The Link Between Relationships and Resilience

Source:
Bryan Samuels, Commissioner
Administration on Children, Youth and Families
U.S. Department of Health and Human Services


* * *
Speaking as a former foster youth, another way to express this truth might be that:

• Pain came into our lives through relationships
• Healing can enter our lives that way, too

Lisa

Safety, Permanence and Well-Being

Child welfare agencies are rated by the CSFR on how well they provide foster care youth with Safety, Permanency and Well-Being.

Currently, the federal government is thoughtfully considering: 

• What exactly does "Well Being" look like? 

•  How can it be measured?

Source:
Bryan Samuels
Commissioner, Administration on Children Youth and Families
U.S. Department of Health and Human Services

The Difference Between Physical And Emotional Safety

Tips for Foster Parents:

• Limit stimulation - be patient and take a slower pace in introducing newness ("welcome to your new foster home, there are all the rules, now let's meet everybody in the household"), because this speed of incoming data can be cognitively understood, but is emotionally overwhelming.
• Follow the lead of the child. 
• Follow the pace of the child.

Tips for Caseworkers:

• Be aware that Transition Points are emotional hot spots
• The internal alarm goes off, signaling danger
• Child welfare has a tendency to try to make moves as quick as possible -- this is not in the best interest of the child, in terms of making them feel safe

Goal:

• To create a place of safety for the child / teenager
• To avoid re-traumatizing the child through further abrupt disruption
• To create a place of order, rather than chaos.
• To create a sense of control, rather than instability.
• To teach the child self-regulation.

Source:
Bryan Samuels, Commissioner
Administration on Children, Youth and Families
U.S. Department of Health and Human Services

Quotes from Time Magazine about Overmedication of Foster Youth

Source: Szalavitz, Maia. Why Are So Many Foster Care Children Taking Antipsychotics?
Time Magazine, November 29, 2011.

• "The influence of pharmaceutical company marketing cannot be overlooked. Ninety-nine percent of youth receiving anti-psychotic medications in the study were given atypical anti-psychotics — the newer generation of these drugs, which are expensive and mostly unavailable in generic form and have been heavily advertised.

• "All of the major manufacturers of these drugs have been fined by the Food and Drug Administration for illegal marketing practices — in part, for marketing the drugs for unapproved use in children — with some convicted of criminal charges.

• "The main condition that antipsychotics are approved to treat —schizophrenia — is extremely rare in children. The rate of schizophrenia in children under 12 is an estimated 2 cases per 1 million children; it affects fewer than 1% of older teens. Anti-psychotics are also approved to treat bipolar disorder, a diagnosis that is highly controversial in children. Some studies suggest that it affects 0.2% to 0.4 % of children, and up to 1% of adolescents.

• And yet, between 1994 and 2003, rates of bipolar diagnoses in youth under 19 rose by a factor of more than 40, according to the National Institute on Mental Health. It seems unlikely to be a coincidence that this rise occurred during the period when atypical anti-psychotics were being illegally marketed for children."

• "Indeed, most of the anti-psychotics used in foster-care youth were for conditions that the drugs were not approved to treat. Fifty-three percent of prescriptions were written for attention deficit/hyperactivity disorder (ADHD), a condition that is ordinarily managed with drugs that have the opposite pharmacological effects as anti-psychotics. The stimulant medications like Adderall and Ritalin, widely used for ADHD, tend to increase levels of dopamine, while anti-psychotics tend to decrease it."

"This study confirms the need for developmentally and trauma-informed practices in the vulnerable foster-care population," says Dr. Bruce Perry, founder of the ChildTrauma Academy. "Misunderstanding the pervasive effects of abuse and neglect leads to the mislabeling of behavioral and emotional symptoms in these children and then to overmedication."

New Federal Requirements for States re: Foster Children, Trauma and Monitoring Medications

President Obama recently signed the Child and Family Services Improvement and Innovation Act (H.R. 2883) into law.

Among other stipulations, this new law:

• Requires States to address emotional trauma in foster children, adopt protocols for using and monitoring psychotropic medications, and describe how they both address the developmental needs of young children in the child welfare system and reduce their length of stay in foster care.

Helping Foster Children Handle Transitions

The Indiana University School of Medicine has developed a one-page tip sheet for Helping Your Child in Foster Care Handle Transitions.

Foster Care and PTSD

• Foster Care Alumni and Post Traumatic Stress Disorder
• PTSD and Children in the Child Welfare System
• How Children and Adolescents React to Trauma
• Responding to a Child's Acute PTSD Reaction
• Effective Treatment for PTSD
• A Child Welfare Response to Traumatized Children
• Strategies for Agencies and Workers
• Preventing PTSD in Children
• Traumatic Stress and Child Welfare Workers
• Assessing Worker Distress
• Ways Supervisors Can Help Caseworkers Deal With Secondary Trauma
• References

Mental Health Needs of Foster Children and Children At-Risk for Removal

A recent issue of Virginia Child Protection Newsletter focused on the mental health needs of children entering foster care and children at risk to enter care.

The article explores:
- The range of mental health needs
- Ways to address those needs using evidence-based practices
- Ways to work with the children
- Methods for parent and foster parent training

http://psychweb.cisat.jmu.edu/graysojh/volume%2085.pdf