Factors Associated with Time to Therapy Referral and Length of Placement of Children in Foster Care

Abstract

ABSTRACT Objective: This article explores the association between therapy referral and length of time in care in a clinical foster care population as well as the relationship between these variables and the child's behavioral characteristics. Method: Children referred for therapy at four different foster care offices of a large foster care agency in New York City were assessed on these variables. Information on behavioral characteristics was obtained from the child's foster parent, the child's teacher and the child's therapist at the beginning of therapy and at regular intervals thereafter. Results: A third of the children were discharged from care at some point during their therapy. The longer it took for a child to be referred to therapy the longer the child spent in therapy and the longer it took for the child to be discharged from care. Children that took longer to be referred for therapy were rated by teachers as presenting more somatization difficulties. Foster parents, teachers and therapists rated children that were eventually discharged from care exhibiting fewer behavior problems after 6 months of therapy. Conclusions: The importance of a timely referral to therapy for children placed in foster care is pointed out. It is argued that the therapist's involvement in the case could be an important catalyst with respect to necessary actions by the family court and other players in the foster care system which would expedite the child's return home or to other permanent caregiver. Findings underscore the importance of caseworker training in psychiatric risk assessment and mental health screening at admission to foster care.