Resiliency And Its Use In Foster Care

One of the greatest challenges facing agencies that provide services to high-risk children and families in community settings is the need to have a well defined Model of Care that is understood and implemented by all involved in service provision. The need for a well defined Model of Care that is supported by research to demonstrate a positive impact on the life outcomes of the families and children we serve becomes increasingly important as the effects of both child welfare reform and mental health reform demand that foster care and community services serve clients who may have otherwise been served in a more intensive residential treatment setting. KidsPeace Foster Care and Community Programs (FCCP), www.fostercare.com, has embraced a Model of Care that is based on Resiliency Theory.

Resiliency Theory arose from the study of the characteristics and life histories of those high-risk individuals who experienced adversity yet managed to avoid poor life outcomes such as: substance abuse; dropping out of school; social and relational problems; mental/emotional problems; problems with law enforcement; and vocational instability. The studies contributing to the theory of resilience refer to various cross-cultural lifespan developmental studies on the lives of children who were born into families and environments that provided serious risk and adversity to the healthy development of the child. Studies include: children born to parents who suffered from mental illness and/or severe chronic substance abuse problems; children raised in homes that subject them to severe neglect and /or abuse; and children raised in environments with severe poverty, crime and instability. Surprisingly, the findings from these long-term studies were that at least 50% - and often closer to 70% - of youth growing up in these adverse conditions developed the life skills necessary to overcome the odds and lead successful lives.

The greatest benefit derived from this research on children who have overcome significant adversity and have thrived in spite of it, is a list of common characteristics found in the lives of these individuals. The list of common characteristics known as protective factors has become a focus in the KidsPeace Model of Care as these characteristics appear to counterbalance the adverse effects that risk factors have on a developing child or on any individual struggling with excessive levels of stress brought on by too much risk/adversity.

The list of factors that increase the likelihood of poor life outcomes (risk factors) and the list of factors shown to increase the likelihood of positive life outcomes (protective factors) fall into similar categories. These categories, which include a variety of both risk and protective factors, include: characteristics the child is born with; various characteristics of the childs home that effect the stability of the environment; the mental and emotional health of the childs parents and or primary care givers; the strength of healthy relationships the child has developed with parents, other supportive adults and positive peers; the level of the childs competencies in areas such as ability to problem solve, ability to read and ability to interact effectively in social situations; and, finally, the childs perception of his/her abilities, which contributes to having positive and realistic goals and expectations for the future.

All children, adolescents and families who are referred to KidsPeace FCCP come to us with a great number of risk factors and various levels of protective factors upon which we can build. The encouraging aspect of resiliency research is that, while we may not have much control over reducing the number of risk factors with which an individual comes to us (past trauma has already occurred, the childs parents are no longer involved with the child, etc.), it is clear that the life problems resulting from any level of risk can be overcome by increasing the number of protective factors. Our work to develop a model of care that is focused on enhancing protective factors through our services began with determining which protective factors we could influence. Like risk, some protective factors are related to inborn characteristics, or related to past development (secure mother-infant attachment) or related to areas beyond the scope of our services (parent education levels, etc). From the list of protective factors that we can influence began the process of determining the role that all of us working in KidsPeace FCCP can play to fully implement a model based on enhancing resiliency.

The KidsPeace Clinical Practice Committee has been charged with moving forward with Model implementation. From this committee, focus group discussions have been conducted to gather input from the various states and from the different community services provided by KidsPeace on implementation ideas and considerations. The results of these discussions, as well as work by Dr. J. Eric Vance, M.D., Treatment Elements in Building Resiliency, have resulted in a comprehensive list of strategies to be carried out to assure fidelity to our model. While the detail of the strategies we have begun to implement is beyond the scope of this article, the general areas of our program focus include: how we recruit and select staff and foster parents to assure good fit to a Resiliency model; reviewing all roles of staff and foster parents to determine the skills they will need to effectively support a resiliency model, and then developing systems for training, evaluating and providing the on-going support and tools needed to enhance their development; revising assessment and treatment planning to improve focus on protective factor enhancement; developing materials to assist all consumers in having a clear understanding of the focus of our programs; and developing measures and quality assurance reports to assist in monitoring our effectiveness in implementing our model, and, most importantly, to monitor the effect our model is having on the lives of those whom we serve.

While all of the programs at KidsPeace, www.kidspeace.org, have already realized the effects of child welfare and mental health reform, our community-based services have realized these effects by increased demands to serve clients with greater acuity and needs. We believe our best response to this is to do all we can to assure that we have fully implemented a model of care that has demonstrated effectiveness with the clients and families we have the privilege to serve.|

Psychosocial Risk And Protective Factors

Early Developmental - Psychosocial Risk
}Premature birth or complications
}Fetal drug/alcohol exposure
}Difficult temperament
}Long-term absence of caregiver in infancy
}Poor infant attachment to mother
}Shy temperament
}Siblings within two (2) years of child
}Developmental delays
}Other adults or older children help with childcare

Early Developmental - Protective Factors
}Easy temperament
}Positive/secure attachment to mother
}First born
}Independence as toddler

Childhood Disorders - Psychosocial Risk
}Repeated aggression
}Delinquency
}Substance abuse
}Chronic medical disorder
}Behavioral or emotional problems
}Neurological impairment
}Low IQ100

Parental Disorders - Psychosocial Risk
}Parent with substance abuse
}Parent with mental disorder
}Parent with criminality

Child Social Skills - Protective Factors
}Gets along with other children
}Gets along with adults outside family
}Likable child
}Sense of humor
}Empathy

Experiential - Psychosocial Risk
}Witness to extreme conflict/violence
}Removal of child from home
}Substantiated neglect
}Physical abuse
}Sexual abuse
}Negative relationship with parent(s)

Extra-Familial Social Support - Protective Factors
}Adult mentors outside
}Support for the child from someone at school
}Support for the child from peers/friends
}Involvement in church or community groups

Social Drift - Psychosocial Risk
}Academic failure or dropout
}Negative peer group
}Teen pregnancy, if female

Outlooks and Attitudes - Protective Factors
}Perception that parent(s) care
}Perception of skills and competencies
}Sense of internal locus of control
}Positive and realistic exceptions for future
}Use of inner faith or prayer

Tom Culver has a Masters degree in Special Education from North Carolina Central University. He has more than 25 years of experience in working with at-risk children and adolescents in both classroom and residential settings. His work for the past 15 years has been primarily focused on the provision of Treatment Foster Care and Community Based services. Tom has been the State Manager for KidsPeace in North Carolina since 2000.