Academic journal article Child Welfare

Characteristics of Difficult-to-Place Youth in State Custody: A Profile of the Exceptional Care Pilot Project Population

Academic journal article Child Welfare

Characteristics of Difficult-to-Place Youth in State Custody: A Profile of the Exceptional Care Pilot Project Population

Article excerpt

This study examines the characteristics of Texas youth designated as 'most difficult to place' recipients of service under the "Exceptional Care Pilot Project" (N = 46). Find- ings include, among others, high levels of comorbid psy- chiatric disturbance (> 3 diagnostic groupings), physical (78.3%) and sexual (88%;) maltreatment, and placement breakdowns (m = 4.8 therapeutic placements). This initial profile of the population provides a base for helping other states identify and plan for the needs of their most trou- bled youth.

The number of children in state custody has risen dramatically over the past decade. The complexity of their service needs has placed enormous pressure on the child welfare system of care. Although some of these children are initially admitted to care to protect them from their damaging environments, extensive histories of childhood maltreatment reduce their ability to relate to substitute caregivers. In some instances, children present such serious behavior problems that parents may refuse to accept responsibility for meeting their ongoing needs and abandon them to the care of the state. Indeed, there are as many children now placed in the custody of the child welfare system for the legal reason of "unruly" behavior as there are for neglect and abuse (Glisson, 1996).

These children are more difficult to place and service in residential settings. The most severely disturbed are referred to hospital and residential treatment, 1) for behavior bizarre, disruptive, dangerous to the youth or others, 2) for failure of the youth to respond sufficiently to outpatient services, and 3) because home, school, and other social settings are unable to cope with the behaviors of the youth or are maintaining or exacerbating the symptoms (Forand, 1999). Placement breakdowns are common and facilities find they have inadéquate resources for supervising and meeting the needs of violent, destructive, or aggressive children (Kearns & Jellinek, 2000).

Although failed placements are often viewed as a consequence of children's out-of-control behavior, unstable placement histories are, in fact, a consistent predictor of increased emotional and behavioral problems (Newton, Litrownik, & Landsverk, 2000). Children with multiple placements, for example, are more apt to end up in incarceration settings (Jonson-Reid & Barth, 2000) or have other negative outcomes (Berrick, Needell, Barth, & Jonson-Reid, 1998; Courtney & Barth, 1996; Eckenrode, Laird, & Doris, 1993; Widom, 1991). The frequency of placement disruptions was made evident by Wells and Whittington (1993), who found that slightly less than 25% of all children referred to a residential treatment center over a twelve-month period had between 6 and 23 out-of-home placements. These repeated changes undermine a sense of stability. With each move, children may experience an increased sense of rejection and impermanence. New attachments may be more difficult and lead to a "pattern of reciprocal alienation and rejection" (Proch & Taber, 1985).

In 2000, the Texas Department of Protective and Regulatory Services (TDPRS) initiated the Exceptional Care Pilot Project (E6) to provide "exceptional" care to the 20 to 30 most difficult-to-place children in the state. The goal of the E6 pilot project was as follows:

To provide residential treatment services to children needing level 6 care in an environment other than hospital setting. Services will include protecting the well-being of the child, enhancing the child's functional abilities and preparing the child for his/her permanency planning goal, by providing the following services as appropriate:

1. routine child care which ensures the health and safety of the child;

2. appropriate educational, recreational, and vocational services; and

3. behavior management, diagnostic services, and medically necessary health care services. (Texas Department of Protective and Regulatory Services 2000, p. …

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