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Therapeutic foster care - what is it?

Posted May 11, 2020 5:00 a.m. EDT

Children in therapeutic foster care have often endured trauma and this type of foster care, provided by foster parents who undergo specialized training, offers them a nurturing environment where they can grow and thrive. (Kasia Bialasiewicz/Big Stock Photo)

This article was written for our sponsor, KidsPeace.

Your childhood often has a big impact on how you go on to live your adult life. For children in the foster care system, it is especially important they are provided opportunities to develop and progress. And for some, therapeutic foster care is an avenue to that end.

While most people are familiar with traditional foster care, many have never heard of therapeutic foster care before.

Therapeutic foster care is different from traditional foster care in the sense it is specifically designed to help children who have mental health needs. Many therapeutic foster children have endured intense trauma and need counseling or medication, in addition to a safe and nurturing home.

Therapeutic foster parents undergo specialized training that equips them with methodologies and management techniques to provide a loving environment where these children can grow and thrive.

"In many ways, therapeutic foster care is a lot like traditional foster care. The whole premise of foster care is for a child to be placed with a family other than their family of origin to address issues such as safety, neglect, abuse or abandonment," said Will Hatch, state manager for the North Carolina chapter of KidsPeace, a private charity foster care organization that serves the behavioral and mental health needs of children, families and their communities.

"However, therapeutic foster care is specially focused on modifying and improving behaviors that come as a result of those experiences — whatever they may be," Hatch continued. "It could be depression, anxiety or even physical aggression. Therapeutic foster care is designed to try and help that child improve their functioning."

"The kids that we see, almost 100 percent of them have had some significant trauma in their backgrounds. That is often the driving force for the problems they're having," added Ken Olson, executive director for KidsPeace New England and the clinical director for KidsPeace Foster Care and Community Programs. "It's super important for our foster parents and our staff to understand that when kids are acting out, it's often the result of that trauma."

It isn't uncommon for children who have experienced or witnessed emotional, physical, sexual or psychological abuse to react to those situations in a variety of ways. Through the course of seven sessions, the KidsPeace therapeutic foster program "trains qualified foster parents to understand and respond to these challenging behaviors so the youth can grow and thrive."

"Therapeutic foster care is a treatment model that employs foster care to provide treatment services to kids who may have formerly been in group homes or residential treatment centers. We recruit and train foster parents with specialized skills to work with these youth," Olson explained.

KidsPeace utilizes the Together Facing the Challenge training and treatment curriculum. A collaboration between KidsPeace, Duke University and Penn State University, the curriculum identifies three factors largely responsible for helping kids in foster care succeed:

  • Supportive and involved relationships between caseworkers and foster parents
  • Effective use of behavior management strategies by foster parents
  • Supportive and involved relationships between foster parents and the youth in their care

The curriculum integrates trauma-informed approaches that help promote healing and resilience, including role-play and hands-on activities.

"This model is evidence-based, meaning there's a lot of data to support that it has positive outcomes," Hatch said. "It includes ways to implement consequences for negative behaviors, ways to build rapport, and teaches specific activities and interventions that are designed to help the foster parent model and teach more appropriate behavior."

Olson emphasized the amount of support that therapeutic foster care offers kids and their families. For example, while a traditional case worker may be handling 18 to 24 kids on their caseload who they see once a month, a therapeutic case worker is handling 10 cases who they visit with once a week.

Additionally, KidsPeace offers a 24/7 crisis support line that is available to all their families should they be in need of extra support and works closely with local social services departments. Rather than being a knock to traditional foster care operations, this is, instead, reflective of the sensitive nature of therapeutic situations that require a more acute level of care.

Olson noted that in North Carolina, many children in therapeutic foster care are actually not part of the child welfare system and are unable to be with their families due to mental health issues, severe depression or self-injury. As a result, birth families are more involved in the treatment foster care process, which is an aspect that is particularly unique to the state.

"Kids belong in families; they do well when they're in families if you can provide the healthy environment that they need," Olson said. "We gather a ton of information on a child's history when they're referred to us, and we try to find out as much as possible about them. It's important that we place the child with the right family — in therapeutic foster care we call this the matching process."

Hatch has been on both ends of the matching process — the one helping to facilitate and the one on the receiving end. Hatch was a foster parent for many years before he transitioned into his role at KidsPeace, and his most recent foster son, who he ultimately adopted, was one of several placements that Hatch had in his home. While reunification with the biological family is typically the ultimate goal, sometimes that isn't possible, and in this case, Hatch was able to provide a forever home for his son.

"He was my third placement and was adopted in 2014. However, I stay in contact with all of the kids that I've fostered," Hatch said. "When the KidsPeace position opened up, I figured there was another way I could continue to help, even if I wasn't taking in kids. I try to meet kids where they are. I see a lot of potential in them, even if they can't see it."

If offered a choice between a stellar foster parent or a stellar therapist for his child, Olson said he would choose the stellar foster parent because "there is power" in family relationships.

"I think that the essence of therapeutic foster care is the power of the relationship that a therapeutic foster parent can have with a child, and that is what I call the primary agent of change," Olson said. "This is the relationship that is going to really make a difference for that child. The relationship that a kid has with the [foster] parent is what is going to get them through to the other side."

This article was written for our sponsor, KidsPeace​​​​​​​.

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