Underserved parents,underserved youth: Considering foster parent willingness to foster substance-using adolescents

Adolescents involved with foster care are five times more likely to receive a drug dependence diagnosis when compared to adolescents in the general population. Prior research has shown that substance use is often hidden from providers, negating any chance for treatment and almost guaranteeing poor post-foster care outcomes. There are virtually no studies that examine the willingness (and its determinants) to foster youth with substance abuse problems. The current study conducted a nationally-distributed survey of 752 currently licensed foster care parents that assessed willingness to foster youth overall and by type of drug used, and possible correlates of this decision (e.g., home factors, system factors, and individual foster parent factors such as ratings of perceived difficulty in fostering this population). Overall, willingness to foster a youth involved with alcohol and other drugs (AOD) was contingent upon the types of drugs used. The odds that a parent would foster an AOD-involved youth were significantly increased by being licensed as a treatment foster home, having fostered an AOD-involved youth in the past, having AOD-specific training and past agency-support when needed, and self-efficacy with respect to positive impact. Surprisingly, when religion played a large part in the decision to foster any child, the odds of willingness to foster an AOD-involved youth dropped significantly. These results suggest that a large proportion of AOD-involved youth who find themselves in the foster care system will not have foster families willing to parent them, thereby forcing placement into a variety of congregate care facilities (e.g., residential treatment facilities, group homes). Specific ways in which the system can address these issues to improve placement and permanency efforts are provided.     

Prior Placements of Youth Admitted to Therapeutic Foster Care and Residential Treatment Centers: The Odyssey Project Population

Two samples of youth in the child welfare system were compared—youth entering residential treatment centers (RTCs) and youth entering therapeutic foster care (TFC). Three questions were addressed: (1) Where were youth living prior to the current placement? (2) Had youth been treated in other systems of care? (3) How many prior placements did youth have? Time 1 data of the national “Odyssey Project” developed by the Child Welfare League of America were used. The^.measure utilized was the child and family characteristics form (CFC). Results revealed that youth admitted to RTCs were more likely to be entering from other systems of care and stepping down to the RTC while youth entering TFCs were more likely to be entering from within the child welfare system and stepping up to a higher level of care. The results have implications for improving clinical practice and for the development of a cross-system perspective on serving troubled youth.     

Foster home licensing and risk of reentry to out-of-home care following family reunification

Family reunification without subsequent reentry is the primary permanency goal for children placed in foster care. While a number of placement-level factors have been examined for their effect on subsequent reentry to care, no study to date has considered foster care licensing. The current study uses statewide administrative data to construct a cohort of foster care youth who entered care between 2009 and 2012 and were reunified by the start of 2013 (N = 7752) to investigate the association between types of foster care and the probability of reentry to foster care up to two years following reunification. We focus specifically on the licensing status of foster homes, and employ propensity score analysis to address selection bias in placement type. A propensity-weighted cox proportional hazard model revealed that youth placed in licensed relative care (LRC) homes and licensed non-relative care (LNC) homes were more likely to reenter foster care than those youth placed in unlicensed relative care (URC) homes during their first spell of foster care.     

It takes a team: Improving placement stability among children and youth with Fetal Alcohol Spectrum Disorder in care in Canada

Concerted efforts have been devoted to improving placement stability for children in care. These efforts have been driven by evidence of negative outcomes for foster children who experience frequent placement changes. Of particular concern are significantly higher rates of placement disruptions among children in care who experience Fetal Alcohol Spectrum Disorder (FASD). This mixed methods study examines the impact of enhanced child welfare practice interventions on placement stability for 182 children in care who experience FASD. A quasi-experimental matched comparison group design was employed, where rates of placement change were compared between children in the Project Regions who received enhanced practice standards to those in the Comparison Regions who did not. The sample included 182 participants including 98 children and youth in care from the Project Region and 84 cases from the Comparison Region. The Project Regions reported considerably lower placement changes (M = .33) than the Comparison Region (M = .98). Logistic regression analysis revealed that worker contact was found to be predictive of placement stability. Specifically, as worker contact increased, the likelihood of placement change decreased [B = − .28, W (5.35, p = .02)]. In keeping with the adage that it takes a village to raise a child, one could add for children affected by FASD, that it takes a dedicated team to promote placement stability and better life trajectories.     

Racial/Ethnic Differences in Court Referred Pathways to Mental Health Services for Children in Foster Care

Racial/Ethnic disparity in placement patterns and service utilization among children in foster care has been documented in a variety of studies. This study examined the role of the court process in referring children in foster care to mental health services and tested for racial/ethnic differences in the patterns of referral and service use. Court records for 142 children ages 2–16, representing Caucasian, African American, and Hispanic racial/ethnic groups were reviewed. Results indicate that the court process does play a significant role in referring children to services. Significant differences by race and ethnicity in mental health service utilization prior to the child's protective placement, as well as service orders, and post-placement service use were identified. Caucasian youth were more likely to receive orders for psychotherapy and to have documented use of psychotherapy than were African American and Hispanic youth, even when the possible confounding effects of age and type of maltreatment were controlled. Implications for the effective delivery of supportive services to those children most in need are discussed.     

The relationship of placement experience to school absenteeism and changing schools in young,school-aged children in foster care

Background

Chronic school absenteeism and frequent school changes, particularly among younger children, may be antecedents for the high rates of school failure and subsequent dropout among youth in foster care. However, the relationship of foster care experience to absenteeism and school change has not been well studied.

Objective

This study examined the association of placement experience with absenteeism and changing schools among 209 urban children in foster care enrolled in public elementary schools.

Methods

A cohort of children aged 5 to 8 years who entered non-relative or kinship foster care from 2006–2008 were followed longitudinally for 2 years from entry into foster care. Children residing in foster care were categorized at the end of the study as early stable, late stable, or unstable, if they achieved a permanent placement prior to 45 days, between 45 days and 9 months, or failed to do so within 9 months, respectively. Children who reunified home were classified as a fourth category. Poisson regression, controlling for baseline factors, was used to compare days absent and number of schools attended across categories of placement experience.

Results

Among the 209 children, 51% were male, 79% were African American, and 55% were initially placed with kin. One third of children reunified home; among children who did not reunify, one half was early stable, and a third was unstable. Adjusted rates of school absenteeism increased in stepwise fashion as children's placements became more unstable; children with unstable placements were 37% more likely to be absent than those with early placement stability (p = 0.029). Children who reunified during the study demonstrated the highest rates of absenteeism; however, there was no significant difference in absenteeism before or after reunification. Number of schools attended increased as stability worsened, with the standardized rate of schools attended reaching 3.6 schools (95% CI 3.1–4.1) over a two year period among children in unstable placements.

Conclusions

The relationship between placement experience and school absenteeism and school change illustrates the need to better coordinate the educational experience of high-risk children in foster care. The secondary finding of high absenteeism among children in the process of returning home illustrates that educational challenges for youth may be equally if not more concerning among the greater majority of youth in child welfare who remain home with birth parents.     

Children's Appraisals of their Experiences in Out-of-Home Care

Few studies have asked children directly about their experiences in out-of-home care. This study uses data collected from 180 nine- to-11-year-old children currently in out-of-home care who were asked about their perceptions and appraisals of out-of-home care. Analysis of variance and chi-square analyses were used to examine whether children's appraisals of their lives following removal from their families of origin differ as a function of age, gender, race/ethnicity, type and severity of maltreatment, length of time in out-of-home care, placement type, attachment to current caregivers, and rating of current caregiver/home. Youth who were sexually and emotionally abused, youth who were satisfied with their current caregivers and placements, and girls were more likely to state that their lives would have been worse had they remained with their families of origin. Youth who were physically abused were more likely to report that their lives would have remained the same. Children living in group care were more likely than those living in family foster care or with kin to report that their lives would have been better had they remained with their families of origin. Differences were not found between children living in family foster care and those living with kin nor did children's appraisals differ based on age, race, ethnicity, length of time in out-of-home care, neglect, or severity of maltreatment.     

Predictors for resolution of antisocial behavior among foster care youth receiving community-based services

Youth in the foster care system are more likely to be diagnosed with mental illness than those in the general population. Within this system, youth with antisocial behavior (e.g., aggressive, oppositional) are overrepresented. The challenges youth with antisocial behavior present to foster care systems make understanding the factors that predict remission in this population important for improving placement stability. Using Optimal Data Analysis (ODA), this study examines potential moderating effects of various individual, social, and strength variables on clinically significant decreases antisocial behavior in a sample of foster care youth over time. Results revealed positive improvements in youths' wellbeing to be the optimal predictor of resolution, followed by positive changes in family functioning and positive changes in adjustment to trauma (i.e., symptoms of PTSD). These results indicate that clinically significant decreases over time in antisocial behavior were associated with concurrent improvement in individual and environmental variables. Implications for service providers working with this population are discussed.     

Youth with disabilities in the United States Child Welfare System

Existing literature suggests that youth with disabilities are known to be at increased risk of maltreatment in the form of abuse and/or neglect. Little is known, however, about the experiences of youth with disabilities who are living in foster care or who are supervised by child protection authorities. This study establishes a baseline estimate of the prevalence of youth with disabilities living in foster care, documents reasons for child protection system involvement, identifies placement types while youth are in care and explores case outcomes. This cross-sectional, exploratory study draws on data from the 2012 Adoption and Foster Care Reporting System (AFCARS) for foster youth in 50 states, the District of Columbia and Puerto Rico. A sample of youth with disabilities (N = 36.492) and a comparison group without disabilities (N = 601.539) were identified. Findings about demographics, reasons for child removal, foster care placements, permanency planning goals and case outcomes are presented. Findings have implications for the prevention the removal of youth from caregivers, the need for family supports to prevent foster care involvement, the promotion of community inclusion of foster youth while in foster care and the need for inter-system collaboration at the transitional age stage.     

Perspectives: Former foster youth refining the definition of placement moves

Research has demonstrated that children who experience numerous moves in foster care are more likely to exhibit behavioral problems and less likely to achieve reunification or permanency. However, current knowledge about how placement move transitions impact children is extremely limited.This study used qualitative methods to explore how former foster youth define a placement move. Results indicated that placement moves can be defined by: 1) Time and relationships; 2) Packing and leaving; 3) Loss of property; 4) Returning home; 5) Type of placement; and 6) Decision-making process. An alternative definition of a placement move is offered and implications for child welfare policy, research and practice are provided.     

Pregnancy risk among older youth transitioning out of foster care

Youth served in the foster care system have higher rates of pregnancy than general population youth; yet we have little information about risk and protective factors to target in order to prevent early pregnancy in this population. We assessed early pregnancy risk and protective factors known for general population adolescents for their relevance to youth in the foster care system. Using data from a longitudinal study of 325 older youth from the foster care system, we examined bivariate and multivariate relationships between these factors and pregnancy between ages 17 and 19 using logistic regression. Models examined the risk for early parenting separately by gender. The pregnancy rate increased by 300% between ages 17 and 19. At 19, 55% of females had been pregnant, while 23% of males had fathered a child. Although this study assessed multiple known factors, few were significant for this high risk group. Females who were not sexually active at age 17 were less likely to become pregnant, but those who reported using birth control were as likely to become pregnant as those who did not. Also, females with a history of arrest were more likely to have a pregnancy between 17 and 19. Males who left the foster care system before their 19th birthday were more likely to make someone pregnant. Youth from the foster care system are at exceptional risk of early pregnancy, regardless of their maltreatment history, religiosity, school connectedness, or academic achievement, particularly in the years between 17 and 19. This high risk group needs pregnancy prevention interventions and access to effective birth control.     

Mentoring and social skills training: ensuring better outcomes for youth in foster care

Youth in foster care face significant life challenges that make it more likely that they will face negative outcomes (i.e., school failure, homelessness, and incarceration). While the reason(s) for out-of-home placement (i.e., family violence, abuse, neglect and/or abandonment) provide some context for negative outcomes, such negative outcomes need not be a foregone conclusion. In fact, interventions created to serve at-risk youth could ostensibly address the needs of youth in foster care as well, given that they often face similar social, emotional, and other challenges. Specifically, the author posits that supporting foster care youth through the use ofmentoring and social skills training could reduce the negative outcomes far too common for many of these youth.     

Developmental Outcomes of Vulnerable Youth in the Child Welfare System

Abstract

Adolescent development of youth in foster care holds great interest for society. This article examines a random sample of 200 adolescents currently placed in foster care on developmental outcomes. Using face-to-face interviews, the present study found that a majority of foster youth have biological families experiencing multiple problems and experience many developmental difficulties. A large percentage of the sample youth experience mental illness, school failure, substance abuse, and other antisocial behaviors. This paper considers implications from the study findings for policy and interventions designed to foster better developmental outcomes among youth in the child welfare system.     

The effects of adoption openness and type on the mental health,delinquency, and family relationships of adopted youth

ABSTRACT

Analyzing the 2007 National Survey of Adoptive Parents, this study examines the impact of open adoption, demographics, and other factors on adopted children’s mental health, delinquent behavior, and family relationships. Specifically, we compare findings for youth in private and public (i.e., foster care) adoptions and identify key similarities and differences between predictors of children’s well-being across these two types of adoption. We find that youth in open foster care adoptions are more likely to receive an attachment disorder diagnosis than those in closed foster care adoptions but are also more likely to have family relationships characterized by trust and adoptive parents’ willingness to recommend adoption to others. Further, we find children in both public and private adoptions who are older at placement are more likely to have posttraumatic stress disorder diagnoses. For children in private adoptions, no statistically significant predictors affected youths’ delinquency outcomes or family relationships, with the exception of parents of private adoptees in households characterized by lower levels of poverty indicating they would be more likely to recommend adoption to others. The implications of the key findings are discussed with regard to service provision for multiple types of adoptive families.     

Stepping Down and Stepping In: Youth's Perspectives on Making the Transition from Residential Treatment to Treatment Foster Care

Older youth preparing to emancipate from the foster care system are often served in residential treatment settings where they have limited opportunities to practice skills for independent living in a community setting. Stepping these youth down to less restrictive environments such as treatment foster care is a growing trend, especially for youth with mental health issues. Yet, few studies have explored the youth's perspective on making this transition. This study utilized qualitative interviews with youths who were participating in a treatment foster care intervention study (n = 8) to gain their perspectives on the process of transitioning from residential care. Youths were interviewed right before they exited residential care and two months after placement in the new foster home. Youths reported hopes for gaining family in the new home as well as fears of placement disruption. Findings point to the need to enlist youths in discussion and problem solving about difficulties they anticipate in the new home and expectations for their relationship with the new foster parents. In addition, the struggles described after two months in the home point to the need for youths to build specific skills to better manage ongoing relationships with foster parents and for foster parent training on how to help build these skills.     

Pre-foster Care Maltreatment Class as a Predictor of Maltreatment in Foster Care

The majority of youth in the foster care system have been removed from their homes as means of protection against parental maltreatment. Studies have shown, however, that foster youth may continue to experience maltreatment after they have entered the child welfare system (Poertner et al. in Child Youth Serv Rev 21(7):549–563, 1999; Tittle et al. in Urbana 51:61801, 2008). In this study, we explore how maltreatment prior to foster care entry may predict maltreatment while in care for youth who are preparing to emancipate. Using latent class analysis and multinomial logistic regression, we find that current or former foster youth with histories of multiple maltreatment (particularly, combined pre-foster care histories of neglect and physical abuse) are more likely to report neglect, physical abuse and sexual abuse in care than those with histories of low maltreatment. These youth should be the target of prevention efforts in child welfare agencies.     

Youth in Foster Care and Social Media: A Framework for Developing Privacy Guidelines

Although youth in foster care most likely use social media websites, there appears to be a lack of policy guidelines related to this use. When one considers youth in foster care, the state's mandate to provide safety, and foster parents' rights to exercise parenting responsibilities, the notion of privacy and the use of social media becomes complex. Critical Systems Heuristics will be introduced as a tool in developing policy recommendations. An application of this framework will be provided which can serve as a guide for an agency or workgroup tasked with developing policy guidelines for social media use by youth in foster care.     

Do Foster Parents and Care Workers Recognize the Needs of Youth in Family Foster Care with a History of Sexual Abuse?

Children in family foster care have the right to participate in decisions regarding their life, however, adults often advocate on behalf of children. This Q methodological study explored whether shared perspectives among foster parents and care workers resemble shared perspectives of youth regarding the psychosocial needs experienced by youth with a history of sexual abuse. Participants sorted a set of statement cards according to what they thought was most important for youth. By-person factor analyses examined how the Q sorts of foster parents and care workers related to those of youth. The results showed that foster parents mostly recognized the group of youth who value an instrumental relationship with their carers, while care workers mostly recognized the group of youth who value support of both foster and birth parents with regard to their preparation for independent living. The two youth groups characterized by ambivalence and autonomy were barely recognized. Results are discussed in light of the expected roles of foster parents and care workers, and youth’s contact with birth parents. Lastly, this study highlights the importance of youth participation, because youth offer unique and varying perspectives about their needs.     

Perceived self-stigma in the utilization of mental health services in foster care and post foster care among foster care alumni

Foster youth experience higher rates of mental health disorders and receive higher rates of mental health services in comparison to the general population. Yet, upon foster care exit, mental health service use drastically declines. Little is known as to the reasons for mental health service decline after foster care exit. However, research studies in the mental health literature have consistently shown that self-stigma and public stigma are significant in mental health service receipt. Studies have also shown that self-stigma affects an adolescent's self-identity, self-efficacy, and interpersonal relationships, which impact self-sufficiency once youth leave foster care. This study explores self-stigma in the utilization of mental health services while in foster care, and whether the stigma developed while in foster care impacts mental health service use upon foster care exit. The role of public stigma in the utilization of mental health services post foster care is also examined. Thirteen former foster youth with a mental health treatment history while in foster care were interviewed. Results show that foster youth experienced self-stigma, which increased the negative impact of mental health service receipt while in foster care. After foster care exit, youth who identified experiencing self-stigma while in foster care tended to discontinue mental health services after foster care exit. In contrast, foster youth who did not identify self-stigma in the receipt of mental health services while in foster care continued accessing services upon foster care exit. Public stigma was not identified as influencing mental health service use post foster care, but was coupled with negative labels, stereotypes, and negative perceptions. Implications for preventive and intervention measures are also discussed/proposed.