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Placement disruption in treatment foster care

Dana Smith et al

Reports of disruption rates in traditional foster care range from 38% to 57% during the first 12 to 18 months of placement (Berrick et al., 1998; Palmer, 1996; Staff & Fein, 1995; Stone & Stone, 1983), with percentages increasing with time spent in foster care. In 1990, 57% of children in care had multiple placements, and almost 30% experienced more than three placements (U.S. House of Representatives, 1994). Placement disruption has been linked to problems with attachment and emotional and behavioral problems in children (Fanshel et al., 1990; Goldstein et al., 1973; Lieberman, 1987; Van der Kolk, 1987). These types of problems are not only harmful to the child but also increase the risk that a cycle of placement instability will be perpetuated (Fanshel et al.); each new disruption provides an increased risk for subsequent disruptions with new caregivers.

TFC has typically been used to treat children in out-of-home care who have more demanding emotional and behavioral needs and who require more intensive structure and mental health services than those in traditional foster care settings (Kutash & Rivera, 1996). On average, youth referred to TFC have spent 4 years in a variety of placements and residential settings prior to entering the TFC placement (Timbers, 1990). With more demanding emotional and behavioral needs and a history of instability, youth placed in TFC appear to be at high risk for placement disruption. Data on disruption rates for TFC populations are even more sparse than for traditional foster care but are estimated to range from 38% to 70% (Fanshel, et al., 1990; Hudson, Nutter & Galaway, 1994; Walsh & Walsh, 1987; Weaver & Farmer, 1991, as cited in Staff & Fein, 1995).

Risk factors associated with placement disruption
Research on individual child factors that increase risk for placement disruption shows that increased age and the presence and severity of behavioral and emotional problems are significantly related to higher rates of placement disruption (Pardeck, 1984; Pardeck, Murphy & Fitzwater, 1985). There is some indication that boys are at increased risk for disruption (Palmer, 1996), but overall the findings regarding the influence of gender on rates of disruption are inconclusive.

Social-interactional factors such as poor parent-child relationship, the child's inability to form positive attachments to caretaker adults, or the child's having lived in chronically abusive or neglectful homes have all been found to be related to placement disruption (Stone & Stone, 1983). It has been suggested that interactional factors such as the relationship between the foster parent and the foster child and the fit between foster parent and foster child characteristics are more predictive of placement outcome than either child or foster parent characteristics alone (Berrick et al., 1998; Doelling & Johnson, 1990).

Some data have suggested that system-level contextual factors (e.g., degree of contact, rapport building, and energy expended by the caseworker; the foster parent's positive relationship with the supporting agency; and caseworker continuity) are associated with increased placement stability (Pardeck, 1984; Stone & Stone, 1983). Other research has indicated that increasing the number of children placed per home exponentially increases the number of daily problem behaviors emitted per child, which thereby increases the risk of placement disruption (Moore, Osgood, Larzelere, & Chamberlain, 1994).

References

Berrick, J. D., Needell, B., Barth, R. P., & Jonson-Reid, M. (1998). The tender years: Toward developmentally sensitive child welfare services for very young children. New York: Oxford University Press.
Doelling, J. L., & Johnson, J. H. (1990). Predicting success in foster placement: The contribution of parent-child temperament characteristics. American Journal of Orthopsychiatry, 60, 585-593.
Fanshel, D., Finch, S. J., & Grundy, J. F. (1990). Foster children in a life course perspective. New York: Columbia University Press.
Goldstein, J., Freud, A., & Solnit, A. J. (1973). Beyond the best interests of the child. New York: Free Press.
Hudson, J., Nutter, R., & Galaway, B. (1994). Treatment foster care programs: A review of evaluation research and suggested directions. Social Work Research, 18, 198-210.
Kutash, K., & Rivera, V. R. (1996). What works in children's mental health services? Baltimore: Brookes.
Lieberman, A. F. (1987). Separation in infancy and early childhood: Contributions of attachment theory and psychoanalysis. In J. Bloom-Feshbach & S. Bloom-Feshbach et al. (Eds.), The psychology of separation and loss: Perspectives on development, life transitions, and clinical practice (pp. 109135). San Francisco: Jossey-Bass.
Moore, K. J., Osgood, D. W., Larzelere, R. E., & Chamberlain, P. (1994). Use of pooled time series in the study of naturally occurring clinical events and problem behavior in a foster care setting. Journal of Consulting and Clinical Psychology, 62, 718-728.
Palmer, S. E. (1996). Placement stability and inclusive practice in foster care: An empirical study. Children and Youth Services Review, 18, 589-601.
Pardeck, J. T. (1984). Multiple placement of children in foster family care: An empirical analysis. Social Work, 29, 506-509.
Pardeck, J. T., Murphy, J. W., & Fitzwater, L. (1985). Profile of the foster child likely to experience unstable care: A re-examination. Early Child Development and Care, 22, 137-146.
Staff, I., & Fein, E. (1995). Stability and change: Initial findings in a study of treatment foster care placements. Children and Youth Services Review, 17, 379-389.
Stone, N. M., & Stone, S. F. (1983). The prediction of successful foster placement. The Journal of Contemporary Social Work, 1, 11-17.
Timbers, G. (1990). Describing the children served in treatment homes. In P. Meadowcroft & B. Trout (Eds.), Troubled youth in treatment homes: A handbook of therapeutic foster care (pp. 21-32). Washington, DC: Child Welfare League of America.
U.S. House of Representatives, Committee on Ways and Means. (1994). Overview of entitlement programs: 1994 green book. Washington, DC: U.S. Government Printing Office.
Van der Kolk, B. A. (1987). The separation cry and the trauma response: Developmental issues in the psychobiology of attachment and separation. In B. A. Van der Kolk (Ed.), Psychological Trauma (pp. 31-62). Washington, DC: American Psychiatric Association.
Walsh, J. A., & Walsh, R. A. (1990). Quality care for tough kids: Studies of the maintenance of subsidized foster placements in the Casey Family Program. Washington, DC: Child Welfare League of America.

Smith, D., Stormshak, E., Chamberlain, P., and Whaley, R.B (2001). Placement Disruption in Treatment Foster Care.
Journal of Emotional and Behavioral Disorders, Fall, 2001.

 

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