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Whitelaw S. Fostering resilience in young people with intellectual disabilities using a 'settings' approach. JOURNAL OF INTELLECTUAL DISABILITIES : JOID 2024; 28:549-566. [PMID: 36977495 PMCID: PMC11059839 DOI: 10.1177/17446295231168186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
The need to foster resilience amongst young people with intellectual disabilities is increasingly recognised within policy. Critically, understanding of the actual means by which this aspiration might be most sensitively and effectively met is considered weak. This paper reports on an exploratory case-study of a social enterprise community café - The Usual Place - that through the promotion of employability, seeks to promote resilience amongst its young 'trainees' with intellectual disabilities. Two research questions were set: "how is 'resilience' conceptualized within the organisation" and "what features within the organisation are significant in fostering resilience"? We identify a range of significant features associated with being able to successfully foster resilience - the need for a foundational 'whole organisation'(settings) approach based on high levels of participation and choice; the negotiation of a constructive dynamic tension between 'support' and 'exposure'; and the embedding of these actions in embodied actions and day-to-day organisational activities.
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Affiliation(s)
- Sandy Whitelaw
- School of Interdisciplinary Studies, University of Glasgow, Dumfries, UK
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2
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Malindi MJ, Hay J. Resilience anchors for children in an out-of-home care institution during and after COVID-19. Front Psychol 2023; 14:1189739. [PMID: 37849481 PMCID: PMC10577382 DOI: 10.3389/fpsyg.2023.1189739] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2023] [Accepted: 08/01/2023] [Indexed: 10/19/2023] Open
Abstract
Growing numbers of children of all ages grow up in out-of-home care institutions due to personal and socioecological risk variables that destabilized their families of origin. In the aftermath of the COVID-19 pandemic which disrupted lives and development, there is particular interest in how children who grow up in out-of-home care institutions cope and develop. This paper reports the findings of a study that sought to document anchors of resilience in children who resided in a care institution run by a non-governmental, church-based welfare organization in one of the central provinces of South Africa. In line with recent developments in childcare, the organization mainly functions via smaller child and youth group homes across the province (compared to bigger children's homes in the past). In our qualitative, phenomenological study, we used the participatory, child-friendly, and less intrusive draw-and-write technique to generate data. We asked the 20 participating children of one of these group homes to make drawings that mirror their lives, and to write paragraphs in which they described their drawings. All were school-going children in care, aged from 12 to 19. There were 11 girls and 9 boys in the study, and one of these identified as "other." The grades ranged from 7 to 12 and they spoke African languages, namely Afrikaans, Sesotho, Setswana and IsiXhosa. We used inductive content analysis to process the data, and the findings indicate that, notwithstanding personal and socioecological risks during and after the COVID-19 pandemic, the resilience of the participants was anchored by a number of universal personal strengths as well as socioecological resources.
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Schütte S, Lohaus A, Symanzik T, Heinrichs N, Konrad K, Reindl V. Longitudinal Associations Between Parenting and Child Behaviour Problems and the Moderating Effect of Child Callous Unemotional Traits in Foster and Biological Families. Child Psychiatry Hum Dev 2023; 54:1274-1286. [PMID: 35239057 PMCID: PMC10435590 DOI: 10.1007/s10578-022-01324-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/30/2022] [Indexed: 11/03/2022]
Abstract
The goals of the current study were to examine (i) differences in parenting between foster and biological parents, (ii) the longitudinal associations with children's internalising and externalising problems and iii) the potential moderation of these by children's callous-unemotional traits (CU traits). Data from 86 foster children (M = 4.44 years, male = 48%) and 148 biological children (M = 3.69 years, male = 49%) with their families were analysed in a longitudinal study with three measurement times. Parenting behaviour did not significantly differ between the foster and biological family groups. Significant longitudinal cross-lagged effects were found for parental warmth and support and children's externalising problems. CU traits moderated the relationship between warmth and support and externalising problems of children. Findings suggest that parenting behaviours and child psychopathology do influence each other over time reciprocally and to a similar extent in both groups. However, there was also evidence for greater temporal stability of psychopathological symptoms and reduced responsivity to parental warmth in children with higher CU traits.
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Affiliation(s)
- Sabrina Schütte
- Developmental Psychology and Developmental Psychopathology, Department of Psychology, University of Bielefeld, P.O. Box 10 01 31, 33501, Bielefeld, Germany.
| | - Arnold Lohaus
- Developmental Psychology and Developmental Psychopathology, Department of Psychology, University of Bielefeld, P.O. Box 10 01 31, 33501, Bielefeld, Germany
| | - Tabea Symanzik
- Developmental Psychology and Developmental Psychopathology, Department of Psychology, University of Bielefeld, P.O. Box 10 01 31, 33501, Bielefeld, Germany
| | - Nina Heinrichs
- Department of Clinical Psychology & Psychotherapy, University of Bremen, Bremen, Germany
| | - Kerstin Konrad
- Child Neuropsychology Section, Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Medical Faculty, RWTH Aachen University, Aachen, Germany
- JARA-Brain Institute II, Molecular Neuroscience and Neuroimaging, RWTH Aachen & Research Centre Juelich, Aachen, Germany
| | - Vanessa Reindl
- Child Neuropsychology Section, Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Medical Faculty, RWTH Aachen University, Aachen, Germany
- JARA-Brain Institute II, Molecular Neuroscience and Neuroimaging, RWTH Aachen & Research Centre Juelich, Aachen, Germany
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Becker TD, Castañeda Ramirez S, Bruges Boude A, Leong A, Ivanov I, Rice TR. Interventions for prevention and treatment of substance use in youth with traumatic childhood experiences: a systematic review and synthesis of the literature. Eur Child Adolesc Psychiatry 2023:10.1007/s00787-023-02265-x. [PMID: 37480386 DOI: 10.1007/s00787-023-02265-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2022] [Accepted: 07/18/2023] [Indexed: 07/24/2023]
Abstract
Most substance use begins in adolescence. Both childhood trauma and associated post-traumatic stress disorder (PTSD) increase risk for early substance use, which is associated with greater eventual severity of substance use disorders (SUDs). When co-occurring, PTSD and SUD can reinforce and exacerbate each other, necessitating integrated treatment approaches. To systematically review existing literature on interventions for prevention or treatment of SUDs among adolescents (aged 10-24) with a history of trauma, with or without PTSD, we searched databases (PubMed, PsycInfo, CINAHL, Cochrane CENTRAL) using search terms related to substance use, trauma, adolescents, and interventions. Searches identified 8134 unique articles, 68 of which prompted full-text screening. Authors extracted data, applied the Effective Public Health Practice Project Quality Assessment Tool to evaluate the evidence, and synthesized findings. Thirty three articles met eligibility criteria, including 13 RCTs. Twenty studies (10 RCTs) evaluated interventions for substance use and co-occurring problems among youth with a history of trauma, predominantly via individual therapy based on cognitive-behavioral principles, although group therapy, case management, and other approaches have also been studied. Interventions with exposure-based components were infrequent but had robust results and minimal adverse outcomes. Thirteen studies examined differential response of youth with a history of trauma to standard SUD treatments, compared to youth without a history of trauma, with mixed findings. Youth with a history of trauma face elevated risk of SUDs and may respond differently to SUD treatments. Several promising interventions have been recently developed.
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Affiliation(s)
- Timothy D Becker
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
- Department of Psychiatry, NewYork-Presbyterian Hospital/Weill Cornell, 525 E. 68th Street, Box 140, New York, NY, 10065, USA.
- Department of Psychiatry, New York State Psychiatric Institute, Columbia University Vagelos College of Physicians & Surgeons, New York, USA.
| | | | - Adriana Bruges Boude
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Alicia Leong
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Iliyan Ivanov
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Timothy R Rice
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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Jovellar-Isiegas P, Jiménez-Sánchez C, Buesa-Estéllez A, Gómez-Barreiro P, Alonso-Langa I, Calvo S, Francín-Gallego M. Feasibility of Developing Audiovisual Material for Training Needs in a Vietnam Orphanage: A Mixed-Method Design. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3118. [PMID: 36833811 PMCID: PMC9966681 DOI: 10.3390/ijerph20043118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Revised: 01/31/2023] [Accepted: 02/08/2023] [Indexed: 06/18/2023]
Abstract
Disabled children living in orphanages in low-income countries may not have access to the therapy they need. The COVID-19 pandemic has complicated the situation dramatically, making online training activities a possible innovative option to meet the real needs of local staff. This study aimed to detect the training needs of the local staff of an orphanage in Vietnam, as well as develop an audiovisual training material and measure its feasibility. Training needs were identified through a focus group carried out by the volunteers of Fisios Mundi, a nongovernmental organization. The audiovisual training material was developed to meet these specific needs. Lastly, its feasibility was evaluated, in terms of both content and format, through an ad hoc questionnaire. Nine volunteers participated in the project. Twenty-four videos were created and structured around five themes. This study expands the body of knowledge on how an international cooperation project can be developed in a pandemic situation. The audiovisual training material content and format created in this project was considered by the volunteers as very feasible and useful for training the staff of a Vietnamese orphanage.
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Affiliation(s)
- Patricia Jovellar-Isiegas
- Department of Physical Therapy, Faculty of Health Sciences, Universidad San Jorge, Villanueva de Gállego, 50830 Zaragoza, Spain
| | - Carolina Jiménez-Sánchez
- Department of Physical Therapy, Faculty of Health Sciences, Universidad San Jorge, Villanueva de Gállego, 50830 Zaragoza, Spain
| | - Almudena Buesa-Estéllez
- Department of Physical Therapy, Faculty of Health Sciences, Universidad San Jorge, Villanueva de Gállego, 50830 Zaragoza, Spain
| | - Pilar Gómez-Barreiro
- Department of Physical Therapy, Faculty of Health Sciences, Universidad San Jorge, Villanueva de Gállego, 50830 Zaragoza, Spain
| | - Inés Alonso-Langa
- Department of Physical Therapy, Faculty of Health Sciences, Universidad San Jorge, Villanueva de Gállego, 50830 Zaragoza, Spain
| | - Sandra Calvo
- Department of Physiatry and Nursing, Faculty of Health Sciences, IIS Aragon, University of Zaragoza, 50001 Zaragoza, Spain
| | - Marina Francín-Gallego
- Department of Physical Therapy, Faculty of Health Sciences, Universidad San Jorge, Villanueva de Gállego, 50830 Zaragoza, Spain
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McTavish JR, McKee C, Tanaka M, MacMillan HL. Child Welfare Reform: A Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph192114071. [PMID: 36360960 PMCID: PMC9655914 DOI: 10.3390/ijerph192114071] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Revised: 10/20/2022] [Accepted: 10/24/2022] [Indexed: 06/01/2023]
Abstract
While there have been ongoing calls to reform child welfare so that it better meets children's and families' needs, to date there have been no comprehensive summaries of child welfare reform strategies. For this systematic scoping review, we summarized authors' recommendations for improving child welfare. We conducted a systematic search (2010 to 2021) and included published reviews that addressed authors' recommendations for improving child welfare for children, youth, and families coming into contact with child welfare in high-income countries. A total of 4758 records was identified by the systematic search, 685 full-text articles were screened for eligibility, and 433 reviews were found to be eligible for this scoping review. Reviews were theoretically divided, with some review authors recommending reform efforts at the macro level (e.g., addressing poverty) and others recommending reform efforts at the practice level (e.g., implementing evidence-based parenting programs). Reform efforts across socioecological levels were summarized in this scoping review. An important next step is to formulate what policy solutions are likely to lead to the greatest improvement in safety and well-being for children and families involved in child welfare.
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Affiliation(s)
- Jill R. McTavish
- Offord Centre for Child Studies, Department of Psychiatry and Behavioural Neurosciences, McMaster University, 293 Wellington Street North, Hamilton, ON L8L 8E7, Canada
| | - Christine McKee
- Offord Centre for Child Studies, Department of Psychiatry and Behavioural Neurosciences, McMaster University, 293 Wellington Street North, Hamilton, ON L8L 8E7, Canada
| | - Masako Tanaka
- Offord Centre for Child Studies, Department of Psychiatry and Behavioural Neurosciences, McMaster University, 293 Wellington Street North, Hamilton, ON L8L 8E7, Canada
| | - Harriet L. MacMillan
- Offord Centre for Child Studies, Department of Psychiatry and Behavioural Neurosciences, McMaster University, 293 Wellington Street North, Hamilton, ON L8L 8E7, Canada
- Department of Pediatrics, McMaster University, 1280 Main Street West, Hamilton, ON L8S 4K1, Canada
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A Public Health Perspective of Post-Traumatic Stress Disorder. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19116474. [PMID: 35682057 PMCID: PMC9180718 DOI: 10.3390/ijerph19116474] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Revised: 05/20/2022] [Accepted: 05/23/2022] [Indexed: 11/25/2022]
Abstract
Trauma exposure is one of the most important and prevalent risk factors for mental and physical ill-health. Prolonged or excessive stress exposure increases the risk of a wide variety of mental and physical symptoms, resulting in a condition known as post-traumatic stress disorder (PTSD). The diagnosis might be challenging due to the complex pathophysiology and co-existence with other mental disorders. The prime factor for PTSD development is exposure to a stressor, which variably, along with peritraumatic conditions, affects disease progression and severity. Additionally, many factors are thought to influence the response to the stressor, and hence reshape the natural history and course of the disease. With sufficient knowledge about the disease, preventive and intervenient methods can be implemented to improve the quality of life of the patients and to limit both the medical and economic burden of the disease. This literature review provides a highlight of up-to-date literature on traumatic stress, with a focus on causes or triggers of stress, factors that influence response to stress, disease burden, and the application of the social-ecological public health model of disease prevention. In addition, it addresses therapeutic aspects, ethnic differences in traumatic stress, and future perspectives, including potential biomarkers.
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8
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Dilly LJ, Pavlov A. Assessing students in foster care for autism spectrum disorders. PSYCHOLOGY IN THE SCHOOLS 2022. [DOI: 10.1002/pits.22657] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- Laura J. Dilly
- Department of PediatricsMarcus Autism Center, Emory University School of MedicineAtlantaGeorgiaUSA
| | - Alexis Pavlov
- Department of PediatricsMarcus Autism Center, Emory University School of MedicineAtlantaGeorgiaUSA
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Job AK, Ehrenberg D, Hilpert P, Reindl V, Lohaus A, Konrad K, Heinrichs N. Taking Care Triple P for Foster Parents With Young Children in Foster Care: Results of a 1-Year Randomized Trial. JOURNAL OF INTERPERSONAL VIOLENCE 2022; 37:322-348. [PMID: 32167402 DOI: 10.1177/0886260520909196] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Young children with a history of maltreatment or neglect in foster families often confront their caregivers with particularly challenging behaviors. This may lead to more parenting stress, an increased risk for the child in foster care to experience further maltreatment, and placement disruptions. We conducted a randomized controlled trial to investigate the efficacy of a parent group training tailored to the special needs of foster families. We hypothesized significant short- and long-term improvements regarding foster parents' parenting competencies, child mental health problems, and related outcomes. Eighty-one families with 87 children in foster care aged 2 to 7 years participated in the trial. For the intervention study, 44 randomly selected families (54%) were offered to participate in the parent group training. Intervention and control group families were reassessed three times over a period of 1 year. Contrary to our expectations, we found no advantages of the intervention group compared with the usual care control group on any outcome measure. Instead, we found some significant changes in both groups across time. Placement into foster care is associated with some favorable outcomes for children in foster care. Additional support for foster families beyond the services delivered in the youth welfare system to foster parents was not associated with more favorable outcomes. The present intervention is likely associated with a low risk of harm but also with a high likelihood of a lack of significant benefits for foster parents and their young children going beyond feeling satisfied about the delivered services. Participating foster families showed favorable baseline results on parenting measures which may have impeded intervention effects to unfold on these proximal variables.
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Monson K, Herrman H, Moeller-Saxone K, Humphreys C, Harvey C. How can mental health practitioners collaborate with child welfare practitioners to improve mental health for young people in out of home care? Early Interv Psychiatry 2021; 15:1768-1776. [PMID: 33474788 DOI: 10.1111/eip.13118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2020] [Revised: 11/07/2020] [Accepted: 01/04/2021] [Indexed: 11/27/2022]
Abstract
BACKGROUND Young people who grow up in out of home care have higher risk of poor mental health outcomes than peers who grow up with their family-of-origin. Interagency collaboration is an important service-level intervention to improve access to mental healthcare. However, few descriptions of collaboration provide guidance about collaboration between individual practitioners. AIM This substudy aimed to contribute to a larger study-the Ripple project-through exploring the experiences of practitioners working across child welfare and mental health services regarding collaboration in the care of young people; and to identify practices that might enhance collaborative work and improve mental health outcomes. METHODS Practitioners from across child welfare and mental health services were purposively sampled and participated in focus groups. Recordings and transcriptions of focus groups were analysed to identify themes within and between groups. A cross-sector expert advisory group was involved in this work. RESULTS Focus groups were convened with 43 practitioners. We identified four themes during analysis, these were: shared understanding of the history and context of problems; specific skills and practices; self-awareness of workers and carers; and involving and supporting carers. CONCLUSIONS A number of practices were identified that might lead to enhanced collaboration between agencies and across interdisciplinary care teams. Supporting mental health practitioners to adopt these might assist interagency and interdisciplinary working.
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Affiliation(s)
- Katherine Monson
- Orygen, Melbourne, Australia.,NorthWestern Mental Health, Melbourne, Australia
| | - Helen Herrman
- Orygen, Melbourne, Australia.,Centre for Youth Mental Health, The University of Melbourne, Melbourne, Australia
| | | | - Cathy Humphreys
- Department of Social Work, The University of Melbourne, Melbourne, Australia
| | - Carol Harvey
- NorthWestern Mental Health, Melbourne, Australia.,Department of Psychiatry, The University of Melbourne, Melbourne, Australia
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Midgley N, Irvine K, Rider B, Byford S, Cirasola A, Ganguli P, Katangwe-Chigamba T, Murdoch J, Pond M, Pursch B, Redfern S, Richards ZL, Shepstone L, Sims E, Smith C, Sprecher E, Swart AM, Wyatt S, Wellsted D. The Reflective Fostering Programme-improving the wellbeing of children in care through a group intervention for foster carers: a randomised controlled trial. Trials 2021; 22:841. [PMID: 34823552 PMCID: PMC8613455 DOI: 10.1186/s13063-021-05739-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Accepted: 10/20/2021] [Indexed: 11/30/2022] Open
Abstract
Background The needs of children in care are a government priority, yet the evidence base for effective interventions to support the emotional wellbeing of children in care is lacking. Research suggests that supporting the carer-child relationship, by promoting the carer’s reflective parenting, may be an effective approach to improving the wellbeing of these children. Methods The study comprises a definitive, superiority, two-armed, parallel, pragmatic, randomised controlled trial, with embedded process evaluation and economic evaluation, and an internal pilot, to evaluate the effectiveness, and cost-effectiveness, of the Reflective Fostering Programme. Randomisation is at the individual level using a 1:1 allocation ratio. The study is being conducted in local authority sites across England, and is targeted at foster carers (including kinship carers) looking after children aged 4 to 13. Consenting participants are randomly allocated to the Reflective Fostering Programme (intervention arm) in addition to usual support or usual support alone (control arm). The primary outcome is behavioural and emotional wellbeing of the child 12 months post-baseline, and secondary outcomes include the following: foster carer’s level of stress, quality of life, reflective capacity, compassion fatigue and burnout, placement stability, the quality of the child-carer relationship, child’s capacity for emotional regulation, and achievement of personalised goals set by the carer. Discussion A feasibility study has indicated effectiveness of the Programme in improving the child-carer relationship and emotional and behavioural wellbeing of children in care. This study will test the effectiveness and cost-effectiveness of implementing the Reflective Fostering Programme as an additional aid to the support already available to local authority foster carers. Trial registration ISRCTN 70832140.
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Affiliation(s)
- Nick Midgley
- Research Department of Clinical, Educational and Health Psychology, zUniversity College London, London, UK.
| | - Karen Irvine
- Centre for Health Services and Clinical Research, University of Hertfordshire, Hatfield, UK
| | - Beth Rider
- Centre for Health Services and Clinical Research, University of Hertfordshire, Hatfield, UK
| | | | | | | | | | - Jamie Murdoch
- Norwich Clinical Trials Unit, University of East Anglia, Norwich, UK
| | - Martin Pond
- Norwich Clinical Trials Unit, University of East Anglia, Norwich, UK
| | - Benita Pursch
- Anna Freud National Centre for Children and Families, London, UK
| | - Sheila Redfern
- Anna Freud National Centre for Children and Families, London, UK
| | - Zena Louise Richards
- Research Department of Clinical, Educational and Health Psychology, zUniversity College London, London, UK
| | - Lee Shepstone
- Norwich Clinical Trials Unit, University of East Anglia, Norwich, UK
| | - Erika Sims
- Norwich Clinical Trials Unit, University of East Anglia, Norwich, UK
| | | | - Eva Sprecher
- Anna Freud National Centre for Children and Families, London, UK
| | - Ann Marie Swart
- Norwich Clinical Trials Unit, University of East Anglia, Norwich, UK
| | - Solange Wyatt
- Centre for Health Services and Clinical Research, University of Hertfordshire, Hatfield, UK
| | - David Wellsted
- Centre for Health Services and Clinical Research, University of Hertfordshire, Hatfield, UK
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Marcellus L, MacKinnon K, Gordon C, Shaw L. Interventions and programs that support the health and development of infants with prenatal substance exposure in foster care: a scoping review. JBI Evid Synth 2021; 19:1844-1886. [PMID: 33993147 DOI: 10.11124/jbies-20-00071] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
OBJECTIVE The objective of this scoping review was to describe the characteristics of interventions and programs that support the health and development of infants in foster care who have prenatal substance exposure, their foster care providers, and birth families. INTRODUCTION Infants in foster care may have experienced prenatal substance exposure, neglect, and maltreatment, as well as disruptions in their relationships with primary caregivers. Despite multiple vulnerabilities, they also have great capacity for overcoming early adversities. Enhanced foster care has been identified as a key influence on the positive development of infants in the child welfare system. INCLUSION CRITERIA This scoping review considered publications that described interventions and programs designed to support foster care providers who care for infants less than 12 months of age with prenatal substance exposure. This review included research studies and gray literature. This scoping review focused on sources that described caregiving interventions and elements of programs that took place within the context of family or home-based foster care. METHODS A three-step search strategy was used to identify publications in the English language from January 2000 to December 2019. A literature search was conducted using MEDLINE, Academic Search Premier, PsycINFO, and CINAHL databases. Titles and abstracts were initially screened to assess if publications met the inclusion criteria, followed by full-text review. Publications that met the inclusion criteria were assessed by two independent reviewers using a data extraction tool developed for this review. Findings were thematically analyzed on the basis of similarity in focus and descriptively presented with tables and figures to support the findings. RESULTS Eighty-one publications were included, including 48 research papers and 33 gray literature sources. Thematic analysis of the focus of each publication resulted in identification of four core themes: i) mental health promotion for infants in care; ii) child welfare program elements; iii) identification of infants and families at risk of requiring foster care; and iv) outcomes for infants in care and their families. The interventions and programs identified during this scoping review were primarily focused on supporting social-emotional development. With the significant focus on infant mental health, supporting birth parents to stay attached to their infants was a key focus of the majority of publications. The concept of being able to proactively identify risk factors that were associated with infants requiring foster care emerged in relation to how family preservation could be supported. Strategies identified as contributing to the development of successful interventions and programs included having foster care providers participate as collaborators in designing services, designing services that are adaptable to a range of contexts, involving community partners outside child welfare, and having developmentally appropriate programs. CONCLUSIONS Infants represent a significant proportion of children in foster care. A developmental perspective is needed for child welfare service planning to address their unique needs. Intervention during the early years holds significant potential for promoting positive developmental pathways and family preservation.
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Affiliation(s)
- Lenora Marcellus
- The University of Victoria (UVic) Centre for Evidence-Informed Nursing and HealthCare (CEiNHC): A JBI Affiliated Group, Victoria, BC, Canada
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Monson K, Moeller-Saxone K, Humphreys C, Harvey C, Herrman H. Promoting mental health in out of home care in Australia. Health Promot Int 2021; 35:1026-1036. [PMID: 31550355 DOI: 10.1093/heapro/daz090] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Young people in out of home care (OoHC) typically have worse mental health outcomes than peers who grow up within a family of origin. Innovations to improve the mental health of this group have tended to focus on pathology rather than mental health promotion and prevention of mental illnesses, and are often costly and challenging to implement. This qualitative study explored perspectives from young people with experience of OoHC in Melbourne, Australia regarding the promotion of mental health in OoHC. The study informed the subsequent development of a system-level intervention to support workers and carers in OoHC and evaluation of its implementation, the Ripple study. We conducted thematic analysis of data from interviews and focus groups with 14 young people aged 18-24 years with diverse identities and experiences of foster, kinship and residential care. We identified four key themes. These were providing a home-like environment; having someone to talk to; connecting to the wider community and having opportunities to become an active citizen. There is a need for both mental health promotion and treatment approaches in interventions to support workers and carers and young people in OoHC. Mental health promotion strategies should include a focus on enhancing existing capacities of carers and workers. Mental health promotion for young people in OoHC depends on strong intersectoral collaboration and youth participation.
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Affiliation(s)
| | | | | | - Carol Harvey
- Department of Psychiatry, The University of Melbourne.,NorthWestern Mental Health
| | - Helen Herrman
- Orygen, The National Centre for Excellence in Youth Mental Health
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Washington T, Stewart CJ, Rose RA. Academic Trajectories of Children in Formal and Informal Kinship Care. Child Dev 2021; 92:2299-2316. [PMID: 33913158 DOI: 10.1111/cdev.13580] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
The academic achievement places children on a positive trajectory for their lifespan. The aim of this study was to examine the academic trajectories of children in out-of-home care (OOCH) and whether kinship care has a protective effect relative to nonkin foster care. The sample analyzed for this study consists of 519,306 racially diverse youth in North Carolina schools 8 to 11 years old in the school year 2009-2010 (e.g., 27% African American, 12% Latinx, 53% White). Four longitudinal administrative data sources were merged to create this unique sample. Multilevel modeling revealed no difference between formal and non-OOHC, but showed differences between nonkin foster, informal, and non-OOHC. Children's academic performance who reside in formal kinship care is similar to children in non-OOHC.
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Affiliation(s)
| | - C Joy Stewart
- University of North Carolina at Chapel Hill School of Social Work
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15
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Chodura S, Lohaus A, Symanzik T, Heinrichs N, Konrad K. Foster Parents' Parenting and the Social-Emotional Development and Adaptive Functioning of Children in Foster Care: A PRISMA-Guided Literature Review and Meta-Analysis. Clin Child Fam Psychol Rev 2021; 24:326-347. [PMID: 33590373 PMCID: PMC8131300 DOI: 10.1007/s10567-020-00336-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/06/2020] [Indexed: 11/30/2022]
Abstract
Children in foster care (CFC) are at increased risk for negative developmental outcomes. Given the potential influence of foster parents' parenting on the development of CFC, this literature review and meta-analysis provide an initial overview of how parenting factors in foster families relate to CFC's developmental outcomes. We aimed to explore (1) whether foster parents' parenting conceptualizations are related differently to various CFC developmental outcome variables and (2) how characteristics of foster parents and CFC moderate these associations. Following the recommendations of the PRISMA statement, we searched four databases in 2017 (with an update in May 2020). Forty-three primary studies were coded manually. The interrater agreement was 92.1%. Parenting variables were specified as parenting behavior, style, and goals and were distinguished further into functional and dysfunctional parenting. CFC development was divided into adaptive (including cognitive) development and maladaptive development. Meta-analyses could be performed for foster parenting behavior and developmental outcomes, as well as for functional parenting goals and maladaptive socioemotional outcomes in CFC. Associations between functional parenting behavior and adaptive child development were positive and negative for maladaptive child development, respectively. For dysfunctional, parenting effects were in the opposite direction. All effects were small to moderate. Similar results were found descriptively in the associations of parenting style and child developmental outcomes. We found similar effect sizes and directions of the associations between parenting behavior in foster families and the child's developmental outcomes as those previously reported for biological families. These findings provide strong support for the significant role of parenting in foster families regarding children's development in foster care.
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Affiliation(s)
- Sabrina Chodura
- Developmental Psychology and Developmental Psychopathology, University of Bielefeld, Bielefeld, Germany. .,Department of Psychology, WU Developmental Psychology and Developmental Psychopathology, University of Bielefeld, P.O. Box 10 01 31, 33501, Bielefeld, Germany.
| | - Arnold Lohaus
- Developmental Psychology and Developmental Psychopathology, University of Bielefeld, Bielefeld, Germany
| | - Tabea Symanzik
- Developmental Psychology and Developmental Psychopathology, University of Bielefeld, Bielefeld, Germany
| | - Nina Heinrichs
- Clinical Psychology & Psychotherapy, University of Bremen, Bremen, Germany
| | - Kerstin Konrad
- Child Neuropsychology Section, Dept. for Child and Adolescent Psychiatry, University Hospital RWTH Aachen, Aachen, Germany.,JARA-Brain Institute II, Molecular Neuroscience and Neuroimaging, RWTH Aachen & Research Centre Juelich, Juelich, Germany
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16
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Hiller RM, Halligan SL, Meiser-Stedman R, Elliott E, Rutter-Eley E, Hutt T. Coping and support-seeking in out-of-home care: a qualitative study of the views of young people in care in England. BMJ Open 2021; 11:e038461. [PMID: 33589445 PMCID: PMC7887338 DOI: 10.1136/bmjopen-2020-038461] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVES Young people who have been removed from their family home and placed in out-of-home care have commonly experienced abuse, neglect and/or other forms of early adversity. High rates of mental health difficulties have been well documented in this group. The aim of this research was to explore the experiences of these young people within the care system, particularly in relation to support-seeking and coping with emotional needs, to better understand feasible and acceptable ways to improve outcomes for these young people. DESIGN AND STUDY SETTING This study used 1:1 semistructured qualitative interviews with young people in out-of-home care in England, to provide an in-depth understanding of their views of coping and support for their emotional needs, both in terms of support networks and experiences with mental health services. Participants were 25 young people aged 10-16 years old (56% female), and included young people living with non-biological foster carers, kinship carers and in residential group homes. RESULTS Participants described positive (eg, feeling safe) and negative (eg, feeling judged) aspects to being in care. Carers were identified as the primary source of support, with a supportive adult central to coping. Views on support and coping differed for young people who were experiencing more significant mental health difficulties, with this group largely reporting feeling unsupported and many engaging in self-harm. The minority of participants had accessed formal mental health support, and opinions on usefulness were mixed. CONCLUSIONS Results provide insight, from the perspective of care-experienced young people, about both barriers and facilitators to help-seeking, as well as avenues for improving support.
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Affiliation(s)
| | - Sarah L Halligan
- Department of Psychology, University of Bath, Bath, UK
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
| | - Richard Meiser-Stedman
- Department of Clinical Psychology, Norwich Medical School, University of East Anglia, Norwich, UK
| | - Elizabeth Elliott
- Department of Psychology, University of Bath, Bath, UK
- School of Psychology and Clinical Language Science, University of Reading, Reading, UK
| | - Emily Rutter-Eley
- School of Psychology and Clinical Language Science, University of Reading, Reading, UK
| | - Tilly Hutt
- Department of Psychology, University of Bath, Bath, UK
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17
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Moussavi Y, Breivik K, Wergeland GJ, Haugland BSM, Larsen M, Lehmann S. Internalizing Symptom Profiles Among Youth in Foster Care: A Comparison Study. Front Psychiatry 2021; 12:711626. [PMID: 34489762 PMCID: PMC8418133 DOI: 10.3389/fpsyt.2021.711626] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Accepted: 07/09/2021] [Indexed: 11/23/2022] Open
Abstract
Background: A high prevalence of anxiety and depression is found among youth in foster care. There is limited knowledge on the anxiety and depression symptom profiles of youth in foster care. We examined latent profiles of anxiety and depression symptoms across three unique youth samples and whether youth in foster care were more or less likely to belong to specific symptom profiles than their peers recruited from clinical or general youth populations. We also investigated if these profiles were predicted by sex and age. Methods: Self-reported anxiety and depression symptoms were assessed by Spence Children's Anxiety Scale and Short Mood and Feelings Questionnaire. Data were pooled from three youth samples (N = 2,005; mean age = 13.9 years, range = 11-18 years) comprising youth in foster care (n = 245), a clinical youth sample (n = 107), and a general population youth sample (n = 1,653). Symptom profiles were identified using latent profile analyses. Multinominal logistic regression was used to predict the latent profile membership. Results: Three profiles that differed both in symptom level and shape were identified and labeled as low, medium, and high symptom profile. Compared to the general population youth sample, youth in foster care had a higher likelihood of belonging to the high symptom profile, but not the medium symptom profile. Youth from the clinical sample had an increased risk of belonging to the medium and high symptom profiles compared to the youth in foster care and general population youth samples. Across samples, girls yielded a higher likelihood of having a medium or high symptom profile. Increasing age was associated with a higher likelihood of being in the high symptom profile. Conclusion: Compared to their counterparts in the general population, youth in foster care are at risk of belonging to a class of youth with high symptom levels across subtypes of internalizing symptoms, indicating the importance of systematic and broad assessment of internalizing symptoms among these youth. Knowledge on the symptom profiles of anxiety subtypes and depression increases our understanding of the treatment needs of youth in foster care.
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Affiliation(s)
- Yasmin Moussavi
- Regional Centre for Child and Youth Mental Health and Child Welfare-West, NORCE Norwegian Research Centre, Bergen, Norway.,Department of Health Promotion and Development, Faculty of Psychology, University of Bergen, Bergen, Norway
| | - Kyrre Breivik
- Regional Centre for Child and Youth Mental Health and Child Welfare-West, NORCE Norwegian Research Centre, Bergen, Norway
| | - Gro Janne Wergeland
- Department of Child and Adolescent Psychiatry, Division of Psychiatry, Haukeland University Hospital, Bergen, Norway.,Department of Clinical Medicine, Faculty of Medicine, University of Bergen, Bergen, Norway
| | | | - Marit Larsen
- Regional Centre for Child and Youth Mental Health and Child Welfare-West, NORCE Norwegian Research Centre, Bergen, Norway.,Department of Health Promotion and Development, Faculty of Psychology, University of Bergen, Bergen, Norway
| | - Stine Lehmann
- Regional Centre for Child and Youth Mental Health and Child Welfare-West, NORCE Norwegian Research Centre, Bergen, Norway.,Department of Health Promotion and Development, Faculty of Psychology, University of Bergen, Bergen, Norway
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18
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Octoman O, Mclean S, Sleep J. Children in foster care: What behaviours do carers find challenging? CLIN PSYCHOL-UK 2020. [DOI: 10.1111/cp.12022] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Affiliation(s)
- Olivia Octoman
- The Australian Centre for Child Protection, University of South Australia, Adelaide, South Australia, Australia,
| | - Sara Mclean
- The Australian Centre for Child Protection, University of South Australia, Adelaide, South Australia, Australia,
| | - Julie Sleep
- The Australian Centre for Child Protection, University of South Australia, Adelaide, South Australia, Australia,
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19
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Richards T, Bertrand J, Newburg-Rinn S, McCann H, Morehouse E, Ingoldsby E. Children prenatally exposed to alcohol and other drugs: what the literature tells us about child welfare information sources, policies, and practices to identify and care for children. JOURNAL OF PUBLIC CHILD WELFARE 2020; 1:10.1080/15548732.2020.1814478. [PMID: 33897309 PMCID: PMC8064734 DOI: 10.1080/15548732.2020.1814478] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/21/2019] [Revised: 08/14/2020] [Accepted: 08/20/2020] [Indexed: 06/02/2023]
Abstract
Many parents who interact with the child welfare system present with substance use issues, which means their children are at risk for prenatal exposure to alcohol and other drugs. Because child welfare agencies play an important role in identifying and providing services to mitigate negative impacts of prenatal exposures, we conducted a search for literature addressing child welfare information sources, policies, and practices related to this population. The search yielded 16 research/evaluation and 16 policy/practice papers, with most addressing exposures to both alcohol and other drugs. The literature most commonly reports that children identified as exposed are referred to child protection agencies during the newborn period. This practice may lead to underidentification, especially of children with prenatal exposure to alcohol. Research suggests that this population is at risk for poorer child welfare outcomes and that there are specific service needs for these children. This review indicates that there is an overall lack of research literature regarding identification of prenatally exposed children involved in the child welfare system that could best inform child welfare policies and practices. Studies investigating how the child welfare system identifies and cares for children with prenatal exposures are needed.
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Affiliation(s)
| | - Jacquelyn Bertrand
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, U.S. Dept. of Health and Human Services, Atlanta, Georgia, USA
| | - Sharon Newburg-Rinn
- Children’s Bureau, Administration for Children and Families, U.S. Dept. of Health and Human Services, Washington, District of Columbia, USA
| | - Heather McCann
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, U.S. Dept. of Health and Human Services, Atlanta, Georgia, USA
- Oak Ridge Institute for Science and Education, Oak Ridge, Tennessee
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20
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A Narrative Review of the Needs of Children in Foster and Kinship Care: Informing a Research Agenda. BEHAVIOUR CHANGE 2020. [DOI: 10.1017/bec.2020.11] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
AbstractAs a result of maltreatment, children in care can present with a range of complex needs and challenges. In addition to direct clinical care commonly provided by paediatricians, psychiatrists, and clinical psychologists, the provision of knowledge and skills to foster and kinship carers have become modes of support common in responding to these needs and challenges. A narrative review of key systematic reviews and empirical research was conducted to assess the effectiveness of existing foster carer interventions. Results indicated a range of methodological characteristics that limit our ability to develop a sound, research-driven, evidence base. As a result, we remain limited in our knowledge about which treatments are effective, for which symptoms they are effective, and for which population subgroups they are most likely to be effective. This review provides a summary of identified needs and challenges in the delivery of foster carer interventions. It provides an account of current treatment components and offers a platform for the development and progression of a programme of research in an effort to advance knowledge in the area.
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21
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Häggman-Laitila A, Salokekkilä P, Karki S. Integrative review of the evaluation of additional support programs for care leavers making the transition to adulthood. J Pediatr Nurs 2020; 54:63-77. [PMID: 32554137 DOI: 10.1016/j.pedn.2020.05.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2019] [Revised: 05/14/2020] [Accepted: 05/14/2020] [Indexed: 02/07/2023]
Abstract
PROBLEM Care leavers face many challenges during their transition to adulthood, such as educational attainment, financial instability, housing problems and relationship problems. Various structured programs and additional support exist to help them make this transition and these provide help before or after they have left care. However, the outcomes of such support programs are fragmented. The aim of this study was to synthesize the empirical evidence of studies that evaluated additional support programs that facilitated the transition of care leavers to adulthood. ELIGIBILITY CRITERIA Six databases were searched that were published in English in peer-review journals from 2010 to 2019. We reviewed 16 studies related to additional support programs with different methodological designs. SAMPLE Care leavers' who have left the foster care. RESULTS There were two different types of programs: single-focused and multiple-focused programs. Half of them provided holistic support. Feedback from care leavers provided practical suggestions for the development of relationships with the staffs and peers, for the development of programs and care leavers own involvement in decision-making. The evaluations showed weak evidence of the effectiveness of housing, employment and educational programs. CONCLUSIONS The programs were poorly described and heterogenous so that the outcomes could not be compared. It was not possible to provide robust information about their effectiveness. IMPLICATIONS We need holistic programs which consider care leavers needs and views, and evaluate rigorously the programs by strong study designs, to determine their effectiveness.
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Affiliation(s)
- Arja Häggman-Laitila
- University of Eastern Finland, Department of Nursing Science, Kuopio, Finland; City of Helsinki, Department of Social Services and Health Care, City of Helsinki, Finland.
| | - Pirkko Salokekkilä
- City of Helsinki, Department of Social Services and Health Care, City of Helsinki, Finland
| | - Suyen Karki
- University of Eastern Finland, Department of Nursing Science, Kuopio, Finland
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22
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Long-term benefits of providing transitional services to youth aging-out of the child welfare system: Evidence from a cohort of young people who use drugs in Vancouver, Canada. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2020; 85:102912. [PMID: 32889145 DOI: 10.1016/j.drugpo.2020.102912] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2019] [Revised: 07/30/2020] [Accepted: 08/09/2020] [Indexed: 11/21/2022]
Abstract
BACKGROUND Youth aging-out of the child welfare system (CWS) experience numerous vulnerabilities including, elevated rates of substance use and substance use disorders. Calls to improve services to transition youth to independence are common; however, evidence of the long-term impacts associated with transitional service utilization is scarce. Further, existing services frequently lack appropriate supports for substance using youth and it is unknown if youth are able to access such services. In the present study, we assess the relationship between transitional service utilization and health and social outcomes among a cohort of people who use drugs (PWUD) that aged-out of the CWS. METHODS Data were obtained from two harmonized cohorts of PWUD in Vancouver, Canada. Those who reported aging-out were asked about service utilization, availability, barriers, and interest across seven categories of transitional services. Multivariable logistic regression analyses were conducted to assess the relationship between having previously utilized transitional services and current health and social outcomes. RESULTS Between December 2014 and November 2017, 217 PWUD reported having previously aged-out of the CWS. Across service categories, reported service utilization prevalence ranged from 16.6-61.8% while unmet demand ranged from 64.8-78.4%. In multivariable analyses, compared to individuals who utilized ≤1 service while aging-out, having utilized 4-7 services was significantly associated with reduced odds of current homelessness (adjusted odds ratio [AOR]=0.29) and engaging in daily drug use (AOR=0.35) (both p<0.05). CONCLUSION Findings suggest that this understudied high-risk population of PWUD and aged-out of the CWS experience long-term benefits associated with transitional service utilization and are interested and willing to engage in these services. However, given high unmet demand, findings also highlight considerable gaps in service delivery and support calls for extending the age of emancipation for all youth in the CWS and in particular, for additional harm reduction and substance use supports embedded into service models.
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23
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Ayer L, Colpe L, Pearson J, Rooney M, Murphy E. Advancing Research in Child Suicide: A Call to Action. J Am Acad Child Adolesc Psychiatry 2020; 59:1028-1035. [PMID: 32145297 DOI: 10.1016/j.jaac.2020.02.010] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2019] [Revised: 02/14/2020] [Accepted: 02/27/2020] [Indexed: 12/26/2022]
Abstract
OBJECTIVE To highlight the problem of child suicide, summarize what is known and not known about the problem in the empirical literature, and provide recommendations with ethical considerations for future research and practice. METHOD The development of this paper was informed by a meeting of national experts on the topic hosted by the National Institute of Mental Health, as well as by a review of the empirical literature. RESULTS We know something about demographic characteristics that are related to higher child suicide rates, but beyond that we know relatively little about risk factors, prevention, and intervention for suicide risk in children <12 years. It is important for child suicide researchers and practitioners to pay particular attention to ethical issues that may be likely to arise in doing this type of work. CONCLUSION Much more research is needed on child suicide in the areas of measurement, prevention, and intervention in order to advance the field and provide practitioners with the tools that they critically need.
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Affiliation(s)
| | - Lisa Colpe
- National Institute of Mental Health, Rockville, Maryland
| | - Jane Pearson
- National Institute of Mental Health, Rockville, Maryland
| | - Mary Rooney
- National Institute of Mental Health, Rockville, Maryland
| | - Eric Murphy
- National Institute of Mental Health, Rockville, Maryland
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24
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Song MK, Bang KS, Kim S, Lee G, Jeong Y. Effects of an Urban Forest-Based Health Promotion Program on Children Living in Group Homes. J Psychosoc Nurs Ment Health Serv 2020; 58:18-29. [PMID: 32286663 DOI: 10.3928/02793695-20200406-01] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2019] [Accepted: 01/23/2020] [Indexed: 11/20/2022]
Abstract
Children living in foster care group homes are more likely to have physical, mental, and social health problems due to parental abuse, neglect, and family breakdown. The purpose of the current study was to develop and apply the urban forest-based health promotion program on children living in group homes in Korea to investigate its effects on perceived health, psychological health, and connectedness to nature. Eight children (mean age = 12.13 [SD = 1.25] years) from three group homes participated in the study. The intervention was conducted individually for each group home once per week for 8 weeks. Quantitative and qualitative data were collected and analyzed. Participants showed significant improvement in restoration. Six themes were identified that reflect participants' experience and the effectiveness of the urban forest-based health promotion program. This program may be considered a possible intervention to promote children's psychosocial health and connectedness to nature. Continuous efforts are needed to further examine the program's effectiveness. [Journal of Psychosocial Nursing and Mental Health Services, 58(6), 18-29.].
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25
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Tubák N, Ábrám Z, Lorand Ferencz I, Nadasan V, Ferencz M, Balázs P, Pénzes M, Foley KL. Smoking prevalence and desire to quit among employees in Transylvanian foster care homes. Cent Eur J Public Health 2020; 28:13-17. [PMID: 32228811 DOI: 10.21101/cejph.a5724] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2019] [Accepted: 07/30/2019] [Indexed: 11/15/2022]
Abstract
OBJECTIVES Few studies have investigated smoking habits among foster care home children and employees, who are at high risk for smoking. Additionally, there are no published studies on the intention to quit smoking among employees of the Romanian Child Protection system, a gap we address in this manuscript. METHODS A repeated cross-sectional survey was conducted among foster care employees in three Transylvanian counties (Mures, Sibiu, Covasna) in January 2014 to February 2015 (baseline) and September-December 2016 (follow-up). A foster home-based smoking prevention and cessation intervention targeting employees and children was conducted between the two waves. Multivariate logistic regression analysis was conducted to determine associations between socio-demographics, reasons for smoking, tobacco use patterns, reasons for quitting, and tobacco policy attitudes on intention to quit (dependent variable), controlling for participation in the smoking prevention intervention. RESULTS 305 employees participated in the baseline (76.4% of females, 23.6% of males) and 304 employees in the follow-up surveys (68.8% of females, 31.2% of males) after the smoking prevention and cessation intervention. At baseline, 34.8% of respondents reported that no one was smoking within the foster care home, which increased to 59.1% at follow-up (p < 0.001). Being male and a high level of professional satisfaction were the only correlates of intention to quit in the bivariate models at baseline. Professional satisfaction and a belief that smoking is bad for one's health were the only correlates of intention to quit at follow-up. In multivariable models, professional satisfaction was the only consistent predictor of intention to quit at both time points (OR 5.63, 95% CI 1.71-18.56; OR 4.98, 95% CI 1.43-17.30). CONCLUSIONS Efforts should be made to promote cessation among foster care employees that includes evidence-based support, along with compliance to policies that prohibit smoking indoors to reinforce cessation efforts.
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Affiliation(s)
- Nimród Tubák
- Department of Hygiene, University of Medicine, Pharmacy, Sciences and Technology of Targu Mures, Targu Mures, Romania
| | - Zoltán Ábrám
- Department of Hygiene, University of Medicine, Pharmacy, Sciences and Technology of Targu Mures, Targu Mures, Romania
| | - Iozsef Lorand Ferencz
- Department of Hygiene, University of Medicine, Pharmacy, Sciences and Technology of Targu Mures, Targu Mures, Romania
| | - Valentin Nadasan
- Department of Hygiene, University of Medicine, Pharmacy, Sciences and Technology of Targu Mures, Targu Mures, Romania
| | - Melinda Ferencz
- Psychiatric Clinic No. 2, University of Medicine, Pharmacy, Sciences and Technology of Targu Mures, Targu Mures, Romania
| | - Péter Balázs
- Institute of Public Health, Faculty of Medicine, Semmelweis University, Budapest, Hungary
| | - Melinda Pénzes
- Institute of Public Health, Faculty of Medicine, Semmelweis University, Budapest, Hungary
| | - Kristie L Foley
- Department of Implementation Science, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
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26
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DePasquale CE, Olson A, Desjardins CD, Bruce J, Pears KC, Gunnar MR, Fisher PA. Exploring the Psychometric Properties of the Parent Daily Report - Toddler Version (PDR-T). INTERNATIONAL JOURNAL OF BEHAVIORAL DEVELOPMENT 2020; 43:447-456. [PMID: 31937982 DOI: 10.1177/0165025419844030] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The present study examined the psychometric properties of a brief parent-report daily checklist of toddler behavior (Parent Daily Report - Toddler Version; PDR-T). Data were collected from three groups of 18-36 month-olds who were followed longitudinally for approximately 1 year: 1) internationally adopted children (n = 156), 2) children placed in foster care due to child maltreatment (n = 79), and 3) community comparison children raised by their biological families (n = 80). An exploratory factor analysis of this measure resulted in three factors, measuring aggressive/noncompliant, positive, and distress behaviors. While there were estimation issues with the positive and distress factors, the aggressive/noncompliant factor exhibited invariance across time and groups, and partial invariance between genders. Significant correlations were observed between this factor and measures of externalizing behavior and inhibitory control (r = .26-.56), but not shyness, fearfulness, or negative affect. This provides support for both convergent and discriminant validity. Reliability of this factor was adequate to good across time and group. Results provide preliminary support for the utility, reliability, and consistency of one factor of the PDR-T as an easy parent-report tool to assess daily patterns and changes in child aggressive/noncompliant behavior over time.
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Affiliation(s)
| | - Anneke Olson
- University of Oregon, University of Minnesota - Twin Cities
| | - Chris D Desjardins
- Center for Applied Research and Educational Improvement, University of Minnesota - Twin Cities
| | | | | | - Megan R Gunnar
- Institute of Child Development, University of Minnesota - Twin Cities
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27
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Vreeland A, Ebert JS, Kuhn TM, Gracey KA, Shaffer AM, Watson KH, Gruhn MA, Henry L, Dickey L, Siciliano RE, Anderson A, Compas BE. Predictors of placement disruptions in foster care. CHILD ABUSE & NEGLECT 2020; 99:104283. [PMID: 31765852 PMCID: PMC7984659 DOI: 10.1016/j.chiabu.2019.104283] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/05/2019] [Revised: 10/31/2019] [Accepted: 11/11/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND Many children who are removed from a dangerous or neglectful home and placed in state custody subsequently experience additional disruptions while in custody, which can compound the effects of ongoing stress and instability. As such, placement stability has been identified as a critical objective and a key indicator of success for children residing in substitutive care. OBJECTIVE To examine the utility of child protective services data in identifying predictors of placement disruption. PARTICIPANTS AND SETTING The current study examined data from youth in Tennessee state custody who had been assessed using the Child and Adolescent Needs and Strengths (CANS) assessment within 30-days of their first, out-of-home placement. The sample included 8,853 youth ages 5-19 years old (M = 13.1; SD = 4.0; 44.8 % female). METHODS Demographics, placement information, and the CANS assessment were collected by the Tennessee Department of Children's Services for all child welfare episodes for children as part of the system's usual standard of care. Bivariate correlation and linear regression models were conducted. RESULTS Multiple risk indices from the CANS appeared to significantly increase risk of placement disruption, including child internalizing and externalizing symptoms, school difficulties, youth affect dysregulation, and child age. CONCLUSIONS The current findings suggest that data collected as part of standard practice by child welfare workers such as the CANS is both feasible and has utility for identifying sources of risk for placement disruptions and to inform possible targets of intervention to enhance placement stability.
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Affiliation(s)
- Allison Vreeland
- Vanderbilt University, Department of Psychology & Human Development, Peabody 552, 230 Appleton Place, Nashville TN, 37203, United States.
| | - John S Ebert
- Vanderbilt University, Department of Psychology & Human Development, Peabody 552, 230 Appleton Place, Nashville TN, 37203, United States
| | - Tarah M Kuhn
- Vanderbilt University, Department of Psychology & Human Development, Peabody 552, 230 Appleton Place, Nashville TN, 37203, United States
| | - Kathy A Gracey
- Vanderbilt University, Department of Psychology & Human Development, Peabody 552, 230 Appleton Place, Nashville TN, 37203, United States
| | - April M Shaffer
- Vanderbilt University, Department of Psychology & Human Development, Peabody 552, 230 Appleton Place, Nashville TN, 37203, United States
| | - Kelly H Watson
- Vanderbilt University, Department of Psychology & Human Development, Peabody 552, 230 Appleton Place, Nashville TN, 37203, United States
| | - Meredith A Gruhn
- Vanderbilt University, Department of Psychology & Human Development, Peabody 552, 230 Appleton Place, Nashville TN, 37203, United States
| | - Lauren Henry
- Vanderbilt University, Department of Psychology & Human Development, Peabody 552, 230 Appleton Place, Nashville TN, 37203, United States
| | - Lindsay Dickey
- Vanderbilt University, Department of Psychology & Human Development, Peabody 552, 230 Appleton Place, Nashville TN, 37203, United States
| | - Rachel E Siciliano
- Vanderbilt University, Department of Psychology & Human Development, Peabody 552, 230 Appleton Place, Nashville TN, 37203, United States
| | - Allegra Anderson
- Vanderbilt University, Department of Psychology & Human Development, Peabody 552, 230 Appleton Place, Nashville TN, 37203, United States
| | - Bruce E Compas
- Vanderbilt University, Department of Psychology & Human Development, Peabody 552, 230 Appleton Place, Nashville TN, 37203, United States
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Taussig HN, Weiler LM, Garrido EF, Rhodes T, Boat A, Fadell M. A Positive Youth Development Approach to Improving Mental Health Outcomes for Maltreated Children in Foster Care: Replication and Extension of an RCT of the Fostering Healthy Futures Program. AMERICAN JOURNAL OF COMMUNITY PSYCHOLOGY 2019; 64:405-417. [PMID: 31468553 PMCID: PMC6917986 DOI: 10.1002/ajcp.12385] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
Preventing the negative impact of maltreatment on children's mental health requires interventions to be contextually sensitive, grounded in theory and research, and effective in reaching and retaining children and families. This study replicates and extends previous findings of the Fostering Healthy Futures (FHF) program, a 30-week mentoring and skills group intervention for preadolescent maltreated children in foster care. Participants included 426 children recently placed in out-of-home care who were randomized to intervention or control conditions. Outcomes measured 6-10 months postintervention included a multi-informant (child, caregiver, teacher) index of mental health problems as well as measures of posttraumatic stress symptoms, dissociative symptoms, quality of life, and use of mental health services and psychotropic medications. There were high rates of program initiation, retention, and engagement; 95% of those randomized to FHF started the program, 92% completed it, and over 85% of the mentoring visits and skills groups were attended. The FHF program demonstrated significant impact in reducing mental health symptomatology, especially trauma symptoms, and mental health service utilization. These program effects were consistent across almost all subgroups, suggesting that FHF confers benefit for diverse children. Results indicate that positive youth development programming is highly acceptable to children and families and that it can positively impact trauma and its sequelae.
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Affiliation(s)
- Heather N Taussig
- University of Denver, Denver, CO, USA
- Kempe Center, University of Colorado School of Medicine, Aurora, CO, USA
| | | | | | - Tara Rhodes
- Colorado Department of Education, Denver, CO, USA
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Zeanah CH. Editorial: Navigating the science-practice gap in child maltreatment. J Child Psychol Psychiatry 2019; 60:1149-1151. [PMID: 31613001 DOI: 10.1111/jcpp.13143] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
This issue of the Journal provides an extraordinarily rich array of timely and important investigations on topics ranging from psychotic symptoms in adolescents to several types of neurodevelopmental disorders to brain structure in young children with sleep disturbances. Papers feature longitudinal studies, a meta-analysis, and intervention research, including follow-up of a randomized clinical trial. Remarkably, these studies involve tens of thousands of children and adolescents residing on four continents. The longitudinal studies are especially noteworthy for their large cohorts and systematic assessments.
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Sellers R, Smith AF, Leve LD, Nixon E, Cane T, Cassell JA, Harold GT. Utilising Genetically-Informed Research Designs to Better Understand Family Processes and Child Development: Implications for Adoption and Foster Care Focused Interventions. ADOPTION & FOSTERING 2019; 43:351-371. [PMID: 31576061 PMCID: PMC6771282 DOI: 10.1177/0308575919866526] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Understanding the interplay between genetic factors and family environmental processes (e.g., inter-parental relationship quality, positive versus negative parenting practices) and children's mental health (e.g., anxiety, depression, conduct problems, ADHD) in the contexts of adoption and foster-care research and practice is critical for effective prevention and intervention programme development. Whilst evidence highlights the importance of family environmental processes for the mental health and well-being of children in adoption and foster care, there is relatively limited evidence of effective interventions specifically for these families. Additionally, family-based interventions not specific to the context of adoption and foster-care typically show small to medium effects, and even where interventions are efficacious, not all children benefit. One explanation for why interventions may not work well for some is that responses to intervention may be influenced by an individual's genetic make-up. This paper summarises how genetically-informed research designs can help disentangle genetic from environmental processes underlying psychopathology outcomes for children, and how this evidence can provide improved insights into the development of more effective preventative intervention targets for adoption and foster-care families. We discuss current difficulties in translating behavioural genetics research to prevention science, and provide recommendations to bridge the gap between behavioural genetics research and prevention science, with lessons for adoption and foster-care research and practice.
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Affiliation(s)
- R Sellers
- School of Psychology, Andrew and Virginia Rudd Centre for Adoption Research and Practice, University of Sussex, Brighton, UK
- Institute of Psychological Medicine and Clinical Neurosciences, School of Medicine, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, UK
| | - A F Smith
- School of Psychology, Andrew and Virginia Rudd Centre for Adoption Research and Practice, University of Sussex, Brighton, UK
| | - L D Leve
- Prevention Science Institute, University of Oregon, Eugene, USA
| | - E Nixon
- School of Psychology, Trinity College Dublin, The University of Dublin, Ireland
| | - T Cane
- School of Social Work and Social Care, University of Sussex, UK
| | - J A Cassell
- Brighton and Sussex Medical School, Falmer, Brighton BN1 9PH
| | - G T Harold
- School of Psychology, Andrew and Virginia Rudd Centre for Adoption Research and Practice, University of Sussex, Brighton, UK
- Institute of Psychological Medicine and Clinical Neurosciences, School of Medicine, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, UK
- School of Psychology, Trinity College Dublin, The University of Dublin, Ireland
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Abel C, Goldsmith CAW, Marzerka M. Pharmacists can improve medication management in the vulnerable population of foster care youth. J Am Pharm Assoc (2003) 2019; 59:629-632. [DOI: 10.1016/j.japh.2019.05.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2019] [Revised: 05/03/2019] [Accepted: 05/17/2019] [Indexed: 10/26/2022]
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Carabez R, Kim JE. PART I: The role of public health nursing in addressing health care needs of children in foster care. Public Health Nurs 2019; 36:702-708. [DOI: 10.1111/phn.12647] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2019] [Revised: 07/03/2019] [Accepted: 07/08/2019] [Indexed: 11/30/2022]
Affiliation(s)
- Rebecca Carabez
- School of Nursing San Francisco State University San Francisco California
| | - Jung Eun Kim
- School of Nursing San Francisco State University San Francisco California
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Prince DM, Vidal S, Okpych N, Connell CM. Effects of individual risk and state housing factors on adverse outcomes in a national sample of youth transitioning out of foster care. J Adolesc 2019; 74:33-44. [PMID: 31136857 DOI: 10.1016/j.adolescence.2019.05.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2018] [Revised: 05/10/2019] [Accepted: 05/13/2019] [Indexed: 10/26/2022]
Abstract
INTRODUCTION Compared to their peers, youth who leave the foster care system without permanency experience greater risks for adverse young adult outcomes, including homelessness, incarceration, substance abuse, and early child birth. Extant literature focuses on individual-level factors related to adversity. In this study, we estimated the impact of state and individual-level risk and protective factors on adverse 19-year-old outcomes among a cohort of U.S. transition age youth. METHODS We used multilevel modeling to analyze prospective, longitudinal data from two waves of the National Youth in Transitions Database (N = 7449). These data were linked to the Adoption and Foster Care Reporting System, the Administration for Children and Families budget expenditures, and the American Community Survey for the period from 2011 to 2013. RESULTS Approximately 30% of the variation in each of the 19-year-old outcomes could be attributed to state-level effects. Residence in a state that spent above average of CFCIP budget on housing supports reduced the risk of homelessness and incarceration. Living in a state with a higher proportion of housing-burdened low-income renters significantly increased the risk of substance abuse and child birth. Individual-level risks were significant: racial/ethnic minority, male gender, past risk history, placement instability, child behavioral problems, residence in group home or runaway. Remaining in foster care at age 19 reduced the odds of homelessness, incarceration, and substance abuse. CONCLUSION Macro factors, including financial support for transition-age youth, and broader housing market characteristics, have a bearing on young adult outcomes, and raise policy questions across social and human service sectors.
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Affiliation(s)
- Dana M Prince
- Case Western Reserve University, Jack, Joseph and Morton Mandel School of Applied Social Sciences, USA.
| | | | | | - Christian M Connell
- Human Development and Family Studies, College of Health and Human Development, The Pennsylvania State University, USA
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Finlayson TL, Chuang E, Baek JD, Seidman R. Dental Service Utilization Among Children in the Child Welfare System. Matern Child Health J 2019; 22:753-761. [PMID: 29423585 DOI: 10.1007/s10995-018-2444-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To examine predisposing, enabling, and need-related factors associated with dental utilization by children involved with the child welfare system (CWS). METHODS Data were analyzed from the National Survey of Child and Adolescent Well-Being (NSCAW; Wave II), a national probability sample of children (2-17 years) following a welfare assessment during 2008-2009 (n = 2806). Caregiver-reported child receipt of dental services in the past year was the outcome in weighted logistic regression models. RESULTS Two-thirds of children had a recent dental visit. Older children (OR 2.95, 95% CI 2.06,4.21 for ages 6-11; OR 2.47, CI 1.82, 3.37 for ages 12-17, compared to ages 2-5) were more likely to have visited the dentist, as were children of more educated caregivers (OR 1.68; CI 1.20, 2.36 for high school, OR 2.45; CI 1.71, 3.52 for more than high school). Children without a usual source of care (OR 0.50; CI 0.27, 0.94) and those living with non-biological parents had lower odds of a recent visit (OR 0.64; CI 0.43, 0.97). Children with dental problems were twice as likely to have a recent visit (OR 2.02; CI 1.21, 3.38), while children with unmet needs who could not afford care had lower odds of utilizing services (OR 0.28; CI 0.16, 0.46). CONCLUSIONS FOR PRACTICE Many children in the CWS, especially younger children (ages 2-5), did not have a reported dental visit in the past year. Cost was a barrier, and caregiver status was associated with the likelihood of obtaining dental care. Health and social service providers should refer these children for dental care.
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Affiliation(s)
- Tracy L Finlayson
- Health Management & Policy, Graduate School of Public Health, San Diego State University, 5500 Campanile Drive, San Diego, CA, 92182-4162, USA.
| | - Emmeline Chuang
- Health Policy and Management, UCLA Fielding School of Public Health, CHS 31-254A, 650 Charles E Young Dr. South, P.O. Box 951772, Los Angeles, CA, 90095-1772, USA
| | - Jong-Deuk Baek
- Health Management & Policy, Graduate School of Public Health, San Diego State University, 5500 Campanile Drive, San Diego, CA, 92182-4162, USA
| | - Robert Seidman
- Health Management & Policy, Graduate School of Public Health, San Diego State University, 5500 Campanile Drive, San Diego, CA, 92182-4162, USA
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Vidal S, Connell CM, Prince DM, Tebes JK. Multisystem-Involved Youth: A Developmental Framework and Implications for Research, Policy, and Practice. ADOLESCENT RESEARCH REVIEW 2019; 4:15-29. [PMID: 30854418 PMCID: PMC6404973 DOI: 10.1007/s40894-018-0088-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/15/2018] [Accepted: 06/23/2018] [Indexed: 05/29/2023]
Abstract
Multisystem-involved youth are children and adolescents concurrently served in the child welfare, behavioral health, and/or juvenile justice systems. These youth are a high risk and vulnerable population, often due to their experience of multiple adversities and trauma, yet little is known about their multiple needs and pathways into multisystem involvement. Multisystem-involved youth present unique challenges to researchers, practitioners, and policymakers. In this article, we summarize the literature on multisystem-involved youth, including prevalence, characteristics, risk factors, and disparities for this population. We then describe a developmental cascade framework, which specifies how exposure to adverse experiences in childhood may have a "cascading" or spillover effect later in development, to depict pathways of multisystem involvement and opportunities for intervention. This framework offers a multidimensional view of involvement across service systems and illustrates the complexities of relationships between micro- and macro-level factors at various stages and domains of development. We conclude that multisystem-involved youth are an understudied population that may represent majority of youth who are already served in another service system. Many of these youth are also disproportionately from racial and ethnic minority backgrounds. Currently, for multisystem-involved youth and their families, there is a lack of standardized and integrated screening procedures to identify youth with open cases across service systems; inadequate use of available instruments to assess exposure to complex trauma; inadequate clinical and family-related evidence-based practices specifically for use with this population; and poor cross-systems collaboration and coordination that align goals and targeted outcomes across systems. We make recommendations for research, practice, and systems development to address the needs of multisystem-involved youth and their families.
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Maltais C, Cyr C, Parent G, Pascuzzo K. Identifying effective interventions for promoting parent engagement and family reunification for children in out-of-home care: A series of meta-analyses. CHILD ABUSE & NEGLECT 2019; 88:362-375. [PMID: 30579168 DOI: 10.1016/j.chiabu.2018.12.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/13/2018] [Revised: 12/06/2018] [Accepted: 12/10/2018] [Indexed: 05/22/2023]
Abstract
BACKGROUND An important obstacle for family reunification following child placement in residential care and other temporary out-of-home care services is the lack of engagement among parents. OBJECTIVE The aim of this meta-analysis is to identify the most effective interventions to promote parental engagement and family reunification. METHOD AND PARTICIPANTS Eight studies, for a total of 2996 families, were used to conduct two series of meta-analyses. Each study examined the effectiveness of a goal-oriented parental engagement intervention, relative to a control group made up of parents who received standard services. Six moderators were analyzed: type of clinical modality, number of clinical strategies, sources of motivation for intervention, focus on the child care staff-parent relationship, child care staff training, and strategies to promote access to intervention. RESULTS Results indicate that parents exposed to goal-oriented engagement interventions showed greater engagement (effect size d = 0.71, CI: 0.35-1.07, p < 0.001) and likelihood of reunification (effect size OR = 2.49, CI: 1.22-5.10, p < 0.05) than parents who received standard services. In particular, moderator analysis showed that parents who specifically participated in a family-focused intervention showed the highest engagement in comparison to parents involved in other types of interventions or who received standard services (effect size d = 1.08, CI: 0.58-1.59, p < 0.001). No moderators significantly explained heterogeneity of studies on family reunification. CONCLUSION Overall, the results underline the effectiveness of family-focused interventions to promote parental engagement. Nevertheless, greater knowledge on the mechanisms by which interventions can increase parents' engagement and family reunification is still needed.
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Affiliation(s)
- Christine Maltais
- Unité d'évaluation des technologies et des modes d'intervention, Direction de l'enseignement universitaire et de la recherché, Centre intégré universitaire de santé et services sociaux du Centre-Sud-de-l'île-de-Montréal, 4565 Queen Mary, Montreal, Québe H3W 1W5, Canada.
| | - Chantal Cyr
- Département de psychologie, Université du Québec à Montréal, Québec, Canada
| | - Geneviève Parent
- Département de psychoéducation et de psychologie, Université du Québec en Outaouais, Québec, Canada
| | - Katherine Pascuzzo
- Département de psychologie, Université du Québec à Montréal, Québec, Canada; Institut universitaire jeunes en difficulté, Centre intégré universitaire de santé et services sociaux du Centre-Sud-de-l'île-de-Montréal, Québec, Canada
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Resilience as a Psychopathological Construct for Psychiatric Disorders. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2019; 1192:479-489. [DOI: 10.1007/978-981-32-9721-0_23] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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Abstract
OBJECTIVE Children who have experienced maltreatment and subsequent placement in foster care are at increased risk of problem behavior. Increased knowledge of the development of problem behavior in this population, particularly during toddlerhood, can greatly inform preventive intervention efforts. This study examined variability in problem behavior among toddlers entering new foster care placements and identified related child and parenting characteristics. METHODS Ninety-one toddlers in foster care (mean = 2.26 years) and their caregivers completed an initial assessment and were reassessed 6 months later. A child's general cognitive ability was assessed via performance on a standardized developmental measure, and child problem behavior, parenting stress, frequency of family routines, and harsh discipline were assessed via caregiver report. RESULTS Upon entering a new foster care placement and 6 months after placement, respectively, 38% and 25% of the toddlers were within the borderline clinical or clinical range in terms of problem behavior when assessed using the Child Behavior Checklist. There was not a significant difference in problem behavior over this 6-month period, suggesting that problem behavior was quite stable among the toddlers as a group. However, general cognitive ability was a significant predictor of individual differences in change in problem behavior, with toddlers with lower general cognitive ability displaying increased problem behavior over this period. CONCLUSION An increased number of toddlers in foster care displayed clinically significant levels of problem behavior, further demonstrating that these children are an extremely high-risk group. The association between general cognitive ability and change in problem behavior highlights the importance of early developmental screenings, which may help identify children at greatest risk of problem behavior and most in need of preventive intervention efforts.
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Grube WA, Liming KW. ATTACHMENT AND BIOBEHAVIORAL CATCH-UP: A SYSTEMATIC REVIEW. Infant Ment Health J 2018; 39:656-673. [PMID: 30365173 DOI: 10.1002/imhj.21745] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Attachment Biobehavioral Catch-up (ABC; Dozier et al., 2006) is a 10-week, in-home intervention primarily for early childhood aged children (ages 6 months-2 years). The ABC intervention seeks to teach parents how to provide nurturing care and engage in appropriate interactions with their children. ABC has been identified as a Level 1 evidence-based practice by the California Evidence-Based Clearinghouse for Child Welfare. However, to date, there has been no systematic review presenting the overall evidence behind ABC available in a peer-reviewed journal. The objective of this review is to address this gap by synthesizing prior literature and evidence, specifically evidence from randomized control trials (RCTs), regarding the effectiveness of the ABC intervention and to determine the contexts in which the intervention has been implemented. To complete this review, literature was searched across three bibliographic databases and relevant Web sites. Only RCTs examining child outcomes were included in the review. Using identified search procedures, 10 articles discussing RCTs which tested the efficacy of ABC were identified. Findings indicate that ABC is effective, when implemented with child-welfare-involved children, at improving emotion regulation, improving externalizing and internalizing behaviors, increasing normative developmental functioning, and attachment quality. Sample information from the 10 RCTs identified is presented as well as additional study characteristics.
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40
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Collins JL, Thomas LJ. The influence of social determinants of health among young adults after they have left foster care in the US. J Clin Nurs 2018; 27:2022-2030. [PMID: 29493839 DOI: 10.1111/jocn.14317] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/16/2018] [Indexed: 11/29/2022]
Abstract
AIMS AND OBJECTIVES To describe the influence of the social determinants of health on health care seeking among young adults after they left foster care. BACKGROUND Extensive research suggests that stakeholders in foster care systems throughout the world struggle to consistently and effectively manage the health and well-being of youth. These struggles extend beyond time in foster care as indicated by poor health and social outcomes throughout the life course. Evidence that describes how young adults address health and related social needs after leaving foster care is missing. DESIGN A phenomenological design, Phenomenology of Practice, was used to collect data. Content analysis was used to analyse the data, using constructs from the Healthy People 2020 SDOH Model to organise the data. METHODS Thirteen young adults who left foster care in the southwestern US were recruited using convenience sampling. Data were collected via individual interviews. RESULTS Young adults formerly in foster care reported using and lacking social support networks to navigate SDOH. The interrelatedness of SDOH on health outcomes after foster care is evident. CONCLUSIONS Social support networks can help explain how young adults are both able and unable to navigate systems to address health issues. Evaluating social networks used to access care is an important aspect of assessment and intervention for these vulnerable young adults. RELEVANCE TO CLINICAL PRACTICE Healthcare providers facilitate healthcare access for young adults who have been in foster care through evaluation of social determinants. Assessment and care planning based on social determinants for those who have been in foster care are critical to ensure the efficacy of interventions designed to address health outcomes. Social support systems are key factors for young adults formerly in foster care to access resources, substantiating the need for ongoing assessment and development of these support systems.
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Affiliation(s)
| | - Laura J Thomas
- Texas Tech University Health Sciences Center, Lubbock, TX, USA
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Akin BA, McDonald TP. Parenting intervention effects on reunification: A randomized trial of PMTO in foster care. CHILD ABUSE & NEGLECT 2018; 83:94-105. [PMID: 30025308 DOI: 10.1016/j.chiabu.2018.07.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/03/2018] [Revised: 06/20/2018] [Accepted: 07/08/2018] [Indexed: 06/08/2023]
Abstract
Evidence-supported parenting interventions (ESPIs) have expanded into child welfare because a growing research base has demonstrated positive results among children with serious emotional and behavioral problems. Despite a clear federal policy emphasis on reunification, few randomized trials have tested ESPIs with biological families of children in foster care; even fewer studies have investigated the distal outcomes of ESPIs. The aim of the current study was to examine the effects of Parent Management Training, Oregon (PMTO) model on reunification. Children in foster care with emotional and behavioral problems were randomized to in-home PMTO (n = 461) or services as usual (SAU) (n = 457). Cox regression models tested whether children in the PMTO group achieved higher rates of reunification. We applied life tables data for integrals calculations to estimate days saved in foster care. Analyses were conducted as intent-to-treat (ITT), and per protocol analysis (PPA). ITT results showed reunification rates were 6.9% higher for the PMTO group (62.7%) than the SAU group (55.8%) with 151 days saved per typical child. PPA indicated that intervention completion strengthened effects as PMTO completers' reunification rates (69.5%) were 13.7% higher than the SAU group (55.8%), and were 15.3% higher than non-completers (54.2%). Days saved were also greater for completers as compared to the SAU group (299 days) and non-completers (358 days). Overall, findings suggest that an in-home parenting intervention positively affected reunification as delivered to biological parents of children and youth in foster care with serious emotional and behavioral problems. Implications and future considerations for research are discussed.
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Affiliation(s)
- Becci A Akin
- University of Kansas School of Social Welfare, Twente Hall, 1545 Lilac Lane, Lawrence, KS 66044, USA.
| | - Thomas P McDonald
- University of Kansas School of Social Welfare, Twente Hall, 1545 Lilac Lane, Lawrence, KS 66044, USA
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Collins JL, Jimenez R, Thomas LJ. Health out of foster care as young adults age out of foster care: A phenomenological exploration of seeking healthcare services after aging out of the US foster care system. CHILD ABUSE & NEGLECT 2018; 81:322-331. [PMID: 29778990 DOI: 10.1016/j.chiabu.2018.05.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/07/2017] [Revised: 04/09/2018] [Accepted: 05/10/2018] [Indexed: 06/08/2023]
Abstract
Some adolescents in the United States who have been abused and/or neglected by caregivers and placed in permanent custody of the state leave, or "age out" of foster care at 18 years of age. Poor health outcomes among individuals who age out are notable, yet few studies describe the phenomenon of seeking healthcare services after leaving foster care. The investigators specifically queried the phenomenon of seeking healthcare services after foster care drawing from the Phenomenology of Practice approach. We interviewed 13 young adults who aged out of care. Investigators extracted lived experience descriptions (LEDs) from interview transcripts and analyzed under phenomenological themes. Healthcare experiences were marked by avoiding self-disclosure, having no choice but to wait, missing family history, and relying on the kindness of strangers. Healthcare providers who integrate the findings into care delivery models will engage young adults with more understanding and sensitivities of ethical practice.
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Affiliation(s)
| | | | - Laura J Thomas
- Texas Tech University Health Sciences Center, United States.
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Nearchou F. Resilience following emotional abuse by teachers: Insights from a cross-sectional study with Greek students. CHILD ABUSE & NEGLECT 2018; 78:96-106. [PMID: 29089140 DOI: 10.1016/j.chiabu.2017.10.012] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/11/2017] [Revised: 10/14/2017] [Accepted: 10/23/2017] [Indexed: 06/07/2023]
Abstract
An integrative socio-ecological model was developed to investigate the impact of emotional abuse by teachers on children's psychological functioning and test the role of social support and self-confidence as protective factors associated with resilience. Emotional abuse by teachers, social support from family, peers, school and a significant adult from the community, self-confidence and psychological functioning were assessed in a sample of young Greek school students aged 9-12 years (n=223, mean age=10.8, SD=0.885). Results revealed that exposure to emotional abuse by teachers predicted behavioural problems in school students suggesting a negative effect of these experiences on psychological functioning. The bootstrapped mediation model showed that the impact of emotional abuse by teachers on psychological functioning was significantly diminished through the influence of social support and self-confidence. Also, social support exerted a strong positive impact on self-confidence. This is the first study to show that individual and environmental factors using a socio-ecological model of resilience influence the adverse outcomes of this form of abuse in school aged children. These findings suggest that emotional abuse by teachers should be considered as a potential source of behavioural problems and adjustment in elementary students. Social support through its strong effect on self-confidence is an important protective factor of resilience against emotional abuse by teachers.
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Affiliation(s)
- Finiki Nearchou
- University College Dublin, Ireland; Aristotle University of Thessaloniki, Greece.
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Toward Creating Synergy Among Policy, Procedures, and Implementation of Evidence-Based Models in Child Welfare Systems: Two Case Examples. Clin Child Fam Psychol Rev 2018; 20:78-86. [PMID: 28236157 DOI: 10.1007/s10567-017-0226-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Over the past four to five decades, multiple randomized controlled trials have verified that preventive interventions targeting key parenting skills can have far-reaching effects on improving a diverse array of child outcomes. Further, these studies have shown that parenting skills can be taught, and they are malleable. Given these advances, prevention scientists are in a position to make solid empirically based recommendations to public child service systems on using parent-mediated interventions to optimize positive outcomes for the children and families that they serve. Child welfare systems serve some of this country's most vulnerable children and families, yet they have been slow (compared to juvenile justice and mental health systems) to adopt empirically based interventions. This paper describes two child-welfare-initiated, policy-based case studies that have sought to scale-up research-based parenting skills into the routine services that caseworkers deliver to the families that they serve. In both case studies, the child welfare system leaders worked with evaluators and model developers to tailor policy, administrative, and fiscal system practices to institutionalize and sustain evidence-based practices into usual foster care services. Descriptions of the implementations, intervention models, and preliminary results are described.
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Tung I, Noroña AN, Lee SS, Langley AK, Waterman JM. Temperamental sensitivity to early maltreatment and later family cohesion for externalizing behaviors in youth adopted from foster care. CHILD ABUSE & NEGLECT 2018; 76:149-159. [PMID: 29102869 DOI: 10.1016/j.chiabu.2017.10.018] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/31/2017] [Revised: 09/29/2017] [Accepted: 10/30/2017] [Indexed: 06/07/2023]
Abstract
Children in foster care frequently have histories of physical/sexual abuse and neglect, increasing their risk for externalizing behaviors (EB; e.g., aggression). According to the differential susceptibility theory, children with reactive temperaments (e.g., negative emotionality) may be particularly vulnerable to early maltreatment, but may also benefit the most from environmental enrichment such as family cohesion. In a high-risk longitudinal sample of 82 children adopted from foster care in Los Angeles County from 1996 and 2001, we examined predictions of EB from childhood to adolescence/young adulthood from temperament, preadoption maltreatment, and adoptive family cohesion. Overall, results from generalized linear models and generalized estimating equations (GEE) did not support differential susceptibility theory - specifically, youth with early reactive temperament did not exhibit heightened sensitivity to maltreatment nor to later adoptive family cohesion. Instead, reactive temperament was associated with higher EB at initial adoptive placement and escalating EB across childhood, controlling for age, gender, race-ethnicity, preadoption maltreatment, and adoptive family cohesion. Preadoption maltreatment history was unrelated to baseline EB, although sexual abuse history predicted escalating childhood EB post-adoption, whereas exposure to family violence (e.g., domestic violence) inversely predicted EB over time. By late adolescence/young adulthood 11-15 years post-adoption, rates of arrest and substance use in this sample were relatively comparable to normative populations of youth, although older age of adoption predicted more substance use in late adolescence/young adulthood. Findings highlight early reactive temperament and preadoption maltreatment as important risk factors to target for ameliorating patterns of EB growth in the first few years of adoption.
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Affiliation(s)
- Irene Tung
- Department of Psychology, University of California, 1285 Franz Hall, Los Angeles, CA 90095, USA.
| | - Amanda N Noroña
- Department of Psychology, University of California, 1285 Franz Hall, Los Angeles, CA 90095, USA
| | - Steve S Lee
- Department of Psychology, University of California, 1285 Franz Hall, Los Angeles, CA 90095, USA
| | - Audra K Langley
- Department of Psychiatry and Biobehavioral Sciences, University of California, 757 Westwood Plaza, Los Angeles, CA 90095, USA
| | - Jill M Waterman
- Department of Psychology, University of California, 1285 Franz Hall, Los Angeles, CA 90095, USA
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Dickes A, Kemmis-Riggs J, McAloon J. Methodological Challenges to the Evaluation of Interventions for Foster/Kinship Carers and Children: A Systematic Review. Clin Child Fam Psychol Rev 2017; 21:109-145. [DOI: 10.1007/s10567-017-0248-z] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Kemmis-Riggs J, Dickes A, McAloon J. Program Components of Psychosocial Interventions in Foster and Kinship Care: A Systematic Review. Clin Child Fam Psychol Rev 2017; 21:13-40. [DOI: 10.1007/s10567-017-0247-0] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Skar AMS, De Abreu RM, Vaughn MJ. Strengthening a Whole Child Approach within Residential Care Settings Through Psychosocial Support and Nutritional Guidance. ACTA ACUST UNITED AC 2017. [DOI: 10.1080/13575279.2017.1371670] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Magruder KM, McLaughlin KA, Elmore Borbon DL. Trauma is a public health issue. Eur J Psychotraumatol 2017; 8:1375338. [PMID: 29435198 PMCID: PMC5800738 DOI: 10.1080/20008198.2017.1375338] [Citation(s) in RCA: 95] [Impact Index Per Article: 13.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2017] [Accepted: 08/30/2017] [Indexed: 01/04/2023] Open
Abstract
Exposure to trauma is pervasive in societies worldwide and is associated with substantial costs to the individual and society, making it a significant global public health concern. We present evidence for trauma as a public health issue by highlighting the role of characteristics operating at multiple levels of influence - individual, relationship, community, and society - as explanatory factors in both the occurrence of trauma and its sequelae. Within the context of this multi-level framework, we highlight targets for prevention of trauma and its downstream consequences and provide examples of where public health approaches to prevention have met with success. Finally, we describe the essential role of public health policies in addressing trauma as a global public health issue, including key challenges for global mental health and next steps for developing and implementing a trauma-informed public health policy agenda. A public health framework is critical for understanding risk and protective factors for trauma and its aftermath operating at multiple levels of influence and generating opportunities for prevention.
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Affiliation(s)
- Kathryn M. Magruder
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, S.C, U.S.A
| | | | - Diane L. Elmore Borbon
- Department of Psychiatry and Behavioral Sciences, UCLA-Duke University National Center for Child Traumatic Stress, Washington, D.C, U.S.A
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Betzalel N, Shechtman Z. The impact of bibliotherapy superheroes on youth who experience parental absence. SCHOOL PSYCHOLOGY INTERNATIONAL 2017. [DOI: 10.1177/0143034317719943] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
As one key element of establishing a superhero persona, many superhero myths are based on the principle of experiencing parental loss at an early age. This study examined the impact of group bibliotherapy using superhero stories with children and adolescents who have experienced parental absence. The 187 participants who resided in foster care were divided into three experimental conditions: Bibliotherapy with superhero stories, bibliotherapy without superheroes, and no treatment. Four dependent variables were tested in a pre–post–follow-up design: Anxiety, violent behavior, aggression, and future orientations. Results indicated that the strongest desired outcomes were obtained in the superhero treatment condition: There were significant positive changes on all four dependent variables, with changes sustained at follow-up. In the other treatment condition, significant changes were observed on only two variables and were not sustained at follow-up. No significant changes were observed in the non-treatment group. On the future orientations scale, only children in the superhero condition indicated change: They gained in future goals and had reduced fantasies about home. In general, results support the effectiveness of bibliotherapy with children and clearly point to the unique contribution of bibliotherapy content tailored to children's specific needs.
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