Foster Care Youth and Chosen Family

"Family isn't whose blood you carry,

it's who you love and who loves you"

~ Jackie Chan as Bob Ho from The Spy Next Door

Stress Hormones Predict Trouble for Kids Left in Abusive Homes

Stress Hormones Predict Trouble for Kids Left in Abusive Homes'
Business Week, May 5, 2010.

Specific hormonal pattern tied to later psychological problems, researchers say...

Children who live with their parents after local child protective services agency enters their lives have worrying levels of a stress hormone compared to those who end up in foster care.

Researchers at the University of Delaware at Newark studied 339 children aged 3 months to 31 months, 155 of whom lived with their birth parents and 184 who landed in foster care, all after child protective services became involved with the families.

The researchers analyzed levels of the hormone cortisol in the children for two days, and found that those who remained with their parents had flatter slopes.

"A blunted pattern of cortisol production appears to confer risk for later psychiatric disorders, most especially psychopathy and substance abuse problems," study author Kristin Bernard and her colleagues wrote. "Although it is premature to suggest specific implications for neglected children, the findings are concerning."

The authors concluded that "foster care may have a regulating influence on children's cortisol among children who have experienced maltreatment."

The findings were published May 3 in the Archives of Pediatrics and Adolescent Medicine.

Youth-Centered Approach to Achieving Permanency

In 2005, the Children's Bureau funded nine demonstration projects through an Adoption Opportunities grant.

Interviews with youth shed light on their feelings about family and permanency:

• The level of commitment an adult brings to the relationship with a youth is what constitutes family—not blood.

• Permanency is a process of building trust, and finding a family is almost always worth the risk.

• Permanency work is not just about finding a home but includes restoring family connections that have been lost. Sibling relationships have been significant to older youth in the project.

• Youth are proud of their self-reliance and their ability to overcome adversity.

For more information about the Dumisha Jamaa Project, visit the National Resource Center for Adoption website.

Understanding the Effects of Maltreatment on Brain Development

Another tool for understanding the emotional, mental, and behavioral impact of early abuse and neglect in children who come to the attention of the child welfare system:

This Child Welfare Information Gateway brief provides basic information for professionals on brain development and the effects of abuse and neglect on that development.

SAMHSA Evidence-Based Practice Kits

The Substance Abuse and Mental Health Services Administration (SAMHSA) is offering a new series of Evidence-Based Practice KITs. The KITs were developed to help move the latest information available on effective behavioral health practices into community-based service delivery.

The KITs contain information sheets, introductory videos, practice demonstration videos, and training manuals.

Currently, five KITs are available:

• Assertive Community Treatment
• Integrated Treatment for Co-Occurring Disorders
• Supported Employment
• Family Psychoeducation
• Illness Management and Recovery

These new KITs are available online and in CD-ROM/DVD format.

Reaching Out to Connect Teens and Young Adults With Resources

REACHOUT.com is an information and support service using evidence based principles and technology to help teens and young adults facing tough times and struggling with mental health, substance abuse and other issues.

All content is written by teens and young adults, for teens and young adults, to meet them where they are, and help them recognize their own strengths and use those strengths to overcome their difficulties and/or seek help if necessary.

NAMI Launches Social Networking Site for Young Adults

The National Alliance on Mental Illness (NAMI) has launched StrengthofUs.org, a new online community where young adults living with mental health concerns can provide mutual support in navigating unique challenges and opportunities during the critical transition years from ages 18 to 25.

Developed by young adults, StrengthofUs.org is a user-driven social networking community where members can connect with peers, share personal stories, creativity and helpful resources by writing and responding to blog entries, engaging in discussion groups and sharing videos, photos and other news.

The site offers resources on issues important to young adults, including:

• Healthy relationships
• Family and friends
• Campus life
• Independent living
• Finances
• Employment
• Housing
• Mental health issues

"Young adulthood is an exciting challenge, but also a confusing and stressful time for anyone," said Michael Fitzpatrick, NAMI executive director. "Life can throw things at you fast."

"Mental illness affects everyone. StrengthofUs.org is intended not just for young adults who have a mental illness, but for anyone entering adulthood that has a friend, parent or other family member facing a mental health problem."

"Most of all, StrengthofUs.org is an interactive, fun space where young adults can share experiences and other information to empower each other, build relationships and offer peer support."

Resiliency Ohio Recently Launched

The website http://www.resiliencyohio.org/ is designed to help children and youth with mental and emotional health challenges and their families learn about and embrace resiliency.

The concepts, and website materials were developed by Resiliency Leadership Ohio, which is comprised of youth experiencing mental health issues and their family members.

Resiliency is defined as an inner capacity that when nurtured, facilitated, and supported by others empowers children, youth, and families to successfully meet life's challenges with a sense of self-determination, mastery, hope, and well-being.

The website includes a video of Ohio youth and families speaking about the role of resiliency in their lives and the importance of having a resiliency perspective for mental wellness.

Whose Permanency Is It, Anyway?

Voices From the 2008 National Convening on Youth Permanence

More than 30 youth and alumni from foster care attending the 2008 National Convening on Youth Permanence participated in an impromptu session facilitated by the Annie E. Casey Foundation's Family to Family Youth Engagement Team. Participants shared their experiences and provided recommendations about improving the foster care system.

What concerned these young people the most were issues of trust; they felt unable to trust the concept and the process of permanency planning. Most youth also reported that they had not been included in the process of identifying permanent connections for themselves.

Youth recommended the following important steps in developing a trusting partnership:

• Redefine permanence to include emotional connections.
• Address the disparities in permanency outcomes for older youth and youth of color.
• Continue the permanency search beyond emancipation.
• Involve youth in planning for future Convenings.

To read the full Recommendations of Youth and Young Adults From the 2008 National Convening on Youth Permanence, please visit:

www.youthpermanence.org/_pdf/materials/mat_2008/recommendations-of-youth.pdf

The California Permanency for Youth Project (CPYP) emphasizes the importance of (1) involving youth in their own permanency planning and (2) using technology to help youth find family connections.

They work with California counties to ensure that youth leave foster care with some kind of permanent connection with a caring adult.

The Emancipated Youth Connections Project involved 20 young adults (ages 17-39) who had exited foster care with no permanent connections. Services were provided to help them make those connections.

To learn more, read the Emancipated Youth Connections Project Final Report/Toolkit, available at:

www.cpyp.org/Files/EYCP-ReportToolkit.pdf

The August 2008 Destination Future: National Youth Leadership Development Conference brought together youth leaders in foster care or formerly in care from around the country to discuss their experiences in foster care and their hopes for the future. This conference was sponsored by the National Child Welfare Resource Center for Youth Development (NRCYD) and supported by the Children's Bureau.

The 94 youth and 74 adults in attendance were divided among eight groups, each with a focus topic for discussion:

• Engaging youth in the National Youth in Transition Database (NYTD) implementation
• Extending the Federal foster care program payments to age 21
• Ensuring youths' success in their academic endeavors
• Meeting youths' cultural needs while in foster care
• Involving youth in the court case review process
• Developing and maintaining youths' connections to family members
• Ensuring that youth who do not go to college can still find a good-paying job
• Ensuring that youths' mental health services needs are met

The conference slogan "Nothing about us without us" reflects the desires of foster youth to take an active role in the decisions that affect their lives and develop ways to influence programs and policies. This theme was raised in all of the small-group discussions.

To read the full report of the conference, Destination Future: National Youth Leadership Conference Report, by Jacqueline Smollar, please visit:

www.nrcys.ou.edu/yd/resources/publications/pdfs/df08rep_w.pdf

Mental Health Practices Toolkit

The REACH Institute, Casey Family Programs and the Annie E. Casey Foundation have worked together to develop a Mental Health Practices in Child Welfare Guidelines Toolkit.

It covers:
* Screening and assessment
* Interventions
* Medication
* Parent support
* Youth empowerment

This toolkit provides suggestions and resources for putting the guidelines into action in child welfare agencies.

Question for Readers: What Do You Think of This Model?

This is new to me...

The Intergenerational Trauma Treatment Model is "a revolutionary trauma treatment for 3-18 year olds and their adult caregivers. It consists of a comprehensive and robust, 21-session manualized program that is informed by trauma theory, attachment theory and advanced CBT techniques. ITTM effectively trains practitioners across all professional designations."

WHAT: The ITTM is a model that works to resolve the impact of trauma on a child through the caregiver.

HOW: The ITTM heals unresolved impact in the caregiver's history first and then re-positions the caregiver in treatment sessions to be the primary impact healer for the child.

WHO: The ITTM empowers caregivers to retain and regain their position as their child's most important and influential support.

For more information on the Intergenerational Trauma Treatment Model, please visit www.theittm.com

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

Emotional Resiliency Resources while pursuing Higher Ed

Addressing the Mental Health Needs of Former Foster Youth in Campus Support Programs,

December 2, 2008.

Download the PowerPoint presentation

California College Pathways conducted a web seminar to provide ongoing learning opportunities and resources for professionals working with current and former foster youth. Mental health experts from Cal State Fullerton and UC Riverside discussed the relationship between mental health support and educational attainment for foster youth in higher education. They shared their evidence-based approach to addressing the mental health needs of former foster youth on campus.

Information provided in the training included:
- Issues foster youth present when transitioning into college.
- Strategies for working with foster care with mental health needs (e.g. medication management, therapy).
- Signs and symptoms of depression and anxiety.
- How to refer a student psychological services.
- Types of counseling and support resources are available on college campuses

A sense of home in exile

Quote from the article A Sense of Home in Exile by Sandra Dudley:

"Materializing exile"

Displacement inevitably complicates and changes people's relationships with objects and places, as well as with each other. In order to live as 'normally' as possible within a new place, Karenni refugees seek to make it familiar in material ways...

-They are attempting to connect two points in space and time.

-They affirm their connections through the ritual of food, clothing and everyday activities.

-They are re-creating a sense of home.

Thoughts on Easter 2009

“Our scars have the power to remind us that the past was real.” – Red Dragon

Thoughts on the shift from victim to survivor

"The 'big click' for survivors comes after seeing a purpose for the pain, and a venue to help others. When pain seems meaningless, folks fall into despair."

~ Lisa Dickson

After Abuse, Changes in the Brain

After Abuse, Changes in the Brain
By Benedict Carey, NY Times, Feb. 23, 2009.

For years, psychiatrists have known that children who are abused or neglected run a high risk of developing mental problems later in life, from anxiety and depression to substance abuse and suicide.

The connection is not surprising, but it raises a crucial scientific question: Does the abuse cause biological changes that may increase the risk for these problems?

Over the past decade or so, researchers at McGill University in Montreal, led by Michael Meaney, have shown that affectionate mothering alters the expression of genes in animals, allowing them to dampen their physiological response to stress. These biological buffers are then passed on to the next generation: rodents and nonhuman primates biologically primed to handle stress tend to be more nurturing to their own offspring, Dr. Meaney and other researchers have found.

Now, for the first time, they have direct evidence that the same system is at work in humans. In a study of people who committed suicide published Sunday in the journal Nature Neuroscience, researchers in Montreal report that people who were abused or neglected as children showed genetic alterations that likely made them more biologically sensitive to stress.

The findings help clarify the biology behind the wounds of a difficult childhood and hint at what constitutes resilience in those able to shake off such wounds.

The study “extends the animal work on the regulation of stress to humans in a dramatic way,” Jaak Panksepp, an adjunct professor at Washington State University who was not involved in the research, wrote in an e-mail message.

He added that the study “suggests pathways that have promoted the psychic pain that makes life intolerable,” and continued, “It’s a wonderful example of how the study of animal models of emotional resilience can lead the way to understanding human vicissitudes.”

In the study, scientists at McGill and the Singapore Institute for Clinical Sciences compared the brains of 12 people who had committed suicide and who had had difficult childhoods with 12 people who had committed suicide and who had not suffered abuse or neglect as children.

The scientists determined the nature of the subjects’ upbringing by doing extensive interviews with next of kin, as well as investigating medical records. The brains are preserved at Douglas Hospital in Montreal as part of the Quebec Suicide Brain Bank, a program founded by McGill researchers to promote suicide studies that receives brain donations from around the province.

When people are under stress, the hormone cortisol circulates widely, putting the body on high alert. One way the brain reduces this physical anxiety is to make receptors on brain cells that help clear the cortisol, inhibiting the distress and protecting neurons from extended exposure to the hormone, which can be damaging.

The researchers found that the genes that code for these receptors were about 40 percent less active in people who had been abused as children than in those who had not. The scientists found the same striking differences between the abused group and the brains of 12 control subjects, who had not been abused and who died from causes other than suicide. “It is good evidence that the same systems are at work in humans that we have seen in other animals,” said Patrick McGowan, a postdoctoral fellow in Dr. Meaney’s lab at McGill and the lead author of the study.

His co-authors, along with Dr. Meaney, were Aya Sasaki, Ana C. D’Alessio, Sergiy Dymov, Benoît Labonté and Moshe Szyf, all of McGill, and Dr. Gustavo Turecki, a McGill researcher who leads the Brain Bank.

Because of individual differences in the genetic machinery that regulates stress response, experts say, many people manage their distress despite awful childhoods. Others may find solace in other people, which helps them regulate the inevitable pain of living a full life.

“The bottom line is that this is a terrific line of work, but there is a very long way to go either to understand the effects of early experience or the causes of mental disorders,” Dr. Steven Hyman, a professor of neurobiology at Harvard, wrote in an e-mail message.

Self Verification

Developed by William Swann, the theory of Self Verification is that once individuals develop firmly held beliefs about themselves, they come to prefer that other people see them as they see themselves - even if their self-views are negative.