Team decision-making service planning for children and adolescents at risk for placement instability: Fidelity and initial outcomes

Leathers, Sonya J.; Diamant-Wilson, Roni; Spielfogel, Jill E.; Annes, Lee; Thomas, Amy; Garrett-Wilson, Shirlyn

doi:10.1016/j.childyouth.2020.105705

Cited by 4 publications

(2 citation statements)

References 28 publications

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“…In this study, most children in services also received them consistently. A history of moves frequently triggers additional service planning (Leathers et al, 2021), and, for 56% of this sample, a move to specialized foster care, which supports a higher level of services. Although this study did not assess changes in mental health needs over time, at the time of the survey less than half of those with diagnoses currently had elevated behavior problems accompanied by functional impairment (28%).…”

Section: Discussionmentioning

confidence: 82%

“…Children with frequent moves have more tenuous connections with caregivers, which might result in less caregiver advocacy and involvement in services and more fragmented, less effective services. Alternatively, moves might trigger more comprehensive mental health services than typical among children in foster care and greater system oversight through administrative review processes (see Leathers et al, 2021).…”

Section: Provision Of Mental Health Services In Out-of-home Carementioning

confidence: 99%

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Mental health services and psychotropic medications provided to children at risk for placement instability in foster care

Leathers

Voort

Melka-Kaffer

2021

Developmental Child Welfare

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Children at risk for placement instability are subpopulation in out-of-home care with a critical need for enhanced mental health services, but little is known about the types and adequacy of the mental services they receive. This descriptive study sought to identify the types of mental health services and psychotropic medications provided to children with a risk for moves, foster parents’ perceptions of their adequacy, consistency of therapy services with evidence-based models, and racial and gender differences in service provision. Foster parents completed telephone surveys for a randomly selected sample of 144 children aged 8–14 in specialized or traditional family foster care with a history of placement moves or hospitalizations in a large state in the US. Over two-thirds of children were reported to have mental health diagnoses, with ADHD most frequent (52%). Most children with a diagnosis received psychotherapy (75%) and psychotropic medications (90%). The majority did not receive additional services. A quarter received therapy supporting use of behavioral interventions in foster homes, with 40% of foster parents reporting this was inadequate. Additionally, half reported inadequate initial training. No racial differences in services were reported. However, girls were more likely to receive therapy described as trauma-focused than boys (30.9% and 5.6%, respectively); more boys received treatment for anger (17%) and psychotropic medication (60%). Findings indicate that children at risk for multiple moves receive a high level of services, but questions are raised about the content and adequacy of these services. Evidence-based psychosocial interventions are needed to support positive outcomes and potentially reduce psychotropic medication use.

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Section: Discussionmentioning

confidence: 82%

Section: Provision Of Mental Health Services In Out-of-home Carementioning

confidence: 99%