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Evidence-based practice is integral to social work, as it often informs best practices. Competent social workers understand this connection in general and the ways it benefits clients in particular. For this Assignment, consider your informed opinion on the relationship between qualitative analysis and evidence-based practice.

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Write a 2-page paper that addresses the following:

  • Choose two qualitative research studies from this week’s resources and analyze the relationship between qualitative analysis and evidence-based practice.
  • Consider how the qualitative study contributes to social work practice and how this type of knowledge would fit into building evidence-based practice.professional writing services near me

Required Readings

Yegidis, B. L., Weinbach, R. W., & Myers, L. L.  (2018). Research methods for social workers (8th ed.). New York, NY:  Pearson.

Lietz, C. A., & Zayas, L. E. (2010). Evaluating qualitative research for social work practitioners. Advances in Social Work, 11(2), 188-202. Retrieved from

Contact Irregular’: a qualitative analysis of the impact of visiting patterns of natural parents on foster placements Deborah Browne* and Ann Moloney†

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Browne, D., & Moloney, A. (2002). Contact irregular: A qualitative analysis of the impact of visiting patterns of natural parents on foster placement. Child and Family Social Work, 7, 35–45. 

Over the years there has been much debate about the effect of parental visiting on children in foster care. While some contend that it is essential to maintain attachment bonds to the birth family, others argue that contact undermines the new relationship with the foster family. By studying descriptions of visiting patterns of 113 foster placements this study attempts to examine how parental access affects the foster child. A qualitative analysis of the written accounts offered by social workers yielded four distinct visiting patterns: Regular and Frequent, Regular but Infrequent, Infrequent, and No Access. The nature of the analysis also allowed for a redefinition of placement outcome into three categories: Successful placements, Ambiguous placements and Crisis placements. Because the categories that emerged from the qualitative analysis were mutually exclusive it was possible to examine, using chi square, whether there was a quantitative relationship between the variables ‘Placement status’ and ‘Visiting patterns’. Analysis of the categorical data showed a statistically significant relationship between visiting patterns and placement outcome. This relationship, however, was not based on how visiting related to Successful or Crisis placements. Instead it was evident that those placements categorized as Ambiguous were far more likely to report Infrequent visiting patterns. Case examples offer an opportunity to examine possible reasons for this relationship. The paper also describes qualitative accounts of how children reacted to the visits. The unique approach to defining placement status in this study may help explain the conflicting findings on this topic over recent years. Impact of visiting patterns of natural parents on foster placements D Browne and A Moloney Child and Family Social Work 2002, 7, pp 35–45 © 2002 Blackwell Science Ltd terns have on children and young people in foster care. The aim of this paper is to look again at how visiting patterns affect placement outcome. It is hoped that, by using more qualitative techniques than previous studies, new associations will emerge. The response to contact of those involved is also described. The importance of continuing ties The theoretical purpose of fostering is to provide a temporary safe home for a child because his or her parents are unable to do so, with the eventual aim of returning the child successfully to the family of origin. With this in mind it is important the child continues to identify with his natural family. As Oyserman & Benbenishty (1992, p. 541) state, ‘if children are to return home . . . their emotional connection to their biological parents must be promoted. One important way to do this is via mutual visitation during the child’s stay in foster care’. Research indicates that such contact does indeed help to promote biological attachments (Weinstein 1960; Aldgate 1977; Triseliotis 1989; O’Higgins 1993). After examining the case records of 92 children in long-term foster care Poulin (1992), for instance, concluded that there was a highly significant relationship between kin visiting and biological family attachment (BFA). The more a child was visited by the natural family, the greater the attachment they had to them. Children who were visited at least once a month had highest average BFA scores, indicating that regular and frequent visiting patterns gave children the most positive sense of attachment with their biological family. Fanshel & Shinn (1978) reported that children whose parents visited regularly were far more likely to have been discharged by the end of their five-year study than children who received infrequent visits or children whose parents’ visits deteriorated over time. Children who were frequently visited also showed greater gains in IQ, better emotional adjustment, and positive behaviour changes, and visiting was also a significant predictor of overall classroom assessment (Fanshel & Shinn 1978, p. 487). The disadvantages of parental visiting Because the evidence has suggested that ‘parental visiting of placed children is essential to the resolution of the function of placement in each family’s problem’ (Hess 1988), many agencies have concluded that they should attempt to arrange visits at any cost. It should also be acknowledged, however, that visiting patterns may not always be conducive to success. Indeed, many researchers have found that, after initial enthusiasm, visiting patterns deteriorate as the placement progresses (e.g. Fanshel & Shinn 1978; Rowe et al. 1984; Wilkinson 1988).There can be many reasons for this, such as how the social worker encourages the natural parent, or the attitudes of the foster parents to the visits (Triseliotis 1989). Therefore, visiting cannot always be seen as positive and desirable. Many children may even react badly to an impending visit, or will behave poorly after a visit (Rosenfeld et al. 1997; Quinton et al. 1998). Additionally, parents may make promises of reuniting the family that are unrealistic and cause older children unnecessary confusion. The reinforcing of these birth family ties may serve only to endanger the new and more positive bonds with the foster family. The issue is appropriately summed up by Bowlby (1965, p. 141) who commented: ‘[T]he records of all agencies are full of evidence of the difficulties created for children in long-term care by their parents’ inability to permit them to settle in a foster-home and feel part of it . . . The children are left in a turmoil of conflicting loyalties. In one child guidance clinic by far the most difficult cases of disturbed foster-children were those whose parents remained in a conflict of feeling about placement and “carried on an active but irregular connexion with the child”.’ In these cases it would arguably be in the child’s best interest to minimize birth family contact. Indeed Quinton et al. (1997) argued that there was little evidence that contact improved chances of a successful outcome in any case. This view has fuelled an interesting debate (e.g. Quinton et al. 1999; Ryburn 1999) to which the current paper may provide some answers. The purpose of this paper is firstly to attempt to redefine visiting patterns based on the accounts offered by social workers, and then to examine what effect, if any, these patterns have on the progress of the placement. Case studies are offered to illustrate the effects noticed in the analysis. In addition, the children’s reactions to visiting are outlined. METHOD Participants Seventeen social workers completed questionnaires for 127 foster placements.The children in these placements had been fostered for varying episodes over a three-year period. They ranged in age from birth to 36 Impact of visiting patterns of natural parents on foster placements D Browne and A Moloney Child and Family Social Work 2002, 7, pp 35–45 © 2002 Blackwell Science Ltd 20 years. Seventy-four foster families participated in the study.To give due regard to external validity it was important that the sample was representative of the population in general (Fernandez 1996). To this end, social workers from both city community care teams and a special fostering project were involved. This ensured a wide spectrum of socio-economic groups and backgrounds, as each area has a different economic emphasis. Attempts were made to obtain similar numbers from each community care area. Materials Social workers and foster parents completed questionnaires that examined various aspects of each foster placement. The questionnaires were designed to look at a wide variety of psychological issues that affect foster children. Questions, or derivations of them, used in previous studies (e.g. George 1970; Baxter 1989) were included where possible. This procedure also served to enhance consensual validity (Fernandez 1996, p. 73). In relation to the current paper, social workers were asked to give detailed accounts of contact patterns. Specifically they were asked: ‘Please describe in detail interaction between [child] and his or her natural parents, mentioning such things as how often they meet, where they meet, how the child looks forward to these meetings, and how the child feels and behaves after these meetings’. The questionnaires also gave information that determined how the placement would be classified in terms of outcome. These details was derived from questions that were asked of both the social worker and the foster parent in relation to how the placement was progressing, or the manner in which it had terminated – whichever was applicable. Examples of the type of information that was used to determine this are given later. Qualitative analysis There are many ways of analysing qualitative data. The approach adopted for the purposes of analysing the written accounts of the social workers and foster parents has been described as ‘interpretive’ (Miles & Huberman 1994; Berg 2001). In this case the interpretation is quite reductive, condensing the content of the written data into units (or categories) that reflect themes or concepts in an attempt to discover patterns of meaning or explanation of what is happening in the foster placement. Care is taken, however, not to lose the impact of the written words of the social workers by overemphasizing categories or quantities. This is done by analysing sample statements and case studies. The accounts given by the social workers and foster parents were coded for meaningful words, phrases and sentences. At this point every attempt was made to follow the coding process described by Miles & Huberman (1994). These ‘chunks’ of information were then grouped into conceptually similar categories. After the categories had been generated, each questionnaire was worked through again to record whether the category was present or not. Reliability of the categories generated through qualitative analysis was tested using an independent assessor. Unreliable categories (inter-rater score of less than 85%) were dropped from the study. Data that are reduced to categories in the manner described here can be subjected to content analysis. There is some debate about whether this is actually a qualitative method at all (e.g. Silverman 1993) as it emphasizes the quantity more than other qualitative techniques (especially the more feminist approaches that are commonly applied to this type of personal account data). Berg (2001), however, argues that content analysis is a valuable tool when used with qualitative data as it ‘is a passport to listening to the words of the text, and understanding better the perspective(s) of the producer of these words’ (p. 242). Seale (1999) also advocates the use of numbers in qualitative research, commenting that ‘there is a variety of ways in which attention to quantification can enhance qualitative work’ (p. 123). These views reflect the beliefs of the present authors, and an attempt is made to use numbers to help to explain and interpret the themes and concepts found in the written accounts. RESULTS Visiting patterns Out of 127 foster placements, data on parental visiting were unavailable for seven placements. The question of visiting did not apply to a further seven, which were either day fostering or of too short a duration for parental visiting to be an issue. This left 113 foster placements for which data were available on visiting patterns during the index placement. In most cases patterns of visiting were readily identifiable and very easily recorded in a quantifiable manner. For instance, in a large number of accounts social workers indicated that contact occurred regu37 Impact of visiting patterns of natural parents on foster placements D Browne and A Moloney Child and Family Social Work 2002, 7, pp 35–45 © 2002 Blackwell Science Ltd larly, with at least one parent, and also quite often. In this case ‘regular’ means that the visit could be expected to happen after a specified period of time. For example: ‘. . . meets his family once every six weeks.Visits mother in her own apartment with his siblings. Met with mother on his own every 4th week.’ ‘[Child] loves his mother and loves seeing her and looks forward to it. During current placement he sees his mother once/twice a month for 2 hours approx. – quality is basic as they have no appropriate accommodation. However, mother of late has been visiting the foster home.’ ‘. . . goes home to his natural family for an afternoon every 2 weeks. He sometimes goes for a visit on Sundays or foster father takes his younger brother with him for a spin.’ ‘. . . for past 2 years 6 weekly supervised access – try to vary venues. Can be difficult to do so.’ In these cases it is clear that visits occur on a regular basis, and also quite frequently, so they were categorized as Regular and Frequent. They were distinguishable from other placements where visiting was also regular (in that the child knew it would happen after a certain period of time) but not as frequent as in the examples given above. These cases were termed Regular but Infrequent. Social workers reported: ‘. . . meetings about 6 times yearly at most.’ ‘About twice a year . . . [child] went to stay with her mother for 3 days at Christmas, and again for 3 days last August.’ ‘Child meets her mother and sisters about twice a year (supervised access) at her own request.’ There were other cases where contact patterns could not be described as regular at all. In these cases the child did not know when he or she could expect to meet his or her parents. For example: ‘Access now very irregular – at parents’ request.’ ‘Occasional, irregular contact from mother (address unknown).’ ‘. . . meets mother about once a year.’ ‘. . . father now lives in the USA. He writes to [child] occasionally and phones him . . . [last year] he spent 6 weeks at home and [child] spent weekends with his father . . . Mum sees him infrequently – twice last year and not yet this year.’ Finally there were the cases where the child did not have contact with his or her natural family, or where contact had ceased. Social workers noted: ‘. . . has had no contact with her mother since late ’92.’ ‘. . . has not seen her mother in a number of years.’ ‘No access.’ In summary, then, four distinct placement patterns were noticed. In the first, the child received Regular and Frequent visits from at least one parent (regular indicating that the child could expect the visit after a certain time). It is interesting to note – as is evident from the examples offered above – that social workers describing these placements were more likely to offer more information.This possibly reflects a positive attitude to a perceived success in this area. Descriptions of other visiting patterns tend to be more succinct, to the point of abruptness in some cases. The second pattern was also regular (as defined above) but could be differentiated by the fact that visits did not occur very often: Regular but Infrequent visits could generally be expected to happen between two and six times a year. The third pattern of visiting was neither regular nor frequent: in the Infrequent pattern, children were not sure when to expect visits, and visits tended to happen about once a year or less. In this pattern the quantity of visits was considered less important than the fact that visits were never certain or at fixed intervals (note for instance the example where the child’s father lived in the USA). The final pattern, No Access, consisted of those who did not currently receive access visits. Once inter-rater reliability scores confirmed that these categories were valid, a content analysis was performed to discover how the 113 placements were distributed across the visiting patterns. Figure 1 illustrates this distribution. As indicated by Fig. 1, most birth parents (n = 52) visited on a Regular and Frequent basis. Parents in only 17 cases visited in an Infrequent pattern and only 13 placements (12%) had parents who visited on a Regular but Infrequent basis. Some of the children (17, or 15% of those for whom data are available, and 21% of those who received access visits) were allowed weekend visits to their parents’ home. Thirty-one placements, or 27% of the 113 for whom data are available, were not in receipt of access visits, or access had ceased during the index placement. Reactions of children to contact As Fig. 1 shows, 73% (n = 81) of the placements looked at were receiving parental visits. Social workers described a number of different ways in which children reacted to these visits. As these reactions are bound to have an impact, even if momentarily, on the placement, it is useful to look at how social workers perceived the children’s responses to visiting. A large number of social workers described reactions that could only be expressed as Positive.Table 1 notes that 62% of all those who received parental visits had some positive reactions. An interesting point that was noted for this category is that social workers often 38 Impact of visiting patterns of natural parents on foster placements D Browne and A Moloney Child and Family Social Work 2002, 7, pp 35–45 © 2002 Blackwell Science Ltd added a comment that the child did not react badly (e.g.‘Enjoys meetings with mother – does not show any adverse reaction afterwards’; ‘Looked forward to these meetings and he was not distressed after them’). This appears to imply that the social workers are more aware of negative consequences. Indeed, children in a very high percentage (53%) of placements reacted negatively to visits. Some of these reactions, as is illustrated in Table 1, are quite extreme (e.g. ‘Fear, inability to speak . . .’). A small number of children (n = 9) appeared apathetic and indifferent towards the visits, but it is possible that this hid deeper feelings. When parents reacted negatively it was either because they treated the child inappropriately or offered unrealistic promises about a reunited family. Another category that emerged was Situation improving. While it was reported that only 13 of the 81 foster placements that were receiving access visits had situations that were improving, this is still an important category. Many social workers reported that inadequate access was a cause of concern for some children (e.g. ‘Very upset when they [meetings] were cancelled – became very quiet in himself’; ‘[Access] was often cancelled – in the beginning he was very upset about this but as time passed he accepted it more and more’), and when the situation improved it can only be seen as a positive outcome. In a small number of cases social workers indicated that the child was suffering because of the behaviour or reactions of their natural parent(s) to the visit.This poor reaction was also not appreciated by the children’s foster parents, who had to deal with upset children after the visits (e.g. ‘Very difficult young mother. Very upsetting visits to [fostering agency] what left [child] very upset and I always had to be there for her’ [sic]). Quinton et al. (1998) reported similar reactions in their study, where foster parents expressed concern about mixed or inappropriate messages from birth parents. Table 1 describes the categories of reactions that were recorded and the frequency with which each category occurred. It should be noted that these categories are not mutually exclusive, and that social workers could describe more than one type of reaction for each placement. It is evident from this table that most of the response to visiting was either positive (62%) or improving (16%). Nonetheless, 53% of placements with visits included some sort of negative reaction of the child to the visit, and a further 11% of children were apathetic towards contact. It is evident that visiting was not always to the advantage of the child. Placement status Probably because of the nature of the analysis, the definition of placement outcome differed qualitatively from other foster care studies. Three levels of placement status emerged in the present study: Successful, Ambiguous and Crisis.These can be defined as follows (SW indicates social worker accounts, and FP indicates foster parent accounts): Successful placements No serious problems were reported or expected to occur. Comments on these placements were very positive: ‘Placement is progressing very satisfactorily.’ [SW] ‘Children returned home . . . all settled down and outlook is very promising.’ [SW] ‘He is treated like one of the family in every way. We all get on well most of the time . . . he has also brought a bit of happiness into our everyday routine . . . we will be sorry to see him go but that is what fostering is all about.’ [FP] ‘[Child] has been integrated very successfully. Is greatly loved and appreciated by all family members. Has improved in school and gained in confidence.’ [SW] ‘I think it is fair to say we all consider [child] very much part of our family now. She is with us now for as long as she wants.’ [FP] Ambiguous placements One or two categories of uncertainty or specified problems were reported by either the foster family or the social worker. Examples of statements that made a placement Ambiguous included: ‘Some anxiety on foster parent’s part in dealing with child’s background (sexual abuse).’ [SW] 39 Regular but Infrequent 12% Regular and Frequent 46% No Access 27% Infrequent 15% Figure 1 Patterns of parental visits (n = 113). Impact of visiting patterns of natural parents on foster placements D Browne and A Moloney Child and Family Social Work 2002, 7, pp 35–45 © 2002 Blackwell Science Ltd ‘[Child] happy at present with foster family . . . Problem is with other family members and other foster children, which may affect [child’s] placement . . . One [other foster placement with the family] has recently broken down.’ [SW] ‘Both the child and the social worker are somewhat unsure of the foster parents’ continuing commitment . . . these issues are all going to arise during her adolescence.’ [SW] ‘[Child] has enormous difficulty trusting his foster parents. The difficulty will be holding on to [child] during adolescence.’ [SW] Crisis placements These are cases in which breakdown, imminent breakdown, report of the onset of serious problems, or three or more examples of uncertainty or problems were reported by the foster family or the social worker. Comments by foster parents and social workers on these placements were quite negative: ‘The whole family was falling apart while [child] was here . . . she had a devastating effect on us all. I finally gave the social worker a deadline when the child had to move on and to be honest everyone was relieved when she left.’ [FP] ‘This child is unhappy in this placement. He was placed with his brother originally but . . . it [the brother’s placement] broke down after 11 months . . . his brother was transferred to another family . . . [Child] is the same age as foster mother’s own child and this has led to a number of difficulties . . . Child also feels isolated . . . Foster parents place huge emphasis on academic achievement and this has put a lot of pressure on the child . . . These foster parents have advanced in age [and I] would recommend that only short-term babies be placed with them [in future].’ [SW] ‘We had reached no compromise with [child’s] drinking and it was no longer possible for [him] to stay in our home and be seen not to care what we thought or felt about his drinking and his idea of why he was staying with our family . . . We asked [child] to leave. I was very angry when [he] left.’ [FP] Foster parents describing Crisis placements were likely to give long and detailed accounts of the problems that arose. The experience of completing the questionnaires appeared quite cathartic; it gave foster 40 Table 1 Reactions of foster children to parental visits No. of % of placements Reaction Illustration cases reported with access visits Positive ‘Looks forward to these visits.’ 50 62 ‘[Child] loves his mother and loves seeing her and looks forward to it.’ Negative ‘Fear, inability to speak, refuses 43 53 to go on some occasions. Once got physically sick.’ ‘The foster parent said he was usually upset and bedwetting for a few days after the access visits.’ ‘After last visit he was visibly upset.’ ‘This contact invariably causes distress for [child].’ Response to parent’s ‘Mother spends more time talking to 5 6 behaviour social worker than to children.’ ‘Expects child to act in infantile manner.’ Apathy towards ‘Child has no interest in seeing natural 9 11 contact parents.’ ‘[Child] would be ambivalent about these occasions . . . her relationship with [parents] appears to be fairly superficial.’ Situation improving ‘[Child] met her mother in July for the first 13 16 time in about 7 years …visits mother’s home more now… looks forward to these visits.’ ‘Sporadic [visits] became more regular. Eventually trial periods at home.’ No. of placements with access visits = 81. Impact of visiting patterns of natural parents on foster placements D Browne and A Moloney Child and Family Social Work 2002, 7, pp 35–45 © 2002 Blackwell Science Ltd parents the opportunity to vent a lot of anger and frustration in relation to a very stressful event (something that perhaps other foster parents with similar experiences would benefit from). Social workers were more likely to point out weaknesses on the foster parents’ side. Placements that were categorized as Ambiguous were very often defined in this way because of statements made by the social worker – foster parents appeared more reluctant to prophesize problems in a placement that was progressing satisfactorily on the surface. The only exceptions were cases where the foster parent pointed out that one or more family members were unhappy with the placement. The majority of placements were successful, and the accounts of these were very positive indeed. Ultimately, and despite the failures and the uncertain cases, it is the heartening descriptions such as those above that offer the most persuasive reason for continuing to develop fostering programmes. Fifty-two (46%) of the 113 foster placements were classified as Successful, 32 (28%) as Ambiguous, and 29 (26%) as Crisis. Two of these levels are similar to the concepts of ‘success’ and ‘failure’ as used in other studies (e.g. Trasler 1960; George 1970; Berridge & Cleaver 1987). Crisis placements have traditionally been referred to as ‘failed placements’, although not all of them had actually suffered a breakdown at the time of the study. Several previous studies have grappled with the problem of defining a failed placement. Many have used definitions based on the length of the placement (e.g. Trasler 1960; Berridge & Cleaver 1987) because alternative more abstract definitions (e.g. social and personal adjustment as used by Fanshel & Shinn 1978) are difficult to measure. The category Crisis placements that emerged in this study is defined not in terms of length of placement, but rather in terms of whether it has reached a state of (literally) crisis. The concept of Ambiguous is new. These placements were not suffering serious problems (i.e. could not (yet) be described as being in crisis), but could not strictly be defined as Successful either. Two examples of Ambiguous placements are offered as vignettes later in this paper. As discussed below, an interesting relationship seems to have emerged between this level of placement status and visiting patterns. Visiting patterns and placement status This section describes the relationship between visiting patterns and placement status. Because these two variables are made up of mutually exclusive levels, it is possible to perform a chi-square analysis on the categorical data. Table 2 illustrates how the patterns are divided among the levels of placement status. It was found that Successful cases were far more likely to follow either Regular and Frequent (n = 18) or No Access (n = 22) patterns than the infrequent patterns. Crisis placements were also more likely to fall into these two visiting patterns. Chi-square analysis of these categories showed that there was a significant relationship at the 0.05 level (c2 = 16.66056, P < 0.02) between ‘Parental visiting patterns’ and ‘Placement status’. A closer examination of how the contingency table is divided reveals more details about this relationship (Figs 2 and 3). Figure 2 illustrates what percentage of each level of ‘Placement status’ falls under each of the ‘Visiting pattern’ headings. It can be seen that of all the Crisis cases (total n = 29, as seen in Table 2), 51.7% had Regular and Frequent visiting patterns. Indeed, for each 41 Table 2 Visiting patterns and levels of placement status Parental visiting patterns Placement status No Access Infrequent Regular but Infrequent Regular and Frequent Total Successful 18 4 8 22 52 Ambiguous 4 11 2 15 32 Crisis 9 2 3 15 29 Total 31 17 13 52 113 c2 = 16.66056, P < 0.02. Impact of visiting patterns of natural parents on foster placements D Browne and A Moloney Child and Family Social Work 2002, 7, pp 35–45 © 2002 Blackwell Science Ltd of the levels of placement status, Regular and Frequent patterns were most common. The interesting information to be derived from Fig. 2 is in the Ambiguous column. Only 12.5% of Ambiguous placements (total n = 32) were No Access, a frequency that more than doubled for both other placement outcome variables. It is also apparent that far more Ambiguous placements had Infrequent visiting patterns compared with the other two placement statuses. As Fig. 3 illustrates, the No Access and both of the Regular categories showed approximately one quarter of cases as Crisis. These patterns all also showed the highest percentage of Successful cases, especially the Regular but Infrequent (total n = 15) pattern (61.5%). When parental access was Infrequent (total n = 17), however, most cases fell into the Ambiguous group (64.7% of the Infrequent category). The Ambiguous placements were ones where there was a certain amount of uncertainty about their ability to survive, and it is interesting that this status seems to have a relationship with Infrequent patterns of parental access (see Fig. 3). These patterns of access were also uncertain, and often happened unexpectedly or after many unsuccessful attempts to establish a visiting pattern. It is very possible that the unstable and uncertain nature of the children’s relationship with their birth family contributed to the ambiguous nature of their foster placements. Ambiguity and instability To highlight the possibilities of this argument further, individual foster placements were looked at more closely. Below are two case examples of Infrequent access patterns (categorized on the basis of the most recent pattern) as described by the social workers. Vignette 1 Annie’s placement was progressing quite well at the time of the study, but the social worker expected problems to arise in the future. Because the foster parents also made some reserved comments about Annie’s behaviour and her future with them, this placement was categorized as Ambiguous. Her social worker commented on parental access. ‘Access was arranged by the [social work] department on a regular basis but parents frequently failed to keep appoint42 34.6 12.5 31 7.7 34.4 6.9 15.4 6.3 10.3 42.3 46.9 51.7 0 10 20 30 40 50 60 70 80 90 100 Successful Ambiguous Crisis Regular and Frequent Regular but Infrequent Infrequent Percentage No Access Figure 2 Percentage of each visiting pattern within each level of placement status. 58.1 23.5 61.5 42.3 12.9 64.7 15.4 28.8 29 11.8 23.1 28.8 0 10 20 30 40 50 60 70 80 90 100 No Access Infrequent Regular but Infrequent Regular and Frequent Crisis Ambiguous Successful Percentage Figure 3 Percentage of each level of placement status within each visiting pattern. Impact of visiting patterns of natural parents on foster placements D Browne and A Moloney Child and Family Social Work 2002, 7, pp 35–45 © 2002 Blackwell Science Ltd ments. Access is now very irregular – at parents’ request. Child has no interest in seeing natural parents.’ Vignette 2 John had been fostered for some time by parents who had also fostered him the last time he came into care. His social worker, however, had some significant reservations about the placement’s ability to survive. Although John’s behaviour was not difficult, his foster parents were beginning to see it as such. He was described as bright and articulate and his foster parents might not have been able to cope with his questions and opinions. Because of these problems, his placement was categorized as Ambiguous. His social worker described the access pattern in the following way. ‘No access with mother over the past 12–18 months – mother in prison – father involved in new relationship – seldom contacts . . . visits rare . . . Initially 6 weekly access organized by social worker – parents frequently failed to keep appointments.’ These vignettes show a typically careless attitude on the part of the natural parents in cases where access was infrequent. It is evident that the two children do not really have behavioural problems, but the unresolved issues that the social worker recognizes as possible future crises can be associated with the inconsistent patterns of contact. This attitude could feasibly be linked to the confusion of the child. Such a relationship is far more disconcerting than the more stable relationship or the Regular access placements or even the poor relationship of the No Access children. This latter group may have formed a healthy identity with their foster family because they are not confused by erratic contact patterns; these are the ‘conflicting loyalties’ that Bowlby (1965) mentioned, as discussed earlier. DISCUSSION AND CONCLUSIONS Four different patterns emerged from the qualitative analysis of the data about these visits: ∑ Regular and Frequent; ∑ Regular but Infrequent; ∑ Infrequent; and ∑ No Access. It was noted that the children’s responses to these visits were not always positive. This is a cause for apprehension for many reasons. Besides the obvious concerns over the welfare of the child, it must also be remembered that foster parents are often left to deal with an upset child without adequate support. It is likely that the impact of visiting depends on a variety of connecting factors including the natural parents’ involvement, their relationship with the foster parents and how quickly the agency intervenes (e.g. Poirier 1998). Visiting patterns can have a long-term, and apparently quite critical, influence on placement outcome, so it is important that the immediate reactions are monitored carefully. This paper has demonstrated the interesting point that the relationship between parental visiting patterns and placement status was based not on certain patterns being more associated with Successful or Crisis placements, but on certain patterns being more associated with Ambiguous placements. Infrequent visiting patterns were far more likely to be Ambiguous. This appears to indicate that those placements that were experiencing less stable visiting patterns were also those that had underlying but (so far) nondisruptive problems. As far as family identity and attachment is concerned, Infrequent visiting patterns would be more likely to result in uncertainty about their status for the children involved. As Bowlby (1965) pointed out, these visiting patterns leave the children somewhat in limbo. Unlike children who maintained regular contact with their parents, or children who had obviously been abandoned by their natural families, these children were more likely to be confused about their probable futures. This was illustrated in the short examples highlighting the situations of two children, Annie and John. The theory is further backed up by the findings of other researchers. Fanshel & Shinn (1978) found that children who were visited infrequently were far less likely to return home than children who were visited regularly, which would indicate that children who are visited infrequently have every reason to be concerned about their futures. Poulin (1992) found that the more often a child was visited by his/her parents the greater the attachment s/he had for them. The divided loyalty issue has been recognized by agencies who realize the dangers of this (despite the benefits) in the new ‘open’ policies for contact (Quinton et al. 1998). The issues discussed in this paper – visiting patterns, reactions to contact, and the impact of visiting on placement outcome – relate to how visiting is arranged and monitored by the fostering agency. Hess (1988) commented that findings indicate that caseworker contact with natural parents is infrequent.This is probably due to heavy caseloads. Fanshel & Shinn 43 Impact of visiting patterns of natural parents on foster placements D Browne and A Moloney Child and Family Social Work 2002, 7, pp 35–45 © 2002 Blackwell Science Ltd (1978, p. 483) maintain that ‘more careful monitoring of parental visiting and judicious casework intervention where visiting falters, particularly early in the child’s placement, seems . . . to be a prime responsibility faced by an agency’. One of the influential predictors of visiting patterns seems to be the relationship between the foster family and the natural family (Oyserman & Benbenisty 1992) and this is something that needs to be carefully regulated by the agency. If, as Oyserman & Benbenisty (1992) suggest, frequency of home visits by the foster child are influenced by the degree to which the foster family encourages or enables a relationship with the child’s family of origin, then it should be the duty of the fostering agency to ensure that such encouragement takes place. Unfortunately, probably due to heavy caseloads and a high rate of staff turnover, visiting patterns and resulting problems are not monitored as carefully as they might be. This is despite the fact that the evidence, from both the present paper and previous research, indicates that visiting patterns can determine how successful is the fostering process. This success may be measured not only by a smooth and successful return home, but also by the attachments of the child or young person placed in care. It should be remembered that the best interests of the child might not necessarily be served by continuous contact with the birth family at all costs. Without a doubt regular contact is essential if the child is to maintain healthy attachments to a birth family to which s/he is likely to return. When this is not the case, however, and contact is likely to be superficial and disruptive, it may be best to minimize access to allow healthy and uncomplicated attachment to develop with the foster family. The question is not a simple one, though, and cannot be dismissed with a perfunctory answer. More research is needed to determine what contact patterns are best for individual children.

Crandall, M., Senturia, K., Sullivan, M., & Shiu-Thornton, S. (2005). Latina survivors of domestic violence: Understanding through qualitative analysis. Hispanic Health Care International, 3(3), 179–187.

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