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Lookup NU author(s): Professor Ruth McGovernORCiD, Dr Claire SmilesORCiD, Dr Claire Grant, Dr Hayley AldersonORCiD, Dr Kerry Brennan-ToveyORCiD, Dr Sally O'KeeffeORCiD, Julie Rankin, Monique Lhussier
Crown Copyright © 2026 Published by Elsevier Ltd. This is an open access article under the CC BY license. http://creativecommons.org/licenses/by/4.0/A growing proportion of children entering state care are born to mothers involved in recurrent care proceedings; a group often characterised by trauma, social disadvantage, and low trust in services. Although a range of interventions have been developed to prevent care entry and support reunification, there remains limited understanding of how and why these approaches operate within complex child protection systems.This study reports a four-stage realist synthesis of 108 academic and grey literature sources to examine what works, for whom, and in what contexts to prevent care entry and enable reunification for mothers at risk of recurrent proceedings. Programme theory development was informed by three stakeholder advisory groups comprising mothers with experience of child removal, practitioners, and academic experts.Findings show that outcomes are shaped not only by individual interventions, but by how these interact with the relational and organisational dynamics of child protection systems. Trauma is conceptualised as both relational and systemic, emerging through interactions between individual experiences and the high-threat, low trust dynamics of child protection systems and influencing interactions between mothers, practitioners, and multi-agency teams. Two key mechanisms underpin improved outcomes: (1) a relational bridge, wherein a trusted practitioner supports communication and shared understanding between mothers and professionals; and (2) a neutral outsider, who promotes fairness, redistributes power, and aligns multi-agency working around shared goals. These mechanisms may be particularly important for women who experience structural disadvantage. Where these mechanisms are absent, interventions may either engage mothers without achieving credible risk reduction or manage risk in ways that undermine engagement.The findings highlight the importance of designing child protection services that build trust, clarify roles, and support coordinated decision-making across agencies. By providing a practice-relevant explanatory framework, this study contributes to understanding how services can better prevent unnecessary care entry and support safe, sustainable reunification, with implications for improving outcomes for children and families.
Author(s): McGovern R, Smiles C, Grant C, Gibbs J, Adisa O, Alderson H, De Backer K, Brennan-Tovey K, O'Keeffe S, Powell C, Rankin J, Wilson CA, Woodman J, Lhussier M
Publication type: Article
Publication status: Published
Journal: Children and Youth Services Review
Year: 2026
Volume: 189
Print publication date: 01/10/2026
Online publication date: 29/07/2026
Acceptance date: 28/07/2026
Date deposited: 26/08/2026
ISSN (print): 0190-7409
ISSN (electronic): 1873-7765
Publisher: Elsevier Ltd
URL: https://doi.org/10.1016/j.childyouth.2026.109208
DOI: 10.1016/j.childyouth.2026.109208
Data Access Statement: Data will be made available on request
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