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Treatment foster care and relationships: Understanding the role of therapeutic alliance between youth and treatment parent

Treatment foster care can be a viable alternative to facility-based placements for youth with both permanency needs as well as mental health challenges. One factor that has been little researched is the relationship between the treatment parent and the youth living in their home. The reminder of this paper discusses the findings and what this means for treatment, policy and further research. The findings suggest that youth in treatment foster care for the most part, report favorable alliance with the treatment parent.

The perception of higher alliance reported by treatment parents has also been observed in other studies of alliance in day treatment/educational and therapeutic wilderness camp settings. (Bickman et al., 2004; Rauktis, Andrade and Doucette, in press). Helping adults generally rate their alliance with the youth higher than the youth rates their alliance with the adult. It is unclear why this difference exits: it may be the result of differences in cognitive functioning due to age or developmental level. An alternate explanation is that the adults, particularly treatment parents, may be reluctant to disclose negative feelings about their relationship with the youth. The fact that adults are more optimistic may serve a protective function: when you are living with a youth with mental health and behavioral challenges, being a little optimistic (although not oblivious) about the relationship may help the parent to persevere during the difficult periods.

The “honeymoon” period was confirmed by treatment parents. When this data was shared with parents, one commented that “every child and parent has a honeymoon – how long it lasts is different – but you had better be prepared ahead of time for when it ends”. This observation has implications for training, supervision and pre-placement planning. Having individualized, and pre-planned contingencies built into a plan and knowing who will do what and when and what additional resources can be added normalizes the situation and reduces the chances of making poor decisions during a crisis: pre-planning makes this a normal and expected event rather than a crisis.

Psychologically preparing or “inoculating” treatment parents may also help: treatment parents suggested role playing with experienced parents as an effective training tool. In fact, after reviewing the data, parents suggested pairing an experienced treatment parent with a professional when doing pre-service training for new parents, as well as experienced parents mentoring unseasoned parents."

Rauktis, M.E., Vides de Andrade, A.R., Doucette, A., McDonough,L. & Reinhart, S. (2005). Treatment foster care and relationships: Understanding the role of therapeutic alliance between youth and treatment parent. International Journal of Child & Family Welfare, Vol. 8, No. 4, p. 157

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