“Fostering” Effective Foster Parent Training Programs: Adaptations of Parent-Child Interaction Therapy for the Child Welfare Setting

Foster parents face considerable challenges in caring for children in the child welfare system, many of whom have significant behavioral difficulties (Stahmer et al., 2005). Foster parents often lack the training and support needed to manage these externalizing behaviors, which contribute to parenting stress and are highly predictive of placement breakdowns (Baum, Crase, & Crase, 2001; James, 2004). Although child welfare agencies provide foster parents with pre-service training experiences, they often lack the capacity and financial resources to implement gold standard, evidence-based interventions that address child behavior difficulties. Parent-Child Interaction Therapy (PCIT) has been well-established as an empirically supported treatment for disruptive behaviors, yet standard delivery of PCIT to children in the foster care system is often impractical due to time, financial, childcare, and personnel constraints. Adaptations of PCIT for the foster care setting may remove some of these barriers to treatment. These adaptations have typically retained the parent-coaching principles inherent to PCIT, but replaced the traditional 12to 20-week format with a shorter, less intensive treatment regimen in order to maintain feasibility within the child welfare context. Preliminary findings from studies using a twoor three-day intensive parent workshop and follow-up phone consultations suggest effectiveness of PCIT adaptations in reducing externalizing behaviors in foster children and maintaining behavioral improvements several months after the end of treatment. Background The role of foster parents in the child welfare system is a multi-faceted one; foster parents are responsible for meeting the physical, social-emotional, educational, and medical needs of the children in their care. These children often have a history of maltreatment or neglect that put them at risk for developing externalizing symptoms and, in many cases, psychological disorders (Oswald, Heil, & Goldbeck, 2010). Data from a national survey of 2,813 foster children under the age of 6 indicated conduct problems to be the most common area of difficulty, more so than cognitive, communication, social, or adaptive difficulties (Stahmer et al., 2005). Previous studies have shown that disruptive behaviors are associated with adverse outcomes for foster children, including greater placement instability (Baum, Crase, & Crase, 2001; James, 2004) and lower rates of reunification with biological parents (Landsverk, Davis, Ganger, Newton, & Johnson, 1996). Many foster parents feel ill-equipped to handle severe conduct problems, which ultimately contribute to parenting stress and caregiver burden (McCarthy, Janeway, & Geddes, 2003). In fact, foster parents have identified the management of challenging behavior as one of their greatest training needs (Hebert & Kulkin, 2017) and cited the inability to handle a foster child’s behavior as a major consideration for ending a placement (Brown & Bednar, 2006). Thus, foster parents require training in effective management of maladaptive child behavior. By providing parenting interventions that address child behavior difficulties, child welfare systems can set foster parents up for greater success, thereby increasing placement stability and foster parent retention (Rork & McNeil, 2011). Problem Statement Although foster parents receive mandatory pre-service training, the content of these programs vary widely by state and often do not provide training in parenting skills that specifically target