Transitional support interventions for care leavers: A scoping review

The purpose of this scoping review was to identify and map knowledge on different types of transitional support interventions currently available to support transition to independent living for care leavers. An extensive search using four research databases was undertaken, resulting in 36 relevant articles for inclusion. Findings were organised thematically into four broad areas: (1) Extended care; (2) A Helping Relationship; (3) Family; and (4) Employment, Education and Training. Findings show that offering a combination of targeted interventions can contribute to a more successful transition. Effective relationship-based practices are critical to the success


INTRODUCTION
Across the globe, approximately 135 million young people are living in state or extended family care (UNICEF, 2022).Although there is some variation internationally on the age at which statutory support for young people living in out of home care ends, for most this will be at the age of 18 (Stein, 2019).At this age young people are legally considered to be adults, and there is an expectation that they will be financially independent and self-reliant (Cameron et al., 2018).The process of moving from state or family extended care to independent living is referred to as 'leaving care' or 'ageing out of care' (Stein et al., 2011).The term used to refer to this process differs between different countries.However, for the purpose of this review we use the term 'leaving care' which is commonly used across European countries (Stein et al., 2011).
The transition from adolescence into adulthood can be a difficult period for all young people.However, for care leavers this journey is particularly challenging as they are expected to make the move into independent living with little support from family or formal care services.Research on care leavers' experiences of leaving care suggests that transition is viewed as an instantaneous, age-driven process with young people feeling ill-prepared for independent living (Atkinson & Hyde, 2019).Unregulated accommodation, a drift through care, multiple social workers and carers, mental health difficulties, tension, anger, grief separation and loss, missing from care episodes and a lack of preparation for adulthood can create feelings of powerlessness, instability and mistrust (Butterworth et al., 2017).Care leavers are further at significant risk of experiencing poor mental health (Memarzia et al., 2015), high unemployment rates (Rome & Raskin, 2017), low post secondary educational attainment (Courtney & Hook, 2017) and homelessness (Lindquist-Grantz et al., 2022).
Improving the process of transition for care leavers has thus become a key priority for governments internationally.Various types of programmes and interventions have been developed to address gaps in leaving care support.These fall under two broad categories: (1).extended care policies; and (2).transitional care programmes (Gilligan, 2018;Taylor et al., 2022).Extended care policies provide young people with the option to remain in their existing living arrangements for an extended period in which they will continue to receive ongoing support to prepare them for adulthood (Van Breda et al., 2020).Extended care policies have been implemented in the UK, Denmark, the Netherlands, Norway, Canada, Australia, New Zealand, South Africa, the USA and Switzerland (Taylor et al., 2022).Alternatively, transitional care programmes aim to support and equip care leavers with the necessary skills required for adult life (Taylor et al., 2022).Eligibility for leaving care support is however age-determined and subject to conditionality (Gilligan, 2018) meaning that not all care leavers will be entitled.
To date, research has focused on the extent to which extended care policies and transitional care programmes improve the process of transition for care leavers with some attempting to demonstrate a direct relationship between leaving care interventions and outcomes (Taylor et al., 2022).However, the evidence base on the effectiveness of extended care policies and transition care programmes remains limited (Mendes & Rogers, 2020;Taylor et al., 2022;Yelick, 2017).A recent systematic review undertaken by What Works for Children's Social Care (Taylor et al., 2022) attempted to summarise best evidence on transition policies, programmes and interventions from around the world.Studies included in the review were based in the US and Australia and only randomised control trials or quasi-experimental designs were included.Due to the tight inclusion criteria, there was no exploration of transitional support interventions for care leavers which sit outside of extended care policies and transitional care programmes.Studies that produced qualitative data were also excluded.Qualitative data can provide important insights into the different types of transitional support interventions that exist for care leavers.
Scoping reviews which allow for the inclusion of various types of literature are a useful tool to identify and map available evidence on a given topic (Peters et al., 2020).They can be used to inform future research and identify knowledge gaps (Peters et al., 2020).The decision to undertake a scoping review of transitional support interventions for care leavers was informed by the need to consider the effectiveness of targeted innovations, particularly with populations of care leavers in countries other than the USA (Taylor et al., 2022).Despite the range of literature available, there has been an unequal focus on how a combination of services, delivered in different ways, can meet the complex needs of young people as they transition from state care in the immediate and longer term.
The original contribution of this scoping review identifies and maps knowledge on different types of transitional support interventions that are currently available.We use the term 'transitional support intervention' to refer to any intervention, programme, service or policy intended to support transition to independent living for care leavers (O'Donnell et al., 2020).By identifying and mapping the literature in this way, the article will illustrate how a combination of transitional support interventions could be advanced in support of the transition from state care to independent living.

RESEARCH QUESTIONS
The scoping review addresses the following research questions: 1. Which transitional support interventions are reported in the literature to support care leavers with their transition into independent living?2. What are the reported key components of transitional support interventions for care leavers?

METHODS
The scoping review was conducted in accordance with the Joanna Briggs Institute (JBI) methodology for scoping reviews (Peters et al., 2020) and the Preferred Reporting Items for Scoping Reviews (PRISMA-ScR) (Page et al., 2021).We believe that these approaches offer a practical and comprehensive approach that captures the diverse and often rich data within the children's social care literature.

Search strategy
A systematic search of the literature was conducted using a staged approach.The first stage involved undertaking a preliminary limited search for relevant papers in two databases.Titles and abstracts of retrieved papers were analysed by three members of the research team to identify initial search terms.Initial search terms were shared with social work practitioners and managers and feedback was used to refine key search terms.An extensive search of four electronic databases: CINAHL complete, Scopus, Social Care Online and Science Direct was then conducted.These databases were chosen as they related specifically to the area of social care and contained the largest variety of journals.Specific search terms used included 'care leaver' OR 'care experienced' AND 'intervention' OR 'programme' OR 'service' OR 'policy' AND 'transition' OR 'leaving care' OR 'ageing out of care' OR 'after care' OR 'independent living'.Reference lists of sources were hand searched to identify additional sources.Papers identified from the full search were collated and uploaded into ENDNOTE and duplicates were removed.

Inclusion/exclusion criteria
The following criteria were used to assess eligibility of papers for inclusion in the scoping review: (1) papers published in English between 2012 and 2022; (2) studies reporting empirical data published in a peer review journal; (3) studies reporting on a transitional support intervention or programme implemented to support transition for care leavers; (4) young people aged 16-25 leaving care; (5) any out of home care setting (foster care, residential care, specialist care); (6) studies undertaken in countries shown to have 'well developed' legislation on child social care (Strahl et al., 2020: 7).Papers were excluded based on the following criteria: (1) secondary research including systematic or scoping reviews; (2) non-peer reviewed papers including protocol papers, commentaries, conference abstracts and thesis; (3) Studies that did not report on a transitional care intervention for care leavers; (4) studies which focused on young people in care as opposed to those leaving care; (5) studies that did not focus on an out of home care setting.

Evidence screening and selection
Titles and abstracts of all retrieved papers were screened by two independent reviewers and assessed against inclusion criteria using the Rayyan.aiplatform which is a web and mobile app for systematic reviews (Ouzzani et al., 2016).Those meeting inclusion criteria were retrieved in full and assessed in greater detail by two reviewers independently.Conflicts were resolved by a third reviewer.Papers that did not meet the inclusion criteria were excluded.For study characteristics of included papers see Appendix 1.

Data extraction and analysis
Guided by the review objectives and questions the research team developed a draft data extraction table (Peters et al., 2020).This was piloted at the initial data extraction stage with two reviewers independently extracting data from five papers (Peters et al., 2020).Following discussion between the research team, the data extraction table was refined.Data extraction included specific details about the publication, study aims, study population and sample size, study design and methods, type of intervention reported, key findings and strengths and limitations of the study.Extracted data were analysed using Braun and Clarke's (2022) thematic analysis framework.Two reviewers (JF/DA) independently reviewed and re-reviewed the data to identify interesting ideas.Initial codes were developed using inductive thematic analysis and semantic coding (Braun & Clarke, 2022).Similar codes were grouped together to identify potential themes.Potential themes were reviewed and refined by three members of the research team (JF/DA/RC).This resulted in the identification of four final themes.

Search outcomes
The search of electronic databases identified a total of 35 261 citations.A total of, 2716 citations remained after removing duplicates.A total of, 2277 additional citations were excluded at this stage based on the following criteria: (1) wrong subject area; (2) wrong population; (3) did not report on an intervention; (4) wrong country; ( 5) not primary research.A total of, 439 papers were screened at title and abstract stage.In total 294 were excluded as they did not meet inclusion criteria.A total of, 145 full text papers were assessed for eligibility.A total of, 109 of these papers were excluded as they did not meet the inclusion criteria.An additional hand search was performed of the reference lists of key articles but resulted in no new relevant material being identified.This resulted in 36 articles that were included in the review.See Figure 1 for the flow of studies through the scoping review, adapted from Page et al. (2021).
F I G U R E 1 PRISMA 2020 flow diagram for systematic reviews.

Thematic findings
The 36 articles that explicitly defined transitional support interventions offered a detailed view of the interventions that are currently available.Taken together they provided some indication of how a combination of services, delivered in different ways, can meet the complex needs of young people as they transition from state care.Following the detailed process of analysis and data extraction described above, articles were thematically grouped into four broad areas: (1) Extended Care; (2) A Helping Relationship; (3) Family; and (4) Employment, Education and Training.

Extended care
Fourteen articles highlighted the strengths and limitations associated with extended care provision designed to help support a transition from care to independent living.In context, extended care enabled care leavers to receive the ongoing support of a professional carer who was already known to them (Arnau-Sabatés et al., 2021).Whilst some opportunities for extended care reflected new legal obligations designed to prolong the provision of care past the age of 18 (Courtney & Hook, 2017), others were implemented to provide a safety net to catch young people who can experience a 'cliff face' of support when their time in care ends (Roberts et al., 2021).
In each example, the texts emphasised how extended care could contribute to improved engagement in education, employment and training, and reduce the risk of homelessness.Throughout these articles, young people and their carers described the experience of extended support as providing a valued service that could help alleviate the distress and anxiety during their transition from 'care' to independent living (Brisson et al., 2022;Curry & Abrams, 2015;Field et al., 2021).
In addition to the provision of extended care, other articles reported on 'wrap-around care' and 'holistic service provision'.For instance, Lindquist-Grantz et al. ( 2022) evaluated a project where wrap-around care was designed to prevent homelessness for care leavers.In contrast to an extended care model (Arnau-Sabatés et al., 2021), where one key professional carer provided guidance and support, the 'wrap-around care' model enabled the advancement of an evidence-based intervention that utilised the expertise of the whole professional team.Although the aim of a whole team approach was to provide an individualised and holistic goal oriented care-coordination process, as per extended care models, articles that defined 10990860, 0, Downloaded from https://onlinelibrary.wiley.com/doi/10.1111/chso.12825,Wiley Online Library on [14/02/2024].See the Terms and Conditions (https://onlinelibrary.wiley.com/terms-and-conditions)on Wiley Online Library for rules of use; OA articles are governed by the applicable Creative Commons License these interventions recognised the benefit of a community development model of support (Mendes, 2012) that alleviated the pressure on a single professional carer (Lindquist-Grantz et al., 2022).
The articles in this section tended to focus on the value of 'community', illustrating how care leavers can be supported to negotiate difficulties by maintaining connections with broader social networks in partnership with a key professional carer.For instance, Mendes and Meade (2014) conducted a study on the 'Stand By Me' leaving care programme in Australia.Designed to offer intensive and continuous case support to young people aged 16 years and over, this project targeted support for those transitioning from out of home care who were assessed as having fewer community connections, and, as a result, were deemed to be most at risk of homelessness.When describing the importance of this scheme, the authors argued that a community development model of support, based on partnership between professionals and mainstream community networks, were more likely to promote the social inclusion of care leavers and by extension facilitate a more successful transition to independent living.
Further examples of extended care included housing support services that could promote the importance of practical, social and emotional support (Brisson et al., 2022;Curry & Abrams, 2015) enabled by effective professional collaborations between young people and their support network (Schelbe, 2018).Housing support services included subsidised housing, transitional housing programmes and permanent supportive housing options (Curry & Abrams, 2015).These programmes further offered young people a range of support services including vocational training and educational support (Brisson et al., 2022).
However, as explained by Berridge (2017) and Field et al. (2021), a key barrier to the attainment of extended care was reported in the absence of an effective professional relationship between the young person and the leaving care service.The authors conclude that where there are tensions between young people and the professionals who support them, there can be inconsistent engagement with interventions on offer.

A helping relationship
When considering interventions that sought to promote positive transitions to independent living, 11 articles were foregrounded in the importance of the helping relationship.While these articles drew upon the term 'relationship-based practice' in varying ways, the theoretical foundation to support this approach and explore its practical implications were not fully explored.Instead, the articles conceptualised a 'relationship' as the active ability of professionals, role models and peers to provide help through social and emotional support, trust and availability to young people (Mantovani et al., 2020) in support of the transition to independent living (Cudjoe et al., 2022).With a focus on coaching and mentoring, Powers et al. (2012), Sulimani-Aidan (2016), Sulimani-Aidan et al. (2020), Jarczok et al. (2021) and Brisson et al. (2022) also explained the importance of mutual relationships.As explained by Sulimani-Aidan (2016: 74), however, the main obstacle to the helping relationship presented when the transition to independent living was characterised by complexity: …the young adults' descriptions of [coaching and mentoring] revealed their complexity for them, especially in relation to the availability of supportive figures and the extent of support they could offer the young adults during this long and complicated transition.
A crucial feature of many of the articles grouped in this section is the description of a complex transition bound to historical and contemporary tensions between young people and the professionals in the support network.A tension that, if left unresolved, led some young people to refuse the interventions being proposed.
To promote the transition to independent living through a relationship-based practice model, Holt and Kirwan (2012), Ridley et al. (2016) and Butterworth et al. (2017) propose the introduction of a 'Link Worker'.As the 'Link Worker' becomes involved in the young person's life at the point of transition, each article considered how some young people may be less likely to associate them with previous negative experiences of 'care'.For this reason, the articles explain that young people may be more likely to engage with the 'Link Worker' who can help them to access the interventions being proposed.Increased access to services could then lead to greater opportunities for collaboration and support.
While many of the articles documented the importance of a relationship between young people and the professional network, the research grouped in this section also highlighted the added value of peer support.For example, Mantovani et al. ( 2020) and Cudjoe et al. (2022) each explained how peer mentoring enabled young people to experience a supportive relationship from another 'care experienced' young person.Analysing the strengths and limitations of the peer mentoring scheme, the research found that 'care experienced' mentors could be more available and supportive than the young person's professional network.The advantages of a peer mentor scheme were reported in altered power dynamics and a relationship that could sustain opportunities for guidance and support during the important transitional process.
The research in this section also highlighted the importance of a helping relationship as an enabler of a positive transition to independent living.However, only one paper advanced a conceptual model to aid the development of a helping relationship (Rouski et al., 2022).In this article, Dialectical Behaviour Therapy was reported as an effective tool to enable young people to work with their professional network to understand and accept their difficult feelings, learn new skills to manage them and become (better) able to make positive changes in their lives.

The role of family
Five articles clustered in this section argued that the transition from care to independent living was better enabled when young people were supported to plan and discuss the opportunity for reunification with their family (Butterworth et al., 2017;Holt & Kirwan, 2012;Ridley et al., 2016).These papers argued that the inclusion of the young person's family in interventions designed to support transitions to independent living could also help the young person to manage difficult feelings and provide emotional and social support (Fernández-Simo et al., 2022).Whilst targeted interventions designed to facilitate opportunities for reunification with family during the transition to independent living were reported as being important for some young people, Devenney (2017) explained that the helping relationship with family members is lost to unaccompanied young people.As a result, the author concludes that extra care is needed to support unaccompanied young people whose transition might be complicated further by the absence of a family network and uncertainty about immigration status.

Employment, education and training
Thirteen articles suggested that the transition from care to independent living could be better supported through interventions that provided targeted support for employment, education and training.Some researchers argued that education programmes that can equally focus on informal education and formal education can also promote opportunities for social mobility as an enabler of a positive transition (Jones, 2014).In this context, Jackson andCameron (2012: 1112) define informal education as the kind of learning that 'goes on outside educational settings and in "free" time'.The specific value of informal education is that it can widen social networks and bring care leavers into contact with adults who can act as role models.All articles grouped in this section showed that engagement in formal and informal employment, education and training can be limited by the existence of relational or perceptual tensions described above.
Building on the opportunities described by Jones (2014) and Jackson and Cameron (2012), Fernández-Simo et al. ( 2022), Furey and Harris-Evans (2021) and Gilligan and Arnau-Sabatés (2017) found that a young person's transition to independent living could be better supported where there was the prioritised facilitation of social support networks that extended to include employment, education and training opportunities.Here the inclusion of employers, colleagues, teachers and training providers in the young person's support network could help centralise the importance and presence of a relationship with professionals that was built on trust and mutual respect.Working alongside family members, peers and other connected professionals, this extended system was reported to support young people to experience responsibility and accountability whilst receiving the guidance and support at the time and place it was needed.
Despite the reported advantages, the important intersection of support that could be provided by education staff, employers and training facilitators was also cited as a cause of tension for unaccompanied young people.According to Devenney (2017) any uncertainty in immigration status can actively hinder a positive transition to adulthood as young people struggle to maintain their own biographical narrative or engage in employment, education and training opportunities.Drawing on Giddens (1991) concept of ontological security, Devenney (2017Devenney ( : 1315) ) argues that: the creation and maintenance of coherent biographical narratives helps [unaccompanied young people] sustain a sense of self that is stable across time, space, and context.
The relevance of biographical narratives in the transition to independent adulthood means that the role of education staff, employers and training facilitators loses all meaning when uncertainty about the present and the future remains.The absence of family presents an additional challenge to the realisation of a positive transition for unaccompanied young people who may be denied the opportunity to engage in formal and informal employment, education and training opportunities.This finding reinforces Mantovani et al. (2020) conclusion about the importance of positive professional helping relationships for unaccompanied young people who may be at more risk of being cut adrift when the time in 'care' comes to an end.
Central to interventions that aimed to promote education, employment and training were youth empowerment programmes, designed to promote and sustain positive psychological empowerment (Nesmith & Christophersen, 2014).Batista et al. (2018) evaluated the benefits of a programme designed to enable young people in the US to take a proactive and influential role in the development of leaving care policy.The authors reported that young people who participated in the scheme were more likely to experience higher perceived control, motivation to influence 10990860, 0, Downloaded from https://onlinelibrary.wiley.com/doi/10.1111/chso.12825,Wiley Online Library on [14/02/2024].See the Terms and Conditions (https://onlinelibrary.wiley.com/terms-and-conditions)on Wiley Online Library for rules of use; OA articles are governed by the applicable Creative Commons License their environments, self-efficacy and participatory behaviour compared to those who did not.As an example of informal employment, the authors found that youth empowerment programmes had particular benefits for young people transitioning to independent living.
Focusing on the concept of resilience as an important characteristic that enables young people to overcome some of the adversities associated with a complex transition, four articles grouped in this section focused on independent living skills training.Whilst Bond (2020) recognises that independent living skills training provided on an ad hoc basis can lead to variable results, Sims-Schouten and Hayden (2017), Nathan and Chaffers (2022) and Hlungwani and Van Breda (2022), each show that formal interventions designed to train young people to develop 'life skills' can promote resilience and support a more positive transition.In this context, Sims-Schouten and Hayden (2017: 1482) define 'life skills' training as: A project designed to improve the life chances and outcomes for those who are moving towards, or have recently left care, with a specific focus on improving employability, training, housing, and mental health and wellbeing.
In each paper, the evidence around leaving care and adversity, including mental health problems was established as a root cause of other problems such as educational inequality, unemployment and social exclusion.The articles by Sims-Schouten and Hayden (2017), Nathans and Chaffers (2022), Bond (2020) and Hlungwani and Van Breda (2022) each showed how targeted training interventions around 'life skills' could not only build resilience but also contribute to better mental health outcomes for care leavers.
Whilst the research on 'life skills' training has implications for practice and policy, these articles also highlight the importance of a professional helping relationship that can centralise the views and opinions of a young person, taking seriously their recommendations for a more accessible, acceptable, responsive and age-appropriate service provision (Sims-Schouten & Hayden, 2017).As seen in previous sections, this relationship can become restricted where unresolved tensions remain.
One specific training intervention designed to enable young people to articulate tensions or anxieties that they might be experiencing during their transition to independent living adulthood was described by Lougheed (2019).Reporting on the outcomes of a doctoral study undertaken in Canada, the author found that mindfulness-based training benefited care leavers in many ways.By increasing self-awareness, emotion regulation, optimism and sleep hygiene, the paper highlights the importance of mindfulness training for young people experiencing adversity, trauma, loss and marginalisation.The paper concludes that mindfulness is a skill that can enable a more positive transition to independence, including engagement with employment, education and training, when used alongside the support network, the helping relationship and the opportunity for extended care.

DISCUSSION AND RECOMMENDATIONS
In response to the first research question, the findings section has summarised the transitional support interventions designed to support care leavers with their transition to independent living.It has shown how and why policy support for extended care, a helping relationship (formal and informal/ professional and personal), family support and targeted approaches to support education, employment and training are being designed to reduce tensions associated with the experience of leaving care can contribute to a more successful transition to independent living.The following subsections will consider the second question, What are the reported key components of transitional support interventions for care leavers?
The first key component of transitional support interventions for care leavers is robust social policy.In each of the 36 papers included in this review, there was broad agreement that the actions taken to support a positive transition to independent living must be supported through social policy and statutory guidance.In all cases, the provision of extended care and transitional services should be accountable within a formal structure that can also intervene when there are ineffective attempts to support the transition from state care to independent living (Curry & Abrams, 2015).Without this provision, extended care and transitional service models are likely to fail (Roberts et al., 2021).Where the eligibility for leaving care support is determined by age or service availability, as opposed to individual need, the actions needed to implement the essential social, emotional and material support that young people leaving state care need can also be lost (Field et al., 2021).
The second component of transitional support interventions for care leavers focuses on promoting social, emotional and material support.The papers by Holt and Kirwan (2012) and Butterworth et al. (2017) each indicated that extended care and transitional support services should be led by a designated 'Link' or 'Outreach' worker who can rely on a professional network and work effectively with the young person and the young person's family (where appropriate) to co-produce and attain common goals.Bond (2020) and Hlungwani and Van Breda (2022) show that a 'Link' or 'Outreach' worker who facilitates the development of 'life skills', through education, employment and training, can also increase the young person's self-esteem and ensure that help, guidance and support is offered at the time and place that it is needed.At a time of critical complexity, Lougheed (2019) and Rouski et al. (2022) showed that the provision of talking and arts-based therapies can also enable young people to engage with their helping networks, articulate their anxieties and worries, and build capacity for transformative change.
The final key component of transitional support interventions for care leavers is relationshipbased practices built on a commitment to reduce the challenges faced by care leavers (Cudjoe et al., 2022).Where services are supported by robust policy and statutory guidance, efforts to promote social, emotional and material support for care leavers can be formally developed to include family members, social workers, residential carers, teachers, housing officers, counsellors, link and outreach workers, facilitated through effective relationship-based practices (Mantovani et al., 2020).
Whilst the 36 articles included in this review engaged with fundamental ideas about relationship-based practice, the theoretical foundation used to undergird interventions and activities and explore practical implications was not considered in equal depth.Notably, the articles did not consistently demonstrate, as a form of agency, the ways that transitional support interventions could enable or inhibit independence, or how the experience of a 'relationship' may be enacted or experienced differently from one person to the next or from one cultural context to another.As relationship-based practice is frequently cited as a key component of transitional support interventions, further research is needed to consider how services can embed this approach as a core feature of all leaving care interventions.
The primary challenge to any recommendation for the development of a theoretical foundation to support relationship-based practice rests on enduring concerns about the variable conceptualisations of human growth and development and the bureaucratic response to extended care and transitional support interventions (Ruch, 2005).Across the globe, care leavers experience unregulated accommodation, a drift through care, multiple social workers and carers, mental health difficulties, tension, anger, grief separation and loss, missing from care episodes, a lack of preparation for adulthood, feelings of powerlessness, instability and mistrust (Butterworth et al., 2017).For reasons outside of their control, they also experience structural inequality, social exclusion and economic inequity (Axford, 2008).For Jarczok et al. (2021) these factors are important because they make the development of relationship-based practice problematic.
Although definitions of relationship-based practice are hard to come by (Ruch, 2005), Trevithick (2003) argues that a professional helping relationship must first be based on the psychosocial approach to practice.Here, the term 'psychosocial' refers to the way that a person's experiences are formed by the interaction between the individual's psychological capabilities and the social environment (Adams et al., 2009).In matters related to leaving care, it is the ability of a service provider and wider social network to manage experiences, enabling, as far as possible, positive interactions with care leavers, that is the key to the development of effective relationshipbased practice (Ruch, 2005).
In each of the 36 articles, the service providers were shown as experts who acted as advocates for care leavers.As shown specifically by Bond (2020) and Rouski et al. (2022), those involved in facilitating transitional support took the time to understand the individual structural causes of distress and work with care leavers, on an individual basis to manage anxiety as a normal emotional response to change.As shown by Sulimani-Aidan (2016), a designated 'Link' or 'Outreach' worker who takes time to time to develop and nurture feelings of security and trust can also help to promote a positive relationship with the young person.For this reason, it could be argued that relationship-based practice with care leavers relies on extended care policies and transitional care programmes that place greater emphasis on developing ways to reduce anxiety.
One way to reduce anxiety for care leavers is to better recognise the importance of incorporating understandings of power and difference in service design, delivery and review.As shown by Sims-Schouten and Hayden (2017) and Brisson et al. (2022), it is important to understand that a psychosocial approach to practice should permeate the praxis of all state care systems.As a minimum training and guidance is therefore needed to ensure that those involved in designing, delivering and evaluating extended care services are able to respect, assess and respond to the uniqueness of each care leaver and their individual circumstances (Hlungwani & Van Breda, 2022).Training on the essential integration of anti-oppressive and anti-racist approaches to psychosocial practice should also be advanced.Consistent with this recommendation, states should legislate against the use of unregulated accommodation, take steps to prevent the drift through care, promote the retention of social workers and carers, invest in mental health services and further promote equal opportunities for social inclusion and economic prosperity (Butterworth et al., 2017).
Driven by the data, the three key components of transitional support interventions for care leavers are presented as a conceptual model, designed to illustrate how the transitional support interventions reported in the literature could co-exist within an original framework for practice (see Figure 2

below).
The outermost ring of the model illustrates the importance of social policy and statutory guidance designed to extend the period of 'care' past the age of 18 and the central ring shows all of the examples of social, emotional and material support reported in the literature.Whilst the 36 papers included in this review described individual transitional support interventions designed to support care leavers with their transition into independent living, unequal attention has been given to the possible advantage of providing a combination of these services.Only by conducting this scoping review has it been possible to illustrate how the combination of interventions reported in the literature could co-exist to help promote (more) positive action.
The inner circle represents component three, the reported importance of effective relationshipbased practices that should be placed at the heart of any extended care interventions designed to support a transition to independent living (Brisson et al., 2022;Cudjoe et al., 2022;Jarczok et al., 2021;Mantovani et al., 2020& Powers et al., 2012).To ensure that the social policy and statutory guidance are being implemented effectively, the service provider, the designated 'Link' or 'Outreach' worker and wider social network, that might include family members, social workers, residential carers, teachers, housing officers and counsellors are each accountable within a formal structure.Informed by the findings of Holt and Kirwan (2012), Butterworth et al. (2017) and Ridley et al. (2016), the directional arrows that intersect the model reflect the suggestion that without legislative and social policy changes, the opportunity to implement the combination of services and achieve effective relationship-based practices so crucial to a positive transition cannot be guaranteed.

Limitations
One limitation of this paper involves sustained outcome or impact measurement.While the intended focus of this review centres on transitional support interventions, it was not possible to consider whether interventions were effective in the long term.More work is needed to evaluate the long-term effect and impact of transitional support interventions.
No sustained approach has been made to identify the gaps within the existing research and practices related to care leavers.As a scoping review, the aim of this paper has been to identify and map knowledge on the different types of transitional support interventions that are 10990860, 0, Downloaded from https://onlinelibrary.wiley.com/doi/10.1111/chso.12825,Wiley Online Library on [14/02/2024].See the Terms and Conditions (https://onlinelibrary.wiley.com/terms-and-conditions)on Wiley Online Library for rules of use; OA articles are governed by the applicable Creative Commons License currently available.It is important to note, therefore, that the papers included in the review focused almost exclusively on what worked.They did not consider barriers to implementation.For this reason, more research is needed to understand the experiences of care leavers who choose not to engage in transitional services.This work is important to develop practices that can support all care leavers equally and effectively.To do this, it is important that further scoping reviews extend the inclusion criteria to account for a broader representation of transitional support, including the analysis of differing socio-cultural contexts and thresholds for state care, different populations, grey and tertiary literature, analysis and researcher positionality.

CONCLUSION
Presenting a summary of the 36 articles included in the review, this paper has highlighted the importance of interventions that seek to support the transition of care leavers to independent living.Illustrating the amalgamation of these factors in an original framework for leaving care interventions, this scoping review has underscored the central importance of relationship-based practices and the need for further research on interventions designed to enable a fuller analysis of impact and effectiveness of interventions in the immediate and longer term.

F
Framework for leaving care interventions.