This article was originally published in The Notebook. In August 2020, The Notebook became Chalkbeat Philadelphia.
It’s a scene that happens all too often to children in Philadelphia – and other cities as well.
It’s late at night or early in the morning, and the home once again erupts in violence. Perhaps it involves the child, perhaps he or she is a bystander.
Police are called, and the child is whisked away to safety. But only to physical safety.
Within weeks, the child may be placed in one of about 3,200 foster homes in the city, where foster parents struggle with a challenge that many aren’t prepared for.
Although agencies dealing with foster care have in recent years stepped up their efforts to prepare parents, “the basic training foster families get is not enough,” says Kamilah Jackson, deputy chief medical officer for child and adolescent services at Community Behavioral Health (CBH) and the Department of Behavioral Health and Intellectual Disability Services in Philadelphia.
“I’ve had way too many experiences dealing with foster parents when they’re like a deer in the headlights,” says Philip V. Scribano, director of Safe Place: The Center for Child Protection & Health at Children’s Hospital of Philadelphia and director of the Child Abuse Pediatrics Fellowship Program at the hospital.
The problem starts well before the child is placed in foster care. The events that made this step necessary are almost by definition traumatic, ranging from abuse or neglect to a parent’s inability to cope with the stresses of child-rearing.
“Children in foster care are more likely than their peers to have chronic illness, mental health concerns, and developmental challenges,” according to a 2015 article in the journal Current Problems in Pediatric and Adolescent Health Care.
And even if the parting is peaceful, simply placing the child in foster care compounds the trauma.
“The very act of taking a child from a family is a trauma,” says Tracey Feild, director of the Annie E. Casey Foundation’s Child Welfare and Strategy Group.
“Even if the family is abusive, they’re still the child’s family. It’s like the child has done something wrong. It’s almost like they’re being punished.”
Physicians and social workers dealing with the foster care system say that one basic problem can be unrealistic expectations by prospective foster parents.
“It’s a nice notion to say, ‘I want to be a foster parent,’” says Staci Boyd, operations director of the Children and Youth Division of the Philadelphia Department of Human Services (DHS).
“But these children are not going to come into your home and act like the perfect child after you’ve taken [them] from the only environment they have known.
“They’re not glad. Their brain does not process ‘glad.’ It’s ‘My mom may have been high, drunk, or whatever, but I was with my mom.’
“There might be a honeymoon for 30 days,” but on the 31st day, things can get crazy, she said.
Training for foster parents
The philosophy of trauma-informed education is to replace the question of “what’s wrong with you?” with “what happened to you?”
In terms of foster parenting, Scribano and other professionals say, one key is realizing that children with serious trauma may display behaviors that one might not expect.
“[Foster] parents may take a more punitive approach if they haven’t been trained,” he says. “More authoritarian. And that can create more problems with the child.
“When the kid is being destructive, you have to manage your own emotions.”
Robbin Pineda, who with her husband, Ernesto, has taken in about 40 foster children over the years, said understanding the impact of trauma is crucial.
Traumatized children who are under stress “revert back to old behaviors, and we understand that.”
To read about the experiences of foster parents Ernesto and Robbin Pineda, click here.
Boyd of DHS says that only in the last two or three years have foster care providers started providing intensive trauma-informed training for their families.
The state requires six hours of annual training for a foster parent to be certified, but Boyd thinks this is inadequate. She says that 25 to 30 hours, with an emphasis on trauma and its effects, is more realistic and that providers approved by DHS are generally providing closer to that.
Foster youth with more serious behavioral issues – about 15 percent of the total caseload – are placed in the Specialized Behavioral Health program, with considerably higher training requirements for foster parents.
“Trauma is woven into everything we do,” says Emily LaBree, director of community and prevention services at Turning Points for Children, one of the city’s major foster-care providers.
Turning Points provides at least 20 hours of training for foster parents in the regular program and has eight recruiters seeking out prospective parents.
It also has an on-call social worker available 24 hours a day for parents faced with a crisis situation.
Louis GrowMiller, senior director of foster care and program services for the agency, says it is not unusual for prospective parents to drop out during the training, whether it’s because their expectations were unrealistic or because the agency doesn’t think they would succeed in the program.
“We have pretty intense conversations with people about whether it’s right for them,” he says.
Donnique Bell, director of program services at another provider, Tabor Services Inc., says that the agency has instituted intensive trauma training in the last fiscal year and that “we want to increase training in specialized areas such as diagnosis and medications.”
Tabor sends a support worker to every foster home on a monthly basis and evaluates foster parents annually.
Working toward solutions
Connect for Foster Parents started in Canada about 16 years ago as a general parenting program for teens and was adapted to foster care systems about three years ago in Sweden.
The Annie E. Casey Foundation says it has proven successful in pilot programs in Delaware and around the country.
Vicki Kelly, a consultant to the foundation, says that parents are trained in groups of eight to 14 in 10 weekly sessions, with continual feedback from the parents.
Sessions are videotaped so the trainers themselves can be evaluated.
Kelly, who was formerly director of the Division of Family Services in Delaware, says that more than 86 percent of the parents have completed the program and generally expressed satisfaction with it.
The program stresses how foster parents can form attachments with children “who come in with learned expectations that people will fail them, give up on them.”
She says that although parents may grasp the intellectual concept that a foster child’s sometimes hostile behavior may be rooted in the past, learning to accept it requires practice. And feedback.
”It’s fine and well for a social worker to say, ‘don’t take it personally.’”
She adds half-jokingly that foster parenting is so challenging that “it’s amazing it ever works.”
Scribano of CHOP offers another perspective.
Although additional training for foster parents would be helpful, he says, the primary focus of child welfare systems has traditionally been about safety.
“Very little is discussed about health and well-being and how a child has weathered the adversities that caused them to be in the system to begin with,” he says. “That’s the trauma part.”
The children “are often moved [into foster care] with little to no knowledge of their medical needs,” he says. “A kid will arrive at our clinic here with a history of chronic asthma and no meds.”
He recently saw a child with vision problems so serious that the child’s eyesight was threatened.
The Fostering Health Program provides complete medical, developmental, and behavioral health evaluations, but has one serious drawback:
“Right now,” Scribano says, “we’re seeing [only] 400 kids a year … in a county child protection system that has over 6,000 children in its care, our patchwork of funding limits our reach.”
Although “some providers are looser than we might like,” Boyd says, she expects that in a year, every foster parent will have been trained in trauma and its effect on foster children.
In the future, she hopes to have a standardized curriculum for all providers under DHS, “with a trauma-informed focus.”
Reporting on issues related to youth in the child welfare system and exiting it is made possible by a generous grant from the Samuel S. Fels Fund.