The importance of maintaining contact between children temporarily or permanently looked after away from their birth parents is now believed to be so important to their psychosocial development as to be written into the Children Act. This position has been argued both on the basis of the rights of children and birth parents and on the claimed strength of the research evidence concerning the positive effects of contact and the negative consequences of its absence. The quality of the research evidence is reviewed. It is concluded that evidence on either the beneficial or adverse effects of contact is not strong and that the design and/or analysis of existing studies contain a number of weaknesses that preclude clear research-based guidance to practitioners.

The aim was to conduct a pragmatic randomized controlled trial (RCT) to evaluate two parenting programmes designed for adopters of children late placed from care. Adoptive parents, with children between 3 and 8 years who were screened to have serious behavioural problems early in the placement, participated in home-based, manualized, parenting programmes delivered by trained and supervised family social workers. The adopters who agreed to join the study were randomly allocated to one of two parenting interventions or to a "services as usual" group. Baseline, immediate post-intervention and six-month follow-ups were assessed using questionnaires and adopter interviews. No cases were lost to follow-up at any point and satisfaction was high with both parenting interventions. At the six-month follow-up, a significant difference (p < 0.007) was found for "satisfaction with parenting" in favour of the intervention group (Effect Size d = 0.7). Negative parenting approaches were reduced in the intervention group. However, no significant differences in child problems were found between the intervention groups and control group, adjusting for baseline scores. Costs analysis showed that a relatively modest investment in post-adoption support would be well spent in improving adopters' satisfaction with parenting in the intervention group compared to the routine service group.

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Moderately depriving orphanage care did not predict enduring adverse consequences in mid-life but subsequent poor adoption experience was associated with outcome.

The aim of this review is to map the literature on the adoption of children from public care, to identify the extent of research-based knowledge and to note gaps in the evidence. Adoption research has grown over the last 40 years but, as the methodological quality has increased, so has the complexity of the questions to be answered. This review covers research on the problem profiles of placed children and the challenges to new parents, matching and preparation, contact arrangements, medium and long-term outcomes and interventions with adoptions in difficulty. The article recommends that adoption research needs to be considered as an integral part of general research into placement choices for children. Looking to the future, the commissioning of large-scale studies is recommended to gain a lifelong perspective on adoption, to identify predictors of outcome, the consequences of contact arrangements for all the parties, and the cost-effectiveness of different types of adoption support. Many smaller scale studies need to be commissioned to monitor the progress of the various policy initiatives and legislative changes designed to increase the use of adoption as a placement choice in the UK.

Background:  Children adopted from care often exhibit behavioural difficulties. There is however limited cost‐effectiveness evidence regarding different interventions to address this. This paper reports a cost‐effectiveness analysis of parenting programmes for these children. Method:  Adoptive parents of children aged between 3 and 8 years participated in home‐based, manualised, parenting programmes delivered by trained family social workers. The adopters were randomly allocated to one of two interventions (n = 19) or to a ‘services as usual’ control group (n = 18). Baseline, immediate post‐intervention and 6‐month follow‐ups were assessed by questionnaires and adopter interviews. Economic costs were calculated. Results:  At 6‐month follow‐up, a significant difference (p < .007) was found for ‘satisfaction with parenting’ in favour of the intervention group. No significant differences were found on child measures between the combined intervention groups and control group, adjusting for baseline scores. The mean costs for the combined intervention group were £1528 higher than for the control group at the post‐intervention point, which was statistically significant (95% CI, £67 to £2782). However, over the entire follow‐up period the difference (£1652) was not statistically significant (−£1709 to £4268). The cost‐effectiveness analysis showed that costs of £731 would be incurred to achieve a point improvement in satisfaction with parenting compared to routine care by the end of treatment, whilst the figure was £337 for a point improvement by the 6‐month follow‐up. Conclusions:  Findings suggest that a home‐based parenting programme for adopters caring for difficult children in the first 18 months of placement may be cost‐effective in enhancing satisfaction with parenting, but not in reducing child behavioural problems, compared with ‘services‐as‐usual’.

LSE has developed LSEThis document is the author's final manuscript version of the journal article, incorporating any revisions agreed during the peer review process. Some differences between this version and the publisher's version remain. You are advised to consult the publisher's version if you wish to cite from it. Cost-Effectiveness of Individual versus Group Psychotherapy for SexuallyAbused Girls AbstractChildren who have been sexually abused may suffer from emotional and behavioural difficulties. Recent research found that individual and group psychotherapy have similar outcomes. In this study we compare the costs and cost-effectiveness of the two therapies and support for carers. Subjects were recruited to two clinics in London and randomly allocated to treatments. Total mean costs of individual therapy were found to be £1246 greater than for group therapy. Costs as they would apply in routine practice were relatively unchanged. Group therapy was thus more cost-effective than individual therapy. Carefully considering the impact of different therapies could allow more treatment to be offered from available staff resources and budgets.