Youth participation in foster youth advisory boards: Perspectives of facilitators

Foster youth advisory boards (YAB) have the objective of promoting foster youth participation in decisions that are made about their lives. There is currently little known about how youth participation is conceptualized or implemented within or across boards. This qualitative study explored youth participation from the perspectives of 42 primary YAB facilitators in 34 states. The study's findings are derived from telephone interviews. A thematic analysis identified four primary approaches to youth participation, which we labeled as being, ‘Adult-Led’ (n = 2); ‘Adult-Driven Youth Input’ (n = 14); ‘50–50 Youth-Adult Partnership’ (n = 16); and ‘Youth-Led’ (n = 2). Within each of these approaches to youth participation, we present findings that explore facilitators' conceptualizations of youth participation, the strategies and program activities they use to enact youth participation, and the strengths and limitations of each of the approaches. Our discussion explores implications for YAB program activities, youth participation in child welfare systems, and future research.     

Voices of former foster youth: Supportive relationships in the transition to adulthood

As the adolescent development literature has recognized the importance of social supports in the transition to adulthood, child welfare research, policies, and programs have turned their attention to the relational needs of youth emancipating from the foster care system. This study builds on the extant literature on social support among transitioning foster care youth; it goes beyond the sole identification of relational networks, to explore how youth actually utilize their network members, and the overall quality of their support system. This study collects data from twenty qualitative interviews with foster youth, ages 18–21. We analyze the data using consensual qualitative research methods in order to develop core themes around shared youth experiences. We found that while foster youth did identify a wide network of both formal and informal supports during their transition to adulthood, there were “holes” in the form of support, especially appraisal and instrumental support, provided by informal network members. Additionally, an unrealistic perception of supportive and permanent relationships may be contributing to poor outcomes in emerging adulthood. Implications for policy and practice are discussed.     

Smoothing the transition to adulthood: Creating ongoing supportive relationships among foster youth

This paper assesses the utility and effectiveness of a foster care model designed to improve youth transitions to adulthood. The model engages the youth's social network, helps youth to develop supportive, ongoing relationships with adults, and is heavily focused on youth empowerment. A three-year evaluation of 88 foster youth revealed that youth exposed to the model felt they had more power over their lives, had a wider variety of supportive adults in their lives, and could better regulate their emotions than those in a comparison group.     

Latent classes of older foster youth: Prospective associations with outcomes and exits from the foster care system during the transition to adulthood

Youth in the foster care system face considerable challenges during the transition to adulthood. However, there is significant variability within this population. This study uses person-oriented methods and a longitudinal dataset of youth aging out of foster care to examine differences in how subgroups of foster youth fare during the transition to adulthood. We identified four distinct latent classes, consistent with prior person-oriented studies of this population, and validated these classes by examining differences on additional relevant factors at age 17. After establishing these classes, we tested their predictive validity by examining differences in outcomes at age 19 in domains relevant to the transition to adulthood, including education and employment, problem behaviors, and mental health problems. Finally, given the importance of extended foster care in promoting better outcomes, we used survival analysis to prospectively examine whether class membership was associated with differences in the rates at which youth left foster care between ages 17 and 19. One large group of youth exhibited moderate behavior problems and left care quickly, while another large group of resilient youth had favorable outcomes and left care relatively slowly. A small group exhibited considerable behavior and mental health problems, but left care more slowly, and a very small group was characterized by a history of pregnancy. Findings suggest considerable variability in service need among older foster youth. Implications for service provision during the transition to adulthood are discussed.     

In their own words: Overcoming barriers during the transition to adulthood for youth with disabilities who experienced foster care

The transition to adulthood can be especially challenging for youth who experience the foster care system. These challenges are magnified for youth with disabilities, who account for at least 40–47% of all children in foster care (Powers et al., 2012). In order to move from a deficit-based to a strength-based approach, this qualitative study focused on understanding the lived experience of transitioning to adulthood for alumni of foster care with disabilities. Semi-structured interviews were conducted with seven young adults who had exited care over a six-month time period. Participants described their journeys from foster care to independence and articulated a vision for a successful adulthood. Key themes that emerged included a desire for stability and personal fulfillment in adult life. Participants also identified common barriers encountered including unmet mental health needs and lack of disability awareness or the implications of mental health diagnosis. Personal strengths that helped overcome those barriers included resilience, advocacy, and self-determination.     

Responsive engagement in mental health services for foster youth transitioning to adulthood

ABSTRACT

As youth near the transition to adulthood and aging out of the foster care system, exposure to stress increases, especially for youth who have less-than-adequate support systems. Although mental health problems among foster youth often continue into adulthood, service use decreases dramatically within a year of turning age 18. Understanding how foster youth experience mental health services as they transition from care provides social workers and other mental health professionals important insight that can lead to specific, targetable strategies. This study sought to explore what situations were helpful in supporting mental health as foster youth transitioned to adulthood. Focus groups and interviews with former foster youth and professionals informed the development of a quantitative instrument, which was used to identify the most supportive and frequently encountered situations former foster youth experienced. Findings indicate the most helpful situations were those in which professionals and mentors were flexible and responsive to their individual needs and trusted their ability to make decisions. Supportive adults who honored their choices and collaborated in decision-making were also helpful. Engaging, empowering, and partnering with transition-age youth may increase the likelihood of positive mental health outcomes for this population, offering implications for family-centered, strengths-based practice.     

Barriers and facilitators for access to mental health services by traumatized youth

Polytrauma is a highly prevalent public health problem in the U.S. with even higher rates in urban areas. Children with polytrauma often end up in multiple child-serving systems (e.g., mental health, child welfare, education, juvenile justice) with needs that are both complex and severe. Providers within these child-serving systems have potential to serve as gatekeepers to trauma services by linking youth with trauma-informed treatments and supports that promote recovery. The purpose of our study was to assess the perspective of providers who participated in a nine-month, trauma-informed care (TIC) training intervention on 1) their capacity to make referrals to trauma-specific services following the training, and 2) factors external to the training intervention that supported or hindered their ability to link traumatized youth with services. A subset of sixteen participants from the TIC training completed individual interviews. These participants were predominantly female, African American, and based in the social services sector. The constant comparative method was used to derive three thematic domains related to participant perceptions regarding youth referrals: 1) Organizational and provider capacity to provide trauma treatment or to make referrals to trauma-specific services, 2) Barriers to youth accessing trauma services, and 3) Suggestions for improving coordination of care and referrals. Our study highlights the influence of contextual factors on whether a TIC training can improve the capacity of agencies and individual providers to support traumatized youth in accessing appropriate services. The development of a structure that formally connects youth-serving agencies and providers with specialists trained in addressing traumatized youth is recommended.     

Foster care transition services for youth with disabilities: findings from a survey of county service providers

This study explores the transition services available for youth with disabilities in foster care and the collaboration among foster care transition programs with other types of providers. Findings from this survey of independent living coordinators working for child welfare agencies indicate that while youth with disabilities are being served through transition programs and these programs collaborate with other government agencies, there are few services targeted directly toward their needs, little collaboration with community-based agencies, and a need for more information sharing.     

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.     

The system-of-care for homeless youth: perceptions of service providers

Service providers' perceptions of the system of care for homeless youth are described. Face-to-face structured interviews were conducted with staff at homeless youth agencies in Los Angeles County (L.A. County) regarding organizational and staff characteristics, issues affecting youth, types of available services, gaps in services, and barriers to service delivery.Overall, agencies were large, well established, and provided multiple services. Most agencies (62%) were concentrated in Hollywood, a cruise area of L.A. County. Clear distinctions emerged between large and small agencies; large agencies had more resources, more professional staff, were established longer, and were policy advocates. Typical of other US metropolitan areas, services for homeless youth in L.A. County are located in cruise areas, and are not as readily available in other geographic areas. Such geographic barriers to providing a comprehensive and coordinated system of care can affect youth's pathways out of homelessness.     

Cultivating youth voice through participation in a Foster youth advisory board: Perspectives of facilitators

This study explored the construct of youth voices in one state youth advisory board (YAB) from the perspective of program staff and child welfare liaisons and administrators (referred to as ‘facilitators’). Our aim was to understand how youth voice is defined and activated on a foster youth advisory board. In-depth interviews with 13 facilitators of a YAB in a Mid-western state were conducted between August 2013 and June 2014. These interviews were a part of a larger study that investigated what 33 current and former elected officers of a YAB learned from participation. Each interview lasted between 1 and 1/2 to 2 h. A grounded dimensional analysis was used to investigate facilitators' perceptions of the impact of participation on the development of advocacy for self and others. Findings indicated that the belief system of facilitators, provision of social support, opportunities to try new roles, and state agency leadership contributed to the cultivation of youth voice through two parallel processes: personalization and professionalization. Suggestions for practice and YAB development are made to enhance sustainability and decrease tokenization of foster youths' voices in child welfare systems.     

Growing up fast: Implications for foster youth when independence and early adulthood collide

Foster care alumni face overwhelming challenges as they transition from care to independence. Torn between their desire to be independent, yet acknowledging they need support, they struggle to find their footing. Adopting a survivor self-reliance mind-set, they set out to earn a bachelor's degree on their own. As they struggle, they compare themselves to non-foster peers who, by enlarge, have a support system enabling them a prolonged entrance to adulthood, which provides a safety net. Without a safety net, and with a focus on independence, decisions youth from foster care make, result in few alumni earning a bachelor's degree.     

Object exploration during the transition to sitting: A study of infants at heightened risk for autism spectrum disorder

Learning to sit promotes infants' object exploration because it offers increased access to objects and an improved position for exploration (e.g., ). Infants at heightened risk (HR) for autism spectrum disorder (ASD) exhibit delays in sitting and differences in object exploration. However, little is known about the association between sitting and object exploration among HR infants. We examined changes in object exploration as HR infants (N = 19) and comparison infants with no family history of ASD (Low Risk; LR; N = 23) gained experience sitting independently. Infants were observed monthly from 2.5 months until 1 month after the onset of independent sitting. At 12, 18, 24, and 36 months, infants completed standardized developmental assessments, and HR infants were assessed for ASD symptoms at 36 months. Although HR infants began sitting later than LR infants, both groups increased time spent grasping, shaking, banging, and mouthing objects as they gained sitting experience. Groups only differed in time spent actively mouthing objects, with LR infants showing a greater increase in active mouthing than HR infants. Findings suggest that HR infants experience a similar progression of object exploration across sitting development, but on a delayed time scale.     

Using the bridges transition framework for youth in foster care: Measurement development and preliminary outcomes

Youth in foster care often undergo multiple transitions before reaching adulthood, and these transitions often create significant stress and can exacerbate emotional and behavioral problems. A measurement instrument (the Youth Experience of Transitions, or YET) was designed to assess foster care youths' understanding of transitions, and this instrument was tested on a group of youth undergoing an intervention program designed to assist them in coping with the stress of these transitions while in foster care. The intervention was based on the Transitions Framework by William Bridges and was implemented in multiple community agencies with funding from the Andrus Family Fund. Using factor analysis, we found that the YET contained two factors representing (1) openness and (2) determination. For youth in the participating foster care programs, growth in openness from baseline to 6 months was linked to a significant decrease in internalizing symptoms; no significant links were found for externalizing symptoms. Implications for foster care intervention programs are discussed.     

Walk-in clinic counselling for emotional regulation with low-needs youth on the autism spectrum

A single-session consultation model for low-needs youth on the autism spectrum is presented with the mental health concern of emotional self-regulation, a common issue in family psychotherapy. This research is contextualised within the growing field of short-term therapy as it intersects the growing demand to therapeutically address clients on the autism spectrum. The treatment intervention is delineated through five sequential phases within the walk-in clinic setting for the practitioner clinician. A rationale, overview, and instruction for the practitioner clinician utilising this novel model is provided through a case study format. By using a more structured and integrated approach to treatment, organised through an externalised metaphor, it is suggested that the current model will be more effective for this specific clinical population. Additionally, a case illustration is provided that scaffolds the treatment model, which includes table formats and pictures. The case study illustrates the self-regulation map metaphor visually and interactively linking client challenges, strategies, and motivations simultaneously on multiple electronic devices in session. Relevant works were selected to explore the effectiveness of single-session consultation models for those presenting on the autism spectrum. Treatment interventions for specific clinical populations are recommended, especially within walk-in clinic therapy. This clinical research introduces a paradigm shift towards therapeutically addressing emotional self-regulation with low-needs youth on the spectrum through virtual, interactive technology.     

Improving access to health care for foster children: the Illinois model

Children in foster care have lower health status than do their peers and limited access to health care. The Illinois Department of Children and Family Services developed HealthWorks, a separate primary care preferred provider system for children in foster care. This study compared claims data for children in HealthWorks with children not enrolled in HealthWorks and with children in Aid to Families with Dependent Children (AFDC) who had never entered foster care. Children enrolled in HealthWorks were more likely than were other children to receive all of the services except general inpatient hospitalizations. They had greater odds of receiving general exams and physicians' services and were more likely to visit the emergency room than children who were not enrolled. They were more likely to receive all of the measured services when compared with children receiving Medicaid through AFDC.     

Mental health and substance use disorders among foster youth transitioning to adulthood: Past research and future directions

At a time when there is increasing attention being given to systematically integrating the well-being of children with the goals of safety and permanence in child welfare, little is known about the psychosocial functioning of foster youth transitioning to adulthood from substitute care. This article systematically reviews 16 peer-reviewed articles and/or research reports to identify lifetime and past year prevalence rates of mental health disorders and service utilization. At ages 17 or 18, foster youth are 2 to 4 times more likely to suffer from lifetime and/or past year mental health disorders compared to transition aged youth in the general population. Findings show that mental health service use declines at ages when the prevalence rate of mental health disorders is peaking. The findings of this review suggest the need to focus future efforts in three main areas: 1) setting a common research agenda for the study of mental health and service use; 2) routine screening and empirically supported treatments; and 3) integration and planning between child and adult mental health service systems.     

The voices of youth formerly in foster care: Perspectives on educational attainment gaps

As a population, youth who experience foster care graduate from high school at rates well below their non-foster care peers (National Working Group for Foster Care & Education, 2014). A Consensual Qualitative Research (CQR) study was conducted to better understand the perspective of former foster youth on the graduation gap and their experience in school. Analysis of focus group data revealed one overarching domain, emotional consequences, as well as seven additional domains that related to youths' experiences surrounding their educational attainment: resilience, basic needs, internalized messages about education, educational stability, consequences of school mobility, fastest or easiest positive exit from K-12, and recommendations from youth. This research highlights the challenges faced by 16 former foster youth, their perspectives regarding the need to raise expectations, and their suggestions for closing the educational attainment gap.     

Spirituality in Latino families of children with autism spectrum disorder

Research on Latino parents of children with intellectual and developmental disabilities (IDD) suggests that these parents often use spirituality to conceptualize and to cope with their child’s diagnosis. However, there are no studies that examine religion among Latino parents of children with autism spectrum disorders (ASD). The current study explores how Latino parents of children with ASD incorporate spirituality into their conceptualizations of their child’s disability. In the current study, 34 Latina mothers of children with ASD were interviewed about autism-related services, family characteristics, and cultural beliefs including spiritual beliefs. Thematic analysis of the transcribed interview data relating to spiritual beliefs was conducted for the present study. Most mothers endorsed beliefs that their child with a disability was a message from God. Within this theme, mothers reported beliefs that their child was a blessing from God, a test from God, a sign from God or that the parent was special. Other parents believed that having a child with a disability was not an act of God, but related to biomedical factors, and another group of parents was unsure about the spiritual meaning of their child with a disability. Lastly, some mothers reported that their larger cultural group believed that having a child with a disability was a punishment or a negative sign from God but they markedly rejected that conception. These findings suggest that providers working with Latino families of children with ASD should acknowledge the importance of spirituality for these families.