Therapeutic Visiting in Treatment Foster Care

A young woman who grew up in foster care recalled her own feelings and those of other children who moved in and out of her foster home: ...all they want is who really cares. (Kahan, 1979, p. 112). When we consider outcomes for children living in out-of-home care, we tend to focus on objective variables such as placement stability, behavior, and school performance rather than on children's perception that someone really about them. It is a universal human need to want someone who really about us-and often an unmet need for children living apart from their families.Most children who are taken away from their are moved several times in care, which can leave them feeling as though they don't belong In Ontario, a 2007 study of children in long-term care (two consecutive years or more) found that 43% stayed in their first foster home, 22% had two placements, and 35% had three or more placements.Although foster caregivers may become attached to children in their homes, it is difficult to continue the relationship when the child leaves and another comes to fill the bed. Thus, a child's best hope for somebody who really cares is their or other family members. Most children in foster care will return to their families sooner or later: a California study that followed children in care over a three-year period found that almost 80% returned home during this time (Courtney, 1994). Children who are deprived of family visiting during placement may be expected to have a more difficult time reintegrating with their families.Attachment Feelings in Children Separated from their FamiliesChild welfare workers and caregivers for children who were neglected or abused by their birth families are likely to overlook or minimize the strength of children's attachments to their families. Yet we know from attachment theory and caregivers' experiences that children tend to maintain their emotional ties to neglectful or abusive (Anderson, 2013; Bowlby, 1982). Even children who lack the capacity for attachment have a need to understand why they are living apart from their and what they may expect of their families in the future.Children in out-of-home care are at risk of identity confusion and diminished self-esteem; especially when they lose their connections with family, their sense of self is likely to be compromised. A teenager in foster care, David, expressed this in a letter to his social worker after a reunion with long-lost relatives. He had entered care at 13 after the second of his caregiving grandparents died and said, never felt that I belonged anywhere. After meeting his other grandparents and relatives, he wrote, feel as though I belong now, and that I am and that is the best feeling anyone could have in this situation (Laird, 1979, p. 186).Children's self esteem is also threatened by living in out-of-home care, especially if they have little or no contact with their families. They are likely to blame themselves for the separation, feeling confused and guilty about how their lives have unfolded. These feelings are likely to undermine children's sense of security and their healthy development during placement. Child welfare workers and caregivers should seek opportunities for helping children in care to resolve their confusion and guilt about their families (Palmer, 1995).Research on the Effects of Involving Parents in PlacementStudies of parental contact with children in out-of-home care have shown that low and uneven levels of engagement are pervasive, and services to and children tend to be separated, leaving important opportunities for parent-child intervention underutilized. (Kemp, Marcenko, Hoagwood, & Vesnecki, 2009, p.101).Children who are hard-to-serve are likely to be moved into group care, where the staff often treats them as though they will not be returning home: Residential treatment providers can get in a mind frame that they are [the youths'] parents (Blau et al. …

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