Preliminary evaluation of A Home Within psychotherapy with clients with a history of foster care

Abstract

Children and youth in foster care often experience numerous traumas both in and out of the child welfare system, and as a result many need access to mental health support. Researchers report low utilization rates of mental health services among individuals who have lived in foster care, often attributed to barriers to both access and receipt of consistent mental healthcare. A Home Within is a national nonprofit organization that aims to reduce these barriers to mental healthcare for those with past or current involvement in foster care by facilitating their access to consistent pro bono psychotherapy for “as long as it takes.” Eighty-five A Home Within therapists completed interviews with trained research assistants at two time points. Interviews included 44 closed- and open-ended questions regarding therapist demographics, client demographics, clients’ presenting concerns and mental health status, and treatment description. Repeated measures analysis of variance (ANOVA) models showed significant decreases in all five outcomes from baseline to termination of treatment. The associated effect sizes for length of time in treatment were medium to large for depression, anxiety, conduct disorder, and perpetrating aggression/violence. There was a small to medium associated effect size for peer relationship problems and the effect of time was not significant for cohabitation relationship problems. Findings provide preliminary support for continued development and evaluation of mental health services facilitated through A Home Within among clients currently or previously in foster care.