Evidence-based practice for youth in supervised out-of-home care: a framework for development, definition, and evaluation

Adolescents comprise more than half of the children in child welfare supervised out-of-home care. This article considers the evidence-base for an array of services to adolescents in out-of-home care and evaluates the existing research base for each program. This review advances a framework for considering the critical need to develop, define, and evaluate the essential elements of out-of-home care services for older foster youth. Policy, program, and evaluation recommendations are forwarded.     

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.     

Research outcomes of prenatal substance exposure and the need to review policies and procedures regarding child abuse reporting

Research on the outcomes of drug-exposed children evinces elevated developmental risks from the interaction of subtle biological vulnerabilities and compromised parenting. States, however, have generally not reviewed the procedures and policies they developed in the early 1990s when there was less research and experience with these children. At that time the gravest risks related to perinatal substance exposure seemed to be excessively punitive treatment of mothers by over-zealous criminal justice prosecutors. This article clarifies policy options for reporting and serving children who are born testing positive for controlled substances and also calls for strengthening existing state policies regarding child abuse reporting and response.     

Parental views of in-home services: what predicts satisfaction with child welfare workers?

Evidence on client satisfaction deserves consideration in the design of child welfare policies, programs, and practices. Data in this study come from the National Survey of Child and Adolescent Well-Being. Clients receiving in-home services reported moderate levels of satisfaction with their child welfare workers. Caregiver reports of having less than two child welfare workers, having more recent contact, and receiving timely, responsive services were associated with higher perceived quality of relationships with child welfare workers. The child welfare workers' reports of cooperativeness by the caregiver were also associated with higher caregiver-reported relationship quality.     

Power through choices: the development of a sexuality education curriculum for youths in out-of-home care

Youths in out-of-home care demonstrate high rates of sexual risk-taking behavior and elevated rates of unintended pregnancy and sexually transmitted infections (STIs). This article profiles the development and characteristics of an innovative pregnancy/HIV/STI prevention curriculum tailored to the needs of youths in out-of-home care. Promising results from an implementation study suggest the need for further dissemination and rigorous testing.     

Frozen in Time: Idealization and Parent-Blaming in the Therapeutic Process

Contemporary theory and culture can lead a therapist to view a client’s positive feelings towards parents as defensive idealization, while negative or hostile feelings may be seen as “deeper” and more important. This article suggests that both idealization of and critical feelings about parents can serve as defenses against other painful emotions and both are developmentally necessary. Contemporary neurobiological and attachment research indicate that “talk therapy” helps individuals manage emotions. This work can be derailed if anger is privileged over idealization. Clinical examples illustrate these ideas and show how unpacking both critical and overly positive attitudes can encourage development. Clients increase their capacity to tolerate a wider range of feelings, maintain a consistent and cohesive sense of self, and build meaningful relationships. Therapists’ countertransferential identification with clients’ parent-blaming and a not uncommon desire to reduce complex and confusing experiences to a more manageable subset of emotions are also addressed.