Sexual and reproductive health policies for foster youth in California: A qualitative study of child welfare professionals' experiences and perceptions of policies

Child welfare professionals and foster parents increasingly suggest the importance of establishing clear and consistent policies and procedures to address the sexual and reproductive health of youth in foster care. The present study examines the content and context of such policies across 18 California counties through a search of publically available county policy documents, and surveys and expert interviews with child welfare professionals (N = 22). A policy framework for agenda setting and policymaking was used to guide the data collection and analysis process. Child welfare professionals were aware of multiple sources of information, support and services for foster youths' sexual and reproductive health, though few practiced in counties with formal policies that outline the resources and support that youth should receive. Participants demonstrated widespread recognition that issues of youth sexual and reproductive health were significant; posing challenges to youth, foster parents and child welfare staff. Identified policy solutions included: 1) training for social workers and foster parents; 2) collaborative partnerships with public health nurses and community providers; 3) data tracking and monitoring of outcomes to assess youth needs and evaluate the impact of programs and policies; and 4) involvement by advocacy organizations in defining problems and advocating for improved services and support for youth in care. Social workers largely perceived that support from child welfare administrators and policy leaders is necessary to prioritize this issue and initiate policy formation. Additional research is needed to further examine the impact of policy mandates on social workers, foster parents and youth in foster care.     

Receipt of help acquiring life skills and predictors of help receipt among current and former foster youth

US law has long recognized the need to help prepare foster youth for the transition to adulthood and states receive funds specifically intended to provide their foster youth with independent living services. Nevertheless, little attention has been paid to whether foster youth in fact receive the services states are supposed to provide using federal funds. This study uses data from the Midwest Evaluation of the Adult Functioning of Former Foster Youth to describe the kinds of help foster youth receive in making the transition to adulthood and the factors associated with help receipt. Study findings call for a redoubling of efforts to provide foster youth with the assistance called for in federal law, provide support for the extension of foster care through age 21 in the interest of ensuring that such assistance is provided, highlight the need to involve foster parents more actively in providing youth with life skills training, and call into question whether current efforts to assist foster youth in acquiring independent living skills are well targeted.     

What Happens to Foster Kids: Educational Experiences of a Random Sample of Foster Care Youth and a Matched Group of Non-Foster Care Youth

Older youth often “age out” of foster care when they reach 18 or 21. Then what happens to them? How do their educational experiences during and after high school compare with children raised in intact families? This study used existing longitudinal data from 1980 through 1986 to investigate the high school and post high school experiences of a group of foster care youth and a matched group of youth living with at least one parent. The results were unequivocal: the foster youth dropped out of high school at a much higher rate and were significantly less likely to have completed a GED. The foster care high school graduates received significantly less financial assistance for education from their parents or guardians. Foster youth reported more discipline problems in school and experienced more educational disruption due to changing schools. They were significantly less likely to be in a college preparatory high school track. The adults in the lives of the foster care youth were less likely to monitor homework. These findings have important implications for child welfare policy and practice.     

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.     

Do Foster Parents and Care Workers Recognize the Needs of Youth in Family Foster Care with a History of Sexual Abuse?

Children in family foster care have the right to participate in decisions regarding their life, however, adults often advocate on behalf of children. This Q methodological study explored whether shared perspectives among foster parents and care workers resemble shared perspectives of youth regarding the psychosocial needs experienced by youth with a history of sexual abuse. Participants sorted a set of statement cards according to what they thought was most important for youth. By-person factor analyses examined how the Q sorts of foster parents and care workers related to those of youth. The results showed that foster parents mostly recognized the group of youth who value an instrumental relationship with their carers, while care workers mostly recognized the group of youth who value support of both foster and birth parents with regard to their preparation for independent living. The two youth groups characterized by ambivalence and autonomy were barely recognized. Results are discussed in light of the expected roles of foster parents and care workers, and youth’s contact with birth parents. Lastly, this study highlights the importance of youth participation, because youth offer unique and varying perspectives about their needs.     

On their own: The experiences of youth after foster care

This study used multiple means to identify 55 young adults who had left foster care in recent years. The young adults who had all emancipated from foster care under the auspices of social services were most often identified by former foster parents, social workers, or other foster youth. This sample of former foster youth are often struggling with ill health, poor educations, severe housing problems, substance abuse, and criminal behavior. Yet the youth in this sample may be surviving more ably than the many former foster youth whom we could not reach.The author thanks Rich Clarke, Pat Lovelock and Sharon Ikami. This study was prepared under Contra Costa County Contract #20-719.     

Factors associated with provision of instrumental social support for physical activity in a foster parent population

PurposeTo examine demographic and psychosocial factors associated with foster parent’s provision of instrumental social support for physical activity among foster youth.MethodNinety-one foster parents completed surveys to assess perceptions of foster child physical activity (activity level, enjoyment, and coordination), five psychosocial variables from Theory of Planned Behavior (positive and negative behavioral beliefs, normative beliefs, perceived behavioral control) and self-efficacy to provide instrumental social support for youth physical activity. Associations between these variables and instrumental social support were determined using multiple regression analysis.ResultsMore supportive normative beliefs and higher self-efficacy for providing instrumental social support, and length of time a foster child resided in the foster parent household were significantly associated with greater provision of instrumental social support.ConclusionAmong foster parents, the perceived social expectations about providing instrumental social support and self-efficacy to provide instrumental social support for physical activity appear to be important influences on foster parent provision of instrumental social support for youth physical activity.     

The Family and Social Networks of Recently Discharged Foster Youth

Many youth leave foster care with disrupted relationships with family and others in their social networks. Previous research has documented the severe adversity that former foster youth face in the transition to young adulthood. Some of these difficulties are at least partially related to a lack of social support that results from frayed relationships. The purpose of this research was to examine the role that social support plays in the transition to adulthood. It was hypothesized that foster youth with higher levels of social support would make more successful adaptations to early adulthood than youth without that support. Ninety-seven former foster youth were followed for 2 years. Youth reported low levels of “feeling close to parents,” but higher levels of “closeness” were expressed for other relatives. Findings were mixed. Organizational involvement and having many “close” friends were associated with better outcomes. On the other hand, family contact and family support was inversely associated with resiliency. The implications of these findings are discussed.     

Nonviolent Resistance: Helping Caregivers Reduce Problematic Behaviors in Children and Adolescents

In this review, the principles of nonviolent resistance (NVR) and studies examining its acceptability and efficacy are reviewed. Originating in the sociopolitical field, NVR has been adapted for numerous settings including parents of youth with externalizing and other problems, foster parents, teachers and school personnel, and caregivers of psychiatric inpatients. NVR has also been applied to reduce accommodation of highly dependent adult children and to improve novice driving habits. The principles of NVR include refraining from violence, reducing escalation, utilizing outside support, and maintaining respect for the other.     

Racial/Ethnic Disparities in Mental Health Service Use for Older Foster Youth and Foster Care Alumni

Studies have shown that foster care alumni have disproportionally high rates of poor mental health outcomes compared to the general population. The purpose of this study was to examine differences in mental health service use for Latino, African American, and White youth while in foster care and upon exit from the foster care system. Secondary data were used to identify youth 1 year prior to exiting the foster care system (N?=?934) and 1 year after exit from the foster care system (N?=?433). Racial/ethnic disparities in mental health service use upon exit from the foster care system were found, with Latino youth using the least amount of services after foster care exit. Racial/ethnic service disparities in type of services used were also found. Findings suggest that a lack of support (e.g., mandatory or voluntary) may be significant in overcoming challenges in the continuation or disruption of services.     

Financial well-being in family-based foster care: Exploring variation in income supports for kin and non-kin caregivers in California

Kinship foster parents have the same responsibilities as nonrelative foster parents and are held to the same standards of rehabilitative care. Nonetheless, their rights to financial supports and their access to other services vary across states depending on the federal eligibility of the child, and/or the licensing criteria caregivers may or may not meet. We know little about the financial supports, well-being, or services of kinship caregivers receiving differential payment schemes and whether or not these financial supports and services make any difference. More fundamentally, in states that operate two- or more -tiered funding schemes for kinship foster parents, we currently cannot even estimate what proportion of kin caregivers receive more, less, or nothing from the government, even though all are entitled to something. Kin and non-kin caregivers in two California counties responded to a written survey focused on the financial wellbeing and income supports available to families. Sources of support were associated with the availability and utilization of other child welfare services for caregivers and for children.     

Linking structure, process, and outcome to improve group home services for foster youth in California

The California Youth Connection obtained funding from two foundations to evaluate the performance of group homes serving foster youth in Alameda County, California, in order to inform state policy-making. The evaluation team initially included 14 foster youth that personally experienced group home living. Three inter-related aspects of service were studied: structure, process, and client outcomes, specifically residents' increase in developmental assets leading to the ability to transition successfully to independent living by the age of 18 years. Data were collected at 32 group homes from 127 residents and 72 staff members using three questionnaires. Both structural and process aspects of services influenced residents' satisfaction with services. However, only the process of care predicted changes in residents' developmental assets. State-level regulatory agencies learned from these results that auditing only structural aspects of services was not sufficient to promote effective services. Further, one structure item and two process items were identified as less consistently occurring in the group homes: timely distribution of clothing allowances, healthy communication between staff and youth, and staff support of regular exercise for the residents. Focusing on these aspects of service first should promote more change in outcomes and satisfaction for foster youth residing in group homes.     

Working parent friendly schools: the role of school instrumental support in work–family conflict

Instrumental support can foster or ameliorate parent experiences of work–family conflict. Based on theories relating social support to stress, a framework for considering how school support affects work–family conflict is proposed and tested. Parent experiences of instrumental support (school schedules, school service provision, and staff accessibility) and school demands on parents (volunteer and homework involvement) were investigated in relation to levels of work–family conflict. Work demands were related to both family-interference-with-work and work-interference-with family; family demands related only to time-based family-interference-with-work. Perceptions of school scheduling as supportive were related negatively to both time- and strain-based work-interference-with family, whereas perceptions of school transportation services were related to both time- and strain-based family-interference-with-work. No buffering effects of these types of support were found. Implications for how community organizations can play a role in ameliorating work–family conflict are discussed.     

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.     

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.     

Foster youth evaluate the performance of group home services in California

In 2003 foster youth employed by a foster youth advocacy organization suggested that an evaluation of group home services to foster youth be conducted in Alameda County, California. This report presents the development and conduct of this evaluation study; how funding was obtained; and how foster youth were hired, trained, and employed to produce a timely and informative evaluation of the performance of 32 group homes where some of the foster youth formerly resided. The results of the study are described in another paper. This report contributes to evaluation practice in the newly emerging field of youth-led evaluations. The achievements of this project in utilizing group home clients to evaluate services with which they were familiar may stimulate other evaluators to develop similar projects, thereby enriching the development of our youth and promoting more informative evaluation findings.     

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.     

A cost–benefit analysis of transitional services for emancipating foster youth

Over 24,000 youth “aged out” of the nation's foster care system in FY 2005. While independent living programs and other services are available to foster youth, and almost all states allow dependency courts to retain jurisdiction of foster youth beyond age 18, outcomes for former foster youth are disturbing. This paper describes a program to address these challenges by providing extended foster care benefits and support to former foster youth from their 18th to 23rd birthdays. A detailed cost–benefit methodology documents expected costs and key benefits of the program. According to this cost–benefit analysis, a program providing funding and guardian support for former foster youth is projected to result in net benefits to the State of California over the 40-year careers of participating former foster youth. The program, if successful for all youth, would increase lifetime earnings and taxes paid due to increased education and would lower use of TANF and prison, resulting in a benefit–cost ratio of 1.5 to 1, using discounted present value dollars. Even at 75% success, the ratio is 1.2 to 1, showing a net benefit to society. This methodology can also be used to assess the costs and benefits of similar programs.     

Testing the ‘overburdening’ hypothesis: Do work and school attendance together place youth transitioning from care at risk for negative housing outcomes?

Youth aging out of the foster care system are often placed in the precarious position of both providing for themselves financially and securing their own housing at a young age. Many also choose to take on the difficult tasks of school attendance and work simultaneously during this challenging time in their lives. The current study tests the ‘overburdening’ hypothesis that examines whether taking on the demands of work and school at the same time could overwhelm and actually hinder the healthy development of youth as they transition from foster care. This question was addressed using longitudinal administrative data from 2913 youth enrolled in a transitional living program at a national nonprofit organization serving youth aging out of foster care in five states between October 2010 and July 2014. Random-intercept and lagged regression models were used to examine the association between school attendance, employment, and housing insecurity. Individually, both school attendance and employment placed youth at decreased risk for housing insecurity and little evidence emerged to support the ‘overburdening’ hypothesis. Results from lagged models suggest that the single best predictor of housing insecurity is a previous episode of housing insecurity. The evidence presented here suggests that for some youth, the decision to attend school and find employment may be a symptom, rather than a cause, of their housing insecurity. Results highlight the importance of practitioners' use of research evidence together with sound clinical judgment to support youth as they navigate the challenging developmental task of transitioning into adulthood.     

Foster parent and teacher assessments of youth in kinship and non-kinship foster care placements: are behaviors perceived differently across settings?

With a growing number of children living in kinship foster care, it is important to understand how youths are faring in kinship care compared to youths in non-kinship care. In the present study, we first evaluate teacher ratings of problem behaviors exhibited in school by youths in kinship and non-kinship foster care. We then examine whether correspondences between parent and teacher ratings of problem behaviors across home and school settings differ by kinship status. The youths in the study represent an ethnically diverse sample (N = 185), with significantly more children of color in kinship placements. Across the majority of problem behavior scales on the Teacher's Report Form (TRF: Achenbach, 1991), teacher perceptions of youth behavior did not differ significantly according to kinship or non-kinship care placement. Furthermore, the youths in this study had elevated scores relative to general population norms on only a few TRF problem behavior scales. A sub-sample (N = 122) with foster parent assessments on the Child Behavior Checklist (CBCL: Achenbach, 1991) permitted comparison of perceptions of youth behavior across the home and school settings for youths in kinship and non-kinship placements. Correlations between the TRF and CBCL composite scale scores (internalizing, externalizing, and total problem behaviors) indicated slightly higher agreement between teacher and foster parent ratings for kinship placements. The non-kinship foster parents reported higher levels of problem behavior at home relative to school. The paper interprets these results and suggests implications for practice and future research directions.