Caregiver Factors Associated with Placement Stability

Placement with Kin.   Studies have concluded that kinship care is the safest and most stable form of out of home care that can be made available to children removed from their parents’ custody (Garnier & Poertner, 2000: Testa, 2002).  Research shows that kinship or relative placements result in fewer moves for children.  In a large scale California study, researchers found that children placed in kinship care had fewer placement moves than children in non-kinship care (Webster, Barth, & Needell, 2000).   An Illinois study found that children placed with kin caregivers were more likely to be in the “stable” population of children in foster care compared to the “mover” group (Rolock,  et al., 2009).  According studies, relative placements can have a 70 percent lower rate of disruption than placements with non-relatives  (Child and Family Research Center, 2004; Northern California Training Academy, 2008).

Other Caregiver Factors.  A recent study identified parenting characteristics of foster parents who were able to increase placement stability or decrease the number of disruptions (Crum, 2009).  The study found that two factors were the strongest predictors of placement stability:  parenting support and limit setting.

Parenting support: Foster parents who have a positive network to help with their parenting duties and who feel connected report feeling less burdened in their foster parent role.

Limit setting: Foster parents who establish firm but flexible guidelines were more likely to experience longer foster care placements. Foster parents who established rigid and firm rules were more likely to experience multiple foster care placements. They were less likely to seek input from their foster children and more likely to perceive their parenting role as being in charge.

Caregiver Factors Associated with Placement Breakdown

Mismatches between children and caregivers.  Research shows that a factor in placement breakdown is the foster parent’s perception of a mismatch between the child’s needs and the caregiver’s abilities.  In a study that asked foster parents about the factors that might lead them to consider ending a placement, foster parents said that if they were “unprepared for problems foster child had” and found that “the foster child did not want to help self”, they could conclude that “the foster child has needs I cannot meet,” and therefore, the foster parent may conclude that he or she “cannot be successful with the child.”  Foster parents reported that a foster child needed to make accommodations to fit into their home (just as by respecting boundaries). 

The child’s  poor relationship with other children in the home.  Studies have shown that placement breakdown is more likely when the foster parents have biological/adopted children (Martin, 1993; Triseliotis, 1989) and when these children feel that their concerns are unimportant and their contributions are not recognized by the agency (Swan, 2002).   Research shows that foster caregivers’ children identify three areas where foster children impact their lives in concerning ways:  fears that they will be the recipients of aggressive acts on the part of the child in foster care (Watson & Jones, 2002); the sense of separation and loss when a child in foster care must leave the family (Swan, 2000; Watson & Jones, 2002); and a sense of loss related to their place and role in the family, especially regarding their relationships with their parents (Wilkes, 1974).

Poor relationships between foster and birth families.   (Brown & Bednar, 2006). Relationships seem to be key between foster family and birth parent. Strained relationships of any nature have the potential to undermine placement stability and without doubt, the child will sense the unstable relationships which surround them. Oosterman et al (2007) concluded that a high level of co-operation between birth families and foster families increased the stability of placement, which would reinforce the argument that collaboration between all parties is important in securing positive outcomes. Other studies report that it is the relationship between birth families and foster families which has the greatest impact on the stability of a placement is the way they view each other appears to be a risk factor for placement stability.

The resource family’s personal circumstances.Studies indicate that resource families may end placements because of their own personal circumstances.  Foster parents report ending placement because of their own declining health (Terling-Watts, 2001; Brown & Bednar, 2006); their advanced age (Terling-Watts, 2001); and changed life circumstances such as divorce, the birth of a child, or retiring (Brown & Bednar, 2006; Gibbs, 2005; Proch & Taber, 1985).  Some disruptions occur because of the death of the foster parent (Wattenberg, et al., 2003).   

Strained relationship with and limited support from the agency.   Foster parents report that they may request the end of a placement as a result of fatigue and burnout, including the stress of being undervalued, having motivations misunderstood, and being provided with inadequate support and information (Heller, et al.,2002).  Studies have indicated that foster parents are more likely to end a placement when they perceive a lack of support from the agency (Fisher, et al., 2000; Rhodes, Orme & Buehler, 2001), including agency red tape (Rindfleisch, et al., 1998) and a lack of support, trust, and open communication with the social worker (Mathiesen, et al., 2001).

A number of strategies have been developed by states early on to find relatives for children who enter foster care and to recruit non-relative resource families for children in care.  These strategies range from aggressive identification of kinship resources at the outset of child welfare system involvement with a family to strengthening the recruitment and retention of non-relative resource families so that good matches can be made when a child enters care.  Child specific recruitment has becomes a key strategy in identifying the most appropriate placement resource for a child when the child must enter foster care.

“ According to the Child Information Gateway diligent recruitment is a strategy that involves recruiting resource families that reflect the race and ethnicity of children in foster care. In order to practice diligent recruitment States and agencies need to review their data on waiting children in care, compare the information with data on the general population by race and ethnicity, and then target their recruitment efforts in the communities that reflect the race and ethnicity of the children in care, particularly those who are overrepresented compared to the general population.”  

The National Resource Center for Recruitment and Retention of Foster and Adoptive Parents at AdoptUsKids (NRCRRFAP) along with the other AdoptUsKids partners, has developed a number of valuable resources to enhance and support the efforts of States, Tribes and Territories in recruiting and retaining foster, adoptive, relative and kin parents. 
Recognizing the need to find families, especially those for older youth who reflect the ethnic and racial diversity of children needing permanency, the Department of Health and Human Services, Administration for Children and Families, Children’s Bureau awarded cooperative agreements to eight grantees in 2008 and to seven grantees in 2010 through the Adoption Opportunities program.  The following provides information on the states and communities that received awards in 2008.

State and County Examples:

Cuyahoga County Department of Children and Family Services – Cleveland, OH
Partners for Forever Families is a public-private partnership designed to promote permanency for older youth in care, siblings who strive to be together, and the support of kinship families who are permanency resources for youth in care. Partners for Forever Families uses a neighborhood-based approach to increase permanency outcomes for youth on the verge of aging out by having a teen specialist work alongside para-professional navigators and neighborhood collaborative staff to demonstrate that found families can be engaged through the process.

City and County of Denver – Denver, CO
Denver's Village has built a diligent recruitment program to improve the safety, permanency and well-being of children by establishing community-based recruitment teams in geographically assigned communities.  The recruitment teams have combined the knowledge, skills and resources of Family to Family collaborations, resource parents, neighborhood communities and Denver Human Services to increase the number of foster, kinship and adoptive families that reflect the characteristics and needs of children in care. The Denver Indian Family Resource Center recruitment team recruits homes that meet both the needs of Native American children and preferences of the Indian Child Welfare Act (ICWA).

Kentucky Department for Community Based Services – Frankfurt, KY
Project MATCH (Making Appropriate and Timely connections for Children) is aimed at finding permanency for children in Kentucky’s foster care system.  It works to: increase the pool of resource parents to more accurately reflect each region’s out-of-home care population;  increase the effectiveness in locating and using appropriate kinship care; fully integrate concurrent planning into permanency planning;  and increase inter- and intra-agency communication between public, private and community stakeholders.

Missouri Department of Social Services – Jefferson City, MO
Extreme Recruitment is an innovative diligent recruitment program that aims to improve permanency outcomes for children in custody in St. Louis, Mo., and surrounding Counties. It has three components: (1) an intensive 12-20 week individualized recruitment effort that prepares the child for permanency, conducts diligent searches to reconnect the child with kin; and achieves permanency through general, targeted and/or child-specific recruitment; (2) connector services for recruited resources to the services necessary to make placements successful; and (3) program evaluation.

New York State Office of Children and Family Services – Rensselaer, NY
Parent for Every Child is a diligent recruitment project carrying out a randomized study of innovative efforts to provide permanency through kinship care, adoption, guardianship or other committed contracts for a minimum of 50 foster care youth with special needs whose parental rights have been terminated. These youth have developmental, emotional and/or behavioral needs and have spent several years in public residential facilities.  Each child is assigned a permanency specialist who  reviews the youth's needs and uses intensive, individual recruitment strategies to find them a permanent resource family.

Oklahoma Department of Human Services – Oklahoma City, OK
The Bridge to the Future project aims to improve outcomes for Oklahoma’s children by developing and delivering innovative, comprehensive strategies for the diligent recruitment and retention of resource families within the State.  Bridge to the Future is developing survey instruments and data mining tools, implementing customer service interventions with staff, developing multi-format training to increase the skills and capability of both resource families and staff in five high-need areas: trauma-informed care, intentional visitation, psychotropic medications, legal and handbook/contract; and building community partnerships.  

Ramsey County Community Human Services Department – St. Paul, MN
The Permanent Families Recruitment Project is aimed at increasing permanency for children by increasing the number of foster and adoptive homes in Ramsey County. African American children and older children and youth are the initial focus of the plan, and lessons learned from working with the African American community will be used to partner and work with the Hispanic/Latino community.

County of Santa Cruz – Santa Cruz, CA
The Santa Cruz County Roots & Wings initiative recruits concurrent and adoptive resource families who are reflective of children in foster care through general, targeted, and child-specific recruitment for concurrent and adoptive families;  ensures resource families are satisfied with services and support; and ensures children are transitioned to a permanent home in a timely manner.

Placement stability is enhanced when caregivers participate in quality assessment processes that provide both the family and the agency with information that is important in deciding whether the family can be a supportive placement resource for children and youth in foster care in general and whether they are the best placement resource for an individual child or youth.  Decision making relates to both types of decisions: whether a family should be licensed as a resource family in general and whether a family is the best resource for a particular child or youth.  

Assessment Tools
A number of assessment tools have been developed that can be used in the assessment process with kin and non-kin resource families: 

Casey Foster Family Assessments (CFFA).  This tool is used with foster parents and child welfare workers that license foster parent applicants. It has also been used with foster-adoptive and adoptive families and child welfare workers in this area. The CFFA was designed to improve recruitment, selection, development, and retention of foster parents in order to improve outcomes for children in foster care. Developed by the Casey Family Programs and the University of Tennessee - College of Social Work, the CFFA consist of two sets of standardized measures to assess foster family applicants. These tools are the Casey Foster Applicant Inventory (CFAI) and the Casey Home Assessment Protocol (CHAP). The tools complement each other. Both tools are designed to be used during the foster family application and selection process, but they can be used after this process, and they assess a broad range of characteristics of foster parents in order to identify strengths and areas for needed development and support.

Casey Foster Applicant Inventory-Worker Version(CFAI-W)The Casey Foster Applicant Inventory-Worker Version (CFAI-W) is a questionnaire designed to assess the potential of foster family care applicants to provide foster care.  Research indicates that his tool can be  used in combination with other methods to introduce standardization and accountability to the assessment of foster parent applicants.

An integrative assessment model as a means of intervention with the grandparent caregiver
(Chapter 4  of Working with Custodial Grandparents.)
This chapter describes an an integrative assessment model for evaluating the situation of custodial grandparents based on Erikson’s psychosocial model of development, attachment theory, and Bronfenbrenner’s ecological systems theory. It explains the essential components of a grandparent caregiver case formulation, including: relevant background information, current life problems and life changes, emotional, social, and physical development, attachment the dyadic and triadic relationships, individual microsystems and shared microsystems, mesosystem, exosystem, and the integration of the collected data.

The Structured Analysis Family Evaluation (SAFE) SAFE  is a home study methodology that was designed to evaluate families for adoption, foster care licensure, relative placement and reunification readiness. It can also be used to accomplish consolidated home studies (simultaneous foster care and adoption study) for concurrent planning purposes.

Assessing adult relatives as preferred caregivers in permanency planning : A competency-based
curriculum.   This curriculum is designed to prepare child welfare supervisors so they can provide the educational and administrative support social workers will need as they identify and assess relatives who could be considered as first placement resources for children in need of out-of-home care, protection and permanency. It provides an overview of the key knowledge and skills needed to respectfully and effectively work with birth families and extended family resources, and it identifies family assessment categories that are different for relatives from the traditional family assessment or home study criteria used with non-relatives coming forward as potential foster or adoptive resources for children.

State Examples:

Missouri: Missouri has developed a Resource Provider Family Assessment Recording Outline to guide the assessment of all resource families.

North Carolina:  North Carolina has developed Instructions for Kinship Care Assessments to guide the assessment of kin as placement resources for children and youth in foster care. 
dss-5204ins
dss-5204
dss-5203

Decision Making

Assessment tools yield important information for the agency and the family in mutually determining whether a family has the interest and capacity to be a resource family for children and youth in foster care.  Selecting an approved family for a particular child or youth is a critical process.  A key practice is sharing information about the child with prospective foster families – information that includes the child’s history, the level of birth family involvement, the child’s behavioral and health needs and information on the child’s Medicaid eligibility.

State Example:

Connecticut has written policy that requires that the social worker, when making the initial phone contact with the foster parent, provide as much information as possible about the child, including any special needs, and the circumstances of placement.

• Agency support and training
• Foster parent teams, mentors, support groups,  peer support, and celebrations and recognition
• Foster parent bill of rights

1. Agency support and training
The California Evidence-Based Clearinghouse on Child Welfare has rated the KEEP program as showing promising evidence in supporting and training caregivers.

KEEP (Keeping Foster and Kin Parents Supported and Trained)
has been rated by the CEBC in the areas of Placement Stabilization and Resource Parent Recruitment and Training. The objective of KEEP is to give parents effective tools for dealing with their child's externalizing and other behavioral and emotional problems and to support them in the implementation of those tools. Curriculum topics include framing the foster/kin parents' role as that of key agents of change with opportunities to alter the life course trajectories of the children placed with them. Foster/kin parents are taught methods for encouraging child cooperation, using behavioral contingencies and effective limit setting, and balancing encouragement and limits. There are also sessions on dealing with difficult problem behaviors including covert behaviors, promoting school success, encouraging positive peer relationships, and strategies for managing stress brought on by providing foster care. There is an emphasis on active learning methods; illustrations of primary concepts are presented via role-plays and videotapes.

Target Population: 4 to 12-year-old children in foster or kinship care placement

Other training programs for unrelated and kin caregivers that have been reviewed by the California Evidence-Based Clearinghouse are:         

Partnering for Safety and Permanence - Model Approach to Partnerships in Parenting (PS-MAPP) The Partnering for Safety and Permanence - Model Approach to Partnerships in Parenting (PS-MAPP)  is a 30-hour preparation and selection program for prospective foster and adoptive parents. PS-MAPP was the first comprehensive preparation and selection program for foster and/or adoptive parents to be developed since the passage of the Adoption and Safe Families Act in 1997. PS-MAPP was created out of consultations with the National Foster Parent Association Board of Directors and out of years of experience with the MAPP (Model Approach to Partnerships in Parenting) family of programs.

Target Population: Prospective foster and adoptive families in both public and private   agencies.

PRIDE (Parent Resources for Information, Development, and Education) was developed with the Child Welfare League of America (CWLA) through a collaboration of 14 state child welfare agencies, two national resource centers, and several universities and colleges. It is a model for the development and support of foster care and adoptive families that is used by private and public child welfare agencies in more than 30 states and at least 19 other countries. PRIDE is designed to strengthen the quality of foster care and adoption services by providing a standardized, structured process for recruiting, training, and selecting foster parents and adoptive parents. This 14-step model for delivering foster care services includes instructions and tools on how to implement the steps of the model and is described in the PRIDE Practice Handbook. CWLA offers training to managers, supervisors, workers, experienced foster parents, and staff on how to implement the model's practices.

Target Population:Prospective foster and adoptive parents; and experienced foster parents.

Foster Parent College (FPC)  is an online training venue for foster, adoptive, and kinship parents. Interactive multimedia courses offered through the site provide resource parents with both pre-service and in-service training on clinical aspects of and parent interventions for their child’s behavior problems. Instructional content is based on social learning theory and attachment theory. There are currently 29 courses on FPC, 15 of which address specific child behavioral and emotional problems. Course topics in the area of parenting strategies include safe parenting, positive parenting, resource parents’ marriage relationships, working with schools and birth parents, house safety, child safety and supervision, kinship care, culturally competent parenting, grief and loss in the care system, and substance-exposed infants. A course on child abuse and neglect is the first in a planned series of pre-service training courses. Most FPC courses can be taken individually via computer or in groups via DVD. Two newer online courses are advanced parenting workshops that were designed to be conducted in a group setting, with a discussion board and homework assignments. In addition, agencies can adapt any of the self-paced individual courses for delivery as group workshops with a discussion board, adding their own homework assignments.

Target Population: Foster, adoptive, and kinship parents, as well as social workers and other mental health professionals who work with resource parents.

Fundamentals of Foster and Adoptive Parenting focuses on training participants to develop the skills, knowledge, values, traits, and motives necessary to prepare them to understand and cope with the experience of receiving an adoptive or foster child into their home. The program’s curriculum was developed by stakeholders from the Maine Department of Health and Human Services (DHHS), and the Child Welfare Training Institute (CWTI), a division of the Muskie School of Public Service at the University of Southern Maine, collaborated with experienced foster and/or adoptive parents. Together they defined the knowledge-base, skills, abilities, and underlying personal characteristics needed to be an effective foster and/or adoptive parent.

Target Population: The target populations of this program are prospective foster and adoptive parents and kinship providers.

State and County Examples:

Washington State has developed a Families First Kinship Care Payment program to encourage placements with relatives for children who are risk of removal from their homes and placement into state custody.

2. Foster parent teams, mentors, support groups,  peer support and celebrations and recognition Studies show that the embeddedness of a foster family in a network of social support is associated with fewer placement disruptions (Redding, Fried, & Britner, 2000).  

State and County Examples:

Connecticut contracts with the Connecticut Association of Foster and Adoptive Parents to provide foster parent- to-foster parent peer support through:  (1) a HELPLINE (a confidential, peer support telephone system available 24 hours a day, 7 days a week  for the use of foster and adoptive parents when they need answers, understanding, information and the sympathetic ear of another foster parent); and (2) a Buddy System (a peer support/mentoring program for foster and adoptive parents that provides support and encouragement at the time of initial licensure and adjustment to foster or adoptive care, or at any stressful time as needed).

Kentucky has developed a range of supports for relative and non-relative caregivers of children in foster care. Among the parenting supports that Kentucky offers are:

Kentucky Foster and Adoptive Parent Training Support Network Fifteen parent led teams in various locations across the state that provide support, training and recruitment. A peer support program—for parents, by parents.

Resource Parent Mentor Program. Experienced foster and adoptive parents serve as mentors to new foster and adoptive parents during their first six months after approval/placement. (Includes weekly calls to respond to questions, concerns or to provide assistance during challenging times 1-877-440-6376)

Kentucky Foster / Adoptive Care Association. Parent-based association dedicated to the empowerment and encouragement of foster and adoptive families through advocacy and training.

Allegheny County, Pennsylvania annually hosts a Department of Human Services Office of Children, Youth and Families Foster Parent Recognition Dinner to acknowledge the generosity of men and women who engage in this critical relationship for children who are removed from their families.

3. Foster Parent Rights
A number of states have developed a bill of rights for foster parents. The National Association of Foster Parents’ website provides links to the bills of rights that states have developed in statute or other policy.

A number of placement-specific services have been identified as important to placement stability: readily available crisis intervention services, transportation, respite services and foster family counseling.

State Examples:

Iowa:  In Iowa, a pilot program is being implemented that offers respite for foster families.  In 2009, a respite care program was introduced in four Northeast Iowa counties by the Iowa Department of Human Services. The program trains adults 19 and older to provide short-term care in the foster home to children in foster care