After Care Services Families Reuniting After Foster Care

After. Care Services: Families Reuniting After Foster Care Placement Felecia Terry Dunson, Psy. D. , Wendy Greggs, BSW, CASAC, LEND Fellows Jenean Castillo, Ph. D, Wendy Breitner, Ph. D, Beth Bryant, Ph. D, LEND Mentors Leadership In Neurodevelopmental Disabilities (LEND) at Westchester Institute for Human Development (WIHD) and New York Medical College Background Methods One of the biggest challenges for the Child Welfare System is sustaining successful reunification of families who continue to have complex and chronic needs after children are discharged from foster care placement. Twenty-eight percent of children admitted into care reentered over the next ten years (Wulczyn. 2004). Of those returning to care, almost 70% reentered within a year (Wulczyn. 2004). Given the complexity of family functioning and the multiple factors that must be addressed to facilitate family reunification, post reunification services are now considered essential (Dougherty, 2004). According to Dougherty (2004), services shown to be effective to sustain reunification have a clinical services component to provide individual, family, substance abuse, and domestic violence treatment. Additionally, financial support (job training, health care, housing assistance), and support networks (day care, respite, links to community based services, wrap around services) are necessary to provide comprehensive support to these families (Dougherty, 2004). Similarly, Dawson and Berry (2002) suggested effective intervention strategies, such as in home services, early intervention, concrete services, behavioral parent training, family focused approaches, strengthening support and community networks. Study Design A program evaluation of WIHD After. Care families utilizing data collected from self-report measures and demographic forms at 6 month intervals. To answer this need in Westchester County, the After. Care program was developed at the Westchester Institute for Human Development (WIHD). The After. Care program is a two year post discharge, community based program using a family empowerment model designed to address the significant needs of reuniting families while promoting the Child Welfare goals of safety, permanency and wellbeing. The goal of the program is to transition families to community-based services as appropriate and to monitor families two years post discharge using informal as well as standardized measures. The purpose of this study is to demonstrate preliminary findings about the implementation and early outcomes of the After. Care program. Data Form PSI CBCL Demographics Parent-Child Dysfunctional Interactions Internalizing Behaviors Family Background Difficult Child Externalizing Behaviors Family’s Current Services Parent Distress Problem Behaviors Total Stress Clinical Scales Subjects and Setting Twenty families for this pilot study were referred intra-agency by clinicians at WIHD Family Program. Participants included families who were transitioning from WIHD’s parenting program to reunification after foster care placement between July 2005 and July 2006. Data Analysis Descriptive and correlational statistics were conducted for parental and child demographics, parent assessment data, and child assessment data. Results Parents indicated an average of 42 years old. Families were composed of an average of 2. 2 children. 70% of the parents were African American, while 25% were White and 5% were Hispanic. There were more female head of household (70%). 95% of families were reported as receiving some type of supportive services. The 43 children followed by the After. Care program were an average of 8. 0 years old, ranging from 1 to 15 years old. 72% of the children were identified as African American, while 22% were Biracial and 5% were White. Contrary to the parent population, 63% of the children were males. Many of the children were reportedly in individual therapy (66%), Special education (38%), and recreation therapy (52%). There was a significant relationship between parent stress, child behavior and mental health treatment. Specifically, there was a strong relationship between reported internalizing (p=0. 865), externalizing (p=0. 896) and total child problem behaviors (p=0. 887); and overall parenting stress. Similarly, there was a significant relationship between parents’ reported personal distress and child externalizing (p=0. 675) and total (p=0. 709) problem behaviors. A significant negative relationship was found for parents involved in individual therapy (p=0. 631) and reported level of parent-child dysfunctional interactions. Additionally, parents who reported having a difficult child also participated in family therapy services at a significant level (p=0. 527). There were no significant relationships found between parent stress and substance abuse treatment, child behavior and parent substance abuse treatment, or child behavior and parent mental health treatment. Transitioning Children Out of Foster Care Children in Foster Care National Standard National Trends (2003) Westchester County (2005) Exiting After 12 months 76. 2% 72. 1% 45. 8% Average Length of Stay 15 months 31. 2 months 35. 6 months Re-entering Foster Care within 12 months 8. 6% 9. 8% 14% Aftercare (2005 -2006) --4. 6% Discussion Objectives 1. 2. 3. 4. 5. 6. To describe the characteristics of parents and children participating in the initial year of the After. Care Program. To examine the relationship between parental stress and child problem behaviors. To examine the relationship between parental stress and parent substance abuse. To examine the relationship between parental stress and parental mental health treatment. To examine the relationship between child behaviors and parent substance abuse. To examine the relationship between child behaviors and parent mental health treatment. Although national standards aim to lower child re-entry into the foster care system to 8. 6% or below, Westchester County re-entry rates were as high as 14% in 2005. However only 4% of the families in the After. Care program were disrupted in the first 12 months after reunification (1 of 20 families). This indicates that After. Care services have improved the successful reunification of families after foster care. 17 of the 20 parents completed a PSI (in reference to their parenting stress) and a CBCL (reporting on their child’s problem behaviors). None of the 17 reported high levels of personal distress. However, 24% reported high levels of dysfunctional parent-child interactions, 18% reported having a difficult child, and 5% reported high levels of overall parental stress. 38% of the children were rated by their parents as having internalizing difficulties. 50% reportedly had externalizing difficulties. 38% of children were rated by their parents as exhibiting overall problem behaviors. Consistent with the literature, families participating in the Aftercare program presented with multiple factors such as financial stress, parent substance abuse, and parent mental illness that impact the ability to safely function as a family. Demographic date indicated that many of the families in the After. Care program were participating in multiple supportive services to address these factors. Efforts should continue to toward ensuring that all families are receiving the clinical and case management services that they need when transitioning out of foster care. Data indicated specific factors that impact parent report of parenting stress and personal stress. Overall parenting stress and parent distress was specifically related to child problem behavior. Additionally parents who were reportedly involved in individual therapy were less likely to report difficult interactions with their children. However families in family therapy were more likely to report difficult child behaviors. These results emphasize the need for clinically based