Adolescent out of-home placement-ml
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  • 1. Adolescent Out-of-Home Placement
    • Melissa Luke
    • Ecological Counseling
    • November 1, 2005
  • 2.
    • “ In every child who is born,
    • under no matter what circumstances
    • and of no matter what parents,
    • the potentiality of the human race
    • is born again.”
    • James Agee
  • 3. 500,000+ children and adolescents are currently in government funded out-of-home care
    • Foster care
    • Residential treatment
    • Juvenile detention
  • 4.
    • Robust research examining services provided, recipients of service, and relevant outcomes within each out-of-home placement setting
    • Paucity of literature incorporating adolescent self-report of experiences in out-of-home placement
      • Attkinson & Zwick (1982) developed client satisfaction questionnaire; no evidence of its use with adolescents
      • in out-of-home placement
      • Garland, Aarons, Saltzman & Kruse (2000)
      • Multidimensional Adolescent Satisfaction Scale (MASS)
    Current research
  • 5. Out-of-home placement decisions
    • Are
    • Voluntary/Involuntary
    • (parental decision)
    • Short-term/ Long-term
    • Single/ Multiple
    • Can be
    • Be selected to meet adolescent’s needs
    • Be detailed and explicit in plan
  • 6.
    • Many of the adolescents in out-of-home care have experienced
    • Multiple placements over a number of years
    • Numerous mental health and/or social services contacts prior to placement
    • 73% have history of neglectful, abusive or otherwise chaotic and dysfunctional homes
    • Sexual abuse; estimated 80% female residents
    • 15-56% didn’t finish high school or earn GED
  • 7. Factors related to placement
    • Race was strongest predictor
    • Neither low income or receipt of public assistance alone increased risk
    • Psychiatric history, prior child placements and legal system involvement increased risk
  • 8. Foster care
    • Protective placement
    • Social service/ child welfare
    • Ranges from 1-3 days to years
  • 9. Adolescents removed from home as a result of
    • Parent unwilling or unable to cope with parenting demands
    • Parental abuse
    • Parental neglect
  • 10. Foster Care Population
    • 275,000+ youth in foster care in 1985
    • 470,000+ youth in foster care in 1995
    • 30% youth in kinship care (relative licensed or approved as foster parent)
    • Foster youth tend to be placed in care younger than residential or juvenile justice placements
  • 11. Demographics
    • African American youth significantly overly represented:
            • 45% African American
    • 37% Caucasian
    • 11% Hispanic
    • African American youth average 2 years longer in care longer than white youth
    • (Kapp, 2000)
  • 12. Mental health
    • Estimated 35-85% youth in foster care have had emotional disturbance
    • Adjusted mental health utilization rate is 28 times that of peers
    • (Yancey, 1998)
  • 13. Placement breakdowns
    • Breakdowns occur through:
    • Care giver refusing to continue further care
    • Adolescent runs away
    • Authorities end placement due to inferior care
    • Parental decision/ disagreement over care
    • Ostensible agreement, but possible cover-up
    • (Vinnerljung, Sallnas & Westermark, 2001)
  • 14. Increased risk for breakdown
    • More breakdowns in non-related foster care than in kinship homes & in private residential care settings compared to publicly owned facilities
    • Adolescents placed further from birth family have higher incidence of breakdown
    • Adolescents placed due to antisocial behavior had most breakdowns & adolescents with a psychiatric diagnosis the next highest number of breakdowns
    • Adolescents having a history of earlier placement breakdown, more likely to experience another subsequent breakdown
  • 15. Consequences of foster care placement
    • Exacerbate emotional/ behavioral problems exhibited by adolescent prior to removal
    • Restricted affective-rage, grief, sadness, despair
    • Disrupted or conflictual emotion bonds (attachment)
    • Educational deficits as compared to peers
  • 16.
    • Emotional, behavioral or psychiatric placement
    • Chemical dependency placement
    • Residential treatment setting
    • Parental consent
    Residential treatment
  • 17. Demographic information
    • missing data and numbers can be misleading
    • settings are both public and private placements
    • population tends to be revolving
      • 30-60% African American
      • 45-55% White
      • Average age 14.8 years old
  • 18. Population
    • Relatively evenly distributed across sex, slightly more males to females
    • However symptoms and diagnoses linked with gender
    • 67% internalizing disorder
    • 43% externalizing
    • 33% both
    • 14% neither
  • 19. Juvenile Justice
    • Correctional placement
    • Adjudicated
    • Delinquency/ PINS
    • Court ordered
  • 20. Demographics
    • 2 million US children and adolescents involved in juvenile justice court system
    • 50,000-150,000 adolescents in system for treatment and custody
    • Disproportionate minority representation
    • 86-88% male; 12-14 % female
    • Age
      • 4% 12 or younger
      • 50% age 13-15
      • 46% 16 or older
  • 21. Correlates of adolescent incarceration
    • Diagnoses of learning disability, emotional disturbance, and ADD/ADHD
    • Internal locus of control- viewed current incarceration as resulting from personal choice
    • 63% youth re-offend
  • 22. What do the three broad out-of-home placement categories have in common?
    • Separation from families and difficulty maintaining parental involvement
    • Difficulty supporting successful transition back home
    • Poor longitudinal outcomes on multiple construct measures
  • 23. Outcome measures
    • Disagreement regarding the goal of placement
    • Protection
    • Permanency
    • Symptom extinction or reduction
    • Sobriety
    • Law abiding behavior
    • Other
    • How will we measure?
    • What else is being left out?
    • Are we concerned with efficiency, effectiveness or efficacy?
  • 24. Omsbudsman’s Appreciative Interview
    • Feeling normal
      • Family
    • Feeling cared about
      • Interest & care
      • Supporting family involvement
      • Security, structure, & guidance
      • Discover & develop potential
    • Feeling my opinions matter
    • Ideas for Improvement
      • Transition
      • Communication
      • Ordinary activities
  • 25.
    • Ideas?
    • Suggestions?
    Future Directions Application to Lily
    • Reactions?