Extracurricular activity participation and educational outcomes among older youth transitioning from foster care

This study examined factors associated with extracurricular participation and whether participation in extracurricular activities is associated with completing high school and attending college among a sample of older youth transitioning from foster care (n = 312). Results indicated that better self-reported grades and greater educational aspirations were associated with extracurricular participation. Participation in extracurricular activities was associated with graduating from high school, but not starting college by age 19. Consistent with provisions of the Preventing Sex trafficking and Strengthening Families Act of 2014, results suggest that efforts that make extracurricular participation a normative aspect of the developmental experience of foster youth are important for their educational well-being.     

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.     

Increasing college access for youth aging out of foster care: Evaluation of a summer camp program for foster youth transitioning from high school to college

Young people who transition from the foster care system face many challenges including lack of support and other educational barriers. They are less likely to graduate from high school than their counterparts and go on to college yet despite challenges, many succeed and take advantage of higher education programs.In Michigan, a state with one of the highest percentage of youth in foster care, Michigan State University developed a small scale, targeted intervention to help transitioning foster youth achieve their goals of pursuing higher education. Led by the School of Social Work in collaboration with other colleges and disciplines, it was demonstrated that a campus based learning program for transitioning foster youth can help contribute toward a perceived increase in knowledge and information about college life, funding and admissions procedures. The educational process involved peer support, role modeling, mentoring and active learning sessions led by the faculty and students who were often foster care alumni themselves. Leaders and speakers came from a range of disciplines, institutions and organizations. This approach and curriculum contributed to perceptions of the camp as enhancing life skills, self-concept, empowerment and sense of purpose. Consequently, this program contributed to the resilience of those who attended and potentially helped build steps from care to higher education.     

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.     

Predisposition to seek mental health care among Black males transitioning from foster care

This study examined the predisposition to seek mental health care in the future for personal and mental health problems among Black males transitioning from the foster care system (n=74). Results of simultaneous multiple regression analysis showed that custody status, diagnosis of a DSM-IV psychiatric disorder, and emotional control contributed significantly to the prediction of Black male's predisposition to seek mental health care. Specifically, Black males who were still in foster care were more predisposed to seek mental health care, whereas those diagnosed with a DSM-IV psychiatric disorder and who adhered more to the norm of emotional control were less predisposed to seek mental health care. Implications for mental health service delivery are discussed.     

Characteristics and trajectories of treatment foster care youth

Using cross-sectional analyses in conjunction with dynamic modeling (hierarchical linear modeling), the authors profiled 119 treatment foster care youth and constructed behavioral change trajectories for a subset of 97 children. Children generally showed improvements in internalizing and critical pathology problem domains but remained the same on measures of externalizing behaviors and total problem score. The number of previous out-of-home placements was positively associated with increased levels of psychiatric symptomatology and served as the most robust predictor for modeling treatment response trajectories across problem domains. Placement instability places the well-being of children at heightened risk, therefore, accurate assessment of child need and risk in relation to caregiver capacities is critical.     

Continuity of care for youth in foster care with serious emotional disturbances

Continuity of mental health care has long been considered an essential component to the delivery of a high-quality mental health services, particularly for children with special needs. Unfortunately, discontinuities in care are common for children in foster care due in part to placement instability, disruptions in health coverage, and the fragmented health system. This retrospective cohort study examined factors associated with continuity of care for youth (aged 5–17 years) in foster care diagnosed with schizophrenia and bipolar disorder. Information on individual-level (demographic and clinical characteristics) and contextual-level variables (county socio-demographic and health care resources) were abstracted from Medicaid claim files and the Area Resource File. Continuity of care was defined as regularity of care—utilization of at least one outpatient mental health visit per month during the year. Multilevel modeling was used to assess the association between individual and contextual-level variables and continuity of care. Of the 952 youth in the study sample, 439 (46.1%) received regular monthly outpatient visits over the 1 year follow-up period. The odds of receipt of regular outpatient treatment were associated with prior outpatient care (odds ratio (OR): 7.43, 95% confidence interval (CI): 2.60–21.20), the presence of a chronic medical illness (OR: 1.45, 95% CI: 0.98–2.16), comorbid anxiety (Or: 1.76, 95% CI 1.22–2.53), or conduct disorder (OR: 1.57, 95% CI: 1.13–2.18), and the use of multiple psychotropic medications as compared to no medications (OR: 1.55, 95% CI: 1.08–2.23). The odds of receiving regular outpatient treatment were higher for youths who resided in suburban areas as compared to metropolitan areas (OR: 1.97, 95% CI: 1.04–3.73) and for those who resided in areas with greater supply of psychiatrists per capita (OR: 1.22, 95% CI: 1.02–1.45). Study findings underscore the need for quality improvement initiatives that improve access to care, care coordination, and continuity of care.     

Transition from care: status and outcomes of youth who age out of foster care

This study shows that a significant portion of youth exiting the foster care system face serious difficulty transitioning to life on their own. Many live on the streets, lack the money to meet basic living expenses, fail to maintain regular employment, are involved with the criminal justice system, are unable to obtain health care, and experience early pregnancies. Although youth reported exposure to independent living training while in care, few reported concrete assistance. Multiple placements while in care and less education correlated with more difficult postdischarge functioning. Training, services, positive supportive networks, and job experience in care are associated with more positive adjustments. The article advances implications for program and policy interventions.     

Educational experiences and aspirations of older youth in foster care

This study documents the school experiences of 262 youth referred for independent-living preparation from the foster care system of one midwestern U.S. county. Of the youth, 73% had been suspended at least once since the seventh grade, and 16% had been expelled. In the past year, 58% had failed a class, and 29% had physical fights with students. Yet the group reported high educational aspirations: 70% wanted to attend college. Those in congregate care and family settings often had school behavior problems. The results support the need for a system of education advocates who work to maintain proper education placements for youth in foster care and help them receive the academic resources they need to graduate from high school and proceed to college.     

Supporting collegiate foster youth and alumni: A mixed-method planning approach for higher education

Despite the proliferation, of on-campus academic support programs for foster youth and alumni (e.g., those formerly in foster care), few conceptual frameworks for developing these programs exist. This study employed Group Concept Mapping (GCM) methodology to delineate a conceptual framework, from the perspective of foster youth and alumni (N = 51), for the development of on-campus support initiatives. GCM is an integrated mixed-method research method that uses non-metric multidimensional scaling and hierarchical cluster analyses, to analyze qualitative data (e.g., statement form) collected during brainstorming sessions. This research was guided by two separate queries: (1) How do foster youth/alumni conceptualize support programs to support foster youth/alumni through to degree completion; and, (2) Is there a difference in priority areas of this conceptualization between current college students, and those who have dropped out of college within the last 18 months? Analyses revealed that participants conceptualized on-campus support programs via an eight-cluster solution, including Campus Awareness, Advocacy, Data Tracking, Pre-College Supports, Fostering Family Connections, Academic Financing, Campus Life, and Peer/Mentor Supports clusters. Additionally, analyses revealed significant priority ratings between areas of this conceptualization. In terms of Importance to academic success, current students rated statements in the Academic Financing and Peer/Mentor Supports clusters significantly lower than did non-students. For Feasibility, current students viewed statements in the Data Tracking, Campus Life, and Peer/Mentor Supports clusters as significantly more feasible than non-students. Pragmatic implications derived from these findings include fostering inclusive campus environments for foster youth/alumni and advocacy undertakings by institutions, on behalf of this population.     

Sibling relationships and internalizing symptoms of youth in foster care

Compared to the sibling literature of the general population, little is known about sibling relationships of youth in foster care. The current study aimed to report on sibling relationships among youth in foster care, and investigate the potential protective nature of sibling relationships of those who have experienced trauma on the expression of internalizing symptoms among a nationally representative sample of 152 adolescents in foster care. Results indicated that the large majority of the sample was currently separated from their sibling. Of those who were not living with their sibling, nearly three quarters saw their sibling monthly or less frequently with one third of the sample reporting never having any contact with their sibling. In addition, bootstrapping methods were used to determine if sibling relationships mediated the effect of trauma on internalizing symptoms. Results indicated that a positive sibling relationship significantly mediated this relationship. Implications of these findings are discussed.     

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.     

Substance use in youth adopted from foster care: Developmental mechanisms of risk

Children who enter foster care are at unique risk for developing substance abuse due to experiencing early life stressors. A large body of research has revealed robust effects of various stressors on later substance use, implicating the role of early neurobiological changes that create chronic internalizing problems. However, less literature has investigated externalizing behavior as a mechanism underlying this relationship. Moreover, few studies have examined these mechanisms through a model of cumulative risk. The present study examined whether the prospective association between cumulative pre-adoptive risk (e.g., maltreatment, age at placement, foster placement instability, ever having lived with birth parent) and adolescent/young-adult substance use was mediated by childhood internalizing and externalizing problems in youth adopted from foster care. Participants included 82 adoptees, most with histories of prenatal substance exposure (72%). We tested parent-rated internalizing and externalizing problems across 5 years in childhood as simultaneous mediators of cumulative risk and level of substance use 11–15 years later. Bootstrapping mediation procedures, controlling for age, prenatal substance exposure, adolescent/young adult mental health symptomatology, and youth participation in follow-up, revealed a significant indirect effect of cumulative risk on substance use through childhood internalizing problems, but not externalizing problems. These results underline the importance of mitigating early risk for children in the child welfare system and call for targeting childhood emotion dysregulation to reduce likelihood of substance abuse among previously high-risk adoptees. Nevertheless, low rates of substance use overall in the present sample underscore the positive impact of adoptive placement on mitigating risk for substance abuse among foster youth.     

Strategies for engaging foster care youth in permanency planning family team conferences

The present study examines strategies conference facilitators used to engage foster care youth in decision-making in the context of permanency planning family team conferences. Data collection included observations of permanency planning family team conferences, followed by interviews with foster care youth and conference facilitators. Data analysis focused on gaining a deeper understanding of how facilitators incorporate youth into decision-making, with a specific focus on the strategies they employed. Four strategies were identified in the analysis: creating a safe space, encouraging the youth voice, re-balancing power, and establishing a personal connection. The study's policy and practice implications, limitations and areas of further research are presented.     

24-month update on the impact of roundtables on permanency for youth in foster care

Although the number of children in foster care has decreased in recent years (U.S. DHHS, 2012), additional strategies are needed to help youth achieve legal permanency before they age out of foster care. One such strategy is the permanency roundtable, which convenes a team of professionals to facilitate the permanency planning process by identifying realistic solutions to permanency obstacles for youth. Nearly 500 youth went through the initial permanency roundtable process in Georgia in 2009. Just over half were male (57%) and over nine in ten (92%) were African American. At the start of the roundtables, the median age was 13, and the median length of stay in foster care was 52 months. Two years after their roundtable, 50% of the nearly 500 children had achieved legal permanency. Analyses, presented separately for three age groups (0–6, 7–12, and 13–18), examine outcomes and predictors of legal permanency. Recommendations, limitations, and areas for future research are discussed.     

Issues of shared parenting of LGBTQ children and youth in foster care: preparing foster parents for new roles

Foster parents have increasingly assumed new and challenging roles during the past decade. Meeting the developmental, attachment, and grieving needs of children and youth in out of home care is challenging by itself, but can become even more difficult with the issues that arise when the child is lesbian, gay, bisexual, transgender, or questioning (LGBTQ). Preservice and in-service foster parent training programs can strengthen shared parenting skills by focusing on the universal critical issues of safety, well being, and permanence for children and youth in foster care. This article will focus on these skill areas: (1) sharing parenting to promote healthy growth and development of LGBTQ youth in foster care, (2) threats to safety of LGBTQ youth in foster care, and (3) general challenges and strategies for preparing foster parents of LGBTQ youth to build support systems.     

Mental health interventions for children in foster care: A systematic review

Children in foster care have high rates of adverse childhood experiences and are at risk for mental health problems. These problems can be difficult to ameliorate, creating a need for rigorous intervention research. Previous research suggests that intervening with children in foster care can be challenging for several reasons, including the severity and complexity of their mental health problems, and challenges engaging this often transitory population in mental health services. The goal of this article was to systematically review the intervention research that has been conducted with children in foster care, and to identify future research directions. This review was conducted on mental health interventions for children, ages 0 to 12, in foster care, using ERIC, CINAHL, PsycINFO, PubMed, ProQuest's Dissertation and Theses Database, Social Services Abstracts, and Social Work Abstracts. It was restricted to interventions that are at least “possibly efficacious” (i.e., supported by evidence from at least one randomized controlled trial). Studies were evaluated for risk of bias. Ten interventions were identified, with diverse outcomes, including mental health and physiological. Six interventions were developed for children in foster care. Interventions not developed for children in foster care were typically adapted to the foster context. Most interventions have yet to be rigorously evaluated in community-based settings with children in foster care. Little research has been conducted on child and family engagement within these interventions, and there is a need for more research on moderators of intervention outcomes and subgroups that benefit most from these interventions. In addition, there is no consensus regarding how to adapt interventions to this population. Future research should focus on developing and testing more interventions with this population, rigorously evaluating their effectiveness in community-based settings, determining necessary adaptations, and identifying which interventions work best for whom.     

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.     

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.