Foster parent training programmes for foster youth: a content review

Foster parent training is a well‐recognized component of providing quality care in child welfare. Well‐trained foster parents can improve placement stability, reduce behavioural problems and encourage successful reunification or adoption. A review of the foster parent training programmes can provide a better understanding of the current state of foster parenting training and inform future practice and policy‐making. This review examined published and unpublished research on foster parent training conducted from 1970 to 2014 and provided an overview of the structure and content of 22 foster parent training programmes. Common patterns in the content and structure of foster parent training programmes are identified and discussed, highlighting trends towards multi‐session in‐service training with eclectic content. The development of new training programmes with strong theoretical grounding that train foster parents on specific behavioural skills is recommended.     

An investigation of foster parent training needs

The training foster parents receive in America, pass the initial training required to certify them to take children into their homes, is not standardized. The Foster Care Independence Act of 1999 (H.R. 3443) requires prospective foster parents to be trained, but it provides only general guidelines for the training content. The training offered differs by state. This research examines what a group of foster parents attending a state foster parent association conference felt they needed in the area of training, to help them fulfil their role. Quantitative and qualitative data were collected. Foster parents were surveyed and ranked their training needs based on 10 pre‐identified needs. They also responded to an open‐ended question about their training needs. Foster parents ranked training to enhance their ability to help the child adjust in their homes and manage challenging behaviours as most needed. The qualitative data suggested that foster parents have additional needs and some are not related to training, such as the need for respite services.     

Finding a routine that works: A mixed methods study of foster parents

Although it is well established that daily routines are important for family well‐being, very little research has been done on how foster parents establish and integrate new foster children into family routines. We used a mixed‐methods, cross‐sectional design, focused on qualitative results to explore how foster parents utilize routines. Twenty‐three foster parents were recruited from a private child welfare agency in a large city in the United States. Surveys were administered to obtain demographic information, overall home atmosphere, and the importance and prevalence of different routines, including mealtimes and sleep schedules. Nine foster parents received a semistructured interview with open‐ended questions. Foster parents reported that routines such as bedtimes, mealtimes, chores, and homework were essential to family well‐being. Because both parents and children had to adjust to living together in an intimate family environment, it was important to establish routines quickly. Foster parents modified routines depending on their child's needs. Along with typical family routines, foster parents reported additional tasks, such as visits with biological parents, meetings with caseworkers, and trainings that affected their family schedule. Results imply that training foster care workers and foster parents about routines can engender stability and emotional belonging for children.     

Foster care placement breakdown in the Netherlands and Flanders: Prevalence,precursors, and associated factors

Family foster care is the option of choice for children in need of out‐of‐home care in Flanders and the Netherlands. Foster care is however a vulnerable intervention, and questions can be raised as to its efficacy. Although the literature on placement breakdown has made significant progress during the last years, empirical knowledge regarding breakdown in Flanders and the Netherlands remains scant. Consequently, this study aimed at investigating prevalence and precursors of breakdowns in long‐term foster care, the duration of placement before breakdown, and the association of child and placement characteristics with breakdown. Case files of 271 Dutch and 309 Flemish foster children were analysed with a coding scheme designed for this study. After 6 years, 398 placements had terminated: 169 placements broke down and 229 placements ended positively. Placements broke down mainly because of behavioural problems of the foster child, foster parents' parenting problems, and conflicts between birth and foster parents. Foster children with behavioural problems, older foster children, foster children denied treatment, and foster children in care because of sexual abuse were more at risk of breakdown. Assessing these factors is important when evaluating the appropriateness of a family foster care placement.     

The impact of foster children's behavioural problems on Flemish foster mothers' parenting behaviour

Foster children often have behavioural problems. Behavioural problems influence the level of parenting stress and can lead to a breakdown. In this study, parenting behaviour of foster mothers is mapped, and the influence of behavioural problems and parenting stress on the parenting behaviour 2 years later is examined. Data of behavioural problems, family stress and parenting were gathered from 49 foster mothers. Problem behaviour has a direct negative impact on parenting and leads to less support and more negative control. It also results in more parenting stress. Foster parents need to be trained aiming at preventing ineffective parenting. The well‐being of foster parents needs to be guarded. Higher levels of parenting stress lead to less effective parenting.     

Independent evaluation of the Triple P Positive Parenting Program in family support service settings

The Triple P Positive Parenting Program is a multilevel system of behaviour‐based parenting training and support. The aim of this study was to determine whether implementation of levels 2 and 3 of the Triple P system, designed for primary care settings, enhances parent, child and family outcomes compared with services‐as‐usual in Alberta, Canada. The study employed a quasi‐experimental, single‐blind and post‐test‐only design. A survey incorporating outcome measures was administered to a sample of 1296 parent‐clients. A total of 923 parents responded, including 172 parents who had received a Triple P (level 2 and/or 3) intervention during the previous 12 weeks. A significant interaction was found between participation in a group‐based parent education programme and receipt of Triple P. Parents who participated in a group‐based parent education programme, and who received a Triple P intervention reported somewhat higher levels of need satisfaction than parents who participated in a group‐based parent education programme but who did not receive a Triple P intervention. No significant difference was found between Triple P and service‐as‐usual groups on any secondary outcome measures including parenting stress, positive interaction, family functioning and child problem behaviours.     

Training foster carers in challenging behaviour: a case study in disappointment?

This paper sets out key features of a semi‐experimental investigation conducted between March 1999 and April 2001 into the impact of training foster carers in techniques to manage challenging behaviour. We identified a sample of children (n = 103) in foster care in four authorities in South Wales who were selected by a checklist as showing behaviours that could be defined as challenging. From this search procedure we identified their foster carers (n = 106) and created a training intervention group for 53 carers looking after 49 children and a non‐intervention comparison group of 53 carers looking after 54 children. Both groups of carers were interviewed using a range of measures before and after the delivery of the training in order to identify any changes they perceived in the conduct of children and changes they perceived in their own capacities as carers. The training was delivered in small groups and evaluative feedback was gathered from carers and from training officers in those agencies that participated in the study. The results suggested that training, as designed and delivered in this study, had limited impact on child conduct and carer capacity. The reasons for this are discussed in light of selected findings. We spend some time on describing our methods in order to expose our approach to the critical scrutiny of readers, whose views would be welcome as we make our future research plans in this field.     

Foster carer perceptions of support and training in the context of high burden of care

The challenges of providing sensitive and structured care for children in foster care go well beyond normative experiences of parenting. The present paper describes a mixed‐methods study of foster carers' perceived need for support and training, referenced to estimates of their burden of care. Semi‐structured interviews were conducted with 17 foster carers in the Canterbury region of New Zealand. Carers' perceived need for support and training were identified through qualitative analysis of interviews using domain analysis method. Carers' burden of care was estimated from the Parenting Stress Index and from a measure of carers' encounters with children's emotional, behavioural and relationship difficulties that was designed for the present study (the Caregiver Behavioural Encounters Index). Foster carers reported substantive, unmet needs for support and training. Foster carers also reported high parenting stress and encounters with a wide range of children's mental health difficulties, including both uncommon and severe difficulties, which together represent an exceptional burden of care. Carers' highest priority need was for training and support on managing and responding to children's mental health difficulties, while their greatest existing support came from Caregiver Liaison Social Workers and other carers. The findings suggest a number of critical implications for practice.     

Examining fostering readiness in treatment parents

Preservice trainings have the potential to improve treatment parent and youth outcomes, yet researchers have noted the lack of empirical research on the effectiveness of these trainings. Preservice outcomes are typically collected immediately after training completion, with little to no follow‐up assessments at other time points. This study aimed to examine the longitudinal changes treatment parents experience throughout preservice training and after a youth is placed in their home. Secondary data analyses were performed on an archival data set (N = 57) that included demographic information and training participant scores from two standardized measurements that examined their fostering readiness before and after preservice trainings as well as after a youth was placed in the home: Personal Dedication to Fostering Scale and Willingness to Foster Scale. Analyses revealed significant changes for treatment parents' personal dedication to fostering, but no significant changes for their willingness to foster. Treatment parents' fostering readiness scores were compared to a normed sample of foster parents and were found to be significantly higher for their personal dedication scores but not for their willingness to foster. The findings suggest certain treatment parent outcomes may change as a result of preservice training and experience with youth, but additional measurements and outcomes should be examined.     

Child Care Caregiver Sensitivity and Attachment

Changes in child care caregivers' sensitivity and in children's attachment security were examined in three studies. Study one involved 55 children enrolled in community based child care. There was no intervention in these sites. Caregiver responsive involvement and children's attachment security did not change over time or when children changed caregivers. Study two involved 71 toddler age children enrolled in family child care homes. The caregivers of these children were enrolled in a family child care training project. Six months after the training security scores increased and caregivers of children who became secure or remained secure were more sensitive following training. Study three involved 36 children enrolled in center-based child care. Children were observed before and after selective staff replacement and in-service training to increase caregiver sensitivity. Six months following intervention security scores increased and caregivers of children who became secure or remained secure were more sensitive following training.     

Child of two worlds: How foster care workers perceive their skills in dealing with worldview differences in foster care

Foster children often encounter worldview differences between their foster family and their birth family, for example, when participating in religious activities and practices. Foster children not only have a right to continuity in upbringing but also consistency in worldview, culture and language. Good co-parenting relationships are important for their identity development. For these reasons, foster care workers are entrusted with the task of supporting the triadic relationship of the foster child, birth parents and foster parents in dealing with worldview differences. Based on in-depth interviews with foster care workers (n = 16) six skills in dealing with worldview differences can be distinguished: (1) basic knowledge of worldviews and identity formation; (2) empathizing with the other; (3) inquisitiveness to discover what is essential for the other; (4) initiating worldview conversations and keeping them going; (5) fostering self-reflection in worldview; and (6) manoeuvring between and monitoring all interests. It is helpful if birth parents are well-informed in advance about the impact of worldview differences and if foster care workers and foster parents are aware of the identity and developmental needs of foster children to explore the worldview of the foster family and the birth family.     

A Randomized Evaluation of Multidimensional Treatment Foster Care: Effects on School Attendance and Homework Completion in Juvenile Justice Girls

Despite growing evidence that child welfare youth are at increased risk for juvenile delinquency, little is known about gender-specific processes and effective treatment programs for girls. Multidimensional Treatment Foster Care (MTFC), an empirically validated intervention for child welfare and juvenile justice populations, has demonstrated efficacy in reducing arrest rates in delinquent boys and girls. In this study, the efficacy of MTFC on school attendance and homework completion was examined in juvenile justice girls who were referred to out-of-home care (N = 81). Results from this randomized intervention trial suggest that MTFC was more effective than group care in increasing girls' school attendance and homework completion while in treatment and at 12 months postbaseline. In addition, the previously reported effect of MTFC on reducing girls' days in locked settings was mediated by homework completion while girls were enrolled in the intervention setting. Implications for policy and practice are described.     

Caregiver‐endorsed strategies to improving sexual health outcomes among foster youth

Foster youth are at an increased risk of unintended pregnancies and sexually transmitted infections (STIs) compared with peers. We conducted 11 semistructured focus groups with 86 foster and kinship caregivers in three child welfare jurisdictions to understand their strategies for monitoring and communicating with youth in foster care around sexual health topics, with the overall goal of developing a training for caregivers to reduce STI and unintended pregnancies among youth in foster care. We used thematic analysis to analyse the data. Three main themes emerged: (1) strategies to communicate with youth about sexual health (trust‐building, open/direct communication, tailoring information to each individual youth, creative conversation‐starters, and self‐education), (2) strategies for monitoring youth (e.g., tailoring monitoring to youth development/characteristics, clearly communicating rules, co‐development of rules, spending time with youth/friends/friends' parents, using technology, using a social support system), and (3) other strategies to promote positive youth development (advocating for youth, engaging youth in goal‐setting). Trainings that provide caregivers with (1) information on sexual health and normal adolescent development and (2) strategies and skills to help caregivers engage in open, evidence‐informed communication, and monitor youth in a tailored, developmentally‐informed manner are likely to improve reproductive health and other outcomes among youth in foster care.     

Impacts of media on sexual behaviour and relationships among youth in foster care

Youth in foster care (YFC) are at high risk of negative reproductive and other health outcomes and may be especially vulnerable to negative impacts of media due to early adversity and a lack of stable caregiver relationships. The aim of this project was to explore how access and exposure to media impacts YFC in order to inform future research in this realm and promote resilience in this understudied population. We conducted semistructured interviews with YFC ages 15–21 (n = 22) and focus groups with foster caregivers (n = 86). We used thematic analysis to analyse data for themes related to media. Youth and caregivers described four main themes: (a) impacts of media on youth norms and attitudes, (b) impacts of media on youth behaviour, (c) impacts of youth exposure to pornography, and (d) caregiver monitoring and mediation of media. Data from this study indicate that media has unique, important effects on YFC norms and behaviours, including sexual behaviours. Foster caregivers encounter multiple barriers to monitoring and mediating media use for YFC. Further research is needed to explore differential effects of media on YFC versus non‐YFC in order to develop effective interventions and mitigate potential negative effects of media.     

Privatising Foster Care: The UK Experience within an International Context

Foster placements for children in care in the UK are being increasingly provided by non‐governmental organizations. However, although local authorities are purchasing almost one third of their required placements from these external agencies, the UK has not yet followed the examples of other English speaking countries. In parts of the USA and Australia all fostering and other child welfare services have been wholly outsourced or transferred from the public to private and non‐profit organizations. A number of these initiatives have been independently evaluated and some of their findings resonate with what seems to be happening in the UK. This article explores these but also other factors which appear to distinguish the policy and practice of foster care in the UK from those of the USA and Australia. Using theory related to the privatization of welfare and relevant domestic and international research, the article examines the development of external commissioning of foster care in Britain. In the light of changing law, ideology and policy, the article concludes by speculating on how the future of fostering and wider child welfare provision in the UK may look, at a time of political change and economic austerity.     

Contact visits between foster children and their birth family: the views of foster children,foster parents and social workers

It has been argued that contact visits between foster children and birth parents can help maintain attachment bonds and support the child's development. However, some research suggests that such visits can be detrimental. This study analyses the characteristics of contact visits and examines children's perceptions of the emotional relationship they have with foster carers and their biological parents. Participants were 104 non‐kinship foster children and their respective foster carers and social workers. Fifty‐six of these foster children had contact visits with their birth parents. Foster children rated the quality of their relationship with foster carers and birth parents using the Affect Scale. Foster children, foster carers and social workers all completed the Evaluation of Contact Visits Questionnaire. Results showed that (i) a high proportion of children had no contact visits; (ii) the contact agreement was often not fulfilled; (iii) many visits were rated as poor quality; (iv) foster carers' evaluation of visits was more negative than that of both foster children and social workers; and (v) children who experienced poor‐quality visits and perceived less warmth and more criticism/rejection from their parents. These results highlight the need to improve contact visits by developing intervention strategies targeted at all those involved.     

Children in permanent foster care in Sweden

The Swedish child welfare system has no permanency planning as we know it from, for example, the United States and Great Britain. Regardless of whether the child is placed in foster care with or without the parents’ consent, the law requires semi-annual reviews and there is no time limit set on reunion. Nevertheless, there are foster children who remain in the foster home throughout the whole of childhood, on terms similar to permanent foster care or adoption. This paper concerns a selection of findings from a research project entitled ‘Is there a difference in being a foster child?’. Foster children aged 10–11 were interviewed three times and the children’s perspective was focused on, complemented by the perspective of their foster parent(s). When interviewed about their relationship to their natural family as well as to the foster family, and about having a sense of family belonging and expectations for the future, 11 of the 22 children perceived their stay in the foster home as permanent and regarded themselves as belonging only to the foster family, although all of the children had contact with their birth parents. The study concerns the children’s views as well as those of the foster parents. The perception of permanency in the absence of a legal option of permanency is discussed.     

Allowing Family to be Family: End-of-Life Care in Veterans Affairs Medical Foster Homes

The Medical Foster Home program is a unique long-term care program coordinated by the Veterans Health Administration. The program pairs Veterans with private, 24-hour a day community-based caregivers who often care for Veterans until the end of life. This qualitative study explored the experiences of care coordination for Medical Foster Home Veterans at the end of life with eight Veterans’ family members, five Medical Foster Home caregivers, and seven Veterans Health Administration Home-Based Primary Care team members. A case study, qualitative content analysis identified these themes addressing care coordination and impact of the Medical Foster Home model on those involved: (a) Medical Foster Home program supports Veterans’ families; (b) Medical Foster Home program supports the caregiver as family; (c) Veterans’ needs are met socially and culturally at the end of life; and (d) the changing needs of Veterans, families, and caregivers at Veterans’ end of life are addressed. Insights into how to best support Medical Foster Home caregivers caring for Veterans at the end of life were gained including the need for more and better respite options and how caregivers are compensated in the month of the Veteran’s death, as well as suggestions to navigate end-of-life care coordination with multiple stakeholders involved.     

Breakdown of teenage placements in Swedish foster and residential care

This article deals with the problem of breakdown in different types of out‐of‐home care (foster care/residential care) for Swedish teenagers. How often are such placements prematurely terminated against the wishes and intentions of child welfare authorities? Which factors appear to increase or decrease the risk of placement breakdown? The sample consists of a national cohort of 776 youths who started 922 placements during 1991. Every placement was followed in municipal case files for a maximum period of five years. Between 30 and 37% of all placements were prematurely terminated, the exact figure depending on whether a narrow or wide definition of breakdown was applied. The lowest rates of breakdown were found in kinship care and secure units, the highest in non‐kinship foster homes. Teenagers who display antisocial behaviour and/or have mental health problems constitute a high‐risk category for most types of out‐of‐home care, but especially in non‐kinship foster homes. Risk factors in relation to breakdown were analysed in the four main forms of Swedish out‐of‐home care separately (foster homes, privately/publicly run residential care and secure units). The analysis pointed out that risk factors are not the same in all types of care, but antisocial behaviour at time of placement increased the risk in most forms of care. Prior research indicates that placement breakdown is a major problem of child welfare in other countries, and this study found that Sweden is no exception.     

Social work,poverty, and child welfare interventions

The relationship between children's material circumstances and child abuse and neglect raises a series of questions for policy, practice, and practitioners. Children and families in poverty are significantly more likely to be the subject of state intervention. This article, based on a unique mixed‐methods study of social work interventions and the influence of poverty, highlights a narrative from practitioners that argues that, as many poor families do not harm their children, it is stigmatizing to discuss a link between poverty and child abuse and neglect. The data reveal that poverty has become invisible in practice, in part justified by avoiding stigma but also because of a lack of up‐to‐date research knowledge and investment by some social workers in an “underclass” discourse. We argue, in light of the evidence that poverty is a contributory factor in the risk of harm, that it is vital that social work engages with the evidence and in critical reflection about intervening in the context of poverty. We identify the need for fresh approaches to the harms children and families face in order to support practices that engage confidently with the consequences of poverty and deprivation.