Long-term consequences of child abuse and neglect

April 2005

What are the advantages of the development and implementation of treatment/therapeutic foster care?

This question was originally posted in May 2002. Since then, there have been new developments in therapeutic/treatment foster care. In fact, therapeutic/treatment foster care is now recognized as an “effective practice.” The response below is an update to the May 2002 FAQ.

Child Welfare staff report that children whose placements are considered “chronically unstable” represent the group in greatest need for effective services. These children not only tend to have a series of unsuccessful foster care placements, but they are often unsuccessful in the most restrictive placements (i.e., hospitals and group care). These children represent a small percentage in the child welfare system, but they consume a disproportionate share of resources. They are often characterized as highly aggressive, disruptive, and as having limited academic and social skills. They are both a challenge to their birth parents as well as to their foster parents.

There are at least two mental health treatment interventions that may prove beneficial to children who are disruptive, aggressive, and defiant and who experience unstable placements. One of these interventions is the therapeutic foster care model developed by Chamberlain and her colleagues at the Oregon Social Learning Center , and the other is the wraparound intervention with which most of us are familiar. The primary goal of using these interventions simultaneously is to improve permanency outcomes for foster children with serious emotional disturbances. These interventions offer several advantages to children; to birth, extended, and foster families; and to staff working in the mental health and child welfare systems.

Specifically:

Both programs meet the criteria for effective intervention, and the evidence suggests that if they are implemented as intended, foster youth will benefit.
The programs promote the child welfare goals of permanency and placement stability, which helps to ensure that mental health and child welfare professionals share the same outcome goals for children in foster care.
The two programs are consistent with system of care principles (e.g., establishing parents as partners, being sensitive to children's culture, and providing treatment in the least restrictive environment possible).
The tremendous support to and inclusion of foster and birth parents contributes to foster parent retention and competencies and to the reunification and adoption of foster children.
Neither of these interventions is heavily dependent upon professional staff, which is important given the critical staffing shortages in the child welfare and mental health systems.
These two interventions are amenable to adapt to a variety of service systems because they provide both manuals and training to help ensure effective implementation.

The Foster Family-Based Treatment Association has just released “Program Standards for Treatment Foster Care” (revised July 2004). The standards include guidelines for the development and implementation of treatment foster care. This document may be ordered for $20.00 a copy at www.FFTA.org

Sections of this FAQ were excerpted from “Evidence Based Practices in Mental Health Services for Foster Youth,” which was developed by the California Institute for Mental Health (www.cimh.org).

Technical Assistance Partnership for Child and Family Mental Health

Child Welfare Frequently Asked Questions

April 2005

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	April 2005 What are the advantages of the development and implementation of treatment/therapeutic foster care? This question was originally posted in May 2002. Since then, there have been new developments in therapeutic/treatment foster care. In fact, therapeutic/treatment foster care is now recognized as an “effective practice.” The response below is an update to the May 2002 FAQ. Child Welfare staff report that children whose placements are considered “chronically unstable” represent the group in greatest need for effective services. These children not only tend to have a series of unsuccessful foster care placements, but they are often unsuccessful in the most restrictive placements (i.e., hospitals and group care). These children represent a small percentage in the child welfare system, but they consume a disproportionate share of resources. They are often characterized as highly aggressive, disruptive, and as having limited academic and social skills. They are both a challenge to their birth parents as well as to their foster parents. There are at least two mental health treatment interventions that may prove beneficial to children who are disruptive, aggressive, and defiant and who experience unstable placements. One of these interventions is the therapeutic foster care model developed by Chamberlain and her colleagues at the Oregon Social Learning Center , and the other is the wraparound intervention with which most of us are familiar. The primary goal of using these interventions simultaneously is to improve permanency outcomes for foster children with serious emotional disturbances. These interventions offer several advantages to children; to birth, extended, and foster families; and to staff working in the mental health and child welfare systems. Specifically: Both programs meet the criteria for effective intervention, and the evidence suggests that if they are implemented as intended, foster youth will benefit. The programs promote the child welfare goals of permanency and placement stability, which helps to ensure that mental health and child welfare professionals share the same outcome goals for children in foster care. The two programs are consistent with system of care principles (e.g., establishing parents as partners, being sensitive to children's culture, and providing treatment in the least restrictive environment possible). The tremendous support to and inclusion of foster and birth parents contributes to foster parent retention and competencies and to the reunification and adoption of foster children. Neither of these interventions is heavily dependent upon professional staff, which is important given the critical staffing shortages in the child welfare and mental health systems. These two interventions are amenable to adapt to a variety of service systems because they provide both manuals and training to help ensure effective implementation. The Foster Family-Based Treatment Association has just released “Program Standards for Treatment Foster Care” (revised July 2004). The standards include guidelines for the development and implementation of treatment foster care. This document may be ordered for $20.00 a copy at www.FFTA.org Sections of this FAQ were excerpted from “Evidence Based Practices in Mental Health Services for Foster Youth,” which was developed by the California Institute for Mental Health (www.cimh.org).