Building Relational Permanence to Support the Transition to Adulthood Among System-Involved Youth

Abstract

The transition to adulthood is challenging for all youth, but this developmental period can present substantial difficulties for youth involved in child-serving systems due to a constellation of adversities and a lack of protective factors present in their lives. Notably, many system-involved youth are disconnected from important relationships and are tasked to navigate the increased demands of adulthood without sufficient support. There is a spectrum of services available for youth transitioning out of system-involvement, but the majority focus on independent living skills, which alone are often insufficient to facilitate a successful transition to adulthood. This paper provides details regarding the importance of building relational permanence—relationships with permanent-supportive individuals—among young adults transitioning out of system involvement. Authors review evidence-based approaches, used by community agencies, which build relational permanence for system-involved youth, while discussing future directions to improve the rigor of research on relational permanence, and action for necessary policy change.

1. Introduction

The transition to adulthood is a time in which young people develop the skills to navigate adult roles and responsibilities. While this period can be challenging for all youth, it is particularly difficult for system-involved youth due to additional barriers they often experience, such as a longstanding history of childhood trauma, fractured social support systems, and a lack of resources. Consequently, system-involved youth—a broad range of young people involved in child-serving systems—are at increased risk for a host of poor outcomes during this time such as housing instability, victimization, and incarceration. Community agencies have an integral role in supporting system-involved youth during the transition to adulthood, but the evidence to date indicates that these supports are often focused on building skills that support autonomy and independence rather than targeting relational support. However, social support is essential for all youth to successfully navigate the transition to adulthood. The purpose of this paper is to provide evidence on the importance of building a specific type of social support—relational permanence (a term used in child welfare)—among system-involved youth during the transition to adulthood. The literature on system-involved youth and relational permanence spans multiple bodies of literature and includes a variety of terminology, methodology, and conceptual frameworks. Therefore, a narrative review was conducted in an effort to integrate information from these diverse bodies of literature. In addition, because relational permanence is a small, but growing body of literature, we intentionally did not apply specific, systematic inclusion or exclusion criteria. In this paper, we first review the literature on the risks and challenges that many system-involved youth face during the transition to adulthood. Next, we discuss the literature on relational permeance and argue for the importance of permanent-supportive connections among all system-involved youth who have been disconnected from important relationships. We then review services provided by community agencies including the small body of literature on those that target relational permanence among system-involved youth. Further, we discuss practical steps to promote relational permanence including the barriers and facilitators of building these relationships. Lastly, we propose important future directions for practice, research, and policy.

2. Experiences of System-Involved Youth

For this paper, we use the term “system-involved youth” to refer to a broad range of young people, including those involved in the child welfare system, juvenile justice, or those experiencing housing instability. Concerningly, there are significant racial disproportionalities among system-involved youth, e.g., [1,2]. The impact of historical and current structural racism has created uneven access and distribution of resources and opportunities that influence system involvement, which is further exacerbated by biases held by professionals within each system [1]. There are different pathways into system involvement, but these trajectories often have marked similarities. Children involved in child welfare, the juvenile justice system, or those who experience homelessness are more likely to have a longstanding history of adversity, including childhood maltreatment and/or experiences of poverty [3,4,5]. It is also not uncommon for youth to be involved in multiple systems. The experience of homelessness often precedes and increases the likelihood of child welfare involvement [6], and upwards of 20–50% of former foster youth experience homelessness by early adulthood [7,8,9]. There is also overlap with the juvenile justice system, and approximately a third of youth involved in the child welfare system have subsequent involvement with juvenile justice [10]. Regardless of the specific sector, system involvement often results in disconnection from social support networks, either through formal (e.g., termination of parental rights) or informal mechanisms (e.g., youth who “run away” from home). While there are unique needs among youth involved in different systems, there is also a notable overlap in their vulnerabilities and lack of protective factors to mitigate the confluence of risk. Consistent with the concept of transdiagnostic interventions, we argue that it is important to target the underlying core needs among all system-involved youth, especially pertaining to social connectedness during the transition to adulthood [11,12].

3. Transition to Adulthood Among System-Involved Youth

According to Arnett’s theory of emerging adulthood, late adolescence through the mid-to-late twenties captures a developmental period in which youth transition to adulthood [13]. During this time, youth encounter new experiences and are tasked to acquire the skills to manage the increased responsibilities of adulthood [14]. Although Arnett’s theory of emerging adulthood has been critiqued for not fully capturing the experiences of all cultural and socioeconomic groups, it nonetheless offers a useful framework for examining the transition of system-involved youth as they exit child-serving systems. Its focus on identity exploration, instability, and growing autonomy provides valuable insights into the developmental challenges young adults face during this critical period. While this developmental period presents challenges for all youth, it is considered a particularly risky transition for system-involved youth [15]. Many youth—such as those transitioning out of the child welfare system—are no longer wards of the state and do not qualify for previously available services [14]. System-involved youth are also not afforded the same opportunities as their same-age peers to practice the skills that support self-sufficiency [16]. The abrupt discontinuation of services, coupled with unreliable supports, can leave youth unprepared to live independently and assume adult responsibilities such as finding housing, employment, and healthcare [15,16]. Due to both acute and chronic adversities, system-involved youth are particularly vulnerable during this juncture for additional risks across many domains of life including housing instability, victimization, incarceration, unemployment, poverty, and mental health problems [15]. In addition, system-involved youth are disproportionately more likely to hold multiple identities that are systematically disadvantaged, which also heightens their vulnerability during the transition to adulthood.

4. Social Support and the Transition to Adulthood

Even though the transition to adulthood presents many challenges for system-involved youth, prior research has elucidated protective factors that mitigate risk during this transition, e.g., [17]. While some assets are more internal to the individual—intelligence, academic achievement, educational aspirations—it is well-replicated that a strong social support system is integral for a successful transition to adulthood [13,17,18]. A strong social support system creates a safety net for all youth when navigating independent living such as finding affordable housing, work, and education [19], and a scoping review indicated that supportive relationships were a key indicator of success among youth transitioning out of the foster care system [20]. Among system-involved youth, examples of a strong social support network include a close relationship with a caregiver, relationship with a natural mentor, or placement stability with supportive caregivers [17]. Prior research has found that social support among youth transitioning out of the foster care system is associated with numerous indicators of a good quality of life including psychological well-being and their capacity to take advantage of housing and educational opportunities [21,22,23,24,25,26,27]. Among youth experiencing homelessness, stronger social support has been associated with less psychological distress including suicidality, loneliness, hopelessness, and other symptoms of severe mental illness [28,29,30,31,32].

Among system-involved youth, social support is often complicated, and many have fractured social support networks [33]. The risk factors of youth in the child welfare system and those who become homeless largely overlap and are often a product of a longstanding history of ruptured social relationships, such as childhood maltreatment or frequent transitions in care [34,35,36]. While not specific to system-involved youth, a recent scoping review revealed that parental involvement—particularly striking a balance between care and autonomy—has a profound influence on the adjustment of emerging adults. These findings emphasize the critical need to cultivate stable, meaningful relationships, especially for system-involved youth [37]. Research also indicates that youth with intersecting, marginalized identities face additional barriers when building social support, and a recent scoping review indicated that familial emotional support was lower among youth who identified with a sexual or gender minority identity [38]. This finding was also supported for foster youth who identified as Black/African American or American Indian/Alaskan Native [27]. Despite a history of inconsistent relationships, some system-involved youth—including those transitioning out of foster care and/or experiencing housing instability—endorse connections to biological family or peers during the transition to adulthood [27,33,39,40]. While some youth return to their biological family when exiting care [41], others maintain their connections to biological siblings even when residing in different foster homes [33]. However, familial support for system-involved youth is often complex, as past experiences within their family relationships—such as childhood maltreatment or substance abuse—may have been the reason for child welfare involvement or the precipitant of an episode of homelessness [42,43]. Other sources of support do exist, and system-involved youth have identified more informal supports such as caseworkers or therapists as important sources of support [44,45]. While this type of support is impactful for system-involved youth, it is often transient due to staff turnover or the discontinuation of services when youth emancipate from care [44,46].

Despite the evidence on the importance of social support, it is important to note that social support has many definitions, and it does not necessarily reflect the presence of quality, permanent connections. Many studies measuring social support among system-involved youth fail to capture the experiences and qualities that are integral to form emotionally supportive and long-lasting relationships [47]. Youth transitioning out of system-involvement are often provided independent living services, but these typically focus on opportunities to develop and utilize social supports to improve educational outcomes or obtain housing and employment [48]. What these plans can fail to do, however, is to create permanent-supportive connections that endure after the provision of formal supports to youth end and throughout the transition to adulthood.

5. Relational Permanence

Even though social support is important for overall well-being, especially during the transition to adulthood, for system-involved youth, it is important to consider their unique history and disconnection from important relationships. Each year, upwards of 22,000 youth do not achieve legal permanence—reunification, adoption, or transfer of legal guardianship—when they transition out of the child welfare system [49,50,51,52]. Youth experiencing homelessness are also disconnected from stable adult relationships, as these youth are more likely to rely on their peer networks rather than parental support [53,54,55,56]. Given the absence of permanent connections to supportive adults, there has been a focus in the field of child welfare to build relational permanence, which has been defined as a “sense of belonging through enduring, life-long connections to parents, extended family or other caring adults, including at least one adult who will provide a permanent, parent-like connection for that youth [57] (p. 509), [58]. Though relational permanence encompasses multiple constructs, it is qualitatively unique. For example, while legal permanence—the reunification, adoption, or transfer of legal guardianship—is marked by longevity, it is not necessarily characterized by a parent-like connection. In addition, while social support often offers a sense of belonging, it can be cultivated from both enduring or more transient relationships. Jones and LaLiberte identified several essential characteristics of relational permanence that center on social connectedness, establishing a safety net, and creating a sense of belonging [57]. In the literature to date, research on relational permanence has primarily been conducted among youth in the child welfare system. The results suggest that youth transitioning out of the foster care system who had a permanent connection with a caring and supportive adult more successfully navigated the transition [44,59,60] and had better psychological well-being [24,60,61,62]. These findings have been replicated among informal relationships for youth outside of the foster care system. Schwartz and colleagues found that adolescents who had either dropped out or were expelled from high school, but had an enduring natural mentoring relationship, demonstrated better educational, vocational, and behavioral outcomes [63]. However, because all system-involved youth—regardless of their involvement in the child welfare system—are at heightened risk for disrupted interpersonal relationships, it is integral for community agencies to prioritize relational permanence especially as these youth transition to adulthood.

6. Supports for System-Involved Youth

6.1. Independent Living Support

Community agencies have the potential to facilitate the development of permanent-supportive connections, especially as youth transition to adulthood. However, the body of literature examining the services offered by community agencies for system-involved youth has largely centered on independent living skills rather than relational support [33,64]. For example, the Foster Care Independent Act of 1999 was designed to support youth as they transitioned out of the child welfare system by supporting their independent living skills [33]. Independent living skills encompass the skills needed for self-sufficiency, which often includes budgeting or vocational skills to obtain employment [33]. While these skills are very important—especially when navigating the increased demands of adulthood—there is generally a lack of resources directed at other important areas of development such as socio-emotional well-being and relational health [33].

This is evidenced by Woodgate and colleagues’ scoping review of interventions delivered in the child welfare system, which found that the majority of studies centered on independent living skills [65]. These interventions were generally associated with positive outcomes in the domains of education, housing, and employment, but the findings were inconclusive on whether these improvements translated to a successful transition to independence [65]. In their review, several interventions had relational components, but few studies measured any outcome related to social support or the construct of “relational permanence” as defined in this manuscript [65]. Findings from a more recent systematic review of interventions with youth aging out of the child welfare system also found that the most commonly studied intervention centered on independent living readiness [66]. While this type of skill-building helped youth to manage the increased demands and responsibilities of adulthood (e.g., achieve housing stability), it did not bolster social support [66]. There were similar findings from a longitudinal randomized control trial examining the impact of Life Skills Training (LST) on social support among youth in foster care compared to services as usual [67]. The results suggested that there was a significant reduction in social support for both the LST and control group over time, indicating that the LST intervention did not improve social support [67]. Not only is there a disproportionate focus on independent living skills, but a systematic review with youth exiting foster care in the U.S. and Canada found that many youth voiced the importance of emotional support and mentorship to help navigate the transition, but failed to receive such support [68].

The prioritization of independent living skills, rather than relational support, also occurs in other systems including the context of homelessness and the juvenile justice system. Wang and colleagues conducted a systematic review of interventions for youth experiencing homelessness and restricted their review to randomized control trials and systematic reviews [69]. Overall, they found that the majority of interventions were individual and family therapy, which were associated with improvements in mental health [69]. In the few studies that included social support as an outcome, there were null effects [69]. Similarly, in a systematic review of interventions designed to prevent or address youth homelessness, there was only a handful of studies that targeted relationships through family interventions [70]. While the methodological rigor of these studies varied, the results suggested that family interventions supported youth well-being and behavioral health, but it was unclear if there were positive effects on housing stability [70]. For youth transitioning out of the juvenile justice system—including those with cross-over involvement in other systems (e.g., child welfare)—there are few programs that targeted relational support [71]. Together, the body of literature on interventions delivered to system-involved youth indicates that the large majority of supports center on independent living skills. Because the methodological rigor of these studies included in these reviews was generally weak, it is unclear whether improvements in independent living skills were sustained or if they reflected a successful transition out of system involvement [63]. There was also a notable absence of research on the role of permanent-supportive connections to help youth apply these skills, bolster their emotional well-being, and ease the transition to adulthood.

6.2. Relational Supports

Despite the overwhelming prevalence of independent living skill interventions among system-involved youth, Økland and Oterholm conducted a scoping review specifically focused on social support interventions among youth transitioning out of the child welfare system [72]. Their inclusion criteria were broad—encompassing both quantitative, qualitative, and mixed-design studies—yet only twelve studies were identified. These interventions varied widely in methodology, but reflected five approaches to bolster social support, which included natural mentoring, formal mentoring, formal mentoring and skills training, network facilitation by intensive family finding, and self-help groups [72]. Given the small body of literature and the variation in methods included, limited conclusions were made. However, there was tentative evidence to suggest that support by mentors and peers was beneficial for youth, which is consistent with a prior systematic review of natural mentoring programs for youth aging out of the child welfare system [48]. Økland and Oterholm also found that youth who engaged in a family finding intervention had improved social support networks, suggesting that this type of intervention created an avenue to identify and build permanent-supportive connections [72]. One of these studies evaluated the Family for Iowa’s Children’s intervention, which utilized family finding tools to identify and help re-build permanent family connections [73]. Youth who engaged in this intervention formed a larger support network, developed an emotional connection to at least one adult, and had a higher likelihood of reunification or kinship care compared to youth who received child welfare services but did not participate in this intervention [73,74]. Similar outcomes were found by Shklarski, who evaluated the Family Finding and Engagement Project at the Children’s Village in New York [75]. Their family search and engagement team used a multi-step approach, which included mobility mapping and social media to help youth rediscover relatives or other significant adults in their lives who also had the capacity to form a stable and supportive relationship. After these individuals were identified, staff then created opportunities to facilitate the development of these new relationships. The results were positive; youth who engaged in this intervention cultivated a stronger support network, and importantly, achieved relational permanence by forming a stable and emotional connection to at least one adult [75].

For youth in other systems—such as those transitioning out of the juvenile justice system—there are several programs that target connections with supportive adults [71]. For example, the Youth Villages program was founded on the principle that connection with family, or another support system, is critical for a successful transition out of the juvenile justice system [76]. Prior research suggests that youth who participated in the Youth Villages program—and had frequent contact and support by a case manager—showed improved outcomes in the domains of health, safety, and housing stability [76]. However, while mentorship from a case manager is an important form of social support, it is not a substitute for relational permanence since it does not represent a stable connection for youth as they transition out of system involvement. The lack of relational permanence was also notable in a recent scoping review of interventions for youth transitioning out of any out of home care setting (e.g., foster care, residential care) [77]. Even though “helping relationships” were foundational to support the transition to independence, youth described this social support as transitory, as it did not accompany them through the long and complex transition to adulthood [77]. These reviews highlight a glaring absence of initiatives that support relational permanence for all system-involved youth, and, in particular, those involved in systems outside of child welfare. This presents a pressing need to develop evidence-based and feasible strategies to cultivate relational permanence for all system-involved youth given the importance of permanent-supportive relationships especially during the transition to adulthood.

7. Community Agencies and Their Role Facilitating Relational Permanence

There have been calls in the field to restructure the types of support provided to system-involved youth. This includes relationship reforms in which professionals proactively bolster youth’s social support networks during and after their time in care [27,78,79,80]. We argue that in terms of relationship reform, it is integral for community agencies to target a specific type of social support—relational permanence—especially during their transition to adulthood. A foundational understanding of relational permanence is needed, including the challenges and facilitators of building permanent-supportive connections with system-involved youth.

7.1. Challenges to Building Relational Permanence

To effectively build relational permanence, it is important to plan for the challenges that arise when helping youth to develop permanent-parent-like connections. Many system-involved youth have a history of childhood maltreatment, which can interfere with the ability to form trusting relationships with safe caregivers, e.g., [81]. This was a prominent theme in a scoping review among youth transitioning from out-of-home care as many youth named their history of trauma as a barrier to forming trusting relationships [45]. Repeated disruptions in important attachment relationships also shape beliefs and expectations for future relationships, especially pertaining to qualities such as stability and dependability [60]. These findings have been replicated among youth in the child welfare system. A higher number of placement moves were associated with fewer stable relationships among Black males [82], and many youth with a history of multiple foster care placements, or who were aging out of foster care, perceived that it was risky to seek help from others [83]. This can result in a “survivalist self-reliance” identity, which is theorized to develop from premature independence, the absence of a stable caregiver, and pride in refuting dependence [33]. While this mindset reflects adaptation to experiences within the child welfare system, it can also impede connection to supportive relationships [33]. Additionally, as noted above, many system-involved youth maintain some form of connection with their biological family despite being physically separated from them. While these relationships are complex and may have difficult relational dynamics, some youth feel discomfort forming relationships outside of their biological family system [33]. This can restrict their openness to form parent-like connections with non-biological family members and constrain the benefits of multiple family relationships [33]. For youth who are open to forming new relationships, there are qualities that interfere with relationship building; youth with a history of foster care who described relationships as disempowering or transactional perceived the support as disingenuous and unreliable [47]. Regardless of whether youth are open to creating (or re-engaging in) relationships with family or non-family, it is important to understand that social and personal relationships can be both sources of support and strain [84].

It is also essential to recognize that many system-involved youth, regardless of the sector, have experienced ambiguous loss [50]. Ambiguous loss reflects losses that have no clear boundaries or endings [85]. These losses also lack societally recognized traditions to grieve or acknowledge the loss, and thus, have no resolution [85]. The scope of ambiguous loss is vast and includes situations in which a person is psychologically but not physically present [85]. For system-involved youth, this could include the termination of parental rights or youth who “ran away” from home and became disconnected from family members [50]. Ambiguous loss also encompasses situations in which a person is physically present but psychologically distant [85] and may reflect circumstances that precede system-involvement such as parental mental illness or substance abuse [50,85]. The loss of home also reflects disrupted attachments to physical places as well as social networks, and for many system-involved youth, this loss goes unacknowledged [86]. The impact of ambiguous loss is significant, and the lack of closure can result in unresolved grief and interfere with the capacity to cope [85]. Among youth in the child welfare system, ambiguous loss has been shown to influence expectations about their social world and family identity as well as their sense of agency to form and maintain enduring relationships [50]. In the limited research on ambiguous loss among homeless youth, Parker and Mayock found that many had a “fragmented or ruptured understanding of family” as their family relationships were characterized by estrangement, separation, abandonment, and feelings of rejection [87] (p. 558).

Moreover, limitations related to systemic and organizational factors create barriers to building relational permanence among system-involved youth. As previously reviewed, implementation studies indicated that relational permanency interventions are time-intensive and have a prolonged preparation phase in order to build trust with staff and support readiness to engage in this process [88]. However, for many staff working with system-involved youth, the demands of a high caseload limit the time available to them to effectively deliver relational permanency interventions. Additionally, the high turnover among case workers can inadvertently disrupt efforts when facilitating relational permanence among youth [46].

7.2. Facilitators of Relational Permanence

Even though there are challenges to building relational permanence among system-involved youth, prior research has identified qualities that support the development of permanent connections to supportive adults. Given the diverse, and often multi-family systems of system-involved youth, it is important to understand the varied levels of membership that each youth has with each family system [47]. Prior research has found that youth in the child welfare system often use socially constructed definitions of families as opposed to strict biological criteria [89]. Seeking youth’s perspectives on the scope of their relationships with biological family, adoptive family, or non-familial relationships, such as mentors or teachers, can help identify potential supportive connections [47,60]. Even though there are benefits to multiple supportive connections, some youth feel tension from having mixed loyalties to more than one family system [60]. These youth may need additional assistance when exploring non-biological connections to navigate the conflicting feelings that may accompany this process [60]. To help process the impact of ambiguous loss on one’s sense of identity and expectations about future relationships, youth should be provided with relational continuity, which is the knowledge about their history especially pertaining to past relationships [50,57].

Importantly, qualitative research has elucidated qualities that support the development of permanent, supportive relationships. Among youth transitioning out of the child welfare system, an essential—but often missing factor—was emotional support [33]. Similarly, focus groups with youth transitioning out of foster care revealed qualities that facilitated relational permanence with natural mentors, which included a mutually meaningful relationship with a trustworthy individual who felt like a family member or role model [90]. These findings are consistent with research in the broader literature indicating that warmth and positive regard are important qualities for high-quality family relationships [38]. In addition to characteristics of the relationship itself, a key antecedent to relational permanence is agency. System-involved youth often experience situations that are out of their control, which creates feelings of powerlessness that can generalize to their beliefs about sustaining relationships with important individuals in their lives [91,92]. Youth transitioning out of the child welfare system who feel constrained by system rules may deny options for extended care [93] and emancipate from care without the support from stable relationships [33]. These findings highlight the importance of choice and bolstering youth’s sense of agency to enact change in their life, especially when balancing independence while simultaneously developing safe and supportive relationships [45].

7.3. Models to Develop and Support Relational Permanence

There are evidence-based practices—built on the foundational principles of relational permanence—that have been designed to build supportive and permanent connections among system-involved youth. While these interventions have been primarily developed and implemented with youth in the child welfare system, their principles transcend the system sector and have the potential to support the development of stable relationships for all system-involved youth. One exemplary model is Intensive Permanence Services (IPS), which prepares youth for relational permanence by addressing trauma, grief, and loss in addition to identifying and building supportive-permanent relationships through family search and engagement processes [88,94]. IPS consists of four phases that are implemented over the course of 18–24+ months, reflecting the time investment needed to adequately nurture relational permanence among system-involved youth.

IPS begins with the Trusting Phase (0 to 10 months), and during this time, workers start to build a relationship with youth. This relationship is foundational because trust and connection are a requisite for youth to engage in the often emotional and vulnerable process of building relational permanence. In addition to relationship building, IPS workers start to use multiple approaches (e.g., genograms, case record reviews, timelines) to identify family and other important relationships [88]. Following Phase 1, IPS workers initiate the Healing Phase (6 to 18 months) to help youth process past and ongoing grief, trauma, and loss as well as its influence on relationships [88]. As part of this process, youth are supported as they explore the questions of “Who am I? What happened to me? Where am I going? How will I get there? and When will I know I belong?” [95] (p. 198). The last two phases of IPS are the Connecting and Supporting Phases. In the Connecting Phase, the IPS worker focuses on relationship building between youth and the caring individuals that were identified during the first two phases [88]. In the final Supporting Phase, the IPS worker continues to support the development of these relationships, which often centers on the role of trust [88]. Throughout these last two phases, the IPS worker still has an active role in helping youth heal from past traumas and to support their socio-emotional development [88].

IPS reflects a holistic approach to build relational permanence for youth in the child welfare system. As reflected by the four phases, IPS is demanding and requires a significant time investment to adequately prepare youth to form new relationships and to identify and facilitate the development of these relationships. Based on qualitative interviews with staff who implemented IPS, several challenges to this model include funding, managing increases in challenging behaviors as youth healed from trauma, and concerns of re-traumatizing youth by unintentionally creating connections with unsupportive individuals [88]. Despite these challenges, staff also shared their perspectives about what helped make IPS a success. This included a youth-driven approach situated within an organizational culture of staff well-being and a systems change in effective collaboration between all stakeholders [88]. Even though it may not be possible to replicate IPS due to the constraints of a given system, this model elucidates key evidence-based strategies that develop and support relational permanence among system-involved youth.

While IPS is an exemplary model as it is built on the evidence-based qualities of relational permanence, the body of research is small and primarily composed of qualitative studies. Therefore, it will be important to build a more robust empirical foundation to determine its effectiveness across systems. In addition, other evidence-based and promising practices are also available. The Family for Iowa’s Children’s (FIC) project [73] and the Family Finding and Engagement Project at the Children’s Village in New York [75] use overlapping, evidence-based strategies to build relational permanence. The FIC has five components, which include (1) referral, (2) information gathering, documentation, search and identification, (3) contact, (4) assessment and engagement, and (5) family ties: transition to family, and documentation [73]. Family finding is at the crux of this intervention, and a trained search and engagement specialist is assigned to each youth to identify important individuals in their life through various outlets (e.g., obituary records, social media, birth certificates). Similarly to IPS, youth receive extensive support in preparation for developing and maintaining relationships to increase the likelihood that relational permanence will be sustained [73]. The Family Finding intervention has similar strategies and is composed of six steps to support older youth in foster care to achieve relational permanence [93]. These steps include (1) discovery, (2) engagement, (3) planning with blended perspectives, (4) decision-making, (5) evaluation, and (6) follow-up and support. Research on the effectiveness of these interventions is varied, but overall, the evidence points to positive outcomes for youth when implemented with fidelity [73,74,75,88]. Though there is evidence for positive outcomes, it is important to conceptualize these findings as preliminary as many of these studies are conducted with small sample sizes. However, a recent implementation of the Family Finding Intervention revealed the challenges that arise when delivering this type of intensive intervention [96]. Permanency specialists who facilitated the Family Finding Intervention spent relatively more time on the initial discovery and engagement steps to prepare youth for the family search and engagement process [96]. Due to the often time-consuming nature of the first two steps, permanency specialists had greater difficulty implementing the remainder of the intervention and faced challenges when operationalizing relational permanence [96]. Implementation studies like these are integral to inform practice, as they revealed the importance of designing an intervention with ample time for initial relationship building between youth and program staff in order to subsequently move onto the steps that lead to relational permanence. The results also highlighted the need for clear protocols that build relational permanence coupled with validated questionnaires that measure the construct of relational permanence and can be re-administered over time to assess progress [96].

8. Implications for Research and Policy

8.1. Research Implications

The characteristics of permanent-supportive connections as well as interventions that bolster relational permanence have been primarily studied within the context of child welfare, but their potential for positive impact transcends system sector. Future work is needed to expand the definition of relational permanence among other system-involved youth who have overlapping experiences yet unique needs compared to those in the child welfare system. This includes a deeper understanding of the prevalence of permanent-supportive connections, the characteristics of these relationships, and youth perspectives about building relational permanence as they transition to adulthood. Building this foundational knowledge is integral to tailor the mechanisms and content of interventions to support relational permanence.

While there are existing interventions that would generalize to youth outside of the child welfare system, supports must be situated within one’s cultural context [97]. Frey and colleagues propose that a key characteristic of relational permanency is for youth to have a lifelong connection to their “family history and traditions, race and ethnic heritage, culture, religion and language” [98] (p. 3). Therefore, in addition to supports that target relationship building, there should also be an intentional focus on how these relationships can facilitate the transmission of traditional knowledge and values [98,99]. For American Indian and Alaska Native youth—who are disproportionately overrepresented in many child-serving systems—the trauma processing support should incorporate a historical perspective (e.g., colonization, genocide, dislocation, forced assimilation) in addition to experiences of ongoing discrimination [97]. Concomitantly, culturally specific healing modalities should be used throughout the healing process [99] and facilitated by elders and the tribal community [100]. Research is also needed to identify a culturally informed search process to identify permanent-supportive connections. Among Indigenous communities, there is social capital in one’s spirituality, faith, and connection to the land [101,102]. It is possible that forming connections with these culturally specific healing modalities or places may serve as pathways to building relational permanence.

The intersecting identities of system-involved youth are also likely to influence relational permanence. One important (and often overlooked) identity to consider in this work is that of LGBTQ+ youth. LGBTQ+ youth are overrepresented in child-serving systems, and a leading reason is due to family rejection and lack of support [103,104,105]. Prior research has found that among youth in the child welfare system, those who identified as LGBTQ+ were less likely to have a supportive adult in their life [106] and had lower perceived family support compared to their non-LGBTQ+ peers [107]. Due to discrimination from both within child-serving systems [108], and from one’s family [104], youth who identify as LGBTQ+ are at increased risk for low relational permanence especially in regard to family relationships. To better support youth who identify as LGBTQ+, or those with any marginalized identity, it is particularly important to understand their “chosen family” and explore non-traditional kinship networks [109,110].

In addition to future research that informs culturally specific strategies to build relational permanence, there is a need to incorporate multiple methods to capture the nuances of relational permanence. The current body of research on relational permanence with system-involved youth has primarily used qualitative methods to gather youth’s perspectives about their current challenges, perceptions of social support, and openness to engage in supports that target relational permanence. While ongoing qualitative work will be important to gather a wider diversity of perspectives, especially among youth involved in child-serving systems outside of child welfare, future research should also incorporate quantitative methods that capture relational permanence. One promising measure is the Youth Connections Scale (YCS), which is a validated scale that measures five domains of youth connectedness and the strength of their relational permanence [57]. Based on findings from a pilot study of the IPS program, youth who engaged in the intervention reported a significant increase on the YCS from baseline to the completion of the intervention [88]. These results indicate the feasibility of incorporating measures such as the YCS into intervention studies to assess change over time. Moreover, Shlarski specifically recommended the YCS as a tool to assess the fidelity of interventions that target relational permanence [75]. Together, it will be critical for future investigation on relational permanence to include a multi-method, longitudinal approach to elucidate key mechanisms of change for building relational permanence among system-involved youth. These studies should incorporate randomized controlled trials to enhance the robustness of the findings of whether relational permanence interventions improve well-being over and above standard care.

8.2. Policy Implications

Policy change is also fundamental to support relational permanence as it influences the allocation of funding and the services offered to system-involved youth [111]. A requisite to shaping policy is creating a shared philosophy about what constitutes child well-being across child-serving systems [111]. As reflected by the myriads of policies across child-serving systems, there are many conceptualizations of child-well-being, which affect the prioritization of specific types of supports. In the child welfare system, well-being was traditionally defined as achieving physical safety and legal permanence, which led to the creation of policies such as the “Adoption and Safe Families Act” and was designed to expediate a child’s time in foster care [112,113]. While these efforts are important, it became clear that physical safety and legal permanence did not equate to child well-being [113]. This motivated a deeper investigation into child well-being to build a comprehensive framework that recognized the full humanity of system-involved youth [111]. Based on interviews with child welfare professionals, key themes of well-being included “humanization, fulfilling connections with a responsive adult, and a long-term, hopeful future orientation” [113] (p. 1). These themes, as well as the definitions of well-being suggested by Jones et al. [111] and Samuels [114], are highly compatible with the abundance of evidence that indicates that well-being necessitates connection to a permanent-supportive adult especially during the transition to adulthood after formal services end. While it is challenging to reach a consensus of child well-being within one child-serving system, let alone across multiple systems, it is integral for policies to reflect the robust evidence on relational permanence to support the well-being of all system-involved youth. To enact meaningful change, coordination is required across multiple system levels. On the federal and state level, it is important for agencies to have the opportunity to apply for grant funding that prioritizes the development of programs targeting relational permanence. Because system-involved youth span multiple sectors, it is also essential to develop cross-system collaboration such as the development of shared data systems to track relational permanency across agencies. Furthermore, programs that bolster relational permanence are intensive and require time. Therefore, within agencies, structural changes are required to provide appropriate training and allow for adequate time and resources to engage in these efforts.

9. Conclusions

This paper provides evidence on the importance of relational permanence for all system-involved youth, especially during their transition to adulthood. System-involved youth are at increased risk for low relational permanence given fractures to their social relationships that often accompany system involvement. Given the literature to date, the majority of programs that support system-involved youth focus on independent living skills, and the few evidence-based programs that target relational permanence are primarily implemented within the child welfare system. Despite the importance of these supports, they are insufficient to meet the evolving needs of young people as they become adults; a critical missing piece is sustained support from a permanent-supportive adult to provide a safety net as youth navigate the increased demands of adulthood and outgrow connections to formal, youth-focused supports. Additional research is needed on relational permanence, especially with youth outside of the child welfare system, coupled with a wider diversity of methods to reveal key evidence-based mechanisms that bolster relational permanence. Alongside this work, policy change is paramount to restructure the type of resources available to community agencies as they support youth transitioning out of system involvement.