Prevention of instability in foster care: A case file review study

Background: Stability in foster care is paramount, since it enables children with a history of maltreatment to experience secure attachment relationships, and decreases the risk for behavioral and emotional problems when growing up. 

Objective: We investigated whether foster care interventions play a role in enhancing foster placement stability, in addition to several characteristics of foster children and foster families. Our hypothesis was that foster children of female gender, relatively young at start of the placement, with less previous foster care placements, staying in kinship care, placed with siblings (if they had any) and in a foster family receiving a training to enhance the foster parents’ knowledge on childhood trauma, an attachment-based video-interaction intervention or Treatment Foster Care, would experience significantly less breakdown in foster care. 

Method: A multilevel analysis was conducted on data from 2000 foster care placements in a 4 year period (2015–2018), concerning 1316 foster families (35.9% kin) and 1542 foster children (49.4% boys, M^age = 7.54 years). 

Results: The frequency of previous foster care placements (OR = 3.56) increased the risk for breakdown, and receiving the Basic Trust intervention (OR = 0.26) or Treatment Foster Care (OR = 0.11) decreased that risk. Other investigated variables were unrelated to breakdown when checked for the number of foster placements and the applied interventions. 

Conclusions: Foster care organizations should systematically monitor important risk factors for breakdown, in order to (timely) intervene if necessary to enhance the chances for continuity of foster care placements. Treatment seems to make a difference.