Mental Health Interventions for Children in Foster Care: A Systematic Review

Erin P Hambrick, Shani Oppenheim-Weller, Amanda M N'zi, Heather N Taussig, Erin P Hambrick, Shani Oppenheim-Weller, Amanda M N'zi, Heather N Taussig

Abstract

Children in foster care have high rates of adverse childhood experiences and are at risk for mental health problems. These problems can be difficult to ameliorate, creating a need for rigorous intervention research. Previous research suggests that intervening with children in foster care can be challenging for several reasons, including the severity and complexity of their mental health problems, and challenges engaging this often transitory population in mental health services. The goal of this article was to systematically review the intervention research that has been conducted with children in foster care, and to identify future research directions. This review was conducted on mental health interventions for children, ages 0 to 12, in foster care, using ERIC, CINAHL, PsycINFO, PubMed, ProQuest's Dissertation and Theses Database, Social Services Abstracts, and Social Work Abstracts. It was restricted to interventions that are at least "possibly efficacious" (i.e., supported by evidence from at least one randomized controlled trial). Studies were evaluated for risk of bias. Ten interventions were identified, with diverse outcomes, including mental health and physiological. Six interventions were developed for children in foster care. Interventions not developed for children in foster care were typically adapted to the foster context. Most interventions have yet to be rigorously evaluated in community-based settings with children in foster care. Little research has been conducted on child and family engagement within these interventions, and there is a need for more research on moderators of intervention outcomes and subgroups that benefit most from these interventions. In addition, there is not consensus regarding how to adapt interventions to this population. Future research should focus on developing and testing more interventions with this population, rigorously evaluating their effectiveness in community-based settings, determining necessary adaptations, and identifying which interventions work best for whom.

Keywords: Foster care; child maltreatment; engagement; interventions; systematic review; treatment.

Figures

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Figure 1
Process of Identifying Articles for Inclusion
Figure 2
Figure 2
Mental Health Outcomes Across all Interventions

References

    1. Bellamy JL, Gopalan G, Traube DE. A national study of the impact of outpatient mental health services for children in long-term foster care. Clinical Child Psychology and Psychiatry. 2010;15:467–479.
    1. Bessell S. Participation in decision-making in out-of-home care in Australia: What do young people say? Children and Youth Services Review. 2011;33:496–501.
    1. Bruskas D, Tessin DH. Adverse childhood experiences and psychosocial well-being of women who were in foster care as children. The Permanante Journal. 2013;17:e131–e141.
    1. Burns BJ, Phillips SD, Wagner HR, Barth RP, Kolko DJ, Campbell Y, Landsverk J. Mental health need and access to mental health services by youths involved with child welfare: A national survey. Journal of the American Academy of Child & Adolescent Psychiatry. 2004;43:960–970.
    1. Casanueva C, Ringeisen H, Wilson E, Smith K, Dolan M. NSCAW II Baseline Report: Child Well-Being. OPRE Report #2011-27b. Washington, DC: Office of Planning, Research and Evaluation, Administration for Children and Families, U.S. Department of Health and Human Services; 2011.
    1. Chamberlain P, Price J, Leve LD, Laurent H, Landsverk JA, Reid JB. Prevention of behavior problems for children in foster care: Outcomes and mediation effects. Prevention Science. 2008;9:17–27.
    1. Chambless DL, Hollon SD. Defining empirically supported therapies. Journal of Consulting and Clinical Psychology. 1998;66:7–18. .
    1. Chu BC, Kendall PC. Positive association of child involvement and treatment outcome within a manual-based cognitive-behavioral treatment for children with anxiety. Journal of Consulting and Clinical Psychology. 2004;72:821–829. .
    1. Conway PH, Clancey C. Comparative-effectiveness research - Implications of the federal coordinating council’s report. New England Journal of Medicine. 2009;361:328–330.
    1. Courtney M, Dworsky A, Brown A, et al. Midwest evaluation of the adult functioning of former foster youth: Outcomes at age 26. Chicago, IL: Chapin Hall at the University of Chicago; 2011.
    1. DeGarmo DS, Chamberlain P, Leve LD, Price J. Foster parent intervention engagement moderating child behavior problems and placement disruption. Research on Social Work Practice. 2009;19:423–433.
    1. Dorsey S, Conover KL, Revillion Cox J. Improving foster parent engagement: using qualitative methods to guide tailoring of evidence-based engagement strategies. Journal of Clinical Child and Adolescent Psychology. 2014;43:877–889.
    1. Dorsey S, Pullman MD, Berliner L, Koschmann E, McKay M, Deblinger E. Engaging foster parents in treatment: A randomized trial of supplementing trauma-focused cognitive behavioral therapy with evidence-based engagement strategies. Child Abuse & Neglect. 2014;38:1508–1520.
    1. Dozier M, Peloso E, Lindhiem O, Gordon MK, Manni M, Sepulveda S, Ackerman J. Developing Evidence-Based Interventions for Foster Children: An Example of a Randomized Clinical Trial with Infants and Toddlers. Journal of Social Issues. 2006;62:767–785.
    1. Farmer EMZ, Burns BJ, Chapman MV, Phillips SD, Angold A, Costello EJ. Use of mental health services by youth in contact with social services. Social Service Review. 2001;75:605–624.
    1. Fisher PA, Kim HK. Intervention effects on foster preschoolers’ attachment-related behaviors from a randomized trial. Prevention Science. 2007;8:161–170.
    1. Ganann R, Ciliska D, Thomas H. Expediting systematic reviews: Methods and implications of rapid reviews. Implementation Science. 2010;5
    1. Garland AF, Hough RL, McCabe KM, Yeh M, Wood PA, Aarons GA. Prevalence of psychiatric disorders in youths across five sectors of care. Journal of the American Academy of Child and Adolescent Psychiatry. 2001;40:409–418.
    1. Garrido EF, Culhane SE, Raviv T, Taussig HN. Does community violence exposure predict trauma symptoms in a sample of maltreated youth in foster care? Violence and Victims. 2010;25:755–769.
    1. Goldman Fraser J, Lloyd SW, Murphy RA, Crowson MM, Casanueva C, Zolotor A, Coker-Schwimmer M, Letourneau K, Gilbert A, Swinson Evans T, Crotty K, Viswanathan M. Agency for Healthcare Research and Quality, No. 89. Rockville, MD: 2013. Child Exposure to Trauma: Comparative Effectiveness of Interventions in Addressing Maltreatment.
    1. Gopalan G, Bannon W, Dean-Assael K, Fuss A, Gardner L, LaBarbera B, McKay M. Multiple Family Groups: An Engaging Intervention for Child Welfare-Involved Families. Child Welfare. 2011;90(4):135–156.
    1. James S, Landsverk J, Slymen DJ, Leslie LK. Predictors of outpatient mental health service use - The role of foster care placement change. Mental Health Services Research. 2004;6:127–141.
    1. Kolko DJ, Hurlburt MS, Zhang J, Barth RP, Leslie LK, Burns BJ. Posttraumatic stress symptoms in children and adolescents referred for child welfare investigation. A national sample of in-home and out of-home care. Child Maltreatment. 2010;15:48–63.
    1. Kools SM. Adolescent identity development in foster care. Family Relations. 1997;46:263–271.
    1. Leve LD, Harold GT, Chamberlain P, Landsverk JA, Fisher PA, Volstanis P. Practitioner review: Children in foster care - vulnerabilities and evidence-based interventions that promote resilience processes. Journal of Child Psychology and Psychiatry. 2012;53:1197–1211.
    1. Lange S, Shield K, Rehm J, Popova S. Prevalence of fetal alcohol spectrum disorders in child care settings: A meta-analysis. Pediatrics. 2013;132:e980–e995.
    1. Leslie LK, Hurlburt MS, James S, Landsverk J, Slymen DJ, Zhang J. Relationship between entry into child welfare and mental health service use. Psychiatric Services. 2005;56:981–987.
    1. Leslie LK, Hurlburt MS, Landsverk J, Barth R, Slymen DJ. Outpatient mental health services for children in foster care: A national perspective. Child Abuse & Neglect. 2004;28:699–714.
    1. MacKinnon DP. Integrating Mediators and Moderators in Research Design. Research on Social Work Practice. 2011;21(6):675–681. .
    1. McCrae JS, Barth RP, Guo S. Changes in maltreated children’s emotional- behavioral problems following typically provided mental health services. American Journal of Orthopsychiatry. 2010;80(3):350–361.
    1. Mersky JP, Topitzes J, Grant-Savela SD, Brondino MJ, McNeil CB. Adapting parent-child interaction therapy to foster care: Outcomes from a randomized trial. Research on Social Work Practice. 2014:1–11.
    1. Miller LM, Southam-Gerow MA, Allin RB. Who stays in treatment? Child and family predictors of youth client retention in a public mental health agency. Child & Youth Care Forum. 2008;37:153–170.
    1. Moher D, Liberati A, Tetzlaff J, Altman DG The PRISMA Group. Preferred Reporting Items for Systematic Reviews and Meta- Analyses: The PRISMA Statement. PLoS Med. 2009;6(6):e1000097.
    1. National Working Group on Foster Care and Education. Fostering success in education: National factsheet on the educational outcomes of children in foster care. 2014 Retrieved from: .
    1. New York State Office of Children and Family Services. Ten for 2010. 2010 Retrieved from .
    1. Patient Centered Outcomes Research Institute. Patient Centered Outcomes Research. 2013 Nov 7; Retrieved from .
    1. Perry BD, Dobson C. The Neurosequential Model (NMT) in maltreated children. In: Ford J, Courtois C, editors. Treating Complex Traumatic Stress Disorders in Children and Adolescents. New York, NY: Guilford Press; 2013. pp. 249–260.
    1. Shipman K, Taussig H. Mental health treatment of child abuse and neglect: The promise of evidence-based practice. Pediatric Clinics of North America. 2009;56:417–28.
    1. Smith DK, Johnson AB, Pears KC, Fisher PA, DeGarmo DS. Child maltreatment and foster care: Unpacking the effects of prenatal and postnatal parental substance use. Child Maltreatment. 2007;12:150–160.
    1. Smith DK, Stormshak E, Chamberlain P, Whaley RB. Placement disruption in treatment foster care. Journal of Emotional and Behavioral Disorders. 2001;9:200–205.
    1. Stein BD, Zima BT, Elliott MN, Burnam MA, Shahinfar A, Fox NA, Leavitt LA. Violence exposure among school-age children in foster care: Relationship to distress symptoms. Journal of the American Academy of Child and Adolescent Psychiatry. 2001;40:588–594.
    1. Stovall-McClough KC, Dozier M. Forming attachments in foster care: Infant attachment behaviors in the first two months of placement. Development and Psychopathology. 2004;16:253–271.
    1. Taussig HN, Culhane SE, Garrido E, Knudtson MD, Petrenko CLM. Does Neglect Moderate the Impact of an Efficacious Preventive Intervention for Maltreated Children in Foster Care? Child Maltreatment. 2013;18(1):56–64. .
    1. Taussig HN, Raviv T. Handbook of Child Maltreatment. Springer; 2014. Foster care and child well-being: A promise whose time has come; pp. 393–410.
    1. Timmer SG, Sedlar G, Urquiza AJ. Challenging children in kin versus nonkin foster care: Perceived costs and benefits to caregivers. Child Maltreatment. 2004;9:251–262.
    1. U.S. Department of Health and Human Services, Administration for Children and Families, Children’s Bureau. National Adoption and Foster Care Statistics Report. 2014 Retrieved from .
    1. Weiner DA, Schneider A, Lyons JS. Evidence-based treatments for trauma among culturally diverse foster care youth: Treatment retention and outcomes. Children and Youth Services Review. 2009;31:1199–1205.
    1. Weisz JR, Kuppens S, Eckshtain D, Ugueto AM, Hawley KM, Jensen-Doss A. Performance of evidence-based youth psychotherapies compared with usual clinical care: A multilevel meta-analysis. Journal of the American Medical Association. 2013;70:750–761.
    1. Willis CE, Holmes-Rovner M. Integrating Decision Making and Mental Health Interventions Research: Research Directions. Clinical Psychology: Science and Practice. 2006;13:9–25.

Source: PubMed

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