Fostering Healthy Futures: A model intervention program for youth in foster-care
Taussig, H., Culhane, S., Garrido, E., & Knudtson, M. (2012). RCT of a mentoring and skills group program: Placement and permanency outcomes for foster youth. Pediatrics, 130 (1), e33-e39.
Introduction:
In 2009, over 400,000 children in the United States were living in foster care. The average age of foster youth is 9.6 years old. Unfortunately, most of these children do not achieve placement stability or permanence (reunification, adoption, or guardianship). Children who live in out of home care are at high risk for many adverse outcomes, and children who are unable to achieve timely permanence are at an even higher risk. Preventative intervention programs aimed at parent management training have shown improvements in placement stability and permanence. Very few programs, however, have taken a youth-centered approach to combat the difficulties with placement and permanence; thus, the current study demonstrates how mentoring and a skills group intervention can directly help preadolescent youth in foster care achieve better placement and permanency outcomes.
Method:
In an evaluation of the Fostering Healthy Futures (FHF) preventative intervention, youth were assigned to either the intervention group (N=56) or a no-treatment control group (N=54). The youth were 9 to 11 years old, and had been placed in the foster care system due to maltreatment The intervention consisted of 2 components: (1) a skills group and (2) one-on-one mentoring. The program was designed to be “above and beyond treatment as usual.”
Skills Group:
The skills group met for 30 weeks, for 1.5 hours each week. Groups were made up of 8-10 children, with 2 group facilitators. The skills groups combined cognitive-behavioral skills and group activities. The skills group covered the following topics:
- emotion recognition
- perspective taking
- problem solving
- anger management
- cultural identity
- change and loss
- healthy relationships
- peer pressure
- abuse prevention
- future orientation
Mentoring:
The mentoring component of the FHF program consisted of 30 weeks of one-on-one mentoring (2-4 hours/week). Mentors were graduate students who were studying social work. The mentors received weekly individual and group supervision, as well as a weekly didactic seminar. The mentoring support was designed to help mentors:
- create empowering relationships with children to serve as positive examples for future relationships
- advocate for appropriate services for the children
- help children generalize skills learned in group through weekly activities
- engage children in a range of activities (extracurricular, educational, social, cultural, and recreational)
- promote attitudes to foster a positive future orientation
Results:
Results of the FHF intervention gave the following findings when comparing intervention youth to youth in the foster care system who did not receive the intervention:
- intervention youth were 71% less likely to be placed in residential treatment
- among children living in non-relative foster care:
- intervention youth had 44% fewer placement changes and were 82% less likely to be placed in a residential treatment center
- intervention youth were 5x more likely to have permanency 1 year post-intervention
- after 1-year post-intervention, intervention youth had a greater rate of reunification and higher rates of adoption
- there was an interaction between baseline behavior problems and intervention status such that the impact of the FHF program on placement changes was concentrated among those children with higher baseline behavior problems.
Conclusion:
These findings demonstrate that participation in a 9-month mentoring and skills group intervention can lead to increased placement stability and total permanence and led to decreases in problem behavior. These finding were particularly true for children who were in non-relative foster care.
Future intervention programs with youth in the foster care system:
- Should take a youth-centered approach
- Consider using social work students as one-on-one mentors
- Provide mentors with weekly supervision