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.     

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.     

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.     

Temporary care foster parents: Motives and issues of separation and loss

Temporary care foster parents, that is, foster parents who specialize in the care of infants, provide an invaluable service to child welfare agencies. They are a unique group among foster parents, and it is important to understand what motivates them to care exclusively for infants. In infant care, separation and loss experiences are repeated more often than in any other kind of foster care. The article identifies five motives most often seen in temporary care foster parents and explores as well the impact of repeatel separation and loss on the foster family. Implications for practice are suggested.     

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.     

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.     

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.     

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.     

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.     

Fostering cultural development: Foster parents' perspectives

Given the increased number of children from racialized groups requiring foster care and the decreasing number of foster parents from racialized groups, transcultural foster placements are on the rise. Addressing racial and cultural diversities within the context of transcultural foster care placements is one of the most pressing dilemmas of contemporary child protection practice, in Canada. In this qualitative exploratory study, the perspectives of regular non-kinship foster parents in two Canadian provinces, who provide foster care to children and youth from racialized groups, were explored through open-ended semi-structured interviews. Participants consisted of nine foster parents, between the ages of 30 and over 60 years old, who were asked to share their experiences regarding transcultural foster care placements. The results of this study indicated foster parents were culturally receptive and ‘fostering cultural development’ in their homes as well as their respective communities.     

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.     

South African social workers' knowledge of attachment theory and their perceptions of attachment relationships in foster care supervision

Despite the prominence of attachment theory in international foster care literature and the importance of attachment relationships in successful foster care, attachment theory and practices do not feature prominently in South African foster care research. Against this backdrop, we interviewed twenty South African social workers' about their knowledge of attachment theory and their perceptions of attachment relationships in their own foster care work. Thematic analysis was used to analyse the interviews. We found that the social workers had limited knowledge of attachment theory and interventions; experienced most biological parents as unmotivated to improve their circumstances and attachment relationships with children; indicated that family reunifications were rare occurrences; reported foster parents were mostly kin; and experienced constraining contextual factors that hindered optimal consideration of attachment relationships in foster care supervision.     

The relationship between re-incarceration and their own childhood foster care experience of women

Using matched state administrative records of women in the Illinois state prison system, we investigate whether incarcerated women with foster care experience during their early (aged 10 to 14) and late (aged 15 to 18) teens do better or worse in re-incarceration rates compared to female counterparts who went to prison but had no foster care experience. We find that women with the early-teen foster care experience have higher rates of re-incarceration than women without foster care, regardless of whether they were reunited with their parents. The adverse association between the first foster care placement during early-teens and re-incarceration is particularly stronger among former female inmates with low education or history of drug addiction than others. We conclude that incarcerated women with foster care experiences, especially in their early teens, need more attention and extra support from the appropriate institutions upon their release. In addition, it seems that foster care can work as a strong signal of possible re-incarceration among women with low education and history of drug addiction.     

An exploratory study of self-esteem and quality of care of 100 children in foster care

This small-scale research study examined children's perceptions of themselves, their situation, career aspirations and hopes for the future. One hundred San Francisco children in foster care were interviewed and filled out a questionnaire. 50 of the children lived in foster family care; 50 in group homes. The Department of Social Services in San Francisco cooperated in executing this study. Children ranged in ages from 8–18. Both male and female children participated. The questionnaire contained two standarized tests, Coopersmith Self-Esteem Inventory and Parks Career Role Inventory. A section was written by the authors to examine how children in care spend their time, and how they feel about where they live and their foster care status. The last part, an open-ended section asks them which foster care setting they liked best, why, and what they would suggest to improve the foster care system. An additional question “Why do you think you are in foster care?” was designed to elicit the children's understanding of why they lived in foster care rather than their biological home.     

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.     

Fictions and Facts about Parents and Parenting Older First-Time Entrants to Foster Care

Knowledge about the parents of older first-time entrants into foster care is embedded in fictions created by media images, anecdotal stories of professionals in the child welfare system, as well as reports and observations of youths who have experienced foster care. Even though there are caring and effective nonrelatives who are foster parents, the public perception of non-relative foster parents is sometimes quite negative. In order to separate some of the facts from some of the fictions about the parents/caregivers of older first-time entrants to foster care, this article will describe the parents and relative caregivers (grandparents and others) of older first-time entrants to foster care in an urban public welfare agency by examining maltreatment data.     

Decision-making skills of emerging adults aging out of foster care

This study examines the decision-making skills of emerging adults that have aged out of foster care and transitioned to independent life. Emerging adults face a wide variety of life-direction determining decisions and those aging out of foster care experience even more significant transitional issues. Youth aging out of foster care may lack the requisite decision-making competencies for coping with these challenges. This study compares the decision-making skills of foster care alumni to a group of similar individuals who were not involved in the child welfare system. Using a validated quantitative survey instrument, 29 foster care alumni and 29 demographically similar non-fostered participants described their general decision-making skills and elaborated on their personal experiences of reaching the age of majority. Statistical analyses of group differences indicate foster alumni score lower on overall decision-making skills and the decision-making process. In anecdotal comments, foster alumni tended to focus on their experience of leaving the foster system, while the non-fostered population elaborated on what it was like to become a legal adult. This study suggests that youth aging out of the foster care system may need support with the aspects of decision-making relating to the generation of alternatives and inferential reasoning about decision consequences as one way to augment and improve the transitional services designed to prepare foster youth for independent life.     

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.     

Foster care in India: An exploratory survey of the community perceptions and prospects for implementation of foster care in a developing nation: A study in Udaipur,Rajasthan, India

This study was conducted in order to assess the prospects for implementing foster care as an alternative to the dominant system of institutional care available to orphaned and abandoned children in India. 653 families in urban Udaipur participated in a mixed-methods based assessment of receptivity to foster and adoptive care. The majority of those who responded reported receptivity to the idea of foster care as an alternative to institutional care. However, analyses demonstrated that respondents also perceived barriers to implementing systematic foster care, particularly with regard to family recruitment due to problems securing family and community support for participation. The results are discussed in light of governmental calls for non-governmental organization and other stakeholders to institute alternatives to foster and adoptive care. The results of this study have applied significance for organizations and practitioners seeking to implement care alternatives for orphan and abandoned children in India.