Future anxiety: Clinical issues of children in the latter phases of foster care

Children in foster placement are often considered clinically in terms of the issues that led to their being separated from their families. Placement has been recognized as a powerful intervention in the lives of children and families, with ramifications of its own extending through time. Despite the movement towards permanency planning, children continue to be exposed to periods of uncertainty, ambivalence, and ambiguity about the resolution of placement. This uncertainty, along with the intrinsic transience and marginal identity connected with the role of foster child, reduces the child's sense of stability, attachment, and predictability. Children in foster care often feel powerless, and may resort to disruptive behavior in an attempt to influence decisions about their future. Other responses include depression, withdrawal, and passivity. Future anxiety is a system issue, which needs to be addressed by the adult caregivers in the child's life. The reality is that children in foster placement often face chronic loss, and caregivers may resist sharing in the child's experience. This dynamic makes the development of a support system to help the caregiver manage feelings about the child and his or her role in the child's life a necessity. Four case examples are discussed, illustrating interventions in working with issues of future anxiety.He is also a consulting psychologist for the Family Life Center at the Massachusetts Department of Social Service.