“And then every time I fell back, I had my friends to help me” Exploring the role of peer relationships for adolescents in alternative care: a systematic review and grounded theory study

BACKGROUND. The positive impact of attachment relations with adults for young people in alternative care is well documented. However, more understanding of parental and peer relationships for young people in alternative care, particularly the potential role of peers in fulfilling attachment needs in this population, is needed. OBJECTIVES. Research objectives are addressed across two studies. In article one, a systematic review searched the existing quantitative evidence base to investigate the research question, how do positive peer relationships influence psychological variables related to coping and resilience in young people in alternative care? In article two, an empirical paper used a grounded theory methodological approach to explore the principle research question, how do young people in alternative care conceptualize parental and peer relationships? PARTICIPANTS AND SETTING. This research portfolio investigated adolescents living in alternative care, of any setting. The systematic review targeted literature relating to adolescents aged ten to eighteen, and the empirical paper included fourteen participants aged fourteen to eighteen, who were still in contact with a birth parent. METHODS. In article one, a systematic search of the literature for studies of psychological resilience-based variables and peer relationships led to the inclusion of ten papers. These were assessed using standardized quality criteria and a narrative synthesis of the methodology and findings are presented. In article two, semi-structured interviews were transcribed and analysed, to propose a grounded theory model. In line with a constant comparative approach, data collection and analysis occurred simultaneously. RESULTS. Article one highlights four key themes, (1) Perceived satisfaction with peer relationships; (2) The impact of peer group processes; (3) Positive attachments in adolescence and; (4) The role of social skills. Article two presents the five key themes of (1) Trust (2) Unresolved trauma (3) Feeling different to peers (4) A need to put others first and (5) A dismissive coping style, associated with anger and self-reliance. These are proposed to be interrelated to a non-linear process model and contextualized within a resilience framework. Conclusions. Relationships are a complex and non-linear process for this population, that is likely to impact on normative developmental processes in relation to others, including peers. Implications for clinical practice and research are highlighted across both articles. Article one emphasizes a need to investigate a positive developmental rhetoric, using standardized measures for variables of resilience and peer attachment directly. Article two presents a need to further explore the nuances of the proposed relationship process presented, in relation to both peers and services, and promotes the value of directly involving young people in this endeavour. It emphasises the importance of trauma informed practice and puts forward relationships as a starting point to interventions with this population