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.     

Infants in Foster Care

Abstract

This article highlights the importance of attachment issues for infants placed in foster care. We offer a framework for understanding how early separation and maltreatment may affect infants' ability to securely rely on a foster parent. We argue that disruptions in foster infants' primary attachment relationships, combined with a history of maltreatment, place these infants at risk for developing predominantly insecure or disorganized attachments to foster parents, regardless of foster parent characteristics. We argue that foster infants' successful passage through the foster care system requires a high level of foster parent sensitivity to their unique attachment needs. We also argue that this level of sensitivity is likely to require specialized training for foster parents.     

Settling into a new home as a teenager: About establishing social bonds in different types of foster families in Sweden

This paper provides a glimpse into young people's experiences and understandings of everyday life during their initial stages of placement in various types of foster families. The way family interactions strengthen or weaken the social bond between foster youth and foster family is focused upon. In this study the young people in kinship foster families reported the strongest social bonds to their foster families and the adolescents in traditional foster families the weakest. This is in line with previous research. However, youth in network foster families with whom they were not so close prior to placement also reported rather strong social bonds to the foster family, which is not well known. Including network foster families in the study sheds light on the importance of adolescents' active involvement and agency in choosing their foster family. Examples of family interactions which seem to be crucial in strengthening social bonds, also in traditional foster families, are e.g. fair treatment by other family members, mutual family activities, negotiating to find solutions, and, which is not so well known, humorous joking and laughing together.     

Externalizing problems in young foster children: Prevalence rates,predictors and service use

Objective

Examining the prevalence of externalizing problems, their predictors and mental health service use for these problems by foster children and foster parents in a representative group of foster children aged 3 to 12 in Flanders.

Method

Survey data were collected on 212 foster children, who had been in the foster family for approximately four months. Foster parents filled out a Child Behavior Checklist to measure foster children's externalizing problems. Foster care workers reported on several potential risk variables for externalizing problems and on foster children's and foster parent's mental health service use. Predictors of externalizing problems were identified from a large number of variables using the method of purposeful selection of variables in linear regression.

Results

40.6% of the foster children had externalizing problems. Foster children who were placed because of behavioral problems had more externalizing problems. Only 20.9% of the foster children with externalizing problems and only 13.9% of their foster parents received professional help.

Conclusions

This study showed that externalizing problems are prevalent in this young foster care population, that it is hard to predict which foster children had externalizing problems, and that foster children and their foster parents rarely receive services for these problems. These findings call for a standard protocol of assessment of foster children's externalizing problems. Moreover, from a preventive viewpoint, guidelines are needed to systematically link young foster children with externalizing problems and their foster parents to appropriate services.     

Keeping in touch: Ecological factors related to foster care visitation

Visitation, assumed to be important for children in foster care, has not been studied in sufficent detail. In the present study, patterns and characteristics of home and foster family visitation and telephone contact are described in a national sample of children in foster care in Israel (n=590). Relations between child, biological and foster family characteristics are explored by type of contact and foster placement. Parent-child contact is most strongly related to foster family characteristics and relations with the biological family. Patterns differ for relative and nonrelative foster families.Dr. Oyserman is on sabbatical leave     

Foster Parents Speak: Preferred Characteristics of Foster Children and Experiences in the Role of Foster Parent

Foster parents play a pivotal role in the child welfare system. A study that employed focus groups with foster parents was conducted at a private foster care agency with the initial purpose of understanding the characteristics of foster children that foster parents both preferred and not preferred. In the qualitative research tradition, their answers addressed the topic of characteristics and expanded to provide additional data on their experience as foster parents. Using theme analysis, the following themes were generated: foster care as service; foster parents' preferences of foster children's characteristics; foster parents do not feel valued or trusted; increased caseworker and foster parent partnership; problems in the foster care and related systems; and focus group as support. Implications for research and practice are forwarded.     

Lights,camera, action: The images of foster care in the movies

Movies often reflect public perceptions. The portrayal of foster care in movies provides insight regarding beliefs and attitudes children, parents, and others bring with them as they interact with the foster care system. The study focus was to identify images of foster care portrayed in 37 nondocumentary movies produced in the United States and Canada between 1921 and 2012. Using Framing Theory, an iterative review process was used to derive three dominant images presented to audiences: child entrance into foster care, a broken foster care system, and life in foster care. Movie images generally misrepresented the realities of foster care in the United States, highlighting the importance of those involved in child custody and providing a more realistic image of foster care.     

Effects of foster care placement on biological children in the home

This project used questionnaires to investigate the effects of foster care on biological children in the foster home setting. In southeast Iowa, 52 foster parents and 51 biological children voluntarily responded. Approximately 77% of the foster parents were concerned about the effects of foster care on their biological children—in particular, that biological children felt left out of the family unit. The majority of the foster parents stated that sharing of parental attention should be discussed with biological children before beginning, and both parents and children felt that pretraining sessions for biological children would help their adjustment to foster care.     

Behavioral health service use and costs among children in foster care

This article compares behavioral health service use and cost for foster care versus nonfoster care children; children before, during, and after foster care placement; and successfully reunified versus nonsuccessfully reunified foster care children. Behavioral health service costs for children in foster care were higher than for children not in foster care. Children in foster care used more services during their foster care placement than before placement and after discharge. Nonsuccessfully reunified children received a significantly larger quantity of services than those successfully reunified.     

Planned and unplanned terminations of foster care placements in the Netherlands: Relationships with characteristics of foster children and foster placements

This study examined the role of placement and child characteristics in the unplanned termination of foster placements. Data were used from 169 foster children aged 0 to 20. Results showed that 35% of all foster placement terminations were unplanned. Outcomes of logistic regression analyses demonstrated that behavior problems, parenting stress and a non-Dutch ethnic background of the foster child increased the likelihood of a placement termination. Furthermore, risk accumulation contributed to unplanned terminations. The results indicate that supporting foster parents in managing problem behavior of the foster child and reducing parenting stress may be a key to an effective prevention of disrupted foster care placements.     

Explorative study into support needs of caregivers in short-term foster care regarding problem behaviour and dealing with biological parents

Family supporting foster care (FSFC) is a directly accessible, short-term and preventive form of foster care for children under the age of 12. Caregivers in this type of foster care need comprehensive support to deal with their complex tasks. In this contribution, the support needs arising from the behaviour of the foster child as well as concerning dealing with the biological parents of 85 Flemish FSFC-parents are examined, as these are areas FSFC-parents specifically ask support for. These support needs are evaluated for possible links with child and foster parent characteristics. More experienced foster parents and foster parents with a foster child showing more externalising problem behaviour ask for more support in managing the child's behaviour.     

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.     

Patterns and Predictors of Early Care and Education for Children in Foster Care

Patterns and predictors of center-based early care and education (ECE) of children in foster care were examined. Participants included 192 pre-Kindergarten age children in foster care. Foster parents reported demographics, ECE and other service use. Foster care history data was abstracted from case files. High rates of attendance in ECE prior to Kindergarten, including Head Start, other center-based ECE, or both were found. Children who attended Head Start were younger when first placed in foster care. Children who attended other center-based ECE services were more likely to live with kinship foster parents and foster families with higher incomes. Latent class analysis of ECE quantity, quality, type, and duration revealed three patterns: part-time Head Start, part-time other ECE, and full-time mixed ECE. Child and foster family characteristics predicted these patterns, illustrating distinct groups with potential implications for the development of children in foster care.     

The Concept of ‘Family’ Among Norwegian Adolescents in Long-Term Foster Care

In Norway, about 8,000 children live in foster homes (about 3.300 in age group 13–17). What does ‘family’ mean to these children? We explored the views and feelings about ‘family’ among 22 adolescents who are living in long-term foster care. Three patterns emerged. Most of the participants expressed confidence and adjustment in the foster home placement and felt bonded to both their foster family and to their birth family. Other adolescents expressed a strong sense of membership to their birth family but not to their foster family, and the remaining adolescents described a weak bond to birth family but a strong bond to their foster family. The main implications of the three patterns are discussed in the light of policy and practice.     

Competencies and problem behaviors of children in family foster care: variations by kinship placement status and race

Formal kinship foster care is an increasingly common form of out-of-home placement, and several important distinctions between kinship care and non-relative foster care have been identified. The present study evaluated the behavior of kinship foster children in comparison to non-relative foster children and children in the general population. A geographically and ethnically diverse sample of foster children (N=240) was assessed for competence and problem behaviors using the Child Behavior Checklist (CBCL: Achenbach, 1991). Kinship foster children closely resembled children in the general population but differed significantly from their counterparts in non-relative foster care, who consistently scored lower on competence and higher on problem behaviors. Substantial proportions of non-relative foster children were in the clinical range on most CBCL measures, but kinship foster children were no more likely than children from the general population to score above clinical cut-offs. Differences between kinship and non-kinship foster children became less dramatic after accounting for child race and gender, which were both associated with kinship status. Child race had a strong main effect for almost all types of problem behaviors, with children of color showing significantly less problematic behavior. Discussion of these results centers on potential explanations for the observed variations in child behavior by kinship status and race.     

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.     

The role of foster parents in helping young people develop emancipation skills

The current focus on preparing youths in foster care for emancipation has largely ignored the critical role foster parents have always played in preparing youths to leave their homes and take their place as successful adults in our society. To assure that programs to enhance youths' skills and abilities to function responsibly are fully effective, they must include foster parents. In doing so, they will exponentially increase the hours of service and training available to eligible youths and develop a resource that will be available to future youths after funds are redirected. It is unrealistic, however, to expect foster parents to provide all of the help that most youths in foster care need. Foster family support and training must be seen as one dimension of an integrated approach that provides all youths with a variety of resources but is specific to the needs of each youth. With appropriate support and training, foster parents can assume professional responsibility for assuring that such plans are implemented, and that youths leaving foster care have what they need to emancipate successfully.     

Adult well-being of foster care alumni: Comparisons to other child welfare recipients and a non-child welfare sample in a high-risk,urban setting

Research has shown that children placed in foster care fall below population norms on many indicators of well-being. Yet few studies have been designed to distill the effects of foster care from conditions that precede foster care. Based on the available evidence, it is also uncertain whether the purported effects of foster care are lasting. This study used data gathered prospectively from an economically disadvantaged, urban cohort to examine whether foster care is associated with decreased educational and economic attainments as well as increased criminality in adulthood. Individuals who were placed in foster care after an indicated allegation of maltreatment were compared to three naturally occurring groups: (a) maltreatment victims who did not reside in foster care, (b) individuals without an indicated maltreatment allegation who were raised in a household with a Child Protective Services (CPS) record, and (c) individuals without an individual or household record of CPS involvement. Using multiple estimation procedures, we found that all participants with a CPS record fared worse in adulthood than their peers without a CPS record. Despite their poor outcomes, foster children functioned as well as other CPS recipients who did not reside in foster care. Our findings indicate that caution is warranted when attributing dysfunction observed in foster children to the effects of foster care. Implications for prevention and intervention within the context of child welfare are discussed.     

Foster fathers performing gender: the negotiation and reproduction of parenting roles in families who foster

ABSTRACT

Foster care research and social work practice tend to focus on how women look after children living in foster care. This focus has limited our understanding of what it is that men do within foster caring families and they are automatically assigned secondary or breadwinning roles. Families who foster involve some form of renegotiation of roles to care for children they foster. While foster caring arrangements are internationally diverse, foster carers often work with social workers. It would therefore seem important for social workers to understand how foster carers negotiate their parenting roles. This paper reports findings from seven main caring foster-fathers who took part in a wider study involving twentythree foster-fathers. The evidence provided by these foster-fathers demonstrate they are highly motivated to care for children and, alongside delivering traditional parenting roles, they negotiate new, non-traditional parenting roles as foster-fathers. These new roles, taken on by foster-fathers, often challenge stereotyped masculinity while they also concurrently enact parenting norms. This study applied Judith Butler’s work on performing gender to foster caring families to theorise on the process whereby foster-fathers negotiate diverse masculinities and continue to reproduce gendered relations in foster caring families.     

Behavior Problems of Sexually Abused Children in Foster Care

Research has shown that sexually abused children display a number of behavior problems. Many of these children are placed in substitute care, especially foster homes. The current project was undertaken to measure foster parents' perceptions about the behavior problems of sexually abused children in their care. Two studies were completed. The first was a large survey of foster parents in a Midwestern state. The second study utilized a sample of foster parents to complete a standardized behavior inventory which has previously been used in child sexual abuse research. The types of behavior problems described by foster parents and implications for future research are discussed.