Current status and evidence base of training for foster and treatment foster parents

Abstract

Nearly every state in the nation requires training for foster parents and treatment foster parents. However, very little is known about the effectiveness of this required training. The current paper provides a comprehensive research synthesis on training of caregivers for youth in these out-of-home settings. The review shows potentially promising directions; however, there is little empirical support for the most widely-used curricula of foster parent training. Scattered research on a wide variety of training protocols and approaches provides little empirical evidence for any specific program. Additionally, research on treatment foster care shows promising and positive results, but has paid little attention to requirements or variations in training for treatment foster parents. Evidence-based programs from other areas (e.g., treatment foster care, parent training) have begun to be tested with foster parents with positive results. The article includes highlights of promising current directions and a discussion of challenges and possibilities for advancing the evidence base on this key topic.

Introduction

Child welfare services in the United States serve over 500,000 youth in out-of-home care at any point in time (AFCARS, 2005). The majority of these youth are served via some form of foster care. Youth who enter foster care are likely to have experienced some form of child abuse or neglect and/or other traumatic events (e.g., domestic violence, impaired caregiver, traumatic loss) (Hazen et al., 2004, Henry et al., 1991). It is well known that youth in foster care display a wide range and depth of behavioral, developmental, social, and educational problems (e.g., Farmer et al., 2001, Clausen et al., 1998, Sawyer and Dubowitz, 1994, Smucker et al., 1996).

Given the severity of foster children's trauma histories and resulting difficulties, it seems apparent that individuals who are becoming foster parents should receive solid training in the range of domains that will be necessary to successfully ‘parent’ these children during the time they reside in foster care. Such a position has a long history of wide endorsement and support (Christensen and Fine, 1979, Galaway et al., 1995, Ruff et al., 1990, Runyan and Fullerton, 1981). A recent study using data from Caring for Children in Child Welfare, a supplemental study to the National Survey of Child and Adolescent Well-being (NSCAW) designed to evaluate the impact of child welfare, Medicaid, state Child Health Insurance Plans (CHIP) programs and policies on service use indicates that there is tremendous variation in the training that foster parents receive (Hurlburt, Leslie, Barth, & Landsverk, in press).

In a recent companion article (Barth et al., 2005), we reviewed the evidence base for parent-training interventions that are currently being used or have potential to be used with families who come into contact with child welfare agencies because of allegations of abuse/neglect. This review identified a range of parent training approaches with varying levels of ‘evidence’ (Chambless and Ollendick, 2001, Hoagwood, 2003, Kratochwill and Stoiber, 2002). This review also pointed out the strong disjuncture between training for ‘biological’ parents and ‘substitute’ parents. Few of the identified approaches in the parent-training review had any evidence base with foster or substitute parents. Only in the last 3 years have any of the identified approaches (i.e., Parent–Child Interaction Therapy, The Incredible Years) been the subject of empirical investigation with a focus on foster parents (Linares et al., 2006, McNeil et al., 2005). Aside from these recent investigations, a search of training programs for foster parents identified a distinct set of training programs developed specifically for foster parents. Therefore, the current review and evaluation examines training specifically for foster parents.