“In theory there is no difference between theory and practice. In practice there is.” This famous quote, attributed to many people including Yogi Berra, is especially relevant for foster parenting. With an increasing number of children in the child welfare system, which some attribute to increasing opioid addiction (see Number Of Youth In Foster Care Up 1.5% In A Year; 36% Of New Entries Due To Parental Drug Use), the question of how states can prepare foster families to handle the diverse needs of those who need care becomes more pressing.
Our recent coverage of states creating salaried positions for professional foster parents (see The Issue Of ‘Professional’ Foster Parents) prompted several reader comments and a conversation with Peggy Terhune, Ph.D., president and chief executive officer of Monarch, who, along with her husband, has fostered more than 100 children. She appreciated the input from OPEN MINDS subject matter experts shared in our briefing, agreed with the concept of designating a profession for foster parents that would allow one parent to stay at home, and emphasized that it should be an option, not a dictate.
Our discussion centered around two questions: First, is there adequate, customized training and are foster parents aware of the resources available to them? Second, does the system prepare foster parents to care for children with special needs? Dr. Terhune shared perspectives on the limitations of training in the current system.
While training resources exist, they are not customized or applicable to real-world situations. “Training just tells you what to do, but in working with kids, you need mentoring,” Dr. Terhune said. “When we had weekly visits due to therapeutic foster child requirements, we were even better parents—we had support, and I had someone I could call if I needed to.” Being able to talk about the crisis of the day (a child who was “palming” meds instead of taking them, threatening suicide or running away) with peers and experts helped. “There’s no right or wrong answer to most of these issues so hearing that our approach was OK and discussing alternatives was helpful.”
Foster parents receive little help in dealing with special needs of children in their care. The Terhunes chose to work with children no one else would take due to their complicated backgrounds and health issues, which makes preparation harder, but they found it invaluable to have a mentor reinforce the parenting approaches they took when faced with maladaptive coping mechanisms and other challenges. “What worked with my [biological] kids wouldn’t work with them,” explained Dr. Terhune. Children who have been beaten, abused, and lost everything require a different approach that is not always intuitive and isn’t always covered in trainings. “They’ve lived through things we couldn’t imagine,” she added. “It’s our job to help shape them, address their negative coping skills and replace them with something that will help them but that’s hard and you don’t always know what to say.”
Investing in training and mentoring services that prepare foster parents to help these children leads to more successful experiences. And while there are national training programs, including the Parent Resource for Information, Development, and Education (PRIDE) Model of Practice from the Child Welfare League of America and Foster Parent Inservice Trainings from the Department of Health & Human Services, the Terhunes found that experience trumps theory in most cases. “All the real-life situations you run into aren’t taught,” said Dr. Terhune. As a result, most foster parents turn to an informal network of peers. However, Dr. Terhune said the ability to work with experienced mentors was essential, which is why state funding is so important. “If it isn’t funded it won’t happen,” she adds.
Our recommendation for health and human service agencies as well as provider organizations serving foster families: Take these real-world experiences into consideration when reevaluating policies and developing care plans. Most state agencies work with foster parents but there seems to be a disconnect between discussion and implementation of programs that adds uncertainty to a stressful situation. One clear takeaway for clinicians: Employ trauma-informed approaches when working with foster children and adults. “It’s so important to be trauma-informed,” said Dr. Terhune, who gave one example why that’s important: If a child has been sexually abused, he or she will have concerns about removing clothes for an exam (see Making Trauma-Informed Care A Scalable Reality and Building A Trauma-Informed Network—One Health Plan’s Approach).
While the issue of paying foster parents salaries took center stage in The Issue Of ‘Professional’ Foster Parents brief, OPEN MINDS experts and Dr. Terhune agree that the most important factors for success are resources and support, a sentiment reinforced by data, which shows that 30% to 50% of foster parents quit within the first 18 months after being licensed (see Foster Parent Retention Revisited). From professional counseling to crisis management supports, respite, and financial resources, OPEN MINDS senior associates urge state agencies to employ better screening and training to ensure that foster parents can care for a growing number of children in need (see Increasing Integration—Foster Care & Health Services and The AFCARS Report).
For more information on foster children, check out these resources in the OPEN MINDS Circle Library:
- Should ‘Foster Parent’ Be A Salaried Position?
- Opportunities & Challenges: The Family First Prevention Services Act
- Increasing Integration—Foster Care & Health Services
- Number Of Youth In Foster Care Up 1.5% In A Year; 36% Of New Entries Due To Parental Drug Use
- Do New Foster Care Rules Move The Needle?
- Complex Needs=Complex Care Management For Children In Foster Care
- More Children, Less Money—The State Of Child Welfare Budgets
- The Child Mental Health Gap—More Prevalence, Less Treatment, More Opportunity
- 2018 Children & Youth Services Market Update
- Specialized Health Exams Recommended For Adopted Children
And join us June 4 for the 2020 OPEN MINDS Children’s Services Executive Summit: Emerging Models For Children’s Health Homes to learn more about trends in “connected care” for children with medically complex conditions.