Multiple Foster Care Placements

by Edie De Vilbiss

She sat in my office over tea and we talked about the things she could do to become more spiritually centered. The conversation drifted to the reasons that she is challenged to trust anyone. A child of a woman addicted to drugs, she was removed by DCFS at three years old. She had the same foster family until she was in fifth grade. With a roof over her head and a deep fear of the unknown, she didn’t say anything about the daily beatings or the verbal abuse for many years. Once she did tell someone, she was removed from that placement. The next several years saw multiple placements. She is not sure how many, more than twelve, she can name them. But, she knows there are more.[1]

“Is there anything you would like to see change about how DCFS (Department of Child and Family Services) handles young people?”

A brief pause, “I want them to be on the kid’s side. I got treated like I was bad or wrong every time I had to be moved. Why couldn’t they understand what was going on with me?”

Indeed. Why is it so hard for adults to understand that outrageous behavior always has a reason? Why is it that when we go into a field to help people, we end up hurting them too? What she’s seeking is called trauma-informed care.  Research is that when a child has been traumatized there are specific behaviors that are difficult to engage with which result.  Rage or self-harm, outrageous language, and other unusual behaviors are common.  When caring adults are trained to respond appropriately to these behaviors, the child can learn to respond to life more appropriately.  When our reaction to the outrageous and unacceptable behavior is rejecting and condemning it increases the child’s negative self-image.  The behaviors not only continue, they get worse.  This is how we, who care for children, make their lives even more difficult.

Data on how often multiple placements are occurring in Louisiana is not readily available. However, the anecdotal reports of the youth we serve indicate that this is an ongoing issue.  We are not the first state to need to address this issue.

In an article on the HHS public access website, Rubin et al. found the following:

The current study provides the most compelling evidence to date that placement stability, independent of a child’s problems at entry into care, can influence well-being for children in out-of-home care. Regardless of a child’s baseline risk for instability in this study, those children who failed to achieve placement stability were estimated to have a 36%−63% increased risk of behavioral problems compared with children who achieved any stability in foster care. The impact of placement stability on behavioral problems was not trivial, as even among the children who carried a low risk for placement instability, 1 in 5 children (20%) failed to achieve any stability in the first 18 months of foster care.[2]

When a child experiences multiple failed placements his or her ability to adapt behavior is not properly developed. Repeated removal likely increases the child’s self-identity as a person who is unworthy of love and nurture. When a caseworker is overwhelmed and dismayed when removing a child, the child does not perceive it is the caseworker’s issue.  The child internalizes a negative self-image.

The merry go round of removing a child and placing them elsewhere has a negative impact on the caseworker, the foster family and the budget as well.

The caseworker is likely to experience the sudden removal of a child for unacceptable behavior as a failure on his or her part. Sometimes the caseworker who responds is an on-call worker with no history with the child. Being new to the child and the case, they might harbor a sense that the previous worker failed in their work. In addition, resources are limited and take time to find. The pressure to keep up with the work load and locate non-existent resource taxes the ability to attend to the well-being of the child’s self image.

Foster-parenting a child is challenging. Other people’s children come to a foster family with a history, unique behavior patterns, and a personality in development. Attending to the physical needs of a child is demanding in itself. Adapting to established behavior requires close observation and adaptation. A “failed” placement does not rest only on the child and the case worker, the foster parent has a sense of inadequacy also.

From a budgetary stance, child removal and seeking a new placement is an expensive endeavor. Immediate costs are high.

  • Often an emergency removal occurs after hours, and there is the expense of overtime.
  • Locating and training foster care families is expensive.
  • Emergency lodging in a hotel room has costs associated with it.

The long term costs of multiple foster care placements may be incalculable.

  • The lost production of the child as an employee when he or she reaches adulthood. .
  • Increased risk of long term incarceration because of unmanaged anger and violence.
  • The medical costs over a lifetime for children with multiple Adverse Childhood Experiences[3] are born by our society.

The issue of multiple foster care placements must be addressed.  New Jersey is tackling this issue. The “key strategies” they identified are:

  • Placing children with relatives or family members when possible
  • Placement matching to make optimal first placements for children
  • Improving services to children in care
  • Programs that support foster caregivers to better address children’s needs
  • Caseworker retention
  • Staff training[4]

The first strategy is addressed in the Louisiana DCFS Policy 4-807. The first consideration is to find a relative who is an appropriate placement.  

Louisiana also has placement specialists who are trained to match a young person with a foster family.

Staff retention is often an issue when people are working with troubled children. Empowering the worker may prove to be a positive avenue for addressing this.

Training in trauma-informed care across the systems, from administrators in the Department of Child and Family Services to Child Placement Specialists, Case workers, and most assuredly to foster parents is a positive step in alleviating the harm from our current system.

Improving services to children in care; programs that support foster caregivers to better address children’s needs, and staff training could all be addressed by rolling out a program of TBRI® (Trust Based Relational Intervention) training for both case workers and foster parents.

TBRI® is an attachment-based, trauma-informed intervention that is designed to meet the complex needs of vulnerable children. TBRI® uses Empowering Principles to address physical needs, Connecting Principles for attachment needs, and Correcting Principles to disarm fear-based behaviors. While the intervention is based on years of attachment, sensory processing, and neuroscience research, the heartbeat of TBRI® is connection.[5]

The principles of TBRI® are practical and simple. Addressing the basic human needs of the young people in our care makes sense.  For caseworkers and foster parents to be trained in trauma informed care principles, with information about how to address the issues will empower positive outcomes. Training together will help form relationships between the caseworkers and foster parents. Common training will engender a common language based on the understanding of life challenges for the young people in our care.

Training is expensive and time-consuming. However, the expenditure to train people appropriately will alleviate much of the long term costs of the foster care merry go round.  We have a moral and legal responsibility to offer the best we can for the youth we serve. When the state removes a child, the state must provide better than the child had. Multiple placements fail this endeavor.


[1] The study referenced below identified a stable placement as one established within 45 days of removal, and instability as not meeting that mark. Her first placement was stable; she was there for years. Once she was removed from that placement, she was unable to re-establish stability with a different caregiver. 

[2] Rubin, David M., MD MSCE, O’Reilly, Amanda, MPH, Luan, Xianqun, MS, Localio, A. Russell, JD MS. The Impact of Placement Stability on Behavioral Well-Being  for Children in Foster Care. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2693406/ accessed 07/24/2019.

[3] https://www.cdc.gov/violenceprevention/childabuseandneglect/acestudy/journal.html

[4] How can we improve placement stability for children in foster care? Casey Family Programs. 10/03/2018. https://www.casey.org/strategies-improve-placement-stability/ accessed  07/25/2019.

[5] https://child.tcu.edu/about-us/tbri/#sthash.aGde0fKv.dpbs

Top Ten Issues in our Society

    1.  Child welfare systems: Chronic underfunding, overwhelming caseloads and a crying need for services  interfere with our ability to really help those who desperately need intervention and support.  Our system damages the very families it tries to help.
    2.  Addiction recovery: Much of the excessive imprisonment in our country is related to addictions to alcohol and other drugs. Our punitive system doesn’t fund the way out of this cycle.  Do we want it to continue? Or do we deeply believe that some people who are addicted to substances don’t really deserve to be helped?
    3. Homelessness–affordable housing:  When we have many citizens living on the streets, it is an indication of a lack of care in our world.  There are as many reasons for homelessness as there are people who are suffering.  Sometimes the people who are without a roof over their head are working. However, wages can be very low, and inexpensive housing is rare.
    4. Job readiness training:  Many times people do not learn basic job skills in their formal education. Without a caring person to teach the basics, young people falter and have difficulty holding a job.  A cycle of unemployment, disenchantment, and negative behavior will ensue.  We have to find a way for people caught in that negative spiral to find a way out.
    5. Healthcare access: Our current system has made some impact. However, a large segment of people cannot afford to pay the premiums for the insurances that are available. They have no recourse for consistent health care.
    6. Mental health recovery: There are many things that can help people who experience life in a way that does not serve them.  Depression, bipolar disorder, addictions, and schizophrenia all are treatable conditions. Access to help is lacking.  We need to let go of the stigma that surrounds mental health issues and create ways to surround people with the healing power of love.
    7. Immigration issues: How can we address the practical negative impact of people crossing borders and working without documentation?  The impact is not just on our economy, it is that these people often work with none of the protection of legal safety practices.  They are vulnerable to unscrupulous employers who take advantage of the fear associated with their legal status.  This issue is negative all the way around.  The narrative that undocumented aliens must be sent back to the home country is too simplistic.
    8. Educational deficits:  There are schools that are failing to teach people to read and compute basic math.  What can we do to support the school and the students to make absolutely certain that each child becomes literate to the basic skills of survival in the 21st century?
    9. Drug dealing-using culture:  Criminalization of drugs has created a culture of predatory dealers, people wrapped up in addiction and a violent response to life.  How can we enter in and address the factors that contribute to this ongoing issues.
    10. Massive incarceration of people.  Our system of mandatory sentencing, get tough on crime, and zero tolerance coupled with the “War on Drugs” have increased the number of prisoners in our country.  The result is massive expenditure on imprisonment, cutting funding on recovery issues, cutting other programs.  Not to mention that we have put a large portion of a generation of parents behind bars. The price paid by the children and families and communities is tremendous.

It’s disheartening to list all of these huge, interconnected problems. Ugh. Closing my eyes and pretending that these issues have nothing to do with me is so tempting. It would be easy to think that my most pressing concern is the interest rate on my Visa. What I experience day to day in working with the population whom I serve is that these issues are present and have a tremendous impact on the lives of real people in our communities. And I know that what touches your life touches my life. We are all connected.

These issues can be impacted by policy decisions in the government offices. However, the government cannot mandate the heart to love people who experience these challenges. The government cannot meet the soulful needs for respect and hope and the belief that things can change. The greatest need we have in our communities is for people who are not experiencing these issues to stop looking down on people who need help.

What do you think? Are these the biggest domestic problems we face? What direction do you think we need to take?

The Roots of Child Welfare Issues

THE ISSUES

In order to know who to talk to and what to look for, I have begun reading more about the issues. The Child Welfare system, Foster Care, and other state agencies and efforts are in response to an even more awful reality. The roots of the problems with families are buried deeply in poverty and violence. Political oppression, lack of opportunity, sex trade, the drug culture and communities blanketed with hopelessness all play a part in this weight pulling down our communities.

HOPE
Yet, there is hope!
“A Path Appears: Transforming Lives, Creating Opportunity” is written by Nicholos D. Kristof and Sheryl WuDunn.

This book details non-profit efforts in agencies throughout the world. But, it is not just about a feel good, let’s see what is possible. The authors also detail efforts to measure the impact that the projects have on the future of the people served. One project is led by an MIT professor, Dr. Esther Duflo. She experiments on different initiatives and helps us to know what actually helps (P. 35-41). The danger in feel good projects is that they can cost a lot of money and have limited effect on actually helping people.

Overall the book is optimistic that our drive to make a difference in the lives of others is a powerful force for good in our world. The problems of our society are challenging. Yet, the human desire to make a difference for others is a spark of hope in this world.

Questioning the child welfare system

I am beginning this blog in order to open a conversation.  I am saddened by the damage that is inflicted upon the victims of child abuse and neglect by the child welfare system which is designed to rescue them.  I do not believe that there is malicious intention involved, simply bureaucratic quagmires.  My hope is that this conversation will lead to a plan and to action.

I have lived through the cultural shift which has occurred around cigarette smoking. When I was a child, many movie stars and television actors smoked on camera.  It was completely acceptable to smoke at one’s desk, in a restaurant, and on an airplane.  That has dramatically shifted in the last thirty years.  This powerfully significant change came about because people started speaking up and pointing out the negative effects of this behavior.  No one person is responsible for this shift. But, it began somewhere and others joined in. Maybe it began in several locations.  Perhaps I will find that our voices are joining others in crying out to do something different for our children.

My work as a Chaplain for a children’s home invites me to really hear a child’s story from their own point of view.  Listening to the pain that they experience through multiple placements, continual adjustment to new environments, rejection from family after family and always a subtext of longing for love and acceptance from their own biological family makes me acutely aware of the failures of our system.   We must rescue these children from abusive and neglectful homes.  But, there has to be a way to do it without having the child rejected over and over again.  Surely we can figure this out!

But, I am not inside that system. I don’t know what barriers it is up against. I don’t know how to fix it.

Maybe you don’t know what I am talking about.

When a child enters into the foster care system, a placement in a foster care home is secured.  This can be challenging because there is often a shortage of homes.  A  child who has been severely abused or neglected will be prone to significant behavior problems.  And, they are not easy problems to manage.  Bed-wetting, cursing, violent outbursts, stealing, and self harming behaviors are not uncommon.  So, care is taken to find the best home possible.

Think of yourself.  Out of the generosity of your heart you have opened your home to a foster child. In comes this child who has behavior problems.  You believe that you can deal with anything.  Yet, this child does something so awful to your child that you realize you would be harming your own child if you keep this one.  So, you call your social worker and they come and pick up the child.  You feel like a failure. It is devastating.  But the child receives an internal message that they are somehow flawed.  This child has been rejected again.

This happens over and over again to some children.  Now, I believe that there are children who find foster families and have a long-term healthy and loving relationship with them.  Or, their parents are able to overcome whatever their barrier had been and receive the child back.  (Which is what we all want!) Frankly, I don’t meet the children who have a successful foster care placement.

The intentions of the agency which has responsibility for the child are in the right direction.  A desire to protect and nurture the child drives the work.  Then intentions of the family which opens its home to foster care are in the right direction.  A desire to be a safe haven for children who need a family.  The intention of the child is in the right direction. A desire to be loved and accepted, but without the skills to behave in an acceptable manner.  If everyone involved is leaning into the right direction, how is it possible that we get it so very wrong for individual children?