Skip to main content

Advertisement

SpringerLink
Log in

Family Reunification of Youth in Foster Care with Complex Mental Health Needs: Barriers and Recommendations

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

Abstract

This study presents findings of a formative evaluation of an innovative pilot program designed to reunify and reintegrate foster youth with complex mental and behavioral needs in residential treatment centers or therapeutic foster care with their families in the community. Data collection methods included in-depth structured case file reviews and semi-structured interviews with the youth, as well as their caregivers, Child Protective Services caseworkers, and pilot program staff. The participants provided important insights regarding system, program, and case-level barriers to the successful reunification of these youth back into the community. Training, practice, and policy recommendations are discussed.

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

Access this article

Log in via an institution

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

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

Notes

  1. A caregiver can be a biological parent, a biological parent whose rights have been terminated, an adoptive parent, a relative, a fictive kin, or anyone deemed appropriate by the child welfare system or the court of jurisdiction.

References

  • Ahart, A., Bruer, R., Rutsch, C., Schmidt, R., & Zaro, S. (1992). Intensive foster care reunification programs. Retrieved February 28, 2012, from http://aspe.hhs.gov/hsp/cyp/xsfcprog.htm.

  • Annie E. Casey Foundation. (2010). Rightsizing congregate care: A powerful first step in transforming child welfare systems. Baltimore: Annie E. Casey Foundation.

    Google Scholar 

  • Barth, R. P. (2002). Institutions vs. foster homes: The empirical base for the second century of debate. Chapel Hill, NC: University of North Carolina, School of Social Work, Jordan Institute for Families.

    Google Scholar 

  • Bronson, D. E. (2005). Re-entry in Child Protective Services: A rapid evidence assessment. Retrieved February 28, 2012, from http://www.pcsao.org/PCSAOTools/_overlay/OhioReEntryReport102005.pdf.

  • Burns, B. J., Phillips, S. D., Wagner, H. R., Barth, R. P., Kolko, D. J., Campbell, Y., et al. (2004). Mental health need and access to mental health services by youths involved with child welfare: A national survey. Journal of the American Academy of Child and Adolescent Psychiatry, 43(8), 960–970.

    Article  PubMed  Google Scholar 

  • Cheng, T. C. (2010). Factors associated with reunification: A longitudinal analysis of long-term foster care. Children and Youth Services Review, 32, 1311–1316.

    Article  Google Scholar 

  • Connell, C. M., Katz, K. H., Saunders, L., & Tebes, J. K. (2006). Leaving foster care: The influence of child and case characteristics on foster care exit rates. Children and Youth Services Review, 28(7), 780–798.

    Article  Google Scholar 

  • Davis, I. P., Landsverk, J., Newton, R., & Ganger, W. (1996). Parental visiting and foster care reunification. Children and Youth Services Review, 18(4/5), 363–382.

    Article  Google Scholar 

  • Fein, E., & Staff, I. (1993). Last best chance: Findings from a reunification services program. Child Welfare, 72(1), 25–40.

    Google Scholar 

  • Fraser, M. W., Walton, E., Lewis, R. E., Pecora, P. J., & Walton, W. K. (1996). An experiment in family reunification: Correlates of outcomes at one-year follow-up. Children and Youth Services Review, 18(4/5), 335–361.

    Article  Google Scholar 

  • Green, D., Belanger, K., McRoy, R. G., & Bullard, R. (Eds.). (2011). Challenging racial disproportionality in child welfare: Research, policy and practice. Arlington, VA: CWLA Press.

    Google Scholar 

  • Halfon, N., Berkowitz, G., & Klee, L. (1992). Mental health services utilization by children in foster care in California. Pediatrics, 89(6), 1238–1244.

    PubMed  Google Scholar 

  • Harman, J. S., Childs, G. E., & Kelleher, K. J. (2000). Mental health care utilization and expenditures by children in foster care. Archives of Pediatric and Adolescent Medicine, 154(11), 1114–1117.

    Google Scholar 

  • Harris, M. S., & Courtney, M. E. (2003). The interaction of race, ethnicity, and family structure with respect to the timing of family reunification. Children and Youth Services Review, 25(5/6), 409–429.

    Article  Google Scholar 

  • Hess, P. (1988). Case and context: Determinates of planned visit frequency in foster family care. Child Welfare, 67(4), 311–326.

    Google Scholar 

  • James, S., Leslie, L. K., Hurlburt, M. S., Slymen, D. J., Landsverk, J., Davis, I., et al. (2006). Children in out-of-home care: Entry into intensive or restrictive mental health and residential care placements. Journal of Emotional and Behavioral Disorders, 14(4), 196–208.

    Article  Google Scholar 

  • Jones, L. (1998). The social and family correlates of successful reunification of children in foster care. Children and Youth Services Review, 20(4), 305–323.

    Article  Google Scholar 

  • Kimberlin, S. E., Anthony, E. K., & Austin, M. J. (2009). Re-entering foster care: Trends, evidence, and implications. Children and Youth Services Review, 31(4), 471–481.

    Article  Google Scholar 

  • Leathers, S. J. (2002). Parental visiting and family reunification: Could inclusive practice make a difference? Child Welfare, 81(4), 595–616.

    PubMed  Google Scholar 

  • Lee, B. R., Bright, C. L., Svoboda, D. V., Fakunmoju, S., & Barth, R. P. (2011). Outcomes of group care for youth: A review of comparative studies. Research on Social Work Practice, 21(2), 177–189.

    Article  Google Scholar 

  • Macdonald, G. (2001). Effective interventions for child abuse and neglect: An evidence-based approach to planning and evaluating interventions. Chichester: Wiley.

    Google Scholar 

  • Magellan Health Services Children’s Services Task Force. (2008). Perspectives on residential and community-based treatment for youth and families. Puyallup, WA: Magellan Health Services, Inc.

    Google Scholar 

  • Maher, E. J., Ward, K. J., Peveto, L., McRoy, R. G., Cuellar, A., & Madden, E. E. (2011). Permanency outcomes for youth with complex mental health needs served by the Child Protective Services Reintegration Project: Phase II evaluation report. Seattle, WA: Casey Family Programs.

  • Patton, M. Q. (2008). Utilization-focused evaluation (4th ed.). Thousand Oaks, CA: Sage.

    Google Scholar 

  • Ryan, J., Marsh, J., Testa, M., & Louderman, R. (2003). Integrating substance abuse treatment and child welfare services: Findings from the Illinois Alcohol and Other Drug Abuse Waiver demonstration. Social Work Research, 30(2), 95–107.

    Article  Google Scholar 

  • Smokowski, P. R., & Wodarski, J. S. (1996). The effectiveness of child welfare services for poor, neglected children: A review of the empirical evidence. Research on Social Work Practice, 6(4), 504–523.

    Article  Google Scholar 

  • Snowden, J., Leon, S., & Sieracki, J. (2008). Predictors of children in foster care being adopted: A classification tree analysis. Children and Youth Services Review, 30(11), 1318–1327.

    Article  Google Scholar 

  • Sommer, R., & Sommer, B. (2002). A practical guide to behavioral research: Tools and techniques (5th ed.). New York: Oxford University Press.

    Google Scholar 

  • Stahmer, A. C., Leslie, L. K., Hurlburt, M., Barth, R. P., Webb, M. B., Landsverk, J., et al. (2005). Developmental and behavioral needs and service use for young children in child welfare. Pediatrics, 116(4), 891–900.

    Article  PubMed  Google Scholar 

  • Stake, R. E. (1995). The art of case study research. Thousand Oaks, CA: Sage.

    Google Scholar 

  • Taussig, H. N., Clyman, R. B., & Landsverk, J. (2001). Children who return home from care: A 6-year prospective study of behavioral health outcomes in adolescence. Pediatrics, 108(1), E10.

    Article  PubMed  Google Scholar 

  • Teare, J. F., Becker-Wilson, C., & Larzelere, R. E. (2001). Identifying risk factors for disrupted family reunifications following short-term shelter care. Journal of Emotional and Behavioral Disorders, 9(2), 116–122.

    Article  Google Scholar 

  • The PEW Charitable Trusts. (2007). Time for reform: Investing in prevention: Keeping children safe at home. Philadelphia: The PEW Charitable Trusts.

    Google Scholar 

  • Thomlison, B., Maluccio, A. N., & Abramczyk, L. W. (1996). The theory, policy, and practice context of family reunification: An integrated research perspective. Children and Youth Services Review, 18(4/5), 473–488.

    Article  Google Scholar 

  • U.S. Census Bureau. (2000). American FactFinder: Detailed tables. Retrieved February 28, 2012, from http://factfinder.census.gov.

  • U.S. Department of Health and Human Services. (1999). Mental health: A report of the surgeon general. Washington, DC: U.S. Public Health Service.

    Google Scholar 

  • U.S. Department of Health and Human Services. (2006). Family reunification: What the evidence shows. Washington, DC: Administration for Children and Families.

    Google Scholar 

  • U.S. Department of Health and Human Services (2008). Child and family services reviews fact sheet. Retrieved February 28, 2012, from http://www.acf.hhs.gov/programs/cb/cwmonitoring/recruit/cfsrfactsheet.htm.

  • U.S. Department of Health and Human Services. (2009). The AFCARS report: Preliminary FY 2007 estimates as of October 2009 (15). Retrieved February 28, 2012, from www.acf.hhs.gov/programs/cb/stats_research/afcars/tar/report15.htm.

  • U.S. Department of Health and Human Services. (2010a). The AFCARS report: Preliminary FY 2009 estimates as of July 2010 (17). Retrieved February 28, 2012, from http://www.acf.hhs.gov/programs/cb/stats_research/afcars/tar/report17.htm.

  • U.S. Department of Health and Human Services. (2010b). Adoption and foster care analysis and reporting system [raw data]. Seattle, WA: Casey Family Programs.

  • Walker, J. S., & Bruns, E. J. (2006). Building on practice-based evidence: Using expert perspectives to define the wraparound process. Psychiatric Services, 57(11), 1579–1585.

    Article  PubMed  Google Scholar 

  • Walton, E. (1998). In-home family-focused reunification: A six-year follow-up of a successful experiment. Social Work Practice, 22(4), 205–214.

    Google Scholar 

  • Wells, M., & Correia, M. (2010). Assessments of safety and risk: Implications for reunification from out-of-home care. Protecting Children, 25(3), 90–108.

    Google Scholar 

  • Wells, S. J., & Fuller, T. (2000). Elements of best practice in family centered services. Urbana, IL: University of Illinois at Urbana-Champaign.

    Google Scholar 

  • Wells, K., & Guo, S. (1999). Reunification and reentry of foster children. Children and Youth Services Review, 21(4), 273–294.

    Article  Google Scholar 

  • Wulczyn, F. (2004). Family reunification. The Future of Children, 14(1), 95–113.

    Article  Google Scholar 

  • Wulczyn, F. (2011). Permanency, disparity and social context. Presentation for the race and child welfare working conference at Harvard Law School, 28–29 January 2011. Retrieved February 28, 2012, from http://www.law.harvard.edu/programs/about/cap/cap-conferences/rd-conference/rd-conference-papers/compatiblefinalrdconferenceppwulczyn.ppt.

  • Yin, R. K. (2008). Case study research. Design and methods (4th ed.). Thousand Oaks, CA: Sage Publications.

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. University of Texas at Arlington, Arlington, TX, USA

    Elissa E. Madden

  2. Casey Family Programs, Seattle, WA, USA

    Erin J. Maher, Kristin J. Ward & Ann Stanley

  3. Boston College, Boston, MA, USA

    Ruth G. McRoy

  4. Travis County Health and Human Services & Veterans Service, Austin, TX, USA

    Laura Peveto

Authors
  1. Elissa E. Madden
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Erin J. Maher
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Ruth G. McRoy
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Kristin J. Ward
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Laura Peveto
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Ann Stanley
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Elissa E. Madden.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Madden, E.E., Maher, E.J., McRoy, R.G. et al. Family Reunification of Youth in Foster Care with Complex Mental Health Needs: Barriers and Recommendations. Child Adolesc Soc Work J 29, 221–240 (2012). https://doi.org/10.1007/s10560-012-0257-1

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10560-012-0257-1

Keywords

Search

Navigation