Sexual and Gender Minority Youth in Foster Care: An Evidence-Based Theoretical Conceptual Model of Disproportionality and Psychological Comorbidities

2021 ◽  
pp. 152483802110131
Author(s):  
Dana M. Prince ◽  
Meagan Ray-Novak ◽  
Braveheart Gillani ◽  
Emily Peterson
Keyword(s):  
Mental Health ◽  
Foster Care ◽  
Theoretical Model ◽  
Minority Youth ◽  
Inclusion Criteria ◽  
Foster Care System ◽  
Psychological Comorbidities ◽  
Sexual And Gender Minority ◽  
And Gender ◽  
Care System

Sexual and gender minority youth (SGMY) are overrepresented in the foster care system and experience greater foster-care-related stressors than their non-SGM peers. These factors may further elevate their risk of anxiety/depressive, post-traumatic stress disorder, self-harm, and suicidality. The system currently produces unequal and disproportionate adverse mental health outcomes for SGMY and needs points of intervention to disrupt this status quo. This article provides an empirically grounded conceptual–theoretical model of disproportionate representation and burden of psychological comorbidities experienced by SGMY in the foster care system. We apply findings from an integrated literature review of empirical research on factors related to overrepresentation and mental health burden among SGMY to minority stress theory to explicate how and why the foster care system exacerbates mental health comorbidities for SGMY. Searches were conducted in June 2020 in PubMed using MeSH terms and title/abstract terms for foster care, sexual or gender minorities, and psychological comorbidities. Inclusion criteria are studies conducted in the United States, published in English, focused on mental illness, and published between June 2010 and 2020. Developmental/intellectual and eating disorders were excluded. The initial search returned 490 results. After applying inclusion criteria, 229 results remained and are utilized to build our conceptual–theoretical model. We assert that the phenomenon of disproportionate psychological comorbidities for SGMY in foster care is best represented as a complex and dynamic system with multiple feedback loops. Extant empirical and theoretical literature identifies three critical areas for intervention: family acceptance, community belonging and queer chosen/constructed family, and affirming and nondiscriminatory child welfare policy.

scholarly journals An Affirmative Coping Skills Intervention to Improve the Mental and Sexual Health of Sexual and Gender Minority Youth (Project Youth AFFIRM): Protocol for an Implementation Study (Preprint)

2019 ◽  
Author(s):  
Shelley L Craig ◽  
Lauren B McInroy ◽  
Andrew David Eaton ◽  
Gio Iacono ◽  
Vivian WY Leung ◽  
...  
Keyword(s):  
Mental Health ◽  
Group Intervention ◽  
Coping Skills ◽  
Pragmatic Trial ◽  
Internalized Homophobia ◽  
Minority Youth ◽  
Web Based ◽  
Sexual And Gender Minority ◽  
And Gender

BACKGROUND Sexual and gender minority youth (SGMY, aged 14-29 years) face increased risks to their well-being, including rejection by family, exclusion from society, depression, substance use, elevated suicidality, and harassment, when compared with their cisgender, heterosexual peers. These perils and a lack of targeted programs for SGMY exacerbate their risk for HIV and other sexually transmitted infections. Cognitive behavioral therapy (CBT) interventions support clients by generating alternative ways of interpreting their problems and beliefs about themselves. CBT, tailored to the experiences of SGMY, may help SGMY improve their mood and coping skills by teaching them how to identify, challenge, and change maladaptive thoughts, beliefs, and behaviors. Based on the promising results of a pilot study, a CBT-informed group intervention, AFFIRM, is being tested in a pragmatic trial to assess its implementation potential. OBJECTIVE The aim of this study is to scale-up implementation and delivery of AFFIRM, an 8-session manualized group coping skills intervention focused on reducing sexual risk behaviors and psychosocial distress among SGMY. Our secondary aim is to decrease sexual risk taking, poor mental health, and internalized homophobia and to increase levels of sexual self-efficacy and proactive coping among SGMY. METHODS SGMY are recruited via flyers at community agencies and organizations, as well as through Web-based advertising. Potential participants are assessed for suitability for the group intervention via Web-based screening and are allocated in a 2:1 fashion to the AFFIRM intervention or a wait-listed control in a stepped wedge wait-list crossover design. The intervention groups are hosted by collaborating community agency sites (CCASs; eg, community health centers and family health teams) across Ontario, Canada. Participants are assessed at prewait (if applicable), preintervention, postintervention, 6-month follow-up, and 12-month follow-up for sexual health self-efficacy and capacity, mental health indicators, internalized homophobia, stress appraisal, proactive and active coping, and hope. Web-based data collection occurs either independently or at CCASs using tablets. Participants in crisis are assessed using an established distress protocol. RESULTS Data collection is ongoing; the target sample is 300 participants. It is anticipated that data analyses will use effect size estimates, paired sample t tests, and repeated measures linear mixed modeling in SPSS to test for differences pre- and postintervention. Descriptive analyses will summarize data and profile all variables, including internal consistency estimates. Distributional assumptions and univariate and multivariate normality of variables will be assessed. CONCLUSIONS AFFIRM is a potentially scalable intervention. Many existing community programs provide safe spaces for SGMY but do not provide skills-based training to deal with the increasingly complex lives of youth. This pragmatic trial could make a significant contribution to the field of intervention research by simultaneously moving AFFIRM into practice and evaluating its impact. INTERNATIONAL REGISTERED REPOR DERR1-10.2196/13462

Medical and Mental Health of Children Entering the Utah Foster Care System

PEDIATRICS ◽  
2008 ◽  
Vol 122 (3) ◽  
pp. e703-e709 ◽  
Author(s):  
J. S. Steele ◽  
K. F. Buchi
Keyword(s):  
Mental Health ◽  
Foster Care ◽  
Foster Care System ◽  
Care System

Consultation Strategies for Working with Professionals Supporting Foster Families

2017 ◽  
pp. 265-287
Author(s):  
Kim Coggins ◽  
Kristie Opiola ◽  
Kara L. Carnes-Holt
Keyword(s):  
Mental Health ◽  
Foster Care ◽  
Children And Families ◽  
Holistic Wellness ◽  
Foster Care System ◽  
Knowledge And Skills ◽  
Children In Foster Care ◽  
Play Therapists ◽  
Care System

Children and families involved in the foster care system present with unique needs requiring support from diverse professionals. Because of the range of stakeholders involved with children and families in the foster care system, play therapists must become knowledgeable and skillful consultants and collaborators to best facilitate holistic wellness for these families. Through this chapter, the authors seek to provide play therapists with a strong foundation of knowledge and skills to draw upon when working with this population. First, readers are introduced to the mental health needs faced by foster care children and families. The authors then describe the diverse roles frequently fulfilled by play therapists as consultants and collaborators within various systems impacting children in foster care. Finally, a case study is included to provide a practical description of how play therapists can integrate a greater use of consultation, collaboration, and advocacy into their work to bet meet the needs of foster care children and families within their care.

In-Home Treatment of Reactive Attachment Disorder in a Therapeutic Foster Care System: A Case Example

2003 ◽  
Vol 25 (1) ◽  
pp. 76-88 ◽  
Author(s):  
Carl J. Sheperis ◽  
Edina L. Renfro-Michel ◽  
R. Anthony Doggett
Keyword(s):  
Mental Health ◽  
Foster Care ◽  
Reactive Attachment Disorder ◽  
Attachment Disorder ◽  
Foster Care System ◽  
System A ◽  
Chronic Trauma ◽  
Reactive Attachment ◽  
Mental Health Difficulties ◽  
Care System

When trauma precedes a child's placement in the foster care system, it can lead to lasting mental health difficulties. Often, children who experience extreme, chronic trauma prior to age 5 develop Reactive Attachment Disorder (RAD). However, the diagnosis of RAD is often overlooked. This article discusses the characteristics of RAD as well as diagnostic criteria and possible etiology. We present the case example of an adolescent diagnosed with RAD as an example of treatment from an in-home perspective.

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