• By Kevin Mount
  • Posted on Friday 13th August, 2010

How they KEEP foster care real in San Diego

It’s a dispiriting variation on Catch 22: children with a history of foster placement breakdown are twice as likely to develop behavioral problems as those whose early experiences of fostering have been stable; but, from another angle, children who already have behavioral problems when they enter foster care are highly likely to experience placement breakdown. This downward spiral of cause and consequence is not only dejecting for the children and families involved, but also costly for child welfare agencies – and worrying for caseworkers, child welfare administrators and health care providers. In an effort to break out of the trap, a foster parent training and support intervention called KEEP has emerged from a collaboration in the US between San Diego Health and Human Services Agency and the Child and Adolescent Services Research Center. Funded by the the National Institute of Mental Health, the program has lately been put through a randomized controlled trial by another partner, the Oregon Social Learning Center. Targeted at children aged five to 12, the KEEP program involves 16 weeks of training, supervision and support in behavior management methods. The emphasis is on positive reinforcement, the use of non-harsh discipline, the clear setting of limits, and the close monitoring of the child’s whereabouts and peer relationships. The trial in San Diego involved 700 foster families – one third relative and two-thirds non-relative. All of the children had been with their current foster family for a minimum of 30 days. The results are striking. There was a clear, direct relationship between the number of prior placements and the likelihood of a current placement breaking down. There was also a strong association between participation in the program and good outcomes, where children were either reunited with their biological parents, moved to reside with other family members or found a suitable adoptive family. A possible explanation for this improvement is that by improving foster parents' competence to manage child behavior problems and so reducing them, KEEP increased the likelihood of a child reuniting with its biological family. There was a third significant benefit: participation in the program moderated the damage done by previous placement breakdown. So for the KEEP group, the outcome of their prior placements made little difference, but for those who did not take part in the program it was a very significant, negative factor. What should policy-makers and program designers take from this study? It provides clear confirmation that placement breakdown can all too easily become a pattern. Without specific attention the pattern will probably continue – and children trapped in it will have a poor chance of being reunited with their birth families. Therefore, in their efforts to look after children with rocky placement histories who are prone to behavioral and emotional problems, foster parents should be provided with training opportunities that increase their parenting competencies. Such help could be provided as a part of all foster care training or as an additional component provided for parents with children coping with behavioral difficulties. • Summary of “Effects of a Foster Parent Training Intervention on Placement Changes of Children in Foster Care” by Joseph M. Price, Patricia Chamberlain, John Landsverk, John B. Reid, Leslie D. Leve and Heidemarie Laurent in Child Maltreatment, Vol. 13, No. 1, pp64-75.

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