Psychosocial Treatment of Children in Foster Care: A Review

Department of Psychiatry, Dartmouth-Hitchcock Medical Center, One Medical Center Drive, Lebanon, NH 03756-0001, USA.
Community Mental Health Journal (Impact Factor: 1.03). 05/2005; 41(2):199-221. DOI: 10.1007/s10597-005-2656-7
Source: PubMed


A substantial number of children in foster care exhibit psychiatric difficulties. Recent epidemiological and historical trends in foster care, clinical findings about the adjustment of children in foster care and adult outcomes are reviewed, followed by a description of current approaches to treatment and extant empirical support. Available interventions for these children can be categorized as either symptom-focused or systemic, with empirical support for specific methods ranging from scant to substantial. Even with treatment, behavioral and emotional problems often persist into adulthood resulting in poor functional outcomes. We suggest that self-regulation may be an important mediating factor in the appearance of emotional and behavioral disturbance in these children.

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    • "Interventions for foster children who have been victimized and homeless can be either narrowly symptom-focused or broadly system-focused (24). The few specific interventions designed for this population have not been well-analyzed because this population is particularly difficult to treat or evaluate (25). "
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    ABSTRACT: Despite the high prevalence of substance abuse and mood disorders among victimized children and adolescents, few studies have investigated the association of these disorders with treatment adherence, represented by numbers of visits per month and treatment duration. We aimed to investigate the effects of substance abuse and mood disorders on treatment adherence and duration in a special program for victimized children in São Paulo, Brazil. A total of 351 participants were evaluated for psychiatric disorders and classified into one of five groups: mood disorders alone; substance abuse disorders alone; mood and substance abuse disorders; other psychiatric disorders; no psychiatric disorders. The associations between diagnostic classification and adherence to treatment and the duration of program participation were tested with logistic regression and survival analysis, respectively. Children with mood disorders alone had the highest rate of adherence (79.5%); those with substance abuse disorders alone had the lowest (40%); and those with both disorders had an intermediate rate of adherence (50%). Those with other psychiatric disorders and no psychiatric disorders also had high rates of adherence (75.6% and 72.9%, respectively). Living with family significantly increased adherence for children with substance abuse disorders but decreased adherence for those with no psychiatric disorders. The diagnostic correlates of duration of participation were similar to those for adherence. Mood and substance abuse disorders were strong predictive factors for treatment adherence and duration, albeit in opposite directions. Living with family seems to have a positive effect on treatment adherence for patients with substance abuse disorders. More effective treatment is needed for victimized substance-abusing youth.
    Clinics (São Paulo, Brazil) 01/2012; 67(1):3-9. DOI:10.6061/clinics/2012(01)02 · 1.19 Impact Factor
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    • "They expect a continuation of their abusive, neglectful experiences; they blame themselves for the abuse; and they have poor self-esteem (Boyd Webb 2006a). They carry a high burden of difficulties caused in part by the consequences of abuse, family breakdown, and being taken into care, and remain at high risk for poor long-term functional outcomes (Charles and Matheson 1991; Racusin et al. 2005). Young people in need often have difficulty focusing on and articulating their thoughts and modulating their affect, limited social skills, and trouble remaining grounded in the present moment (Hansen 2006). "
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    ABSTRACT: We discuss preliminary findings from a study that investigated the effectiveness of a Holistic Arts-Based Group Program (HAP) for the development of resilience in children in need. The HAP teaches mindfulness using arts-based methods, and aims to teach children how to understand their feelings and develop their strengths. We assessed the effectiveness of the HAP by using comparison and control groups, and standardized measures. We hypothesized that children who participated in the HAP would have better scores on resilience and self-concept compared with children who took part in an Arts and Crafts group (the comparison group), and children who were waiting to attend the HAP (the control group). A total of 36 children participated in the study; 20 boys aged 8–13 years and 16 girls aged 8–14 years. A mixed-designed MANOVA was conducted using scores from 21 participants. We found evidence that the HAP program was beneficial for the children in that they self-reported lower emotional reactivity (a resilience measure) post-intervention. No changes were noted for perceptions of self-concept. Consideration should be given to how we can attend to young people’s needs in relevant ways as resilience is a condition of a community’s ability to provide resources as much as it is part of an individual’s capacity for growth. Programs such as the HAP can engage children in a creative and meaningful process that is enjoyable and strengths-based.
    Journal of Child and Family Studies 10/2011; 21(5). DOI:10.1007/s10826-011-9544-2 · 1.42 Impact Factor
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    • "The prevalence of mental health disorders with children in foster care are estimated as high as 80% (dosReis et al., 2001; Landsverk & Garland, 1999; Halfon, Mendonca & Berkowitz, 1995). Children in foster care are also 16 times more likely to have psychiatric diagnoses and 8 times more likely to be taking psychotropic medication than children in community samples (see Racusin et al., 2005). "
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    ABSTRACT: Caregivers serve as gatekeepers for children while in the child welfare system, but few studies have focused on the caregiver and the factors that influence the use of mental health services for the children under their care. The purpose of this study was to examine the child's mental health need, the caregiver's level of stress, depression, and social support, and the utilization of mental health services by children using the three most common types of caregivers in the child welfare system (i.e., birth parent, relative caregiver, and foster parent). Data comes from the Patterns of Care (POC) study of five public sectors of care. The present study examined parents/caregivers and youth from the child welfare sector. Findings suggest that while birth parents were more likely to endorse more risk factors for themselves, and the children under their care had a higher level of mental health need, they were the least likely to utilize mental health services for the children under their care. Implications for the child welfare and mental health systems are discussed.
    Children and Youth Services Review 05/2010; 32(5):691-697. DOI:10.1016/j.childyouth.2010.01.005 · 1.27 Impact Factor
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