Challenges of EBI for foster children

By: Dr. Cheri Shapiro

An important question for behavioral health providers and organizations considering evidence-based approaches for children, youth, and families involves the population being served. One important group of youth that are at high risk for a range of poor outcomes are youth in the foster care system. Importantly, children and adolescents in the foster care system are often burdened by trauma, or unresolved grief and loss (for example, see work by Dr. Monique Mitchell) that cannot be ignored.

Children in the foster care system also may evidence social, emotional, developmental, or behavioral challenges and are at increased risk of poor academic performance. Parenting interventions are often seen as a primary method of intervention for these families with a goal of reunification; however, as noted in earlier blog posts, we need to pay careful attention to factors that are facilitators or barriers to treatment completion. This is critical when serving our most vulnerable youth.

One recent mixed-methods study examined reasons for treatment dropout in a study of evidence-based parenting interventions for children and families within the foster care system (Becci A. Akin & Sachiko Gomi, 2016, Journal of Social Services Research, SSN: 0148-8376 (Print) 1540-7314 (Online)). Qualitative analysis of treatment records found that the most common barriers to treatment completion were family based concerns including parental substance abuse and mental health problems. A second barrier, termed “treatment relevance,” meant that in about 25% of the cases studied, family reunification was no longer a goal for these cases. Additional barriers, although less common, included family conflicts, time demands on families, and changes in treatment provider.

In summary, evidence-based parenting interventions offer significant promise for improving youth and family well-being; however, more work is needed to tailor these approaches for specific groups of youth, including those within the foster care system.

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