Shared Family Care: Out-of-Home Care Programs for Serving Parents and Children Together

Figures & data

Table 1. The (inter)national networks of residential and foster care scholars approached.

Academic Workplace Youth at Risk (The Netherlands)

Baptist Coalition for Children and Families (US)

The Board of Child Care (BCC) (US)

The Child Welfare League of America (CWLA)

Eurochild

The board of the European Scientific Association on Residential and Family Care for Children and Adolescents (EUSARF)

International Association of Outcomes Based Evaluation and Research (IAOBER)

International Research Network on Transitions to Adulthood from Care (INTRAC)

FICE International and FICE Netherlands

The International Work Group for Therapeutic Residential Care (TRC)

The Netherlands Youth Institute (Residential Youth Care network)

SOS Children’s Villages (international and Dutch association)

The research group Residential Youth Care of the University of Applied Sciences (Leiden, The Netherlands)

Note. The networks that responded are in bold.

Table 2. Geographical location of shared family care programs (N = 23).

	Shared Family Foster Care (SFFC)	Shared Residential Care (SRC)	Family Residential Treatment (FRT)	Total
	N	N	N	N
North America	1	2	1	4
US	0	2	1	3
Canada	1	0	0	1
Europe	0	9	7	16
Sweden	0	1	0	1
The Netherlands	0	5	4	9
Switzerland	0	2	3	5
Italy	0	1	0	1
Asia (Middle East Region)	0	1	0	1
Israel	0	1	0	1
Oceania	0	0	2	2
Australia	0	0	1	1
New Zealand	0	0	1	1
Total	1	12	10	23

Table A1. Existing shared family foster care programs.

SFC program	Population served	Physical setting	Programming goals and activities
(1) Live In Family Enhancement (Canada LIFE program)	(mostly indigenous) parents at risk of neglect or having youth placed into care	Families live in a foster home together with a family mentor	Provide supports around trauma, loss, substance misuse, and domestic violence (see more details in paper).

Table A2. Existing shared family residential care programs.

SFC program	Population served	Physical setting, Personnel & Duration	Programming goals and activities
(1) Family Care Program (Texas Baptist Children’s Home, US)	Vulnerable children and families referred by church or providers	Up to 5 families housed in each cottage with resident staff supervision and role modeling	Children often attend public schools, parents attend High School or employment classes. Program includes group work, parent training, and religious services (see more details in paper).
(2) Family treatment program (Ranch Ehrlo Society, US)	Families wishing to reunite with child(ren) in care	Each family has their own home, with their own keys. Staff available 24/7 as needed, but will only come as scheduled or invited.	Many structured activities: group sessions: parent support/education group; recovery group; horse therapy; writing group; compassionate parenting.
(3) Shabtai Levy Mothers’ Unit (Israel)	Mothers assessed as neglectful or physically and emotionally abusive toward their child(ren)	Eight to ten women reside at the unit at any given time, with up to two children each.	Treatment includes individual emotional, dyadic and group therapy; skills training for cooking, budget management, and relationships (see more details in paper).
(4) KINGS (Accare, the Netherlands)	Children with severe behavioral problems and their parents. The children and their parents are often facing significant adversities.	Each family lives in separate inpatient living unit. Therapy sessions and meetings are held in a central building. Family caregivers are available all day and on call at night.±6 week inpatient program.	Intensive EMDR trauma treatment for parent and child. Family caregivers have experience with cognitive-behavioral training and trauma-sensitive care. Caregivers train parents in validating positive child behaviors by using video feedback.
(5) Family training program Heizenholz (Switzerland)	Families with concerns about child well-being or to manage child behavior.	The center can accommodate up to 6 parents with children.	Parents facilitate changes in the situation of their children through discussion with staff, peer support, shared daily living, and trying out new problem-solving skills.
(6) Aeschbacherhuus Eltern-Kind Angebot [parent-child program] (Robert Aeschbacher-Stifting, Switzerland)	Parents and pregnant mothers who need help for themselves and their child and want to accept it.	The building complex includes four children’s living groups, several apartments, a large garden with a swimming pool, playgrounds. Ideally, a stay should not exceed one year.	Parents receive support in childcare, living, and parenting skills. Collaboration with the parents, their environment, their families and external care providers. Parents engage with the outside world (work, employment, further education etc.), children are looked after in the day-care center or attend public school.
(7) Gezinsbehandeling [Family treatment] Harreveld (Horizon, the Netherlands)	Parents are not capable of raising their children (0–18 years old), due to child’s behavioral problems, struggle with problems themselves and/or financial problems	Families live temporarily at one of three locations. Once every two weeks the families are allowed to go home for a weekend, so they can practice what they have learned.	Program works to calm the family, reduce parents’ stress, strengthen (parenting) skills, engage a social network that can support the parents in parenting, and reduce the behavioral problems of the children. Aftercare is provided to maintain the improved family situation.
(8) Baby House foundation (Netherlands)	Mothers who need temporary extra support in caring for their baby.	11 mother-child units divided into 3 phases of intensive support toward independence.	The Mother-Child Unit aims to offer (expectant) mothers shelter and support before, during and after the birth of their baby. The mother receives guidance in caring for the baby, creating a secure bond, and building a social network. Biological fathers can also be involved.
(9) Investigation flats (Sweden)	Families with allegations of maltreatment.	This facility is used as both a day treatment and 24-hour residential setting. The family stays, with social workers and care workers, for about four weeks	During the time spent in the investigation flat, the child’s and family’s situation are assessed. There are also elements of casework and family group work services.
(10) Gezinsopname [Family admission] (Mereo, the Netherlands)	Families with parenting issues, excluding parents with serious psychiatric of addiction problems	Farmhouse in the countryside, short-term intensive family admissions of five days.	Through making parents aware of their behavior and giving insights into mutual communication with their children, the family can start to acquire new behaviors. The program offers several fixed components such as the videotaping of breakfast conversations.
(11) Yulius Family Treatment (Gezinsbehandeling the Netherlands)	Families with stress on multiple domains.	Families live in own apartments for an average of 3–4 months. no 24/7 supervision, but family therapists can observe (in consultation with the family) via a one-way screen.	Treatment focuses on various aspects of the family (see more details in paper).
(12) Communities for pregnant women and mothers with children (Bologna, Italy)	Pregnant women, including minors, and single-parent families, struggling in carrying out parental duties; may have court involvement.	Two residential care units (rural and small town locations) structured as a big house with a lot of bedrooms, one for each family and some shared rooms (kitchen, bathroom, living room, garden). Rotating 24/7 staff. Families stay about 14 months, ranging from a few weeks to 45 months.	Mothers are supported in their parental roles with individual psychological support if needed, focused on their past, childhood, parenting problems or sometimes trauma. Group support is also provided.

Table A3. Existing Family Residential Treatment (FRT) programs.

SFC program	Population served	Physical setting, Personnel & Duration	Programming goals and activities
(1) Mutter Kind Haus (Switzerland)	Pregnant women and women with their children who need protection	Inpatient house offering living space for seven woman and eight children	Promote development of the child and mother by well-trained, experienced staff who accompany the women in socio-pedagogical, educational, social and economic areas.
(2) Psychiatric Clinic in Thurgau {Station für Eltern Kind-Behandlung Switzerland), https://www.stgag.ch/fachbereiche/psychiatrische-klinik/psychiatrische-klinik-muensterlingen/psychotherapie/station-fuer-eltern-kind-behandlung/	Mentally ill mothers or fathers with children aged 0–5	Inpatient treatment unit with four mother/father – child treatment places.	Diagnostics and therapy for parent as well as the child and the parent-child interaction (see more details in paper).
(3) Behandlung von Müttern mit Baby [Mother-Baby treatment] (Klinik SGM, Switzerland)	Mothers with a mental illness who require inpatient treatment with babies	Inpatient stay (for up to 12 months). Single rooms specially tailored to needs of mothers and babies.	Support, advice and special therapy supports the mother’s recovery and the relationship with her child. The baby is looked after during the mother’s therapy times so she can concentrate on regaining stability.
(4) Family inpatient treatment [Gezinsopname] (Plinthos, the Netherlands)	Families that suffer(ed) severe domestic violence and families where postpartum depression paralyzes the life of mother, child and the whole family.	Short-term inpatient treatment	Strengthen parenting and restore safety through psychiatric treatment using interactions within and outside the family.
(5) Clinics De Stee & De Bron, Expertise Center for Treatment and Assessment of Parenting and Psychiatry (GGZ Drenthe, The Netherlands) https://ggzdrenthe.nl/media/01-folders/folder-informatie-voor-verwijzers-gezinspsychiatrie-g-gp009–0714.pdf	Families with babies (0–2) or children (3–12) facing adversities that impair family functioning, development, and/or safety.	Each family has their own bedrooms, toilet and shower. Families share a living room, dining room and kitchen. One apartment allows independent living to be practiced. Family trainers are present during the day and night. Treatment duration is about 4 months.	Obtaining a clear perspective for the child or children growing up at home with their parent(s) or (partially) with other caregivers. Parents have the optimal opportunity to learn and grow in parenting. The parent(s) can demonstrate that they can grow into a “good enough” mother or father.
(6) Granger Grove family care program (Unnamed NGO, New-Zealand)	Mothers who have experienced significant abuse, trauma, transience and instability and their children (0–5)	Mothers and children live in two-bedroom units with their own bathroom and a communal dining room, kitchen, lounge and laundry. Staff are available 24 hours a day to offer guidance and help.	Mothers learn new parenting and life skills and how to deal with health problems, access community resources, sort out relationships and gain an understanding of domestic violence, child abuse and trauma through educational and therapeutic classes and individual therapy for themselves and their children. Children attend an on-site preschool.
(7) Gezin Total, family treatment [Family Total] (Horizon, the Netherlands)	Families with long-term multiple and complex problems (psychosocial and/or psychiatric and social-economic), with children aged 0–18 years old.	Family treatment for 12 weeks. A family mentor is present in the family for six hours a day, phasing out to two hours a day. Maximum duration of 6 months.	Main goal is that the family has control over their own family life, in which the best home for all family members is chosen and realized. Residential family treatment can be part of family exploration phase (one week) or a “formation phase.”
(8) San Miguel Family Center (Yourtown, Australia)	Young homeless parents (up to 25 years old) and their children	Up to 3 years of fully furnished housing for up to 21 families, followed by up to 3 years of outreach support. Facilities include an activity center, swimming pool, children’s playground, tennis courts, and a community garden.	Help families tackle homelessness and underlying issues by offering a stable home, social interaction with other young families, skills for independent living, child development support, expressive therapy, play groups, counseling and advice.
(9) High and Intensive Care (HIC) Youth (Yulius, The Netherlands)	Young people from 12 years old with acute, serious psychiatric problems and their parents	Short clinical admission of a few days, in which one of the parents is present and stays with their child constantly.	To stabilize the crisis and offer peace. Parents are actively involved in the treatment by the family therapists, nurses, and sociotherapists.
(10) CHARM, LUND’s residential care program (Collaborative Burlington, USA)	Women who are expecting or have recently delivered babies and have a history of opioid use disorder	Residential care for moms and babies.	Moms receive intensive treatment structure, and safety via an inter-disciplinary team. Activities include nurse home visiting, outpatient substance abuse treatment, economic support, peer support, parenting education, children’s services and emergency needs, incentives.