DOI: 10.1111/cfs.

12697

ORIGINAL ARTICLE

Needs and availability of support among care‐leavers: A mixed‐

methods study

Tehila Refaeli PhD

Spitzer Department of Social Work, Ben‐

Gurion University of the Negev, Beer‐Sheva, Abstract
Israel Data are scarce on the long‐term needs of care‐leavers and on the support resources
Correspondence that are available for them in the years after leaving care. This mixed‐methods study
Tehila Refaeli, Spitzer Department of Social presents data on the needs and availability of support of 222 Israeli care‐leavers,
Work, Faculty of Humanities and Social
Sciences, Ben‐Gurion University of the Negev, suggesting that the most urgent needs of care‐leavers are a lasting need for a stable
PO Box 653, Beer‐Sheva 8410501, Israel. and available support figure and assistance with educational issues. For some
Email: [email protected]
care‐leavers, these needs are fulfilled by their mentors. Parents and other familial
Funding information figures were found to be the most common support resource for care‐leavers, which
Israel Science Foundation (ISF), Grant/Award
Number: 690/12 highlights the need for the intervention of social workers to improve relationships
within families while the children are still in care. Due to high rate of young people
who have no support resources and a low rate of services utilization, social services
should provide a platform to support this group, using mentors and other supporters.
The longitudinal data of up to 4 years after leaving care indicated that the availability
of various types of informal support improved over the years, and the reports on
difficulties in relationships of the care‐leavers with their parents were significantly
fewer 4 years after leaving care than on the verge of leaving care.

K E Y W OR D S

care‐leavers, informal and formal support, mentors, needs of care‐leavers, parental support

1 | I N T RO D U CT I O N The current study aims to bridge this gap by employing a retrospective

point of view of 4 years after leaving care, while examining the current
Emerging adulthood, broadly referring to the ages of 18–29 years and past needs of support of care‐leavers and the availability, duties,
(Arnett, 2015), is a challenging period for young people who grew up and contribution of various support resources. Additionally, although
in out‐of‐home placements. In many countries, formal out‐of‐home several longitudinal studies examined how the lives of young
care ends at age 18, and many care‐leavers benefit from only limited care‐leavers changed in the years after leaving care (e.g., Courtney
assistance thereafter (Mendes & Snow, 2016). In the past two et al., 2011; Dixon, 2008), to the best of my knowledge, studies did
decades, extensive worldwide research has revealed that many not examine how the availability of the support resources changes
care‐leavers experience difficulties in managing independent life tasks, over the years.
including housing instability, unemployment, poverty, and more (e.g.,
Dixon, 2012; van Breda, 2018). Accordingly, one of the most explored
issues is how the availability of support resources after leaving care 1.1 | Social support for care‐leavers: Needs and
can assist care‐leavers in meeting the challenges of the transition to availability
independent life (Hiles, Moss, Wright, & Dallos, 2013). However, data
are scant on the needs of young care‐leavers after leaving care and on Social support—that is, the exchange of resources between two
the availability and quality of support resources in the years afterward. people with the intention to improve the well‐being of the recipient

Child & Family Social Work. 2019;1–9. wileyonlinelibrary.com/journal/cfs © 2019 John Wiley & Sons Ltd 1
2 REFAELI

(Shumaker & Brownell, 1984)—is important for promoting resilience rather than achieved support, which examines the support that an
among vulnerable young people, such as care‐leavers (Anonymous, individual actually received. This approach stems from the assessment
2017; Dinisman, 2014), especially during the transition from care to that there are emotional benefits to constantly knowing that support
independence. Previous studies have indicated that care‐leavers lack is available (Lakey & Cohen, 2000; Sherbourne & Stewart, 1991). Five
support nets that are sufficiently wide and strong to help them types of perceived support are typically considered to provide differ-
through the demanding challenges of the transition to independent ent needs of the recipients (Sherbourne & Stewart, 1991): emotional
adulthood (Hiles et al., 2013; Sulimani‐Aidan, 2018); understanding support (understanding, encouragement, and expressions of feelings),
their specific needs for support is, therefore, important for improving affectionate support (expressions of love and affection), positive social
their quality of life after leaving care. Moreover, it is important to interaction (namely, the availability of others to enjoy being with the
study the needs of care‐leavers some years after leaving care, because recipient), informational support (guidance, information, and advice),
the time immediately after leaving care is accompanied by fears that and tangible support (material aid and assistance). However, very
might considerably affect their perspectives (Bengtsson, Sjöblom, & few studies have explored these types of support in relation to care‐
Öberg, 2018). leavers and identified their availability (Dinisman, 2014; Frimpong‐
Manso, 2017).
1.1.1 | Formal support
1.2 | Research goals
As formal support aims to help care‐leavers cope with the transition to
independent life, many countries have developed legislation that First, this study aimed to portray the needs of support for care‐leavers
either extended the duration of their care services or developed in different life domains, both 4 years after leaving care and retrospec-
designated services for care‐leavers (Mendes & Snow, 2016). The tively (namely, their perspective of their needs up to 4 years after
present study was conducted in Israel, where there is no legislation leaving care). Second, the use of a mixed‐methods design allowed
to support care‐leavers and young people who leave residential or exploring the availability of various resources of formal and informal
foster placements by the age of 18 years. Thus, after leaving care, only support 4 years after leaving care. Finally, the longitudinal design
a few services are available for these young people, and these are allowed examining whether the availability of informal support (and,
mostly operated by non‐governmental organizations that serve only especially, parental relationships) changed between the time before
a small number of care‐leavers (Schwartz‐Tayri & Spiro, 2017). In leaving care to 1 and 4 years after leaving care.
addition, care‐leavers may use the services that are available to all
young people in need in the general population, for example, social
workers in welfare agencies. The ability of formal resources to help 2 | METHODS
care‐leavers meet the challenges of independent life has not yet been
unequivocally established (Greeson, Garcia, Kim, & Courtney, 2014; This mixed‐methods study employed both qualitative and quantitative
Schwartz‐Tayri & Spiro, 2017), probably due to scant data on the data, thus enabling to confirm one method with data from the other
care‐leavers' needs from these sources of support. (triangulation), confront them one with the other, and provide wide
and rich data following the research aims (Johnson, Onwuegbuzie, &
Turner, 2007; Morse, 1991). The quantitative and qualitative data
1.1.2 | Informal support
were collected simultaneously and had the same status, represented
Various figures in the informal (social) net of care‐leavers—including by the model QUAN+QUAL (Johnson et al., 2007).
their birth families, partners, peers, and mentors—can provide
different means of support. Indeed, many young care‐leavers return to 2.1 | Data collection
live with their biological parents or extended family members (Collins,
Paris, & Ward, 2008). Studies of how the relationship of care‐leavers Data were derived from a three‐wave longitudinal study in Israel.
with their parents affects their adjustment to independent life have Young people about to leave care were recruited from 26 residential
yielded mixed findings (Jackson & Cameron, 2012; Wade, 2008), but care settings in Israel and were followed up for 4 years. The residential
the issue has not been explored with a longitudinal perspective. Some care settings included all 19 Israeli welfare settings for young people
studies indicated that care‐leavers use their relatives as a main source without severe mental illness, which care for children who were
of support (Anonymous, 2017; Wade, 2008). In addition, other signifi- removed from home due to abuse or neglect, and seven youth villages,
cant adults can provide informal support to care‐leavers, including whose populations were similar to those in the welfare settings and
romantic partners, peers, and mentors (Frimpong‐Manso, 2017; Snow that care for adolescent immigrants and adolescents from underprivi-
& Mann‐Feder, 2013; Wade, 2008). Their availability and contribution leged families.
to care‐leavers require further exploration. In the first wave of data collection (T1), research assistants arrived
The common approach for studying informal support focuses on at the residential facilities and met with the young people a few weeks
perceived support, which refers to the subjective feeling of the before they left care, in a group setting. They presented the research
support receiver that support will be available when it is needed, aims and, after explaining about the meaning of informed consent,
REFAELI 3

asked for the young people's consent to participate. During the filling Mentor (T3)—Participants were asked whether they have or had a
of the questionnaires, the research assistants also clarified items and mentor in recent years (yes/no(. If they answered positively, they were
answered questions, as needed. asked to answer three open‐ended questions about the types of sup-
In total, 276 participants answered the questionnaire (1.8% port provided by the mentors, the ways that support was provided,
refused to participate). A year later (T2), telephone interviews were and its impact on their lives.
conducted with 234 of these participants (an 84.8% response rate). Availability of informal support (T1–T3)—The Medical Outcomes
At this time‐point, about two thirds of the participants were carrying Study (Sherbourne & Stewart, 1991), which included 19 items
out their military or civic service (in Israel, military service is compul- (α = .93–.97) divided into five subscales: emotional (four
sory for all citizens at the age of 18, and lasts 3 years for men and items, α = .81–.86), affectionate (three items, α = .77–.81), positive
2 years for women). About 3 years later (T3), that is, approximately social interactions (three items, α = .73–.81), informational (four items,
4 years after leaving care, telephone interviews were conducted again α = .82–.86), and tangible (five items, α = .79–.90). Participants were
with 222 of the participants (an 80.4% response rate of the original asked whether they have a friend or someone close to provide each
sample). At T3, all participants had concluded their military service. type of support, on a scale from 1 (never) to 5 (all of the time). Means
were calculated for each aspect separately and for the 19 items
together.
2.2 | Participants Quality of relationship with parents (T1–T3)—A short version of the
Relationship with Father/Mother Questionnaire (Mayseless & Hai,
Similar to T1, 68.4% of the participants at T3 were from youth villages, 1998), which included 11 items that examined the perception on the
and 31.5% were from welfare settings. The average age at T3 was relationships, separately with the mother and the father, on a 5‐point
23.0 years (SD 1.0), and 59.5% of the participants were men. The scale ranging from 1 (not at all) to 5 (always true). Three scales were
mean overall length of stay in care was 5.9 years (SD 2.9). Fifty‐five used: “positive relationships with mother” (eight items, α = .90–.91),
percent of the participants had full high‐school diplomas, but only “positive relationships with father” (eight items, α = .90–.89), and
24.5% of all participants met the basic requirements for higher “difficulties in relationships with parents” (six items, α = .60–.77).
education. At T3, 55% of the participants lived with their parents, The T3 questionnaire also included two open‐ended questions about
13% lived with their partners, 10% rented accommodation, 9% lived possible changes in the quality of their relationships with their parents
with relatives, and the rest had other kinds of living arrangements since the time they left care and for the reason for these changes.
(e.g., student dormitories).

2.4 | Ethical considerations

2.3 | Instruments The study followed the ethical guidelines of the author's university and
was approved by the respective ethics committee. All participants
The survey included questionnaires (containing close‐ended questions
signed an informed consent form at T1. As mentioned above, research
and, at T3, also open‐ended questions) that were specific to this study,
assistants explained to the young people the meaning of informed
as well as other, widely used research tools, as detailed below.
consent and clarified that participation is completely voluntary and that
Background questions (T1–T3)—Gender, marital status, accommo-
they could stop their participation at any time, without any negative
dation, and so on.
consequences. Participants were asked to confirm their consent at T2
Current needs for support (T3)—Four items regarding the needs for
and T3. Confidentiality of the participants' identity was assured.
support in secondary education, employment, accommodation, and
personal guidance. Responses were rated on a scale of I do not need
support, I need support, and I already have support. 2.5 | Analytic plan
Support needs for care‐leavers (T3)—One open‐ended question:
“What are the needs of care‐leavers in the years after leaving care?” For the quantitative data, descriptive analyses are presented on the
Use of services (T3)—Participants were asked to indicate whether participants' current needs of help, use of services, and availability of
they had used each of nine services during the past year (yes/no), informal support. Analyses of variance (ANOVAs) for repeated
including social security, social welfare offices, and more (they could measure were used to examine the changes in informal support and
also add further services to the list). The sum of formal services used in the relationships with parents at each time‐point.
by participants was calculated. For the qualitative data, a thematic analysis (Miles & Huberman,
Romantic relationships (T3)—Two items, rated on a 5‐point Likert 1994) of the open‐ended questions was used to find the main themes
scale, referring to feelings of closeness with the partner (1 = very close, that are relevant for each question, following the steps of data
5 = not at all close) and satisfaction with their romantic relationships reduction, data display, and drawing conclusions. With the use of this
(1 = very satisfied, 5 = not satisfied). approach, the themes emerged from coding the quotes of all 222
Support figures (T3)—One open‐ended question: “who are the peo- participants and from identifying repeated themes. This approach
ple who help you today?” was used to examine the data concerning the open‐ended questions
4 REFAELI

on the needs of care‐leavers with support, the mentor's contribution, was for someone from the residential facility to continue “being there”
and the reasons for changes in the quality of relationships with one's for the care‐leavers:
parents. Two separate readers examined the qualitative findings to
I felt as if I had been thrown out. No one called, no one
verify the interpretations of the data. To enrich and broaden the find-
asked how you are, what do you do, anything … […]
ings, the qualitative and quantitative data are presented side by side.
Four years have passed and I have not received a phone
However, the separate analyses enabled the application of an explor-
call yet.
atory approach in data analysis, namely, using the qualitative data to
develop new theoretical contributions, rather than to simply verify Another theme that emerged was the expectation that support fig-
the quantitative data. ures (either from the residential care or not) will actively pursue the
contact with the care‐leavers, either to feel that someone cares about
them or because they needed support but, due to the perception that
3 | FINDINGS they ought to be independent at this age, felt uncomfortable asking
for it: “Young people seem to be more independent, so they will not
3.1 | Needs for support ask for help … Perhaps this is why someone should initiate contact
with them.”
Table 1 presents the frequencies of needs of support at T3. The most
dominant need was for support concerning acquiring higher educa- 3.1.2 | Concrete needs
tion, whereas the other needs were reported much less frequently. It
is also clear that personal guidance is the field that these young people Although the main need that the participants voiced was emotional,
receive more support than do the others, but it is only for about a fifth concrete needs were also commonly mentioned. The most highlighted
of the participants, whereas half said that they do not need this type need was for someone who would provide general guidance and
of support. advice after care: “They [care‐leavers] especially need someone to
The response of participants to the question “what are the needs direct and help them to be focused. Help everyone reach where they
of care‐leavers in the years after leaving care” provided rich data of want to advance.”
the various needs of care‐leavers from the time of leaving care and Similar to the quantitative data (Table 1), when the participants
until 4 years later. The themes that emerged can be divided into emo- specified domains in which they need help, the most prevalent domain
tional needs and concrete needs. These two types of need are was postsecondary education, including different specific needs in this
discussed separately below. domain, for example, the need for professional guidance in choosing
the field of study and the institution, explanations of the processes
3.1.1 | Emotional needs required to acquire postsecondary education, and help in finding
financial support for tuition. One of the care‐leavers explained that
A repeated theme was the need for someone to be available for the this need is derived from the absence of informal support and role
care‐leaver after leaving care: “Care‐leavers need much more involve- models:
ment in their lives, more accompaniment along the way, for someone
There is a need for a service that will call [care‐leavers]
to interested in them ….” This is not a request for therapeutic interven-
and provide a list of scholarships, a place you can come
tion (which was mentioned by very few participants) but, rather, a need
to consult with someone. […]. Care‐leavers do not have
to know that there is someone who cares about them, as other partici-
an older brother who already did it. So this service can
pants testified: “Anything can help, even just a phone call to talk.”
help them.
In line with this theme, a recurring motive was the feeling of being
neglected by the residential facilities, which resulted from the need to In the employment domain, which was also frequently mentioned, the
leave care abruptly. The participants used very strong words to main issue raised was the need for help in finding a job, as one of the
describe this feeling, for example, “The feeling is of being thrown care‐leavers specified: “Teach them [the care‐leavers] how to talk to
out at once like a dog.” A common expectation of the participants people; how to avoid being nervous, how to introduce themselves in
new places … They [the care‐leavers] should be prepared for this
TABLE 1 Frequencies of needs of support at T3 (%; N = 222) before leaving care.”
Needs Already has No need for Notably, very few participants referred to other specific needs of
support support support support, for example, in housing, economic support, and the utilization
Life domains
% % % of rights.

Secondary education 67.1 6.3 26.6 The main concrete suggestion raised by the participants was to
prepare care‐leavers for independence in the different life domains
Employment 39.2 3.2 57.7
when they are still in care: “[They should] create courses that explain
Accommodation 33.3 4.1 62.6
how to manage outside: find a job, write your resume, find suitable
Personal guidance 29.7 18.5 51.4
work, or how to behave in the army.” Some referred more broadly
REFAELI 5

to the need of care‐leavers to have an after‐care plan: “To guide them, significant way, including family members (an older brother or sister,
to talk to them about the future ….” an uncle or aunt, and a grandparent) or staff from the residential care
One of the participants summarized the main feeling of leaving (the manager, the housemother, or the guides). Other figures, such as
care and, accordingly, the need for a comprehensive support: bosses, neighbours, commanders during the military service, or a
Rabbi, were less frequently mentioned as mentors.
You need a lot of help … you feel that everything falls on
Analysis of the qualitative data revealed that most participants
you. […] When you go out, you do not know where to
considered at least one—and, usually, more than one—of the following
start, you do not know the life outside [of care]. What to
duties of the mentor to be important for them after leaving care: Some
do? Work? Study? Suddenly, there is no one to guide you.
participants perceived the mentor as a person who helps them “with
everything,” whereas others referred to the mentor as “a role model.”
Some participants elaborated on the types of support that the mentors
3.2 | Availability of support
provide, usually several types of support, which are interlinked and

3.2.1 | Formal support feed each other. One participant referred to his or her boss as provid-
ing such a multilevel support:
Next, it was examined how the care‐leavers had utilized formal social
He helped me with everything. Taught me how to handle
services during the year preceding the interview (T3). Almost half of
myself. I was taking care of the machines. He taught me
the participants (49.1%) reported that they had not used any formal
that … […] He helped me learn how life goes, provided me
service in the past year; 27.9% reported using one service; 16.7%
with a way.
reported using two services; and only 6.3% reported using three to five
services. Most participants (54%) used the social security institution One participant referred to a staff member in the residential care: “She
(which provides unemployment allowances, among other things), and always cared about me.” This quote highlights the second common
a quarter used services related to education (either special support from theme, namely, of the mentor being a stable figure in the life of the
the institutions in which the participant studies or services to complete care‐leaver, who provides love and warmth (the repeated words were
high‐school education). Welfare services were used by 10.4% of the “he/she cares about me/loves me”). The third main theme raised by
participants, whereas other services, including the two services for the participants is that the mentor is a substitution for other figures,
care‐leavers, were used only by 0.4% of the participants. including father, mother, older brother or sister, or grandparents; as
one of the participants said, “He was like a father to me.”
Some participants shared the long‐term results of the mentor sup-
3.2.2 | Informal support
port. Analysing these data revealed three main themes. First, for some
Romantic relationships participants, the directions and advice of the mentor promoted self‐
Four years after leaving care, most participants were not married confidence, as one participant said: “He strengthened me, made me
(91%), but 58.9% were involved in a romantic relationship. Of all par- believe in myself, helped me develop my [positive] current self‐
ticipants, only a few were in a new relationship (<6 months), whereas perception.” This young man also referred to another important role
6.8% were married, and 5.9% had children. Most participants (85.7%) of the mentor, namely, transforming him to “a better human being”:
reported feeling very close to their partners, and almost all participants “I was in a very bad situation, I used drugs and alcohol. He helped
(95.2%) were either satisfied or highly satisfied in their relationship. me out of it … Until now I think about him and stand on my feet”; or
as another participant explained: “I became a different person because
Social net of my mentor.” The third theme was of the mentor as a figure who
At T3, 24.8% of all participants testified that they currently have no pushes the care‐leavers to higher achievements, for example, to find
social support whatsoever; the rest reported being socially supported a job or be promoted at work: “He sometimes ‘slapped’ me with his
by their friends (26.1%), parents (either one parent or both; 25.7%), words so as to ‘wake me up’. He directed me to get myself together
romantic partners (18.5%), relatives (grandparents, uncles, aunts, etc.; … to find a job.”
15.8%), and siblings (12.6%). Only a few participants mentioned other
resources of social support, such as staff from the residential care, a
3.3 | Changes in informal support
Rabbi, a therapeutic figure, or a boss. Then, it was examined whether
care‐leavers receive support from different types of resources (e.g., 3.3.1 | General informal support
friends and siblings). Of all participants, 43.2% reported one type of
support resource, 15.8% reported two types, 9% reported three types, A series of one‐way ANOVAs for repeated measures were used to
and the rest reported having more than three types of resource. identify how each of the five types of informal support changes over
time (Table 2). Generally, the participants reported high levels of
Mentor informal support of all types at all three time‐points; however, some
At T3, 75.7% of the participants testified that they either have or had differences were found. Generally, support from different types was
a mentor, that is, an adult whose impact on them is positive and higher at T3 than at T1 and T2, and the lowest levels of support were
6 REFAELI

TABLE 2 Means and SDs of types of informal support at three time‐ reported that they experienced a positive change in their relationships
points with their parents than at the time they were in care; 39.1% reported

T1 T2 T3 no change in the relationships with their parents, and 9.3% reported a

negative change.
Type of support M SD M SD M SD F η2
Four themes emerged in the qualitative data as reasons for posi-
Emotional 4.15 .83 4.32a .83 4.49a,b .82 12.97*** .06
tive changes in the relationships of the participants with their parents.
Affectionate 4.21 .89 4.43a .77 4.44a .86 7.12** .04 The most common explanation for improvement in the relationship
a,b
Positive social 4.42 .71 4.48 .81 4.67 .62 8.83*** .04 with one's parents was the personality change that the care‐leavers
interaction underwent after leaving care, which they described using words such
Informational 4.06 .87 4.24a .86 4.43a,b .84 14.01*** .07 as “I grew up” or “I have changed.” Some of the participants also
Tangible 4.17 .78 3.96a .98 4.34b .97 13.85*** .07 explained that they can now better understand their parents and/or
a,b appreciate what they had done for them. As one participant said:
General index 4.19 .70 4.25 .73 4.46 .75 12.62*** .06

Note. The scale is 1 = never to 5 = all of the time. I was a problematic child and they have had economic
Abbreviation: SD, standard deviation. difficulties that I did not know how to deal with … .
a
Significantly different (p < .001) from T1 (Bonferroni post hoc). Now I am the one who supports them, because I
b
Significantly different (p < .001) from T2 (Bonferroni post hoc). understand their situation better.
*p ≤ .05. **p ≤ .01. ***p ≤ .001.
Another common reason was moving to live with or in close proximity
to one's parents: “I live at home and we see each other every day. I
reported at T1. One exception is tangible support, which was lower at help my mom with what she needs and with what I can help.” Some
T2 than at T1 and T3. refer to the technical means that allow them to maintain contact with
their parents, which had improved since they left care: “Now … I can
3.3.2 | Relationships with birth parents call them whenever I like. In the residential facility, I couldn't do that.”
The third explanation for improvement, which was mentioned by a
A series of one‐way ANOVAs for repeated measures (Table 3) indi- few participants, was moving away from the parents' home. Finally,
cated that, although the reports on having positive relationships with the fourth theme, which was the least common, referred to changes
either the mother or the father of the participants were not signifi- that the parents underwent in the years after the participants left care.
cantly different between the three time‐points, the reports on difficul- In some cases, this change included the parent seeing the care‐leaver
ties in these relationship were significantly fewer at T3 than at T1. Of in a more positive light and/or feeling proud of their child's achieve-
all participants, 38.5% did not respond to these questions due to ments: “They saw that I grew up and that I am fine and making prog-
either the death of the parent (20.2%) or not being in contact with ress. So, they believe in me more and are proud of me more, and this
one or both parents (18.3%; no significant differences in these per- affects the relationship.” However, these positive changes have not
centages between the three time‐points). made the parents a source of advice and guidance for most
The subjective perspectives of the participants revealed some participants.
nuances in how and why the relationships of care‐leavers with their The explanations for a negative change in the relationships with
parents change after leaving care. At T3, most participants (51.2%) one's parents were contradictory. Some participants referred to phys-
ical distance between the care‐leaver and their parents as the reason
TABLE 3 Means and SDs of quality of relationships with parents at for this negative change: “… I am not at home frequently. I live in
three time‐points another place.” Others referred to the opposite, that is, that living with
Relationships with their parents was the reason for the negative change: “It's difficult for
T1 T2 T3
parents them that I live with them. They don't want me to stay.” Less common
M SD M SD M SD F η2 explanations were the disappointment of the parents with their child
Positive relationship 3.74 .82 3.60 .84 3.64 .89 2.88 .02 and having a different religious status.
with mother
Positive relationship 3.49 .82 3.43 .81 3.45 .91 .76 .00
with father
4 | DISCUSSION
Difficulties in 3.06 .94 2.95 .79 2.85a .97 3.66* .02
relationships with This study employed a mixed‐methods approach and used data from a
parents
3‐point, large‐scale longitudinal study. It provides a wide perspective
Note. The scale is 1 = not at all to 5 = always true. on the support that is needed and that is available for care‐leavers in
Abbreviation: SD, standard deviation. the years after leaving care. Although care‐leavers are known to be
a
Significantly different (p < .001) from Time 1 (Bonferroni post hoc). at the highest risk of failing to manage adult life tasks and require suit-
*p ≤ .05. able formal support (Anonymous, 2017; Stein, 2006), a relatively high
REFAELI 7

proportion of care‐leavers in the current study reported to have no The findings also indicated that the availability of various types of sup-
one to support them. Additionally, the findings indicate that the vari- port increased with years after leaving care, which may stem from the
ety of resources available for care‐leavers is low as compared with availability of the romantic partners of many care‐leavers and of the
other young people at risk (de la Haye et al., 2012; Kennedy et al., friends that they had made during the years after care. However, as
2012) and that they do not fully utilize the services that are available Stein (2006) highlighted, the care‐leavers who experience leaving care
for them. as the most challenging (the “victims” group) need additional formal
Mentors were mentioned in regard to the contribution of their support because they lack informal nets.
guidance to the young people, but the young people also referred to
their constant and stable presence in their lives and to the emotional
support they provide. Similar to the findings of Schofield, Larsson, 4.1 | Conclusions
and Ward (2017), some care‐leavers in the present study referred to
mentors as substitutes for parents or other relatives. These findings This study is one of the few to follow a large sample of care‐leavers
stress the absence of parental figures and represent the ingrained for a substantial period (4 years) after leaving care. The main theoret-
desire of some care‐leavers for unconditional love and caring. Indeed, ical contribution of the qualitative part is the finding that, when the
the finding of Dinisman (2014) indicates that, although tangible and care‐leavers refer to their needs, they mainly refer to emotional needs
informational support can be replaced by adequate preparation before (which were not addressed in the quantitative part of the study),
leaving care, emotional support cannot be replaced by this rather than the need for guidance. Similarly, regarding the mentor's
preparation. duties, the qualitative data indicate that emotional needs, in addition
Both the qualitative and quantitative data indicated that acquiring to instrumental and guidance needs, are pivotal for care‐leavers. Inte-
higher education is the most pressing need for care‐leavers, as they grating these data reveals that a stable relationship with a suitable per-
are well aware of the ability of education to assist them in escaping son—namely, a mentor—can considerably assist care‐leavers in coping
their marginality and economic distress. However, their low high‐ with their multiple life's demands. In addition, the findings also con-
school achievements and their economic difficulties, among other fac- tribute to the body of literature on the relationships between care‐
tors, hinder them from acquiring higher education (Dixon, 2012; Jack- leavers and their parents; the quantitative data indicate that difficul-
son & Cameron, 2012). The qualitative data also indicated the absence ties in these relationships are reduced 4 years after leaving care,
of role models, especially to provide support concerning educational whereas the qualitative data indicate that these changes mainly result
tasks, possibly because they are the first generation in their families from the maturation of the care‐leavers, rather than from changes in
who aim to acquire higher education. the behaviour of their parents.
An important issue that the current findings raise is the relation- The support of mentors can be a useful tool of intervention with
ship of the care‐leavers with their parents, which generally improved relatively small costs. The current findings suggest that mentors pro-
after leaving care. Thus, although care‐leavers did not experience suf- vide care‐leavers with all the needed types of support, including the
ficiently good parenting as children, their parents may be good sup- need for caring and affection, which was mentioned as the most
port providers for them as adults. As many care‐leavers return to needed type of support. Previous findings, as well as those of the cur-
live with their parents after leaving care (Collins et al., 2008), rent study, indicate that care‐leavers do not fully utilize their rights
neglecting interventions with parents—a common phenomenon in (Courtney, Lee, & Perez, 2011), which is another aspect in which a
many out‐of‐home services today—might lead to negative results for mentor can help. Mentors can also be especially influential in
some care‐leavers. empowering and encouraging care‐leavers to achieve higher educa-
The findings suggest that care‐leavers experience the lowest levels tion and help them through the process of integrating into higher
of support just before leaving care—a surprising finding, especially education.
regarding the informational support. At this time, these young people The need to prepare care‐leavers to independent life prior to leav-
are flooded with fears (Bengtsson et al., 2018) and, therefore, may not ing care, which was highlighted by this study, is strongly supported by
be able to appreciate the support from each other and from the resi- previous studies (e.g., Dinisman, 2014; Diraditsile & Nyadza, 2018).
dential care staff, which will end soon. Surprisingly, 1 year later, Such preparation can be achieved through real‐life experiences while
although still at the beginning of their transition to independence, in care (e.g., cooking meals), and it should also include interventions
the participants reported greater support of most types, which could concerning the development of friendships (Mann‐Feder, 2018). Not-
be explained by the enlistment of most of them to military service— withstanding, it is impossible to avoid the essential needs of care‐
which has been shown to provide young people with basic needs leavers for ongoing emotional support, especially for those who do
and to help them create close relationships with peers (Kaplan & not have familial resources, which pertain to a large group of the
Rosenmann, 2014; Lieblich, 2012). In this context, the effect of the care‐leavers. Social work services should be offered to these care‐
military service on care‐leavers in Israel can be similar to that of the leavers, mainly stressing the need for a stable figure of support.
extended care in other countries such as the United States; that is, it Several limitations of this study should be taken into consideration.
delays the transition from care to independent living. These findings First, the generalizability of the findings should be considered carefully
highlighted the need to enable a gradual transition to independence. because, in Israel, most out‐of‐home placements are in residential
8 REFAELI

facilities (as compared with placement mostly in foster care around the & Family Social Work, 22(1), 195–202. https://doi.org/10.1111/
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