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About this publication
When parents separate, there are major consequences for a child. Among other things, the family must decide where the child will live and the extent of contact the child will have with each parent. The aim of this systematic review was to examine the importance of different custody arrangements on children's and adolescents’ well-being, mental health, and relationship to parents, as well as coparenting and parental conflict. We answered three research question (Nordic studies):
1) What are the consequences of extensive contact/joint physical custody compared to less contact/sole physical custody? We included one cohort study. There is limited evidence: we cannot say whether there are differences in children’s mental health between custody arrangements.
2) What are parents', children’s, and adolescents’ experiences of and preferences for different custody arrangements? We included 17 qualitative studies of families with joint physical custody. The studies identified many themes of importance to children’s and adolescents’ experience of joint custody, including child-parent relationships and parental relationship, practicalities, distance between homes, flexibility, sense of belonging and safeguarding the children’s wishes.
3) Which factors related to different custody arrangements can be associated with or influence children’s and adolescents’ lives and mental health as well as coparenting and parental conflict? We included 23 quantitative studies, which assessed the association between different custody arrangements and relevant outcomes for children and parents. The factors that appeared most to influence (attenuate) the associations between custody arrangements and outcomes (e.g., mental health), were relationships within the family (child-parent, coparenting/parental conflict) and family preconditions (parental health and finances).
The complex interaction between prominent themes and factors in the qualitative and quantitative studies suggests that a particular custody arrangement can be experienced very differently from one child to another. Based on the current evidence it may appear that relations within the family, as well as communication and conflict between the parents, perhaps are as important for how children and youth fare, as the custody arrangements themselves.
When parents separate, there are major consequences for children and adolescents. Among other things, the family must decide where the child or adolescent will live and the extent of contact the child will have with each parent. Parents choose visitation and custody arrangements based on their current life situation, family experiences, the child's needs, and other aspects. Permanent custody relates to which decisions the parents can make on behalf of the child.
Joint physical custody means that the child has residency with both parents, although in practice the child does not necessarily live half of the time with each parent. There is an increase in families choosing joint physical custody or extensive contact with both parents (at least one third with each). Currently, parents may choose to have joint physical custody or not. In the fall of 2021, the government proposed to consider making joint physical custody the main rule in the new Act relating to Children and Parents (the Children Act). The present systematic review was commissioned by Bufdir and will contribute to the government's consideration.
The objective of this systematic review was to summarize the research on different custody and living arrangements that affect children and adolescents. The systematic review is an update and an expansion of an earlier systematic review published by the Norwegian Institute of Public Health. The research questions in the present systematic review are:
- a) What are the consequences of extensive contact with both parents compared to less contact with one of the parents, for children’s and adolescents’ (0-19 years) well-being, mental health and relationship with parents, as well as coparenting and parental conflict?
b) What are the consequences of joint physical custody compared to sole physical custody for children’s and adolescents’ (0-19 years) well-being, mental health and relationship with parents, as well as coparenting and parental conflict?
- What are parents', children's and adolescents’ experiences of and preferences for different custody arrangements?
- Which factors related to different custody arrangements can be associated with or influence children’s and adolescents’ lives and mental health as well as coparenting and parental conflict?
The three research questions involved slightly different inclusion criteria, mainly:
- Question 1 (consequences): longitudinal cohort studies published 2016-2022
- Question 2 (experiences): qualitative studies published 2010-2022
- Question 3 (factors): quantitative studies (cross-sectional and cohort) published 2010-2022
A research librarian, in collaboration with the project group, prepared a joint search strategy for all three research questions. We searched in standard databases such as MEDLINE, PsycInfo, EMBASE, Sociological Abstracts and Social Services Abstracts, in addition to e.g., Nordic science archives, Google Scholar, selected relevant journals and reference lists of relevant publications. Time constraints necessitated limiting the review’s scope.
Thus, in line with the protocol and in collaboration with the commissioner, we chose to include only Nordic studies for questions 2 and 3. Additionally, we decided that questions 2 and 3 would be answered with an abridged procedure. We conducted a systematic review for question 1 on consequences, including assessments of risk of bias and certainty of the evidence (GRADE). For questions 2 and 3, we assessed the studies’ methodological limitations/risk of bias, extracted results, and summarized the findings narratively. Findings on themes and factors from the qualitative and quantitative studies where combined.
The literature search yielded 2,743 references, which we assessed on title and abstract level. We assessed 194 full-text publications and included a total of 40 Nordic studies.
Question 1 about consequences: We included one prospective cohort study. It had very high risk of bias. Our results show that it is uncertain whether potential changes in children’s mental health from age 7 to 11 are associated with custody arrangements.
Question 2 about experiences: We included 17 qualitative studies. All concerned joint physical custody. Seven studies had minor or minor/moderate methodological limitations, thus, we emphasized these in our analyses and presentation of findings. We identified three main categories of themes:
- Perspectives on joint physical custody. Children and parents had somewhat diverging perspectives, but emphasized how flexibility, fairness and rigidity could be important. Children emphasized that they would like to have information and the opportunity to state their opinion, but not necessarily be given the responsibility to decide (depending on the child's age).
- Practical conditions. Living in two homes, often with diverging rules and routines, were challenging for some children. This partly depended on characteristics (e.g. personality) of both children and parents. Many children emphasized aspects of the exchange days, such as frequency of exchanges, day of the week it happened and practices surrounding the exchange. Distance between homes gave rise to practical challenges, and affected social relationships with friends and other family members, as well as access to leisure activities and networks. How the arrangement (joint physical custody) was practiced often changed over time, without resulting in a change in the agreement on joint physical custody.
- Relationships. Many children and parents mentioned coparenting, parental conflict, willingness to communicate and communication style. In order to have positive experiences with joint physical custody, children emphasized e.g. a low degree of parental conflict, good parental relationships and coparenting. The parental relationship also affected the child's thoughts about their opportunities to influence their own daily life. For some, their relationship with each of the parents was characterized by feelings of loyalty, thoughts about what was fair for the parents, a desire to ensure contact with both parents and not creating or worsening any conflict. Most of the children were satisfied with joint physical custody as they valued equal contact with both parents.
For most themes, there were children who expressed both positive and negative sentiments, and the children differed about what was important to them; thus, there were differences in how their everyday life in joint physical custody unfolded. Overall, differences within the themes related to the child's age and time in joint physical custody.
Question 3 about factors: We included 23 quantitative studies of which we assessed 21 studies as having a high or high/unclear risk of bias. The studies compared different custody arrangements in relation to child and adolescent outcomes (e.g., mental health), and explored which factors influenced these associations. In particular, factors that seemed to influence the association between custody arrangement and outcome were relational factors and family demographics: The relationship between parents and the child-parent relationship appeared to be important, and family preconditions, such as finances and parental health, appeared to be somewhat important. This indicates that when such factors were taken into account, there were fewer or no differences between different custody arrangements with respect to these outcomes (i.e., the associations diminished, and the groups became more similar).
Discussion and conclusion
When assessing the quantitative and qualitative studies together, we found that both show the importance of relations, between children and parents, and between the parents. These relations seem to be important for which custody arrangement is chosen, how the arrangement works, and the relations themselves appear to impact children’s and adolescents’ mental health. It seems that parental finances influence the association between custody arrangement and outcomes in children and adolescents, such as mental health.
The current evidence is insufficient to draw any clear conclusions about whether there are differences between children in different visitation- and custody arrangements with regard to well-being, mental health, relationship with parents or between parents. The qualitative studies indicate that certain factors, such as the parent-child relationship and degree of parental conflict, are important for children to have a positive experience of joint physical custody, while the findings concerning other factors, such as flexibility, are more nuanced. In the quantitative studies, it seemed that relationships and family preconditions (e.g., finances) were most influential. The complex interplay between factors and themes identified as central in the quantitative and qualitative studies, suggests that there are multiple important aspects for how custody arrangements work and are experienced by a child. Based on the findings in this systematic review, we cannot say that the services that meet families where parents have separated can recommend one custody arrangement over another, without taking the individual family into consideration. Relationships within the family, communication and conflicts between the parents are perhaps as important for how children and adolescents feel as the custody arrangements themselves.