Skip to main content

Advertisement

Log in

Children’s Psychosocial Rehabilitation: Clinical Outcomes for Youth with Serious Emotional Disturbance Living in Foster Care

  • Published:
Child and Adolescent Social Work Journal Aims and scope Submit manuscript

Abstract

Children living in foster care are an especially vulnerable population who often come to the attention of Medicaid mental health providers. These children experience a high incidence of emotional and behavioral disorders and may have specialized treatment needs related to their living arrangement status. This study assessed whether Children’s Psychosocial Rehabilitation could effectively treat youth with severe emotional and behavioral disorders who live in foster care. Analysis of data from an open trial of 218 clinically-impaired youth, aged 3–18 years, revealed no reliable differences in treatment outcome between foster versus non-foster children, with a trend toward more favorable outcomes for foster youth. Findings justify further study of the effectiveness of this Medicaid-funded service for the treatment of youth in care.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  • American Academy of Child and Adolescent Psychiatry & Child Welfare League of America. (2002). Foster care mental health values subcommittee policy statement. Retrieved 9 May 2008 from: http://www.aacap.org/cs/root/policy_statements/aacap/cwla_foster_care_mental_health_values_subcommittee.

  • American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders (4th ed., text revision). Washington, DC: American Psychiatric Association.

  • Bates, M. P. (2001). The Child and Adolescent Functional Assessment Scale (CAFAS): Review and current status. Clinical Child and Family Psychology Review, 4, 63–84.

    Article  PubMed  Google Scholar 

  • Blankertz, L. E., Cnaan, R. A., & Freedman, E. (1993). Childhood risk factors in dually diagnosed homeless adults. Social Work, 38, 587–596.

    PubMed  Google Scholar 

  • Burns, B. J., Schoenwald, S. K., Burchard, J. D., Faw, L., & Santos, A. B. (2000). Comprehensive community-based interventions for youth with severe emotional disorders: Multisystemic therapy and the wraparound process. Journal of Child and Family Studies, 9, 293–314.

    Article  Google Scholar 

  • Chernoff, R., Combs-Orme, T., Risley-Curtiss, C., & Heisler, A. (1994). Assessing the health status of children entering foster care. Pediatrics, 93, 594–601.

    PubMed  Google Scholar 

  • Clark, H. B., Lee, B., Prange, M. E., & McDonald, B. A. (1996). Children lost within the foster care system: Can wraparound service strategies improve placement outcomes? Journal of Child and Family Studies, 5, 39–54.

    Article  Google Scholar 

  • Clausen, J. M., Landsverk, J., Ganger, W., Chadwick, D., & Litrownik, A. (1998). Mental health problems of children in foster care. Journal of Child and Family Studies, 7, 283–296.

    Article  Google Scholar 

  • Costello, E. J., Angold, A., Burns, B. J., Erkanli, A., Stangl, D. K., & Tweed, D. L. (1996). The Great Smoky Mountains Study of youth: Functional impairment and serious emotional disturbance. Archives of General Psychiatry, 53, 1137–1143.

    PubMed  Google Scholar 

  • Courtney, M. E., Piliavin, I., Grogan-Kaylor, A., & Nesmith, A. (2001). Foster youth transitions to adulthood: A longitudinal view of youth leaving care. Child Welfare, 80, 685–717.

    PubMed  Google Scholar 

  • Craven, P. A., & Lee, R. E. (2006). Therapeutic interventions for foster children: A systematic research synthesis. Research on Social Work Practice, 16, 287–304.

    Article  Google Scholar 

  • Dore, M. M. (1999). Emotionally and behaviorally disturbed children in the child welfare system: Points of preventive intervention. Children and Youth Services Review, 21(1), 7–29.

    Article  Google Scholar 

  • dosRios, S., Zito, J. M., Safer, D. J., & Soeken, K. L. (2001). Mental health services for youths in foster care and disabled youths. American Journal of Public Health, 91, 1094–1099.

    Article  Google Scholar 

  • Earls, F., & Jung, K. G. (1987). Temperament and home environment characteristics as causal factors in the early development of childhood psychopathology. Journal of the American Academy of Child and Adolescent Psychiatry, 26, 491–498.

    Article  PubMed  Google Scholar 

  • Garland, A. F., Hough, R. L., Landsverk, J. A., McCabe, K. A., Yeh, M., Ganger, W. C., et al. (2000). Racial and ethnic variations in mental health care utilization among children in foster care. Children’s Services: Social Policy, Research, and Practice, 3, 133–146.

    Google Scholar 

  • Garwood, M. M., & Close, W. (2001). Identifying the psychological needs of foster children. Child Psychiatry and Human Development, 32, 125–135.

    Article  PubMed  Google Scholar 

  • Halfon, N., Berkowitz, G., & Klee, L. (1992). Children in foster care in California: An examination of Medicaid reimbursed health services utilization. Pediatrics, 89, 1230–1237.

    PubMed  Google Scholar 

  • Halfon, N., Zepeda, A., & Inkelas, M. (2002). Mental health services for children in foster care (Policy Statement No. 4). Los Angeles: University of California, Center for Healthier Children, Families, and Communities.

    Google Scholar 

  • Henggeler, S. W., Rowland, M. D., Randall, J., Ward, D. M., Pickrel, S. G., Cunningham, P. B., et al. (1999). Home-based Multisystemic therapy as an alternative to hospitalization of youths in psychiatric crisis: Clinical outcomes. Journal of the American Academy of Child and Adolescent Psychiatry, 38, 1331–1347.

    Article  PubMed  Google Scholar 

  • Henggeler, S. W., Schoenwald, S. K., Rowland, M. D., & Cunningham, P. B. (2002). Serious emotional disturbance in children and adolescents: Multisystemic therapy. New York: The Guilford Press.

    Google Scholar 

  • Hodges, K. (1994). The Preschool and Early Childhood Functional Assessment Scale. Ypsilanti: Eastern Michigan University.

    Google Scholar 

  • Hodges, K. (2000a). The Child and Adolescent Functional Assessment Scale (2nd Rev.). Ypsilanti: Eastern Michigan University.

    Google Scholar 

  • Hodges, K. (2000b). Child and Adolescent Functional Assessment Scale self-training manual (2nd Rev.). Ypsilanti: Eastern Michigan University.

    Google Scholar 

  • Hodges, K., Doucette-Gates, A., & Liao, Q. (1999). The relationship between the Child and Adolescent Functional Assessment Scale (CAFAS) and indicators of functioning. Journal of Child and Family Studies, 8, 109–122.

    Article  Google Scholar 

  • Hodges, K., & Wong, M. M. (1996). Psychometric characteristics of a multidimensional measure to assess impairment: The Child and Adolescent Functional Assessment Scale. Journal of Child and Family Studies, 5, 445–467.

    Article  Google Scholar 

  • Hodges, K., Xue, Y., & Wotring, J. (2004). Use of the CAFAS to evaluate outcomes for youths with severe emotional disturbance served by public mental health. Journal of Child and Family Studies, 13, 325–339.

    Article  Google Scholar 

  • Kerker, B. D., & Dore, M. M. (2006). Mental health needs and treatment of foster youth: Barriers and Opportunities. American Journal of Orthopsychiatry, 76, 138–147.

    Article  PubMed  Google Scholar 

  • Landsverk, J., & Garland, A. F. (1999). Foster care and pathways to mental health services. In P. A. Curtis, G. Dale Jr., & J. C. Kendall (Eds.), The foster care crisis: Translating research into policy and practice. Child, youth, & family services (pp. 193–210). Lincoln: University of Nebraska Press.

    Google Scholar 

  • McCurdy, B. L., & McIntyre, E. K. (2004). ‘And what about residential…?’ Re-conceptualizing residential treatment as a stop-gap service for youth with emotional and behavioral disorders. Behavioral Interventions, 19, 137–158.

    Article  Google Scholar 

  • Moore, K. A., Vandivere, S., & Ehrle, J. (2000). Sociodemographic risk and child well-being. In Assessing the new federalism: National survey of American’s families (Series B. No. B-18). Washington, DC: Child Trends.

  • Murphy, J. M., Pagano, M. E., Ramirez, A., Yolanda, A., Nowlin, C., & Jellinek, M. S. (1999). Validation of the Preschool and Early Childhood Functional Assessment Scale (PECFAS). Journal of Child and Family Studies, 8, 343–356.

    Article  Google Scholar 

  • Offord, D. R., Boyle, M. H., Racine, Y. A., & Fleming, J. E. (1992). Outcome, prognosis, and risk in a longitudinal follow-up study. Journal of the American Academy of Child and Adolescent Psychiatry, 31, 916–923.

    Article  PubMed  Google Scholar 

  • Piacentini, J., Bergman, R. L., Jacobs, C., McCracken, J. T., & Kretchman, J. (2002). Open trial of cognitive-behavior therapy for childhood obsessive-compulsive disorder. Anxiety Disorders, 16, 207–219.

    Article  Google Scholar 

  • Pilowsky, D. (1995). Psychopathology among children placed in family foster care. Psychiatric Services, 46, 906–910.

    PubMed  Google Scholar 

  • Roberts, R. E., Attkisson, C. C., & Rosenblatt, A. (1998). Prevalence of psychopathology among children and adolescents. American Journal of Psychiatry, 155, 715–725.

    PubMed  Google Scholar 

  • Rosenhack, R., & Fontana, A. (1994). A model of homelessness among male veterans of the Vietnam War generation. American Journal of Psychiatry, 151, 421–427.

    Google Scholar 

  • Shlay, A. B., & Rossi, P. H. (1992). Social science research and contemporary studies of homelessness. Annual Review of Sociology, 18, 129–160.

    Article  Google Scholar 

  • Stroul, B., & Friedman, R. (1986). A system of care for children and youth with severe emotional disturbances (Revised Edition). Washington, DC: Georgetown University Child Development Center, National Technical Assistance Center for Children’s Mental Health.

  • Susser, E. S., Lin, S. P., Conover, S. A., & Struening, E. L. (1991). Childhood antecedents of homelessness in psychiatric patients. American Journal of Psychiatry, 148, 1026–1030.

    PubMed  Google Scholar 

  • U.S. Department of Health and Human Services. (1999). Mental Health: A report of the Surgeon General. Rockville: National Institute of Mental Health, National Institutes of Health, U.S. Department of Health and Human Services.

    Google Scholar 

  • U.S. Department of Health and Human Services. (2001). Child maltreatment 1999: Reports from the states to the National Clearinghouse on Child Abuse and Neglect. Washington: Government Printing Office.

    Google Scholar 

  • U.S. Public Health Service. (2000). Report of the surgeon general’s conference on children’s mental health: A national action agenda. Washington, DC: Department of Health and Human Services. Retrieved from the web 7 May 2008. http://www.surgeongeneral.gov/topics/cmh/childreport.htm.

  • Velez, C., Johnson, J., & Cohen, P. (1989). A longitudinal analysis of selected risk factors for childhood psychopathology. Journal of the American Academy of Child and Adolescent Psychiatry, 28, 861–864.

    Article  PubMed  Google Scholar 

  • Vernberg, E. M., Jacobs, A. K., Nyre, J. E., Puddy, R. W., & Roberts, M. C. (2004). Innovative treatment for children with serious emotional disturbance: Preliminary outcomes for a school-based intensive mental health program. Journal of Clinical Child and Adolescent Psychology, 33, 359–365.

    Article  PubMed  Google Scholar 

  • Vinnerljung, B., Hjern, A., & Lindblad, F. (2006). Suicide attempts and severe psychiatric morbidity among former child welfare clients—a national cohort study. Journal of Child Psychology and Psychiatry, 47, 723–733.

    Article  PubMed  Google Scholar 

  • Weisz, J. R., Doss, A. J., & Hawley, K. M. (2005). Youth psychotherapy outcome research: A review and critique of the evidence base. Annual Review of Psychology, 56, 337–363.

    Article  PubMed  Google Scholar 

  • Weisz, J. R., Weiss, B., & Donenberg, G. R. (1992). The lab versus the clinic: Effects of child and adolescent psychotherapy. American Psychologist, 47, 1578–1585.

    Article  PubMed  Google Scholar 

  • Weisz, J. R., Weiss, B., Han, S. S., Granger, D. A., & Morton, T. (1995). Effects of psychotherapy with children and adolescents revisited: A meta-analysis of treatment outcome studies. Psychological Bulletin, 117, 450–468.

    Article  PubMed  Google Scholar 

  • Williams, N. J. (in press). Preliminary evaluation of children’s psychosocial rehabilitation for youth with serious emotional disturbance. Research on Social Work Practice.

  • Williams, S., Anderson, J., McGee, R., & Silva, P. A. (1990). Risk factors for behavioral and emotional disorder in preadolescent children. Journal of the American Academy of Child and Adolescent Psychiatry, 29, 413–419.

    Article  PubMed  Google Scholar 

  • Wilmshurst, L. A. (2002). Treatment programs for youth with emotional and behavioral disorders: An outcome study of two alternate approaches. Mental Health Services Research, 4, 85–96.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Nathaniel J. Williams.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Williams, N.J., Sherr, M.E. Children’s Psychosocial Rehabilitation: Clinical Outcomes for Youth with Serious Emotional Disturbance Living in Foster Care. Child Adolesc Soc Work J 26, 225–234 (2009). https://doi.org/10.1007/s10560-008-0160-y

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10560-008-0160-y

Keywords

Navigation