Examining the Contribution of Childhood Abuse and Parental Relationships to the Mental Wellbeing of Former Grewing in Out of home Care setting: The Moderating Role of Perceiving the therapeutic Stuff as an Attachment Figure

Background: The research literature extensively explores the aspects and factors contributing to children who grew up in an out-of-home setting (Crawford & Bradley, 2016; Mishra et al., 2020), as well as the processes and reasons for removal  from their homes (Nagbi & Baum, 2018; Harel, Etzmon, & Dekel, 2013). Additionally, numerous studies focus on the transition from residential care to adulthood (Za'ira & Benvenishti, 2008; Peled-Laskov et al., 2019). However, there seems to be a dearth of research on the effects of the therapeutic relationships in the residential care, particularly in terms of perceiving the therapeutic stuff as attachment figures (Gur, 2006).  To fill this gap, the current study examined the associations between recollections of childhood abuse and parental attitudes and mental health. Moreover, the study wished to examine the moderating role of perceiving the therapeutic stuff as potential attachment figure on these associations among former out-of-home care youth, compared to those who were known to social services but not removed from their homes.

Method: The study included 146 participants aged 21-40: 73 former out-of-home care youth and 73 youth who were treated by a community social worker but not removed from their homes. Participants completed the following online questionnaires: Childhood Trauma Questionnaire (CTQ), Parental Bonding Instrument (PBI), Working Model of the Other (WOHTO), Mental Health Continuum-Short Form (MHC-SF), and a demographic questionnaire.

Findings: The first research hypothesis, which posited that there would be differences in the research variables between former out-of-home care youth and those who were not removed from their homes, was partially supported. No differences were found between the groups in the research variables, except for parental overprotection. Those who were not placed in out-of-home care reported higher levels of parental overprotection compared to those who were. The second research hypothesis, which assumed a negative correlation between childhood abuse and adult mental health, was partially supported. A negative correlation was found only between emotional abuse and mental health, comparing to physical or sexual abuse. The third research hypothesis, which posited that there would be a positive correlation between parental care and mental health and a negative correlation between parental overprotection and mental health, was partially supported. While a positive correlation was found between parental care and mental health, no significant correlation was found between parental overprotection and mental health. The fourth research hypothesis, which predicted that perceiving the therapeutic stuff as an attachment figure would moderate the relationship between recollection of childhood abuse and parental attitudes and mental health among former out-of-home care youth, was not supported. However, an interaction analysis between parental overprotection and perception of a the therapeutic stuff as an attachment figure revealed that former out-of-home care youth who reported parental overprotection along with receiving the therapeutic stuff as an attachment figure also reported lower mental health in adulthood compared to those who were not removed from their homes.

Conclusions: This study shed light on the adult lives of children who were removed from their homes and placed in out-of-home care setting, while examining the relationship between childhood abuse, perceived parental attitudes, and their mental health in adulthood. Additionally, the study's primary contribution to both the theoretical and practical fields stems from the findings of the interaction analysis between parental overprotection and receiving the therapeutic stuff as an attachment figure, and the link between this interaction and lower mental health in adulthood. Previous research on out-of-home placement has focused on the process of leaving home and adapting to the new setting, from both the child's and parents' perspectives, but no research has examined the loyalty conflicts experienced by children who are removed from their homes during the adaptation process in the new setting, and the implications of these conflicts for their adult lives.

In conclusion, the findings of this study may assist in developing tailored therapeutic interventions for children who are removed from their homes and may also pave the way for further research in this area.