Children and Youth Services Review 122 (2021) 105899
Available online 29 December 2020
0190-7409/© 2020 Elsevier Ltd. All rights reserved.
What does research tell us about young people’s participation in decision
making in residential care?
Lynne McPherson a,*,1, Meaghan Vosz a,1, Kathomi Gatwiri a,1, Natalie Parmenter a,1,
Noel Macnamara a,2, Janise Mitchell a,2, Joe Tucci b,2
a Centre for Excellence in Therapeutic Care, Australia
b
CEO, Australian Childhood Foundation, Australia
A R T I C L E I N F O
Keywords:
Participation
Young people
Decision making
Residential care
A B S T R A C T
More than three decades ago, the United Nations Convention on the Rights of the Child signalled to an international audience that all children under the age of 18 years are to be regarded as having certain rights. These
rights include the right to be actively involved in decisions that affect their lives. In spite of this international
obligation, which has been translated globally into policy and legislation across the world, little is known about
the extent to which it is enacted in practice for young people living in residential care. This article reports on a
systematic scoping review which investigated research publications on participation in making life-impacting
decisions by young people. A critical theoretical lens was applied to the collation and analysis of publications,
enabling a multidimensional presentation of fve emerging themes. The implications for practice and policy
include the need for organisations to challenge professional attitudes and disrupt practices which exclude young
people from participating in decisions that impact on their lives, and for residential care staff and social workers
to provide information and safe and inclusive spaces to support young people to form and express their views.
Having heard their views, responsible adults must then demonstrate that they have been taken seriously.
1. Introduction
It is increasingly evident through the literature that participation
involves more than just ‘having a say’ and must include access to information about the decisions to be made and one’s rights in the process,
including the right to be listened to and taken seriously (Lansdown,
2011; UNICEF, 2017). The principles dictated by the United Nations
Committee on the Rights of the Child have been embedded into various
international and state-based legislation governing the care planning
process, and are utilised in national and state department training
manuals and practice guidelines on working with children (Children
Youth and Families Act, 2005, Vic). While the term ‘participation’ is not
used in UNCROC, Article 12 enshrines children’s right to access information and articulates the obligations of adults to ensure that children
and young people can effectively participate in decisions that affect their
lives and have their views seriously considered in all matters that affect
them. The Committee on the Rights of the Child has noted in particular
the participation rights of children and young people separated from
parents and who have experienced violence, abuse and neglect to
participate in administrative and judicial proceedings (United Nations
Committee on the Rights of the Child, 2009). The Committee has
endorsed a widely-held view of children and young people’s participation as the “… ongoing processes, which include information-sharing
and dialogue between children and adults based on mutual respect,
and in which children can learn how their views and those of adults are
taken into account and shape the outcome of such processes” ((United
Nations Committee on the Rights of the Child, 2009, p. 3).
In this study, we focus on the way these obligations have been
enacted for young people who are placed in residential care. We interrogated how power operates within care settings and the implication for
young people’s participation in decision making. We theorised that
those with less power—young people in residential care—would
* Corresponding author.
E-mail addresses: [email protected] (L. McPherson), [email protected] (M. Vosz), [email protected] (K. Gatwiri), natalie.
[email protected] (N. Parmenter), [email protected] (N. Macnamara), [email protected] (J. Mitchell), [email protected]
(J. Tucci).
1 Locked Mail Bag 4, Coolangatta, QLD 4225, Australia.
2
Post Offce Box 3355, Richmond, Victoria 3121, Australia.
Contents lists available at ScienceDirect
Children and Youth Services Review
journal homepage: www.elsevier.com/locate/childyouth
https://doi.org/10.1016/j.childyouth.2020.105899
Received 5 August 2020; Received in revised form 21 December 2020; Accepted 22 December 2020
Children and Youth Services Review 122 (2021) 105899
2
potentially be silenced in the context of a service system that privileged
management information systems demonstrating effciencies and cost
savings. Residential care, as just one component of the wider child
protection system, has been heavily critiqued in England in recent years
as being dominated by neoliberal ideology and, as a consequence,
bureaucratised processes and practices (Munro, 2011). In this context, it
is possible that power may be tightly held by those who make signifcant
life decisions in relation to young people in care, often senior bureaucrats, for fear of ‘losing control’ should they allow participation and the
consideration of diverse perspectives in the decision-making process.
2. Participation in the context of residential care settings
Young people placed in residential care have been referred to as the
most vulnerable of the vulnerable (Gatwiri, McPherson, Parmenter,
Cameron, & Rotumah, 2019). They cannot live in a family arrangement
and often will have been placed in residential care with little notice or
consultation due to an emergency situation and whilst in care may
continue to be at risk of harm (Moore, McArthur, Death, Tilbury, &
Roche, 2018). This placement process may have silenced their voice in
that, regardless of their wishes, feelings and views, a decision has been
made for them to live in residential care (Larkins et al., 2015). Whilst
any child who has been removed from home and placed in out-of-home
care may be considered to be vulnerable, it is widely understood that
young people in residential care exhibit highly complex needs and histories and often respond to intensive therapeutic trauma-informed care
(Gatwiri, Cameron, McPherson, & Parmenter, 2020; Moore et al., 2018).
The term ‘complex’ describes the different intersecting experiences of
children and young people living with “multiple problems, complicated
and diffcult to describe situations” which often lead to multiple and
elaborate interventions by competing services (Jackson, McKenzie, &
Frederico, 2019, p. 114). The literature shows that young people in
residential care are likely to have experienced signifcant trauma, abuse
or neglect, often demonstrating pain-based and challenging behaviours,
including self-harming, substance misuse and offending (McPherson,
Gatwiri, Tucci, Mitchell, & Macnamara, 2018). Residential care is often
regarded as a placement of ‘last resort’ where, having been removed
from or rejected by their families, young people with signifcant traumabased emotional, physical and behavioural challenges must learn to live
in a group setting with other vulnerable youth, and staff who rotate daily
on a roster.
2.1. The Australian context
In Australia, consistent with many Western countries, 6% of children
and young people in out-of-home care are placed in residential care,
with the vast majority of children and young people in care in homebased care arrangements (AIHW, 2020). Historically, Australian child
welfare legislation, programs and care arrangements have drawn
heavily from the English system (Swain, 2014). Unlike many other
countries, however, Australia does not have a history of large campusstyle therapeutic residential facilities which offer onsite educational
and therapeutic programs (Swain, 2014). Residential care in this
country is funded by state and territory government departments and
delivered by non-government community service organisations. Programs are typically delivered in suburban houses, accommodating four
to six young people, cared for by rostered staff who hold welfare or
youth work qualifcations (Gatwiri et al., 2019). Whilst residential care
services in Australia vary according to state and territory policy, they are
distinct from psychiatric in-patient and juvenile correction units and do
not typically include onsite education programs. Once in residential
care, young people in Australia and internationally continue to be
vulnerable, and at a stage in life when they may also be exploring and
exercising agency. Extensive international research identifes that those
who transition from state care, including residential care, experience
greater levels of hardship than their peers. Care-leavers encounter more
homelessness, unemployment, substance abuse, contact with the criminal justice system, social isolation and interpersonal problems than
peers who have not experienced the care system (Fernandez & Atwool,
2013; Gypen, Vanderfaeillie, De Maeyer, Belenger, & Van Holen, 2017;
Hemphill, Heerde, & Scholes-Balog, 2016; Muir & Hand, 2018; Welch,
Fowler, Ross, Withington, & McGhee, 2018). Outcomes are particularly
poor for Indigenous care-leavers and those leaving residential care
(Gatwiri et al., 2019; Mendes, Saunders, & Baidawi, 2016). The evidence
also suggests that young people with disability in residential care settings experience additional barriers to participation in decision making,
such as lack of access to assistive communication, and a lack of confdence with practitioners (Franklin & Goff, 2019). Studies reporting on
young people who are placed in residential care are clearly dominated
by ‘narratives of failure’, with research often reporting on poor outcomes (Brady & Gilligan, 2019).
A growing body of knowledge identifying the developmental impact
of complex trauma in early years and beyond (see, for example, Atkinson, 2013; Carr, Duff, & Craddock, 2018; Cook, Blaustein, Spinazzola, &
Van der Kolk, 2003; Spinazzola, Van der Kolk, & Ford, 2018) suggests
that many young people placed in residential care are likely to struggle
with the process of decision making (Carr et al., 2018; D’Andrea, Ford,
Stolbach, Spinazzola, & Van der Kolk, 2012). Having experienced
trauma and/or neglect whilst in the care of adults who held positions of
trust, and commonly experiencing exclusion from aspects of daily decision making, young people in these circumstances often have diffculty
trusting people and processes. They may communicate their unresolved
pain and frustration by demonstrating challenging and antisocial behaviours, including chronic substance misuse, self-harming and
aggression. At the same time, once they are placed in residential care,
young people face a series of major life decisions which need to be made
about future relationships, education, training and future plans. In this
context, participation in the decisions that will affect their lives becomes
increasingly challenging, yet critically important.
The importance of enabling ‘every child’s right to be heard’ (Lansdown, 2011) is well documented internationally, in the form of local
legislation and policy such as the Children Youth and Families Act 2005
(Vic) and the Commonwealth Child Safe Framework (Australian Government, 2019), principles for practice, practice resources and practice
guidance (Lansdown, 2011; McDowall, 2016). What may be less well
known is the extent to which participatory practice is operationalised—in particular, whether young people in residential care are
being given a say, being heard and have an influence in case and care
planning decision-making that affects their lives. In 2018, ten Brummelaar and colleagues conducted a narrative review sourcing research
in relation to youth participation in decision-making procedures in
residential care (ten Brummelaar, Harder, Kalverboer, Post, & Knorth,
2018). The review covered the period from 2000 to 2016 and found that
there were enablers and challenges surrounding participation at the
individual young person, organisational and cultural levels. This current
study builds on earlier work with a critical theoretical lens, reporting on
contemporary publications from 2010 to 2020 which focus on the
participation in life decisions by young people placed in residential care.
What follows is an articulation of the methodology adopted for this
study.
3. Study design and methodology
3.1. Systematic scoping review
A systematic scoping review was identifed as the most appropriate
method, given the identifed need to scope the availability of research in
this area and to identify research gaps (Gatwiri et al., 2019). We adopted
a fve-phased approach in conducting our review, following Arksey and
O’Malley (2005) methodological framework for scoping reviews. The
phases are: (i) developing a research question, (ii) systematically identifying relevant studies, (iii) screening and selecting relevant studies
L. McPherson et al.
Children and Youth Services Review 122 (2021) 105899
3
based on identifed inclusion and exclusion criteria, (iv) charting the
data and (v) collating the results (Arksey & O’Malley, 2005).
3.2. Theoretical frame
A critical perspective was an appropriate theoretical lens through
which to analyse the data. Where injustices are perpetuated by dominant attitudes held by those who have power, a critical approach enables
the deconstruction of tightly held, but disempowering discourses
informing practice (Bronner, 1994). We conceptualise residential care
practices as being imbued with power. Issues of power relationships
between staff and young people may facilitate or act as barriers to young
people’s genuine participation in decisions that affect their lives. As
such, our analysis privileges young people’s perspectives and lived experiences of residential care in the context of the relevant but socially
and politically powerful policies, culture and structures under which
they live. A critical perspective also recognises young people’s agency at
the intersections of these structural, political and institutional constraints, including organisational culture, which may also enable or
inhibit participation. It also affords a deep exploration of specifc practice architectures and the conditions that enable or constrain participation and decision-making recognition in residential care.
3.3. Five-phased approach (Arksey & O’Malley, 2005)
3.3.1. Phase one: Developing the research question
The initial phase confrmed the research question: what does
research tell us about young people’s participation in decision making in
residential care? Our conceptualisation of ‘participation’ was informed
by the work of Lundy (2007), whose model of participation has been
shown to provide a sound framework for implementing participation in
child welfare practice and care settings, particularly emphasising the
need for practitioners to listen and give due weight to children and
young people’s views (Jackson, Brady, Forkan, Tierney, & Kennan,
2020; Kennan, Brady, & Forkan, 2019). Lundy identifed four elements
of participation for decision-makers to address in enabling the authentic
participation of children and young people. These are: space, voice,
audience and influence (Lundy, 2007). The element of space involves the
provision of safe, friendly, accessible, culturally safe and inclusive
spaces. In these safe spaces, young people are considered an integral part
of the decision-making process and have support to form their views.
Having a safe space to form one’s views is understood to come before
expressing views. Secondly, it involves creating mediums and environments where voice is not merely tokenistic but rather a genuine process
of facilitation and engagement into the needs of young people.
Respecting young people’s right to have a view is a critical principle to
participation. This also involves addressing any barriers and obstacles
that may suppress participation in decision making. The third element,
audience, ensures that young people have access to people who have the
power to make decisions and that, in turn, adults listen, hear and give
weight to those views, taking into account the age and stage of development of the young person. Finally, participation involves young
people witnessing the way in which their views are considered and acted
on by those in power. This element of influence suggests that decisions
and processes should involve young people with a clear demonstration
of the outcomes of their input (Lundy, 2007).
The term ‘decision making’ was defned to include all decisions that
affect the lives of young people in residential care, consistent with
Article 12 of the United Nations Convention on the Rights of the Child
(1989).
3.3.2. Phase two: Systematically identifying relevant studies
In this phase, we systematically identifed relevant studies by
developing a search protocol in consultation with our university
research librarian. Seven databases were searched: Academic Search
Premier, Cinahl, Medline, ProQuest, PsycInfo, Scopus and InfoRMIT.
The search terms adopted were: ‘youth’ OR ‘young people’ OR ‘young
person’ OR ‘adolescent’ OR ‘child’ AND ‘decisions’ OR ‘decision making’
AND ‘residential care’ OR ‘group care’ OR ‘institutional care’ AND
‘participation’ OR ‘collaborative decision making’.
3.3.3. Inclusion criteria
We developed clear inclusion and exclusion criteria for the strategy,
in consultation with the research librarian, to ensure that we were only
including manuscripts that would have relevance to residential care as it
is constructed in Australia, focusing on offering care to young people, as
opposed to infants and children, in small home-like environments (as
opposed to congregate care settings) with rostered staffng models. Only
studies focusing on out-of-home care arrangements and residential care
were included.
We searched for full-text articles published in the English language
between 2010 and 2020 in scholarly journals. The search was conducted
between May and June 2020. A ten-year time frame was chosen to limit
our results to contemporary fndings in what is a rapidly evolving feld of
practice. Peer-reviewed, scholarly manuscripts were included where
they published research in relation to young people (under 18 years) in
residential care and their participation in decisions that may affect their
lives. A limited selection of grey literature was sourced in tandem to the
peer-reviewed publications. Reports sourced in this phase were research
reports that were not scholarly publications and appeared to have
relevance to the research question.
3.3.4. Exclusion criteria
Where manuscripts reported on residential care arrangements that
were primarily mental health programs or, alternatively, were operating
as large orphanage-style arrangements, these were excluded as having
limited relevance to this study focus. We also excluded publications
identifying other non-out-of-home care/looked-after children settings,
such as disability and medical settings, schools and legal or youth justice
settings.
Manuscripts that were not peer-reviewed research publications
including guidelines for practice and theoretical publications were
excluded. Whilst of value in their own right, these publications did not
directly address the identifed research question. Some studies report on
multiple forms of care, for example, foster care and residential care.
Where the distinction between forms of care—for example, home-based
care and residential care—was not able to be made, we excluded the
publication.
3.3.5. Phase three: Charting the data
The initial search involving the seven databases resulted in 3250
scholarly, peer-reviewed studies being identifed and eight publications
for consideration from the simultaneous grey literature search (see
Fig. 1). The frst level of screening and selection involved the removal of
duplicates (n ¼ 56) before eliminating on the basis of the title of the
publication (n ¼ 2,248), leaving 954 publications to review. In accordance with the inclusion and exclusion criteria, two researchers then
vetted the abstracts, excluding a further 800 studies. Finally, the
remaining 154 full publications were screened, with two researchers
reviewing the full-text publication for relevance to the research question
and adherence to the inclusion and exclusion criteria. Where there was a
lack of consensus between the two researchers about the relevance of a
particular publication, at this stage and in relation to the screening of
abstracts earlier, a third researcher moderated with a majority decision
being made. This fnal process resulted in 11 studies being selected for
inclusion in the thematic analysis.
3.3.6. Phases four and fve: Collating and analysing the results
The fnal set of publications for thematic analysis are summarised in
Table 1. This table identifes the author and location of the eleven
studies, including fndings, methodology, and key implications and
recommendations (see Table 1). Four of the studies were conducted in
L. McPherson et al.
Children and Youth Services Review 122 (2021) 105899
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Australia, two studies in the United Kingdom and Norway, and one study
in Italy, Sweden and the Republic of Ireland respectively. Seven studies
involved data collection directly from young people in care, whilst four
used secondary data sources to study young people’s participation,
including case fles and reports from staff.
In our analysis, we drew upon Braun and Clarke (2006) thematic
analysis method, which values reflexivity as a central factor for uncovering assumptions, and implicit and underlying socially constructed
meanings in qualitative research (Clarke & Braun, 2017). This method
goes beyond the identifcation of signifcant information to offer further
interpretation and implications through a process of deeper thinking
about aspects of the topic and patterns in the data (Clarke & Braun,
2017). The phases for guiding the thematic analysis were: becoming
closely familiar with the data, “generating initial codes … searching for
themes … reviewing themes…generating a thematic ‘map’ of the analysis, defning and naming themes …, ongoing analysis to refne the
specifcs of each theme and the overall story … generating clear defnitions and names for each theme” (Braun & Clarke, 2006, p. 87).
4. Results and thematic discussion
Five core themes were identifed inductively from an analysis of the
results. These are presented and critically analysed below. A critical lens
is applied to the discussion of themes (Bronner, 1994) and, where
relevant, reference is made in the discussion to Lundy’s elements of
effective participation (Lundy, 2007, 2018).
4.1. Genuine participation in ‘everyday life’ decisions but little or no say
about ‘major life’ decisions
Three studies found that young people in residential care felt that
they had a say about the everyday running of the residential unit and
Fig. 1. PRISMA Chart.
L. McPherson et al.
Children and Youth Services Review 122 (2021) 105899
5
Table 1
Results summary.
Author Country Methodology Findings Implications/Recommendations
Brady et al.
(2019)
Ireland Secondary analysis of 40 Health Information
and Quality Authority (HIQA) reports, which
measured compliance with Ireland’s National
Standards for Foster Care, Residential Care
and Special Care in Tusla agencies across
Ireland. Each report was analyzed according
to how much opportunity young people were
given to participate and voice their wishes and
needs during care reviews and other processes
relating to their care.
Reports were analyzed using the following
criteria: everyday decision making,
participation in care reviews, access to
information and advocacy services and access
to complaints systems. Good practice was
found overall. Differences in the application of
the standards and levels of participation were
found between foster care and residential care.
This review occurred prior to the
implementation of a three-year action
programme geared to embed children’s
participation across all out of home care
structures across the country. Further primary
research involving children and young people in
care is needed to collect the perspectives of
young people and their carers and how they
experience inclusive decision making.
McCarthy
(2016)
Northern
Ireland
Qualitative study which examined the case
studies of 13 young people across four
residential childcare centres in Ireland and
their capacity to ensure children’s rights to
participate in decision-making. Semi
structured interviews were constructed for
data collection and themes were drawn from
the data.
Themes from the data included: everyday
issues, keeping friendships, being involved in
decisions that affects their lives, admission to
residential care, access to family members,
future planning and education. From the data
a number of factors which influence the means
of participation by young people. Factors
included: personalities of the young people,
resources and space for inclusion and
participation and the skills and training of
professionals charged with their care.
More resources for care professionals is required
to help ‘bridge the gap’ between young people
knowing about their rights to participate and
being included and contributing in decisions
which affect their lives.
McDowall
(2018)
Australia Mixed method approach using mixture of
online survey or telephone or face-to-face
interviews. The questions contained both
qualitative and quantitative content. In total,
1275 young people aged 10–17 years
participated. Data was analyzed via SPSS
The study revealed 81% of respondents were
quite happy with where they were currently
placed. Ninety-three percent of respondents
reported feeling safe and secure. Carers were
the main source of support for young people.
There were 44% of young people who were
aware of having a case plan. Only 43% of those
44% were involved in its development. Home
based care was more benefcial compared to
residential care or independent living.
Further steps need to be taken to not just ‘voice’
the needs of young people but to actively
dismantle barriers that prevent young people
from taking an active role in decision making
that affects their lives. More provisions are
required for care workers to establish frm
connections with young people. More attention
needs to be placed on young people in
residential care ensuring they are able to
achieve the same outcomes as their peers living
in other forms of care.
Moore et al.
(2017)
Australia Qualitative participatory study which
involved 27 young people aged between 10
and 21 living in residential care which asked
for their perspectives on what makes living in
residential care safe. Interviews were semistructured, face-to-face and took between 45
and 90 mins in duration. Interviews were
transcribed coded via NVivo software and
analyzed via a grounded theory approach. Key
concepts from the data were categorized in
alignment with the research questions via the
constant comparison method. Analysis was
inductive, coding was deductive in nature.
From the fndings, young people reported that
more care needs to be taken in matching
young people with care workers, more focus
on risks which exist in residential care,
creating a more ‘home-like’ environment and
increased participation of young people in
decisions which affect their lives.
More needs to be done from the practice, policy
and research felds to actively engage young
people in discussions about their care
experience not only to improve their experience
but to strengthen their sense of control over
their lives and their future.
Moore et al.
(2018)
Australia Participatory qualitative study attached to a
wider study on children’s safety. Interviews
were conducted with 27 young people aged
10–21 asking them their opinions on safety in
residential care. Interviews asked young
people directly about what staff can do to
make their lives more safe and secure.
Interviews were face-to-face, either one-onone or in pairs. Interviews were semistructured and focused on what young people
felt could be done to improve their safety and
wellbeing.
Young people expressed the importance of
employing care staff who possess qualities of
being caring, proactive and persistent in
building attachments with them. It was
important to young people that they felt
listened to and that care staff prioritized the
voices of those in their care. Young people felt
it was important that care staff engaged with
them proactively in building skills in selfprotection.
Findings revealed that child-worker
relationships need to be prioritized and young
people need to be consulted with and included
in decision making which affects their safety,
wellbeing and future outcomes. This should be
done by prioritizing ongoing training for staff,
and implementing open and clear channels of
communication for young people to express
concerns or risks to their safety.
Pålsson
(2017)
Sweden Qualitative study using a multi-method design
incorporating observation data, interviews
and case fle analysis. Inspectors were
interviewed and observed, and 147 case fles
were examined from a representative sample.
Data pertaining to children’s views collected
from observations and interviews from
inspectors differed to data found within
children’s case fles. Regulatory quality
criteria used by inspectors appears to
contradict what children perceive to be the
most important in regard to their care. For this
reason, more engagement and participation of
children in decision making is needed to
ensure children’s voices are heard and their
needs addressed.
Improving the quality of care for children living
in care in Sweden is centred around the
relationship between the young person and
those that provide them with daily care. A
combination of relationship building and
creating positive living environments were
important to the young people whose case fles
were examined. There are calls for quality
measures to be standardized across Sweden to
reduce too much variation in perceptions of care
quality.
RoeschMarsh et al.
(2017)
United
Kingdom
This study utilized an action research
approach whereby the researchers work in
partnership with those being investigated.
First phase involved a process of reflection
and data collection to better understand the
complexities of children’s involvement in care
A majority of social workers and reviewing
offcers felt that children’s input into care
reviews had a signifcant impact. Most young
people who were involved in the study
understood the decisions being made about
their care. Of those young people who were
This study provided promising evidence that
young people’s participation in care reviews has
a positive impact on the young person as well as
future outcomes relating to their care. The study
was conducted on a small scale, so future studies
examining young people’s participation in care
(continued on next page)
L. McPherson et al.
Children and Youth Services Review 122 (2021) 105899
6
Table 1 (continued)
Author Country Methodology Findings Implications/Recommendations
plan reviews. The research team examined a
local authority’s evaluation, conducted
interviews with key stakeholders and held
focus groups with reviewing offcers. Second
phase involved a qualitative process of
engaging young people in interviews prior to
care plan reviews. Reviewing offcers were
given reflective questionnaires which asked
questions regarding children’s participation in
reviews. There were 69 questionnaires in
total, 48 over the age of 10 years and 22 were
aged between 2 years and 9 years of age.
Social workers were also engaged in the
questionnaire process, of whom 52 opted to
fll out a questionnaire. In a third phase, 26
young people flled out a mixed methods
questionnaire containing a mixture of
qualitative and quantitative questions relating
to their comprehension of the review process
and whether they felt part of or included in the
review process. Data was analyzed via the
statistics software package, Stata. Qualitative
data was stored and analyzed via NVivo.
involved, 69% of them believed their input
made a difference on the outcome of their care
reviews. All young people stated that they had
someone they trusted they could go to
following their review session.
reviews across a broader representative sample
across the United Kingdom are encouraged.
Serbati and
Gioga
(2017)
Italy Qualitative, semi-structured interviews were
conducted with a combination of 21 young
people (n = 7), social workers (n = 7) and
residential care workers (n = 7) asking for
their perceptions on outcomes of the
residential care experience. Questions were
structured around young people’s wellbeing
and specifc elements which enhance
outcomes for their future. Young people were
aged between 20 and 27 years of age and had
been in residential care between 1 and 11
years in duration. Interviews lasted 60 min or
more in duration. Thematic analysis was
employed following the collection of
interview data.
Young people identifed the following
elements contributing to positive outcomes for
their future: job prospects, personal
relationships, the ability to tell one’s life story
and the ability to complete a personal life
project (realistic goals for the future). Young
people who self-reported as doing well after
care attributed relationship development and
support in developing a personal life project as
a means for getting where they were in the
present day. Support in rebuilding family
relationships was also important.
Better communication is required between
young people, their social worker, residential
care workers and the young person’s families.
Better long-term outcomes are attributed to
stronger attachments and connection with
family. It is important for social workers and
residential care workers to facilitate the
rebuilding of connections and listening to young
people’s wishes should they wish to reconnect
or re-establish attachments with their birth
family.
Southwell
and Fraser
(2010)
Australia Quantitative study using a self-reporting
questionnaire addressed to young people
living in residential care. The questionnaire
was devised following focus groups and
consultations with young people living in
residential care, foster care and kinship care.
In total, 169 young people aged between 6 and
18 years of age responded to the questionnaire
representing 34% of the total population of
young people in residential care (n = 503).
Descriptive and inferential statistical analysis
techniques were employed.
There were positive outcomes reported in
relation to young people’s sense of being able
to participate in decision making. Of those
surveyed, 77% of them felt they had a say in
every day household matters, 86% felt that
they were being listened to and 94% felt they
had the rules explained to them. There was
less satisfaction with inclusion in decision
making for higher order matters. Only 28%
knew about their own case plan and what was
contained within it, 56% felt they had
decisions made by the child protection system
adequately explained to them and 65% felt
they had an adequate explanation as to why
they entered the child protection system.
Research concluded that whilst results on young
people’s participation in care was promising,
there is more to be done from an institutional
level to facilitate better inclusion of young
people in higher order decision making around
their future within and outside of their care
journey.
Vis and
Fossum
(2015)
Norway Quantitative study utilizing a questionnaire
designed for social workers in Norway,
developing an understanding of how social
workers perceived children’s participation in
decision making and interactions and
engagements which would facilitate young
people’s participation. A total of 87 social
workers completed the questionnaire and
were recruited from two different child
welfare organizations in Norway. Chi-square
and t-tests were used to analyze demographic
differences and one-way analyses were used to
examine differences in perspectives on
children’s participation in decision-making.
Young people living in foster care were found
to have more opportunities to participate in
decision making in comparison to young
people in other care situations such as
residential care. Differences were attributed to
the personal circumstances of the young
people namely the nature of their social or
behavioural capacity determined their
placement in either foster care or residential
care. Young people’s capacities have
determined their opportunities for
participation.
Future research should look at the types of
decisions young people are and are not included
in and look at what aspects contribute to
diffculties in including young people in
decision making.
Vis et al.
(2012)
Norway Quantitative study using an agree or disagree
questionnaire designed for case managers and
social work students focusing on what kinds of
factors contribute to a young person
contributing to decisions regarding their care
and future. There were 86 participants in the
questionnaire in total. There was a pre and
post measure assessment.
The questionnaire was designed using a 5-
Some key reasons why case managers were
hesitant to include young people in decisionmaking included: avoiding further
psychological harm, trouble communicating
with young person, unclear loyalty or unstable
relationship connection, young person not
having the capacity to participate, different
understandings of what participation means
Further resourcing is required for care
practitioners to strengthen their communication
skills with young people, particularly those with
social or behavioural challenges. Caseprocessing needs to be reformed, becoming
more ‘child-friendly’ so young people are able to
clearly understand processes and provide
informed input into the development of case
plans and plans for their future wellbeing.
(continued on next page)
L. McPherson et al.
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were able to exercise some choice about issues such as recreational activities, meals, household chores and telephone calls (Brady et al., 2019;
McCarthy, 2016; Serbati & Gioga, 2017). These fndings are consistent
with the proposition that young people should be supported in their
right to voice their views on everyday matters in informal settings
(Lansdown, 2011). However, when it came to decisions that young
people considered as ‘major life decisions’ (Brady et al., 2019; Moore
et al., 2018) or a ‘shared care plan’ (Serbati & Gioga, 2017), the
emerging picture was different. Nine studies found that young people
felt that they either had no say at all or that when they had a say, it did
not influence the outcome of key decisions and was not ‘given due
weight’ (Brady et al., 2019; McCarthy, 2016; McDowall, 2018; Moore
et al., 2018; Roesch-Marsh, Gillies, & Green, 2017; Pålsson, 2017;
Southwell & Fraser, 2010; Vis & Fossum, 2015). These major decisions
included where they would live, the nature and frequency of access to
family and friends, education and training, employment options and
plans for the future. Typically, power and control with respect to these
decisions were held by the caseworkers, often social workers, who were
responsible for the creation and review of the care plan (known in
Australia as ‘case plans’) for the young person.
Care/case plans are commonly used tools in statutory care situations
where major decisions about the young person’s future are made. In
spite of the case-planning and review process being a core opportunity
for the participation of young people, a concerning fnding in three
studies found that many young people in residential care were not aware
of the content of their case plan (McDowall, 2018; Pålsson, 2017;
Roesch-Marsh et al., 2017). This concern was an international one,
found in studies conducted in Sweden, the United Kingdom and
Australia. In one Australian survey involving 1273 young people in outof-home care, 68% felt that there was a lack of opportunities to have a
say in important decisions, less than half of these young people were
aware that they had a case plan and just 43% reported that they had
been involved in its preparation (McDowall, 2018). Other Australian
reports indicated a similar picture, with between 21% and 25% of young
people in residential care surveyed indicating that they do not usually
get to have a say and do not usually feel listened to (NSW Department of
Communities and Justice, 2019; Robertson, Laing, Butler, & Soliman,
2017). In Sweden, a study involving an analysis of 147 case fles showed
that 30% of the young people had not been consulted about their care
plans (Pålsson, 2017). Where young people were given a voice in the
planning process, the critical role of preparation of the young person for
planning meetings was highlighted (Roesch-Marsh et al., 2017).
4.2. Bureaucratisation and formal processes impact participation
Whilst the issues identifed may appear to be related to the frst
theme, the emphasis here is on the nature of bureaucratic requirements
that constrain participation versus the presence of a safe relational space
created for the young person. Major life decisions with respect to young
people in residential care were often reported to be made in formal
meeting settings that were not conducive to young people participating.
In some situations, young people and residential care staff were not
invited to participate in these signifcant decision-making forums and
allocated social workers were seen as reluctant to share the outcomes of
the meetings (Vis, Holtan, & Thomas, 2012). In other situations, young
people reported that the process was intimidating for them. A typical
picture of these decision-making meetings was a number of professionals sitting around a table in a formal meeting arrangement,
experienced by the young person as “all these tall adults towering over
you” (Roesch-Marsh et al., 2017, p. 908), and for which there had been
limited or no preparation for the young person.
In summary, both the setting and space created, and the bureaucratised care planning process were experienced as constraints to
effective participation across several studies (Pålsson, 2017; RoeschMarsh et al., 2017; Vis & Fossum, 2015). In contrast, where young
people reported a safe, relational space with a key professional, usually a
residential care worker or social worker, they felt able to voice their
opinions (McCarthy, 2016). In a small qualitative study in Ireland, a
young person suggested that there was strong rigidity in how decisions
are made by social workers:
Once a social worker makes a decision I don’t think there is any
compromise … I’ve never been in a situation where a social worker
makes a decision and you say “Well, I’m not really happy about that”.
I’ve never heard them say “well, maybe we can negotiate”. It’s “well,
that’s the decision, that’s it …” (McCarthy, 2016, p. 380).
Another young person in this study suggested that the lack of risktaking by social workers was “more about covering themselves”
(McCarthy, 2016, p. 381) in an attempt to protect themselves from being
blamed should something go wrong.
Applying a critical lens to this fnding, ‘risk aversion’ in contemporary practice is seen as a product of neo-liberal ideologies applied in a
welfare setting, where much of the focus is on targets and accountability
for effcient, rather than effective, handling of cases and performance
standards which measure outputs rather than outcomes in health and
welfare settings (Green & McDermott, 2010). This managerialist paradigm places social workers in the invidious position of being largely
accountable to their organisational hierarchy as opposed to the clients
that they seek to serve. Structural constraints within this neo-liberal
capitalist system and the fact that social workers’ practice is framed
by these discourses, which often sees children as objects for adult care
and professional treatment, rather than persons to build warm relationships with, appear to prevent young people from participating in
decision making. Within this context, risk-assessment and riskminimisation tools, used as instruments of accountability, tend to be
prioritised and to drive practice in organisations, rather than the
complexity of contemporary person-centred practice which promotes
participation (McDermott & Green, 2010).
4.3. Professionals’ attitudes and beliefs about young people and
participation influencing their behaviour
The issue of ‘control battles’ emerged, where it was seen that some
staff members found that everyday participation by young people could
Table 1 (continued)
Author Country Methodology Findings Implications/Recommendations
point Likert scale with twenty statements
pertaining to the nature of obstacles which
hinder children’s participation in decision
making. Data was analyzed in a three-step
process. Correlations were drawn between
variables.
A three factor
solution which aimed to explain 50 per cent of
the variance was produced because it resulted
in fewer cross loadings than the other
approaches.
and a desire to minimize conflict between
child and birth family.
L. McPherson et al.
Children and Youth Services Review 122 (2021) 105899
8
be challenging. Residential care staff described the process of ‘having a
say’ as not always straightforward (McCarthy, 2016, p. 374). In this
study, diffculty in facilitating participation was expressed by social
workers, where young people in residential care presented with challenging behaviours and with an “absence of pro-social language and
behaviour, their desperation to be heard can cause diffculties for them”
(McCarthy, 2016, p. 377). Two studies, highlighting the diffculties
faced by this cohort, found that young people in family-based placements were more likely to be included in major decision-making processes than young people who were placed in residential care (Brady
et al., 2019; Vis & Fossum, 2015). Indicating that professional attitudes
and beliefs about young people could be problematic, Vis and Fossum
(2015) noted that:
Diffcult children also have the right to participate in decision
making. Children and adolescents admitted to residential care may
indeed fnd themselves in an even more vulnerable situation
compared to children who are looked after at home or placed in
foster care (Vis & Fossum, 2015, p. 284).
Key professionals’ beliefs also emerged as a determinant in the young
person’s participation in decision making (Brady et al., 2019; Vis &
Fossum, 2015). Three distinct approaches to participation were identifed, based on a study involving the care inspection process, where the
inspectors made decisions about what information they gave weight to
(Pålsson, 2017). Approaches were founded on inspectors’ beliefs and
attitudes. These beliefs and attitudes informed their sense of purpose in
their work as falling into one of three categories:
(i) A compliance function, where children’s ‘voice’ is seen as a
requirement that may not impact or influence the process of
inspection
(ii) Supportive advocacy, where children’s views are both elicited
and reflected in the inspection process, or
(iii) Protection, where children’s perspectives are sought, however,
limited agency is given to them, and the belief that their wellbeing must be protected limits their participation (Pålsson,
2017, pp. 37–38).
Interestingly, this study found that although inspectors recorded
remarks made by 397 children, only 3% of these remarks influenced the
outcome of the inspection. A clear fnding was that children exerted
limited influence in the process of inspection involving their care. In
another study, the age and experience levels of social workers were
found to inform how they engaged with young people. In this study,
experienced case managers were found to be less likely to prioritise and
facilitate the participation of children in decision-making processes than
social work students, who saw participation as important and a priority
(Vis et al., 2012). Factors associated with social workers’ reluctance to
facilitate participation among young people in residential care were
cited to be communication diffculties, that it was seen as unnecessary or
that the caseworker held concerns that it may be harmful for the child to
participate (Vis et al., 2012). These authors also reported on the earlier
work of Shemmings, who found that social worker’s attitudes toward
participation fell into two dichotomous positions: that of their ‘rights’ to
have a voice that was heard versus a need to ‘rescue’ young people from
any further harm (Vis et al., 2012). Professionals’ mis/understanding of
participation (informed by the social and cultural context which often
views children and young people as vulnerable, lacking in agency and in
need of adult protection) further suppresses participation in decision
making by young people.
Across each of the studies identifed in this theme, it is evident that
key professionals hold much power in progressing both the facilitation
of young people’s ‘voice’ and the level of influence that their wishes and
views are given. The way in which that power is enacted is influenced by
ideology, attitudes and beliefs about young people in residential care,
the role of key workers to advocate or protect and views about the value
versus perceived risks associated with participation.
4.4. Organisational culture facilitating or constraining young people’s
participation
The role of organisational culture also emerged as a factor influencing social workers’ preparedness to facilitate participation (Vis &
Fossum, 2015). A pilot study explored social workers’ views on child
participation from two different child welfare organisations, fnding that
social workers employed in community-based child protection were
more likely to support participatory practice than those working in
residential care units. Whilst a difference in the client cohort may have
been a contributing factor, this study identifed organisational culture as
a key to this fnding, suggesting that bureaucratic organisations with
rigid structures and standardised operating models may inhibit professionals’ willingness to respond to young people flexibly and creatively (Vis & Fossum, 2015). This fnding is consistent with the frst and
second themes where young people report that their input is either not
sought or taken into account, and that the highly bureaucratic settings
under which these decisions are made are not conducive to effective
participation. Additionally, issues of power and control were identifed
as barriers to facilitating young people’s participation. In one study, a
young person identifed that:
Everyone was arguing and shouting basically and you’re sitting there
like … a wee 11-year-old isn’t going to say anything … like I didn’t
feel like I had anything that was gonna help, even though it was
about me. They just had so many views and opinions about what was
going on in my life I didn’t feel I could say anything because they
were all so strong (Roesch-Marsh et al., 2017, p. 909).
An organisational culture that privileges the voice of adults is indicated by this young person’s experience, and is one which is unlikely to
hear the voice and views of children and young people. A recent review
of Aboriginal and Torres Strait Islander children and young people in
out-of-home care made a similar fnding, that ritualism in organisational
cultures can further constrain their participation in decision making.
Ritualism is defned as the “acceptance of institutionalised means for
securing regulatory goals … [and where] caseworkers take comfort in
the rituals of casework, such as safety assessment and risk assessment
while losing focus on the goal of child protection” (Davis, 2019, p. 160).
As such, the organisational structures through which children and young
people can have their voices heard must be easy to follow and not
layered with bureaucratic and ritualistic “red tape” to minimise the
possibility of the experience becoming aversive and counterproductive
(McDowall, 2018, p. 108).
4.5. The central role of relationship and relational practice in facilitating
young people’s participation
The fnal theme was that of the importance of relationship and
relational practice in residential care, and the extent to which a trusting
relationship could enable young people to participate in decision making. Participation in major life decisions was conceptualised as an
ongoing process, rather than an event that only took place at scheduled
review meetings (Roesch-Marsh et al., 2017). When viewed this way, the
effectiveness of participation relies on a sound process and, in turn, relationships that facilitate and support the planning and preparation for a
care plan review, including decisions about setting and space, who attends, the role of the chair and the participation of the young person
(Roesch-Marsh et al., 2017).
Studies in this review highlighted the foundational role of the relationship and relational practice (Moore et al., 2018; Moore, McArthur,
Death, Tilbury, & Roche, 2017; Roesch-Marsh et al., 2017). There were,
however, mixed fndings when it came to the extent to which a
L. McPherson et al.
Children and Youth Services Review 122 (2021) 105899
9
consistent trusting relationship was available to young people in out-ofhome care. Australian young people have also expressed reservations
about the motivation of some residential care staff, citing an apparent
lack of interest or skill (Moore et al., 2018). Young people were able to
articulate the qualities of trusted staff who were skilled in forming
trustworthy relationships: demonstrating that they cared, being
encouraging and supportive, being willing to spend time with young
people, being consistent and available, taking their safety seriously and
protecting them from harm, ‘hanging in’ with young people over time
and providing young people opportunities to ‘have a say’ (Moore et al.,
2018, p. 72).
The signifcance of meaningful relationships for children and young
people in residential care has been widely acknowledged (Harder,
Knorth, & Kalverboer, 2013) in terms of promoting resilience, supporting the young person exhibiting challenging behaviour and ensuring
active participation in decisions affecting young people (Cahill, Holt, &
Kirwan, 2016). Contemporary residential care programs, whilst not a
homogenous group, theorise that the traumas that were experienced in a
relationship can be treated in and through the use of a trusting, reparative relationship, which is seen as a central component of residential
care (Spinazzola et al., 2018).
5. Implications for policy, practice and further research
Drawing on the fve themes in this study, several implications may be
drawn for practice, policy and research. Firstly, practitioners and
organisational managers can disrupt the division between everyday and
major life decisions in young people’s lives. Such disruption may refocus
our obligations to enable young people participation in all decisions that
affect them, individually and as a group, as both a means and an end.
These are obligations not diminished by young people’s need for protection, but through which their empowerment can be facilitated
(Lansdown, 2018). Responding to the second theme highlighting the
formality, bureaucratisation and/or ritualism that constrains participation, an opportunity arises to authentically engage young people,
practitioners and policy actors in reconceptualising accountability,
removing the drivers of risk-aversion and managerialism in program and
organisational cultures, and balancing risk, protection and young people’s agency in decision making. Applying Lundy’s model to practice,
Kennan et al. (2019) suggest that young people can be included in major
life decisions through one-to-one consultations, inviting them into care
planning meetings, and supporting their participation through using
youth-friendly processes and language, such as using worksheets to
explore and record their views before meetings. Practitioners can also
work one-to-one with young people to explore the communication styles
they prefer and what to expect in decision-making forums, and enable
them to express their views. Policy actors can support these practices by
including children and young people with experience in residential care
in policy-making processes, giving due consideration to their views and
respecting their lived experience (Vosz, Keevers, Williams, et al., 2020).
Theme three indicates scope for developing organisational practices
to challenge practitioner views that participation may not be in young
people’s best interests. Well-supported participation may facilitate
young people’s agency within a context of respectful relational practice
and developing autonomy (Tisdall, 2017). This theme points to the need
for workforce capacity-building to support practitioners in providing
information, introducing safe and inclusive spaces, supporting young
people to express their views and practise participation, and learning to
take these views seriously in residential care decision-making. Applying
Lundy’s model directly to practice, organisations can model the
involvement of children and young people in program design, service
evaluation, workforce recruitment and development. Elsewhere, we
have discussed some of the organisational and practice implications for
involving young people in residential care decision-making (Vosz,
McPherson, Parmenter, & Gatwiri, 2020).
Linking themes three and four, we suggest that professionals’
attitudes and organisational cultures are mutually reinforcing within the
policy context. Following Gal (2017) arguments, an ecological approach
to identifying and implementing micro-, meso- and macro-level practices can support young people to enter into trusting relationships with
practitioners and policy actors, enabling them to overcome barriers to
their participation within supportive, respectful and reflexive organisational cultures and policy contexts (Gal, 2017). Programs that include
children and young people, demonstrate respect for their agency and
give weight to their views should be implemented throughout funded
services, and these should be supported by accreditation and evaluation
policies.
Two further implications for future research may be drawn from
themes four and fve: organisational cultures that may constrain young
people’s participation and the central role of relational practice.
Drawing on the element of influence in Lundy (2007) model of participation, young people need to see that participation makes a difference.
Youth-led research may identify and trial program designs and organisational cultures that embed young people’s participation but requires
ethical attention to the ‘democratisation’ of the research process and
attention to the ‘now what’ of research with young people (Canosa,
Graham, & Wilson, 2018). Finally, the review highlights the inability of
existing policy and practice to operationalise relationality with young
people in residential care. Graham et al. (2018) found that recognising
young people as unique stakeholders, and entering into intergenerational dialogue with them in policymaking, may bridge the gap between
the rhetoric and reality of participation. In practice, co-production and
co-design methods that enable genuine dialogue between young people,
practitioners and policy actors are needed to better understand the
practices that enable young people’s participation in residential care
decision-making at individual and systemic levels (Tisdall, 2017).
6. Limitations of the study
Whilst a rigorous methodological approach was employed to source
relevant publications in accordance with the research question and the
inclusion and exclusion criteria, it is possible that articles relevant to this
study were not identifed. Additionally, scoping reviews do not provide
a critical review of the available research. Rather, they offer a charting
and collation of the literature available in relation to an identifed topic
(Arksey & O’Malley, 2005). They do not, therefore, attempt to investigate the methodological validity, nor assess the quality of each study. In
spite of these limitations, and with appropriate caution, our review offers implications for practice and policy and further research.
7. Conclusion
This systematic scoping review addressed the research question:
what does research tell us about young people’s participation in decision
making in residential care? The review systematically identifed
contemporary research literature which had a focus on the international
obligation for adults to enable young people’s participation in decision
making that affects their lives. The search protocol for this research is
transparent and was conducted in accordance with a scoping review
methodology. Analysis of the eleven documents that were accepted for
review identifed fve core themes.
In spite of more than 30 years of the United Nations Convention on
the Rights of the Child (1989 ((()1989, 1989, 1989 it seems that
organisational policy and cultures may not prioritise participatory
practice with young people in residential care. The fndings of this
systematic scoping review suggest that conceptualisations of young
people’s participation in the residential care workforce, organisational
cultures and policy fail to address the obligations of professionals and
policy actors to explore, understand and improve their own practices
and obligations to enable young people’s participation in decision
making. As a consequence, the gulf between the UNCROC’s intentions
and residential care practice and policy persist internationally. Research
L. McPherson et al.
Children and Youth Services Review 122 (2021) 105899
10
suggests that whilst some young people in residential care can participate in ‘everyday decision making’, many are excluded from major life
decisions that will impact on future living arrangements, relationships,
education and employment. Professional attitudes and organisational
culture were seen to act as barriers to effective participation, whilst
trustworthy, consistent relationships were identifed by young people as
critical to them having a voice and an influence in life-affecting decisions. Further research is required to learn more about the experiences
of young people who feel respected and listened to.
CRediT authorship contribution statement
Lynne McPherson: Funding acquisition, Conceptualization, Data
curation, Formal analysis, Methodology, Supervision, Writing – review &
editing. Meaghan Vosz: Conceptualization, Data curation, Formal
analysis, Methodology, Writing – review & editing. Kathomi Gatwiri:
Conceptualization, Data curation, Formal analysis, Methodology,
Writing – review & editing. Natalie Parmenter: Writing – review &
editing. Noel Macnamara: Funding acquisition, Conceptualization,
Writing – review & editing. Janise Mitchell: Funding acquisition,
Conceptualization, Writing – review & editing. Joe Tucci: Funding
acquisition, Conceptualization, Writing – review & editing.
Declaration of Competing Interest
The authors declare that they have no known competing fnancial
interests or personal relationships that could have appeared to influence
the work reported in this paper.
Appendix A. Supplementary material
Supplementary data to this article can be found online at https://doi.
org/10.1016/j.childyouth.2020.105899.
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