Foster Care is part of the deal!

Over the next 10 months, Jake and his brother were moved 11 times, sometimes in short succession.

This quote is from a report issues by the Saskatchewan Advocate, Bob Pringle. The report details the events that occurred to Jake prior to his death. In taking a child into care, we enter into a bargain with them that care will be better. As the report notes, Jake was a vulnerable child.

Our investigation found that Jake was vulnerable in many ways due to his young age, the challenges presented by his parents, his inability to talk along with suspected delays in other areas, and his 11 placements during his 19 months in care. (p.5)

This is a serious challenge for a child. Coming from dysfunction, systemically Jake was placed in a form of systemic dysfunction but with strangers. Pringle also notes that the role of child protection when a child is in care is to act as a parent so they should do that - which can be tough when the parent is a system that cannot offer stability in placement and relationships. Children can pay a price for that.

(child protection) did not prioritize Jake's developmental health in the management of his case, as they should have when acting as his parent. As a result, many opportunities to address his suspected developmental delays were missed. (p.5)

It is not that others were unconcerned, as the report notes that several other professionals had raised their worries for Jake. As the report title suggests, Jake got lost in the system.

I pondered the issues of foster care as well when I saw the story of Detective Jack Mook. He is a Pittsburgh police officer who found two boys living in foster care in what is described as horridly deficient conditions. His story is reported by the Huffington Post. However, this is a story of a system who appears to have lost sight of two boys who ought not to have been living in the home. It appears not to have been a fit place for them. Fortunately, this story has a happier chapter now being written.

Fostering got a further bad rap as a Calgary foster parent was convicted of sexual assaults of several children in his care over a period of years. The Calgary Herald reports that the abuse seems to have gone on for about 9 years.

Yet fostering is tough work typically done by highly dedicated people who seek to offer temporary or longer term care to children who cannot be with their families. Research recently published by Thompson, McPherson & Marsland remind us that there is a cost, particularly for family who have their own biological children in the home. Relationship change as a result of the foster children. These researchers note that biological children place importance in their position within the family (e.g. oldest, youngest). This forms part of how they relate to their parents. This positional security can be disrupted with foster children also present. Foster children also bring competition for parental resources - a competition that biological children must enter.

Foster parents and their children need support. As the story of Jake illustrates, children coming into foster care arrive often with significant challenges that can place a great deal of demands on the whole of the family system. The biological relationships still need nurturing while creating room for the foster children to be part of the family.

As children come into care we offer them a bargain that this will be better. We have a real obligation to honour the bargain. But we also have an obligation to effectively support foster parents and their biological children.

Aging out

The question of children who grow up in the foster or group care system has been a haunting one. The answers are too often discouraging. Long term research continues to tell us that these youth are more likely to end up homeless, poor, mentally ill, involved in the criminal justice system and be parents of children far too early. There are of course, exceptions. Many of us who have worked in or around the child protection system know the exceptions.

I have had former foster and group care youth in my classes at university. I have met some who have managed to create careers in the trades. This is partially because of good planning and caring adults who saw these youths into adulthood.

Increasingly we are seeing that young people from all sorts of family situations are taking longer to transition into adulthood. They stay at home longer, they take longer to establish themselves in careers and they will have a harder time affording their own house. Even those who come from relatively advantaged environments face these challenges. Those who have grown up in care face much greater obstacles as their support systems are often weaker.

Making the point is a video which is making the rounds.  Aging out

You Tube has many other such videos.

In an environment where the income gaps between the rich and the rest (the famous 1%), the pressures on the most vulnerable will grow. Those in foster and group care are amongst the most vulnerable. We must challenge the policy makers to recognize this and create programs that do bridge the transition as strongly as possible. Many jurisdictions are trying to tackle the problem with a variety of creative programs. More options are needed. Perhaps one discussion worth having is, that if society as a whole sees more kids staying at home longer into adulthood, why would we not expect that this vulnerable population will not also require such supports which significant extension of foster care would create? It's a tough question in environments where governments are into austerity. But what does it cost us to have these youth unsuccessful and placing demands on our health care and justice systems?

Fortunately, we are seeing fewer children in group or institutional care in Canada as seen in the following charts from the Canadian Incidence Study:

These help us to realize that policy changes can shift what happens, although the data also tells us that the rate of involvement with child protection in Canada is growing. The growth of kinship care may mean that there are more family members who will be there for the child over the long term. 

American data is also quite informative about what happens to kids as they come into care:

Some UK data adds to the debate:

The point, of course, is that we need to have the debate. What we have now is not working that well whether we are talking Canada, the USA or the UK.

Foster Caregivers

Foster parents have often been accused of simply seeing the care of children as a money making scheme - their business so to speak. This has rarely been my experience in decades of working in the field. While there have been a few occasions where I wondered about the motivation of the foster parent, they have been rare indeed.


New research published this week in the British Journal of Social Work offers insight into the views of foster parents and their perceptions. The work was done in Australia but resonates for me.


The goal of a foster parent is to find ways to offer a family environment for children who are, in most cases, temporarily in their care. For many children, the stability of the foster home can represent an almost foreign experience. This can lead some children to quickly adapt and even start to call the foster parents mom and dad. For other children, it is a difficult to adapt fearing to do so would be disloyal to their biological family. Some children arrive with few behavioural or medical problems - many arrive with complex issues.


It is with this in mind that I found the research of Blythe et al of note. The authors, who did a qualitative study, show the real dilemma that can exist between children in short versus long term care.

Participants identified the responsibility of a short-term foster-carer to include preparing the children for either reunification with their birth fam- ilies or transition to a long-term placement. Given the notion of future re- unification or transition, participants described that to assume a mothering role was inappropriate. Conversely, participants specified their responsibil- ity as a long-term foster-carer to involve embracing the children into their own families. Felicia explained: ‘In short-term you’re preparing the child for their long term placement. Where long-term—you’re it. So you’re mum. . . . Your family becomes their family.’

With this, you can see the competing roles that many foster parents must manage. However, this research also helps us to see the level of commitment that foster carers bring to the task:

Foremost in participants’ stories was their commitment to the children. Most participants described a willingness to accept the good with the bad, celebrating and lamenting with and for the children. Although some parti- cipants revealed caring for the children was often arduous due to the chil- dren’s complex behavioural, developmental and psychological needs, their commitment to the children was unwavering. When reflecting on her own commitment, Gloria commented:

...it’s been bloody hard work but I guess we went into these two boys [thinking] okay, we’re going to see them through and no matter what is required, we’re going to do the best we can to make sure that happens.

The degree of emotional commitment also needs to vary depending upon the length of anticipated stay. The longer the stay, the greater the commitment to being "mother". Some of the research participants also spoke about trying to make up for deficits that the children had experienced.


The complex needs of the children and the competing need to provide a secure, safe and nurturing environment was something that showed in this research. Also evident is the ambiguous role of the foster parent who is the carer but not the legal parent.

It is clear that the participants perceived themselves as mothers to the long-term foster children in their care. However, questions remain regard- ing how these women maintain their maternal self-perception within a gov- erning system that retains legal authority over the children, thus limiting their maternal autonomy.

This research showed the deep commitment to the role and belies the critics who seek to demean the contribution that foster parents make to the care of children who come into the system. This research shows what I have come to understand is the norm. Yes, there are sad cases where foster carers have not been safe - those cases are important ones for us to also research and understand but they should not be the story of what is typical.


Reference:


Blythe, S.L., Halcomb, E.L., Wilkes, L. & Jackson, D. (2012). Perceptions of Long-Term Female Foster-Carers: I’m Not a Carer, I’m a Mother. British Journal of Social Work, online first. doi:10.1093/bjsw/bcs047

What happens to children placed in care?

This is the essential question that a new UK study posed. American research previously referred to on this blog has suggested poorer life trajectories. Thus, the British study adds more to the picture. There were 431individuals who, at age 30, provided details on what had occurred in their life trajectory. The report notes that "Compared with cohort members with no public care history, a greater proportion...from public care were from poorer socio-economic background, single motherhood and were underweight at birth." There was also a larger minority representation, particularly blacks. This is not an unexpected result given the long history of poor and minority populations within child protection systems throughout the western countries.

However, for those children admitted to foster care earlier and younger, the outcomes are more favourable. Non foster care outcomes, such as residential care, are less favourable. Pre-care characteristics could not full explain the differences. One vital conclusion is the quality of staff in residential group care really does seem to matter.

Some of the key findings in this research include:

• longer stays in care tended towards poorer outcomes;
• placement instability was also related to poorer outcomes;
• care systems are typically not able to offer all of the supports and roles that a family offers;
• a single, stable and caring long term placement generally leads to better outcomes and, not surprisingly, unstable placements and frequent placement changes lead to poorer outcomes;
• one-off placement, even short term, may have long term negative implications if that placement was a traumatic process for the child, if that admission was mishandled;
• older age at placement is also related to poorer outcomes;
• placement prior to age 1 did not seem to have the poorer outcomes which may challenge some of the assumptions of attachment theory according to the authors;
• Adverse events of the first year appear to be overcome-able by longer term subsequent positive events.

They also postulate that pre-placement negative events and the effects of placement may be countered by providing good support to a family such that the family environment is much improved for the child upon return. They also note that it is important to support the family changing while the child is out but also offering specific services to support the child. If, upon return home, the family life is one of continuing adversity for the child, then longer term outcomes may well continue to be poorer.

This research has real implications for clinical practice. Perhaps the most vital lessons are that the child protection system continues to be one that is most likely to serve the poor, disadvantaged and minority populations. The life circumstances of these populations are such that they are more likely to come to the attention of CPS. Society, which has the power to solve many of these complex problems seems unwilling to do so. A recent report in Canada from the National Council of Welfare presents data that tells us that a 2% increase in the goods and services tax, with proceeds targeted to poverty reduction, could provide the funds needed to eliminate poverty. It is highly improbable that this would happen. Such policy options exist but instead, we are going to see governments avoid such solutions meaning that CPS will continue to end up dealing with the implications of poverty and its related challenges.

Child protection is a clean up service, in some respects, for the problems that larger society does not wish to effectively address. Yet child protection will also face criticisms at three crucial points: when a child known to child protection dies; when a child is wrongly apprehended and when child protection remains over involved in disadvantaged populations creating an image of focusing upon them.

Reference:

Dregan, A. & Guilford, M. (2011). Foster care, residential care and public care placement patterns are associated with adult life trajectories: Population-based cohort study. Social Psychiatry and Psychiatric Epidemiology, In Press. DOI 10.1007/s00127-011-0458-5.