Academic journal article Child Welfare

Treatment Foster Care Services: A Research Agenda for Child Welfare

Academic journal article Child Welfare

Treatment Foster Care Services: A Research Agenda for Child Welfare

Article excerpt

Treatment foster care is a recent and rapidly expanding alternative child welfare and child mental health service for meeting the needs of children and adolescents with serious emotional and behavioral disturbances and their families. Treatment foster care programs provide intensive, foster family-based, individualized services to children, adolescents, and heir families as an alternative to more restrictive residential placement options. Findings indicate that treatment foster care, when compared with residential treatment services, (1) is less expensive, (2) is able to place more children in less restrictive settings at discharge, and (3) produces greater behavioral improvements in the children served. The role of treatment foster care programs in children's service systems is different than that of traditional family foster care or residential treatment care [Bereika 1992]. In treatment foster care programs, children and their families receive coordinated, multisystemic services while the child lives in the normalizing environments of a protective family, school, and community. Treatment foster care programs were developed in response to the limitations of the current child welfare service system, the crisis in traditional foster care services, and the lack of family-based mental health interventions for children who are not able to live with their own families.

Treatment foster care appeared as early as the mid-1970s when the model (also known as therapeutic foster care, foster family-based treatment, and specialized foster care) emerged as an alternative to placing children and adolescents in institutional settings. In this article, the term treatment foster care will be used. Previous review of the development of treatment foster care traces the influence to the deinstitutionalization and normalization efforts in mental health and special education during the 1970s [Bryant 1981; Bryant and Snodgrass 1990]. Concurrent influences from child welfare include the changing role of foster parents, the growing number of seriously troubled children entering the child welfare system, and permanency planning and family preservation developments [Thomlison 1992]. Four more recent and significant factors have contributed to the development of treatment foster care services.

First, public sentiment and government funding meshed in the 1980s and started a movement to keep even the most troublesome children within family settings. The cost of caring for and treating a growing, challenging population of children escalated at a time when the federal government began retreating from financing children's services. Increasingly, the cost of children's services became the burden of state and county governments. This increase in local responsibility required the development of less costly yet more effective services for this growing population.

Within this context of fiscal restraint and strong public opinion that children need to remain in families, treatment foster care emerged as a key component in a "system of care" for emotionally disturbed children and adolescents [Stroul and Friedman 1986; Stroul 1999] The Child Adolescent Service System Program (CASSP) of the National Institute of Mental Health began promoting a system of care built primarily on community and family-based services for seriously emotionally disturbed children through multisystem collaborations (e.g., mental health, child welfare, special education, juvenile justice, health). As every state embraced CASSP values and its vision of a system of care for children, demand for treatment foster care increased throughout the United States.

Second, the proliferation of treatment foster care programs across the United States, Canada, and Europe made this service model increasingly visible. The rapid development of treatment foster care programs is apparent from national and international surveys [Snodgrass and Bryant 1989; Hudson et al. 1990; Hudson et al. …

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