Introduction
Youth in foster care have high rates of adverse experiences during formative years. Due to these risk factors, foster youth exhibit a great need for rigorous therapeutic services. Research indicates youths who are actively receiving therapeutic care have increased odds of high school completion and overall productive engagement.
https://doi.org/10.1016/j.childyouth.2020.104777
The American Academy of Pediatrics, Healthy Foster Care Initiative, identifies mental and behavioral health as the “greatest unmet heath need for children and teens in foster care.” Contributing factors include complex trauma, frequently changing placements, broken relationships, inconsistent access to mental health services and the over-prescription of psychotropic medications.
https://www.ncsl.org/research/human-services/mental-health-and-foster-care.aspx
Generally, children and youths in foster care have a high use of mental health services, also compared to the general youth-population. However, relative to their high rate of mental disorders, the service utilization by foster youth seems low, and findings indicate that a considerable part of this population does not receive services according to need.
https://bmchealthservres.biomedcentral.com/articles/10.1186/s12913-018-3365-6
Task
Plan effective interventions proven to be effective on youth within the foster care system. Multidimensional Treatment Foster Care (MTFC) emphasizes close adult supervision, fair and consistent limits, predictable consequences, supportive adult relationships and limited exposure to deviant peers by placing youth individually in a specially trained foster family. Studies comparing youth in MTFC vs. diverse group care programs found that MTFC youth spent less time in locked settings, had fewer criminal referrals, and had fewer delinquent peers at follow-up.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2515489/
Treatment Foster Care is a distinct, powerful, unique model of care that combines the best aspects of traditional foster care with residential care. Focuses in TFC are: 1) safety and well-being of the youth, 2) clinical treatment of youths emotional, behavioral, and medical conditions, and 3) intensive parental training.
Strength based perspective, resiliency theory, client centered and trauma focused approaches are essential aspects of TFC.
Process
Funding for a Treatment Foster Care Parent Training program in the city of Virginia Beach would be acquired by utilizing funds allocated by Title IV-B, Title IV-E, CAPTA Title 1 and 2, and the SAMHSA Federal Community Mental Health Services block grant.
The treatment needs of many children or youth in foster care require a therapeutic foster parent with specialized training. The parent must be available 24 hours a day to respond to crises or to the need for special therapeutic interventions, as well as being required to attend all multidisciplinary service planning or treatment plan meetings. Therapeutic foster care parents must complete training required of all licensed foster parents and must receive 30 additional clock hours of pre-service, evidence-based training to prepare them to become treatment oriented foster care parents prior to having children placed in the home.
Community Mental Health Services Block Grant (MHBG):
Funds from this grant are used to provide comprehensive, community-based mental health services to children with serious emotional disturbances and to monitor progress in implementing a comprehensive, community-based mental health system.
https://www.samhsa.gov/grants/block-grants/mhbg
Title IV-E:
Title IV-E pays for costs associated with placement, case management, administration, and training. Title IV-E funds are not flexible, and do not pay for services for the child or family.
Title IV-B:
Title IV-B is a capped allocation to each state to use for a wide range of services to preserve or support families, reunify children, and promote and support adoptions. Comparatively, Title IV-B funds is much less restricted than Title IV-E, allowing states to support a range of prevention, early intervention, permanency-related services and supports for children and families.
https://calswec.berkeley.edu/sites/default/files/cw_and_mh_fund_sources_1.pdf
Child Abuse Treatment and Prevention Act (CAPTA) Title I & II
CAPTA is a Federal Grant consisting of two parts, Title I allocates funds for general programs and Title II allocates funds for community based child abuse prevention services.
https://sgp.fas.org/crs/misc/IF10590.pdf
Evaluation
Outcome variables that have been used to gauge outcomes of TFC youth include measures of intellectual functioning, academic performance, perceptions of social environment, and levels of internalizing and externalizing behavioral problems. Some evaluations of TFC programs have used additional measures of success, including changes in the foster child’s self-esteem, sense of identity and personal worth. Comparisons of TFC with other options suggest that TFC results in improved social skills and psychological adjustment, reduced behavior problems, greater rates of placement permanency, less restrictive postdischarge placements, and lower costs than institutional programs.
https://link.springer.com/content/pdf/10.1023/A:1009418809133.pdf
Transgenerational child welfare involvement has long been considered in literature. One study had a significant finding that women who had been in TFC as adolescents were less likely to experience child welfare involvement in adulthood when compared to peers in the TAU (treatment as usual) group. By preventing future child welfare involvement when juveniles become parents themselves, TFC has the potential to significantly impact mental and behavioral health of future generations. Additionally, the data also showed that the women had fewer criminal convictions.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7717599/
Conclusion
Randomized control trials confirmed agencies using the team-supported model of TFC in a foster home setting helps to prevent the escalation of delinquent or violent behavior in youths, decrease the rate of teen pregnancies and encourage better academic engagement.
https://www.streetroots.org/news/2021/11/10/treatment-foster-care
Increasing the number of specially trained treatment foster parents decreases the likelihood of negative outcomes faced by youth placed in the foster care system. Treatment parents are a critical part of the multidisciplinary team responsible for the care of youth in treatment foster care. TFC reinforces the values and life skills necessary for a successful life, filled with caring, contribution and commitment. Ongoing training for treatment parents includes trauma-informed interventions, crisis intervention skills, life skills development, and brain-based interventions, as well as discussions and groups for support.
https://childrensguild.org/child-family-community/treatment-foster-care/
Credits
Boyd, L. W. & Foster Family-based Treatment Association. (2013, July). Therapeutic Foster Care: Exceptional Care for Complex, Trauma-Impacted Youth in Foster Care. State Policy and Reform Center. https://childwelfaresparc.files.wordpress.com/2013/07/therapeutic-foste…
Cheatham, L. P., Randolph, K. A., & Boltz, L. D. (2020). Youth with disabilities transitioning from foster care: Examining prevalence and predicting positive outcomes. Children and Youth Services Review, 110, 104777. https://doi.org/10.1016/j.childyouth.2020.104777
Congressional Research Service (CRS). (2022, March). Child Welfare: Purposes, Federal Programs, and Funding. https://sgp.fas.org/crs/misc/IF10590.pdf
Larsen, M., Baste, V., Bjørknes, R., Myrvold, T., & Lehmann, S. (2018). Services according to mental health needs for youth in foster care – A multi-informant study. BMC Health Services Research, 18(1). https://doi.org/10.1186/s12913-018-3365-6
Lee, B. R., & Thompson, R. (2008). Comparing outcomes for youth in treatment foster care and family-style group care. Children and Youth Services Review, 30(7), 746–757. https://doi.org/10.1016/j.childyouth.2007.12.002
Mental Health and Foster Care. (2019, November 1). National Conference of State Legislatures. Retrieved April 23, 2022, from https://www.ncsl.org/research/human-services/mental-health-and-foster-c…
Redding, R. E., Fried, C., & Britner, P. A. (2000). Predictors of Placement Outcomes in Treatment Foster Care: Implications for Foster Parent Selection and Service Delivery. Journal of Child and Family Studies, 9(4), 425–447. https://doi.org/10.1023/a:1009418809133
Saldana, L., Campbell, M., Leve, L., & Chamberlain, P. (2020). Long-Term Economic Benefit of Treatment Foster Care Oregon (TFCO) for Adolescent Females Referred to Congregate Care for Delinquency. Child Welfare, 97(5), 179–195. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7717599/
Treatment Foster Care - The Children’s Guild. (2022, March 2). The Children’s Guild. Retrieved April 23, 2022, from https://childrensguild.org/child-family-community/treatment-foster-care/
University of California, Berkeley. (2013, October). Major Fund Sources in Child Welfare and Mental Health. University of California Press. https://calswec.berkeley.edu/sites/default/files/cw_and_mh_fund_sources…
US Department of Health and Human Services. (2020, April 16). Community Mental Health Services Block Grant. Substance Abuse and Mental Health Services Administration. Retrieved April 23, 2022, from https://www.samhsa.gov/grants/block-grants/mhbg