Abstract
As U.S. policy and practice further constrains the prevalence of residential treatment for youth with emotional and behavior challenges, treatment foster care (TFC) placements are expected to expand and serve challenging youth who were previously receiving group care placement. Treatment foster parents play an essential role in the delivery of TFC and its potential to be a transformative and healing environment for youth. Using qualitative analysis of semi-structured interviews from 23 experts in TFC practice as well as more general child welfare training and implementation science, this paper seeks to build knowledge around the training and support needs of TFC parents from the perspectives of TFC experts. Findings suggest the importance of TFC parents viewing themselves as treatment providers and not just parents. They need to have competencies specific to working as a member of a treatment team, knowledge of public systems, and skills to manage youth challenging behaviors. Best practices in equipping TFC parents should follow adult learning principles that focus on experiential learning with peer support and ongoing coaching or reinforcement.
Highlights
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Treatment foster care (TFC) parents are more than just caregivers, they are also essential treatment providers.
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TFC parents need behavioral management skills and behavioral health competencies.
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TFC parent trainings should include experiential learning, peer support, and coaching.
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References
Barth, R., Rozeff, L., Kerns, S. E. U. & Baldwin, M. (2019). Partnering for Success: Implementing a cross-systems collaborative model between behavioral health and child welfare. Childrenand Youth Services Review. https://doi.org/10.1016/j.childyouth.2019.104663.
Beidas, R. S., Cross, W., & Dorsey, S. (2014). Show me, don’t tell me: behavioral rehearsal as a training and analogue fidelity tool. Cognitive and Behavioral Practice, 21(1), 1–11. https://doi.org/10.1016/j.cbpra.2013.04.002.
Bellonci, C., Holmes, L., & Whittaker, J. (2019). Re-thinking therapeutic residential care (TRC) as a preventive service: examining developments in the US and England. Residential Treatment for Children & Youth, 36(1), 35–53. https://doi.org/10.1080/0886571X.2018.1536495.
Child Welfare League of America (2015). Bills to Strengthen Use of Therapeutic Foster Care (TFC) Introduced. https://www.cwla.org/bills-to-strengthen-use-of-therapeutic-foster-care-tfc-introduced/.
Chamberlain, P. (2003). The oregon multidimensional treatment foster care model: features, outcomes, and progress in dissemination. Cognitive and Behavioral Practice, 10(4), 303–312. https://doi.org/10.1016/S1077-7229(03)80048-2.
Chamberlain, P., & Reid, J. B. (1998). Comparison of two community alternatives to incarceration for chronic juvenile offenders. Journal of Consulting and Clinical Psychology, 66(4), 624–633. https://doi.org/10.1037//0022-006x.66.4.624.
Cohen, A., & Mosek, A. (2019). “Power together”: professionals and parents of children with disabilities creating productive partnerships. Child and Family Social Work, 24(4), 1–9. https://doi.org/10.1111/cfs.12637.
Cuijpers, P., Cristea, I. A., Karyotaki, E., Reijnders, M., & Hollon, S. D. (2019). Component studies of psychological treatments of adult depression: a systematic review and meta-analysis. Psychotherapy Research, 29(1), 15–29. https://doi.org/10.1080/10503307.2017.1395922.
Dorsey, S., Farmer, E. M. Z., Barth, R. P., Greene, K. M., Reid, J., & Landsverk, J. (2008). Current status and evidence base of training for foster and treatment foster parents. Children and Youth Services Review, 30(12), 1403–1416. https://doi.org/10.1016/j.childyouth.2008.04.008.
De Wilde, L., Devlieghere, J., Vandenbroeck, M., & Vanobbergen, B. (2019). Foster parents between voluntarism and professionalisation: unpacking the backpack. Children and Youth Services Review, 98, 290–296. https://doi.org/10.1016/j.childyouth.2019.01.020.
Eddy, J. M., & Chamberlain, P. (2000). Family management and deviant peer association as mediators of the impact of treatment condition on youth antisocial behavior. Journal of Consulting and Clinical Psychology, 68(5), 857–863. https://doi.org/10.1037/0022-006X.68.5.857.
Family First Prevention Services Act (2018). Pub. L. 115–123.
Family Focused Treatment Association (n.d.). What is Treatment/Therapeutic Foster Care (TFC)? https://www.ffta.org/page/WhatisTFC#:~:text=Treatment%20Family%20Care%20(formerly%20treatment,needs%20require%20intensive%20or%20therapeutic.
Family Focused Treatment Association (2019). Program Standards for Treatment Foster Care (5th ed.). https://cdn.ymaws.com/www.ffta.org/resource/resmgr/files/publications/2019_program_standards_for_t.pdf.
Farmer, E. M. Z., Burns, B. J., Dubs, M. S., & Thompson, S. (2002). Assessing conformity to standards for treatment foster care. Journal of Emotional & Behavioral Disorders, 10, 213–222. https://doi.org/10.1177/10634266020100040301.
Farmer, E. M. Z., Burns, B. J., Wagner, H. R., Murray, M., & Southerland, D. G. (2010). Enhancing “usual practice” treatment foster care: Findings from a randomized trial on improving youth outcomes. Psychiatric Services, 61(6), 555–561. https://doi.org/10.1176/appi.ps.61.6.555.
Farmer, E. M. Z., & Lippold, M. A. (2016). The need to do it all: exploring the ways in which treatment foster parents enact their complex role. Children and Youth Services Review, 64, 91–99. https://doi.org/10.1016/j.childyouth.2016.03.005.
Fisher, P. A., Gunnar, M. R., Chamberlain, P., & Reid, J. B. (2000). Preventive intervention for maltreated preschoolers: Impact on child’s behavior, neuroendocrine activity, and foster parent functioning. Journal of the American Academy of Child and Adolescent Psychiatry, 39, 1356–1364. https://doi.org/10.1097/00004583-200011000-00009.
Fisher, P. A., Burraston, B., & Pears, K. (2005). The Early Intervention Foster Care program: Permanent placement from a randomized trial. Child Maltreatment, 10(1), 61–71. https://doi.org/10.1177/1077559504271561.
Fixsen, D. L, Naoom, S. F, Blase, K. A, Friedman, R. M., & Wallace, F. (2005). Implementation research: A synthesis of the literature. Tampa, FL: University of South Florida, Louis de la Parte Florida Mental Health Institute, The National Implementation Research Network (FMHI Publication #231). https://nirn.fpg.unc.edu/sites/nirn.fpg.unc.edu/files/resources/NIRN-MonographFull-01-2005.pdf.
Frederico, M., Long, M., McNamara, P., McPherson, L., & Rose, R. (2016). Improving outcomes for children in out-of-home care: the role of therapeutic foster care. Child and Family Social Work, 22(2), 1064–1074. https://doi.org/10.1111/cfs.12326.
Greeno, E. J., Lee, B. R., Uretsky, M. C., Moore, J. E., Barth, R. P., & Shaw, T. V. (2016). Effects of a foster parent training intervention on child behavior, caregiver stress, and parenting style. Journal of Child and Family Studies, 25, 1991–2000. https://doi.org/10.1007/s10826-015-0357-6.
Hebert, C. G., & Kulkin, H. (2018). An investigation of foster parent training needs. Child and Family Social Work, 23(2), 256–263. https://doi.org/10.1111/cfs.12413.
January, S. A. A., Hurley, K. D., Stevens, A. L., Kutash, K., Duchnowski, A. J., & Pereda, N. (2016). Evaluation of a community-based peer-to-peer support program for parents of at-risk youth with emotional and behavioral difficulties. Journal of Child and Family Studies, 25(3), 836–844. https://doi.org/10.1007/s10826-015-0271-y.
Kim, H. K., Pears, K. C., Leve, L. D., Chamberlain, P., & Smith, D. K. (2013). Intervention effects on health-risking sexual behavior among girls in foster care: The role of placement disruption and tobacco and marijuana use. Journal of Child & Adolescent Substance Abuse, 22(5), 370–387. https://doi.org/10.1080/1067828X.2013.788880.
Knowles, M. (1984). Andragogy in action: applying modern principles of adult learning. San Francisco: Jossey-Bass.
Lee, B. R., Bright, C. L., Svoboda, D., Fakunmoju, S., & Barth, R. P. (2011). Outcomes of group care for youth: a review of comparative studies. Research on Social Work Practice, 21, 177–189. https://doi.org/10.1177/1049731510386243.
Leve, L. D., Chamberlain, P., & Reid, J. B. (2005). Intervention outcomes for girls referred from juvenile justice: effects on delinquency. Journal of Consulting and Clinical Psychology, 73(6), 1181–1185. https://doi.org/10.1037/0022-006X.73.6.1181.
Lincoln, Y. S., & Guba, E. G. (1985). Naturalistic inquiry. Newbury Park, CA: Sage.
Lyon, A. R., Wiltsey Stirman, S., Kerns, S. E. U., & Bruns, E. J. (2011). Developing the mental health workforce: review and application of training approaches from multiple disciplines. Administration and Policy in Mental Health, 38(4), 238–53. https://doi.org/10.1007/s10488-010-0331-y.
Mersky, J. P., Topitzes, J., Janczewski, C. E., & McNeil, C. B. (2015). Enhancing foster parent training with parent-child interaction therapy: evidence from a randomized field experiment. Journal of the Society for Social Work & Research, 6(4), 591–616. https://doi.org/10.1086/684123.
Murray, M., Culver, T., Farmer, E., Jackson, L. A., & Rixon, B. (2014). From theory to practice: one agency’s experience with implementing an evidence-based model. Journal of Child and Family Studies, 23(5), 844–853. https://doi.org/10.1007/s10826-013-9738-x.
Murray, M. M., Southerland, D., Farmer, E. M., & Ballentine, K. (2010). Enhancing and adapting treatment foster care: Lessons learned in trying to change practice. Journal of Child and Family Studies, 19(4), 393–403. https://doi.org/10.1007/s10826-009-9310-x.
Nadeem, E., Gleacher, A., & Beidas, R. S. (2013). Consultation as an implementation strategy for evidence-based practices across multiple contexts: Unpacking the black box. Administration and policy in mental health and mental. Health Services Research, 40(6), 439–450. https://doi.org/10.1007/s10488-013-0502-8.
Nicholson, J., & Valentine, A. (2019). Key informants specify core elements of peer supports for parents with serious mental illness. Frontiers in Psychiatry, 10, 106. https://doi.org/10.3389/fpsyt.2019.00106.
Osei, G. K., Gorey, K. M., & Hernandez Jozefowicz, D. M. (2016). Delinquency and crime prevention: overview of research comparing treatment foster care and group care. Children & Youth Care Forum, 45, 33–46. https://doi.org/10.1007/s10566-015-9315-0.
Piescher, K. N., Schmidt, M., & LaLiberte, T. (2008). Evidence-based practice in foster parent training and support: Implications for treatment foster care providers. Center for Advanced Studies in Child Welfare. https://cascw.umn.edu/wp-content/uploads/2013/12/EBPFPTrainingSupportComplete.pdf.
Price, J. M., Chamberlain, P., Landsverk, J., Reid, J., Leve, L., & Laurent, H. (2008). Effects of a foster parent training intervention on placement changes ofchildren in foster care. Child Maltreatment, 13, 64–75. https://doi.org/10.1177/1077559507310612.
Price, J. M., Chamberlain, P., Landsverk, J., & Reid, J. (2009). KEEP foster-parent training intervention: Model description and effectiveness. Child & Family Social Work, 14(2), 233–242. https://doi.org/10.1111/j.1365-2206.2009.00627.x.
Puddy, R., & Jackson, Y. (2003). The development of parenting skills in foster parent training. Children & Youth Services Review, 25, 987–1013. https://doi.org/10.1016/S0190-7409(03)00106-3.
Rodriguez, J., Olin, S. S., Hoagwood, K. E., Shen, S., Burton, G., Radigan, M., & Jensen, P. S. (2011). The development and evaluation of a parent empowerment program for family peer advocates. Journal of Child and Family Studies, 20(4), 397–405. https://doi.org/10.1007/2Fs10826-010-9405-4.
Schofield, G., Beek, M., Ward, E., & Biggart, L. (2013). Professional foster career and committed parent: role conflict and role enrichment at the interface between work and family in long-term foster care. Child and Family Social Work, 18, 46–56. https://doi.org/10.1111/cfs.12034.
Seibert, J, Feinberg, R, Ayub, A, Helburn, A., & Gibbls, D. (2018). State practices in treatment/therapeutic foster care. Research Triangle Park, NC: RTI International. https://aspe.hhs.gov/system/files/pdf/259121/TREATMENTFOSTERCARE.pdf.
Smith, D. K., Leve, L. D., & Chamberlain, P. (2011). Preventing internalizing and externalizing problems in girls in foster care as they enter middle school: Impact of an intervention. Prevention Science, 12(3), 269–277. https://doi.org/10.1007/2Fs11121-011-0211-z.
Stokes, T. F., & Baer, D. M. (1977). An implicit technology of generalization. Journal of Applied Behavior Analysis, 10, 349–367. https://doi.org/10.1901/jaba.1977.10-349.
Westermark, P. K., Hansson, K., & Olsson, M. (2011). Multidimensional Treatment Foster Care (MTFC): results from an independent replication. Journal of Family Therapy, 33, 20–41. https://doi.org/10.1111/j.1467-6427.2010.00515.x.
Woolf, S., Schünemann, H. J., Eccles, M. P., Grimshaw, J. M., & Shekelle, P. (2012). Developing clinical practice guidelines: types of evidence and outcomes; values and economics, synthesis, grading, and presentation and deriving recommendations. Implementation Science, 7, 61. https://doi.org/10.1186/1748-5908-7-61.
Wilson, K., & Evetts, J. (2006). The professionalisation of foster care. Adoption and Fostering, 30(1), 39–47. https://doi.org/10.1177/030857590603000106.
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The National Center for Evidence-Based Practice in Child Welfare (NCEBPCW) is operated by the University of Maryland, School of Social Work and is made possible by grant number 90CT7001 from the Children’s Bureau. The contents of this paper/presentation are solely the responsibility of the NCEBPCW and do not necessarily represent the official views of the Children’s Bureau, Administration on Children, Youth and Families, Administration for Children & Families, or the US Department of Health and Human Services. The authors would like to thank the following child welfare and training and knowledge transfer experts who contributed to this paper: Lucy Berliner, Ken Berrick, Laura Boyd, Paul Brylske, Patti Chamberlain, Irene Clements, Melissa Devlin, Shannon Dorsey, Bob Ennis, Elizabeth Farmer, Maria Jose Horen, Angela Jachelski, Ellen Kahn, John Landsverk, Wendy Lane, Robin Leake, Kyla Liggett-Creel, Kantahyanee Murray, Maureen Murray, Judith Schagrin, Mike Stempkovski, Jaden Webb, and Lee White. More information about Partnering for Success can be found at: www.institute.umaryland.edu.
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Lee, B.R., Phillips, D.R., Steward, R.K. et al. Equipping TFC Parents as Treatment Providers: Findings from Expert Interviews. J Child Fam Stud 30, 870–880 (2021). https://doi.org/10.1007/s10826-020-01808-z
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DOI: https://doi.org/10.1007/s10826-020-01808-z