A psychoanalytic psychiatrist in the world of foster care

Recent developments in psychoanalytic developmental psychology offer a conceptual framework for understanding the effects of inadequate parenting on psychological development. The very need for foster care, almost by definition, usually indicates that parenting has been inadequate, and there fore children in foster care comprise a special population of developmentally handicapped individuals. Many of the problems that confront foster care agencies can be understood in terms of the individual child's psychological developmental arrest and its deleterious effect upon his or her ability to benefit from placement. Certain cultural factors within the community involved with foster care compound the problem. More clinically sophisticated service is therefore a key element in the remediation of many of the obstacles to adequate foster care services.Earlier versions of this paper were presented at the Meeting of The American Psychoanalytic Association in Atlanta, Georgia, May 1978 and in New York City, December 1978.     

Changes in Externalizing and Internalizing Problems of Adolescents in Foster Care

Using a developmental psychopathology framework, this study aimed to examine changes in externalizing and internalizing problems of adolescents in foster care and to determine whether type of maltreatment, gender, and age influenced trajectories. Authors used 3 waves of data from the National Survey of Child and Adolescent Well‐Being. Growth‐curve analyses of 106 adolescents aged 13–16 in foster care revealed that externalizing and internalizing problems decreased over time. Adolescents, particularly boys, placed in foster care as a result of sexual abuse, physical abuse, or neglect demonstrated faster decreases in externalizing problems and, similarly but to a weaker degree, internalizing problems than did those placed in foster care as a result of other forms of maltreatment.     

Developmentalism and the Rhetoric of Best Interests of the Child

Abstract

The foster care system in Australia has recently recognised the importance of encouraging lesbians and gay men to become foster carers. Whilst this may be seen as an important step towards overcoming social stereotypes that position lesbians and gay men as unfit parents, I propose that foster care public policy in Australia is shaped by a number of key assumptions that effectively exclude lesbian and gay foster parents. In particular, I focus on how the logic of developmentalism [where children are assumed to follow a (hetero)normative developmental pathway] and the rhetoric of best interests of the child (within which a particular moral framework is employed to judge who can and who cannot protect children) work to recenter a normative understanding of families and parenting that encourages lesbians and gay parents to adopt a heterosexual model of parenting.     

Beyond Competence: Fostering LGBTQQI Ally Development Through Supervision

In this critical literature review, the authors examine how counseling supervisors can ethically and effectively foster supervisees’ lesbian, gay, bisexual, transgender, queer, questioning, intersex (LGBTQQI) ally development. Synthesis of the integrated developmental model of supervision with a framework for affirming LGBTQQI case conceptualization is described. Practical examples are provided for each component of the proposed model, and a case study is provided to illustrate application of LGBTQQI ally supervision.     

Associating, mobilizing, politicizing: local developmental agency from without

Decades of increase in external aid programs sparked a wide range of criticisms pointing to misaligned interests, lack of accountability, and the reproduction of developmental traps. The success of development from without is more likely if it generates domestic developmental agency. In this article, we contribute by conceptualizing and measuring dimensions of developmental agency. Our research analyzes the strategic case of European Union regional development programs in Eastern Europe, where this external organization spent nearly a decade on establishing local developmental agency. We collected survey data of 1200 local organizations from two regions each in Czech Republic, Hungary, and Poland. We examine the post-accession position of organizations that participated in pre-accession assistance programs. We test a hypothesis of marginalization in the framework of recentralized developmental governance, and we examine links between patterns of pre-accession involvement and post-accession developmental agency. We identify factors that might make external developmental programs more likely to foster local developmental agency.     

Understanding Responses to Foster Care: Theoretical Approaches

Foster children making the transition from birth to foster homes or from foster homes to foster homes often present problematic behaviors. Limitations of attachment theory and reactive attachment disorder are presented, and three alternative approaches for understanding behaviors exhibited in foster settings are presented: conservation of resources, child alienation model, and developmental trauma disorder.     

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.     

Compliance and Internalization in Preschool Foster Children

Child compliance and internalization are socio-cognitive developmental processes which are critical for children's social outcomes in multiple arenas. These developmental processes are found to be compromised in maltreated children. The current study was designed to add to the extremely limited literature on compliance and internalization in maltreated children in foster care. Compliance and internalization tasks were administered to preschool foster children, videotaped and later coded. Through parent-report questionnaires completed by the foster parents and observations of the foster home, the relation of compliance/internalization to child behavior problems, foster care experiences, and the foster home environment was examined. Findings revealed that most children showed committed compliance, but over 50% of children exhibited “deviation” behaviors in the internalization task. HOME acceptance scores (via observation of parent and child in home setting) significantly contributed to children's compliance levels but did not significantly contribute to their internalization. Internalization was related to children's externalizing behavior problems. These findings are considered in the context of future research and practice with respect to young children in foster care.     

Comparing the health status of low-income children in and out of foster care

Children in foster care face poverty, family dysfunction, neglect, and abuse, with high rates of chronic health, emotional, and developmental problems. This study compared the overall health status of a group of children entering foster care with a group of Medicaid-eligible children living with their parents, matched for age and gender. It identified significantly more health and developmental problems in children in foster care than in the comparison group. Possible contributors to the higher percentage of problems among foster care children may be that the foster children have more problems related to the underlying risk factors resulting in placement, or that the foster care physicians conducted a more comprehensive assessment or had lower clinical thresholds. Further research is necessary to identify and treat the problems of this high-risk group.     

Displacement,caregiving, and the ecological system of youth in foster care: a theoretical perspective

Children involved in the child welfare (i.e., foster care) system are at a greater risk for numerous negative outcomes in adolescence and adulthood (e.g., lower educational attainment, higher risk for a criminal record). For children in foster care who experience placement disruption (i.e., removed from a foster home and placed in another nonpermanent placement), the risks significantly increase. Informed by the ecological systems model, the authors propose a theoretical perspective to explain the unique aspects of a foster child’s development and discuss how this framework informs child welfare practice and intervention for foster children at risk for placement disruption. This perspective has the potential to provide a framework that has implications for foster caregivers and child welfare professionals and to inform future policies.     

Health and mental health services for children in foster care: the central role of foster parents

It is well documented that children enter foster care with special health and mental health needs and, while in care, those conditions are often exacerbated. However, less attention has been given to foster parents who have the most contact with these children. Results are presented from a national study on the developmental, health and mental health care needs of children in foster care that included foster parents' perspectives and observations. Their role in improving child well being is explained and recommendations for policy, practice and advocacy also are included.     

Ethiopia's developmental state: A building stability framework assessment

Ethiopia has been lauded for its economic growth and progress in human development indicators. For some, that success is rooted in the developmental state approach advocated by the government. For others, the theory of the developmental state and the practice in Ethiopia were often at odds. Up until 2018, ideas that challenged the state and its approaches were not welcome, and politicians, academics and journalists were jailed for expressing alternative views. However, this appears to have changed, and in June 2018 the Deputy Prime Minister called for debate on the developmental state model. This article explores Ethiopia's developmental state model using the building stability framework, analysing its ability to establish fair power structures, foster inclusive economic growth, develop conflict‐resolution mechanisms, create effective and legitimate institutions, and enable a supportive regional environment. We find the developmental state was effective in a number of ways, but that this modality of governance appears to have passed its peak of securing advantage in Ethiopia. A shift from the developmental state to developmental democracy appears to be underway. Decision‐making and economic policies need to align with this change.     

Children in Foster Care and the Development of Favorable Outcomes

Young foster children have invariably faced a variety of risks that are strongly linked to long-term deficits in functioning across multiple developmental domains. Despite these risks, however, some children demonstrate more favorable outcomes and exhibit adaptation and the development of assets. In the present study, the relationship of early childhood factors (e.g., maltreatment history, placement history, parenting practices, environmental stress, developmental status, and attachment behavior) to the development of favorable outcomes in middle childhood was examined in a sample of foster children who had been in foster care in preschool (N = 35). Favorable outcomes were defined as demonstrations of emotion regulation and school adjustment during middle childhood. Developmental status (particularly attention and executive functioning) and a lack of environmental stress during early childhood foster care experiences had a significant positive relationship with the development of emotion regulation and school adjustment in middle childhood.     

Nutritional status of foster children in the U.S.: Implications for cognitive and behavioral development

ObjectiveChildren in foster care are at greater risk for poor health, physical, cognitive, behavioral, and developmental outcomes than are children in the general population. Considerable research links early nutrition to later cognitive and behavioral outcomes. The aim of this narrative review is to examine the prevalence of poor nutrition and its relation to subsequent health and development in foster children.MethodRelevant studies for inclusion were identified from numerous sources (e.g., PubMed, Google Scholar, and reference sections). Inclusion criteria were studies published between 1990 and 2016 of (i) the nutritional status of children in foster care or (ii) the nutritional status of children exposed to early adversity (e.g., low-income and internationally adopted children) or (iii) the developmental effects of poor nutrition and micronutrient deficiencies.ResultsTwo key findings that have adverse implications for cognitive development emerged: (i) the prevalence of anemia and iron-deficiency anemia is higher among foster children than among the general population of children in the U.S., and (ii) the developmental demands of catch-up growth post-placement may lead to micronutrient deficiencies even after children have begun sufficient dietary intake of these nutrients. Moreover, there is a paucity of recent studies on the nutritional status of children in foster care, despite the multiple factors that may place them at risk for malnutrition.ConclusionAttention to nutritional status among care providers and medical professionals may remove one of the possible negative influences on foster children's development and in turn significantly alter their trajectories and place them on a more positive path early in life. Recommendations for further research, policy, and practice are discussed.     

Developmental outcomes after five years for foster children returned home, remaining in care, or adopted

A substantial proportion of children who enter foster care in the US are infants or toddlers and will exit from foster care before they have been in care for long, either returning home or to adoption. These first years of involvement may predict a significant amount about children's longer term development so understanding developmental outcomes after five years is valuable to understanding if child welfare services (CWS) are serving the intention of promoting the well-being of children. A subsample of 353 infants (less than 13 months of age when investigated by CWS) and subsequently placed into foster care were selected from the National Survey of Child and Adolescent Well-Being. After 66 months, these infants had been reunified, adopted, or were still in foster care. Bivariate comparisons were completed. Statistical controls for maltreatment type and severity, demographic traits, and current caregiver education were implemented to help clarify the role of terminal child welfare placement, current caregiver behaviors, and household income, on eight linear regression models of developmental outcomes. Results support the longstanding tenet of child welfare services policy that remaining in foster care is less developmentally advantageous than having a more permanent arrangement of return home or adoption.     

Historical, Developmental, and Behavioral Factors Associated with Foster Care Challenges

Three agency-based studies explored the associations of traumatic child histories, as well as their developmental, health and behavioral problems with foster care challenges such as placement instability. The findings represent the convergent perspectives of child welfare workers and foster parents in small cities in Ontario. Alone and in aggregate, child and familial traumas and problems were very strong predictors of various foster care challenges. Foster parent training and other support needs are discussed.     

The Placement History Chart: A Tool for Understanding the Longitudinal Pattern of Foster Children's Placements

Despite growing concerns about foster placement instability, little information is available regarding the longitudinal patterns of placement histories among foster children. The purpose of the present study was to develop a charting system using child welfare records to facilitate a better understanding of longitudinal patterns of placement history for 117 foster children. The resulting Placement History Chart included all placements that occurred during the observed time period and accounted for various dimensions: number, length, type, and sequence of placements; timing of transitions; and total time in out-of-home care. The Placement History Chart is an effective tool for placing foster care experiences within a broader developmental context. As such, the Placement History Chart can be a valuable research tool for understanding various dimensions and variations of placement transitions among foster children by capturing sequences and cumulative risks over time. Furthermore, this chart can facilitate the development of intervention programs that are developmentally sensitive and effectively address particularly vulnerable subpopulations of foster children.     

Reunification of foster children: Factors associated with reunification outcomes in Flanders and the Netherlands

Although a significant number of foster children eventually return to their birth parents, evidence-based models for permanency planning are scarce, and there is a lack of clear decision-making criteria for reunification. This study aimed to establish further knowledge about reunification. Both reunification pace and factors which are associated with reunification were examined. The focus was on factors related to the foster child, the birth parents, the foster parents and the foster placement, and reasons for removal. Case file analysis was performed for 580 Flemish and Dutch foster children ages 0–18. Cox regression analyses showed contact with birth parents to be most strongly associated with reunification. Moreover, particularly placement related factors (e.g., legal framework, additional support services, contact with birth parents) increased the likelihood of reunification. Furthermore, over a period of six years approximately 15% of foster placements led to reunification notably during the first 2.5 years of placement. Policy makers and foster care professionals are therefore encouraged to timely aim for permanency planning. Reunification efforts should be planned from the start of the foster placement. If subsequently reunification proves not feasible, permanency should be secured within the foster family.     

Planning a mentorship initiative for foster parents: Does gender matter?

Despite the use of mentoring programs in fields such as business, career training, and youth development, little is known about how mentoring can be used to train and support new foster parents. This paper describes how Concept Mapping was used with current foster parents to develop a conceptual framework suitable to plan a foster parent mentor program. A secondary aim of this study was to explore priority differences in the conceptualization by self-reported gender (foster mothers vs. foster fathers). Participant data was collected via three qualitative brainstorming sessions, and analyzed using non-metric multidimensional scaling and hierarchical cluster analysis. Findings indicate that foster parents participating in this study conceptualized effective mentor programs via a seven cluster solution. Study results also showed no significant differences in cluster ratings by gender. Implications for practice and program planning are identified, as well as areas for future research.