How children and young people understand and experience individual participation in social services for children and young people: a synthesis of qualitative studies

ABSTRACT Although there is a growing knowledge base on children and young people’s (CYP) participation in child welfare and social work, it is necessary to systematically describe and summarise the knowledge from their subjective perspectives. This study has conducted a meta-analysis of qualitative research on CYP’s experiences of individual participation in social services for children and young people. We specifically focus on what the research literature can tell us about how they understand the concept of individual participation and which professional practices they find essential for their participation in the services. The aim is to present knowledge about individual participation in social services seen from the CYP perspective.


Introduction
In recent years, there has been an increasing awareness of children's and young people's (CYP) right to participation.The emphasis on children's rights in the United Nations Convention on the Rights of the Child (UN Convention on the Rights of the Child, 1989, art 12) to express their views freely and be heard in all matters affecting them has led many countries to incorporate children's participation rights into legislation and policies (Tisdall, 2017).In academic research and public discourse, special attention has been given to children's participation in the child welfare context (Kosher & Ben-Arieh, 2020;Skauge et al., 2021).Today, CYP are seen as experts in their own life, and it is widely recognised as essential to involve CYP in child welfare decision-making processes (Toros, 2021b).
However, although participation is a crucial concept in the child welfare system today, several challenges remain.One challenge relates to the lack of clarity of what is meant by CYP's right to participation (Landsdown, 2010).Research shows no agreement in practice about what participation entails and how it is achieved.While some professionals understand participation as only hearing and informing the child, others include CYP's right to have a say in decisions, especially for older children and young people (Toros, 2021a;van Bijleveld et al., 2015).Van Bijleveld et al.'s (2015) literature review suggests that even if children want to have a say in important decisions, social workers often see CYP as too vulnerable and incapable of making these decisions.Toros' (2021aToros' ( , 2021b) ) recent systematic reviews of CYP and social workers experience with participation confirms this.Even if CYP participation is valued in theory, CYP often experience non-participation.Toros concludes that the concept of participation needs a lesser protectionist approach in the practice field to fulfil the goal of participation in practice.
What is included in the concept of participation has consequences for how the purpose of participation is understood and how it is practiced (Skauge et al., 2021, p. 10) and understandings of what constitutes participation require guidance by the CYP themselves (Toros, 2021b, p. 397).We therefore need more knowledge on how CYP understand, define, and experience participation in the social services.To fill this knowledge gap, we developed a systematic review to explore and synthesise qualitative research on participation in social services from CYP's perspectives.Through a meta-analysis of qualitative studies, we provide a systematic description of the current knowledge base.We identify and re-analyse the existing qualitative research exploring how CYP in social services understand participation and what they experience as essential practices for achieving participation.The aim is to gain in-depth understanding of the perspectives of the CYP of participation in the social services.

Theoretical perspectives on participation
Research often uses article 12 in the UNCRC to form a basis for the definition of CYP participation (Skauge et al., 2021).Further, literature presents various models and concepts defining how to achieve participation in decision-making processes.One model is found in Hart (1992) capturing different levels of participation, ranging from non-participation to shared decision-making, depending on the involvement of CYP in the decision-making process.Although this model is a useful tool to identify whether CYP have actual participation, it has been criticised for being too static and not sufficiently focusing on processual aspects (Paulsen, 2022;Skauge et al., 2021).Shier's model (2001) complements Hart emphasising dialogue and interaction between CYP and decision makers as essential elements in participation and describing how to facilitate CYP's right to participation.Another model is Lundy's (2007) describing four key elements that constitutes participation for CYP; space, voice, audience, and influence.These elements point to chronologically organised steps to promote the creation of a safe and supporting environment for children to express their views and to ensure that their views are listened to and acted upon.Lundy's model complies with Shier's in the understanding that meaningful participation requires interaction and dialogue with the child.
The central issue for this review is CYP's own understandings and experiences of individual participation in the social services.Based on our synthesis of qualitative research knowledge on this theme, we relate our discussions about how CYP understand and experience participation practises to Lundy's and Shier's perspectives.

Methods and materials
To synthesise existing qualitative studies, we employed meta-ethnography as our method (Malterud, 2017;Noblit & Hare, 1988).Meta-ethnography is a detailed and systematic strategy for translating the meaning of text and findings across qualitative studies.The meta-ethnography process includes seven steps: 1: getting started, 2: deciding what is relevant, 3: reading the studies, 4: determining how the studies are relevant, 5: translating the studies into one another, 6: synthesising translation, and 7: expressing the synthesis.
We started by searching for studies in the following electronic databases: PsycInfo, Web of Science, SocIndex, Social Care Online, Web of Science, Scopus (step 1).Our searches used variations and combinations of keywords targeting five main concepts: children, children's participation, children's social services, children's perspective and qualitative research.Details for our search are presented in Table 1.We conducted the last search on June 2nd, 2022.After removing duplicates, the first and second authors examined the titles and abstracts independently and excluded irrelevant articles.The following inclusion criteria were used to choose articles: (1) The study was an empirical study, written in English, and published in a peer-reviewed journal.
(2) The study included qualitative studies exploring participation in social and welfare services from CYP's perspectives.Only qualitative results were included for mixed-method studies.
(3) The study sample was children at risk in receipt of help from social services.We followed the UN convention's definition of a 'child' as a person under 18 but included studies with users of services up to 23 years old talking about their earlier experiences.(4) Studies published after January 2010.
The same authors conducted full-text screening of 129 publications, assessed their relevance and excluded articles that were not relevant (step 2).We excluded 89 articles because they focused more on CYP's experiences of the quality of help rather than on participation.We evaluated the quality of the 40 eligible publications independently and in accordance with the Critical Appraisal Skills Programme's (CASP) checklist.Through a negotiation process, we excluded 15 publications because they lacked reflexivity and descriptions of the analytical method.The flow diagram shows an overview of the data collection.
The studies included a total of 584 CYP, with samples ranging from five to 109 informants, aged 5-23 years.Eight studies included children under the age of 10 years, but none of the studies differentiate between the age of the children in the presentation of findings.Eighteen studies are based on individual interviews, two combine individual and focus group interviews, three used focus group or group interviews, and two studies used activity-based interviews.The studies varied in their focus on CYP's participation.Some describe their understandings and preferences concerning participation, others describe how they were treated by the professionals and the degree to which they influenced the decision-making processes.Three studies (Bolin, 2016;Cudjoe et al., 2020;Husby et al., 2018;Saebjornsen & Willumsen, 2017) focus on children's experience of participating in meetings.In all but three studies the professional context is child welfare or child protection services where the focus is on participation in assessments, decision-making in

Procedures for analysis and synthesis
In meta-ethnographic analysis, a first-order analysis is conducted to identify relevant key metaphors in the included articles, defined by Noblit and Hare (1988, p. 28) as central concepts used by the authors to describe results.In this phase of the analysis, all three authors read the articles thoroughly (step 3).We focused on identifying key metaphors in the articles describing how CYP understand participation and what practices they found to be essential for participation.We then ranked the articles according to the amount of empirical data associated with this analytical focus.We chose Dewhurst et al. (2017) as an index article which is characterised by rich data, systematic presentation and illustrative key metaphors.This article functioned as a departure for comparison and interpretation of the included articles (Malterud, 2017;Malterud & Ulriksen, 2011, p. 4).
In the next phase, the second-order analysis, the results of the first-order analysis is synthesised.We then determined how the studies were related by listing key metaphors from each study vertically in separate columns of a grid to determine how the metaphors were connected (step 4).We made one grid for metaphors about understanding and one about essential practices.The vertical locations of metaphors in each grid were adjusted so that each horizontal row contained thematically related metaphors (step 5).We then systematically compared the key metaphors and their content from the index study with those of the other studies and created several preliminary thematic groups.By condensing the thematic groups stepwise, we synthesised the content of the authors key metaphors and translated them into new common concepts (step 6).The outcomes of this analytical process represent our second-order reciprocal translation (Malterud, 2017;Noblit & Hare, 1988) and our presentation of results is structured according to our new concepts.

Results
Below we present our synthesis of the main findings from the different primary studies for the two themes: (a) CYP's understandings of participation, and (b) what they regard as significant practices for the experience of participation.The findings were consistent across the different studies, which is elaborated on below.Select quotations from the articles are used to illustrate the findings.

CYP's understanding of participation as partnership
Our analysis identifies two elements in CYP's understanding of participation that we synthesised into the concept 'participation as a partnership': mutual exchange of information and being actively involved in dialogue and in decision-making processes.

Mutual exchange of information
Our analysis reveals that a mutual exchange of information between the services and CYP is essential for CYP's understanding of participation, including the services asking how they are experiencing their situation and providing them with information about work processes.Participation means being included in discussions about the child or young person's individual situation and future (Polkki et al., 2012, p. 116) and includes social workers informing CYP about the reasons for their contact with the service and presenting alternative ways to improve their situation.For CYP, information is essential to understand why the service has become involved in their lives and the reasons for decisions that are being taken (Cudjoe et al., 2020;Kriz & Roundtree-Swain, 2017;Nunes, 2022;Polkki et al., 2012).The included studies present several accounts about CYP not receiving information about the proceedings with the services, as this quote from a girl in contact with child welfare services illustrates: No, they didn't say anything to me.I was not told what to do at this place, I was just seated there waiting for them to finish.I'm not the only one, most of the children who come here have no idea what goes on here and what they have to do.(Cudjoe et al., 2020, p. 5) A common theme is that the CYP want information to be transparent from the beginning to the end of the working process, and that this is essential for any meaningful participation from CYP (Cossar et al., 2016;Cudjoe et al., 2020;Dewhurst et al., 2017;Kriz & Roundtree-Swain, 2017;Nunes, 2022;Polkki et al., 2012;van Bijleveld et al., 2014).

Active involvement in dialogue and decision-making processes
Further, the studies show that CYP's understanding of participation includes being involved as active participants in the working processes throughout their contact with the services.Lauri et al. (2021) explain that for CYP, regardless of their age, a critical element of participation is being engaged in dialogue with professionals to create meaning for their situation, being listened to and being taken seriously.Husby et al. quote Sophia (17), who reflected upon the difference between just being listened to and taken seriously: I said that I wanted to go into a helping profession in the future.Instead of doing as many people before had donegiving me a strange glance and starting to talk me out of such planshe said that he would help me realise these plans.(2018, p. 446) This quote reflects an understanding of participation that includes being actively involved in dialogue.Fitzgerald and Graham (2011, p. 496) add to this and describe participation as reaching decisions 'conjointly through conversation about the issues of most concern to the children'.
The included studies stress that having the opportunity to influence actions and measures initiated by the service, or 'having a say', is a part of CYP's understanding of participation, but there are variations in how much influence they want.While some studies show that CYP understand participation to influence decisions made about them (Montserrat et al., 2021;Polkki et al., 2012;Rytkonen et al., 2017, p. 735), other studies emphasise that participation is not necessarily the same as making the final decisions as long as CYP understand the service provider's rationale (Cossar et al., 2016;Dewhurst et al., 2017;Dillon et al., 2016, p. 83;van Bijleveld et al., 2014).A quote from a girl in van Bijleveld et al.'s study illustrates this: 'Even if the decision was already made, we [she and her second case manager] would sit down and discuss it, as long as I needed to understand it ' (2014, p. 257).
Our analysis shows that CYP's understanding of participation as partnership relates to regaining a sense of control over their lives and their engagement with the services (Dewhurst et al., 2017;Montserrat et al., 2021), exercising personal agency (Bolin, 2016;Dillon et al., 2016;Fylkesnes et al., 2018;Kruger & Stige, 2015;Stafford et al., 2021) and feeling valued as a competent partner (Mitchell, 2022;Paulsen & Thomas, 2018;Stafford et al., 2021).Participation concerns what Kriz and Roundtree-Swain (2017) describe as 'maturing into independent adults who possess the capacity to make decisions on their own'.

Significant practices: developing relational space
The analysis identified three practices that are significant to CYP's experience of participation in social services, which we synthesised into the concept 'developing relational space'.The three practises describe different kind of relational barriers and possibilities that CYP experienced as essential to participation: The significance of listening practises, the significance of building relationships and the significance of power-sensitive practices.

The significance of listening practices
Analysis demonstrated that the social workers' different kinds of listening practises are essential for CYP's experience of participation.CYP experience that being listened to is more than merely hearing what they say.An example is Husby et al. (2018, p. 446) study that describes 'careful listening' as the children's experience of having their wishes respected.Social workers' communicating genuine interest in CYP's well-being and being receptive to their attempts to communicate their needs are other examples of essential listening practices (Dewhurst et al., 2017;Lauri et al., 2021;Mitchell, 2022).Rytkonen et al. (2017) show that CYP feel included if the atmosphere is inviting and open between social workers and CYP, as opposed to closed-off and excluding.A quote from a young person with experience from social and health services in school illustrates this point: 'If she or he's … like rude or looks like she or he's not interested … or you can clearly see that she or he's in a hurry and wants to get on with you quickly, so you don't even bother' (Rytkonen et al., 2017, p. 736).This quote describes how a 'mechanical' listening practice leads to an experience of not being listened to.
Further, listening practices requires professionals to be receptive to the different way in which CYP communicate their needs (Dewhurst et al., 2017).Professionals' conception of CYP's voices must go beyond the verbal, be open to different ways of expression and be active in helping CYP to communicate their needs (Dewhurst et al., 2017;Kriz & Roundtree-Swain, 2017;Nybell, 2013).Nybell (2013Nybell ( , p. 1231) ) describes the importance of creating 'an alternative context through which young people may speak'.A young person's story of using music as a resource for communicating with the social worker in a child welfare institution is an example of an 'alternative communication context': me and [name of the SW], we heard a lot of music in the car.It was Nirvana and those kinds of bands … Together with [the SW] I used many hours of talking about things.Talking through things really helped me at that time.(Kruger & Stige, 2015, p. 113) This quote illustrates how music can facilitate dialogue and thus enable the mobilisation of positive participation practices.

The significance of building relationships
The analysis shows that the quality of relationships between CYP and social workers is essential for their experience of participation.All the included studies show that for the participation to be meaningful, building trusting relationships is central.To achieve this, several studies emphasise the importance of establishing a stable relationship with only one person (Arbeiter & Toros, 2017;Husby et al., 2018;Paulsen & Thomas, 2018;Saebjornsen & Willumsen, 2017).CYP value 'knowing their caseworker' (Paulsen & Thomas, 2018) and that the social worker is 'not [be] a remote figure' (Cossar et al., 2016).A related theme is CYP that appreciate informal relationships and social workers who are 'like a friend' (Mitchell, 2022, p. 6) or that relationships with an 'off the record' quality (Nybell, 2013(Nybell, , p. 1233)).Kriz and Roundtree-Swain (2017, p. 39) quote Marvin, who said, 'you can't just go there and do the job, because kids need more'.These statements illustrate that building relationship beyond the professional that result in knowing the professionals as private persons sometimes are essential for meaningful participation to take place.

The significance of power-sensitive practices
Result from the included studies presented a broad range of accounts about how counterbalancing power relations and situating CYP as the key person are significant for CYP's experience of participation.Such power-sensitive practices are often described as 'child-centred' as opposed to 'adultcentred' practices (Arbeiter & Toros, 2017;Kriz & Roundtree-Swain, 2017;Lauri et al., 2021;Nybell, 2013).For example, Arbeiter and Toros (2017, p. 22) study of child-protection assessments shows how a girl felt that the worker was not interested in her well-being but rather in her mother 's (2017, p. 22).Other examples of adult dominated practices are when social workers try to 'push ideas' on the children (Kriz & Roundtree-Swain, 2017;Kruger & Stige, 2015;Paulsen & Thomas, 2018), or when adult use their position as professionals to discursively exclude CYP as a relevant participant in decision-making processes (Dillon et al., 2016;Kriz & Roundtree-Swain, 2017;Paulsen & Thomas, 2018).Example of this is when adults' 'negative labelling' of CYP (Kriz & Roundtree-Swain, 2017, p. 38) or descriptions of CYP as 'being a kid' (Mitchell, 2022) influence whether they are regarded as worthy of participation or not, or when children are ignored in a meeting even if they are present (Cudjoe et al., 2020).
Power-sensitive practices are when social workers actively empower CYP by letting them become the key person in the institutional business.This is when CYP are invited to set the agenda in a meeting, when they are actively included in making decisions, or when CYP's insight and knowledge are explicitly recognised (Fitzgerald & Graham, 2011;Husby et al., 2018;Paulsen & Thomas, 2018;van Bijleveld et al., 2014).Adult power can also be productive and promote CYP experience of participation.For example, the included studies show that adults in powerful positions can empower CYP to become the key person (Saebjornsen & Willumsen, 2017;Schiller, 2015), such as when a girl explained that a supportive adult empowered her to give her point of view in a meeting (Husby et al., 2018).

Discussion
A vital issue in this study is to identify and synthetise qualitative research on how CYP understand and experience participation.The review reveals that CYP understand participation as a partnership, and implies being properly informed and 'having a say' in decision-making.Further, our analysis demonstrates that CYP experience participation as a highly relational achievement, where listening practices, relational work and power issues are essential.Our findings thus correspond with conceptualisations of participation presented by Shier (2001) and Lundy (2007), emphasising the commitments for adults to cooperate with CYP in implementing their human and legal rights imperative in UNCRC article 12.
What is included in the concept of participation has consequences for understanding of its purpose and how social services practise participation for CYP (Paulsen, 2022;Skauge et al., 2021).This review suggests a consensus in CYP understanding of participation, emphasising their agency and right to control over one's own life.CYP regard their capacity to be actively involved in decision-making processes as high, regardless of age.This finding resonates with other studies exploring CYP's participation experience (Fylkesnes et al., 2021;Toros, 2021b;van Bijleveld et al., 2015).In line with Lundy's (2007) model this means that for participation to be meaningful CYP voices, regardless of age, must be facilitated, and adult professionals must give them space and opportunity to express their views.We will argue for increased sensitivity to CYP's understandings of participation in line with what this study shows.Awareness in the social service of their understandings can promote their participation in practice.That said, critical voices claim that a universal norm of participation lack sensitivity to the different needs CYP might have and to contextual factors (Skauge et al., 2021).It is therefore essential to acknowledge that understandings of participation can vary between CYP, for example, according to their age and cultural context.Even if the included articles in this review concerns CYP at different ages from a diversity of countries, cultures and professional contexts, the authors do not distinguish between this when presenting their analysis of CYP view.We lean on Fylkesnes et al. (2021, p. 7) who describe participation as a 'balancing act', where adults both must involve CYP in working processes, ask for their opinions and convey to them that their view is important, while at the same time asking them in a sensitive and skilful manner and being aware that sometimes expressing an opinion can be difficult.In this way, participation becomes a way of communicating care for the individual child and not a standardised procedure.
While laws and conventions establish CYP's right to participation, it is realised through interaction between CYP and adults (Lundy, 2007;Mannion, 2007;Shier, 2001).Our review found that the social workers listening skills are essential for CYP experience of participation and highlight aspects of relational qualities between CYP and social workers.Following Lundy (2007), adults must receive training in active listening skills to ensure the CYP right to an audience communicating with children in their preferred ways.In addition, place and space are essential for the development of child-adult relations that promote children's agency and possibilities for having their voices heard (Mannion, 2007;Seim, 2018).In a study of children's participation in Ireland, Horgan et al. (2017) show how children experience their opportunities for participation stronger in everyday activities at home, in school and in the community where formalised structures and adult processes and attitudes are less dominant.Our study indicates that it is essential to develop relational spaces that increase CYP opportunities to participate and have their voice listened to, even if social welfare decisionmaking processes are part of a formal bureaucratic structure.Facilitating a material and social environment (space and audience) that seeks to enrich relationships between adults and children is significant for what opportunities CYP have for participation (voice and influence).Formal meetings characterised by adult-led attitudes and processes are probably not one of these.Even if children are present in a meeting and express their views, there is a risk of muting their voices by the lack of a relational space that facilitates their voices being heard.

Strengths and limitations
We used a systematic search and conducted the review according to PRISMA guidelines.One limitation of our study is that we cannot guarantee that our sample is complete, and other relevant studies within this area may appear in the future.Even so, through the analyses presented, we have validated that our sample provides sufficient data saturation (Malterud, 2001).Our analyses are based on 25 primary studies and comprise a broad range of empirical data from 452 children from 12 different countries.Our analysis is grounded in the thick descriptions that this sample provided.
Despite this, some validity limitations related to the sample need to be made explicit.In a metaethnographic study, different approaches in a sample will usually add to the variation of findings (Britten et al., 2002;Malterud & Ulriksen, 2011), but choosing studies with different theoretical and methodological approaches and designs raises issues of commensurability (Britten et al., 2002;Dixon-Woods et al., 2005).Methodological challenges in our study mainly stem from different conceptualisations and theoretical approaches to participation in the included studies.It is sometimes unclear whether the understanding of participation comes from the researcher or the participants in the study.In a recent literature review exploring how researchers apply the concept of 'child participation' in the child welfare context, Skauge et al. (2021) conclude that authors often use the term without theoretical operationalisation to frame their studies.Nevertheless, the CYP's accounts in the included articles are detailed, making it possible to assume how children understand and experience participation.We have tried to balance this epistemological heterogeneity by following transparent meta-ethnography analysis procedure.
Another point to mention is that the children's age in our sample ranged from 5 to 23 years, but it was impossible to identify variations in CYP views related to age because the material did not display this.

Conclusion
Our study demonstrates the need to develop understandings of participation and related practices that include CYP's perspectives.Landsdown (2010) distinguishes between CYP's right to participation and their opportunities to exercise it.The current study reveals important themes for research and practice on how to improve CYP opportunities for meaningful participation in social services.There is a need to develop spaces and places for children's participation that promote dialogical meaning-making processes where social workers collaborate with CYP in making decisions.When children are given a voice by being present in decision-making processes but feel that they, in fact, have little or no opportunity to be heard or have influence on decisions, then this indicates that their participation is merely tokenistic (Hart, 1992).
Finally, a matter that is missing in this review concerns CYP collective participation (Seim & Slettebø, 2011) and participation at the systemic level.For further research, we see that is relevant to explore CYP participation in political processes at the community level.Involvement of CYP at this level can possibly contribute to promote changes in the space and place for CYP participation at the individual level.

Table 2 .
Presentation of included studies and key features.-of-home placements and family support services.Two studies examine multiple social services and one study explored participation in CYP's contact service. out