Instability in the lives of foster and nonfoster youth: Mental health impediments and attachment insecurities

Foster youth are at risk for negative mental health and psychosocial outcomes, including when they are on the brink of emancipation from care into self-sustained adulthood. Factors believed to affect outcomes among foster youth include residential and school instability. Although frequent moves to new homes and schools are common for youth living in poverty, instability for foster youth involves not only changing homes and schools but often also changes in caregivers, thus putting foster youth at risk for disrupted attachment relationships. For the current study, structural equation models examined links between instability, mental health problems, and attachment insecurities in foster and at-risk nonfoster youth. A model containing instability provided a better fit to the data than a model containing foster care status only. Group comparisons revealed that instability was associated with posttraumatic stress disorder symptoms for foster but not nonfoster youth. Implications of instability in the lives of foster youth are discussed.     

Adolescents in foster care: Predicting behavioral maladjustment

This exploratory study utilized foster caretakers as the source of information about foster care adolescents' behaviors. Foster care maladjustment was operationalized as the incidence of internal and external maladaptive behaviors reported by the youths' caretakers. Child-related variables and organization-related variables were then used to predict foster care maladjustment. The sample consisted of 152 randomly selected adolescents 16 years old and older in foster care under the supervision of the Los Angeles County Department of Children's Services. White youths and those in group homes/residential settings were more likely to have dysfunction in both areas. In addition, those youths placed at older ages and those who had spent more time in their current placement were more likely to exhibit external maladaptive behaviors. Treatment and service delivery implications are drawn from these findings. The importance of the foster caretaker as a provider of information and as a participant in the treatment process is also highlighted.     

Parent Management Training, Relationships with Agency Staff, and Child Mental Health: Urban Foster Parents' Perspectives

Many foster parents are ill prepared to meet the behavioral needs of children placed in their homes. Research suggests they lack training in evidence-based behavioral interventions and feel unsupported by child welfare professionals. Given the complex needs of foster children and increased rates of placement disruption for foster children with behavior problems, implementation of effective interventions is essential. However, little is known about foster parents' receptivity to these types of interventions. In this qualitative study, we examine urban foster parents' perceptions of the specific elements of parent management training (PMT), an evidence-based treatment for disruptive behaviors that teaches parents to improve desired behaviors and decrease oppositional behaviors by rewarding positive behaviors (positive reinforcement) and responding to negative behaviors with mild, consistent punishments such as timeout or a privilege removal. We present data from four focus groups (N = 38). While the questions focused on parent's perceptions of PMT, responses often related to parent interactions with agency staff. Four strong themes emerged from the data. First, foster parents discussed a need for more support and training in how to address children's behaviors, but also had concerns that some PMT discipline techniques would be ineffective based on their past experiences with foster children. Second, they described how staff communication skills and allegations of child abuse could affect parents' motivation to continue fostering. Third, they expressed a need for more detailed information about children's histories and visits with biological families as the lack of information contributed to difficulty in meeting foster children's needs. They suggested that joint training of foster parents and staff in the intervention could improve their ability to work together to support the child's positive behaviors. Finally, parents reported little involvement in child mental health services and doubted the effectiveness of the mental health services their foster children received.     

Carers of Children: A Comparative Study of the Practices of Residential and Foster Carers

SUMMARY. This article takes further the themes outlined in Children & Society, Volume 3(1) of examining the practices of special foster and residential caregivers in terms of the management of daily and other recurrent social events, and the methods used by caregivers to control children. Data are also presented on the role activities of caregivers and their interactions with children. Care practice in the special foster homes was generally found to be significantly more child-oriented than in the children's homes, and possible explanations for this are considered. Evidence is presented which serves to counter the tendency, in the wake of recent controversy surrounding children's homes, to scapegoat caregivers and children for shortcomings in residential care. The article has important implications for residential caregivers and foster care workers; and also for administrators and other child welfare professionals such as |field social workers, educational psychologists and psychiatrists.     

Aggressive behaviors among Korean children in out-of-home care: The role of placement characteristics

Using data from the Korean Panel Study on Children in Out-of-Home Care, this study examined the impact of placement characteristics on aggressive behaviors among children in out-of-home care by placement type. The sample was divided into three groups based on placement type: institutional care (n = 118), group homes (n = 95), and foster care (n = 212). Results from hierarchical multiple regression analyses indicated that the length of stay in out-of-home care significantly influenced aggressive behaviors amongst children in institutional care, such that increased duration of out-of-home care decreased the level of aggressive behaviors. Perceptions of stigma/discrimination also significantly influenced aggressive behaviors displayed by children in institutional and foster care. Children with a higher perception of stigma/discrimination were more likely to exhibit severe aggressive behaviors than were their counterparts. On the other hand, placement characteristics had no significant influence on aggressive behaviors of children in group homes. The study findings suggest that children's mental health problems and disabilities should be considered during the placement procedure and interventions focusing on decreasing stigmatization should be developed and provided for children in out-of-home care.     

Separation and loss: Assessing the impacts on foster parent retention

Foster family homes are utilized as the primary substitute care arrangement for over one-quarter million dependent children annually in the United States. An unsuccessful retention of foster family homes permeates the country's foster care system, thus requiring a determination of the major factors which contribute to foster parent retention or loss. To this end, a comparative census survey of a statewide foster parent population was conducted. When respondents from currently licensed homes were compared with those previously licensed on factors pertaining to the separation and loss experience, significant differences were found in two major dimensions: (1) training and (2) agency services and supports. Both dimensions were indicated to be viable factors of foster parent retention.     

An overview of current clinical issues in separation and placement

This article reviews a wide range of literature and the knowledge base that is necessary for effective treatment of children in foster and adoptive homes. The pitfalls in clinical work with placed children are identified. In addition to the psychological effects of placement on children, there is review of knowledge affecting both foster and adoptive parents. Treatment approaches and tools that are presented in the literature are summarized.     

Selective Campaigning for Foster Homes: An Empirical View

Experts on child welfare agree that it is vastly more desirable to care for children separated from natural parents in foster homes than in institutions. However, a shortage of foster homes has been a perennial problem in virtually every community in which they are needed. It would appear that, to the extent to which potential foster parents do exist in a community, this shortage could be attributed to inadequate and/or misdirected publicity.     

Effects of a Foster Parent Training Program on Young Children’s Attachment Behaviors: Preliminary Evidence from a Randomized Clinical Trial

Young children who enter foster care experience disruptions in care and maltreatment at a point when maintaining attachment relationships is a key, biologically based task. In previous research, we have found that young children experience challenges as they form attachments with new caregivers. They tend to push their new caregivers away, even though such children are especially in need of nurturing care. Further, many caregivers do not respond in nurturing ways when their children are distressed, which we have found is problematic for young children in foster care. We developed an intervention that is designed to help caregivers provide nurturance even when children do not elicit it, and even when it does not come naturally to them. This paper presents preliminary findings of the effectiveness of this intervention on children’s attachment behaviors. Forty-six children were randomly assigned to either the experimental intervention or to an educational intervention. For three consecutive days, attachment behaviors were reported across three distress-eliciting situations. Children whose parents had received the experimental intervention showed significantly less avoidance than children whose parents had received the educational intervention. These preliminary results suggest that the intervention is successful in helping children develop trusting relationships with new caregivers.     

Children discharged from kin and non-kin foster homes: Do the risks of foster care re-entry differ?

This study investigates whether the type of pre-discharge placement, kinship versus non-kinship foster care, has a net impact on children's likelihood of re-entering substitute care after controlling for possible selection biases through the use of regression adjustment and propensity score matching (PSM). Children in kin and non-kin foster care are compared on their rates of foster care re-entry, using bivariate comparisons and accelerated failure time (AFT) models. Lower rates of foster care re-entry after reunification from kinship homes are attributed to differences in child characteristics at removal, greater stability of kin placements, and gate-keeping functions that agencies and courts exercise over discharge and re-entry options. Children adopted from kinship and non-kinship homes exhibit similar re-entry rates, but the results for legal guardianship are mixed.     

Children with problematic sexualized behaviors in the child welfare system

This study assessed the utility of the Child Sexual Behavior Inventory (CSBI) in a child welfare sample. In this study, 97 children from ages 10 to 12 from either foster boarding homes or a residential treatment center participated. Researchers interviewed foster parents or primary therapists about children's sexual behavior, traumatic events, clinical symptoms, and their attitudes toward the child. Findings revealed that problematic sexualized behaviors were more prevalent in the residential treatment center (RTC) sample than they were in a normative sample. The pattern of associations between sexual behavior problems, traumatic events, and clinical syndromes in both the RTC and the foster boarding home (FBH) samples was similar to what has been found in samples in which biological custodial parents were the respondents. Analyses comparing youth who met the criterion for having problematic sexualized behaviors and youth who did not meet the criterion revealed that the two groups differed on clinical symptoms, prior traumatic events, and negative reports by caregivers. Results confirm the utility of the CSBI measure for this population and highlight several important clinical and programmatic concerns for addressing problematic sexual behavior in children in the child welfare system.     

Attachment Behavior of Children Adopted Internationally at Six Months Post Adoption

The purpose of this pilot study was to describe attachment behavior in children adopted internationally at 6 months post adoption. Twenty-two children and their adoptive mothers were observed at home for completion of an attachment measure. Mothers also completed a questionnaire on their child's preadoption care. Comparisons of children low and high in attachment security suggested that low secure children showed predominantly ambivalent attachment behavior or that they were still in the process of forming an attachment. Children having foster versus orphanage care prior to adoption differed in quality of preadoption care and in certain attachment behaviors, but not in overall attachment security.     

Mental health service utilization and time to care: A comparison of children in traditional foster care and children in kinship care

Existing research indicates that children who are involved with the child welfare system and placed in various forms of out-of-home care experience emotional and behavioral problems. It is also suggested that children placed in kinship care are less likely to receive mental health services than children placed in non-kinship foster homes. This study sought to compare children in non-kinship foster homes to children in kinship care to determine their receipt of mental health services and the time it took for children in kinship care to receive mental health services compared to children in non-kinship foster homes. Using a Cox regression, researchers determined that children in kinship care had a 14% lower likelihood of receipt of mental health services compared to their counterparts in non-kinship foster placements.     

Assessing results of the Alameda project

This note assesses the Alameda Project, a successful experiment conducted in California and designed to restore foster children to their home or to provide alternative continuous care. The study is examined critically against research which indicates that the majority of foster children come from economically disadvantaged homes and that restoration to homes in which the environmental conditions are not adequately improved often results in the recurrence of problems or the development of new problems.     

Attachment Behavior of Children Adopted Internationally at Six Months Post Adoption

The purpose of this pilot study was to describe attachment behavior in children adopted internationally at six months post adoption. Twenty-two children and their adoptive mothers were observed at home for completion of an attachment measure. Mothers also completed a questionnaire on their child's preadoption care. Comparisons of children low and high in attachment security suggested that low secure children showed predominantly ambivalent attachment behavior or that they were still in the process of forming an attachment. Children having foster versus orphanage care prior to adoption differed in quality of preadoption care and in certain attachment behaviors, but not in overall attachment security.     

Attitudes of special foster parents and residential staff towards children

This paper compares the attitudes of special foster parents and residential staff towards children in their care. The exercise was carried out as part of a comparative study of care practice in ‘special’ foster homes (accommodating children traditionally considered too old or difficult for fostering) and ordinary community or children's homes. Overall, care practice in the foster homes was significantly more child oriented than in the children's homes. This finding cannot, however, be explained in terms of attitudinal differences between foster parents and staff. Staff attitudes generally appeared more conducive to the provision of child oriented care than those of the foster parents.     

Placement type matters: Placement experiences in relation to justice system involvement among child welfare-involved youth and young adults

Out-of-home placement in the child welfare system is related to justice system involvement. Yet, few studies address the similarities and differences of child welfare placement types in relation to justice system involvement within the same sample of youth, which can provide a more nuanced understanding of the relationship between the two. Utilizing a sample of child welfare youth with substantial out-of-home placements (N = 794), we investigate trajectory group experiences on each of three child welfare placement types, and cross-tabulate each with justice system trajectory groups to examine subgroups. The five-group model fits best for foster homes and group homes; four groups for residential facilities. Relationships between justice system groups and placement types were significant. Youth with chronic justice system involvement had more experiences in group homes and residential facilities; youth with less justice system contact tended to have foster home experiences. Implications for policy and practice are presented.     

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.     

Adoption in the Media

Abstract

This article reviews four print pieces from national magazines and newspapers. They cover the subjects of adoption of older children from foster care, importing pregnant women from foreign countries to facilitate American adoptions of their babies, the death of a child with reactive attachment disorder, and the adoption of Chinese girls in New York City.     

Foster Parents' Understanding of Children's Problematic Attachment Strategies

ABSTRACT

Foster mothers and biological mothers were interviewed regarding their understanding of children's insecure attachment strategies and their knowledge of foster care issues. In addition, parent sensitivity was assessed and case workers in the foster care system reported on foster mothers' effectiveness. As expected, foster mothers reported significantly more attachment-related difficulties with their foster children than biological mothers reported with their natural children. Foster mothers were not significantly different from biological mothers in their understanding of attachment strategies, knowledge about foster care issues, or sensitivity. Case workers' reports of foster parent effectiveness were significantly related to foster parents' knowledge about foster care issues but were not significantly related to parents' understanding of attachment strategies. We discuss the importance of sensitivity to attachment issues among foster parents.