Participation of Children, Birth Parents and Foster Carers in the Matching Decision. Paternalism or Partnership?

Participation of children, birth parents and foster carers in matching decision-making has the potential to improve the outcomes of a foster care placement. When practitioners choose which foster family is the best fit for a foster child, those affected by the foster care placement should be involved in decision-making when possible. This research paper examined the influence of children, birth parents and foster carers in the matching decision from a practitioners’ perspective. Semi-structured interviews were conducted with 22 practitioners from 17 of the 28 foster care organisations in the Netherlands responsible for matching children with foster families. The analysis identified three themes that diminished the influence of children, birth parents and foster carers on the matching decision: assumptions, timing and feasibility. The findings emphasize that the influence of stakeholders on the matching decision is highly contextual. In the matching process, practitioners can be seen as key figures in facilitating the influence of stakeholders; yet, are also confronted with the difficulty of dealing with more than one stakeholder, who can have opposing interests, in an – often – compromised setting with limited choices.


Introduction
N on-kinship foster care placements have a deep impact on children, birth parents and foster carers. Children placed in an unknown foster family This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited. might have to change schools and could lose contact with their friends, causing feelings of fear, helplessness and confusion (Fawley-King et al., 2017;Reimer, 2010). Birth parents experience a sense of loss from having diminished contact with their child and losing their parenting role (Schofield et al., 2011). For foster carers, the arrival of the foster child can be stressful and demanding (McKeough et al., 2017;Thompson et al., 2016). All three 'parties' are stakeholders in the foster care process. They have an interest in the success of the placement and are affected by its objectives and outcomes.
Participation in decision-making empowers stakeholders and can diminish negative effects (Bell, 2011;. Children who participate in decisions feel more valued and are less likely to experience desperation, anxiety or anger towards a care decision (Bessell, 2011;Ten Brummelaar et al., 2018). Although children have a right to have their views heard in decisions related to their lives (United Nations Convention on the Rights of the Child), they are often inadequately involved in decision-making processes (Arbeiter and Toros, 2017;Bessell, 2011;Krappmann, 2010;Ten Brummelaar et al., 2018). In classification models on child participation, a distinction is made between children taken seriously and children having no real influence (Charles and Haines, 2014;Hart, 1992;Shier, 2001). To adequately include children in decision-making, it is essential that they are not only heard, but that their views are respected (Krappmann, 2010). Practitioners' reasons for inadequately involving children are mostly related to age (Berrick et al., 2015) and to the underlying image of children as vulnerable or incapable (Arbeiter and Toros, 2017;Van Bijleveld et al., 2014).
Birth parents often feel stigmatised, poorly informed and unheard in decisions concerning their child in out-of-home care (Höjer, 2009). Child protection workers often employ a 'practitioner as expert' approach in which they maintain a dominant position (Healy et al., 2012) or even decide for the family instead of with the family (Arbeiter and Toros, 2017). Using this approach, practitioners maintain a power position in which they are the experts and who assess whether the input of stakeholders is worthy of consideration (Levin et al., 2017). Barriers for involving birth parents are their perceived unwillingness, insufficient time, workers' lack of confidence in their own skills, and a lack of supervision (Arbeiter and Toros, 2017;Darlington et al., 2010).
Foster carers want to be provided with necessary information and included as partners in decision-making (López López and Del Valle, 2016;Rosenwald and Bronstein, 2008). When they feel valued and taken seriously, they have a better relationship with the organisation and are more likely to continue fostering (Sellick, 1996). However, social workers mention mixed views on the appropriateness of treating carers as equal partners in decisions (Kirton et al., 2007). They argue that foster carers are not always able to 'see the bigger picture'. Furthermore, the responsibility of social workers for the outcome of the foster care process could be a barrier to treating foster carers as colleagues (Kirton et al., 2007).
Overall, participation is a way to put the values of social work, such as equality and fairness, into practice (Arbeiter and Toros, 2017;Levin et al., 2017) and provides an opportunity to improve child and youth care . In the Netherlands, the Jeugdwet [Youth Act] 2014, BWBR0034925implemented in 2015promoted a movement from care 'Participation in decision-making empowers stakeholders and can diminish negative effects' to participation (Bouma et al., 2018). The law requires practitioners to talk with instead of about children and parents. Practitioners need to inform children and parents of the youth care plans and cannot do anything without the approval of stakeholders unless a judge rules otherwise or when participation could inflict serious harm to those involved. However, implementing participation is challenging, since practitioners must navigate between the views of those involved, legal norms and principles, economic and bureaucratic conditions (Pösö and Laakso, 2016), and the less than ideal circumstances (Colton et al., 2008;Zeijlmans et al., 2017).
One decision in foster care that requires participatory practice is the matching decision. The matching decision forms the beginning of a non-kinship foster care placement and is a crucial starting point to forge partnership and cooperation (Bessell, 2011). The matching decision is described as finding the most compatible foster family available for a child, while also forging a solid foundation to maximise the chance of placement success (Zeijlmans et al., 2018). To investigate how stakeholders can be involved in the matching process and the extent to which this is happening in the Netherlands, this research paper will address the following question: 'How do children, birth parents and foster carers participate in the matching decision in family foster care, according to matching practitioners?' . Interviews with practitioners from the Netherlands were conducted to better understand children's, birth parents' and foster carers' involvement in the matching decision. This will provide more insight into the mechanisms behind current practice and generate possible points for improvement. Practitioners' views related to the chances and difficulties of involving stakeholders are vital to improve foster care practice, while simultaneously stimulating the scientific debate on shared decision-making.

Method
In the Netherlands, foster care organisations employ practitioners whose main responsibility is to match children with foster carers. This provides an opportunity to interview people who have years of experience making matching decisions and who can provide an image of both normative decision-making as well as general reflections on practice. An inductive qualitative methodology, using semi-structured interviews with practitioners responsible for matching children with foster carers, was chosen due to the exploratory nature of the research question.

Participants
Our sample consisted of 22 matching practitioners from the Netherlands. There were 19 women and three men in the sample, and the average age was 46.4 years (SD = 8.66). Two interviews were held with a pair of matchers, since these colleagues wished to be interviewed together to complement each other's knowledge. The practitioners' average years of experience with matching was 9.3 (SD = 4.33).
The matching practitioners were employed by 17 of the 28 foster care organisations in the Netherlands. Fifteen organisations operate on a regional level and two (out of four) on a national level. The methodology used for  Baat et al., 2014). The main difference, related to the involvement of children, birth parents and foster carers in the matching process, is whether practitioners responsible for matching have face-to-face contact with stakeholders or acquire the information indirectly through other professionals (see Table 1).

Instruments
A semi-structured interview was developed to explore the decision-making process of matching. The interview incorporated questions related to the four categories of the Decision-Making Ecology (Baumann et al., 2014) to include not only case factors, but also organisational, external and decision-maker factors. While the interview covered the full range of issues related to matching in family foster care, the influence of children, birth parents and foster carers was prevalent throughout the interview, for example, in questions like: 'How does matching in this organisation work?' and 'Could you provide an example of a recent match?'. Furthermore, the influence of stakeholders was the focus of one section of the interview, which asked specifically: 'To what extent are the wishes of children/birth parents/foster carers considered during the matching decision?'. Two pilot interviews were conducted to test the interview. Since the interview proved satisfactory, no changes were made and the pilot interviews were included in the analysis. The interviews took on average 90 minutes.

Procedure
To recruit practitioners, a combination of convenience and purposive sampling was used (Flick, 2009) with the aim of achieving heterogeneity in location and work methods. First, using convenience sampling, matchers willing to cooperate in the study were included. They were approached using the researchers' network and through a symposium on matching, an online foster care forum and social media. After the initial response, the recruitment strategy was adjusted to a purposeful approach in which a diversity of A semi-structured interview was developed to explore the decision-making process of matching' 'To recruit practitioners, a combination of convenience and purposive sampling was used' matching methods was the central aim. To achieve this, the recruitment was targeted towards specific organisations that were either assumed to use a different methodology or from a region in which we did not have any participants. When multiple practitioners from one organisation were motivated to join, a deliberate decision was to select the practitioner who would add to the diversity of the study (i.e. male practitioners due to the larger proportion of women in the sample). Furthermore, after interviewing colleagues from the same organisation on three occasions, the decision was made to discontinue this practice; the interview with colleagues did not yield significant additional information. The recruitment of new practitioners stopped when the interviewer determined that further interviews would likely generate no relevant information.
To accommodate the practitioners, the interviewer travelled to the foster care organisation at a time suitable for them. After providing an explanation of the research, the practitioners signed an informed consent form. The interviews were recorded using an audio device and were subsequently transcribed and anonymised for data analysis. The research was approved by the Ethics Committee of the Department of Pedagogical and Educational Sciences of the University of Groningen in January 2015.

Data Analysis
The transcripts were coded using ATLAS.ti (version 8; Scientific Software Development GmbH, https://atlasti.com) and thematically analysed following the guidelines of Braun and Clarke (2006). Decisions and the themes resulting from the analysis were discussed with the research team. The first author was responsible for coding and clustering the data. Initial codes were generated using principles of open and inductive coding, wherein each relevant extract about matching was selected and coded using a descriptive label on the essence of the extract. After the initial coding, codes related to the influence of stakeholders were clustered into three categories: children, birth parents and foster carers. While clustering, only matching defined as choosing an already screened and approved non-kinship foster family was included, while other methods that were mentioned during the interviews, such as 'child-centred recruitment' (i.e. finding non-registered families willing to foster a certain child) or 'foster carer-led matching' (i.e. foster carers respond to distributed profiles of children), were excluded. The interview focused on 'traditional' matching and these methods were only briefly explained by practitioners. Furthermore, the data were considered to be a reflection of an individual's opinion and daily practice habits intertwined with the organisational culture and guidelines. Since our interest in the analyses was on daily practice, we did not attempt to separate the individual from the organisational influences. However, we did analyse whether the differences between organisations affected the influence of stakeholders on the matching decision.

Results
The aim of this study was to analyse how children, birth parents and foster carers influence matching decisions. Although most participants acknowledged 'Codes related to the influence of stakeholders were clustered into three categories: children, birth parents and foster carers' the importance of participation in the matching process, the interviews also showed that the influence of stakeholders on the matching decision is sometimes futile. Overall, their influence appeared to be highly contextual. The themes, therefore, focus on the underlying patterns resulting in a diminished influence of stakeholders on matching. Three themes emerged: assumptions, timing and feasibility. Assumptions are the practitioners' beliefs that underlie their reasons for decreasing the influence of stakeholders; timing has to do with the moments of involvement in the matching process; and feasibility relates to the achievability and practicability of the stakeholders' influence due to the compromised context of the matching process. These themes are explained in detail below with quotations to illustrate the findings.

Assumptions
Throughout the interviews, practitioners described characteristics and behaviours of stakeholders in order to make assumptions about their ability to participate in the matching process. These assumptions could result in a belief that diminished influence on the matching decision would be in the best interests of the stakeholder or other stakeholders involved. Assumptions also related to the different methods of involving stakeholders in the matching decision: direct or indirect involvement. However, this did not appear to directly diminish or increase the influence of stakeholders on the matching decision. Both could lead to the same influence of stakeholders, but indirect contact was guided by the assumption that a new face could be confusing or difficult for stakeholders, while those using direct contact felt that it could provide more information than only paper-based wishes. The assumptions that could diminish the influence of stakeholders will be described per stakeholder (children, birth parents and foster carers) as the details for each are different; however, the general concept underlying the theme is similar for each group: when practitioners assumed that influence on the matching decision would not be beneficial, the stakeholders' influence decreased.

Children
Children who were considered unable to express their wishes or opinions and children for whom knowing about the transfer to another family might be too stressful were less likely to participate in the matching process.
'Look, we did not involve the girl, she was notified after everything was set and done. Just because, well, it is dramatic when you have lived in a family since you were three and when you are 14 you have to leave. That is just terrible. So you do not want to bring additional stress with everything that is going on, so we told her only then.' (Matcher 19) In general, older children were seen as more active participants in approving and accepting the foster care placement, while younger children remained uninformed or unheard on occasions, as reflected in the quotation. Sometimes, practitioners mentioned an arbitrary cut-off point they used in their daily practice that determined whether a child was old enough to be involved. These cut-off points differed per interview: older than 12 years for eight practitioners, ten years for two practitioners and six years for two others. However, exceptions to this cut-off point happened when older children were perceived as 'too vulnerable' or younger children were considered outspoken.

'The influence of stakeholders on the matching decision is sometimes futile'
'When practitioners assumed that influence on the matching decision would not be beneficial, the stakeholders' influence decreased'

Birth Parents
The influence of parents on the matching decision could diminish if parents were assumed to be uncooperative or unconstructive in their involvement, by either being unable to formulate realistic wishes towards a future placement or forming a potential risk for placement breakdown. When the wishes of parents were assumed to be non-cooperative and unrealistic, they were quicker to be disregarded in the matching decision.
'A very Christian family, for example… well, that is something that I think should be honoured. But well, if it cannot be a family that is coincidentally for a certain soccer team or something… you know, those are the kind of discussions you get sometimes. And then it is no longer helpful. Then it is, well then it will never be satisfactory. Then it is defiance against foster care in itself. And we should stay away from that.' (Matcher 9.1) The general views of practitioners on the willingness and ability of parents to cooperate during the matching decision were diverse. Some practitioners indicated that, in most cases, parents were able to cooperate, while other practitioners described birth parents as difficult to involve in the matching process. When involvement of parents was considered potentially harmful to the success of a placement, practitioners decided to exclude parents from some aspects of the matching process. In the example provided in the following quote, the perceived threat to the placement success resulted in the foster carers and birth parents not meeting each other, which meant that the birth parents would not be able to express their views on the ability of the foster carers to care for their child.
'So, I estimate whether those people [parents] will constantly show up on the doorstep. If so, we cannot let them meet [with the foster carers] like that. If we do, you will have a situation in half a year where the child must move out because parents constantly show up.' (Matcher 11)

Foster Carers
Foster carers' influence was diminished due to assumptions about their ability to reflect critically on the placement's impact. Foster carers who were seen as able to reflect on their own abilities and to say 'no' to a matching proposal were approached sooner when there were doubts about the suitability of a matching decision, while foster carers who were too eager to foster or more likely to say 'yes', due to their sentiments for a child, were less often approached.
'Then we can also request information from the trainer who did the foster carer's initial screening and it might well be that the answer is: "Well, foster carers are perfectly capable of telling you whether they can or dare to do this". And it can also be that the trainer says: "Well, do not do this, because these foster carers would say yes, while it might be that they will regret it in two weeks when it turns out they shouldn't have".' (Matcher 14) Furthermore, practitioners sometimes overruled the foster carer's opinion. Mostly, this entailed cases in which the foster carers thought that they could do something and the practitioner did not think so, or the foster carer's opinion went against the regulations set within the organisation. The following quote is from a practitioner who explained that they would overrule foster carers' wishes due to a regulation to have a minimum of two years between the age of the foster child and the biological children in the foster family.
'The general views of practitioners on the willingness and ability of parents to cooperate during the matching decision were diverse'

'Practitioners sometimes overruled the foster carer's opinion'
'And we also tell the foster family this. If they want to foster children in the age of two to nine years old, but they have a son aged seven, we will tell them: "Well, that is going to be from two to five years old then…". And, actually, we do not even go higher. If your child is seven, then you have experience to age seven, so we would not quickly place a child of nine years.' (Matcher 17)

Timing
The timing of stakeholders' participation in the matching process appeared to differ per case and stakeholders, which altered their influence on the matching decision. Early involvement was described as unconstrained, since no match had been decided upon. It entailed asking children and parents about their wishes and needs for a foster family, and foster carers about their expectations and wishes regarding a future foster child. This information could be used as input for making the matching decision. When stakeholders were not involved in this stage, practitioners had to estimate or guess what might or might not be important to the stakeholder. For foster carers, gaining information on their wishes and expectancies intertwined with their training and selection as foster carers. Participation of parents and children in this early stage was in some cases impossible or skipped, resulting in less influence on the matching decision, as explained by the following practitioner: 'Beforehand, we have, if it succeeds, contact with parents to map the wishes of parents regarding the foster family. (…) And, well, then you really get the information about the child at first hand. But that is not always possible. When parents absolutely disagree with the outof-home placement, well… then they will not come to us.' (Matcher 16) After information on a case was gathered, the decision was made as to which family would be linked to the foster child. In three interviews, practitioners talked about presenting stakeholders with multiple options and allowing them to decide. One was a practice example of a case in which a mother was presented with multiple options for her child after refusing the first placement alternative. The other two cases were practitioners who mentioned that presenting multiple alternatives to children or birth parents could be beneficial yet impossible due to the lack of families. However, after the decision was made, stakeholders could still influence the decision when practitioners asked for their opinion or approval. Thus, the decision could still be changed when deemed necessary. Furthermore, as part of this evaluation process, meetings could be organised in which stakeholders got to know each other and expressed how they felt. However, the general pattern seems to be that as the matching process progresses, the stakeholder's power to influence the decision outcome diminishes. Children, especially when younger, were mostly involved last and, therefore, had hardly any potential to change the matching decision, as can be seen in the following quote: 'I think there is more and more attention for it, for asking children after they have been [visiting the foster carers] what they think and whether they have any questions or want to bring something to their new house. (…) So, those kind of things. But then the match has already been made. So, it is actually after…' (Matcher 3) When children were involved after birth parents and foster carers had already approved the placement, the meeting between the child and foster carers could 'As the matching process progresses, the stakeholder's power to influence the decision outcome diminishes' be viewed as the start of the placement and not as a part of the matching process.

Feasibility
Practitioners described that although participation of children, parents and foster carers was desirable, it was not always feasible due to the lack of foster families, time or other practical issues. To deal with the lack of foster families, practitioners often asked stakeholders for leeway in their wishes and explained from the outset that finding the perfect fit is impossible. One practitioner described it as follows: wishes were not used as a checklist, but as guidance for finding a match. The lack of foster families not only diminished the capacity to adhere to the wishes of children and parents, but also the preferences of foster carers were stretched when practitioners felt that they could be a good match to a specific child. In these cases, the best interests of the child to be in a foster family were more important to the practitioner than adhering to the preferences of foster carers. However, in those cases, the foster carers always had the opportunity to express their views on the placement and a refusal was acceptable.
'And then call them [foster carers] and I say: "…but I have a question for you outside of your preferences, because I am calling about a boy of eight". Even though their preferences are up to five. "May I continue talking or should I stop now?" And sometimes they will say: "Just stop, we will not do that". Well fine, I just had to give it a try. And sometimes they will say "keep talking".' (Matcher 13) Time was the second factor making participation less feasible. In a crisis placement, but also in other placements with a sense of urgency, practitioners explained that they have very limited time to decide, which reduced their ability to involve others in decisions. Often, children and parents would not be involved in the decision-making process, and foster carers were only quickly asked whether they were available and willing to foster this case.
'And in a crisis placement, it is of course very difficult to involve people, children or parents, because they often only know about it when Child Protection Services are at their door… And with long-term placement, then it is of course more a process in which parents are also involved.' (Matcher 3) Other practical limitations mentioned were mostly related to parents, such as the termination of parental rights, imprisonment, admission to a mental health facility, or complete absence from their child's life.

Discussion
Participation in decision-making has been shown to have positive effects on the outcome of decisions and the wellbeing of those involved (Bell, 2011;. In the Netherlands, participation of children and parents is a mandatory requirement in the new Youth Act (Bouma et al., 2018); however, participation of stakeholders in the matching process is not self-evident. By interviewing practitioners about the influence of children, birth parents and '[Stakeholder] participation… was not always feasible due to the lack of foster families, time or other practical issues' foster carers on the matching decision, three themes were found that diminish the influence of these stakeholders: assumptions, timing and feasibility. Practitioners must handle the difficulty of dealing with more than one stakeholder, who can have opposing interests, in an often compromised setting with limited choices. This endorses the findings of Pösö and Laakso (2016) who claim that matching requires a great deal of navigating between different interests, subjective views and the, sometimes, compromised context of decision-making. Although most practitioners acknowledge the importance of participation and work with the best interests of those involved in mind, this study shows that participation of stakeholders is not straightforward.
Stakeholders depend on others to facilitate their participation and consider their input in the matching decision. Practitioners have a key role in facilitating the involvement and influence of children, birth parents and foster carers. The only exception that is mentioned in the Dutch Youth Act for excluding or diminishing the influence of children and parents in decisions concerning their lives is when participation could inflict serious harm upon those involved. This study showed that assumption, timing and feasibility diminished the influence of stakeholders on the matching decision. Prior research has already highlighted the 'paternalistic view' that practitioners sometimes have towards their work with clients (Arbeiter and Toros, 2017;Healy et al., 2012;Kirton et al., 2007;Levin et al., 2017). This study, in a way, also portrays practitioners as using a 'paternalistic view' of participation. Practitioners' assumptions about the ability of stakeholders could diminish their capacity to influence the matching decision; practitioners could also determine when and how stakeholders are involved; and, even in a compromised context, they could choose which stakeholders' wishes to fulfil and which to ignore. Although there are very good examples of cooperation and partnership in matching decision-making, there is a belief among practitioners that they know what is in the best interests of children, birth parents and foster carers. However, even if unintentionally, this practice may harm the relationship between them and the stakeholders (Bessell, 2011;Sellick, 1996;Ten Brummelaar et al., 2018), and negatively affect the foster care placement (Bell, 2011;.

Strengths and Limitations
By including practitioners from 17 of the 28 organisations in the Netherlands, this study provides a geographically diverse sample of Dutch foster care organisations, including two (of four) national foster care organisations. The matching practitioners from these organisations gave an overview of the everyday practice of making matching decisions and the participation of children, birth parents and foster carers in this process. Their daily experience with matching decisions allowed them to thoroughly describe the practice of decision-making. Furthermore, their viewpoints allowed us to analyse the reasons behind the practitioners' actions during this process.
Although practitioners provided a nuanced description of daily practice, the experiences of children, birth parents and foster carers in the matching process were not included in this research. Including their views might have provided a different image, since practitioners might portray the practice of matching as more participatory than children, birth parents or foster carers to make a 'This study shows that participation of stakeholders is not straightforward' 'This study provides a geographically diverse sample of Dutch foster care organisations' positive impression (Collins et al., 2005). After all, participatory practice is considered by most workers and clients to be positive and needed (Arbeiter and Toros, 2017;Levin et al., 2017).

Implications and Recommendations
Involving practitioners in a qualitative manner proved a valuable way to gain more insight into the complexity of daily practice. Practitioners are responsible for implementing policy and research into their daily work and are, therefore, an important source of information for understanding and improving social work practice. However, the experiences of children, birth parents and foster carers also deserve attention. Therefore, a retrospective qualitative study among stakeholders would be an interesting follow-up study. The views of stakeholders might offer more awareness of their experiences of participation and the positive and negative aspects of undergoing a placement transfer, and provide their insights into good practices.
This study also provides interesting recommendations for practice. To enhance the participatory involvement of stakeholders in the matching decision, the underlying patterns of the three themes could be tackled. First, practitioners should be encouraged and compelled to involve stakeholders in their decision-making processes, and aided to revise their assumptions about stakeholders' involvement. This should include educating them about the importance of participation, but also training them to improve their skills in talking to stakeholders. By improving their skills, stakeholders can be assisted in participation, even when they might be less able to formulate and express their wishes. Second, it could be interesting to start trials, with cooperative and highly able stakeholders first, to determine whether it is possible to include children or parents in the choosing of foster families. And last, more effort should be put into finding more foster families to generate a wider pool of carers and a higher chance to find a match that fits the wishes and needs of those involved.
'The experiences of children, birth parents and foster carers also deserve attention' 'More effort should be put into finding more foster families to generate a wider pool of carers'