Intervention Program Highly Effective in Treating Abused Children in Foster Care

The Fostering Healthy Futures program, a mentoring and skills training program for abused children placed in foster care, has the potential to reduce mental health disorders and associated problems in children with a history of maltreatment, according to a new study.

Drs. Heather Taussig and Sara Culhane of the University of Colorado’s School of Medicine conducted a small, randomized trial measuring the efficacy of the Fostering Healthy Futures program among 156 foster children ages 9–11 from the Denver area. Their findings were published in this month’s issue of the Archives of Pediatric and Adolescent Medicine.

The study compared the outcomes of two groups of foster children with histories of abuse after they underwent different types of mental health assessment. The first group was composed of 77 children who were classified as the control group and received only a preliminary evaluation of their mental health and cognitive and educational performance. The second group involved 79 children who received the same evaluation as the control group, but also underwent a 9-month mentoring and skills group training program. This program—called the Fostering Healthy Futures program—involved children participating in skills groups composed of 8–10 children and 2 facilitators, and completing a curriculum that implemented problem solving, anger management, emotion recognition, healthy relationships, and abuse prevention strategies. Each child enrolled in this program also met with a mentor, usually a social worker, for 2–4 hours per week.

During the study, both the children and their caregivers were interviewed on the child’s mental health problems and symptoms at three different stages of the study: once prior to the intervention, once at the conclusion of the intervention, and again 6 months after completion of the intervention. The children’s teachers, in addition, were surveyed twice prior to the intervention. Children’s symptoms of post-traumatic stress disorder and dissociation, quality of life, and receipt of mental health services and psychotropic medications were measured throughout the investigation.

As a result of the study, the children assigned to the treatment group showed dramatic improvement in multiple mental health measures compared to the children who did not receive the treatment. Children in the treatment group reported a better quality of life at the conclusion of the intervention, and showed fewer mental health problems and fewer symptoms of dissociation six months after the intervention. Also, children who had undergone the intervention program were less likely to receive mental health therapy six months after the intervention (53%) than those children who did not undergo the intervention (71%).

The researchers suggest that the combination of mentoring and training in coping skills can significantly improve mental health and satisfaction with life among abused children in foster care. Although the researchers note that more research on the intervention program is needed to evaluate its efficacy on a grander scale as well as studies that consider the effects of abused foster children who are shifted among multiple caregivers overtime, their small study demonstrated promising success for the Fostering Healthy Futures model.

According to the U.S. Department of Health and Human Services’ (HHS) Administration for Children & Families (ACF), an estimated 3.7 million investigations or assessments on child abuse or neglect were conducted by Child Protective Services throughout the U.S. in 2007, the highest rate in 5 years. About 23.7% of these investigations or assessments find at least one child to be the victim of maltreatment. Children in foster care present a host of risk factors due to their previous upbringings in household environments that may have involved domestic violence (physical or sexual abuse), psychological abuse, congenital substance abuse, malnourishment, or other types of abuse or neglect.

According to ACF, at least 15% of child victims in foster care suffer from a disability such as behavioral problems, emotional disorders, or medical conditions. About 5.3% are diagnosed with a behavioral problem, and 3.7% are diagnosed with an emotional disorder, including depression, dissociation, post-traumatic stress disorder, social problems, attention-deficit hyperactivity disorder, suicidal behavior, and conduct disorders. These figures, however, are considered to be grossly underscored since most children in foster care do not undergo psychological evaluation.

Sources: Archives of Pediatrics & Adolescent Medicine, Heather N. Taussig, PhD and Sara E. Culhane, PhD, JD, Impact of a Mentoring and Skills Group Program on Mental Health Outcomes for Maltreated Children in Foster Care, August 2010

MedPage Today, Michael Smith, Abused Children Benefit from Skills Training, August 2, 2010


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