Policy vs. Practice: Supporting Biological Family Connections for Youth in Substitute Care

Abstract

Biological family contact is critical to child wellbeing in non-relative substitute care. Drawing on the Capability Approach, this study sought to learn how and in what ways policy supporting family contact is carried out in practice and the impact on children. This qualitative study was conducted in the Czech Republic which has been transitioning from child institutional care to a foster care system. Sixty-six Czech stakeholders were interviewed across a spectrum of positions and perspectives, including care leavers, and child welfare professionals in NGO’s, children’s institutions, and government officials. Despite policies mandating parental involvement, care leavers often navigated family connections alone or were deliberately kept apart. Professionals often found it challenging and frustrating to engage parents, doubting it was in the best interests of the child. Some NGOs focused on effective parent engagement and saw success in reconnecting young people with their families. Practice recommendations include a shift toward prevention and family preservation, education of professionals about the importance of family connections, and empathy training to understand parent behaviors, needs, and motivations. The Capability Approach highlights the importance of child participation in decisions that affect their lives, including their right to know their own families.

1. Introduction

Children placed in non-relative substitute care (“care leavers”) experience loss as a result of family separation, even when that separation is in the best interests of the child. Maintaining contact with families is critical for attachment, identity, and coping with loss. Whether or not this occurs is in the hands of the professionals and other adults and dependent to some extent on their views on the value of family contact. In the Czech foster and institutional care system, this affects numerous children, whose voices are seldom heard in research on this topic. Although empirical evidence favors ongoing interactions with biological families, tensions among stakeholders often hinder these efforts. This study explores both care leaver and professional perspectives on supporting family connections in the Czech Republic.

Family time is generally understood as critical for children removed from their families and is recognized as a fundamental right rather than an optional service (UN 1990). Maintaining contact helps sustain bonds between children and their families, facilitating potential reunification by enhancing attachment and motivating parents (Casey Family Programs 2020; Orlando et al. 2019). Infrequent or no contact post-separation can lead to ambiguous loss, in which children grieve for parents who are psychologically present, but physically absent (Boss 2006). Frequent and consistent quality time with parents has been found to alleviate anxiety and feelings of abandonment that can arise from separation. It reduces the intensity of grieving, and for children who might be able to reunify, nurtures the attachment relationship (Boss 2006; Mitchell 2016; Samuels 2009).

Regular contact with parents is associated with better child behavior and mental health. Children in foster care with frequent parental contact are less likely to be depressed and exhibit significantly fewer negative externalizing behaviors (McWey and Cui 2017). Care leavers report that having contact and at least some knowledge of their biological families are important to them, even when those relationships are strained—an observation made in both the U.S. and Czech Republic (McWey and Cui 2017; Navrátil 2014, 2015). A Slovenian study that examined loneliness among children raised in residential care settings found that they had substantially fewer supportive relationships overall and emphasized the need for staff–family partnering and family-focused interventions (Kristan et al. 2021). Often the child’s physical or other concrete needs are considered to the exclusion of emotional and relational wellbeing, sometimes ignoring the importance of biological family relations, or foster parent input, and can leave children struggling with relationships, creativity, and self-realization, all critical components of the Capability Approach (Ben-Arieh et al. 2014; Nesmith 2020; Sandin 2014).

Notably, there is limited research that examines authentic youth experiences and their interactions with decision-makers in this context (Nesmith 2013). This study aimed to fill that gap by exploring multiple perspectives, especially that of the care leavers themselves, and those of adults driving decisions that affect them.

2. Conceptual Framework and Contextual Factors

2.1. Capability Approach

This study’s conceptual framework draws from Sen and Nussbaum’s Capability Approach (Nussbaum 2007; Sen 1999), which focuses on holistic child wellbeing and strengths. The focus on capabilities underscores conditions that enable a “full” life, marked by such features as love, participation in a social life, and having choice about what identity to live by. As minors, youth lack autonomy and hold limited decision-making power regarding their living situation, especially in non-relative welfare placements. The Capability Approach suggests that having this power to make decisions both contributes to their individuality, and provides validation that they arrived at decisions based on choices they were able to consider and evaluate for themselves.

While there is limited Czech research on child wellbeing in social care, it echoes this perspective. For example, studies by Navrátilová (2015) and Punová et al. (2020) revealed a lack of hope or optimism among children receiving traditional social services, which in turn, was linked to loneliness and disconnection from meaningful relationships. In the Czech child welfare system, youth participation in decision-making—central to the Capability Approach—has historically been excluded (Palovičová 2017; Navrátil 2014, 2015). Research on the Czech child welfare system seldom incorporates children’s perspectives—but is vital, as it is their lives that are most impacted and in fact their perspectives differ substantially from that of adults (Biggeri and Karkara 2014; Bubleová et al. 2014; Punová et al. 2020; Selwyn et al. 2017).

2.2. Contextual Factors in the Czech Republic

In the Czech Republic, legislation recognizes the importance of a family home environment for child wellbeing, aligning with United Nations declarations (Act No. 359/1999 Coll. 1999; UN 1990). However, child protection laws lack clarity in defining “wellbeing,” narrowly focus on education, nutrition, and safety, while ignoring emotional wellbeing and biological family connections (Kornel 2015; Navrátilová 2018; Biggeri and Karkara 2014). The system’s struggle to support continuous family relationships is compounded by challenges like heavy caseloads and insufficient strategies for family cooperation (Biggeri and Karkara 2014). Despite a preference for children to be cared for by individuals rather than institutions and a significant effort starting in 2013 to transform the system (referred to by participants as “the transformation”), the widespread use of institutions persisted, with around 8000 children residing in 203 institutions as recently as 2020, including facilities for infants and toddlers (MoLSA 2020; Lumos 2020). In 2021, a formal ban was passed, against placing infants up to age three years in institutional settings with three years to fully implement it. However as of spring of 2024, there remained 309 infants and toddlers in institutions (Brno Daily 2025). It was only as recently as the start of 2025 that the practice of placing infants and toddlers into institutions was completely stopped (Pohanka 2025; Brno Daily 2025). That said, the number of children over four years old in infant homes has been increasing.

3. Materials and Methods

This qualitative study aimed to address the question: How and in what ways are biological family connections supported and encouraged among young people placed in substitute care settings in the Czech Republic? Sub-questions are: To what extent do these efforts satisfy youth’s desires for family contact and relationships? When these connections are not encouraged, what are the contributing factors? To answer these questions, we drew on firsthand perspectives of young people raised in these situations as well as a wide range of professionals who work with and for them.

In qualitative research, the researcher’s positioning can shape findings and interpretations. All components of this study were conducted in the Czech Republic by an American expert in foster care outcomes in consultation with Czech social work scholars from two different universities. The project was initiated in part because the U.S. is among several countries with a robust foster care system that the Czech system has been seeking to transition to from one of institutional care. The two countries have much to learn from each other as both systems have flaws as well as strengths. The Czech consulting scholars were experts specializing in child and adolescent development, family social work, foster care, and family law regarding social and legal protection and provided feedback on the driving research questions and as well as relevant cultural and political context regarding the child welfare system.

3.1. Sampling

Purposive sampling was employed to gather diverse perspectives from stakeholders influencing care leavers’ lives. Instead of segregating findings by stakeholder groups, our approach intentionally examined their responses as they apply to each other, acknowledging their interconnectedness and collective impact. Initially, the Czech consultants identified NGOs in the country’s three largest metropolitan areas of Prague, Brno, Ostrava that work with foster families and institutionalized youth. When possible, two individuals from the same organization were interviewed, to represent different roles and perspectives from that location. Care leavers who were at least 18 years old, placed in non-relative care settings, and served by these organizations were invited to be interviewed. Care leavers were excluded if they had cognitive developmental disabilities affecting their ability to understand or respond to interview questions.

Because they had multiple placements, the care leavers described experiences procured from a wider range of institutions, NGOs, and foster homes than the agencies that were included in the study. To ensure representation from non-urban areas, participants identified additional programs, institutions, and adult care leavers to invite to the study and add new perspectives. Additionally, participants were recruited at two national conferences sponsored by the Ministry of Labour and Social Affairs (MoLSA) which featured speakers from diverse regions and backgrounds, including care leavers, government ministries, NGOs, and institutions.

3.2. Measures and Data Collection

Semi-structured interview guides were tailored to participant roles: care leavers were asked to discuss placement history and family relationships and contact; NGO and institution professionals described their services and youth engagement efforts; while magistrate and ministry employee questions focused on government policies. The draft interview guides were reviewed and refined by professionals from two NGO’s that worked extensively with care leavers.

Each interview included an English-speaking researcher and a native Czech interpreter, and allowed participants to choose the language they desired. Care leavers were offered private locations for the interviews; professionals were interviewed at their workplaces and included tours of their facilities, including institutional homes and NGOs that served foster families and/or young people transitioning from care (institutions or foster homes). Interviews averaged an hour in duration.

3.3. Analysis

Qualitative thematic analytic methods were used to identify and code themes in interviews and field notes, using NVivo software. This entailed an iterative process of reading, identifying roughly defined themes, then coding patterns as supporting evidence (words, phrases, longer quotes) to refine themes, and identify instances of divergence within and between those themes. The principal investigator and consulting scholars separately assessed the data, codes, and associated patterns across and within each participant subgroup, and identified, developed, and cross-checked the thematic constructs (Miles et al. 2014). The analysis examined both the concrete information provided and, especially among the care leavers, the interpretation, nuances, and meaning they attributed to their experiences or expressed opinions (Creswell et al. 2007).

3.4. Participants

Most studies examine a single group of impacted participants when studying child welfare outcomes. Because there are many influencers who impact whether and how a child will have access to their biological families while in a substitute care setting, this study intentionally aimed to capture these varied perspectives and interviewed individuals in a wide range of roles. This was particularly important in this context, because children in the system move in and out of different settings. Even those who remained in institutional care their entire childhood seldom remain in the same institution because they tend to focus on different age groups and moved as they hit different age milestones. Sixty-six individuals from 16 cities and villages across the country were interviewed. The locations represented six major regions of the Czech Republic including Central Bohemia, Moravian-Silesia, Pardubice, Ústí nad Labem, Olomouc, and South Moravia.

Twenty care leavers, averaging 23.4 years old were interviewed. They were removed from their biological families on average at 3.7 years old, ranging from two months to eight years old. Additionally 28 NGO service providers, 10 institutional staff, and 8 government workers were interviewed. These professionals included social workers, executive directors, “educators” (social service workers typically in child institutions), head nurses, child psychologists, child protection workers, and government child protection workers and policy makers.

4. Results

The focus of the findings regards the importance of, experiences with, and support for connections to biological families from perspectives including care leavers, child protection social workers, and professionals responsible for children in substitute care settings. The social workers and other professionals were from both NGO’s and government-run child institutions. The findings presented here first give voice to the care leaver firsthand experiences, which are often the least heard. Following that are perspectives of social workers and other professionals who had a significant influence and power over their lives.

4.1. Care Leaver Perspectives

To humanize their deeply personal experiences, the findings here refer to care leavers with names, using pseudonyms to protect their privacy. Three care leaver themes speak specifically to factors that influenced contact and engagement with biological parents. First, a lack of placement stability that included not only having different caregivers, but different types of settings. Second, care leavers shared an intense longing to locate and know their biological families. Third, despite the policy mandate to facilitate and support connections to biological families, children continued to bear the burden of coordinating contact with biological family, oftentimes in the face of resistance by foster families, institutions, or social workers. The overriding message was that care leavers really wanted and needed the support from adults in their lives who controlled decisions about them.

Most did not receive support in doing so and most took actions to locate their families, with mixed results. In light of the Capability Approach, being afforded the personal agency to have a connection and relationship with their parents was a significant concern threaded throughout the care leaver stories and for many, a continued source of stress and concern.

4.2. Care Leavers Experienced a Complicated Path to Adulthood

A lack of stability was the norm among the care leavers. Of the 20 care leavers interviewed, after initial removal from their families, none resided in a single setting their entire childhood. While we see a great deal of instability in countries that do not use institutions for young children, as in the U.S., the role of institutions adds another layer of movement. They typically are organized around age. Even within those designed for the youngest, from birth to age three, once they reach toddler age, they are shifted to a new unit to allow for a unified schedule and program tailored for that age group. One institution director explained:

It is necessary for the regime. We have babies to one year. But toddlers, they have different regimes. Infants sleep two times per day. Little babies are awake after lunch. Older toddlers go sleep. The schedules are too different. We will see in this half of our house are toddlers. You will see downstairs we have babies.

This also means that siblings are often separated from each other. As several institution professionals explained, a child placed as a baby will begin with their biological family, then move to the infant unit, then shift to a toddler unit with new caregivers, then move to a new children’s home for older children. At school age, they may move to another one that embeds a school system. And after that, some are moved to placements for adolescents.

One care leaver whom we will call Jakub, had no recollection of his biological family but was told he was placed in an institution at six years old. After a year, he was moved to a family foster home, then returned to his biological family—which lasted only a year—then back to his foster home. Eliška offers another example of a complicated placement trajectory. She lived with her biological family until she was five years old when she entered a foster family where she and her biological brother were abused for over nine years. At 15 years old, the foster family sent Eliška to a children’s institution where she remained until she was 21. Eliška’s story ended positively; she connected with an NGO aimed at serving young people exiting institutions. She spoke of how they helped her to regain her sense of self-worth and eventually employed her to go into institutions and work directly with young people.

There were also care leavers who lived in their foster homes well into adulthood. This surfaced more in the caregiver and professional perspective interviews, but is worth noting here. Although the country was working to shift to a short-term foster care system, there remains many long-term foster care situations in which the child was neither adopted nor reunited. The NGO professionals pointed out that once children entered foster care, they most often remained there minimally until 18 years, but often until age 26 and after post-secondary education was completed, a benefit that does not exist in short-term foster care placements.

4.3. Intense Longing for Family Connection Regardless of Living Situation

The care leavers were eager to talk and had much to share. The most consistent message across every care leaver who was interviewed was that no matter their situation, they wanted communication and a relationship with their biological families. Most often it was their mother whom they sought, but for some it was a sibling, grandparent, or father. From a capability perspective, this spoke to decision-making power. This was often paired with direct or indirect messages that it was not an acceptable request. As children, the care leavers wanted a voice in this decision that had such an influence in their lives, but only a fraction of them received support toward this end.

Adéla, for example, shared some conflicted feelings. She indicated that she viewed her foster parents as her parents. She described a happy childhood, in which she felt particularly connected to her [foster] mother. However, she worried about betraying her foster mother if she sought to locate her biological mother. Her voice lowered to a whisper,

I have a secret. I have a really big secret in front of my family. They don’t know and I need to find a way because…it’s a very big deal in our family.

Because she felt she had to keep this a secret, she had no choice but to embark on this effort alone.

A year ago…I realized I can really know the face of my mother! On any social media. And I then came up with the idea that I can find my mother, by my own, without asking anyone else. So, I just found my mother.

Many of the care leavers shared fantasies they had in advance of meeting their biological parents, which spoke to their sense of identity. They dreamed of being accepted, finding familiarity, a place of belonging—hopes that were only sometimes realized. At the time of our interview with her, Adéla had not yet met her biological family, but she thought about it a lot.

I haven’t contacted her [mother]…I just can’t find the comfortable way for doing it. If I found the perfect conditions for meeting, I would. I would.

[researcher: “what are perfect conditions?”] well, that she would be nice.

Lukaš, who was raised mostly in an institution, understood that living with his mother had resulted in problems for him, yet he yearned to live with her:

Lukaš: … it was bad with my mom because at that time she had another boyfriend. It was someone else every time. And it was not good to live with them together. For that reason I actually started making troubles and was put into an institution.

Researcher: “What would you change about your experiences?”

Lukaš: Oh, I would change it to be completely different from the very beginning, because to be away from Mom is actually terrible. But they decided it was better than being with Mom. But if I could change it, I would rather stay with Mom than to go to the orphanage.

4.4. Children Burdened with Responsibility to Coordinate Family Contact in Face of Resistance

Most of the care Leavers encountered barriers to connecting with their families. This was either a direct effort to deny them access to family, or an indirect effort to persuade care leavers to abandon their pursuit.

4.4.1. Caregivers May Intentionally Create a Barrier to Family Connection

Eliška experienced an overt attempt to prevent contact. She and her brother spent nine years in foster care but were never legally freed for adoption:

When we came to the foster family, they changed our surname. So probably we were taken out from our biological family…my biological mom came to visit me at the foster family and she was thrown out. She wasn’t allowed to see us children.

Denied the opportunity to have a connection, she did not learn the identity of her mother or that her mother had tried to see her until she was 21.

Other care leavers received messages that seeking biological families would hurt their foster parents, as Eva explained:

I am nervous about it. It’s a big deal. My [foster] mom’s soul, my mom, it hurt last time…when I was, I don’t know, eight, nine years old, I asked. Sometimes I asked about my parents. I asked, ‘what about my mom?’ And my [foster] mom, she gets upset and she started crying. But not because it’s my fault. It is just because she felt moved. She had to find a way to tell me ‘I am your mom.’ But I knew that she is my mom too…Now I realize I’ve never talked with her about my feelings about my biological parents…I think it is an understanding out of respect.

While nearly all the care leavers expressed a desire to see their parents or regret that they could not live with them, one outlier, Adamek, recognized it was better for him to be in foster care with little family contact. He had tested out a return to home, but after year, requested to return to foster care:

It was the hardest year out of all my childhood. When my father was in prison during Christmas, they blamed me for that. Because that year went really wrong way. We didn’t like each other. It was my initiative that I wanted to go back to my foster family. I went back…Without my biological family knowing, I was already in contact with my foster family and we were discussing the way back to their home.

Unlike other participants who secretly sought contact with their parents, Adamek did the opposite—he secretly sough contact with his foster parents and navigated his way back into substitute care.

4.4.2. Children Cannot Do It Alone

In most cases, the onus was on the children to ask or initiate contact with biological families. Embarking on rekindling a family relationship was fraught with hope, anxiety, disappointment, and occasionally relief or joy. Even when their request for contact was granted, the participants revealed that, as children, they needed guidance and support. It was not easy to predict how well the reunion would go, and many held intense hope that it would unfold easily. They were often unprepared to address or face a wide range of unanticipated consequences such as whether they would be accepted as family by all members of the family, if their parent would treat them as their own, or if the unhealthy reasons that led to the child’s removal had improved.

Many of their stories told of resistance or absence of support from their foster parents, social workers, or other care provider. Aleš, who was raised in a foster home that he liked, also wanted to reconnect with his biological parents and his foster parents did not object to that effort. However, when his biological family required that he come alone, neither his foster parents nor his social worker helped him advocate for himself or ensure he had the support he needed during the encounter. In the end, he did not visit. Aleš explained:

I have had no visits, none, since I last tried to live with them. I told myself at Christmas I would like to visit them, see my parents, even though they don’t let me know. It was kind of weird for me because it was already obvious, visible, in between that the relation is, let’s say, broken. It’s not really a relationship of mother and son anymore. That the distance is obvious like this. I wanted some guidance. I wanted my [foster] parents to go with me. I didn’t want to go alone. But my biological family wanted me to come alone. So that was the trouble of it.

4.4.3. NGO’s Aimed at Reconnection Proved Helpful

The most supportive entities we encountered were NGO’s that offered services targeted toward helping care leavers reunite with their families. As a young adult, Eliška eventually sought help finding her family from such an NGO. She described the emotional process she experienced, with the support of a social worker:

The first person they [NGO] helped me to contact with was my grandfather. I love him very much. He passed away recently. I got to spend with him one year. He said he was waiting for us to gather together to leave life. My grandfather helped contact with my mother. That was four years ago. I knew they’d had my little sister, she was one year old. I can’t remember the feelings but I guess I was angry with my mother. Lots of feelings. When we contacted, my mom was sometimes still taking drugs and the apartment was not ok. But now she’s better. She’s moved to Vienna and we see each other and talk about things very often. I have forgiven her already.

Others offered similar examples in which the support of a social worker or other professional made it possible for them to reconnect with their families.

4.5. Professional Perspectives: New Expectations, Mixed Buy-In, and Natural Challenges

The Capability Approach recognizes the role that policy makers and social service providers play in child participation. Among the professionals, three themes reflected their engagement with biological families. First, the impact of national policy reform to increase family engagement was not well-received by many of the professionals, across roles. Second, engaging biological families is difficult and requires more support than simply new laws. Third, working to make the child’s residence more welcoming to families shows some promise.

4.5.1. New Expectations from Government Transformation Are Met with Skepticism

Child welfare government workers were interviewed to understand the context and changes in policies and government priorities for children in out-of-home care. These included people who were either specifically involved in developing and implementing the transformation process, or who were government social workers with child welfare programs whose work was influenced by the shifting expectations. All referenced changes based on a 2013 child welfare system transformation effort. Prior to this, they explained, foster homes more closely resembled unofficial adoptions than temporary placements for children. After the transformation was underway, while it was not officially sanctioned, it was still quite common for children to enter a foster home with no plans for that child to ever return to their biological families, nor to be adopted. An NGO social worker shared:

Recently we had reform, transformation of foster care…before, when children were in foster family, there was rule to make against time between biological family and foster parent. So again it was like adoption but it was called foster care. After the transformation in 2013, they started to make importance about biological family and children again.

A government worker saw this as a continuing program, and explained that once a child was placed outside of the home, it tended to last until adulthood:

We have got the problem that it is quite easy to take child out from their parents to the institution and it is quite hard to get him out of institution back to parents. So it is quite normal that the children stay in these institutions for a long time. Until they turn 18 years.

Similarly remarks were made in regard to children placed in foster homes; they typically remained there into adulthood. Those that did leave foster care tended to be moved to a congregate care setting rather than back home or adopted. Knowing they likely could raise the child through adulthood created a disincentive for foster parents to reach out to biological parents, which was also observed in the care leaver findings.

Professional responses provided some context of why this continued even though the 2013 reforms shifted expectations, according to our participants, change was slow and there remained a large share of children in institutions or these long-term foster homes. A MoLSA participant explained why adoption was so rare:

We have adoption too but it is not so common that children are like legally free to adoption. I think that many of the foster carers would like to do it but the children are not legally free to do it. I think this is more the problem. And it makes another kind of problem, the competition between the biological parents and this foster carer. Because they want to adopt the child and they want to separate the child from the parents

Another MoSLA participant remarked that if biological families were given more support at the outset, they could avoid placing children in institutions altogether, but that even after the 2013 transformation in the civil code, the system continued to place little emphasis on prevention:

Our system is mainly, the whole system of child protection, is mainly built on institutional care. It’s like a pyramid where the bottom is institutional care and at the point of the pyramid, you have some child protection and prevention of the failure of the families. It is the smallest amount of the money and effort.

4.5.2. Engaging Biological Parents Is Complicated and Often Uncomfortable

Professionals who worked directly with children in placement settings and were required to implement the new family engagement expectations revealed challenges in practice. First, all made it clear they believed they were acting in the young person’s best interests. Most, including those running institutions, believed that a family environment was best, as one institution director shared:

For sure foster care instead of institution is better for them because there is someone who they can contact physically, who can hug them. Because when they leave the children’s home, there is just the relationship with the institution…every child living in an institution wants to live in a family.

Although the new transformation effort mandated those working in child welfare to encourage family relationships, all the professionals indicated that engaging biological families was challenging. Several found it frustrating or even damaging. However, there were others, mostly NGO’s but some institutions, that viewed family engagement as critical and valuable. When professionals were hesitant or opposed to family engagement, they provided one of three reasons. First, they believed biological parent contact would negatively impact foster parents who planned to raise the children through adulthood. One NGO director who was also a foster parent viewed biological parents as disruptive to the child’s relationship with the foster parents:

I think, especially with the little kids, when the long-term foster parent really tries to build up their attachment and the biological family interferes, the attachment weakens.

The second reason was that engaging biological families is difficult, time-consuming, and often unrewarding work. Several NGO professionals recognized the importance of biological families to children, but were concerned it was a burden on foster parents to engage with the families. One social worker who served as a director for foster parent support programming explained:

We just had a conference where we were all surprised by the methodologist of the ministry who told us, really told us, that it should be primary responsibility of the foster parents, really, to start the contact with the biological family—which we already didn’t like because it can bring troubles. For us in the organization, we realize the huge burden that the foster parents have to carry. That they really need support in this.

The third reason to avoid family contact was that biological families were believed to be unhealthy for children, by virtue of the reasons that led to the child’s removal. Most of the professionals interviewed noted that the children tend to seek their biological families if not as children, then as young adults. Many worried that the biological parents would expose children to unhealthy or harmful behaviors:

…children from the homes often come back to their biological family and even if they live in a healthy [foster] family, they come back to biological family and start the crime or so that’s why until 2013, contact with these [biological] homes were stopped.

A MoLSA social worker also discussed this concern, but blamed the problem on the lack of support for biological parents:

But problem is that there is nobody who will work with the family, with the parents, to change their situation. So they are going to see the child, they have some kind of relationship, but the situation with the parents is still bad so they cannot go back

4.5.3. Engaging Successfully Means Supporting Parents and Making Them Feel Welcome

The professionals who reported the greatest success engaging families were those who both believed it was in the best interests of the child, and who created a space that was welcoming to family. One institution director who valued family contact emphasized to their staff that even if the parents are challenging, this is really to support the children:

You have to work more with biological parents than if you don’t try. When the parents for the first time come here, the educators feel that the parents should feel lucky that their children are here. I explain to the educators that the parents are the most important thing for the child and they are not doing this for the parents but for the child. Because it is one thing you can do.

This director shared the importance of educating the staff (“educators”) in why family relationships are valuable even when the child cannot return home and role modeling for them how to reach out with patience and withholding judgment.

When asked about family visits, the institutional administrators indicated that families generally do not visit. A contributing factor may be that the families did not feel welcome. For example, one director shared that he did not trust the biological families with the children and that they had to “watch them very carefully,” which can feel intimidating to parents. In an effort to make institutional settings more family-like, children are now expected to live in units of no more than eight, with two day educators and one night educators. However, all but one institution we visited was still large, with several units each housing 24 to 48 children in one or two large buildings with dorm-like halls of small, shared bedrooms and a common space.

The one outlier was a director who created a more natural space for children and their visiting families. The children lived in large homes in a residential neighborhood, which, according to the director, was more welcoming to biological parents. The educators were trained to empathize with the parents’ experience and respond to that. Instead of holding visiting hours, families were invited to join the activities:

They [parents] don’t feel good that they have a child in a children’s home. So if they come and somebody said, “whoa, what are you doing here? It is dinner time here. So go away and you have to come back only on Wednesday at 3:00.” Then they never come again.

The director explained that one biological parent expressed the importance of physical contact with her child for her own motivation:

One of the moms told me “If…I can feel him and smell him, it was for me so important, so I know that I have to work to be able to be with him”. She does it because she is more motivated. She comes and has coffee in the garden. The plan is to give the parents more experience to be good parents. So we will start with the welcome and they are here with the child. If it is ok, the parents can take the child to town maybe for ice cream, a short walk. If it is ok, then maybe they will go to Prague because there are more opportunities to visit something, do something. If everything is ok, then we can leave them in this flat.

This director recognized the role that visits played in parental motivation.

5. Limitations

Participants were invited via a purposive non-probability sampling method. This leaves the findings vulnerable to selection bias that may be more favorable to the care setting as the initial contacts. While qualitative methodologies do not typically employ probability sampling strategies, it does mean that we may be missing important voices in this study. We did not visit every institution. One institution holding a reputation of being the least family-like did not permit a visit. These findings, however, represented a range of experiences and opinions and the care leavers were forthcoming with their critiques.

The two systems of care, foster care and institutional, are very different and in some ways warrant separate studies. However, the trajectories of the participant care leavers seldom involved only one experience or the other. To include only those who resided exclusively in one or the other would be to sample on a very limited group of children that is not reflective of the majority of childhood experiences in substitute care. Transitioning between these and even within systems (especially institutional care), is an important part of the care leavers’ stories and a contributor to loss of contact with biological family members.

6. Discussion

The care leavers in this study revealed a strong yearning for biological family contact. The findings highlight that care leavers are profoundly affected by systemic obstacles including lack of agreement on the value of family contact. Despite barriers, there are examples of successful approaches to facilitate family connections. The NGO’s acknowledged family engagement’s value but struggled to assist foster parents in this aspect, while traditional institutions tended to be less welcoming or parent-friendly.

Concerns among some professionals that family engagement strains children’s feelings about loyalty or negatively impacts attachment foster parents are not empirically supported. Research like Maskaant et al. (2016) and McWey and Cui (2017) refutes the notion that family contact will erode emotional security or caregiver bonds. Evidence suggests that young people often search for biological families as young adults, as seen among care leavers in this study and the absence of family contact can complicate identity formation as well as inadequately prepare them for adulthood (Šašková and Mertová 2011).

6.1. Implications for Practice

Critical practice implications land on individuals, both the children and the social workers and other professionals work with them, as well as the larger system that manages how children are cared for in substitute care settings.

6.1.1. Enhancing Child Wellbeing: Professionals’ Roles and Strategies

For improved child wellbeing, professionals engaging with children must prioritize education about child development, attachment, and identity. It must also include training in empathy, the value of family contact, and child participation. Social workers, in particular, stress the importance of supporting not only children but their families, recognizing the critical and lasting role parents play in a child’s life. Social workers can help facilitate positive encounters between foster parents and biological parents until they are more at ease with it. Role-playing or practicing encounters before a real visit may also alleviate some of the anxiety (Nesmith 2013). Some research demonstrates that when social workers and other professionals encourage and support foster parents to engage with and communicate directly with biological parents, the parents indeed visit more regularly (Nesmith 2015). These interactions can in turn spark empathy and compassion between the parties.

The Capability Approach emphasizes the importance of children’s involvement in decisions regarding substitute family care, stressing identity development linked to family origins (Punová et al. 2020). Service providers must be trained to prioritize child participation in decision-making, as legally mandated (Navrátilová 2015).

Service providers and government officials who write policy need education about the experiences of most parents who lose custody, often due to poverty-related challenges. Following the lead of some NGO’s and institutions, we see that it is possible to engage with parents. Instead of stigmatizing, supporting parents means addressing underlying emotions rather than external behaviors. Facilitating safe and open communication between children and their families can help them develop skills to navigate complex family dynamics, and provide the foundation for smoother transitions to adulthood. Empathy means recognizing that most parents also desperately want their children back, but have very limited services to help them improve their social functioning and parenting skills (Bubleová et al. 2014; Lumos 2020).

If children are provided opportunities for safe and open communication with their families, they have an opportunity to practice skills to navigate complex family interactions with the support of adults rather than on their own in secret or later when they exit care. Additionally foster parents, institutional staff, and social workers can help the child manage their expectations to mitigate disappointment if family does not meet up with hopes.

6.1.2. Systemic Changes

Key systemic changes are imperative, shifting investment focus from removing children from their homes (secondary intervention) to supporting parents to keep them (primary and tertiary prevention). Disproportionate financial, personnel, and capital support still favors institutions, the costliest form of childcare, with poorer child outcomes (Lumos 2020). The fragmented Czech child welfare system, overseen by multiple ministries, makes comprehensive change difficult, complicates decision-making, and pits ministries against each other for funding allocation (Cilečková and Chrenková 2011). This complexity hampers efforts to facilitate change, despite evidence favoring alternatives to institutional care, which appear to be the most unwelcoming to families. Policy changes initiated in 2008 aimed at inter-ministerial cooperation, have created some improvements including reduced institutional placements and support for substitute family care (Chrenková 2015). This is in part because NGO’s were funded to provide community-based foster care education and support services, and bolstered short-term foster care with better compensation and training (Cilečková et al. 2012; Šašková and Mertová 2011). The most recent ending of placing infants and toddlers into institutions signals significant and meaningful progress and recognition that children fare best when raised in family settings. However, there remains institutions that house older children. This speaks to the continued need to identify and support foster families to meet the need and public education on the importance of family connections and necessary support for family preservation. Finally youth voices must be included and heard in shaping systemic change.

While most of the professionals interviewed cited the value of the U.S. or UK systems of foster care relative to the Czech system, the U.S. system is far from perfect. One of the most significant issues in the U.S. foster care system is a lack of stability in terms of movement from one substitute care setting to another, especially for adolescents. Forty percent of U.S. children in substitute care experience more than two placements and the longer they are in care, the more likely they will experience more placements (Annie E. Casey Foundation 2024; Zhou et al. 2021). In particular, youth who admitted to foster care as adolescents typically experience multiple placement transitions and are likely to leave the system when they become adults rather than by adoption or family reunification (Maguire et al. 2024; Zhou et al. 2021).

This has an overall detrimental impact on children’s sense of belonging and value, and can have substantial lifelong implications for care leavers in regard to their ability to form future stable relationships (Maguire et al. 2024). While the emphasis on foster care as a short-term solution is intended to ensure children quickly move into a permanent situation, that has not played out well in practice. An artifact of the Czech system was that, while it was less common for children to return home or be adopted, it was quite common for children to remain in the same foster home until long into adulthood, as old as 26 years. In this sense, the Czech system provided more stability than the U.S. system.

The extant research, however, points to the overriding value of temporary foster care over long-term substitute care, and above all prevention in the form of supporting families before they reach the point that a child must be removed. Early detection of problems and funding for early intervention to keep families together remains a strong need in both countries.