Qualitative exporation of relationships with important non-parental adults in the lives of youth in foster care

Family Support, Resilience, and Life Goals of Young People in Residential Care

Establishing goals for young people in residential care (RC) is a gap in the literature, especially in terms of the relationship between family support and resilience. The literature suggests that RC is associated with the breakdown of family relationships, so the possibility of the family playing a positive role in establishing life goals for young people is reduced. However, family support in the context of organization and stability can be assumed to be a protective factor for the formulation of life goals and contribute to the resilient development of young people. This study aimed to analyze the role of family support in the process of setting goals for young people in RC, as well as to analyze the potential mediating role of resilience in the previous association. The sample included 124 young people aged between 12 and 23 years living in RC. The results point to a positive association between family support (autonomy) and the planning of life goals and verify the total mediating effect of resilience in this association. The results are discussed considering attachment theory and the role of the family in the adaptive development of young people. This study's findings provide important indications for developing future interventions.

The Development of Young Peoples' Internalising and Externalising Difficulties Over the First Three-Years in the Public Care System

Although we know there are high rates of mental health difficulties amongst young people in out-of-home care (i.e. social welfare-involved children), there is limited evidence on the longitudinal development of these problems, particularly from when they enter the care system. Using the routinely collected carer-reported strengths and difficulties questionnaire, we explored internalising (emotional and peer) and externalising (conduct and hyperactivity) difficulties for 672 young people across their first 3 years in the UK care system (2-16 yrs, 51% boys, 76% Caucasian). In all cases stable profiles (resilient or chronic) were most common, while changing profiles (recovery or delayed) were less common. Findings showed that entry into the care system is not enough of an intervention to expect natural recovery from mental health difficulties. Number of placements and being separated from siblings were associated with greater difficulties. Implications for child welfare and mental health systems are discussed.

Intervention development to improve foster youth mental health by targeting coping self-efficacy and help-seeking

This study articulates the iterative development of an intervention called Strengthening Youth Networks and Coping (SYNC), which is designed to target coping self-efficacy and help-seeking intentions and behaviors among youth in foster care. The overarching goal is to design an intervention that will be a feasible and acceptable enhancement to existing child welfare services, and that will address modifiable determinants among adolescents involved in child welfare system that are related to elevated risk for mental health challenges, limited support network capacity, and service disengagement after exiting foster care. In this paper, we describe our initial needs assessment, explain how we selected proximal intervention mechanisms (i.e., intermediate outcomes) to target, and outline the preliminary intervention development process, including ongoing insights we received from a research advisory group including members with lived experience. Next, we report and discuss the initial acceptability pre-testing data collected from youth (N = 30) as well as feasibility data collected from providers (N = 82), results from which were used to refine the SYNC intervention framework prior to robust efficacy testing. Findings highlight the need and importance of targeting youth coping and help-seeking, integrating programming within existing transition services, delivering this content in a group-based format that includes near-peer mentors and facilitators with lived experience, and developing options that work for the heterogeneous population of young people in foster care. The results also highlight the key objective of capturing youth's interests prior to enrolling in the program (e.g., language used in recruitment materials), holding their interest throughout the program (e.g., creating opportunities for youth to engage with other youth with similar experiences), and suggestions to encourage youth's engagement and participation. This paper articulates the value of this intervention development approach, and the sequential phases of this intervention development process as well as the results, which may be useful to applied researchers and practitioners working with youth in foster care and other priority populations.

Exploring the support services of foster care leavers: An institutional ethnographic study

Research has documented the challenges faced by foster care leavers in their transition to independent living or adult lives revolving around education, employment, accommodation, substance use and criminal involvement. Although studies have investigated the support available to foster care leavers, there is inadequate research on the contribution of social service organisations where most foster leavers receive services. More particularly, in Denmark, child welfare services do not reach foster care leavers as a specific target group beyond 23 years. Therefore, the perspectives of foster care leavers about their experiences with support resources from a non-governmental social service organisation in Denmark were explored. This was an institutional ethnographic study involving in-depth interviews with 17 foster care leavers at the organisation where they received services. Data from the interviews were analysed following a thematic analysis. Themes including networking and social skills, practical support and sense of family were reported. The study demonstrates that the need for social connections and relationships, education and employment is a priority for foster care leavers. Professionals working with foster care leavers should teach the population relevant skills that could help them build healthy relationships with others. Policies should be developed to support the roles performed by such social service organisations to ensure that foster care leavers do not experience difficult transitions into independent living.

Broadening the perspective on youth's systems of support: An ecological examination of supportive peer and adult relationships during adolescence

This study applies the theory of positive youth development (Lerner et al., 2010) and the youth systems framework (Varga & Zaff, 2018) to the examination of supportive peer and adult relationships across multiple contexts in which youth develop. Results of egocentric social network analysis indicated that high school-aged youth nominated significantly more adults than middle school-aged youth. Peers and adults both acted as important sources of support, although often the types of support they offer differ. Outdegree centrality of peers was a significant predictor of character. The size of a participant's youth system, measured as the number of contexts accessed, along with average closeness in adult relationships, was a significant predictor of contribution. Thematic analysis of interview data identified four themes, aligned with the five actions of developmental relationships, as contributing factors to youth-adult closeness and youth perceptions of support (Pekel et al., 2018). Implications for youth-adult relationships are discussed.

Coping and support-seeking in out-of-home care: a qualitative study of the views of young people in care in England

OBJECTIVES

Young people who have been removed from their family home and placed in out-of-home care have commonly experienced abuse, neglect and/or other forms of early adversity. High rates of mental health difficulties have been well documented in this group. The aim of this research was to explore the experiences of these young people within the care system, particularly in relation to support-seeking and coping with emotional needs, to better understand feasible and acceptable ways to improve outcomes for these young people.

DESIGN AND STUDY SETTING

This study used 1:1 semistructured qualitative interviews with young people in out-of-home care in England, to provide an in-depth understanding of their views of coping and support for their emotional needs, both in terms of support networks and experiences with mental health services. Participants were 25 young people aged 10-16 years old (56% female), and included young people living with non-biological foster carers, kinship carers and in residential group homes.

RESULTS

Participants described positive (eg, feeling safe) and negative (eg, feeling judged) aspects to being in care. Carers were identified as the primary source of support, with a supportive adult central to coping. Views on support and coping differed for young people who were experiencing more significant mental health difficulties, with this group largely reporting feeling unsupported and many engaging in self-harm. The minority of participants had accessed formal mental health support, and opinions on usefulness were mixed.

CONCLUSIONS

Results provide insight, from the perspective of care-experienced young people, about both barriers and facilitators to help-seeking, as well as avenues for improving support.

A Systematic Review of Internet Communication Technology Use by Youth in Foster Care

This systematic narrative review of the literature reports on the experiences of foster youth regarding the use of Internet Communication Technologies (ICTs) such as social media, focusing only on studies that include youth voice. We searched seven databases for articles published internationally from 2010 to 2020 in which foster youth were interviewed regarding their beliefs about ICTs. Youth report benefits of ICTs including to their relationships and identity formation opportunities, and discuss risks of ICTs and how they manage them. ICTs may benefit positive youth development. Stakeholders may consider ways to assess and support healthy ICT use.

Individual and interpersonal factors associated with psychosocial functioning among adolescents in foster care: A scoping review

Risk reduction and strength enhancement are both necessary strategies to improve outcomes for youth in foster care who have experienced adversity. Decades of research have articulated the negative long-term outcomes of youth in foster care, but less is known about youth-level modifiable protective factors that can be nurtured through intervention to improve well-being. This scoping review was conducted to synthesize the state of the science on proximal, modifiable individual and interpersonal factors that are associated with psychosocial well-being among adolescent youth in foster care. Following rigorous and recommended methods, we systematically searched, selected and synthesized 20 years of peer-reviewed literature focused on 13-19 year olds in foster care. 41 peer-reviewed, quantitative studies met specified inclusion criteria and were included in this review. We charted the data and synthesized our findings in consultation with an advisory group of researchers, practitioners, and youth with lived experience. Overall, the review highlighted key categories of individual factors (individual strengths, psychosocial needs, and developmental skills) and interpersonal factors (relationships with peers/siblings, caregiving adults, and caring adults in the community) that can have protective value and are associated with psychosocial functioning for adolescent youth in foster care. Moreover, when youth have their needs met, increase their skills and develop strengths, it often leads to better outcomes as well as more and/or higher quality relationships with important people in their lives. Similarly, when youth develop and maintain quality relationships, those connections often lead to opportunities to advance their skills, strengths and positive outcomes. The results of this review contribute new insights for research, practice, and policy intended to enhance psychosocial well-being for young people in foster care. Findings also highlight specific individual and interpersonal factors that interventionists might consider as potential targeted mechanisms of change when developing programming for this population. Implications are discussed.

Mentors' experiences of mentoring justice-involved adolescents: A narrative of developing cultural consciousness through connection

Mentoring provides a relational intervention that can promote positive youth development among adolescents who are involved in the juvenile justice system. The perspectives of mentors engaging these youth, particularly insights considered through a cultural humility lens, have been largely absent from the literature to date. This study examined predominately White, middle- to upper-class adult mentors' experiences mentoring racially diverse, working-class youth. Semi-structured qualitative interviews were completed with 23 mentors participating in a community-based mentoring program. Themes were derived from inductive content analysis. Emergent themes illustrative of the mentoring process included (a) establishing a connection despite differences, (b) identifying mentees' personal and environmental challenges, and (c) raising consciousness around structural issues. Despite coming from different backgrounds and experiences, mentors who worked with justice-involved adolescents were motivated to connect with their mentees. Mentors developed a greater awareness of structural challenges influencing adolescents by learning about the multifaceted experiences and needs of their mentees.

Assessing trustworthiness: Marginalized youth and the central relational paradox in treatment

Marginalized youth are at elevated risk for mental health difficulties, yet they encounter numerous barriers to engagement with mental health services. Past negative experiences with family, social workers, and systems of care contribute to distrust of service providers and ambivalence about engaging in trusting relationships with adults. This longitudinal qualitative study explored how marginalized youth living with mental health conditions make decisions about trust in their relationships with helping professionals. Semi-structured, open-ended in-depth interviews were conducted with 13 young women living with a mood or anxiety disorder, exploring trust, mutuality, and disconnection in relationships between marginalized youth and helping professionals. Eleven of the participants also participated in a second interview, 3 months later, that explored participants' relationships with friends and family. Transcripts were analyzed using thematic analysis and interpreted through the lens of relational-cultural theory. Results indicated that the majority of interview participants described feeling unseen, judged, or invalidated in their relationships with family members. Four themes emerged as factors in the assessment of the trustworthiness of service providers: genuine caring; understanding; non-judgmental acceptance; and adult respect for youth agency. Concerns about confidentiality and mandated reporting informed participants' decisions about disclosure in these relationships. Analysis of findings reveals evidence of the central relational paradox in these descriptions of helping relationships, reflecting the simultaneous appeal and peril of vulnerability in relationships, especially relationships characterized by power differentials. Findings suggest that practitioners working with marginalized youth can expect both openness and guardedness in the treatment relationship.

Supporting the emotional needs of young people in care: a qualitative study of foster carer perspectives

OBJECTIVES

Young people who have been removed from their family home and placed in care have often experienced maltreatment and there is well-developed evidence of poor psychological outcomes. Once in care, foster carers often become the adult who provides day-to-day support, yet we know little about how they provide this support or the challenges to and facilitators of promoting better quality carer-child relationships. The aim of this study was to understand how carers support the emotional needs of the young people in their care and their views on barriers and opportunities for support.

DESIGN AND PARTICIPANTS

Participants were 21 UK foster carers, recruited from a local authority in England. They were predominantly female (86%), aged 42-65 years old and ranged from those who were relatively new to the profession (<12 months' experience) to those with over 30 years of experience as a carer. We ran three qualitative focus groups to gather in-depth information about their views on supporting their foster children's emotional well-being. Participants also completed short questionnaires about their training experiences and sense of competence.

RESULTS

Only half of the sample strongly endorsed feeling competent in managing the emotional needs of their foster children. While all had completed extensive training, especially on attachment, diagnosis-specific training for mental health problems (eg, trauma-related distress, depression) was less common. Thematic analysis showed consistent themes around the significant barriers carers faced navigating social care and mental health systems, and mixed views around the best way to support young people, particularly those with complex mental health needs and in relation to reminders of their early experiences.

CONCLUSIONS

Findings have important implications for practice and policy around carer training and support, as well as for how services support the mental health needs of young people in care.

Perspectives of Youth Aging Out of Foster Care on Relationship Strength and Closeness in their Support Networks

Research, practice, and policy focus on the importance of relationships with young people aging out of foster care, especially relational permanency. While previous research has examined these relationships, typically with mentors, foster parents, or biological parents, few have examined the quality of strong network ties within support networks. This study incorporated a network approach to understanding how youth discussed strong ties and defined closeness in relationships. Qualities of strong ties included stability, multidimensional support, advocacy, honesty and genuineness, commonalities, trust, and small interconnected core networks. Understanding qualities youth value in close relationships may help service providers in supporting and enhancing relational permanency from multiple sources of support for youth aging out of the foster care system.

Sharing personal health record data elements in protective custody: youth and stakeholder perspectives

OBJECTIVE

The study sought to develop the necessary elements for a personalized health record (PHR) for youth emancipating from child protective custody (eg, foster care) by collecting thoughts and ideas from current and former foster youth and community stakeholders who have a significant amount of experience working with emancipating young people.

MATERIALS AND METHODS

We employed a mixed methods, participatory research design using concept mapping to identify key features for PHR across stakeholders.

RESULTS

In the clusters, common themes for necessary elements for a PHR included health education, health tips, medication instructions, diagnoses including severity, and website resources that could be trusted to provide reliable information, and addressed data privacy issues such as the primary user being able to choose what diagnoses to share with their trusted adult and the ability to assign a trusted adult to view a part of the record.

DISCUSSION

By directly involving youth in the design of the PHR, we are able to ensure we included the necessary health and life skills elements that they require. As a PHR is created for foster youth, it is important to consider the multiple uses that the data may have for emancipated youth.

CONCLUSION

A PHR for foster youth needs to include an appropriate combination of information and education for a vulnerable population. In addition to providing some of their basic health and custody information, a PHR provides an opportunity to give them information that can be trusted to explain common diagnoses, medications, and family health history risks.

Automated Patient Linking for Electronic Health Record and Child Welfare Databases

There are 427,000 children in protective custody in the United States. A lack of integration between the child welfare data system and electronic health record systems complicates the communication of critical health history details to caregivers. We created and evaluated automated ten custom algorithms linking these data. Deterministic matching was performed using combinations of first and last name, date of birth, and gender. If unmatched, a non-deterministic algorithm allowed for punctuation differences and letter transpositions. Of the children linked deterministically, 91.3% were linked. Of the ones undergoing non-deterministic matching, 71.3% were linked. Sharing integrated data is the first step in systematically improving health outcomes for children in protective custody. This approach represents an automatable and scalable solution that could help merge data from two disparate sources.

The Role of Shared Decision-Making in Shaping Intent to Access Services for Adolescents in Protective Custody

Including children in protective custody (e.g., foster care) in legal decisions positively impacts their perceptions of the legal system, with giving youth a voice being particularly important. Studies have primarily focused on including young people in legal processes; however, for adolescents in protective custody, decisions about living arrangements, education, and long-term planning are made outside the courtroom, with ramifications for young people and their perceptions of both legal and child protection systems. This study looks at such decision making using existing data from 151 adolescents who were ages 16-20 and had been in child welfare protective custody for at least 12 months. During in-person interviews we assessed their desired amount of involvement in a recent decision and their perceptions of their actual involvement. Youth named other individuals involved in decision-making. Data were coded and analysed to identify discrepancies in young people's perceptions of desired and actual levels of involvement. Results indicate that while the majority of adolescents (96%) are participating in decision-making, they generally desire more involvement in decisions made (64%). Only 7% of youth reported that their level of personal involvement and the involvement of others matched what they desired. The most common individuals identified in a decision made were child protection workers, legal professionals, and caregivers or family members. These findings enhance the existing literature by highlighting the unique issues related to giving young people in protective custody a voice, and provide an empirical foundation for guiding policies around who to involve in every-day decisions made for young people preparing for emancipation from protective custody.

Understanding support network capacity during the transition from foster care: Youth-identified barriers, facilitators, and enhancement strategies

This study explores how foster care experiences can impact support network functionality as young people exit the foster care system. This can be conceptualized as a function of both network member capacity to provide adequate support to address young adult needs, and network stability, which reflects cohesion within and across relationships to facilitate consistent support over time. We conducted support network mapping and semi-structured interviews with youth in foster care aged 16-20 (N=22) and used theoretical thematic analysis to explore support barriers and facilitators in relation to the organizing concepts of support capacity and network stability. Overall, support capacity was limited by interpersonal difficulties inhibiting the presence and supportiveness of some network members (including family members, informal peer and community-based connections, and caseworkers), whereas network stability facilitated multidimensional support through strong and interconnected relationships with caregivers and service providers. Emergent network patterns reflected distinct subgroups of more and less functional support networks, and strategies for network enhancement focus on promoting youth-directed services and support, developing youth skills and opportunities to invest in informal relationships, and using network assessment to identify unmet support needs. Findings advance a framework for understanding how foster care impacts support network characteristics, and inform ongoing efforts to address resulting limitations through services and programming.

Assessing Support Network Stability With Transition-Age Foster Youth: Measuring Change Over Time

OBJECTIVE

This study uses the Support Network Assessment for Practice (SNAP) approach to measure the support provided to young people transitioning from foster care.

METHODS

The SNAP was administered on two occasions, approximately 7 months apart, to a cohort of transition-age foster youth (n = 27). Analyses investigated measurement reliability and sensitivity to change for network-level characteristics as well as baseline factors associated with relationship stability.

RESULTS

Most network-level indicators had strong test-retest correlations, and differences in mean scores over time also were detected, suggesting measurement sensitivity to change. Respondents were able to explain most observed changes in their networks, further suggesting reliable measurement. Stable relationships were those reported as stronger and providing more multifaceted support and those with family members and/or parent figures.

DISCUSSION

The SNAP approach could be used to facilitate planning around support needs for youth transitioning out of foster care and to evaluate efforts to enhance support networks.

Permanency and the Educational and Economic Attainment of Former Foster Children in Early Adulthood

Foster children are at disproportionate risk of adverse outcomes throughout the life course. Public policy prioritizes permanency (exiting foster care through reunification with birth parents, adoption, or legal guardianship) as means of promoting healthy development and wellbeing for foster youth, but little empirical evidence indicates that permanency, including its most preferred form-reunification-promotes positive outcomes. Using multi-system, statewide longitudinal administrative data, we employed logistic and mixed-effects regression to examine educational attainment and earnings among former foster youth in early adulthood. We included a variety of sociodemographic and economic controls to reduce selection bias. We found that youth who did not attain permanency (those who aged out of care) had significantly higher odds of graduating high school and enrolling in college than reunified youth and youth who exited to guardianship, and similar odds as adopted youth. Earnings were similar across groups. Among aged-out (but not reunified) youth, odds of high school graduation and average earnings were higher for those who spent more time in foster care prior to age 18. Notably, some findings were sensitive to the categorization of youth who ran away from care. Overall, results suggest that permanency alone is insufficient to promote foster youths' educational and economic attainment.

Supporting Mentoring Relationships of Youth in Foster Care: Do Program Practices Predict Match Length?

Implementation of research- and safety-based program practices enhance the longevity of mentoring relationships, in general; however, little is known about how mentoring programs might support the relationships of mentees in foster care. Benchmark program practices and Standards in the Elements of Effective Practice for Mentoring, 3rd Edition (MENTOR, 2009) were assessed in the current study as predictors of match longevity. Secondary data analyses were conducted on a national agency information management database from 216 Big Brothers Big Sisters agencies serving 641 youth in foster care and 70,067 youth not in care from across the United States (Mean = 11.59 years old at the beginning of their matches) in one-to-one, community-based (55.06%) and school- or site-based (44.94%) matches. Mentees in foster care had shorter matches and matches that were more likely to close prematurely than mentees who were not in foster care. Agency leaders from 32 programs completed a web-based survey describing their policies and practices. The sum total numbers of Benchmark program practices and Standards were associated with match length for 208 mentees in foster care; however, neither predicted premature match closure. Results are discussed in terms of how mentoring programs and their staff can support the mentoring relationships of high-risk youth in foster care.

“Who Knows Me the Best and Can Encourage Me the Most?”: Matching and Early Relationship Development in Youth-Initiated Mentoring Relationships with System-Involved Youth

Youth-initiated mentoring (YIM), in which youth select adults from within their communities to serve as mentors in relationships that are formalized through mentoring programs, has the potential to redress problems faced by many mentoring programs that could adversely affect system-involved youth, such as volunteer attrition and premature match closures. However, only a few programs have implemented YIM, and there is little research on this approach. This qualitative interview study examines the formation of YIM relationships and how they are experienced by mentors ( n = 14), youth ( n = 17), and the youths’ parent/guardian ( n = 6). Youth tended to select adults whom they had encountered through school or social services. Findings indicate that the YIM selection process contributed to mentor, youth, and parent/guardian investment in the mentoring relationship and to the youth’s rapid development of feelings of closeness and trust in the mentor. Knowing that mentors would be nonjudgmental, trustworthy, and dedicated appeared to facilitate positive relationship development, which is important given the difficulty of engaging and serving system-involved youth in mentoring programs.

Connectedness to family, school, peers, and community in socially vulnerable adolescents

Youth who feel connected to people and institutions in their communities may be buffered from other risk factors in their lives. As a result, increasing connectedness has been recommended as a prevention strategy. In this study, we examined connectedness among 224 youth (ages 12-15), recruited from an urban medical emergency department, who were at elevated risk due to bullying perpetration or victimization, or low social connectedness. Regression analyses examined multiple domains of connectedness (family, school, peer, community) in relation to adjustment. Youth who felt more connected to parents reported lower levels of depressive symptoms, suicidal ideation, non-suicidal self-injury, and conduct problems, higher self-esteem and more adaptive use of free time. Youth who felt more connected to their school reported lower levels of depressive symptoms, suicidal ideation, social anxiety, and sexual activity, as well as higher levels of self-esteem and more adaptive use of free time. Community connectedness was associated with less social anxiety but more sexual activity, and peer connectedness was not related to youth adjustment in this unique sample. Findings suggest that family and school connectedness may buffer youth on a trajectory of risk, and may therefore be important potential targets for early intervention services.

Predictors of Premature Match Closure in Youth Mentoring Relationships

Although mentoring is a popular and effective means of intervention with youth, the positive effects of mentoring can be diminished by premature match closure of relationships. Program, mentor, and mentee characteristics were examined as predictors of premature match closure. Secondary data analyses were conducted on a large national database of mentoring programs consisting of match and youth risk information from 170 mentoring programs and 6468 matches from across the U.S. Premature closure was associated with mentee age at match inception and 19 individual mentee characteristics. The set of mentee characteristics were examined as part of a cumulative risk index encompassing seven conceptually combined categories including family background characteristics, school functioning problems, engagement in risky health behaviors, self-regulation difficulties, engagement in illegal or criminal activities, and internalizing and externalizing behavior problems. Both the age of mentees when matched and the cumulative risk index score significantly predicted premature closure. Results are discussed in terms of directions for future research and suggestions for enhancing mentoring program practices.

Childhood adversity and the risk of substance use and delinquency: The role of protective adult relationships

Youth involved in the child welfare system experience multiple early adversities that can contribute to increased risk of substance use and delinquency. Although adverse childhood experiences (ACEs) have been associated with poorer behavioral outcomes among youth, less is known about the possible protective factors that may influence the relationship between early adversity and risk-taking behavior. This study examined whether protective adult relationships moderated the link between cumulative ACEs and substance use and delinquency after controlling for demographic characteristics in child welfare-involved youth. The sample included 1054 youth, ages 11-17, from the National Survey of Child and Adolescent Well-Being II who were in the first wave of data collection. Results showed that protective adult relationships moderated the relationship between ACEs and substance use, but not for delinquency. Specifically, under lower levels of protective adult relationships, cumulative ACEs related to increased substance use among youth. Implications for child welfare practices to target youths' support systems are discussed.

Fostering Higher Education: A Postsecondary Access and Retention Intervention for Youth with Foster Care Experience

Most youth in foster care aspire to obtain higher education, but face daunting obstacles in doing so. While societal interest and effort to support foster youth in achieving higher education has grown, very few supports have evidence to show that they are effective at improving postsecondary outcomes. In an effort to address the dearth of clearly articulated, evidence-based postsecondary support approaches for foster youth, we have developed Fostering Higher Education (FHE), a comprehensive, structured, and evaluable postsecondary access and retention intervention composed of elements (professional educational advocacy, substance abuse prevention, mentoring) that are either evidence based or promising based on the scientific literature and their ability to address the outcomes of interest. This paper describes the development and youth usability and practitioner feasibility testing of the FHE intervention approach, which was developed through funding from the National Institute on Drug Abuse. Youth usability feedback was primarily positive, with the majority of participants indicating they found the FHE activities interesting and useful, and were comfortable participating in them. Practitioner feasibility feedback was also primarily positive, with almost unanimous ratings of the FHE intervention components as very important to provide to youth and that all would be feasible for an organization to implement, though the mentoring components were seen as slightly less feasible than other components. Next steps and implications of this intervention development process are discussed.

Le réseau familial de jeunes adultes hébergés en famille d’accueil jusqu’à leur majorité

L’étude documente le réseau familial de 12 jeunes adultes qui, au cours de leur enfance, ont fait l’objet d’une mesure de placement en famille d’accueil jusqu’à leur majorité. L’objectif est de décrire la composition de leur réseau familial, de cerner l’importance des liens familiaux d’origine et d’accueil ainsi que d’identifier ce qui a pu faciliter ou entraver le maintien de ces liens. Tous ont participé à une entrevue individuelle semi-dirigée au cours de laquelle ils ont été invités à construire deux génogrammes : l’un représentant leur famille lors de la période de placement et l’autre leur famille actuelle. Les résultats suggèrent que les représentations familiales sont diversifiées et spécifiques au vécu de chaque participant. Si la complémentarité des liens entre les familles d’accueil et d’origine existe pour quelques participants, la tendance est davantage orientée vers l’exclusivité des liens. Enfin, même si la qualité du lien est un prérequis essentiel pour assurer un placement positif, elle ne garantit pas le maintien du lien après la fin des services.

Professional and youth perspectives on higher education-focused interventions for youth transitioning from foster care

Youth transitioning from foster care to adulthood access and succeed in college at much lower rates than the general population. A variety of services exist to support youth with their postsecondary goals, but few if any have evidence for their effectiveness. As part of a National Institute on Drug Abuse-funded intervention development project to design Fostering Higher Education, a structured, testable postsecondary access and retention intervention for youth transitioning from foster care to adulthood, focus groups were conducted with community stakeholders to collect recommendations for how to most effectively structure the intervention. Analyses of focus group findings resulted in four theme groups: (1) general recommendations for intervention development; (2) recommendations for an educational advocacy intervention component; (3) recommendations for a mentoring intervention component; and (4) recommendations for a substance abuse prevention intervention component. These themes offered a variety of important insights for developing interventions in a way that is usable for youth and feasible for communities to implement.

Supportive Relationships Among Former System Youth With Mental Health Challenges

This study explored the supportive relationships that former system youth (FSY; e.g., foster care) with mental health challenges identified as “key” in making the transition to adulthood. In-depth semi-structured interviews were conducted with 59 FSY, ages 18 to 25, with mental health challenges. Participants were asked to reflect on their relationships with a key helper or what the literature defines as a natural mentor, “an adult that has been particularly helpful, or supportive,” in this case with their mental health. Seventy-six percent ( N = 45) of the participants identified a key helper. Relationship qualities that emerged as salient to successful transition included consistency, mutuality, and empathy. The nature of support received included emotional, informational, and tangible support. Implications for research, practice, and policy are discussed.

Psychosocial pathways to sexually transmitted infection risk among youth transitioning out of foster care: evidence from a longitudinal cohort study

PURPOSE

To test the fit of a theoretically driven conceptual model of pathways to sexually transmitted infection (STI) risk among foster youth transitioning to adulthood. The model included (1) historical abuse and foster care experiences; (2) mental health and attachment style in late adolescence; and (3) STI risk in young adulthood.

METHODS

We used path analysis to analyze data from a longitudinal study of 732 youth transitioning out of foster care. Covariates included gender, race, and an inverse probability weight. We also performed moderation analyses comparing models constrained and unconstrained by gender.

RESULTS

Thirty percent reported they or a partner had been diagnosed with an STI. Probability of other measured STI risk behaviors ranged from 9% (having sex for money) to 79% (inconsistent condom use). Overall model fit was good (Standardized Root Mean Square Residual of .026). Increased risk of oppositional/delinquent behaviors mediated an association between abuse history and STI risk, via increased inconsistent condom use. There was also a borderline association with having greater than five partners. Having a very close relationship with a caregiver and remaining in foster care beyond age 18 years decreased STI risk. Moderation analysis revealed better model fit when coefficients were allowed to vary by gender versus a constrained model, but few significant differences in individual path coefficients were found between male and female-only models.

CONCLUSIONS

Interventions/policies that (1) address externalizing trauma sequelae; (2) promote close, stable substitute caregiver relationships; and (3) extend care to age 21 years have the potential to decrease STI risk in this population.

Career mentoring needs of youths in foster care: voices for change

PROBLEM

Adolescents with a history of foster care placement are more likely to become homeless, have mental illness, become parents too early in life, or become incarcerated within the juvenile justice/prison system. In addition, a low percentage of young adults, who formerly were in foster care, complete vocational training or higher education.

METHODS

This was a qualitative study, using focus group methodology. Four focus group sessions were conducted with youth living in foster care. The purpose was to obtain their perceptions about mentoring. Focus groups comprised six to eight youths per group and were guided by a semi-structured interview guide.

FINDINGS

A total of 27 youth in foster care participated in focus group interviews. Mean age was 16.4 (SD = 0.68) years. Youth participants were very knowledgeable about mentoring programs for at-risk youth, along with negative psychosocial outcomes experienced by former foster youth. However, they remarked that they are given few opportunities for career mentoring. The overall themes that emerged from narrative data were needing and finding authority figures, hooking up with a career mentor, and deserving the good life.

CONCLUSION

Career mentoring is an affordable and feasible intervention for child welfare agencies. This could lead to more motivated and prepared youth living in foster care for vocational training or higher education. Learning opportunities from a career mentor may be a lifeline for preventing negative psychosocial outcomes for foster youth, reward achievement goals, and improve overall quality of life in emerging adulthood.