Care leavers’ views about transition:

a literature review

Cathy Atkinson and Rebekah Hyde

Cathy Atkinson is based at the Abstract

Department of Education, Purpose – Considerable attention has been given to the vulnerability of young people leaving care in the UK
Faculty of Education, in their transition to adulthood. To date, however, there has been limited focus on the perceptions of care
Manchester Metropolitan leavers about what factors enable and inhibit effective practice. The paper aims to discuss these issues.
University, Manchester, UK. Design/methodology/approach – This systematic literature review sought to elicit the views of UK care
Rebekah Hyde is Educational leavers in identifying barriers and facilitators to the process of transition to adulthood. Qualitative studies in the
Psychologist at Cornwall care-leaving field were identified, of which seven met inclusion criteria and were included in the final synthesis.
Findings – The findings yielded a range of facilitators, including authentic and consistent relationships with
Council, Cornwall, UK.
those acting in the role of corporate parent; and flexible systems, which accommodated personal readiness
for leaving care. Barriers included insufficient recognition of, and a lack of support for, the psychological
dimensions of transition, exacerbated by insufficient support networks.
Research limitations/implications – This literature search yielded seven qualitative papers, some with
small sample sizes, meaning that the findings may not be representative of a wider population or directly
relevant to international contexts.
Practical implications – Suggestions for enhancing the transition process are posited. In particular, the
potential usefulness of an “interdependence” transition approach for UK care leavers is proposed.
Originality/value – This study analyses qualitative data, thus constituting a response to policy calls for care
leaver views to be central to transition processes.
Keywords UK, Barriers, Facilitators, Transition to adulthood, Leaving care, Care leavers
Paper type Literature review

Introduction
Previous research has indicated that UK care leavers, on entering adulthood, are at heightened
risk of homelessness, custody, sexual exploitation, becoming not in education, employment or
training (NEET), mental health issues, social exclusion and death in early adulthood
(Greenwood, 2017; Stein, 2005; The Centre for Social Justice, 2015). Furthermore, low
participation rates for care leavers in education and training equate to reduced opportunity
when entering an overburdened youth labour market (Jackson and Cameron, 2012; Stein,
2005). Despite this, a small amount of research indicates that some care leavers go on to
further and higher education, which brings them enhanced employment prospects
(Harrison, 2017). Since the Children (Leaving Care) Act of 2000, there have been positive
shifts in the legislative landscape to extend statutory protection to 25 years, an
acknowledgement that care leavers are often catapulted into “instant adulthood” without the
necessary skill set and support network (Stein, 2008, p. 41). Nevertheless, evidence suggests
that practice related to transition to adulthood remains largely age, rather than needs-driven
Received 27 May 2018 (Hiles et al., 2014; Munro et al., 2011). With many care leavers remaining unprepared for
Revised 14 October 2018
9 December 2018 adulthood, poor outcomes for this vulnerable but by no means homogenous group have
Accepted 4 February 2019 persisted (Stein, 2006; The Centre for Social Justice, 2015).
This research was supported by
the Department for Education (DfE) The changing pattern of youth transitions can be seen to further disadvantage care leavers’
National College for Teaching and transition to adulthood. Pathways to adulthood have become increasingly complex since
Learning (NCTL) ITEP award
2015–2018. the 1980s (Furlong et al., 2003). The emergence of a so-called boomerang generation,

PAGE 42 j JOURNAL OF CHILDREN'S SERVICES j VOL. 14 NO. 1 2019, pp. 42-58, © Emerald Publishing Limited, ISSN 1746-6660 DOI 10.1108/JCS-05-2018-0013
a media-coined term capturing a state of fluctuating between dependence and independence, is
characterised by increased youth dependency on family; and slower and more gradual transitions
to adulthood (Goldfarb, 2014). Recent statistics suggested many young people are now living
with their parents into their 20s and 30s (The Office for National Statistics, 2016). By contrast,
care leavers do not have the option of retreating to a familial safety net, having been denied the
secure base that provides an emotional springboard into independence (Stein, 2004). Unlike their
peers, care leavers are often required to navigate simultaneous changes at transition to
adulthood, sometimes having to manage a number of concurrent life events (e.g. leaving care,
managing a tenancy, entering the workplace, etc.). Stein (2008) describes the “compressed and
accelerated transitions to adulthood” (p. 39) faced by care leavers, who can often be denied
sufficient time and support to navigate and adjust to these multiple transitions.

Barriers and facilitators

Recent policy advisory documents and governmental reports have emphasised potential factors
influencing and affecting effective transition practice. In terms of issues, one barrier reported by care
leavers is the inadequacy of pathway planning (Munro et al., 2011; The Centre for Social Justice,
2015, 2016). A pathway plan is a statutory document that follows the care leaver through
the transition process, documenting their needs across multiple domains (DfE, 2010). Another is
the perceived shortage of suitable independent or semi-independent living arrangements
(The Centre for Social Justice, 2014; DfE, 2017). This concern has also been echoed within
literature, with access and availability varying across local authorities, perhaps due to the level of
interworking between leaving care and housing teams (Dixon et al., 2006; Hiles et al., 2014).
Many care leavers report the abrupt loss of a support network and subsequent onset of loneliness
or depression, perhaps due to a lack of support to address their emotional needs on leaving care
(House of Commons Education Committee, 2016; The Centre for Social Justice, 2015). A lack of
input around practical issues such as budgeting advice and cooking is another reported barrier in
the transition to independent living (Harris, 2009; The Centre for Social Justice, 2013).
Conversely, the Right2BeCared4 report (Munro et al., 2011) identified supportive and consistent
relationships with professionals including social workers and involvement in decision-making
processes as facilitative. Care leavers valued the process of preparing their pathway plan, when
reflective of their current circumstances and goals. Flexible and available support, which could be
readily accessed at any stage of the transition process, was valued. A report involving discussion
groups with 88 care leavers highlighted further facilitators (Ofsted, 2012). One-third of
participants reported that issues could have been ameliorated via additional budgeting advice,
easier access to important documents (e.g. passports) and availability of emotional support.
A small number reported that continued contact with foster carers helped their transition to
adulthood, providing an ongoing social network.

Rationale and aims of the current study

A key strand to recent legislative changes has been the call for increased self-advocacy for care
leavers when planning for transition (Stein, 2008). The Care Leavers Regulations (DfE, 2010) as well
as guidance from The United Nations Convention on the Rights of the Child advocated that care
leavers should have greater choice and control when planning for transition to adulthood.
Recent evidence, however, has suggested that care leavers can be peripheral to preparing for
adulthood processes (Dixon et al., 2006; Munro et al., 2011). Moreover, the lack of qualitative studies
conducted with care leavers in the UK has made it difficult to identify what care leavers perceive to be
barriers or facilitators to the transition process (Parry and Weatherhead, 2014). This current literature
review responds to this participation agenda by focussing on care leavers’ perspectives about
barriers and facilitators to successful transition to adulthood.

Method
Search strategy
The study was focussed on a single country (the UK), as it was envisaged that it would be difficult to
draw conclusions across different countries, given their diverse contexts and care systems.

VOL. 14 NO. 1 2019 j JOURNAL OF CHILDREN'S SERVICES j PAGE 43

 An extensive, systematic search of the following electronic databases was carried out: PsycINFO,
Education Resources Information Centre, Applied Social Sciences Index and Abstracts and Web of
Science. A review of the University of Manchester’s library catalogue was also conducted. Key
search terms were: care leavers, leaving care, UK, preparing for adulthood, transition to adulthood
on leaving care and transition for care leavers. Searches were conducted between June 2016 and
January 2017. Inclusionary parameters were devised and all of the included studies met the
following criteria: published after The Children (Leaving Care) Act of 2000; participants were young
people who were care leavers; involved face-to-face individual interviews with care leavers;
adopted a dominant qualitative paradigm with priority given to the perspectives of care leavers
through interview; included empirical data which included direct quotes from care leavers; written in
English; focussed solely on the UK context; primary focus on preparing for independence or
transition from care; subjected to peer review in an academic journal. In focussing on the voices of
care leavers, it was hoped that the following research question could be addressed:
RQ1. What do UK care leavers report as barriers and facilitators in the transition to adulthood?

Outcomes of systemic search

Initial screening of 68 articles yielded a large number of studies undertaken in non-UK contexts,
reflecting increased international focus on preparing care leavers for adulthood (Jackson and
Cameron, 2012) and suggesting avenues for further review, beyond the scope of this paper.
The systematic search identified eight qualitative studies, of which seven met the inclusionary criteria.
One article was excluded on the basis that it did not adopt transitioning to adulthood as its primary
focus (Pinkerton and Rooney, 2014). A descriptive overview of the studies can be found in Table I.

Table I Studies overview

Study Article Focus Sample size, gender, age, location Methodological approach

1 Adley and Level of emotional support available to 6 care leavers Semi-structured interviews;
Jupp Kina care leavers 18–21 years phenomenological analysis
(2014) Gender not specified but sample diverse in terms
of gender and race
Recruited through a leaving care team in an urban
local authority in England
2 Amaral (2011) Factors bolstering care leavers’ 35 care leavers Semi-structured interviews;
engagement with leaving care services 16–23 years thematic analysis
Gender not specified
Recruited via throughcare and aftercare services
in central Scotland
3 Butterworth Care leavers’ experience of transition 12 participants with suspected mental health Semi-structured interviews;
et al. (2016) between health care services needs either with service contact (6) or without (6) thematic analysis
10 female; 2 males
18–22 years
One local authority in the West Midlands
4 Driscoll (2013) A resilience framework is applied to 4 male, 3 female, all white British Semi-structured interviews;
care leavers 16–20 years grounded theory approach
Location not specified, but care leavers said to
have come from a range of places
5 Horrocks Life course theory applied to care 1 male, 1 female Informal interviews;
(2002) leavers Location not specified ethnographic in orientation
6 Matthews and Health priorities of care leavers and the 9 participants (six care leavers and three in the Semi-structured interviews;
Sykes (2012) impact of transition on their health process of leaving care) interpretative phenomenological
2 males; 4 females analysis
17–21 years
Two, two-tier rural local authorities in England
7 Rogers (2011) Care leaver transition trajectories and 5 young people plus interviews with college and In-depth biographical
access to available support university student support staff ) interviews; thematic analysis
3 females; 2 males (all in post-16 education)
South East of England

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Figure 1 shows the data screening process, documenting how the final seven studies were
selected. The current review adopted a systematic search strategy that was guided by the
Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines
(Moher et al., 2009). The PRISMA guidelines have been widely used in many systematic literature
reviews and help to ensure that the review process is transparent and replicable. All studies that
met inclusion criteria were coded for quality using a bespoke framework developed from criteria
taken from the studies of Spencer et al. (2003) and Henwood and Pidgeon (1992). This checklist
included the following criteria and one point was awarded for the presence of each:
appropriateness of the research design; clear sampling rationale; well-executed data collection;
analysis close to the data; emergent theory related to the problem; evidence of explicit reflexivity;
comprehensiveness of documentation; negative case analysis; clarity and coherence of the
reporting; evidence of researcher–participant negotiation; transferable conclusions and evidence
of attention to ethical issues. A qualitative study was categorised as “low” quality if a total score of
0–4 was achieved; “medium” quality studies were rated at 5–8 points and “high” quality achieved
9–12 points.

Figure 1 Screening process

366 studies identified

through database
searching

366 studies screened

298 studies excluded

automatically as screening of
abstracts indicated not
particular to UK context

68 full text articles

assessed for eligibility

60 full text articles excluded as further

screening of papers revealed that they were
not particular to UK context nor did they
prioritise the voices of care leavers through
face-to-face interviews

7 studies included in
qualitative synthesis

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 Six out of the seven studies, having been scrutinised using the framework for qualitative
evaluation, were found to be of high quality. The decision to ultimately include the one medium
quality paper (Amaral, 2011) was taken on the basis that all care leaver voices were still
considered valid, pertinent and worthy of inclusion. Moreover, data from Amaral’s (2011) study
appeared consistent with data from the high qualities studies.
Participant data, that is, verbatim quotes, were then subjected to thematic analysis (Braun and
Clarke, 2006), using an inductive approach to identify key themes related to barriers and
facilitators in preparing for adulthood. Inductive codes were initially developed by the first author
and subsequently reviewed and amended by the second author. In total, 14 themes and
58 codes were initially identified. These were refined to 8 main themes and 37 subthemes through
discussion and constant checking of the data.

Findings
Study design
The seven included studies comprised of exploratory, qualitative research designs.
Semi-structured interviews were used in five of the studies (Adley and Jupp Kina, 2014;
Amaral, 2011; Butterworth et al., 2016; Driscoll, 2013; Matthews and Sykes, 2012). Informal
interviews were used in Horrocks’s (2002) study while in-depth biographical interviews were
employed in Roger’s (2011) study.

Sample
Study samples ranged from 5 to 35 participants. Participants across studies ranged in age from
16 to 23, although precise ages were not specified in two of the studies (Horrocks, 2002; Rogers,
2011). With the exception of two studies (Matthews and Sykes, 2012; Driscoll, 2013),
participants were recruited either from one local authority or area (e.g. central Scotland) within
both urban and rural UK contexts.

Focus
All seven studies considered particular aspects of leaving care, namely: the emotional support
available to care leavers (Adley and Jupp Kina, 2014); factors motivating care leavers to engage
with services (Amaral, 2011); care leavers’ experience of transition between child and adult health
care services (Butterworth et al., 2016); health priorities of care leavers (Matthews and Sykes,
2012); and care leavers’ transition trajectories and access to support (Rogers, 2011). Two papers
viewed care leavers’ experiences from the theoretical lenses: of resilience (Driscoll, 2013) and life
course theory (Horrocks, 2002), respectively.
Emergent key themes and subthemes are shown in Table II. These will now be discussed in
turn. The findings section is structured around the eight emergent themes, with barriers and
facilitators included under each theme. It is noted that there is some overlap within the differing
sections, particularly relating to the role of personalisation and flexibility for young people
preparing to leave care.

Pathway planning – barriers

A day is a long time, let alone six months. Six months between each pathways plan. If I had my way I’d
have them re-assessed every 2-3 months (Butterworth et al., 2016, p. 7) (Participant 7, unnamed).

Pathway planning is the statutory planning process, which involves the documentation of an
over-arching plan to support care leavers throughout their respective transitions. Care leavers in
Butterworth et al.’s (2016), Driscoll’s (2013) and Matthews and Sykes’s (2012) studies described
pathway planning as a largely bureaucratic, depersonalised “tick-box exercise” which did not
secure meaningful engagement in preparation for adulthood. Participants reported incomplete
and outdated pathway plans, which for a small number were initiated on the cusp of leaving care

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Table II Themes and subthemes
Subthemes
Emergent themes Facilitators Barriers

Pathway planning Flexibility around support Pathway planning as impersonal and

Consistent relationships bureaucratic
Chances to experiment with being independent Lack of consistent and coordinated care
Lack of support influencing young Supportive living environments associated with
person’s motivation educational engagement
Support figures influencing motivation to engage with
education or health
Increased autonomy and control
Second chances The role of flexibility Openness to support
Past support figures
Time to reflect
Emotional/psychological readiness for Flexibility around support Declining mental health and coping abilities
leaving care Emotional needs overlooked
Sudden loss of support network and
associated isolation
Level of autonomy required
Self-reliance and the “help” paradox Personal strength (up to a point) Active rejection of perceived authoritarian
Professionals’ understanding the dynamics of “saying no” styles of help
Self-reliance as self-protection
Lack of self-efficacy/shame around help
seeking
Dissociating oneself from the system
Habit
Transitioning to adulthood Differing support needs at transition Instant adulthood
Keeping care leavers “in the loop” The idea of independence vs the reality
Not prepared for the reality of independence
Accommodation arrangements
Lack of skills Self-management skills and resilience
Budgeting difficulties
Perceived lack of professional skill
Corporate parenting model Personal connection Contractual nature of support
Continuous care Age rather than needs dependent
Personalised support arrangements

(Matthews and Sykes, 2012; Rogers, 2011). Some participants in Driscoll’s (2013) and
Butterworth et al.’s (2016) studies, and all five care leavers interviewed by Rogers (2011)
concluded that those overseeing the pathway planning process appeared to only be fulfilling a
contractual obligation, as opposed to showing genuine interest. Inconsistent staffing and
coordination amongst professionals influenced this perception (Butterworth et al., 2016; Driscoll,
2013). Additional barriers included frequent personnel changes and perceived shortcomings
around the frequency and nature of contact with (past or present) social workers or aftercare
advisors (Amaral, 2011; Butterworth et al., 2016; Driscoll, 2013; Rogers, 2011).
All seven studies highlighted the nature of care throughout transition planning as insufficiently
consistent or coordinated. Four papers identified that care leavers did not feel emotionally prepared
for transition to adulthood, with priority given to practical rather than emotional support during
pathway planning (Adley and Jupp Kina, 2014; Butterworth et al., 2016; Matthews and Sykes, 2012;
Rogers, 2011). Additional inconsistencies were highlighted for those who had experienced transition
between child and adult mental health services (Butterworth et al., 2016; Horrocks, 2002). All but one
participant reported poor coordination, with some placed on long waiting lists before moving to a new
team where they were expected to forge relationships with other professionals.

Pathway planning – facilitators

[…] like contact the GP themselves “cos normality it is the carer or guardian that has to do it. And I think
they should have a bit more independence” (Matthews and Sykes, 2012, p. 402) (Participant 4, female).

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 Timing and flexibility around support was valued by care leavers during pathway planning.
For example, one care leaver regretted dismissing an offer of practical cooking support, and
subsequently “ate toast and jam most days and nicked my housemates’ food” (Rogers, 2011,
p. 421). Others declined untimely “one off” offers of cooking and budgeting support, which were
not then presented again (Adley and Jupp Kina, 2014; Rogers, 2011). Instead, care leavers
requested supported opportunities for practical experience of being independent before leaving
care (e.g. making their own medical appointments) (Butterworth et al., 2016; Matthews and
Sykes, 2012). Others wanted offers of support from social care to be renewed several times
(Adley and Jupp Kina, 2014; Rogers, 2011). Flexibility extended to wanting the choice to change
aftercare advisors if the relationship was poor (Butterworth et al., 2016).
Some care leavers in Amaral’s (2011) paper indicated that support offered by keyworkers
attached to supported living placements helped to strengthen their independence skills. Care
leavers’ willingness to accept support within caring and consistent relationships was discussed in
six of the papers, and is a possible facilitator to supporting preparations for adulthood. Care
leavers also proposed possible solutions for those facing transition between child and adult
mental health services, including: joint working visits between care coordinators, greater clarity
around mental health support and for information about treatment options and diagnosis to be
delivered in an accessible, non-intimidating manner.

Support and motivation – barriers

I probably would have sorted myself out a lot earlier if I’d had someone there who gave a crap about
what was happening (Rogers, 2011, p. 423).

All five care leavers in Rogers’ (2011) paper were attending college, but a lack of adult support
and perceived interest in their long-term goals affected their motivation and ability to achieve to
their potential. Matthews and Sykes (2012) identified the need for support figures to “push” care
leavers to focus on their health needs (p. 401). Findings also highlighted how the absence of
personalised support impacted on the initiation of good health care routines or completion of
educational pathways (Butterworth et al., 2016; Matthews and Sykes, 2012).

Support and motivation – facilitators

I’m gonna stick something out now and make her proud (Driscoll, 2013, p. 145) (Charlotte, aged 19).

Care leavers in Driscoll’s (2013) study identified that educational success was facilitated by foster
carers or other interested individuals, such as teachers, going above and beyond in their roles.
Two care leavers in Driscoll’s (2013) study were grateful that carers had pushed them to apply
themselves at General Certificate of Secondary Education (GCSE) when they had lacked
motivation. Two more had dropped out of college on entering independent living, but later
returned to education once back in supported accommodation, attributing these arrangements
as influential. Nonetheless, the view that support figures were instrumental to care leavers’
autonomy and motivation was not shared across all papers. Some care leavers preferred the
“reduced surveillance” (Butterworth et al., 2016, p. 6; Horrocks, 2002) and freedom of an
aftercare model, associated with an enhanced sense of control, autonomy and responsibility.

Second chances – barriers

For a small number of care leavers, a lack of flexibility on the part of training and/or education
settings thwarted opportunities for a second chance (Driscoll, 2013). For example, despite
applying to college with sufficient qualifications, John’s application was rejected due to his
criminal record and he remained unemployed.

Second chances – facilitators

Eh don’t want to make the same mistakes as ah made last time, ah want to learn frae them and make a
go o’it this time (Amaral, 2011, p. 8) (Dean).

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Two studies identified second chances as instrumental in enabling care leavers to pursue
preferred training and/or career goals (Amaral, 2011; Driscoll, 2013). Despite underachieving in
GCSE exams, all seven care leavers in Driscoll’s (2013) study demonstrated self-determined
attitudes towards pursuing future goals. Descriptions suggested that most were motivated to
engineer a counter-narrative to a past where they had not achieved academically or vocationally.
Some attributed their lack of achievement to living in non-supportive environments. Others
recognised that encouragement from supportive adults had been a motivating force. However,
personal complications sometimes impeded success, which meant that flexibility around
admissions to academic institutions and/or places of employment was seen as vital in facilitating
second chances. Driscoll (2013) exemplified this through the experience of Anabel. By allowing
her to continue with her A-levels despite underperforming at GCSE level, Anabel’s school
supported her longer-term goal of going to university.
Second chances for care leavers in Amaral’s (2011) paper were associated with time to reflect on
the past, a desire to have better outcomes for oneself or one’s children, and learning from
previous experiences. As they matured, past reflections gave care leavers an enhanced sense of
autonomy and a desire to take charge, despite past difficulties.

Emotional/psychological readiness for leaving care – barriers

I don’t think I had any health needs when I came out of care, ‘cos my depression happened after […] I
guess it happened when I moved into my own place, and I was alone, I had to deal with it (Matthews
and Sykes, 2012, p. 402) (Participant 3, female).

A lack of emotional readiness for independence was identified as problematic in four papers, with
some care leavers describing their reaction, in a similar fashion to the young person above, in
terms of declining mental health and coping abilities after leaving care. A greater number
described diminishing or lost support networks as undermining readiness for independence
(Adley and Jupp Kina, 2014; Butterworth et al., 2016; Matthews and Sykes, 2012; Rogers,
2011). In two studies, care leavers attributed their lack of readiness to their emotional needs not
being prioritised during transition planning (Adley and Jupp Kina, 2014; Rogers, 2011). Adjusting
to the level of autonomy required on independence was a hurdle for a small number of care
leavers (Adley and Jupp Kina, 2014; Matthews and Sykes, 2012).
Isolation was understood by care leavers as having no one to check in on them or to lean on in
times of need (Adley and Jupp Kina, 2014; Horrocks, 2002; Rogers, 2011). Care leavers were
sometimes taken by surprise by the sudden nature of transition (Matthews and Sykes, 2012;
Rogers, 2011), while others linked increased isolation to dwelling on past negative experiences,
which affected their emotional well-being (Adley and Jupp Kina, 2014).

Emotional/psychological readiness for leaving care – facilitators

I think [you need] more help with the emotional, psychological stuff when you’re first living on your own.
Just someone checking in on you, or giving you a call. I didn’t get any of that (Rogers, 2011, p. 418)
(Care leaver, unnamed).

Some care leavers sought more intensive support in the early stages of transition on the basis that
this earlier phase could be more challenging (Adley and Jupp Kina, 2014). However, some felt
they would have a better idea of what support might be required after some experience of
independent living, thus highlighting the need for flexibility and personalisation around transition
support (Adley and Jupp Kina, 2014; Rogers, 2011). Someone expressing genuine interest by
“checking in” on them or giving them a call was appreciated (Adley and Jupp Kina, 2014; Rogers,
2011), while other recommendations included professionals spending time with them to identify
gaps in their support network before leaving care (Adley and Jupp Kina, 2014).

Self-reliance and the “help” paradox – barriers

I used to have the attitude I can do it on my own, but you can’t do it on your own (Adley and Jupp Kina,
2014, p. 5).

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 Some care leavers recognised the limitations of self-reliance (Adley and Jupp Kina, 2014;
Amaral, 2011; Driscoll, 2013), and found increased openness to support unburdening.
A number of care leavers in Amaral’s (2011) study reflected how getting older or leaving care
had increased their willingness to accept support, thus individual maturity levels came to bear
as a potential barrier.
Self-reliance was sometimes a deliberate rejection of perceived authoritarian styles of help
(Amaral, 2011; Driscoll, 2013). A small number of care leavers were adamant that they were not
going to be told what to do and rejected support. This stubborn self-reliance was generally in
response to a perceived failure on the part of professionals to take a collaborative,
person-centred approach to their transition or because professionals were perceived as not
having initiated support or contact (Driscoll, 2013; Horrocks, 2002).
Adley and Jupp Kina’s (2014) study highlighted that some care leavers rejected help as
a means of dissociating themselves from the care system, a theme reiterated by Amaral (2011).
Others reported a perceived lack of self-efficacy around help seeking or feeling ashamed to ask.
Initiating social care support requests was sometimes a challenge, leading to the
recommendation that social workers approach care leavers with offers of help in the first few
instances (Adley and Jupp Kina, 2014; Butterworth et al., 2016). Horrocks (2002) and Rogers
(2011) acknowledged the contradiction between seeking personalised support from social
workers or leaving care workers, whilst also avoiding them if care leavers did not perceive that
the adults would meet their needs.

Self-reliance and the “help” paradox – facilitators

I’ve got my own mentor, that’s me (Driscoll, 2013, p. 143) (Dean, care leaver aged 20).

Four studies highlighted the theme of self-reliance (Adley and Jupp Kina, 2014; Butterworth et al.,
2016; Driscoll, 2013; Horrocks, 2002). Care leavers in Butterworth et al.’s (2016) study tended to
regard their self-reliance as a strength: “I’ve had to learn how to deal with it myself” (p. 4). A few
understood self-reliance as a protective mechanism against the perceived absence of care or fear
of rejection (Butterworth et al., 2016; Driscoll, 2013). Care leavers saw self-reliance as a personal
strength in helping them survive independently in and beyond care (Driscoll, 2013).
Equipping social workers with greater insight into the dynamics behind care leavers’ help
acceptance or refusal responses was seen as facilitating more person-centred, flexible
approaches to supporting transition.

Transitioning to adulthood – barriers

[…] it was like I’d been in a bubble for three years, and here’s the real world, hope you like it, sort of
thing (Butterworth et al., 2016, p. 5).

Care leavers in Butterworth et al.’s (2016), Horrocks’s (2002) and Rogers’s (2011) studies described
transition in terms of “instant adulthood” (Stein, 2008, p. 41). Transition, as experienced by all five care
leavers in Rogers’s (2011) study, was a singular time point rather than a gradual process – described
as instant severance from support and something around which they had little control. By example,
one care leaver reported receiving a letter in the post informing her of the termination of (unspecified)
support (Matthews and Sykes, 2012). Care leavers reported being troubled by the lack of practical
information provided around transition. Mark, a Care leaver in Amaral’s (2011) study, was unsettled
by the lack of updates and forewarning from his social worker around his impending accommodation
move. However, many were updated, expressing a preference to be kept informed about the
practical details around transition (Amaral, 2011; Butterworth et al., 2016).
The majority of care leavers in Adley and Jupp Kina’s (2014) paper said that whilst they felt
prepared, and even eagerly anticipated independence, the reality was not as expected. Others
described independence as something of a shock (Adley and Jupp Kina, 2014; Roger, 2011).
Being autonomous involved shouldering responsibility for all aspects of daily life, including
cooking and cleaning, whilst juggling college or job demands without support. Some care leavers

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felt transition planning did not prepare them for the reality of life beyond care (Adley and Jupp
Kina, 2014; Butterworth et al., 2016; Matthews and Sykes, 2012). Predominantly, this was
attributed to care leavers’ perceived instantaneous expulsion from care and shrinkage in their
support networks.

Transitioning to adulthood – facilitators

I think [you need] more help with the emotional, psychological stuff when you’re first living on your own.
Just someone checking in on you, or giving you a call. I didn’t get any of that (Rogers, 2011, p. 418).

Balanced against the above narratives were suggestions that over time some were able to adapt
to some of the practical and emotional demands of independence (Adley and Jupp Kina, 2014;
Horrocks, 2002).
Some care leavers in Adley and Jupp Kina’s (2014) study suggested more intensive support
initially, while others felt that support needs would only become apparent once they had
experienced independence, again highlighting the role of flexibility and personalisation when
supporting individual care leavers.
Accommodation arrangements contributed to some care leavers’ perceptions of readiness for
independent living. Care leavers in Amaral’s (2011) paper pinpointed support offered by
keyworkers attached to supported living accommodation as strengthening their independence
skills. Staff availability was central to this, with staff being on hand to provide advice.

Lack of skills – barriers

[…] all the work you’ve done when you were with under 18 its just gunna go to waste cause, you’re
gunna crumble if you have challenges, you’re not going to have anyone to help you with that you’ve
never faced before […] (Butterworth et al., 2016, p. 6)

The ability to manage money was sometimes a barrier to successful independent living (Adley and
Jupp Kina, 2014; Matthews and Sykes, 2012; Rogers, 2011). Some care leavers used their
social welfare allowance to go out with friends, ran out of money or were unable to afford food.
For others, a perceived lack of self-management skills was a barrier to thriving independently,
with anxiety expressed around having to take charge and direct things themselves. This was
invariably linked to low self-efficacy around coping and a perceived lack of support. A few
responded to independence by abdicating responsibility and living a carefree lifestyle. Reluctance
to take charge was evident in ambivalent responses to managing daily living tasks. Care leavers
spoke of craving structure and a figure to ground them after leaving care, wanting an overseer to
“take that motherly role to check up on us” (Adley and Jupp Kina, 2014, p. 5; Rogers, 2011).
Professionals’ perceptions of care leavers’ mental health difficulties and relevant support
was highlighted as problematic (Butterworth et al., 2016). Care leavers saw the need for more
in-depth training to enhance professionals’ knowledge.

Corporate parenting model – barriers

[…] jis need tae have an understandin’ […] don’t think aboot their joab but they need actually tae ‘hink
aboot he young person’s need (Calum) (Amaral, 2011, p. 5).

Care leavers (Butterworth et al., 2016; Driscoll, 2013; Rogers, 2011) emphasised the contractual
nature of support offered by social care describing it as time-limited, infrequent and impersonal.
Care leavers were therefore suspicious of professional support and tended to resent or reject it
(Butterworth et al., 2016; Rogers, 2011).
Amaral (2011) found continuity of care facilitated transition to independence, while frequent
personnel changes led some care leavers to conclude that forging these relationships was not
worthwhile, each new figure becoming “just a face” (Butterworth et al., 2016, p. 5).
There was a perception that support offered by the corporate parent was on an age, rather than
needs basis. Care leavers in Butterworth et al.’s (2016), Driscoll’s (2013) and Horrocks’s (2002)

VOL. 14 NO. 1 2019 j JOURNAL OF CHILDREN'S SERVICES j PAGE 51

 studies regarded this age-driven system as uncompromisingly harsh. Driscoll (2013)
exemplified this through the experience of John who, despite valuing the relationship with his
keyworker who was “more like a friend”, was told that she would stop working with him “right”
on his “eighteenth birthday” (p. 144). The inflexibility of these arrangements was interpreted as
setting care leavers apart from their peers who were not suddenly cut off from the familial safety
net because they had reached a particular age (Adley and Jupp Kina, 2014; Butterworth et al.,
2016; Horrocks, 2002).

Corporate parenting model – facilitators

[…] keep in touch and see how I’m getting on (Amaral, 2011, p. 5).

Care leavers highlighted the value of professionals showing genuine interest in their personal
journey when preparing for adulthood (Amaral, 2011). Factors facilitating engagement with
transition support included: concerned and available professionals; a personal connection and
support which did not feel contractual.

Discussion
To the authors’ knowledge, this is the first systematic literature review to bring together
qualitative studies to highlight the barriers and facilitators around transitioning to adulthood, as
defined by care leavers. Consistent with past literature, studies within this review all broadly
acknowledged Stein’s (2008) view that care leavers, relative to their peers, experienced a
“compressed and accelerated transition to adulthood” (p. 53), for which many felt ill-prepared.
Care leavers understood this in terms of both limited practical skills and psychological
readiness for leaving care (Adley and Jupp Kina, 2014; Butterworth et al., 2016;
Horrocks, 2002; Matthews and Sykes, 2012; Rogers, 2011). Other than those living
semi-independently (Amaral, 2011), care leavers described being catapulted towards
independence and struggling to cope with feelings of isolation. The emergent emphasis on
unmet emotional support needs highlighted the relevance of Dima and Skehill’s (2011)
hypothesis to a UK context: the view that psychological dimensions of those leaving care can
be “neglected” during transition (p. 2537).
Care leavers in this review, particularly in Horrocks’s (2002) and Rogers’s (2011)
studies, experienced transition from care as an instantaneous, age-driven process,
over which they had limited choice or control. These findings again aligned with Stein’s
(2004, 2008) analysis of the compressed nature of transition, experienced through
care leavers having to navigate multiple, simultaneous changes without sufficient time to
adjust. With the exception of Amaral’s (2011) study, care leavers described inadequate
planning to address transitioning to adulthood, including a lack of opportunity to revisit
support or skills.
Findings suggested that self-sufficiency – transitioning to adulthood with minimal or inconsistent
support – is expected of UK care leavers. Self-sufficiency within this review took various forms of
“instant adulthood” (Stein, 2008, p. 41), although it should be noted that self-sufficiency
constituted a deliberate choice by some UK care leavers who, perceiving a lack of adequate or
available support, chose to disengage with or reject support.
The importance of reliable relationships for care leavers during transition is consistent with
past literature (Ofsted, 2012; Pinkerton and Rooney, 2014). Supportive relationships
motivated care leavers with regard to their education, training or personal goals and
health needs (Amaral, 2011; Driscoll, 2013; Matthews and Sykes, 2012). Reports of
past support were replaced by testimonies of diminishing or lost support networks upon
leaving care. Despite the generally negative reports, however, this review was able to draw
out qualities of a relationship that made care leavers more open to support and less
inclined towards “survivalist self-reliance” (Samuels and Pryce, 2008, p. 1199). Facilitators
to supportive relationships during the transition process included: availability of
professionals; a genuine concern for the young person; and support that was not

PAGE 52 j JOURNAL OF CHILDREN'S SERVICES j VOL. 14 NO. 1 2019

perceived as contractual (Amaral, 2011; Butterworth et al., 2016; Driscoll, 2013; Matthews and
Sykes, 2012; Rogers, 2011).
Research findings were reasonably balanced between barriers and facilitators, although it should
be noted that care leavers tended to speculate on aspects potentially facilitative to the transition
process, rather than reporting what had actually worked. A key facilitator was flexible support
from the corporate parent, thereby accommodating personal readiness for transition.
Personalised forms of support bolstered care leavers’ motivation to both engage with support
and pursue personal goals. However, inconsistent or unavailable support was commonplace.
This sometimes precipitated self-reliance on the part of care leavers, at times, equating to
rudderless forms of independence.

A model for interdependence

Care leavers’ transition-related preferences within this review resonated with an interdependence
approach previously described by Propp et al. (2003). These authors proposed
“interdependence” – a state envisaging social connectedness and availing of support as and
when needed – as a transition approach in direct challenge to ideas that self-sufficiency should be
the end goal for care leavers on entering adulthood. This approach built on Stiver’s notion of
interdependent living defined as: a “blending of self-sufficiency and dependency” involving
“a process of counting on other people to provide help in coping physically and emotionally with
the experience and tasks encountered in the world when one has not [yet] sufficient skill,
confidence, energy and or time”. Accordingly, Propp et al. (2003) envisaged that interdependent
living for care leavers would be operationalised through social support, community connections
and supportive relationships.
In alignment with this approach, care leavers in this review described a preference for
interdependence-informed approaches based on the ability to access ongoing support
dependent on need. The potential utility of Propp et al.’s (2003) ideas within a working
framework for approaching transition for UK care leavers is now explored. At this stage, it
should be noted that while Propp et al. (2003) proposed an interdependence model of practice,
this represented more of a position statement, rather than an operable practice process.
Nevertheless, the following section will begin to explore its possible use in informing dimensions
of support in UK practice.
First, this current review recognised a disconnect between an accelerated time frame
for independence and the psychological adjustment period involved in leaving care. There
was a strong inference that existing UK transition models for care leavers fail to recognise
that practical and psychological aspects of transitions do not necessarily happen
simultaneously, with potentially separate time frames required for each. Contrastingly, Propp
et al.’s (2003) interdependence approach stressed the role of support in empowering
care leavers to cope both “physically and emotionally” during transition (p. 263), thus
acknowledging the multiple dimensions of transition. Interdependence, an approach for which
UK care leavers expressed a preference, therefore involved recognition of the need for flexibility
and sufficient time for individual care leavers to adjust to the differing dimensions of leaving care
with support.
Most care leavers within this review reported struggling to function autonomously
without support. Propp et al.’s (2003) approach again highlighted a helpful alternative,
emphasising the need for a gradual and supported move towards autonomy.
The interdependence approach stressed the value of care leavers “counting on other
people” (p. 263). For UK care leavers, the ability to do so was facilitated by experiencing
relationships built upon genuine concern; and availability and consistency from those
acting in the role of corporate parent, including personal advisers and social workers.
For a few, an outcome of receiving this type of support was enhanced motivation for personal
goals. That a corollary of interdependence-informed practice within the context of this study
was enhanced engagement with education, training and employment goals may therefore hold
promise for challenging the stubbornly stagnant NEET statistics in the care leaving population
(DfE, 2017).

VOL. 14 NO. 1 2019 j JOURNAL OF CHILDREN'S SERVICES j PAGE 53

 Differences between existing independence transition models as defined by UK care leavers and
an interdependence approach are summarised in Table III. Ultimately, UK care leavers wanted to
be able to count (but not depend) on reliable others during a (gradual, not instantaneous) journey
to independence.

Limitations and future directions

This systematic review study is not without its limitations. First, while the focus on UK studies
allowed for a sharpened focus, aggregating views across differing international care systems and
contexts was not possible within the scope of this single paper. It is recognised that this may limit
the transferability and international application of findings. However, recent research points to
similarities in findings among the views of care leavers across countries and welfare regimes,
suggesting that the findings here may have international relevance and resonance (Mendes and
Snow, 2016).
In accordance with the search criteria, only seven peer-reviewed studies were located,
although these represented diverse contexts and foci. The relatively small samples sizes
(n ¼ 5–35) could be seen as another limitation, although arguably this allowed for more in-depth
consideration and representation of personal testimonies and individual voices. The choice to
exclude non-peer-reviewed academic journals undoubtedly excluded the voices of care leavers
featured in a range of non-peer-reviewed reports such as those by The Centre of Social Justice
(2013, 2014, 2015). Yet, the rationale for doing so often related to the lack of clarity around
sample and data analyses, suggesting that these studies lacked the rigour of peer-reviewed
publications. The approach adopted by Baker (2017) in a recent review on the topic of care
leavers’ transitions utilised a broader search strategy. It included studies featuring a range of
research designs and employing differing methodologies, which, while possibly yielding a wider
and richer data set, did not fit with the primarily qualitative focus of this current review.
Nevertheless, on reflection, it seems possible that had the search strategy within this existing
review been more flexible and included studies with a wider range of methodologies, the
findings may have illuminated even more barriers and facilitators.
Suggested areas for future research include establishing a practice framework for
corporate parents to support the operationalisation of interdependence-informed
transition practice for UK care leavers. Since the completion of this review, a framework
has been developed for use within an educational psychology practice context, within which
multiagency working with social care practitioners would form a crucial part of effective practice
(Atkinson et al., 2019; Hyde and Atkinson, 2019). The framework offers corporate
parents recommendations for practical application of interdependence-orientated support
across preparing for adulthood key areas (e.g. paid employment, good health, community
involvement and independent living) with a view to preparing care leavers as early as possible
for adulthood.

Conclusion
This systematic literature review has begun to redress a research gap by foregrounding
care leavers’ experience of transition to adulthood. In doing so, it has supported the view that
care leavers’ subjectivity, their nuanced and individual views, are instrumental in enabling better
insight into the factors that are facilitative to the transition process (Rooney, 2013.

Table III Independence vs interdependence approaches

Independence Interdependence

Expectations of self-sufficiency Available support from concerned and genuine adults

Rudderless forms of independence Transition as a process
Instant adulthood Personalisation and flexibility
Loss of, or reduction in support network(s) Maintained support networks
Inconsistent support and support gaps Multiple dimensions of transition (e.g. logistical, psychological and emotional)

PAGE 54 j JOURNAL OF CHILDREN'S SERVICES j VOL. 14 NO. 1 2019

This review has highlighted that often transition can be an abrupt, non-personalised process
whereby individuals are jettisoned into self-sufficiency without sufficient preparation
(Stein, 2012). Psychologically, many care leavers’ coping abilities were undermined by the
requirement to assume such high levels of autonomy on leaving care without adequate
support. Future studies might consider how a model of transition to adulthood based on an
interdependence framework (Propp et al., 2003) could improve outcomes for care leavers.

Implications of the research for policy and practice

Policy implications:
■ The need to re-consider the discourse within policy documents around “independence”
(as opposed to “interdependence”) as potentially encouraging a view that young people should
be autonomous/self-sufficient on leaving care.
■ The need for policy documents to emphasise the need for a liminal, in between “transitioning” phase
as young people (gradually) prepare to leave care.

Practice implications:
■ The potential utility of an “interdependence” informed transition model for young people preparing to
leave care.
■ The need for greater recognition of the psychological and emotional dimensions of leaving care.
■ Greater personalisation around pathway planning processes.

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About the authors

Dr Cathy Atkinson is Curriculum Director of the Doctorate in Educational and Child Psychology
Programme and is also an HCPC Registered Educational Psychologist. Research interests include
motivational interviewing, educational psychologists and therapeutic interventions, how children
access their right to play, supervision and human givens therapy.

Dr Rebekah Hyde is an Educational Psychologist for Cornwall Council. Within her practice,
she is interested in furthering the potential of looked after children and those preparing
to leave care. Dr Rebekah Hyde is the corresponding author and can be contacted at:
rebekah.hyde@cornwall.gov.uk

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