The need to do it all: Exploring the ways in which treatment foster parents enact their complex role

Treatment foster care (TFC) is an appealing approach for treating youth with emotional and behavioral disorders because it combines the potential for intensive interventions with opportunities for growth and development in a family-based setting. To accomplish this, TFC requires treatment foster parents to simultaneously play roles of both substitute caregiver/parent and front-line professional. This requires that treatment foster parents excel at both the behaviorally focused elements of an interventionist while simultaneously enacting the more relationally-based aspects of a parent. To date there has been little in the literature to explore the extent to which practicing treatment foster parents actually utilize both behavioral and relational approaches in their work with youth. This paper uses baseline data from a randomized trial (n = 247) to explore eight potential approaches that treatment foster parents might use (including: monitoring/supervision, approaches to discipline, consistency of responses to behaviors, time together, adult-child conflict, positive affect towards the child, perspective taking/empathy building, and communication) as well as a measure of their own assessment of their role. Results show that treatment foster parents recognize the complexities of their role, and most view themselves more as parents than as treatment providers. Substantial variation was evident on all examined dimensions of the treatment parent role (except supervision/monitoring). Variations in treatment parent approaches were most significantly related to child's age and their own view of their role. The paper concludes with discussion of implications and directions for future research.