July/August 2018Vol. 19, No. 6Mental Health Interventions for Children in Foster Care

Children placed in out-of-home care usually have suffered adverse childhood experiences or situations that can lead to high rates of mental health problems, such as disruptive behavior disorders, attention deficit/hyperactivity disorder, posttraumatic stress disorder and other anxiety disorders, and mood disorders. Between 50 and 80 percent of children in foster care meet the criteria for at least one mental health disorder, and 23 percent meet the criteria for more than one. These children, however, are difficult to treat because of the transitory nature of out-of-home care. For example, some interventions meant for birth parents and their children are inappropriate in a foster home setting, or the child may have experienced two or more placements within a couple of years, making the continuity of treatment difficult. Additionally, some families may prefer to avoid the stigma of seeking out mental health care.

An article in Children and Youth Services Review aimed to evaluate intervention research in order to identify promising solutions to help children in foster care who are in need of mental health care. The study focused on research involving children who were between the ages of birth and 12 years.

Researchers selected interventions based on the following inclusion criteria:

• The intervention showed at least one positive child mental health outcome for children in foster care.
• The intervention could be delivered at home or in an outpatient/community setting.
• The intervention contained at least one specific and unique therapeutic component rather than only enhanced foster care or wraparound services.
• Outcome and engagement rates were measured after the completion of the intervention.
• There was an evaluation of the intervention's effectiveness.

Researchers identified 10 interventions that fit the above criteria—Attachment and Biobehavioral Catchup, child-parent psychotherapy, Fostering Healthy Futures, Incredible Years, Keeping Foster Parents Trained and Supported, Kids in Transition to School, parent-child interaction therapy, short enhanced cognitive-behavioral therapy, trauma-focused cognitive-behavioral therapy, and Treatment Foster Care Oregon for Preschoolers. Most of these interventions were developed for foster care situations, but 4 of 10 interventions were not developed specifically for use in the foster care setting; however, they proved to be applicable to this population. Further, the diversity among these interventions in terms of characteristics, frameworks, and delivery sites indicates that it may be possible to tailor interventions to specific needs and patient preferences.

"Mental health interventions for children in foster care: A systematic review," by Erin P. Hambrick, Shani Oppenheim-Weller, Amanda M. N'zi, and Heather N. Taussig (Children and Youth Services Review, 70), is available at https://www.sciencedirect.com/science/article/pii/S0190740916302717.