Introduction
Over 400,000 children and adolescents are a part of the foster care system in the United States of America (Child Welfare Information Gateway, 2020). Each year, over 30,000 of those adolescents age out of the foster care system, and about half of these individuals have no income four years post-exit from the system (iFoster, 2020). Once these adolescents age out, they are egregiously more likely to struggle financially. These adolescents, while still within the home, demonstrate habitual problem behaviors as a way of dealing with the trauma they have experienced that resulted in their induction into the system (O’Neal, 2018). Many of the parents are not adequately trained to handle these challenges and are left to navigate their own way to stay within the regulations placed on discipline and parenting within the guidelines of their state’s mandates (Pennsylvania State Resource Family Association, 2020). Some of the challenges could be mitigated with proper intervention, such as a support group for the families who choose to foster children and adolescents. I propose that the best form of support is to strengthen the family units to create a more secure base for the individuals being fostered, and to build a structure that prepares the individuals for life in the “real world,” to reduce the economic burden caused by the unstable finances most adolescents who age out of foster care experience.
Evidence-Based Intervention
In my search to find a program that is aimed toward fostering families in a group setting, an intervention was not to be found. While some programs incorporate bits and pieces of programming that is beneficial to these families, no single program incorporated every aspect that I had hoped to find. Considering necessity is the mother of invention, this sparked a passion in my mind to design an intervention that takes these aspects and combines them into one program, incorporating family, child, therapeutic professionals, and community, to best prepare these adolescents for their departure from their foster family.
In this program, 10-15 families would participate in each grouping involved in the intervention. The families would commit to twice-monthly meetings, consisting of around an hour of scheduled group therapy, followed by a 30-minute opportunity for the families to interact with each other. For the hour-long therapy portion, the families would be divided into subgroups for group therapy. These group therapy sessions would divide the families into smaller groups to focus on issues that are shared between these smaller divisions. The first grouping would be the parents, followed by the foster children, divided into developmentally appropriate age ranges, and the biological children, divided into developmentally appropriate age ranges. These age ranges would split the children from 0-4 years old, 5-7 years old, 8-12 years old, 13-15 years old, and 16-18+ years old (in some states, and under special circumstances, adolescents in a foster care setting can postpone aging out until 21).
The parent group would receive training in how to handle problem behaviors and other emotional issues that come as a result of trauma and maltreatment. This training would address not only trauma like neglect or sudden death/loss, but also trauma related to sexual and mental abuse, family history of incarceration, abandonment, any development of antisocial behaviors, and other challenges that foster children face. Parents will also be instructed in how to establish boundaries and parent effectively within the strict guidelines mandated by the state to protect the children in their care. This training would include suggestions for rewarding good behavior, and behavior modification techniques when problem behavior rears its head. One possible suggestion in terms of structuring discipline could include methods like what has been suggested in the Treatment Foster Care Oregon intervention (Orton, 2019).
In TFCO (Treatment Foster Care Oregon), the individual who is being fostered is enrolled in a points system with three different tiers that represent additional privileges as a reward for “leveling up.” The foster parents are instructed in what constitutes gaining or losing points, down to even the attitudes of those in their care. Teachers are also included in this system, creating consequences both positive and negative for their behavior within the classroom. The process of moving to the next tier up involves a few weeks’ worth of good behavior, teaching the foster children to set goals and reach for them. It also teaches responsibility for actions and accountability in both the family and school settings.
Another promising intervention that involves parental training is GenerationPMTO, a parent–training-based intervention spread over the course of 6-14 weekly sessions, depending on the program (Suski, 2020). The intervention is founded on theories surrounding parenting and child development. The focus of the intervention is creating protective factors, like improved family management, stronger attachment between parent and child, and positive parent-child interactions outside of discipline.
The parent groups also provide social support for each other. While the nuances and finite details of the struggles they are facing within their individual homes will vary widely, their shared experiences with caring for their foster children will encourage the development of relationships among themselves. These relationships will provide support for the parents so that they feel less alone and have people to talk to about their difficulties during the intervention as well as once the intervention ends.
The first grouping of children, aged 0-4, will be made up of both foster children and biological children. This group will be monitored by professionals while they free play. This will help the children who struggle with more antisocial tendencies to have a safe place to interact with peers and receive correction when they are exhibiting problem behaviors or antisocial behaviors.
The following age bracket, 5-7-year-olds, will be the first group to experience the split between biological children and foster children. This split will be carried through each subsequent age bracket. These children will also have a session with a professional to guide conversation through conflict resolution and obedience to authorities, like parents. The professional that leads the group with biological children will be prepared to answer some common questions among this group, such as: why does my new sibling look/act different? Why did my parents decide we needed another person in our family? What happens if this new family member leaves? The professional assigned to the foster children will be prepared to handle discussions geared toward the foster children, like dealing with trauma, mental health concerns, adjustment to a new place and family, and other topics that are brought up in their time together. The 8-12-year age bracket will run in a similar fashion, with answers to questions being raised to match their maturity. Therapeutic professionals will also be prepared to handle topics related to the adjustment in friendships and puberty associated with the latter half of this age bracket.
In the 13-15-year-old age bracket, therapeutic professionals will be prepared to handle more difficult questions related to social and interpersonal relationships, as this period of adolescence can frequently be characterized by a shift away from the immediate family to draw closer to friend groups. As adolescents of both biological and fostering groups are forming a sense of identity, they may wrestle with their role within their family or in society. This is a specific area that I believe that formatting this program as group therapy will be a great benefit to the participants, because adolescents will be able to form friendships with others in their age group who have shared experience with this shared part of their lives, and a shared piece of their identities.
Finally, in the 16-18+ age bracket, much more conversation will surround job/future planning. In an ideal world, this program would be run through an organization involved in the community that can form or utilize existing connections with businesses, colleges, technical schools, and places where apprenticeships are possible. As a part of the intervention aimed at this age group, these individuals involved in different aspects of the community would be given sessions to speak to the biological and foster groups, making them aware of opportunities that are at their fingertips. This aspect of the intervention is specifically targeting the rates of financial and job insecurity experienced by foster children who age–out of the system, showing them ways that they can actively pursue the future they want. While this level of community involvement would take time to establish, it has great potential to benefit these adolescents, and minimize the financial toll that society pays for not adequately preparing these adolescents who age–out.
Empirical Evidence
While this specific intervention has not been run, and therefore has no empirical backing, certain aspects of what has been proposed have been tested and proven effective. An aspect of great importance and value is the nature of the program: group therapy. In the last 30 years, group therapy has come under the microscope and proven as a stand-up form of intervention (Montgomery, 2002). Group therapy can take on many forms, some of which are more heavily focused on building community and support for all group members, and others are aimed at educating and modifying behavior. There is great variety within that spectrum where this intervention would fall. Group therapy has also proven to be a great benefit to families in improving familial attachment and connection, parental empowerment, and child behavior (Ruffalo et al., 2005).
Incorporating aspects or even the exact measures of the TFCO program brings with it the vast success that the program has had as it has been utilized. Research has shown this intervention to be effective in reducing incarceration and other risky behaviors in teens who have been involved in the foster care program (Orton, 2019). Considering that this intervention also creates clear boundaries for those who are enrolled, it also shows great potential in improving family bonds. Similarly, the Generation PMTO intervention has improved familial relationships and parenting skills. In studies that researched the effects of the intervention, it was found that 9 years post-intervention, attachment had been improved and problem behaviors significantly decreased. Research also shows improvement in the problem behavior and social skills that foster children displayed when PMTO was applied when compared to services as normal (Akin et al., 2018).
Conclusion
Foster families are a critical structure within society that could benefit from interventions specifically designed to strengthen the unique family system. Individuals who have been through the system have challenging odds to face and frequently lack the support that those who are entering the adult world from a more traditional family setting are blessed with. This intervention not only intervenes in a preventative nature, but also builds a stronger community around those families and individuals who have been a part of the system. Group therapy has been shown to build support that foster families can benefit from. As aspects of this intervention have been established, they have positively impacted those individuals involved. With the help of a team of therapeutic professionals who have a passion to support this family model, this intervention holds great promise to benefit not only the families, but also the surrounding community in integrating the fostered individual as a productive member of society. This wholistic approach to caring for the individual in foster care creates the proverbial village to raise a child and promote their success.
References
Akin, B. A., Lang, K., Yan, Y., & McDonald, T. P. (2018). Randomized trial of PMTO in foster care: 12-month child well-being, parenting, and caregiver functioning outcomes. Children and Youth Services Review, 95, 49-63.
Child Welfare Information Gateway. (2020). Foster care statistics 2018. Washington, DC: U.S. Department of Health and Human Services, Administration for Children and Families, Children’s Bureau.
iFoster. (2020). 6 Quick Statistics of the Current State of Foster Care. iFoster. https://www.ifoster.org/6-quick-statistics-on-the-current-state-of-foster-care/.
Montgomery, C. (2002). Role of dynamic group therapy in psychiatry. Advances in Psychiatric Treatment, 8(1), 34–41. http://doi.org.ezaccess.libraries.psu.edu/10.1192/apt.8.1.34
Orton, B. (2019, July 24). Treatment Foster Care Oregon. Retrieved November 12, 2020, from https://www.blueprintsprograms.org/treatment-foster-care-oregon/
O’Neal, K. (2018). What Are the Most Common Behavior Issues in Foster Children? Adoption.com. https://adoption.com/most-common-behavior-issues-foster-children.
Pennsylvania State Resource Family Association. (2020). Support. https://www.psrfa.org/being-a-foster-parent/support/.
Ruffolo, M. C., Kuhn, M. T., & Evans, M. E. (2005). Support, Empowerment, and Education: A Study of Multiple Family Group Psychoeducation. Journal of Emotional and Behavioral Disorders, 13(4), 200-212. http://ezaccess.libraries.psu.edu/login?url=https://www-proquest-com.ezaccess.libraries.psu.edu/docview/214922813?accountid=13158
Suski, A. (2020). GenerationPMTO – Blueprints Programs. https://www.blueprintsprograms.org/programs/198999999/generationpmto/.