Natural mentoring among older youth in and aging out of foster care: A systematic review

Due to their histories of caregiver maltreatment, living instability, and potential attachment challenges associated with out-of-home care, older foster youth represent a particularly vulnerable group of adolescents at increased risk for a number of poor well-being outcomes. However, research supports the notion that a relationship with a competent, caring adult, such as a mentor, may serve protectively for vulnerable youth, and a nascent yet growing body of literature suggests that naturally occurring mentoring relationships from within youth's social networks are associated with improved outcomes among young people in foster care during adolescence and the transition to adulthood. This systematic review is the first to comprehensively identify, synthesize, and summarize what we currently know from nearly a decade of theories, concepts, and research findings pertaining to natural mentoring among adolescent youth in foster care. A bibliographic search of seven databases and personal outreach to mentoring researchers and practitioners through a national listserv yielded 38 English-language documents from academic sources and the gray literature pertaining to natural mentoring among older foster youth. We identified quantitative studies that have been conducted to test the theories and hypotheses that have emerged from the qualitative studies of natural mentoring among youth in foster care. Together, this literature suggests that natural mentoring is a promising practice for youth in foster care. Based on our findings from the systematic review, we make practice recommendations to encourage the facilitation of natural mentoring within child welfare contexts and outline an agenda for future research that more rigorously investigates natural mentoring among older youth in foster care.     

Latent classes of older foster youth: Prospective associations with outcomes and exits from the foster care system during the transition to adulthood

Youth in the foster care system face considerable challenges during the transition to adulthood. However, there is significant variability within this population. This study uses person-oriented methods and a longitudinal dataset of youth aging out of foster care to examine differences in how subgroups of foster youth fare during the transition to adulthood. We identified four distinct latent classes, consistent with prior person-oriented studies of this population, and validated these classes by examining differences on additional relevant factors at age 17. After establishing these classes, we tested their predictive validity by examining differences in outcomes at age 19 in domains relevant to the transition to adulthood, including education and employment, problem behaviors, and mental health problems. Finally, given the importance of extended foster care in promoting better outcomes, we used survival analysis to prospectively examine whether class membership was associated with differences in the rates at which youth left foster care between ages 17 and 19. One large group of youth exhibited moderate behavior problems and left care quickly, while another large group of resilient youth had favorable outcomes and left care relatively slowly. A small group exhibited considerable behavior and mental health problems, but left care more slowly, and a very small group was characterized by a history of pregnancy. Findings suggest considerable variability in service need among older foster youth. Implications for service provision during the transition to adulthood are discussed.     

The association between perception of relationship with caregivers and behaviours of youth in foster care: a child and caregiver perspective

The transition into foster care can be difficult for children. Research has consistently shown an increased risk for children in foster care to exhibit higher levels of problem behaviours in comparison to youth in the general population. The purpose of this study was to analyse the associations between the youths' perception of their relationship with their caregiver on their perception of their own internalizing and externalizing behaviours as well as the youths' perception of the relationships with caregivers and how caregivers report of youths' internalizing and externalizing behaviours. This study utilized the secondary data from the general release version of the National Survey of Child and Adolescent Well-Being [National Survey of Child and Adolescent Well-Being (2009) Introduction to the wave 1 general and restricted use releases, Nation Data Archive on Child Abuse and Neglect, Ithaca, NY]. Significant relationships between youths' perception of relationship with their caregiver were found with both youth perception of internalizing behaviours and caregiver perception of internalizing and externalizing behaviours. Results are explained with implications for practice, training, research and policy.     

Case file coding of child maltreatment: Methods,challenges, and innovations in a longitudinal project of youth in foster care

State social service agency case files are a common mechanism for obtaining information about a child's maltreatment history, yet these documents are often challenging for researchers to access, and then to process in a manner consistent with the requirements of social science research designs. Specifically, accessing and navigating case files is an extensive undertaking, and a task that many researchers have had to maneuver with little guidance. Even after the files are in hand and the research questions and relevant variables have been clarified, case file information about a child's maltreatment exposure can be idiosyncratic, vague, inconsistent, and incomplete, making coding such information into useful variables for statistical analyses difficult. The Modified Maltreatment Classification System (MMCS) is a popular tool used to guide the process, and though comprehensive, this coding system cannot cover all idiosyncrasies found in case files. It is not clear from the literature how researchers implement this system while accounting for issues outside of the purview of the MMCS or that arise during MMCS use. Finally, a large yet reliable file coding team is essential to the process, however, the literature lacks training guidelines and methods for establishing reliability between coders. In an effort to move the field toward a common approach, the purpose of the present discussion is to detail the process used by one large-scale study of child maltreatment, the Studying Pathways to Adjustment and Resilience in Kids (SPARK) project, a longitudinal study of resilience in youth in foster care. The article addresses each phase of case file coding, from accessing case files, to identifying how to measure constructs of interest, to dealing with exceptions to the coding system, to coding variables reliably, to training large teams of coders and monitoring for fidelity. Implications for a comprehensive and efficient approach to case file coding are discussed.     

Mental health and behavioral problems of youth in the child welfare system: residential treatment centers compared to therapeutic foster care in the Odyssey Project population

This is the first multisite, prospective study of behavioral and mental health disorders of youth in residential treatment centers (RTC) and therapeutic foster care (TFC), and the first study to compare the two. This study addressed two questions in a sample of 22 agencies in 13 states: (1) how prevalent were emotional and behavioral disorders in the youth admitted to RTCs and TFC?, and (2) were the youth in RTCs significantly more likely to be disturbed than youth served in TFCs? Data were drawn from the Time 1 phase of the longitudinal national "Odyssey Project" developed by the Child Welfare League of America (1995). Measures included an extensive child and family characteristics form (CFC) and the Child Behavior Checklist (CBCL). The results revealed extremely high levels of behavioral and mental health disorders in the sample as a whole, well above the norms for a non-child welfare population. The prevalence of disorder in the RTC population was substantially greater than in the TFC population.     

The legal rights of LGBT youth in state custody: what child welfare and juvenile justice professionals need to know

Youth in state custody, regardless of their sexual orientation or gender identity, have federal and state constitutional and statutory rights. These rights guarantee a young person safety in their placement as well as freedom from deprivation of their liberty interest. Many lesbian, gay, bisexual, and transgender (LGBT) youth have these rights violated on a regular basis. Many cases in both the child welfare and juvenile justice contexts have resulted in extensive and time-consuming consent decrees as well as sizable damages awards. Knowledge of a youth's legal rights can help providers avoid legal liability while creating a safer and healthier environment for LGBT youth. This article provides a general overview of the successful federal legal claims that youth in the child welfare and juvenile justice systems have made, discussion of the rights generated as a result, particle application of these rights to the experiences of LGBT youth with hypothetical scenarios, a focus on specific rights that emanate from certain state laws, and a focus on specific concerns of transgender youth.     

Reducing racial disparities and disproportionalities in the child welfare system: Policy perspectives about how to serve the best interests of African American youth

This article examines current debates about how to reduce the overrepresentation of African American youth in the child welfare system and address related disparities. These debates reflect tensions between four long-standing perspectives in child welfare: expedient permanency, cultural continuity, family preservation, and social advantage. For each point of view, proponents' unique framing of the problem, use of research, and preferred intervention strategies are described. The emphasis of current federal policy on expedient permanency and transracial adoption is explored, followed by a detailed review of the literature evaluating the impact of this intervention on child and system-level outcomes. It is argued that conclusive evidence does not exist in support of transracial adoption and the expedient permanency perspective above others. Implications for policy and future research are discussed.     

The Personhood in Dementia Questionnaire (PDQ): Establishing an association between beliefs about personhood and health providers' approaches to person-centred care

Purpose of the studyInterest in person-centred dementia care has flourished in the last two decades. Despite growing interest in the development and implementation of person-centred approaches to dementia care, important empirical questions remain. For instance, although Kitwood (1997) emphasized that personhood, a status extended by others, is at the heart of person-centred care, to our knowledge, no one has demonstrated empirically that beliefs about patient status influence how care is provided. The purpose of this series of three studies was to operationalize Kitwood's definition of personhood in order to test this hypothesis.Design and methodsTo operationalize Kitwood's definition of personhood, we generated items to create the Personhood in Dementia Questionnaire (PDQ; Study 1). We then completed preliminary tests of the PDQ's convergent and discriminant validity (Study 2). Finally, we examined the PDQ's relationships with other constructs such as burnout and job satisfaction, and we used linear regression to test the hypothesis that health providers' beliefs about personhood influence intended approaches to dementia care (Study 3).ResultsIn Study 1, we generated a pool of 64 potential questionnaire items. In Study 2, a 20-item version of the PDQ demonstrated good internal consistency, resistance to socially desirable responding, and evidence of convergent and discriminant validity. In Study 3, PDQ scores accounted for a significant proportion of variance in health providers' intended approaches to dementia care, including pain management. PDQ scores were not related to job satisfaction or to most aspects of burnout.ImplicationsThese results provide the first direct empirical evidence of Kitwood's (1997) theory that beliefs about patient personhood have the potential to influence health providers' care decisions, including decisions about pain management.