Part two of a two-part series. Read part one here.
In Wisconsin, “professional parents” with specialized training are matched with teenage girls in foster care who have survived sexual abuse. In Texas, these caregivers remain at home full time, and can rely on 24-hour crisis support from a treatment team.
Minnesota foster youth with therapeutic needs live with a full-time employee of the state’s Department of Human Services, who works with a case manager, a mental health professional, a nurse and a behavioral analyst to support the child’s needs.
Therapeutic, treatment or “professional” foster homes differ from standard foster homes, where caregivers are licensed and receive a stipend to care for a child, ranging from $300 to $1,000 a month — funds that are essentially aimed at meeting their basic needs.
The goal of therapeutic foster care is more specific, to keep foster youth out of in-patient psychiatric units and group care facilities, an effort that exists in different forms across the country. And in Washington state, this key housing model is a central part of plans underway to move children out of hotels and offices, where they’ve been housed due to a state failure to find suitable placements.
While professional foster care programs differ across states, they typically require that foster families take in just one child at a time, unless breaking up a sibling group poses a threat to a child’s well-being. Professional foster families are also often required to have at least one parent who is not working outside the home, and they’re paid more than standard stipends, even those provided for children in need of specialized care such as those with physical disabilities.
A common goal is to keep children out of in-patient psychiatric units and group care facilities. And that means access to round-the-clock clinical support and training in how to best handle children’s emotional crises.
“There’s a lot of support in treatment foster care I didn’t necessarily get with traditional care,” Patrice Hazelwood of Richmond, Virginia, told a reporter with the Fostering Families Today magazine, The Imprint’s sister publication. A couple of years ago, Hazelwood became a licensed therapeutic foster parent after decades as a traditional foster caregiver. “To be able to have a therapist and a counselor pretty much involved every other week — they’re able to direct me to resources if he needs help, without having to wait a month or more for a referral,” she said.
The specialized training that caregivers like Hazelwood receive can include how to care for children who have been sexually abused and how to de-escalate emotional disturbances, as well as building a deeper knowledge of how childhood trauma can affect behavior, and what works best to soothe a child suffering from trauma. There is also now a monthly support group available to the families, Hazelwood said.
Minnesota has several variations on traditional foster care intended to help children who have high emotional and behavioral needs. They include Intensive Therapeutic Homes, in which the state’s Department of Human Services hires a foster parent as a full-time employee. That professional parent works with the clinical team, schools and community agencies to support the foster child’s needs, according to the Department of Human Services. The services are paid through Medicaid-funded disability waivers.
Another Minnesota program is called Intensive Treatment in Foster Care, in which the department certifies community agencies to provide additional therapeutic services and intervention for children living in traditional foster family homes — a program that will soon expand to include kids living with legal guardians or in group homes. Mental health professionals visit children at home or meet with them in community settings to provide services like psychotherapy or crisis assistance.
Erin Bouchard, who has been a licensed foster parent through a private therapeutic foster care agency for 10 years in Ontario, Canada, wrote recently about the experience in a column for Fostering Families Today.
Bouchard noted that fostering a child at a “therapeutic level” means there are often many more professionals involved in the care: therapists, specialists and other workers.
That also makes the role more complex at times. Along with the extra support, “there’s more opportunity for miscommunication and misinformation,” she said.
“As resource parents, it’s vital that we become the common denominator in the relationship in order to better navigate the revolving door of professionals in and out of our homes and our lives,” Bouchard added. “Learning to keep good notes and communicate for clarity are keys to your child’s success.”
“There’s a lot of support in treatment foster care I didn’t necessarily get with traditional care.”
— Patrice Hazelwood, therapeutic caregiver
As in Washington and other states, the Department of Family and Protective Services in Texas has struggled to find safe placements for older children in foster care who require extra care. It, too, has implemented professional foster care in some settings.
The department describes its Treatment Foster Family care as a “multidisciplinary treatment approach” for children ages 17 and younger with “very high needs and complex trauma history” and is aimed at keeping those children out of group homes or psychiatric hospitals.
In addition to receiving training on mental health care, the foster parents have access to a treatment team and 24-hour on-call case management, with specialists who can respond immediately to the home, according to the Department of Family and Protective Services.
Department spokesperson Marissa Gonzales said professional foster parents are paid a monthly stipend of approximately $4,300 — $137.52 a day per foster child — to care for the youth full-time.
In recent years hundreds of Texas children, like those in Washington, have slept in office buildings, hotels and other emergency placements as they await licensed homes.
Gonzales said specialized foster care has been an option for some of these children, but it’s typically used as a short-term option of no more than a year while children prepare to enter a more permanent situation or transition to traditional foster care.
Many awaiting licensed placement have “behavioral and emotional needs that are beyond what Treatment Foster Family Care homes are equipped to treat,” Gonzales said.
More often, the homes are used “as a step-down option for children who are coming out of a more intensive care setting, but who still need additional supports,” Gonzales said in an email. Children with more intensive needs in Texas are currently more likely to be sent to one of the state’s residential treatment centers, she added.
The goal was to reunify Y.S. with her mother, who was completing court-ordered services to be able to get Y.S. and her sibling back home.
According to a write-up on the state’s website, the treatment team worked with the child and her mother and helped the family continue therapy after the program ended. Her mother was able to regain full custody of her children.
Valarie Edwards contributed to this report.
