Needed services for foster parents of sexually abused children

Foster parents with little preparation and short notices must often deal with severe emotional and behavioral difficulties of sexually abused children. This article reports on a survey of the services provided to foster parents who care for sexually abused children in a large city in the Northeast United States. Agency directors, social workers and foster parents were asked to respond to mailed questionnaires. The results indicated that foster parents consistently reported that they received less extensive educational and support services than were reported by social workers and directors of foster care agencies. All groups recommend further expansion of training programs for foster parents of sexually abused children.This paper was presented at the Temple University Chapter, Phi Delta Kappa, Philadelphia, PA, April 5, 1990.Ms. Egan is a Research Assistant; Ms. Cossett and Ms. Auletta were studients from Smith College School for Social Work.     

Health and mental health services for children in foster care: the central role of foster parents

It is well documented that children enter foster care with special health and mental health needs and, while in care, those conditions are often exacerbated. However, less attention has been given to foster parents who have the most contact with these children. Results are presented from a national study on the developmental, health and mental health care needs of children in foster care that included foster parents' perspectives and observations. Their role in improving child well being is explained and recommendations for policy, practice and advocacy also are included.     

Decision-making around psychotropic medications for children in foster care: Perspectives from foster parents

Background and objectiveChildren in foster care have complex mental health needs and receive high rates of psychotropic medications. Rarely can foster parents make legal decisions about treatment, yet they are intricately involved in the child's life and responsible for the child's safety and well-being. We aimed to conduct the first study of foster parent perspectives on decision-making relevant to the use of psychotropics with children in foster care.MethodsWe conducted semi-structured phone interviews with 13 parents in a small northeastern state who had fostered a child receiving psychotropics in the past 5 years. The state child welfare agency sent information about the study via email to all foster and adoptive parents for whom they had email contact. Interviews queried parents' knowledge and attitudes toward psychotropics, engagement in decisions, and recommendations for the decision-making process. Interview responses were coded and synthesized using mixed inductive and deductive methods in Dedoose software.ResultsChildren came into care on an average of four psychotropics. Parents reported receiving little information about the medications and finding information on their own. Parents acknowledged the potential benefits of medications, yet attitudes were largely against their use. Internal and external pressures for and against the use of medications were described. Many parents felt left out of the decisions and recommended team decisions.ConclusionsEfforts to improve foster parents' knowledge of medications, side effects, and monitoring, as well as team decision protocols, are sorely needed to improve decisions for this population.     

Implementing critical health services for children in foster care.

This article reports recommendations that were developed at the California Conference on Health Care for Children in Foster Care, organized to discuss implementation in the state of CWLA's Standards for Health Care Services for Children in Out-of-Home Care. Programs and legislation developed in the state are also discussed.     

Extending transitional services to former foster children.

This article describes what a private agency expended while addressing the transitional needs of former long-term foster youth and examines the association between expenditures and adult outcomes. Not all young adults accepted supports extended to them. In the sample, 41% of the young adults incurred expenses after age 19. Of those using supports, about two-thirds incurred expenses for higher education, and slightly fewer for continued housing support. Median expenses were generally stable or declining between ages 19 and 21, although almost all declined after age 22. Young adults who received extended supports tended to be better off at follow-up, although some troubled young adults used extensive, expensive services.     

Genetic services for foster children: an unmet need?

The genetics revolution has significant ramifications for child welfare. An overview of genetic disorders and of the expanding array of genetic services is given. Findings of an exploratory study of the proportion of children in out-of-home care in two cities who had diagnosed genetic disorders and who met criteria for referral to genetic services, and utilization of genetic services are presented. The findings suggest that genetic services that might be beneficial to foster children and their biological families are not being offered. Implications for foster care are discussed.     

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.     

Trauma-informed services for children with incarcerated parents

Children of incarcerated parents have often experienced not only the trauma of family separation, but also other forms of adverse events. Social workers can improve service delivery to this population by incorporating SAMHSA’s components of trauma-informed care (TIC). Translating TIC concepts into practice is an important but challenging goal for social work practitioners. The first half of this article reviews the literature about the effects of parental incarceration on attachment, stigma, physical and mental health, and intergenerational transmission of trauma. The latter half of the article applies principles of TIC by offering specific recommendations for conceptualizing cases through the lens of trauma and utilizing trauma-informed responses with these children.     

Evidence-based treatments for trauma among culturally diverse foster care youth: Treatment retention and outcomes

This study describes the implementation of three evidence-based treatments addressing traumatic stress symptoms within a wraparound foster care program in Illinois. Child–Parent Psychotherapy (CPP), Trauma-Focused Cognitive Behavioral Therapy (TF-CBT), and Structured Psychotherapy for Adolescents Responding to Chronic Stress (SPARCS) were implemented with a racially diverse sample of youth ages 3–18 at six agencies. Culturally sensitive adaptations were made to treatment approaches to improve client retention and outcomes. Data analyses revealed no racial differences in retention in the program and no differences in outcomes between minority youth exposed to the intervention and other participants. All three evidence-based treatments were effective in reducing symptoms and improving functioning among minority youth. Implementation issues, including challenges and culturally competent accommodations, are discussed.     

Fostering homeless children and their parents too: the emergence of whole-family foster care.

Children should not be placed in out-of-home care simply because their families lack the means to provide for their basic needs, yet this practice continues nationwide. A new program based in St. Paul, MN, gives county social service departments the placement option of whole-family foster care. The target population is adult parents and minor children without stable residences, where the children are at risk of placement in out-of-home care. Although the parents and children may have special needs, there are no safety risks that would necessitate separating children and parents. The program's design is described and policy questions discussed.     

Medical complexity and placement outcomes for children in foster care

ObjectiveMedical complexity threatens placement stability and permanency outcomes for children in foster care (FC). This study aimed to characterize for US children in FC: 1) medical complexity, using number of diagnosed types of disability as a proxy; 2) demographic and removal characteristics based on level of complexity; and 3) whether increasing levels of complexity were associated with foster care placement outcomes.MethodsThe analysis included children in FC, ages 0–21 whose disability status was clinically assessed and documented (n = 538,695). Using data from the FY 2014 Adoption and Foster Care Analysis and Reporting System, medical complexity was categorized (0–4 +) based on 5 disability types: emotional, hearing/vision, intellectual, physical, and other. Bivariate analyses (χ² tests, Kruskall-Wallis) compared the distribution of demographic and removal characteristics among complexity groups. Multiple logistic regression evaluated relationships between medical complexity and placement outcomes, including length of stay in FC, placement stability, and permanency.ResultsTwenty-three percent of the sample had 1 disability type, 7% had 2, 3% had 3, 1% had 4 +, and 67% had no disability. Children with increasing complexity were more likely to be older, older on FC entry, male, Black, non-Hispanic, placed in a group home or institution, have abuse, neglect, and/or child disability/behavior as reason for removal, and have poor placement outcomes.ConclusionChildren in FC with greater medical complexity are at risk for undesirable placement outcomes. By recognizing and addressing the unique needs of this vulnerable population, pediatric providers and child welfare staff may identify strategies to improve placement outcomes.     

Attitudes of special foster parents and residential staff towards children

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

The potential for successful family foster care: conceptualizing competency domains for foster parents

The potential to foster successfully starts with developing and supporting competency in 12 domains: providing a safe and secure environment, providing a nurturing environment, promoting educational attainment and success, meeting physical and mental healthcare needs, promoting social and emotional development, supporting diversity and children's cultural needs, supporting permanency planning, managing ambiguity and loss for the foster child and family, growing as a foster parent, managing the demands of fostering on personal and familial well-being, supporting relationships between children and their families, and working as a team member. This article describes each domain and reviews relevant research to help guide the assessment of practicing and future foster parents.     

Nonresident father support and reunification outcomes for children in foster care

Over the past decade an interest in fathers and their contributions to family stability and children's healthy development has heightened the attention paid within the child welfare field to identifying, locating, and involving fathers. The article presents findings from analyses of data on nonresident fathers and child welfare case outcomes for foster children. Using data available from a telephone survey of child welfare caseworkers, together with administrative data on case outcomes, a positive association between nonresident father support and reunification outcomes for foster children is shown. The sample of foster children with nonresident fathers who provided financial support, nonfinancial support, or both types of supports, were far more likely to experience a reunification outcome than children whose fathers did not provide these supports. The findings demonstrate associations between support and reunification but cannot demonstrate causality given the cross-sectional nature of the dataset. More research is needed to better understand the nature of nonresident father support in the lives of foster children, and the quantity and quality of interactions between mothers, nonresident fathers, and their children.     

Making parents pay: The unintended consequences of charging parents for foster care

Most families in the child protective services system also interact with the child support enforcement system. This study exploits a natural experiment in Wisconsin, created by the state's large regional variation in child support referral policy, to estimate a potentially important effect of child support enforcement on the duration of out-of-home foster care placement. The effect we examine is whether requiring parents to pay support to offset the costs of foster care delays children's reunification with a parent or other permanent placement. We find evidence of this unintended effect, which is important not only because longer foster care spells are expensive for taxpayers, but also because extended placements in foster care may have consequences for child well-being. Our results highlight the potential importance of cross-systems analysis and the potential consequences when the policies and fundamental objectives of public systems are inconsistently coordinated. We discuss the implications of our findings for child support and child protective services policy.