Foster parent training programmes for foster youth: a content review

Foster parent training is a well‐recognized component of providing quality care in child welfare. Well‐trained foster parents can improve placement stability, reduce behavioural problems and encourage successful reunification or adoption. A review of the foster parent training programmes can provide a better understanding of the current state of foster parenting training and inform future practice and policy‐making. This review examined published and unpublished research on foster parent training conducted from 1970 to 2014 and provided an overview of the structure and content of 22 foster parent training programmes. Common patterns in the content and structure of foster parent training programmes are identified and discussed, highlighting trends towards multi‐session in‐service training with eclectic content. The development of new training programmes with strong theoretical grounding that train foster parents on specific behavioural skills is recommended.     

Searching for effective interventions for foster children under stress: a meta‐analysis

Foster children experience a lot of stress because of their life histories and changes in their family circumstances, such as foster care placement. It is important that foster parents recognize the early signs of stress in foster children and learn how to act in a non‐threatening and understanding manner. Family‐based interventions may help in this. In this paper, we report on a meta‐analysis of studies (n= 19) of the effectiveness of such interventions. All studies used a pre‐test/post‐test design. Both problem behaviour in foster children and the parenting skills of foster parents improved by 30%; however, none of the interventions were specifically intended to help young children (<4 years) to cope with stress. The importance of interventions for young foster children is discussed, as well as the necessary elements these interventions should include.     

Predictors of behavioural problems in foster children: the key role of impulsivity

Although several variables have been reported to be associated with behavioural problems in foster children, few studies have sought to establish more precisely the extent to which these variables may explain problematic behaviour. The main aim of this study is to determine the extent to which certain variables may predict behavioural problems shown by foster children. Participants included 104 foster children and their respective foster families. Multiple linear regression analysis revealed that the following variables predict behavioural problems in foster children: impulsivity/attention deficit in the child, level of burden in the foster carers, rigid or authoritarian parental discipline, and criticism/rejection by the foster parents. The model explained 46% of the variance in behaviour problems, with the greatest predictive power (29%) corresponding to the variable ‘impulsivity/attention deficit’. The results show that impulsivity/attention deficit is the most powerful predictor of behavioural problems in foster children. This is consistent with the findings of various studies that have reported an association between a lack of inhibitory control and problematic behaviour.     

Foster care placement breakdown in the Netherlands and Flanders: Prevalence,precursors, and associated factors

Family foster care is the option of choice for children in need of out‐of‐home care in Flanders and the Netherlands. Foster care is however a vulnerable intervention, and questions can be raised as to its efficacy. Although the literature on placement breakdown has made significant progress during the last years, empirical knowledge regarding breakdown in Flanders and the Netherlands remains scant. Consequently, this study aimed at investigating prevalence and precursors of breakdowns in long‐term foster care, the duration of placement before breakdown, and the association of child and placement characteristics with breakdown. Case files of 271 Dutch and 309 Flemish foster children were analysed with a coding scheme designed for this study. After 6 years, 398 placements had terminated: 169 placements broke down and 229 placements ended positively. Placements broke down mainly because of behavioural problems of the foster child, foster parents' parenting problems, and conflicts between birth and foster parents. Foster children with behavioural problems, older foster children, foster children denied treatment, and foster children in care because of sexual abuse were more at risk of breakdown. Assessing these factors is important when evaluating the appropriateness of a family foster care placement.     

Contact visits between foster children and their birth family: the views of foster children,foster parents and social workers

It has been argued that contact visits between foster children and birth parents can help maintain attachment bonds and support the child's development. However, some research suggests that such visits can be detrimental. This study analyses the characteristics of contact visits and examines children's perceptions of the emotional relationship they have with foster carers and their biological parents. Participants were 104 non‐kinship foster children and their respective foster carers and social workers. Fifty‐six of these foster children had contact visits with their birth parents. Foster children rated the quality of their relationship with foster carers and birth parents using the Affect Scale. Foster children, foster carers and social workers all completed the Evaluation of Contact Visits Questionnaire. Results showed that (i) a high proportion of children had no contact visits; (ii) the contact agreement was often not fulfilled; (iii) many visits were rated as poor quality; (iv) foster carers' evaluation of visits was more negative than that of both foster children and social workers; and (v) children who experienced poor‐quality visits and perceived less warmth and more criticism/rejection from their parents. These results highlight the need to improve contact visits by developing intervention strategies targeted at all those involved.     

Adopted foster youths' psychosocial functioning: a longitudinal perspective

Researchers have long debated whether adopted youth manifest disproportionate levels of psychological dysfunction compared with non‐adopted youth. Yet, missing from the debate has been a clear understanding of the specific subgroups of adopted youth who may develop behaviour problems and of the risk factors associated with various vulnerable populations. This longitudinal study examined one subpopulation of adopted youth – former foster children – in order to determine their immediate and long‐term functioning, particularly in comparison with their adopted non‐foster care peers. The central goal of this study was to ascertain the prevalence of behavioural problems in adopted foster youth compared with adopted non‐foster youth and to chart the longitudinal course of their behavioural problems. Participants included adopted foster youth (n = 293) and adopted non‐foster youth (n = 312) from a statewide sample of adopted youth, aged 2–18 years. Data were collected from the adoptive parents at approximately 2, 4 and 8 years after adoption. Adoptive parents rated youths’ functioning with the Behaviour Problems Inventory. According to parental report, a striking number of the foster youth displayed behaviour problems, although the non‐foster care group of children also displayed noteworthy levels of problem behaviours. The rates of behaviour problems in both groups far exceed what is observed in the general population of children.     

An investigation of foster parent training needs

The training foster parents receive in America, pass the initial training required to certify them to take children into their homes, is not standardized. The Foster Care Independence Act of 1999 (H.R. 3443) requires prospective foster parents to be trained, but it provides only general guidelines for the training content. The training offered differs by state. This research examines what a group of foster parents attending a state foster parent association conference felt they needed in the area of training, to help them fulfil their role. Quantitative and qualitative data were collected. Foster parents were surveyed and ranked their training needs based on 10 pre‐identified needs. They also responded to an open‐ended question about their training needs. Foster parents ranked training to enhance their ability to help the child adjust in their homes and manage challenging behaviours as most needed. The qualitative data suggested that foster parents have additional needs and some are not related to training, such as the need for respite services.     

Mothers and fathers in treatment for methamphetamine addiction—Parenting,parental stress,and children at risk

Parents addicted to methamphetamine (“crystal meth”) are likely to be impaired in meeting parental responsibilities, and the developmental settings can be highly disadvantageous for children. Therefore, parenting by methamphetamine‐addicted mothers and fathers needs further exploration, while considering the impact on children affected by parental substance use. In our study, we analysed parenting practices and parental stress as well as children's behavioural problems using standardized assessments. The sample consisted of 87 methamphetamine‐addicted parents in recovery. We obtained data on parents' current substance use and on their psychological distress. Multiple regression analysis was performed to identify predictors of children's overall problems. Parents reported high levels of parental and psychological distress, even after achieving abstinence. Especially depressive perceptions of parenthood appeared problematic. While recovering from methamphetamine addiction, parents exhibited a precarious psychosocial situation and problematic parenting behaviour. Dysfunctional parenting practices were evident in both indifferent and overreactive tendencies. Children were at risk of behavioural and emotional problems. Variables associated with parenting showed significant predictive value for children's overall problems, beyond current substance use, and psychological distress. These findings are discussed in terms of a family‐oriented perspective in order to promote parenting capabilities of methamphetamine‐addicted parents and to prevent problematic development of their children.     

What changes in ‘parenting’ approaches occur over the course of adolescent foster care placements?

An overview of the parenting skills and strategies utilized by foster carers looking after adolescents was given in an earlier paper. This paper focuses specifically on the relationship between the behaviour of fostered adolescents and the quality of parenting provided by the carer. In particular, the paper considers the consequences of situations in which fostered young people have a detrimental impact on other children within the foster family, as this was an especially difficult situation for foster carers to manage. Similarly, foster carers appeared to find it difficult to maintain good parenting skills with young people who were at risk due to their own sexual behaviour although, conversely, caring for a young person whose sexual behaviour put others at risk was connected with improved parenting. The quality of parenting provided by the foster carers was also influenced by the level of stress they were experiencing, with increased levels of stress leading to poorer parenting of the fostered adolescent.     

Child of two worlds: How foster care workers perceive their skills in dealing with worldview differences in foster care

Foster children often encounter worldview differences between their foster family and their birth family, for example, when participating in religious activities and practices. Foster children not only have a right to continuity in upbringing but also consistency in worldview, culture and language. Good co-parenting relationships are important for their identity development. For these reasons, foster care workers are entrusted with the task of supporting the triadic relationship of the foster child, birth parents and foster parents in dealing with worldview differences. Based on in-depth interviews with foster care workers (n = 16) six skills in dealing with worldview differences can be distinguished: (1) basic knowledge of worldviews and identity formation; (2) empathizing with the other; (3) inquisitiveness to discover what is essential for the other; (4) initiating worldview conversations and keeping them going; (5) fostering self-reflection in worldview; and (6) manoeuvring between and monitoring all interests. It is helpful if birth parents are well-informed in advance about the impact of worldview differences and if foster care workers and foster parents are aware of the identity and developmental needs of foster children to explore the worldview of the foster family and the birth family.     

Lesbian and gay individuals' path into foster parenting in Norway—Barriers and facilitators at the person and system levels

Growing numbers of lesbian, gay, bisexual, transgender, questioning (LGBTQ) people are becoming foster parents in several western countries. The LGBTQ perspective on the child welfare system has received little attention in practice, research and policy. Despite their increased rights, LGBTQ foster parents continue to face challenges related to fostering. Knowledge is needed on LGBTQ individual perceptions of the process of becoming foster parents, including barriers and facilitating factors. This paper reports on the experiences of 13 gay or lesbian foster parents in Norway. The study shows a lack of knowledge about the possibility of becoming foster parents due to lack of information directed at them as a minority group. Participants felt vulnerable and experienced “minority stress” before encountering the child welfare system, while mainly experienced the encounter with the staff as good and respectful. Although several valued being treated “like everyone else” by the system, others questioned why LGBTQ-specific parenting issues were not raised and discussed. Apart from lack of information, the process towards foster parenting seemed mostly hampered by participants' own assumptions that sexual identity would be a barrier and to some extent biological parents' refusal. The study suggests that foster care and child welfare services would benefit from information in recruitment of foster parents, aiming at being more inclusive. Furthermore, we address gender and sexuality diversity related to foster care work and highlight the strengths and challenges it may offer.     

Finding a routine that works: A mixed methods study of foster parents

Although it is well established that daily routines are important for family well‐being, very little research has been done on how foster parents establish and integrate new foster children into family routines. We used a mixed‐methods, cross‐sectional design, focused on qualitative results to explore how foster parents utilize routines. Twenty‐three foster parents were recruited from a private child welfare agency in a large city in the United States. Surveys were administered to obtain demographic information, overall home atmosphere, and the importance and prevalence of different routines, including mealtimes and sleep schedules. Nine foster parents received a semistructured interview with open‐ended questions. Foster parents reported that routines such as bedtimes, mealtimes, chores, and homework were essential to family well‐being. Because both parents and children had to adjust to living together in an intimate family environment, it was important to establish routines quickly. Foster parents modified routines depending on their child's needs. Along with typical family routines, foster parents reported additional tasks, such as visits with biological parents, meetings with caseworkers, and trainings that affected their family schedule. Results imply that training foster care workers and foster parents about routines can engender stability and emotional belonging for children.     

KEEP foster-parent training intervention: model description and effectiveness

In this paper, we describe the development and history of the Keeping Foster Parents Trained and Supported (KEEP) foster-parent training intervention. KEEP intervention represents a modified version of the Multidimensional Treatment Foster Care intervention developed by interventionists at the Oregon Social Learning Center and is designed to provide training and support for children ages 5–11 in regular foster care. We also report on the initial findings from a programme of research focused on determining the effectiveness of the intervention. Thus far, the results indicate that the intervention is effective in reducing child behaviour problems and that the effects of the intervention are mediated through changes in parenting behaviour. There is also evidence that the KEEP foster-parent training intervention increases the chances of a positive change of placement (e.g. child reunited with biological parents) and mitigates the negative risk-enhancing effect of a history of multiple placements. We conclude with a discussion of unanswered questions and directions for future research.     

Physical and mental health changes in aging foster parents: Do child behavioural problems hasten declines?

This study examined foster parent physical and mental health over time. It was hypothesized that increased severity and frequency of child behavioural problems, whether externalizing or internalizing, would be associated with poorer health over time, especially for foster parents ≥60 years of age. Data from the baseline and Wave 2 interview of the 2010 National Survey of Child and Adolescent Well‐Being were used. The final analytic sample included kin and nonkin foster parents who had custody of a foster child for both waves of data collection (n = 962). Ordinary Least Squares regression models with lagged dependent variables showed that foster parents ≥60 had deteriorating physical health over time, but caregiver age alone had no association with worsening mental health. However, parents ≥60 caring for children with externalizing behavioural problems had significantly improved physical health. Mental health of parents ≥60 significantly diminished if child externalizing or internalizing problems worsened. Findings indicate that for aging foster parents, externalizing child behaviours may stimulate physical activity and improved physical health, yet any type of child behavioural problem can deteriorate mental health functioning.     

Assessment of problem behaviour by foster parents and their foster children

This study investigates the level of agreement between foster parents and foster children about problem behaviour and how this is associated with the breakdown of a foster care placement. The study took a sample of foster parents and their foster children (n= 60), who were aged 11–17 years, and analysed the severity of problem behaviour displayed by the foster children within 3 months of placement in the foster family and a year and a half later. The level of agreement was established with the intra‐class correlation coefficient, which represents both the differences in scores and the differences in ranking. This coefficient shows that there is a statistically significant difference in the level of agreement on the Internalizing Problems scale of the Child Behaviour Checklist between the placements that broke down and those that continued. The level of agreement is associated with the severity score, which in turn is associated with the outcome of the foster care placement. To avoid placement breakdown, problem behaviour should also be assessed from the perspective of the foster child.     

Promoting quality parent–child visits: the power of the parent–foster parent relationship

Parent–child visits for children in foster care are often fraught with tension, particularly between foster parents and parents. Qualitative interviews with 42 social workers, foster parents and parents revealed more positive relations when foster parents recognized parent fears and shared power over parenting decisions with them. Social workers can support the process by clarifying visiting expectations and encouraging foster parents to reach out to parents.     

Children in permanent foster care in Sweden

The Swedish child welfare system has no permanency planning as we know it from, for example, the United States and Great Britain. Regardless of whether the child is placed in foster care with or without the parents’ consent, the law requires semi-annual reviews and there is no time limit set on reunion. Nevertheless, there are foster children who remain in the foster home throughout the whole of childhood, on terms similar to permanent foster care or adoption. This paper concerns a selection of findings from a research project entitled ‘Is there a difference in being a foster child?’. Foster children aged 10–11 were interviewed three times and the children’s perspective was focused on, complemented by the perspective of their foster parent(s). When interviewed about their relationship to their natural family as well as to the foster family, and about having a sense of family belonging and expectations for the future, 11 of the 22 children perceived their stay in the foster home as permanent and regarded themselves as belonging only to the foster family, although all of the children had contact with their birth parents. The study concerns the children’s views as well as those of the foster parents. The perception of permanency in the absence of a legal option of permanency is discussed.     

Growing up in foster care: providing a secure base through adolescence

As the UK Government White Paper, Care Matters: Time for Change , suggested, foster children need the care system to provide them with good quality foster family care that will help them through childhood to success and fulfilment of their potential in adult life.
This paper draws on the third phase of Growing Up in Foster Care , a longitudinal study of 52 children in planned, long-term foster care (1997–2006). It aims to increase our understanding of the transformational power of foster family relationships over time and particularly in adolescence. It shows how a secure base parenting model, using concepts from attachment and resilience, can be applied to foster care of adolescents. The paper uses case material to demonstrate each dimension of this secure base model and to emphasise how, even when adolescents have had stable and effective placements, they are likely to need support through into adulthood.     

Sleep among youths in foster care: Associations with potentially traumatic events,PTSD and mental health

Among maltreated youth in foster care, little is known about frequency of sleep problems and its association to potential traumatic events (PTEs) and mental health. Among youths in foster care, we examined: (1) sleep patterns, difficulties initiating and maintaining sleep (DIMS) and related functional impairment; (2) whether exposure to PTEs, symptoms of post‐traumatic stress disorder (PTSD) and general mental health problems are associated with DIMS and related functional impairment, controlling for age, gender and time in foster care; and (3) whether PTSD and general mental health problems mediate the association between PTEs and DIMS. Foster youths in Norway (n = 299) completed a survey on sleep behaviour, the Child and Adolescent Trauma Screen, and the Strengths and Difficulties Questionnaire. Overall, 53.2% reported DIMS. For 82.1%, these sleep problems had lasted 3 months plus. Increased PTEs, PTSD and general mental health problems were all associated with increased DIMS score. Increased rate of PTEs was associated with decreased sleep duration. PTSD and general mental health problems partially mediated the association between PTEs and DIMS. Youth in foster care are at high risk of sleep problems, related to traumatic experiences and mental health problems. Treatment of PTSD may improve sleep problems among maltreated youth.