Pathways to Permanency: A Systematic Review of Factors Associated with Family Reunification After Foster Care

Abstract

Background Reunification with birth families is often a primary goal for children placed in foster care, yet the decision-making processes surrounding reunification remain complex and multifaceted. Objective This systematic review aims to identify and analyze factors influencing the reuni- fication of children and youth with their birth families after a foster care placement. Method Four databases (PsycINFO, Scopus, Web of Science and PubMed) were searched, resulting in 5309 articles. Thirty-four studies were selected based on inclusion criteria, all providing multivariate quantitative results of factors related to reunification or time to reunification, including child-related, family-related, case-related, and systemic factors. The studies, primarily conducted in the United States (n = 23), involved over one million chil- dren under 18 years old who experienced foster care. Most studies used administrative data (n = 24), with sample sizes ranging from 125 to 275,774 participants. Results The review highlights that various factors influence reunification outcomes. Older age at entry, family stability, and foster carer involvement increase the probability of reuni- fication, while health issues, poverty, and parental problems reduce it. Conclusions Recommendations are made for practice, policy, and future research to improve reunification outcomes. Key areas include supporting families, training foster carers, conducting early screenings, prioritizing equity in policy, addressing disparities, strengthening post-reunification services, and focusing future research on underrepresented populations, longitudinal studies, organizational factors, and challenges such as neglect and abandonment