Foster Care & Youth Offending Criminal Justice Forum Wellington, February, 2009 Dave Robertson Clinical Director, Youth Horizons Little research into foster care in NZ and data collection by CYFS is limited in terms of its ease or retreavability So, while mention will be made of NZ data where available, research detailed in this presentation will have a wider international flavour.

Kids in Welfare Care Are at Particular Risk of Offending In NZ about 5,000 children and young people in C&P and YJ placements, over 95% are C&P, 1/3 under age of 6 Maxwell et al (2004): C&P histories predicted later offending (0.24; p<.001) Australian welfare boys 13x and girls 35x more likely to enter juvenile justice system. Offending often known prior to entry into JJ system (54% by age 11-15) (Community Services Commission, 1996) U.S study: welfare boys 5x and girls 10x relative risk of later incarceration (Jonson-Reid & Barth, 2000) Australian study: examined the drift of welfare children into juvenile justice settings. From their sample of 80 young people: males 13x and females 35x more likely to enter juvenile justice system than community sample. Offending often known prior to entry into youth justice system (54% by age 11-15) (Community Services Commission, 1996). Another Australian study found that about 50% of 17-20 yr olds reported committing criminal offences since leaving care and protection (Maunders et al, 1999). Prospective U.S study following 590 youth: males 5x and females 10x relative risk of later incarceration (Jonson-Reid & Barth, 2000)

Risk Factors for Offending Disadvantaged Neighbourhoods Behaviour & Mental Health Problems School Attainment Maltreatment Risk Factors for Offending Learning Problems Parent-child Relationship Marital Change Discipline F.C kids share many of the background risks factors for offending: Parental Mental Health Supervision Substance Abuse Unemployment Criminality

Foster Care Outcomes: The Big Picture Homelessness Mental Health Offending Teenage pregnancy Many of these risk factors present in regular foster care continue into adulthood: increased rates of homelessness, unemployment, poverty, teenage pregnancy and mental health problems, as well as offending. Teenage Pregnancy: 2.5 x risk ( ); Australia: 1/3 pregnant or gave birth soon after leaving care ( ) Unemployment & Homelessness: 20% experience homelessness & 20-50% unemployment soon after leaving care (ref) Mental Health: Unemployment/Poverty

We know that foster care population are a high needs group who are at risk of poor life outcomes, including offending, despite regular foster care intervention Regular foster care is not an effective intervention for those a risk of youth offending Despite the high rate of young people in foster care who later go on to offend, one cannot conclude that foster care causes or predisposes children to offending – as little is known what might have been otherwise

Foster Care-Specific Risk Factors Predictive of Later Offending 3 risk factors present in foster care that are highly correlated with later youth offending Behaviour problems prior to and during foster care predict later offending, as well as teenage pregnancy, mental health problems, and substance abuse (Taussig, 2002) Multiple spells: Jonson-Reid and Barth (2000) under took a prospective examination of 590 youth in welfare care later incarcerated for serious violent or felony offences and found that multiple spells in/out of foster care independently predicted later incarceration. Multiple spells in foster care highlights the risks associated with reunification if the natural families and/or youth aren’t equipped or supported through this transition. Multiple Placements: International problem endemic to regular foster care In the UK, Only approximately half of those in care for four years or more have spent the last two years in the same foster placement. (Bullock et al., 2006). British and European studies cite between 20% and 50% of long-term foster placements end prematurely (Oosterman et al., 2007; Strijker et al., 2005). Why is it a problem? Expensive, leads caregiver stress & burnout, predicts further placement disruption and is associated with child distress, exacerbation of attachment problems and a range of poor life outcomes including offending, it predict decreased family reunification, increasing severe behaviourand mental health problems, and time in residential care (James, 2004; Hussey and Guo, 2005)

Youth Problem Behavior Drives Disruptions Project KEEP After 6 behaviors, every additional behavior on the PDR increases the probability of disruption by 17 % 7

Placement Stability Predictors Agency involvement Quality of care giving Treatment Foster Care Agency Involvement is a key variable in mediating placement stability. Degree of agency support (Bryant, 2004), pre-placement planning (Gilbertson and Barber, 2003), agency personnel forming positive relationships with caregivers (Bryant, 2004), frequency of social worker contact (Bryant, 2004), and consistency of case manager (with permanency becoming less likely as the number of worker changes increases) all mediated the rate of placement breakdown (Pecora, 2007). Quality of caregiving: Such features include foster parent motivation, involved and nurturing foster parents, support from relatives, ability of foster parents to address the behavioural and emotional needs of the children, and foster parents who welcome and accept the child in times of distress, which encourages more secure child attachment. Treatment foster care: The, provision of treatment foster care in the under 6’s ( Early Intervention Treatment Foster Care) has up to 30% fewer placement disruptions compared with regular foster care, despite a more challenging population, and less caregiver burnout (Bryant, 2004). In adolescents, Multi-dimensional Treatment Foster care has evidence superior placement stability in both USA (Chamberlain and Reid, 1998; Eddy and Chamberlain, 2000; Chamberlain, 2003) and Sweedish samples (Westermark, et al., in press). The Swedish study reported that children placed in standard foster or residential care had 2-3 times more placement breakdowns compared with MTFC. The psychiatric and externalizing behaviour symptom load in the MTFC sample was similar to or higher than youth in psychiatric inpatient units and secure care.

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Successful Treatment FC Interventions MTFC MTFC-P Project Keep Agency Involvement is a key variable in mediating placement stability. Degree of agency support (Bryant, 2004), pre-placement planning (Gilbertson and Barber, 2003), agency personnel forming positive relationships with caregivers (Bryant, 2004), frequency of social worker contact (Bryant, 2004), and consistency of case manager (with permanency becoming less likely as the number of worker changes increases) all mediated the rate of placement breakdown (Pecora, 2007). Quality of caregiving: Such features include foster parent motivation, involved and nurturing foster parents, support from relatives, ability of foster parents to address the behavioural and emotional needs of the children, and foster parents who welcome and accept the child in times of distress, which encourages more secure child attachment. Treatment foster care: The, provision of treatment foster care in the under 6’s ( Early Intervention Treatment Foster Care) has up to 30% fewer placement disruptions compared with regular foster care, despite a more challenging population, and less caregiver burnout (Bryant, 2004). In adolescents, Multi-dimensional Treatment Foster care has evidence superior placement stability in both USA (Chamberlain and Reid, 1998; Eddy and Chamberlain, 2000; Chamberlain, 2003) and Sweedish samples (Westermark, et al., in press). The Swedish study reported that children placed in standard foster or residential care had 2-3 times more placement breakdowns compared with MTFC. The psychiatric and externalizing behaviour symptom load in the MTFC sample was similar to or higher than youth in psychiatric inpatient units and secure care.

Agency Involvement is a key variable in mediating placement stability Agency Involvement is a key variable in mediating placement stability. Degree of agency support (Bryant, 2004), pre-placement planning (Gilbertson and Barber, 2003), agency personnel forming positive relationships with caregivers (Bryant, 2004), frequency of social worker contact (Bryant, 2004), and consistency of case manager (with permanency becoming less likely as the number of worker changes increases) all mediated the rate of placement breakdown (Pecora, 2007). Quality of caregiving: Such features include foster parent motivation, involved and nurturing foster parents, support from relatives, ability of foster parents to address the behavioural and emotional needs of the children, and foster parents who welcome and accept the child in times of distress, which encourages more secure child attachment. Treatment foster care: The, provision of treatment foster care in the under 6’s ( Early Intervention Treatment Foster Care) has up to 30% fewer placement disruptions compared with regular foster care, despite a more challenging population, and less caregiver burnout (Bryant, 2004). In adolescents, Multi-dimensional Treatment Foster care has evidence superior placement stability in both USA (Chamberlain and Reid, 1998; Eddy and Chamberlain, 2000; Chamberlain, 2003) and Sweedish samples (Westermark, et al., in press). The Swedish study reported that children placed in standard foster or residential care had 2-3 times more placement breakdowns compared with MTFC. The psychiatric and externalizing behaviour symptom load in the MTFC sample was similar to or higher than youth in psychiatric inpatient units and secure care.

Implications Comprehensive response addressing range of needs: mental health, behavioural, social, family, developmental, educational. 2. Foster care-specific red flags (externalising behaviour problems, multiple placements) should trigger intensive case monitoring and response: 3. Services need to actively minimise factors that contribute to placement disruption and promote factors that increase placement stability 4. Develop a range of foster care responses including treatment foster care for children and YP at risk of offending

Thank You

Treatment Foster Care Regular Foster Care Treatment of child via managed therapeutic care relationship Driven by behavioural problems/clinical Needs of young person; C&P issues may also be present Intensively supported placement and placement delivery High coordination with other sectors (e.g. education, mental health services) Specialized, highly structured, time-limited and goal-oriented Evidence based outcomes Primarily care of child Care often not highly integrated with other interventions Primarily driven by care and protection issues in environment of child Care environment is more autonomously delivered, less supervised, less structured, less supported Generalized care and often open-ended Treatment of child via managed therapeutic care relationship (care parents part of treatment team) Primarily driven by behavioural problems of young person; care and protection issues may also be present Intensively supported placement and placement delivery High coordination with other sectors (e.g. education, mental health services) Specialized, highly structured, time-limited and goal-oriented Evidence based outcomes Primarily care of child (treatment may or may not occur by external providers) Care often not integrated with other interventions Primarily driven by care and protection issues in environment of child Care environment is more autonomously delivered, less supervised, less structured, less supported Generalized and often open-ended