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Longer Foster Care Better?

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A recent report of a study of young adults who had been placed in foster care as adolescents found that those in a program with caseworkers of higher levels of education and salaries, lower caseloads and access to more services had fewer mental problems, ulcers and cardiometabolic disorders . This was not a study that randomly assigned foster youth to these two types of care so it is well to be cautious in going too far with the results. Yet it is a very promising finding. We know too little about the effects of foster care. We know that some children thrive and go on to be productive members of the community. Other children leaving foster care have troubled lives involving substance abuse, homelessness and criminal activity. We need to know what makes the difference.It is good to know that enhancing foster care seems to make a positive difference in the lives of youth. At what cost? The report includes 2 items regarding cost. Enhanced foster care cost 60% more. The youth who were in the enhanced foster care group spent nearly 2 more years in care than the other group.Would our community agree to spend 60% more on foster care then we do now? As a state we are having difficulty funding K through 12 education. We can't figure out how to have all of our citizens covered by health insurance. We have backed off of funding higher education. Increasing foster care funding by 60% doesn't seem realistic.A note of caution. This study only involved adolescents. They are just a part of the foster care caseload and we don't know if the same type of enhanced foster care would have the same results for younger children. So if we only funded enhanced foster care for adolescents, total foster care funding would not have to increase 60%.The second cost of spending nearly 2 more years in foster care raises a more difficult question. Isn't foster care supposed to be temporary? One idea behind foster care is that children should only be placed out of their home when they are in danger and that a safe and permanent home should be found as quickly as possible preferably with their own legal family. The findings of this study turn this on its head.In this society we are constantly balancing the value of family independence and autonomy against the interests of the larger community. This study suggests that larger community interests regarding these youth might supersede family interests. On the other hand how about the idea of enhanced family services? Perhaps it is time for a study of what adolescents like those in the study might achieve with enhanced services within their own home.Kessler, R.C. et al. (2008). Effects of enhanced foster care on the long-term physical and mental health of foster care alumni. Archives of General Psychiatry. Vol. 65, No. 6.

Comments

costello 9 years, 6 months ago

Thanks for blogging on an important subject very dear to my heart.I adopted a teenaged boy from foster care a few years ago. It's been the most challenging and life-altering thing I've ever done. He'll be 17 soon, and we're still struggling with major behavioral and emotional problems. There just aren't enough services to help. And the services that are there - really aren't there because there's no money behind them. You can be eligible for a service and never see it.I believe my son is better for having been adopted by me. He was bouncing from home to home in foster care, moving every 4 to 5 months. He's been stable with me for almost 4 years now, and there have some been improvements in his behaviors and emotional control. But the costs to me - financial, emotional, personal, jobwise - have been huge.I base this on my own experience and maybe other kids are easier, but I would really hesitate to recommend that anyone adopt an unknown teen from foster care. On the one hand, kids need to be raised in families. On the other hand, few families can cope alone with the issues many of these kids present. And the state pretty much washes its hand and walks away once the adoption decree is signed.Not that the services available before the adoption are that great. We lost a good worker who had known my son for two years when the foster/adoption contract came up for bid and was awarded to a different agency in 2005. Generally the workers are undertrained and overworked. And when you find one who seems to know something, she disappears pretty quickly.There aren't lots of people lining up to adopt teens. And the ones that do often give up. The failure rate for teen adoptions is something like 25%. I can't blame those who give up. It's hard hard hard work parenting a damaged teen. But every failed placement just causes more hurt for a kid who's already been hurt too much.Thanks again for blogging on this topic.

Ronda Miller 9 years, 6 months ago

I second all that you stated, costello - and not just a parent, but a loving, caring, stable, consistent, intelligent, knowledgeable, patient parent/adult/friend/teacher/minister/scoutleader/aunt-uncle-grandparent/ neighbor,etc., within their life. Every child who hasn't been in foster care needs this also. Basically the needs of all of us are the same - to be loved unconditionally and to be gently guided through the temporary dark times and into the lighter, brighter moments of life.

notajayhawk 9 years, 6 months ago

"A recent report of a study of young adults who had been placed in foster care as adolescents found that those in a program with caseworkers of higher levels of education and salaries, lower caseloads and access to more services had fewer mental problems, ulcers and cardiometabolic disorders ."Maybe because the higher-educated and higher salaried case workers are the ones with enough seniority to take the easier cases?Just a thought.

johnp 9 years, 6 months ago

Thanks to costello and Ronda for sharing their experiences. notajayhawk - the study controlled for case difficulty so taking easier cases would not explain the differences.pogo - I agree that we do not know enough about the results for youth in foster care in Kansas.

Ronda Miller 9 years, 6 months ago

John, after a lot of thought on this topic through the night I wanted to also mention that children who have been through the foster care system are often viewed in an "extremely" negative light. They may be one of the last groups of people who are sterotypically viewed as likely to commit crime, end up with addictions, have unhappy lives. I think it is essential for people to view EACH foster person as an individual with their own unique set of circumstances, strengths, and personalities. While I think the majority would do better to have additional assistance for a longer time, that is not to say "all" of them would. It should be decided on a case by case basis and not grouping them as a whole.I remember a few years back that I was told by someone who worked as the head of licensing for daycares that, "Foster children did not belong in childcare". I asked her if they belonged under a rock. Her thinking was that if a foster child has been sexually or physically abused their tendancy might be to harm another child. Well guess what real world, there are all kinds of children with those experiences in childcare now - where did they think they had been going before social workers stepped in and removed them, and where do they think they weill be put when they are in a foster home if they are not yet school age? It is attitudes such as that that really hurt people who have been in the system. Could you imagine someone in any position making that statement about a black child, or an Hispanic child, or a female or male child? Or a child with special needs (which a lot of them are emotionally).

Ronda Miller 9 years, 6 months ago

John, I agree with Costello that you raise some wonderful questions about our current foster care system. As a person who lived in a foster home, was later adopted and fostered many children myself, I would like to add my two cents worth if I may.I think that it would be extremely beneficial to have foster children stay in the system for an additional couple of years for the following reasons: we are finding that the brain is not fully development in children/teens/young adults until the age of 25 and a lot of these young people (I know because I was there) are late to development because of trauma that they incurred due to the reasons they were first placed in foster care. This means a couple of extra years of guidance, love, a constant in their lives would be very helpful. A secondary reason to extend care is because of the emotional harm that the youth goes through once they leave the family/system. The abandonment issues that they have experienced and felt come back with sledgehammer force when what they have known for the past several years is stripped from them and they feel as though they are on their own and no longer cared for. I hope there will continue to be studies done about this issue. Can foster children grow up to become important and fuctional in our society - I feel as though I am. A system that feels it lets our children down can also be known to produce some exceptional adults - my brother and sister are great examples of this. My brother now works at the Embassy in Bagdad. As you may have noticed, this topic is near to my heart - thank you for letting us share our thoughts and feelings!

Ronda Miller 9 years, 6 months ago

And a reasonably good thought at that, nota!Pogo, I would be the first to agree that the system needs major overhauling - you raise some great points of question.

costello 9 years, 6 months ago

I agree, Ronda. I once knew a woman who complained bitterly that her children were being held back in school because there were so many foster children in their classes. Where should foster children go to school? Or maybe they shouldn't go to school at all? Herd them into a "home" somewhere and keep them out of society. That way we won't be bothered by them.I feel very discouraged about reform for foster care. It's like a knot you can't find the ends of, so you can't disentangle it. I feel for the kids caught in the system. Whether they survive and thrive seems to depend more on their inherent qualities or the luck of encountering a really caring adult along the way than on anything the system provides.Every kid should have an least one adult in his or her life who thinks he or she is the cat's meow. And every adolescent and young adult should have an older more experienced adult to guide him or her. In short, every kid needs a parent.

johnp 9 years, 6 months ago

notajayhawk and Ronda - I included the full reference to the study so that anyone could read it and make and independent judgment about its quality. notajayhawk is correct that the best experimental control is random assignment. On the other hand there are statistical controls that can examine some of the more obvious variables.costello - Good point about youth chosing to leave care at age 18. When youth enter care at age 16 or 17 and leave at 18, there is not much time to have any positive effect. On the other hand when youth enter care at say 14, there is time to make a difference.

Ronda Miller 9 years, 6 months ago

I agree, nota that we need much more information to base any decisions on - we aren't told how many people were involved in this study, for how long a time period, really nothing. And as we know studies tend to show the outcome of what they are doing the study about in the first place. Wait, that can not be true!

notajayhawk 9 years, 6 months ago

johnp (John Poertner) says: "the study controlled for case difficulty so taking easier cases would not explain the differences."How do you 'control' for anything in a study with a non-randomly assigned data set?

johnp 9 years, 6 months ago

notajayhawk and Ronda - I included the full reference to the study so that anyone could read it and make and independent judgment about its quality. notajayhawk is correct that the best experimental control is random assignment. On the other hand there are statistical controls that can examine some of the more obvious variables.costello - Good point about youth chosing to leave care at age 18. When youth enter care at age 16 or 17 and leave at 18, there is not much time to have any positive effect. On the other hand when youth enter care at say 14, there is time to make a difference.

costello 9 years, 6 months ago

My question is: how do we force kids past the age of 18 to stay in foster care? They're legally adults.The kids I know can't wait to sign themselves out as soon as they hit 18. I assume there are some who are more mature and goal-oriented who decide to stay in the safety of the system until they're 21, but those few probably have a higher rate of succeeding with or without services.

denak 9 years, 6 months ago

I have been a foster parent for about 5 years. Honestly, I think there are just some children that are out for the count even before their life really begins. I know that is going to make some people angry but I have had some children, and known of some children, who no matter how intensive the therapy and services are, that thier life is just going to suck. The amount of abuse they suffered has screwed them up so badly that they are never going to be "normal." I think too many people, usually those who have never worked in foster care or who are new to foster care, still believe that you can save some of these kids and you can't. Sometimes, most of your time is spent running around trying to put out the latest fire. There are some children that I tried hard with but it was to no avail. You can advocate and advocate, make sure the child takes his or her meds, make sure the child goes to therapy, fight with them to go to school, do everything for them and that child still isn't going to succeed and there are so many reasons why they won't.Longer foster care might work for some. Having a resiliant nature might work for some. Being in the same foster home or being adopted might work for some but for some, they are just going to be casualities.I'm not saying we should wash our hands of them. They are children after all. But sometimes we have to be realistic.As for you pogo, I doubt you even know any social worker and especially any that work in the foster care sector. Most of the foster care social workers that I have had the priviledge to meet and work with are very realistic about their children. They are not wishy washy do-gooders. They know that they are dealing with some of the ugliest situations in life and they aren't naive about the chances of some parents and children. Are there some inept social worker? Sure there are and I had one for one child. But most of them do what they can for each child.Dena

johnp 9 years, 6 months ago

Just to clarify. I left the University of Kansas in 1995.

Pro_Counsel 9 years, 6 months ago

costello (Anonymous) says: "Well, I'm no expert, but I've always thought CBT was a good thing - and pretty much an alternative to medication."I am.It is."Sadly, I have to say that I agree with Dena that some kids are just past saving. It's hard to know which, though. So you have to give it a good effort."I can empathize. My practice is primarily in the area of substance abuse. I knew going in that I wasn't going to win them all; the odds say it'll be less than half of them. But you have to look at each individual one as one of those that might. It's a fine line, and I really admire both what you've done and the perspective you have on it....Pogo (Anonymous) says: "Why would John Poertner risk his bread and butter to spill the beans about the pis* poor preparation our current social work education provides for public welfare practioners?"And maybe you can think of a better way? The nightmare situations these workers face in their daily routine are beyond what can be taught in a classroom. Nobody is prepared ... and nobody can imagine the difficulty of their job ... until they get there.

costello 9 years, 6 months ago

Sadly, I have to say that I agree with Dena that some kids are just past saving. It's hard to know which, though. So you have to give it a good effort.My son is very challenging, and I know one experienced foster parent who told me that he couldn't be "fixed" and to give up and move on.Another one, who has become a good friend of mine, told me that when she first met me 3+ years ago, she thought I was wasting my time with him, he would never change. But she told me recently that she thought he has changed and is likely to be a better adult for having been in my home.I agree with my friend. The efforts have helped my son. He was likely to repeat his parents' lives, but now I'd say it's a better than even chance that he'll avoid the worst of their issues. And I have at least 15 months more to work with him - more if he sticks around after he turns 18.But as I said before, the costs to me have been enormous. I'm exhausted. The first friend mentioned above says I should have given him up and moved on, because I'd make a great foster or adoptive parent to other teens - teens who might profit more from what I have to offer. She says for this one kid - who's likely to have a bad outcome no matter what you do for him - I could work with many more who can actually be reached. I don't know. I love my son.I would have liked to have done foster care with teens when my son is grown, but I'm not sure I won't be completely wiped out by then.I don't know what you do for the hard kids. They need families too. And some of them can be helped to a greater or lesser extent. It isn't an all-or-nothing thing. Some improvement is better than none.

costello 9 years, 6 months ago

Hi Pogo: You seem to have a chip on your shoulder. I think your points would be better received if you couched them in more temperate words.You say: "John Poertner is from the University of Kansas School of Social Welfare which has an anti-male 'feminist' agenda that includes the feminization of young men/boys."I can't speak specifically to this, but I do agree that boys get short shrift in the foster care system. Most of the workers are women, and too many of them don't seem to have any insight at all into boys. I adopted a son, and I was a CASA for three boys - ages about 9 to 14 - and I do think the boys are penalized for male behavior. I doubt it's the result of a feminist agenda. The young women who work for the agencies just done "get" boys."The bottom line is is that school is filled with ... twits who just want a piece of paper so they can go out and RUIN childrens' lives."Honestly, I haven't been impressed with a lot of SW's I've met - although some are very good - but I don't think I've yet encountered one who actually went to SW school with the goal of ruining children's lives. I think most of them want to do a good job and help kids. They sincerely believe what they're doing is the right thing, and they're doing the best they can with the tools they have."who push 'cognitive behavioral therapy' and drug addicition: 8 talk sessions:than some happy pills."Well, I'm no expert, but I've always thought CBT was a good thing - and pretty much an alternative to medication. And SW's can't prescribe meds, so why would they be pushing them?

costello 9 years, 6 months ago

"The nightmare situations these workers face in their daily routine are beyond what can be taught in a classroom. Nobody is prepared : and nobody can imagine the difficulty of their job : until they get there."I'd like to add that the same holds for foster/adoptive parents. Even after thinking about adopting for years, even after researching, even after seeing my sister adopt, even after warnings from friends, even after the mandatory MAPP class, I had no idea what I was getting into.

tvc 9 years, 5 months ago

Pogo, you seem to have a dog in this fight. Why don't you identify who you are and what your role in the system is if you are going to call all social workers out? It would be extremely hard to stay and fight in a broken system. I think workers have to decide which battles are worth fighting. I have appreciated the case workers that have fought with me to help children. There are several careers that tend to be dominated by one gender or another. I think feminism is fighting to keep gender from deciding anyone's profession. I work with DCCCA now. I only do emergency and respite care, but I find them to be very respectful and understanding:.You know, all that touchy, feely stuff that Pogo hates, but as a foster parent makes me feel that I am not alone. http://www.dccca.org/fostercare/aboutfc.html

costello 9 years, 5 months ago

"The failure of 'mainstream' social workers to recognize and understand the reality that the removal of a child from the family harms the child underscores just how stupid these head bobbers are. The child welfare industry must accept the reality that it works in a 'least worst' decision making environment. It does not because it lacks leaders who have the courage to couch the system as just that: Least Worst and NOT best."I agree that removing a child from his or her family is extremely damaging. And I agree that the system doesn't seem to understand that. I read an excellent law review article a year or so ago proposing that one of the factors a judge should have to weigh in deciding whether to remove a child is the potential trauma to the child if removed.I also agree that politics drives a lot of this. Sadly, a worker is more likely to be punished if she decides to leave a child with the family then the child is hurt than if she takes the child. The general public doesn't seem to understand this equation - the damage to the child from being removed from its parents versus the risk of damage from being left in the home. Many people seem to think that children are like little dollies - move them here and there at will. They'll be ok.I'm not sure you can blame the school of social work for this, though. Social workers are caught in a system which is driven by political decisions which are made to appease a public which knows almost nothing about foster care or the kids trapped in it and has no interest in learning more.

Deb Engstrom 9 years, 5 months ago

I am licensed through TFI Family Services, formerly The Farm. Although I have young children now, in the past I have done teenage males exclusively. I really have enjoyed working with TFI. I have also worked with DCCCA and even though things were kind of hectic with them while they were learning the system, all is well now and they have been very supportive. Unfortunately, the kid is not always the primary consideration in placement decisions and that is very frustrating. Often times it's more about the adults.

costello 9 years, 5 months ago

"It's amusing you note in each of your posts, costello, that it's a "she" social worker."Yeah, I just didn't want to type out "he or she," "him or her," "his or hers" every time. Most - but not all - of the workers I've worked with were women.

costello 9 years, 5 months ago

"SRS does not want policy questions nor shall SRS tolerate one iota of dissent."If true, it would be very difficult for a SW to make any change from the inside."I maintain a social worker who has never been terminated or at the very least suspended and/or reprimanded for advocacy issues on behalf of a child or dependent adult isn't worth a hill of beans as a social worker."If the SW is terminated, he or she is no good to any kids - or elderly. Being fired changes nothing. If the higher ups in the agency don't agree with a decision by the individual SW, the higher ups will win with or without that SW on staff. She either changes her decision and stays on salary, or she's fired (or quits) and the higher ups do what they want. If she's still there, she may be help to help someone else tomorrow. It seems to me that your proposal has all of the principled, caring SW's losing their jobs, leaving the field clear for those who are just there because it's a job."top that nonsense with the privitization of this intricate process with an outfit like Kaw Valley and disaster looms on the horizon.":-) Well, I share your views on KVC too. I'm not a fan.I've considered working within the system, because I care intensely about the kids in our foster system. I've concluded that I can't do it. Inside the system, you're part of the system, and it will overwhelm you. And it isn't just the SW's who are to blame. In fact, I'd argue they aren't even largely to blame. The problem's elsewhere. Higher up. And it isn't just the social service agencies. The courts and the attorneys also play their parts. It just appears to me that each of those actors playing their roles - case worker, GAL, judge, CRB, foster parent, therapist, etc., etc., etc. - is trapped in a bad system which they can do little to change. Change requires some political will, and that requires some public interest. I once spoke with a man who had run for political office and asked him about foster care. His response? "No one cares."The system's a disaster. But you can't get people to really pay attention. They simply don't care until a kid is hurt or killed, and they can blame a SW.I've concluded that to help foster kids you need to scale back your ambitions, pick one child, adopt him or her, get him out of the system. Unfortunately, as I said in my first post, I can't recommend that anyone adopt an unknown teen from foster care. It's very difficult.So how can you help? I wish I had an answer. I'll probably do foster care in a couple of years when I've completed some of my other goals. If any of my foster kids is adoptable, I'll adopt again. If not, I can at least give a stable home to a kid while he or she needs one.

costello 9 years, 5 months ago

"Another foster parent that is not a fan of kVC. I am no longer a KVC home!"Who are you licensed with? Do you like them? I'm interested in teenagers only. Any agency better with them?

tvc 9 years, 5 months ago

Another foster parent that is not a fan of kVC. I am no longer a KVC home!

Flap Doodle 9 years, 5 months ago

girlfriend, your bud got the spanking he deserved. Get over it.

tvc 9 years, 5 months ago

Marion, I had to do a little research on that little comment. Cool posts that link all the time even if it does not add anything to the conversation. I thought the "crazy" left was always looking to make everything "fair". Welcome to the crazy but fair left side!The Cool and Marion approved post:Pogo, you seem to have a dog in this fight. Why don't you identify who you are and what your role in the system is if you are going to call all social workers out? It would be extremely hard to stay and fight in a broken system. I think workers have to decide which battles are worth fighting. I have appreciated the case workers that have fought with me to help children.There are several careers that tend to be dominated by one gender or another. I think feminism is fighting to keep gender from deciding anyone's profession.I work with DCCCA now. I only do emergency and respite care, but I find them to be very respectful and understanding:.You know, all that touchy, feely stuff that Pogo hates, but as a foster parent makes me feel that I am not alone.

costello 9 years, 5 months ago

Pogo: I'm perplexed as to why you would cite a federal law mandating termination in certain cases, then turn around and blame SRS for terminating parental rights."the adoption statistics for children within Kansas are atrocious; and especially for the ':older:.harder to place child:.'."I don't know what the statistics say, but by definition it's very difficult to find homes for hard to place children."The level, type, and orientation of service a child gets all depends on what County controls that child"That's true."because the chief social worker is the County Judge and the flunkies who work for said Judge: The lawyers who get paid to do very little (G.A.L.: Guardian Ad Litems) and the CASA types."The judge isn't a social worker and - at least in the cases I've seen - doesn't act as one. At any rate SRS isn't in charge of the judge.The GAL's aren't adequately compensated. Several years ago I looked into this: In Shawnee County - at least at that time - GAL's were paid a flat fee of $30,000 for a caseload of 250 kids. That's about a kid a day. That's not enough time to get to know anything about a kid. Again SRS has nothing to do with this.I'll agree with you that the CASA program is useless - at least in Douglas County. In my opinion the program here is in bed with KVC, so the CASA is never allowed to criticize the workers in his or her report to the court. Say as much bad stuff as you like about the kids or the parents but don't include anything negative about KVC. And there's much negative which could be said about KVC. ;-) So the court gets a lopsided view of the situation."I don't even think the families are given access to free legal represenation, but I may be wrong in that regard; and even if they do, it's 2nd rate."They are."Ya gotta pay for justice and sustaining your rights in this state (not to mention the Nation)."I'll agree, but I don't think SRS created that particular problem."Quentin Tarantino's Reservoir Dogs"I'm afraid the movie reference went over my head."And, again, why aren't these social workers subject to ..."I don't know if SW's are subject to pre-employment drug screening and random drug tests. I don't know why they should have to be. Personally I oppose such measures because they only increase the level of fear and paranoia which I believe already pervades this system.You seem to believe that SRS is a nest of druggies. I'll give that the same amount of credence I'd give to any snide innuendo made by an anonymous poster on a website. Don't know if it's true, but if it is, the information should be taken to someone who can actually do something about it.

costello 9 years, 5 months ago

"costello ... is an apologist for a bankrupt social service delivery which is useless from the bottom up."I'm surprised you would read my posts here and come to that conclusion. Maybe you didn't read my posts? I'm actually very critical of the system.If I had my way, far fewer kids would come into foster care, more support would be given to families to keep their kids in their homes, and more money and work would be put into reintegrating kids quickly with their parents.I remember being nearly hooted out my Children and the Law course for arguing that a 6 year old girl would be more damaged by being removed from her mother than from being allowed to live with her mother's poor housekeeping. A class full of future lawyers, and I was the only one who seemed to understand that taking kids from their parents hurts them - a lot. And when I agreed with the dissenting judge that the state would be better off hiring a housekeeper for mom than taking the kid, I was roundly sneered at by all. In fact I believe it's because I'm NOT an apologist for the system that I received a B instead of an A in the class - from a teacher who was definitely a social worker type. I wasn't popular in the class and treated almost as if I were in favor of child abuse.And now I learn that I'm an apologist for the system! ;-)"I'm done trying to have a dialectic with someone who just wants to feel right about what they're doing without first having a global understanding of the playing field SHE is on."I have a pretty good understanding of the playing field for an outsider. I have no illusions about it. And I'm not sure what exactly I'm doing that I need to feel right about. I adopted a kid from foster care. Period."SRS social workers are zealots when it comes to TPR. You can hear them in their cubicles; excited that 'Did you hear a Smith baby came into custody today?!!! The case plan will be a TPR:.we know that family, don't we:.?' Or things about having tubes tied, blah, blah, blah."I can well imagine these sorts of conversations, and I find them deplorable too. I'm not an insider, however. You write as if you are. Have you actually heard these conversations?"You write as if you're the mother hen type."Thank you!"You have your place in the system, but certainly not as a social worker."No, I'm not social worker. Nor have I any interest in being one.You sound pretty cynical, Pogo. And not just about this topic. You also seem determined to disagree with people. Personally I agree with a lot of what you say, but you're so ugly in the way you say it. Are you trying to persuade anyone to your point of view? Or do you just like making vitriolic statements? Seems kind of pointless to me.Since you're done "trying to have a dialectic with" me, I'll just say it was interesting. I enjoyed the discussion. Take care.

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