Therapy Outcome with Children in Foster Care: A Longitudinal Study

The present paper describes a naturalistic study of therapy with children in foster care. The goal was to attempt to begin to understand what happens to children in foster care while they are in therapy. The functioning of all children referred for therapy in a foster care agency was assessed as rated by different informants at different points in time over an 18-month period. These children present with low-level behavior problems but the level and type of problem they present with depends on the person rating the child and the child’s gender and age. Two thirds of the children improve and do so within the early stages of therapy. One third of the children do not improve. The distinguishing feature of this group appears to be the high level of aggressive behaviors reported at intake. Results suggest that improvement depends on the eye of the beholder. These findings are discussed and recommendations for therapeutic and systemic practice are made. The importance of using multiple informants when evaluating the treatment needs of children in care is pointed out as is the need to rethink therapeutic strategies with children that present with high levels of aggressive behavior at intake and show no improvement after the first 6 months of therapy.