Foster Parents’ Perceptions of Factors Needed for Successful Foster Placements

The purpose of the study was to describe the needs of foster parents for placement success. Sixty-three foster parents from a central Canadian province were asked the following question: “What do you need for a successful foster placement”? Foster parents grouped together all responses, which were analyzed using multidimensional scaling and cluster analysis procedures. Foster parents indicated that they needed the right personality and skills, information about the foster child, a good relationship with the fostering agency, individualized services, community support, linkages to other foster families, supportive immediate and extended families, as well as self-care skills. There were some differences between the existing literature and the needs identified by study participants. Differences included the need for information about policies and procedures, their treatment by professionals, and the need for formal foster parent organizations.     

Latino Foster Parent Health Perceptions of Chronic Conditions: A Qualitative Exploration

Prior work using nationally representative data of children in the child welfare system suggested that Latino foster parents were less likely to identify children in their care as having chronic conditions. Hispanics comprise over one-fifth of children in foster care, the majority of whom have special health care needs, and there is a growing need to recruit qualified Latino families into the child welfare system. Little is known about Latino parents’ health perceptions regarding chronic conditions, and potential reasons for differing identification rates of children with special health care needs. We conducted 17 home-based, in-depth interviews with Latino foster parents to explore health perceptions and cultural beliefs for children in their care around the concept of chronic illness. We found that Latino foster parents’ understanding of conditions that occurred “over and over again” related to emotional and behavioral health problems. In contrast, their perception of “chronic” was associated with terminal, biological conditions that had limited treatment options, such as cancer, HIV, and hepatitis. Latino foster parents did not interpret the survey question on chronic illness as it was intended, and their view of recurrent conditions did not reflect chronic health conditions. Developing survey questions that are culturally sensitive should improve accuracy in assessing chronic health conditions for this high-risk population. Sensitivity to cultural interpretation for this high-needs population is vital to enhancing communication between families and health providers caring for children in foster care.     

Foster Families: A Systematic Review of Intention and Retention Factors

Background: Compared to residential care, family foster care is the preferable type of alternative care for neglected or abused children as it provides a familiar context that supports children’s developmental needs. New foster families are needed to care for these children. Objective: This systematic review aims to provide a critical analysis of the literature, identifying factors that explain the intention to become and to continue as a foster family. This review was performed following the PRISMA checklist and guidelines, through a search conducted in the following databases (no restrictions were made): PsycArticles, PsycInfo, Psychology and Behavioral Sciences Collection, Academic Search Complete, ERIC, Scopus, and Web of Science. Study eligibility: The review includes empirical quantitative and/or qualitative studies in English, Portuguese, and Spanish, with community and/or foster parents’ samples and explores the factors for becoming and/or retention of foster parents. Results: Forty-nine studies were included. The results revealed that the intention to become a foster parent is largely influenced by motivational factors, personal and family characteristics, individual values and beliefs, social context influences, and perceived familiarity with the child protection system. The retention of foster families is closely related to factors within the child protection system, personal or family characteristics, foster child characteristics, and placement challenges. The relationship with agencies and professional support stands out as the most important factors. Limitations and Implications: This review did not include studies focused on children with specific needs and characteristics, and future research should consider the particular challenges of fostering this group. Practice implications of these findings for the recruitment, selection, and retention of foster families will be discussed.

     

Infant mental health: Monitoring our movement into the twenty-first century

At a time when our guidance is increasingly sought by parents, courts, and social policy planners, it is critical that infant mental health professionals establish clearer standards for training, engage in more rigorous self-monitoring of our clinical and our research efforts, and recognize the extraordinary risks for bias in all of our work. It is not necessary that we speak with one voice. In fact, our field has been enriched by its transdisciplinary nature and by its many points of view. But it is critical that we offer assessments, engage in treatment, conduct our research, and do our teaching free of uncontrolled contamination by our own unresolved childhood experiences, our idealizations, our needs for control: in short, that we be truly open to the data and truly available to the families. Examples are offered of the risks if we fail, and a call is made for careful transdisciplinary training, supervision, individual psychotherapy, and collegial monitoring for infant mental health clinicians, researchers, and educators, alike.     

Support Needs and Satisfaction in Foster Care: Differences Between Foster Mothers and Foster Fathers

Family foster care is a vulnerable youth care intervention. The recruitment and retention of foster parents causes concerns. Offering support to foster mothers and foster fathers can augment the satisfaction and the intent of continuing fostering. Clearer understanding of the support needs of foster parents and their satisfaction with the foster care placement can lead to the identification of ways to improve the support offered. Although differences between foster mothers and foster fathers regarding their support needs and satisfaction can be expected, knowledge about these differences is nonexistent. Differences in support needs and satisfaction between 86 foster mothers and foster fathers who reported on 120 foster children were examined. No differences between foster mothers and foster fathers were found. Both foster parents had higher support needs regarding dealing with the birth parents compared to support needs in handling problem behavior of the foster child. For both foster mothers and foster fathers satisfaction with collaboration with the foster care worker, satisfaction with recognition experienced and satisfaction with reunification of the foster child, did not differ across these aspects. Satisfaction of foster parents can be increased by keeping in balance the rights and needs of birth parents and those of foster parents. Acknowledging that foster parents are experts on their foster child and consulting them on important decisions will also contribute significantly to their satisfaction.     

Development of an Intervention for Foster Parents of Young Foster Children with Externalizing Behavior: Theoretical Basis and Program Description

Foster parents are often faced with serious externalizing behaviors of their foster child. These behavioral problems may induce family stress and are related to less effective parenting and often increase. Foster children with behavioral problems are also more at risk of placement breakdown. An intervention to support foster parents of young foster children with externalizing behaviors is necessary to improve the effectiveness of foster placements. Based on research on effective parenting interventions and special needs of foster children, a treatment protocol was developed. This paper describes theoretical foundations for the content and form of the intervention and gives an overview of the modular treatment protocol. Preliminary outcomes of this intervention as well as challenges and future developments and research activities are discussed.     

Meeting the emotional needs of infants and toddlers in foster care: The collaborative mental health care experience

This paper describes a partnership between an infant mental health consultation program and child welfare authorities, with a special focus on the use of a consultation model to support infants and toddlers in foster care. The authors describe a model of practice that incorporates the transactional model with a developmental perspective to help foster parents understand and address the emotional needs of these children. The clinical implications section reviews strategies for addressing attachment and relationship disturbances, promoting self‐regulation, and enhancing social competence in infants and young foster children.     

Professionnalisation des assistantes familiales et intérêt de l’enfant accueilli

For 30 years, in France, foster care has been regulated by specific legislation which provides for the professionalization of one of the foster parents – the mother, more often than not. The authors – clinical psychologists – analyse the impact of the last legislation on foster care. A recent law aims to consider foster care as a job like any other, at the risk of underestimating the specificity of this social function, that is, offering to a child in trouble with his own family an ordinary living environment and the “ordinary” parenting skills of foster parents. The authors suggest ways to conceive the professionalization of foster parents in order that it will meet the child's interests and needs.     

Predictors of Placement Outcomes in Treatment Foster Care: Implications for Foster Parent Selection and Service Delivery

Treatment foster care (TFC) is a normalizing environment in which to treat those children whose particular needs are not addressed in traditional foster care and for whom an institutional setting is a restrictive and unnecessary alternative. However, when the foster care placements of these emotionally and behaviorally disturbed children fail, as they often do, the children are shifted from one home to another without the opportunity to experience permanence or emotional attachment, resulting in poor adjustment to foster care. Placement stability, which depends in part upon effective matching of foster children with potential foster families, is critical for achieving positive outcomes in TFC. Yet, there is a dearth of information to guide placement agencies in making decisions about matching foster children with families. Moreover, once a successful match has been made, it is equally vital that service delivery be of high quality so that permanence is maintained. We review research on the predictors of positive outcomes in foster care, focusing on studies involving emotionally or behaviorally disturbed children, and provide recommendations for selecting foster parents and for ensuring high quality foster care services and placement stability.     

Development of a Family-based Program to Reduce Risk and Promote Resilience Among Families Affected by Maternal Depression: Theoretical Basis and Program Description

Depression is a family matter. It not only diminishes the quality-of-life of the depressed person, but also strains the resources of the family unit and increases the children's risk of developing significant problems that start early and persist into adulthood. Although treatment of a parent's depression is critical, many families also need professional intervention to reduce children's risk. This article reviews the evidence on needs of these families and shows that the theoretical and clinical evidence exists to support the design of interventions for families affected by maternal depression. A preventive intervention developed from this foundation is described, the Keeping Families Strong (KFS) program, that is designed to promote resilience and reduce the risk for psychological disorders in children of parents with depression. The pilot study on the KFS program, conducted in adult mental health outpatient settings, is described. Families participate in 10 meetings 90 min each, with a group for parents and for children (10 years and older) conducted concurrently. The program structure and content are described, the challenges of implementing a family preventive intervention in actual clinical settings are discussed, and a case example is provided, as well as preliminary outcome data on ten families. In sum, we provide a strong rationale for the potential of preventive interventions for families affected by maternal depression.     

Patient inquiry into mental hospitalization: a quantitative analysis.

In this section we have assembled a small collection of data concerned with the issue of whether or not adolescents would profit from reflective inquiry into the closed area of mental health care. We have analyzed, arranged and interpreted the data from our study and conclude it demonstrates that adolescent inpatients did profit substantially from a reflective inquiry into mental health care. The number of subjects involved in this experimental program was small. The subjects of the experimental program were not selected randomly. Moreover, the researcher could not control for a number of intervening variables. For this particular group the intervening variables were many: changes in the subjects' individual treatment program, level of tranquilizing medication, attitude of other staff toward the experimental program, relations with parents or relatives, et cetera. This list covers some of the more important weaknesses of the experimental design. In the account of the experiment we reported the influence of other significant intervening variables as they emerged during the course of the study. Even with these important limitations the total push of the results in the direction of our argument compels us to conclude that it is clearly profitable for adolescent inpatients to reflectively inquire into the closed area of mental health care. Although the data reported here are not of predictive value, we believe they indicate the importance of having adolescent inpatients reflectively examine their social situation.     

Motives for Fostering Children with Alcohol-Related Disabilities

A sample of 63 licensed foster parents was asked, “What motivates you to foster a child who has a fetal alcohol spectrum disorder?” The responses to this question were grouped together by licensed foster parents. The grouped data were subjected to multidimensional scaling and cluster analysis. Results indicated that foster parents were motivated to care for children with alcohol-related disabilities by witnessing positive changes in the children in their care, helping children focus on their strengths, using their own parenting experience, earning an income, assisting children who have disabilities, and helping children stay connected to their families and communities. Foster parents who foster children with alcohol-related disabilities foster for similar reasons to those who foster children with special needs in general. Differences between the literature on foster parent motives and study results were described. Foster parents who are caring for children with alcohol-related disabilities see their care as specialized, see their roles as long-term helpers facilitators to children, their birth families and home communities, and emphasize positive experiences of fostering.     

Opening Comments

Child placement policies and practices are always based on ideas as to what kind of society we want to be. We want to keep a balance between the needs of the child and those of the parents—divorced, biological, foster, or adoptive. We seek new legal frameworks to allow for different kinds of placements with varying degrees of access, openness, and privacy. The goal is to find relationship arrangements that will do justice to all the individuals involved. The job of shaping and testing new arrangements, determining their limits, may take decades. We will learn who are the parents actually ready to raise a child in joint custody or to foster or adopt a child while maintaining access to the biological parents. We will learn what forms of access are likely to enhance or jeopardize the relationships and growth of the participants. We will discover patterns that encourage or discourage parents in undertaking new forms of placement and ways for professionals to relate to these families. We may find that the issue of the “compulsive” identity search is less critical than the difficulties involved in establishing intrafamilial boundaries and developing optimal conditions for raising children. The art of anticipating agency-induced “latrogenic errors” will become indispensable. It will be used for developing fair ground rules for those involved in the experience of child placement. This will improve an imperfect world by restoring two concepts—that the rights of the individual can be protected without neglecting the needs of others and that contractual arrangements and interpersonal commitments cannot only be revised but also honored. These concepts have rapidly weakened since Freud. On the basis of his theories the psychology of the family and the community shifted dramatically to that of the individual's internal plight. The culmination of that powerful trend was seen among mental health professionals who focused exclusively on the phenomenology of the foster child's or adoptee's identity search, fantasies, and anxieties, and only incidentally on the concerns of the adoptive, foster, and biological parents. The professionals were aware of the dynamic patterns of coalitions and splits set up between an agency's representative and the sets of parents involved, but for them these interactions were merely the background in a drama of intrapsychic forces struggling for resolution. The tendency has been to look inside people's heads and to consider the agency's involvement and the organizing power of the interpersonal arrangement as secondary influences in the making of problems. This tendency—by no means only a lamentable and myopic error of the past—may be yielding. Whether disguised as interactional theory, as family-oriented perceptions, or as awareness of context, consideration for the needs of others is coming back. More adoptees and foster children are concerned that their successful search may prove to be less than welcome to unconsenting biological parents. More professionals are concerned with preventing a particular outlook, whether it be the doctrinaire position of the courts or agencies thirty years ago or the self-actualizing drive of the adoptee or foster child today, from asserting itself at the expense of others. Practitioners look for a new ethic and for informed viewpoints to make wiser decisions when dealing with child placement. The following section offers three such viewpoints. The first paper favors the continuity of biological or previous family ties across a variety of child placement settings and views the identity search as more than an inner event, as a nonpathological social quest and an integrative experience. The second paper attributes the “compulsive” identity search to “psychological stress within the adoptive family” and “distortion in the vitally important area of adoptive education”; it stresses the importance of safeguarding the contractual foundations of adoption. The third paper emphasizes the need to develop empirical data on the impact on birth parents, adoptive parents, and adoptees of the movement to unseal adoption records; it describes a study of the attitudes of birth parents who relinquished children in the past. The strengths of each presentation are limited by the problems imposed by self-selected samples, but the papers afford the reader the opportunity of looking at the child-placement experience from different perspectives.     

Clinical application of attachment theory in permanency planning for children in foster care: The importance of continuity of care

Permanency planning is a critical issue facing all children in foster care. Foster children frequently suffer from developmental delays and severe behavior problems, often leading to repeated displacements that in turn increase the risk for attachment disorders. To prevent the emergence of such disturbances, an Attachment Clinic was developed in Montreal to offer consultation to Youth Protection workers. A specific problem has frequently been identified in this Clinic: Should a child who has developed a significant attachment to his or her foster parents return to the biological parents or stay in the foster family? The choice between the two families is even more difficult when the parenting competencies of the biological parents seem to have progressed while the child has developed secure attachments in the foster family. Clinical cases will be presented to illustrate such dilemmas. Concepts rooted in attachment theory have been very useful to understand such problems, and have led us to believe that children's best interests lie in the preservation of their attachment ties and that repeated ruptures of such ties constitute a severe trauma. Resistances of the milieu to our position will be discussed as well as the Court's decisions in light of Canadian jurisprudence.     

Repairing links: building attachments in the preschool classroom

A psychoanalytic model of preschool consultation is presented, born of the conviction that psychoanalysis has powerful tools with which to tackle some of our most difficult and entrenched community problems. Since trauma is known to impact our ability to think reflectively and symbolically (Fonagy, Moran, and Target 1993), the clinical methods of psychoanalysis-drawing on the ideas of container/contained, the capacity to hold alternate points of view, and the capacity to reflect empathically (here with teachers in the face of their at times harsh and insensitive treatment of students)-are crucial to success in work with cumulatively traumatized staff (Khan 1963). The strongest resistances to consultation arise from an anti-attachment system developed as a result of cumulative trauma and operating at multiple levels in the preschool. Consultation services are organized around an understanding of this anti-attachment system. At various levels of the system, including staff, parents, and children, consultants work to facilitate secure relationships in the preschool setting. These relationships foster recognition of children's emotional complexities and build cooperative links between staff and parents, in an atmosphere that otherwise might often push adults into fearful, self-protective states that interfere with their contact with children's states of mind.     

Machiavellianism and Spontaneous Mentalization: One Step Ahead of Others

In spite of the Machiavellians' successful strategies in exploitation of others, they show cognitive deficiencies, especially reduced mind‐reading skill. Theory of mind is usually regarded as an ability to make inferences about the mental states of others and thus to predict their behaviour. In our study, we have instead emphasized a motivation‐based approach, using the concept of spontaneous mentalization. This concept is construed solely in a motivational context and not in relation to the automaticity of mind‐reading ability. It entails that people in their social relations make efforts to explore the thoughts and intentions of others and are motivated to make hypotheses about the mental state of the other person. We assumed that what is peculiar to Machiavellianism is spontaneous mentalization as a kind of motivation rather than mind‐reading as an ability. To measure spontaneous mentalization, we created a set of image stimuli and asked our participants to describe their impressions of the pictures. The results show that individual differences in spontaneous mentalization correlate positively with the scores of Machiavellianism. These results suggest that those who have a stronger motivation for putting themselves into the mind of others can be more successful in misleading and exploiting them. Further research should be carried out to clarify how spontaneous mentalization and mind‐reading ability relate to each other. Copyright © 2011 John Wiley & Sons, Ltd.     

The transactional model of early home intervention

This article describes a developmental model for early home intervention and treatment of environmentally and biologically at-risk infants and their parents: The Transactional Model of Home Intervention. The model identifies the development of both infants and parents as targets of intervention and considers their ongoing interactions or transactions within the family context as the vehicle of intervention. The child and his physical/social environment are conceptualized as actively influencing one another in their reciprocal transactions. An early intervention program based on this transactional model is described. The intervention is tailored to suit the needs of both child and parents and, more generally, the needs of the family. The intervention process involves a problem-solving model of education by which parents acquire cognitive strategies that will enable them to assess the needs of their child and to design a program to fulfill these needs.     

Providing therapy to children and families in foster care: a systemic-relational approach

Foster care is a system created to protect children from an unsafe home environment yet multiple foster home placements, conflictual or nonexistent relationships between foster parents and birth parents, long, drawn out court battles, and living in an on-going state of not knowing when or if they will be going home are just some of the challenges many children in care are expected to manage. This paper presents a guide for therapists working with families involved in foster care. Utilizing ideas from the postmodern therapies and structural family therapy, suggestions will be provided about who needs to talk to whom about what, when to have these necessary conversations, and how to talk to people in a way that mobilizes adults to take action for the children, with the goal of minimizing postplacement trauma, strengthening and repairing relational bonds, and moving children out of foster care and into permanent homes as quickly as possible.     

Psychodynamic counselling with parents of children with developmental disabilities

A joint treatment of parents and child can be the treatment of choice when dealing with developmental disabilities. In our clinical experience, we have observed that psychoanalytically oriented support (developmental guidance), which involves the child and the parents together, answers the needs and addresses the difficult dynamics that are characteristic of developmental disabilities.