Many Swedish children are growing up with difficulties in the family, and it is common that this children as next of kin have a higher incidence of mental illness and poor school performance. There is a risk that in these families occur secrecy, rapid unpredictable changes and reverse liability and role distributions. The children can have difficulty understanding what is happening and may feel anxiety, fear, guilt and shame. Much of the child's energy can be focused on family problems, preventing their own development and impacting negatively on well-being. Even though the situation for children as next of kin may differ in many ways, their needs may be similar in several respects. Swedish social care services provide various forms of support and interventions for these children; however, there is little knowledge of the results of the support given. The basic idea of support group activities is that children from similar domestic situation will meet and support one another, can take advantage of the knowledge of group leaders and that the children have the opportunity to talk about their situation. A support group for children is both a preventive and promotive effort; intervention aims to prevent ill health but also improves the mental health and social situation of the children. Systematic follow up is a part of evidence-based practice, which is in turn based on systematic knowledge from the user's experience, scientific knowledge and professional experience. Systematic follow up in the context of children as next of kin is about continuously exploring their needs and obtaining whether the child had adequate support, need more support, or whether there is a need for other support. A single case study was conducted in 2015/2016 of one organization, within municipal care, that provides support in the form of group activities for children as next of kin. The target group was healthy children aged 6-12 years whose parents or siblings had a serious medical condition or disability. The study approach was participatory action research, where the group leaders collaborate with the researchers, in order to implement systematic follow up. Data were collected from the group leaders through interviews, meetings, documents and notes.

Objectives/Outcomes: Data collection is ongoing but preliminary findings can describe the implementation process of systematic follow up in four phases: enthusiasm, confusion, fumbling and decision.