had gradually evolved during the time in placement, from a more critical and negative view in the beginning. One informant, Anna, ² illustrated this after being out of foster care for 9 months: ‘Well now I am [positive to the placement], but if you had asked me 3 years ago I wouldn’t have been.’ When looking back at T1, when she was about to move out after 4 years in foster care, she reported the anger of not being in control of meeting friends and family at the beginning of her placement, but her perception of the time in care had changed gradually towards feelings of increased control and satisfaction towards the end of the placement.

Another informant, Fredrik, reported a similar experience at T2. Referring to the gradual change of attitude over time towards the placement, which was a common process among the informants, he said, ‘It was kind of a maturity thing.’ At T1, Oskar described his mandatory time spent in residential care as ‘the hardest thing I’ve ever done’, but at T2 he gave a contradictory response to the question whether he thought he had benefited from the 2 years spent in residential care:

Hell yeah. You know (…) Well I often have the feeling that I’ve been born again. I have a totally new mindset, I’m a new person. I behave differently. Before [placement] I thought I was like a lone ranger and said fuck love (…). You know, being ‘hate full’ instead of loving. But now, I’m making a choice every day, like being full of love.

Oskar’s description represents the sub-theme of being reborn, a change that goes beyond ordinary experiences of coming of age. When talking about his time in residential care he describes becoming a completely ‘new person’ where love has overruled hate. Others reported gratitude to the social services for making the placement decision in time. Ella, though in voluntary placement, at T1 described herself as having been forced into residential care. However, by T2 she considered her placement as crucial for her survival:

I would have been dead if I had not come there [to residential care]. I had gone under because of my drug addiction. It wouldn’t have worked.

Another sub-theme explaining the process of re-framing experiences of out-of-home care is the abovementioned feeling of gratitude towards society. Most informants who expressed a positive retrospective view of the placement also reported this gratitude and a notion that society had given them a second chance in life, as for instance described by Bjorn at T2:

I am so grateful. They [Social Services] have given me my life back. I don’t know where I would have been if I had not been placed.

This retrospective acceptance of their placement, as having given them a second chance, and their gratitude for it, is of significance. It helps young care leavers to understand the often traumatic event of being placed and constitutes an important factor in making sense of and ascribing meaning to their time in care. This inner process of re-framing of experiences of societal care may over time help to promote resilience (see also Fahlberg 1994; Schofield 2001; Stein 2012).

Increased self-reliance

The second theme related to the inner world strategies concerns the process of gaining increased self-reliance. Generally at T1, most of the informants reported ambivalence towards the issue of their pending transition out of care. They were looking forward to the transition but at the same time they were also worried about housing, finances, availability of support from the social services and how to make ends meet by themselves (see also Bengtsson, Sjöblom and Öberg 2017).

However, at T2 several informants described an emerging self-reliance in the form of putting their trust in themselves and becoming active agents in their life. This experience seems to have been connected to the same process of gradual change mentioned above, but it had now changed focus towards themselves instead of outwards towards professionals, e.g. social workers or foster parents. One informant, Oliver, used the following metaphor at T2 when describing his feelings about leaving residential care after 1 year: ‘Well, I felt ready to cut the umbilical cord.’ This is a strong metaphor capturing the parent-like relationships that can develop between young people and their caregivers in out-of-home care. Moreover, according to Oliver, he was not being cut loose by somebody else – he was doing the cutting himself. This inner-oriented agency in Oliver’s case appears to have continuously increased over time. At T1, describing his feelings towards mandatory care where he was not able to make his own decisions, he said, ‘I hated them in the beginning when giving me mandatory care.’ However, by T2 he gave a strong statement on moving from being objectified in the hands of others, to becoming independent and being in control.

A growing feeling of self-reliance does not mean there are fewer obstacles to overcome; rather, it means recognition of the need to navigate towards new tools to overcome them. At T2 after leaving care Carina described how she was handling complicated issues regarding her contacts with authorities.

Well, it’s up to me now. I’ll have to make the phone calls and ask them directly what I’m supposed to do. It may sound crass but I have learnt that I can’t rely on others solving my problems any more. I do it myself.

Young care leavers beginning to manage constitutes an inner developmental process of increasingly perceiving and trusting oneself as an active agent, which seems to contribute to a general sense of increased control. This was something that Carina at T1, 8 months prior to the second interview, had mixed feelings about. She described the state of not being in control of her life after enrolment in care as a ‘psychological crash’:

It came to a crash. In a way I have always been an adult, I’ve been the one in control and responsible for things. And then, I ended up here [in residential care] and suddenly I was not supposed to do that anymore. And, at the same time, I’m on my way to be an adult and am supposed to be responsible. So, yes, it was a great crash.

Even though Carina did not feel in control during her placement, her conclusion at T2 when leaving care was that now, in the process of becoming an adult, she must navigate towards a mindset of ‘do it myself’. This emerging sense of control was also described by Alma at T2: ‘It’s like me directing my own life now.’ David gave a deeper description of this experience:

It’s not like anyone tells me what to do any more. It’s more my own responsibility, my own initiative. And that makes me feel like, well it feels like more meaningful to be 100% in control of what I’m doing. This makes me do things that are important to me – instead of doing things to please others.

David describes the process of negotiating the benefits of taking a more adult responsibility over his own life.

Outer world strategies

The other main perspective generated from this study is the informants’ stories of strategies towards a context outside themselves. This outer world perspective is presented in Table 2 by the theme Restructuring of the social network which generated three sub-themes: reconnecting with family; having positive peer relationships; and maintaining contact with professional caregivers.

Table 2. Themes and sub-themes describing the informants’ outer world strategies.

Themes	Sub-themes
Restructuring the social network	Reconnecting with family
	Having positive peer relationships
	Maintaining contact with professional caregivers

Restructuring of the social network

A crucial factor associated with resilience among young care leavers, well documented in previous research, is a close attachment to a parent or parent-like person (Rutter, Giller, and Hagell 1998; Schofield and Beek 2005; Stein 2005, 2012). Many of the informants had experienced problematic relationships with their biological parents but the overwhelming majority still described the contact with them in positive terms, as providers of both emotional and practical support. In the first interview Erika told a story of severe problems with her biological parents involving domestic violence and communication problems: So when I had to visit my parents I couldn’t make it, I couldn’t even look at them. It [our relationship] was so infected.

In the second interview she reported choosing to move back in with her parents after 3 years in foster care.

The main reason [for moving back] was that I felt that I didn’t belong anywhere. This [parental home] is where I grew up, this is my family, and this is where I belong (…) even though it is like, well like it is.

The sense of belonging was crucial to her and made it worthwhile facing the possible adversities entailed in moving back with her biological parents and re-experiencing their troubled relationship. She described how, post-care, she maintained other important relationships with adults to compensate for the lack of support from her family of origin:

I had a teacher in high school that is still very important to me. I have more or less felt like she is my mother. (…) I have made sure to stay in touch with her (…). It’s like me creating those kinds of relationships with grown-ups so that I know that I’ll manage.

Apart from describing a restructuring of her social network, Erika showed self-reliance by being the one creating and maintaining a supportive and parent-like relationship with her former teacher.

Ella, who moved into a halfway house after 1 year in care, in both interviews described her mother as the most important person in her life. When asked what made her mother so important, she replied:

It’s the feeling of security. You know, before [the placement], if I came home with the police, high on drugs and alcohol (…), she was never angry with me. She always showed me that I belonged with her.

It is evident that both a sense of belonging and emotional support from the family were of great importance to the informants in forming a solid base for promoting resilience. This implies that strategies of navigating towards maintaining these relationships were important. Ella, though living a long way from her hometown, made sure to keep contact with her mother by visiting her on weekends.

In both interviews Erik reported that losing contact with his biological family was a problem while being in foster care for 2 years. Asked at T2, after having moved back to his parents, whether he had received any help from professionals while in care to reconnect with his family, he said:

No, I solved it myself. I went home to my mother’s house sometimes after school just to say hello. Other times I told her to visit me; we just went for coffee or something. So, it kind of solved the problem.

Erik was lucky to have been placed in proximity of his biological mother, which was not the case for the majority of the informants and often made the intergenerational relationship more difficult.

One of the recurrent topics in the informants’ narratives was experiences of doubts about where to move after leaving care. Two emergent issues were how to avoid the risks of getting together with old ‘antisocial’ friends and how to establish contact with new, supportive friends – both well-known resilience-promoting factors (Newman and Blackburn 2002; Rutter, Giller, and Hagell 1998). Oskar, at T2 living in an apartment close to his former residential home and far from his hometown, explained why he had ended up living there after discharge from care:

Well, it was my call. I was thinking, there are so many sober people here and so many trying to do what I do [staying out of trouble] (…). You know, living and staying in the programme [Narcotics Anonymous] and struggling to stay sober (…). Living another life really.

A combination of pursuing self-efficacy and being invited by social workers to participate in planning his life post-care had made it possible for Oskar to choose living surrounded by supportive friends though still struggling with the issue of staying sober, an issue he was aware of even at T1: ‘I won’t be able to stay out of drugs in my old neighbourhood among all my old friends.’

Girl- and boyfriends without experience of social problems were reported as important, not only as providers of emotional support but also as a bridge to other rewarding relationships, which, as for Oskar, could continue even after dissolving the love relationship:

When I met my girlfriend (…), well it was her friends from the beginning, so I met them through her. And when we broke up (…), when she left, I didn’t have anyone to hang out with. So I kind of stayed with them.

At T2 Fredrik told a story of reuniting with his old rewarding friends in his hometown, and of the significance this network had for him. He appreciated the reunion and reflected about the problems his former lifestyle with drug abuse had caused for their relationship:

They didn’t want to hang out with me when I was on drugs (…). [But now] it means a hell of a lot, it really does. Old friendships you know, it’s so fun to be back together. It makes me so happy.

Fredrik described how positive peer relationships were supportive of staying sober by setting terms and conditions, e.g. by refusing to socialize with him earlier when being on drugs.

The last sub-theme under Restructuring of the social network concerned maintaining the contact with former professional caregivers. After leaving care there are no formal assignments regulating contact between care leavers and the professional foster carers or the staff at residential care units. For many care leavers, this can imply the dissolution of a long and close relationship. However, at T2 more than half of the informants still had contact with their former professional caregivers after leaving care. Many reported a shift towards an ‘informalization’ of the relationship, of the formal care relationship becoming more like a friendship. At T2 Bjorn described this transformation of his relationship with a former key professional contact: ‘We have built a very strong relationship. We’re kind of friends. So it’s not just professional.’ Furthermore, Bjorn described how he was introduced to his girlfriend through this key contact, as through a private relationship between friends.

However, the most common description of ongoing contact with former carers related to receiving ongoing emotional support, as described by Fabian at T2:

They are always there for me, regardless of whether I’m placed there or not. Some residential homes just care about the money they receive (…). But the place where I lived, they really care. If I need help, they’ll give me the help I need.

At T2, Anna was still in contact with the mother in her former foster family, who brought her food and helped her with practical issues. When asked whether there was any formal agreement regulating their relationship she replied:

No, there is no such deal whatsoever. They have just become family (…). Yes, I’ve got myself another family where I feel I belong.

Anna thus described the general and profound importance of a sense of belonging, here provided by her former foster carers.

Discussion

The aim of this study was to investigate young Swedish care leavers’ experiences of managing adversities when leaving out-of-home care by studying self-reported strategies and grasping to what extent these strategies promoted resilience. The main findings from the thematic analysis show that these strategies concern both the care leavers’ inner world: Re-framing of experiences and Increased self-reliance, and their outer world: Restructuring of the social network. One main finding of this study is that these strategies are continuously negotiated and change over time.

While these strategies are in line with established resilience-promoting factors (see, e.g. Newman and Blackburn 2002; Rutter, Giller, and Hagell 1998), this longitudinal study additionally demonstrates how the informants navigate towards supportive factors both in themselves as individuals and in relation to their surroundings, while also negotiating the meaning of these factors. In this sense this study, by focusing on care leavers’ own narratives about their transition process out of care, provides a deeper understanding of the interplay between the inner struggle and the contextual conditions of the transition from placement in care to adulthood.

As outlined above, there is in general strong evidence for poor outcomes for this group of care leavers. However, these results to a large extent stem from cross-sectional quantitative studies (Berlin, Vinnerljung, and Hjern 2011; Courtney and Dworsky 2006; Courtney et al. 2011; Vinnerljung and Sallnäs 2008), which provide broader knowledge on so-called ‘outer world’ outcomes. However, this perspective neglects care leavers’ own subjective ‘inner world’ experiences – experiences revealed in this study as a negotiation occurring and changing over time. Without doubt the informants in this study also faced numerous challenges and problems during their transition; however, a problem perspective and the outcomes as such were not in focus.

Rather, our study focused on the subjective strategies the young informants reported using to handle the adaptation to post-care adulthood and promote resilience. We have shown how young care leavers are engaged in continuous processes of negotiation in order to understand and provide meaning to their former time in placement. This process is particularly evident in the evaluation and re-evaluation of the time in placement at T1 and T2. The main pattern of change was from a negative experience described at T1, to a more positive sense making revaluation at T2. This change in perception of the placement in care was gradual process in most cases, but some informants described a radical shift experienced as ‘rebirth’. Several informants at T1 reported negative experiences of their placement, but at T2 reported gratitude towards society, because they acknowledged that their placement had provided the help they had needed. These results show that when young care leavers’ experience of placement is in focus, both in research and in practice, the time frame of the transition is decisive and must be acknowledged.

Another inner process revealed in this study is the ‘navigation’ towards increased self-reliance, described by the informants as a process of successively taking increased responsibility for their life and increasingly trusting in their own ability to live an independent life. This must be considered in light of still being in care (for some, as a mandatory measure with rules and regulations) at T1, but managing to navigate towards a mindset of ‘doing it myself’, which was a recurrent pattern at T2.

From an outer world perspective, this study shows how informants navigated towards integration into a functional social network using strategies for re-structuring and optimizing their network in order to increase the benefits by selecting supportive relationships, and minimizing the risks by avoiding ‘anti-social’ friends from their former network.

Many reported maintaining a close relationship with former professional carers even after their transition out of care. These relationships were described in terms of ‘family’ and ‘friendship’ and were no longer based on formal assignments, but on a mutual agreement and trust. Our findings are especially relevant in a Swedish context where at present there is only vague legislation regulating formal support after leaving care. It appears to be a question of individual choice for the caregivers and the care leavers to navigate and negotiate for close continuous relationships (see also Höjer and Sjöblom 2010). This is, however, an example of the interplay between process-oriented strategies in the inner and outer world that may help the care leaver to form the solid bedrock for resilience and ‘move on’ from care to adulthood (see also Stein 2012).

The question of representativity is difficult to assess. However, as stated above, our informants faced numerous challenges and problems during their transition. We therefore propose to interpret the ‘optimistic’ findings of our study as a main effect of a difference in focus compared with many other studies in the area. As important as knowledge of adversities and outcomes is knowledge of young care leavers’ experiences of and strategies for handling these adversities, and how these strategies can promote resilience. Still, as outlined in the Method and Analysis section, our results are based on a fairly small sample and can only with caution be transferred to a broader population of care leavers. However, these findings of constant development of strategies to manage adversities contribute important knowledge about the transition out of care. This knowledge will hopefully have implications for practice in developing support for young care leavers during their transition. It is important to arrange more gradual transitions as then care leavers are given more time to better plan for their future, and take a more active role in their present lives. This will also give them an opportunity to make sense of their past experiences in care. Furthermore, a cohesive policy for prolonged support from caregivers is also important in supporting continuity in relationships and providing a sense of belonging for the young person. This type of prolonged support from caregivers could be an important alternative for those lacking or having a minimum of support from their family of origin.

As part of an ongoing longitudinal research project, we hope in the future to be able to give more in-depth results regarding how different long-term processes and outcomes are played out in care leavers’ transition process.

Disclosure statement

No potential conflict of interest was reported by the authors.

Notes

1. One participant was 16 at the time of the first interview but turned 17 later that year and was therefore included.

2. Names and identifying details have been changed to guarantee confidentiality.