This article is an attempt to analyse and describe the process of change in child substitute care that has taken place since the re-independence of Estonia in 1991. These changes started with adopting new terms and ideas. However, while international terminology and concepts have been accepted, local conditions affect this acceptance of concepts as well as their practical development. In the present article, the aim is to look at the process of changing discourse in Estonian institutional substitute care. Overall, it was found that, in the reform of substitute care, the way in which and the extent to which new concepts have been applied through current activities are not enough to achieve internal changes in the development of the substitute care itself. Although family-like care and family-based care have been promoted and applied, the nature of these terms and their place in child substitute care remain dormant. It seems that, contrary to the desired goal of decreasing the burden of institutional substitute care, this burden has in fact increased. In addition, an issue of concern needing attention is a remarkable tension between paid professional and relationship-based care.