Healthy Futures for Children in Foster Care: Translating Evidence into Practice

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DESCRIPTION (provided by applicant): Children and adolescents in foster care are a high-risk special needs population with an extremely high rate of developmental, behavioral, and mental health problems attributable to multiple childhood traumas. Although isolated evidence-based interventions have been found to improve comprehensive assessment and treatment of mental health problems, to improve parenting skills of foster and birth parents, and to enhance the critical visitation process, no community has translated these individual interventions into a comprehensive, coordinated, and sustainable program. The goal of Healthy Futures is to implement such a model program. Specific Aims: The specific aims are to 1) Develop and implement a training program for health professionals who care for the foster care population on using validated assessments, and on coaching parenting skills and visitation; 2) Implement validated assessments of family needs/strengths and child development/mental health problems; 3) Implement a promising coached visitation model for birth parents and their children, including a mental health intervention for extremely high risk families; 4) Implement evidence-based mental health treatments for Children in Foster Care, including Trauma-Focused Cognitive Behavioral Therapy (all ages) and Inter-Personal Psychotherapy (adolescents); 5) Implement evidence-based parenting programs for foster and birth parents; and, 6) Disseminate and diffuse findings via child welfare, public health, and professional organizations (including on a national website with toolkits for professionals). Methods: We will convene an oversight group to plan each stage of the integration, while a local agency will assess and measure each stage of this three-year process. We will train Visitation Specialists, child welfare caseworkers and administrators, and mental health and pediatric professionals on the use of a secure web- based system that will be used for inter-disciplinary communication. Children entering foster care and their parents will receive assessments that will be scored, analyzed and shared through this secure web-based system (COMET). Based on these assessments, professionals will triage families into an appropriate level of visitation (coached or supervised), mental health intervention (child parent psychotherapy) and/or parent skills training. We will also train professionals on coaching parents using the principles of a specific evidence-based parenting skills program (Incredible Years). Professionals will periodically re-assess how children and families are faring and use re-assessments to re-assign families to interventions. We will also increase the access to mental health care for children in foster care by offering on-site evidence-based mental health services. Organization: We have more than 20 years of experience locally and nationally in foster care, a rich history of collaboration, and a receptive community. PUBLIC HEALTH RELEVANCE: Children in foster care are known to have extremely poor long-term mental health outcomes, rooted in multiple adverse childhood experiences that include maltreatment, impaired parenting, exposure to domestic violence, and ongoing separation and loss. Sixty percent of children return to their parent, so that addressing parent and child emotional and behavioral health problems, building on a family's assets, and healing the parent- child relationship are crucial to preventing future maltreatment and improving long-term mental health outcomes. Through Healthy Futures, we will improve the training of professionals and integrate evidence-based parenting skills training, coached visitation and mental health interventions into the care of children in foster care and their families.