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Program Components of Psychosocial Interventions in Foster and Kinship Care: A Systematic Review

Abstract

Foster children frequently experience early trauma that significantly impacts their neurobiological, psychological and social development. This systematic review examines the comparative effectiveness of foster and kinship care interventions. It examines the components within each intervention, exploring their potential to benefit child and carer well-being, particularly focussing on child behaviour problems, and relational functioning. Systematic searches of electronic databases included PsycINFO, MEDLINE, Web of Science Core Collection, the Cochrane Collaborations Register of Controlled Trials (CENTRAL) and Scopus to identify randomised or quasi-randomised trials of psychosocial foster/kinship care interventions, published between 1990 and 2016. Seventeen studies describing 14 interventions were included. Eleven studies reported comparative benefit compared to control. Overall, effective interventions had clearly defined aims, targeted specific domains and developmental stages, provided coaching or role play, and were developed to ameliorate the effects of maltreatment and relationship disruption. Interventions effective in reducing behaviour problems included consistent discipline and positive reinforcement components, trauma psychoeducation, problem-solving and parent-related components. Interventions effective in improving parent–child relationships included components focussed on developing empathic, sensitive and attuned parental responses to children’s needs. Given the prevalence of both behaviour problems and relational difficulties in foster families, targeting these needs is essential. However, interventions have tended to measure outcomes in either behavioural or relational terms. A more coordinated and collaborative research approach would provide a better understanding of the association between parent–child relationships and child behaviour problems. This would allow us to develop, deliver and evaluate programs that combine these components more effectively. Protocol Registration Number: PROSPERO CRD42016048411.

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Correspondence to Jacqueline Kemmis-Riggs.

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The authors declare that they have no conflict of interest.

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Ethics approval was obtained by the University of Technology Sydney Human Research Ethics Committee.

Appendix: Electronic Search Strategies

Appendix: Electronic Search Strategies

PsychINFO

AB (foster care OR kinship care OR foster child* OR foster parent* OR foster carer* OR foster mother OR foster father OR foster family OR out of home care OR looked after children) AND AB (intervention OR therap* OR counsel?ing OR cognitive behavior?ral therapy OR psychotherapy OR family therapy OR treatment OR training).

  • Limits: Published Date: 19900101-; Publication Type: All Journals; English.

  • Expanders—Apply related words; Search modes—Boolean/Phrase.

MJ (foster care OR kinship care OR foster child* OR foster parent* OR foster carer* OR foster mother OR foster father OR foster family OR out of home care OR looked after children) AND MJ (intervention OR therap* OR counsel?ing OR cognitive behavior?ral therapy OR psychotherapy OR family therapy OR treatment OR training).

  • Limiters Published Date: 19900101-; Publication Type: All Journals; English;

  • Expanders—Apply related words; Search modes—Boolean/Phrase.

Cochrane Collaborations Register of Controlled Trials (CENTRAL)

foster care or kinship care or foster child* or foster parent* or foster carer* or foster mother or foster father or foster family or out of home care or looked after children:ti,ab,kw and intervention or therap* or counsel?ing or cognitive behavior?ral therapy or psychotherapy or family therapy or treatment or training:ti,ab,kw.

  • Limits: Publication Year from 1990 to 2016 (Word variations have been searched).

Medline

(exp Foster Home Care/px [Psychology] OR out of home care.mp. OR looked after children.mp.) AND (intervention.mp. OR therapy.mp. OR Counseling/OR Cognitive Therapy/OR treatment.mp. OR training.mp. OR Family Therapy/).

  • Limits: 1990—current; English.

Social sciences citation/web of science core collection

TOPIC: (“foster care” or “kinship care” or “foster child*” or “foster parent*” or “foster carer*” or “foster mother” or “foster father” or “foster family” or “out of home care” or “looked after children”) AND TOPIC: (intervention or therapy OR therapies or counsel?ing or “cognitive behavioral therapy” or psychotherapy or “family therapy” or treatment or training).

  • Limits: Refined by: LANGUAGES: (ENGLISH); Timespan: 1990–2016.

  • Indexes: SCI-EXPANDED, SSCI, A&HCI, CPCI-S, CPCI-SSH, ESCI, CCR-EXPANDED, IC.

Scopus

TITLE-ABS-KEY (foster care OR kinship care OR foster child OR foster parent* OR foster carer* OR foster mother OR foster father OR foster family OR out of home care OR looked after children) AND TITLE-ABS-KEY (intervention OR therap* OR counsel* OR cognitive behav* OR psychotherapy OR family therapy OR treatment OR training).

  • Limits: PUBYEAR > 1989 AND (LIMIT-TO (LANGUAGE, “English”)) AND (LIMIT-TO (SRCTYPE, “j”)).

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Kemmis-Riggs, J., Dickes, A. & McAloon, J. Program Components of Psychosocial Interventions in Foster and Kinship Care: A Systematic Review. Clin Child Fam Psychol Rev 21, 13–40 (2018). https://doi.org/10.1007/s10567-017-0247-0

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  • DOI: https://doi.org/10.1007/s10567-017-0247-0

Keywords

  • Interventions
  • Foster care
  • Kinship care
  • Systematic review
  • Looked after children
  • Maltreatment