Mentoring, skills development associated with improved mental health in foster care children

Incorporating mentoring and group skill-building intervention programs for children in foster care may help improve mental health outcomes in this population, according to a report in the August issue of Archives of Pediatrics & Adolescent Medicine, one of the JAMA/Archives journals.

"Children who have been maltreated and placed in foster care are at risk for significant mental health problems including depression, posttraumatic stress, dissociation, social problems, suicidal behavior, attention-deficit/hyperactivity disorder and conduct disorders," according to background in the article. "Studies of Medicaid claims suggest that as many as 57 percent of youths in foster care meet criteria for a mental disorder."

Additional background information suggests that although children in foster care are in significant need of mental health services, the majority of these children do not receive the necessary treatment. Heather N. Taussig, Ph.D., and Sara E. Culhane, Ph.D., J.D., both of the University of Colorado School of Medicine in Aurora, Colo., studied 156 children ages 9 to 11 years in the Denver area who were maltreated and placed in foster care. Participants were randomly placed in a control group (77 children) or intervention group (79 children). Children and their caregivers were interviewed prior to randomization, immediately following the intervention and again six months later.

The study was conducted from July 2002 to January 2009 in two Colorado counties, and included a nine-month Fostering Healthy Futures (FHF) preventive intervention program. The FHF program consisted of two components: skill development groups and one-on-one mentoring by graduate students in social work. The skills group followed a standardized curriculum that combined traditional cognitive-behavioral skills group activities with process-oriented materials and included weekly activities that encouraged children to practice newly learned skills with their mentors. The curriculum worked to build skills in specific areas including emotion recognition, problem solving, anger management, healthy relationships, peer pressure and abuse prevention.

"After adjusting for covariates, intent-to-treat analyses demonstrated that the treatment group had fewer mental health problems on a multi-informant factor six months after the intervention," the authors write. Additionally, children in the treatment group reported fewer symptoms of dissociation six months after the intervention and also reported better quality of life immediately following the intervention. There was also a trend suggesting that youths in the treatment group were less likely to report symptoms of posttraumatic stress than those in the control group.

"Despite the cluster of risks associated with maltreatment, including poverty, high-risk neighborhoods, parental psychology, substance use and domestic violence, this study suggests that the Fostering Healthy Futures intervention promotes greater life satisfaction and better mental health functioning among maltreated youths placed in foster care," the authors write. "These are important findings given the dearth of evidence-based treatments for this vulnerable population."

(Arch Pediatr Adolesc Med. 2010;164[8]:739-746. Available pre-embargo to the media at www.jamamedia.org.)

Editor's Note: This study was supported by grants from the National Institute of Mental Health and also received funding from the Kempe Foundation, Pioneer Fund, Daniels Fund and Children's Hospital Research Institute. Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.