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Promoting Infant Mental Health in Foster Care
Core Function: Research and Evaluation
This research project is a community-based longitudinal comparative effectiveness study focused on infants in foster care, a very vulnerable and understudied population. The objectives of this study are to acquire crucially needed evidence to support interventions promoting infants’ mental health in foster care, while building community capacity to deliver infant mental health interventions and services to foster families.
Nationally, approximately 50,000 infants under 12 months enter foster care every year. Infants enter foster care with multiple risks that are exacerbated by the loss of their first attachment relationship, even if the quality of care they received was poor prior to removal. Their reactions to this loss, combined with their other vulnerabilities, make them difficult for foster caregivers to care for in ways that help them self-regulate and develop a secure new attachment. Currently, there are virtually no prevention and intervention efforts that have a very early, preventive focus on children in the child welfare system. Consequently, as these children age their needs and vulnerabilities intensify, decreasing the probability of reunification, escalating difficulties in attachment with related problems of emotional disturbance, and eventually leading to more costly care in increasingly restrictive settings.
This study enrolls foster families (N=210) over the course of 27 months when their infants are approximately 11-20 months old. The foster families are randomly assigned to experimental and comparison conditions involving two different prevention programs. The experimental group receives an attachment theory based program, Promoting First Relationships (PFR), and the comparison group receives early education support services. Both groups receive a pre-test prior to random assignment, an immediate post-test, and 6 and 12- month post-tests of caregiver sensitive caregiving, parenting stress, and commitment to this infant; and infant emotional and behavioral regulation, attachment security, and developmental status.
The intervention, PFR, has been developed at the CHDD and is widely recognized throughout the state as a successful program that promotes the ability of foster parents to develop secure attachment with their foster infants. Secure attachment may help prevent later adverse consequences, including the regulatory, social, and emotional problems that contribute to multiple foster placements and the later serious conduct and mental health problems that are prevalent among children in foster care. |
