Attitudes & Beliefs of Child Welfare Stakeholders toward Child Welfare-Based Natural Mentoring for Older Youth in Foster Care: A Focus Group Study

Johanna K.P. Greeson, PhD, MSS, MLSP | Allison E. Thompson, MSS Annual Research & Policy Conference on Child, Adolescent, and Young Adult Behavioral Health March 24, 2015 | Tampa, Florida

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Acknowledgment

• This study was funded in full by Penn’s Office of the Vice Provost for Research, University Research Foundation.

• We thank Philadelphia Department of Human Services for facilitating the completion of this work.

• We thank the child welfare professionals and youth for sharing their time & views with us!

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Aging Out of Foster Care • From 2003-2009, the number of youth emancipating from foster

care increased by nearly a third

• Older youth exiting foster care without legal permanency continue to represent at least one in ten exits from foster care each year

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Increased Risk

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Why?

Reaching the age of majority is no longer predictive of the ability to live

independently of parents/parental figures, or for youth who age out of

foster care, the state

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But, there is

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Increased Protection? Natural Mentoring

• A supportive relationship with a caring adult is protective among at-risk youth, and normative for healthy adolescent development

• Natural mentoring is one mechanism for cultivating caring relationships

Natural

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What is a Natural Mentor?

• A very important, nonparental adult that exists in a youth’s social network, like a teacher, extended family member, service provider, community member, or coach, who “provides ongoing guidance, instruction, and encouragement aimed at developing the competence and character of the young person” (Rhodes, 2002).

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Quantitative Studies: NM among Foster Youth

• Suicidal ideation, having received a STI, aggressive behaviors (i.e., hurting someone in a fight)1

• Arrests at age 19, depression symptoms, stress &

Life satisfaction2

• Homelessness &

Worked in past year3

• Income expectations & asset ownership4

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1 Ahrens, K. R., DuBois, D. L., Richardson, L. P., Fan, M-Y, & Lozano, P. (2008)

2 Munson, M.R. & McMillen, J.C. (2009)

3 Courtney, M. E., & Lyons, S. (2009)

4 Greeson, J. K. P., Usher, L., & Grinstein-Weiss, M. (2010)

• Most important qualities of a NM 1, 2 – Trust, love and care, availability and support,

authenticity, respect, and consistency/longevity

• Important supports provided by NMs 3 – Emotional support, guidance/advice, role-

modeling, tangible support, normative experiences

Qualitative Studies: NM among Foster Youth

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1 Greeson, J. K. P., & Bowen, N. K. (2008)

2 Munson, M. R., Smalling, S. E., Spencer, R., Scott, L.

D., & Tracy, E. M. (2010)

3 Ahrens, K. R., DuBois, D. L., Garrison, M., Spencer,

R., Richardson, L. P., & Lozano, P. (2011)

Caring Adults ‘R’ Everywhere

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Caring Adults ‘R’ Everywhere (C.A.R.E.)

• Developed by Dr. Johanna Greeson as a social work PhD student at University of North Carolina-Chapel Hill in 2007, under the direction of Dr. Mark Fraser

• Theory based and research driven

– Resilience Perspective

– Life Course Perspective

– Positive Youth Development Theory

– Relational Cultural Theory

• Manualized 12-week intervention

– Identification, screening & training of natural mentors

– Group activities & supportive one-one sessions with dyads

– Weekly 2-hour community-based time for dyads, which focuses on building life skills

– Formal dinner and graduation to celebrate the relationships

– Booster sessions/aftercare

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• Introduction to C.A.R.E. • Pre-Intervention Work

– Assessing Youth’s Permanent Connections

– Screening & Background Checking Natural Mentors

• Training Natural Mentors – Icebreaker/Introductions – Adolescent Development – Understanding How the Child

Welfare System Works – Trauma-Informed Natural

Mentoring – Practices of Effective Natural

Mentors – What Should We Do? – Establishing & Maintaining

Boundaries – Wrap-Up

• Facilitating Development of Growth-Fostering Relationships between Youth In Care & Their Natural Mentors – Orientation to C.A.R.E. – Permanency Pact – Weekly Supervision for Dyads – Separate Monthly Informal Support

Groups for Youth & Natural Mentors

– Group Field Trip(s) – Casey Life Skills – Affect Regulation

Training/Mindfulness – Video Portraits – Celebration/Graduation

• Aftercare/Booster Sessions

Caring Adults ‘R’ Everywhere (C.A.R.E.)

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Vetting of C.A.R.E. Among Stakeholders

• Two qualitative, focus group studies conducted with key stakeholders – Child welfare professionals – Older youth in foster care

• Research question – What are the attitudes and beliefs of child welfare

professionals and youth in foster care about the implementation of a child-welfare based natural mentoring intervention for older foster youth?

• Benefits of the studies – To assist in developing context-specific NM programs – To build on current literature by exploring the child welfare

organization as a setting for implementation – To inform the pilot of C.A.R.E., a novel NM intervention

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Methods

• Recruitment & participants – 20 Philadelphia DHS child welfare professionals who had

served at least one youth age 15+ at risk of aging out in past 3 years • 75% female; 53% AA; average age: 48.5 (SD=9.8)

– 17 older youth in foster care at risk of aging out • 47% female; 94% AA; average age: 18.1 (SD=1.42)

• 11 focus groups conducted (July 2013 – March 2014) – Facilitated by PI/Doc Student who used a structured guide

– Each lasted approximately 2 hours

– Digitally recorded & transcribed

– Lunch served and $30 compensation for youth

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Analysis

• Team of 2-3 researchers analyzed the transcripts • Conventional content analysis

– Iterative, descriptive process to inductively discover concepts, themes, and trends

– Constant comparative analysis – First cycle coding

• Assignment of codes and sub-codes in order to organize data into readily analyzable units

– Second cycle coding • Identification of larger patterns, emerging themes, and exemplary

quotes to create a parsimonious understanding of the data

• Use of Dedoose, online qualitative data analysis software, to facilitate the process

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Results from CWs Summarized

– NM programming supported by child welfare professionals

– DHS is limited in the supportive role it can provide to youth

– Youth perspective is important in implementing CARE

– Need for a nuanced screening process to vet NMs

– Benefits of NM relationships

– Need for additional infrastructure/support

– Potential challenges in implementation

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Role of DHS • DHS plays a limited role in the lives of youth in foster care

– The role of DHS ends when a youth turns 18 or 21 years old

– DHS workers are paid professionals, and their relationships with youth are often temporary and can abruptly end

– NMs may meet an important need for youth aging out of care

• “And sometimes when our kids get to be 18 they just want to get out of the system so maybe if they’d have a mentor you know somebody that can give them structure and guidance they might go on towards education, because a lot of them they’re just like I want to be done with DHS and when you ask them what do they want to do with their life, they don’t know.”

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CW Insight on Importance of Youth Perspective

• Child welfare interventions for older youth are most effective when they empower youth to be leaders and seek out youth perspective

• Natural mentoring capitalizes on youth perspective, as it is a youth-directed process

• “I think a lot of teens, they want help and they want advice but they don’t want to admit it. So I think that’s a difficult thing, wanting the independence, so you have to try to find a connection somehow to get to that, to have them let you help them, let you assist them or frame it in them having the choice, giving them the choice and not telling them what to do, giving them options of what to do or how to do something.”

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Vetting

• Youth may select natural mentors with past criminal records or child welfare involvement

• A nuanced process is needed to ensure that appropriate NMs are selected and not excluded based on a past history that no longer presents a safety concern

• “So in life people make mistakes, people change, people get better….you beat somebody up or even, and I’m going to say it, you sold drugs; that is a horrible thing but you sold them when you were 19, you went to jail for five years and you’ve come out, paid your dues, and you’ve got a job and that is no longer part of your life or who you are. Some of that experience might be very valuable to this 17 year old who is questioning whether that’s a way to make a living.”

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Authentic Support

• Authentic care and support is crucial to the natural mentoring relationship for youth in foster care, many of whom have experienced relational disruption and trauma

• “There’s a bond that, ‘I’m not your mother, I’ve never been your mother but I’ve cared about you for so long that the fact that you’re doing things that are displeasing to me doesn’t change the love that I have for you.’ And to me that’s the difference with a natural mentor and someone who’s paid to provide the service; even if it’s kin who provides a temporary home, they’re being paid to provide a service and if the bond isn’t there, it could get to the point where it’s not worth the money.”

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Child Welfare Climate & Culture

• Child welfare case workers and supervisors felt that they did not have the time or resources to deliver a natural mentoring intervention

• “…it would have to be an identified group of people whose time and energy was spent on the natural mentoring process because we do so much. We have so much responsibility and so many time constraints and so many regulations and so many deadlines, with so many resource limitations that you would need the people who were working on it to bring the same level of commitment that you would expect from the natural mentor and from the child.”

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Results from Youth Summarized

– Youth were cautiously optimistic about NM programming

– Desire for permanent relationships with caring adults

– Descriptions of present NM relationships

– Challenges related to the formation of NM relationships

– Strategies for helping other foster youth to identify NMs

– Benefits of a NM intervention

– Challenges related to a NM intervention

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Desire for Permanent Relationships

• Youth discussed their desire for permanent relationships with adults – Characterized by love, affection, and safety – Irrespective of a legal status

• “Especially if you ain’t got your parent, all you, all you want and all you, all you really desire is just love and affection. That’s it at the end of the day”

• “It’s good to know that you got somebody that’s not going anywhere, no matter what you do. They could be disappointed in you, but—They’ll never go anywhere, so it makes you appreciate them.”

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Youth Conceptions of NM

• Youth described natural mentors as “like family,” trustworthy, able to provide guidance and support, and reciprocally beneficial

• “He was my neighbor. His name was Mr. B. He was a pastor at a church and like he was kind of like my mentor too.... Like I remember one summer I couldn't have a summer job because I was dealing with the court and all that, so like he just brought me to his church, you know. He gave me like little jobs to do around his church. You know, like he’ll pay me and then, or like if he’ll go away, he’ll leave me, like he’ll leave me with his dog, you know, to help feed his dog and feed his plants. And like, then like he used to take me out to games, to Sixers’ games and all that. Then like we’d talk about my situations. Like we wouldn’t really talk, like talk around people like, like that was around us like, like people, like members of his church because like he was the only one who knew about my situation. He didn’t want everybody to be, their business.”

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Challenges Related to NM Relationships for Youth in Foster Care

• Youth discussed limited social networks or fractured relationships within their networks, making it challenging to identify a natural mentor

• “A lot of us, we grew up without our fathers, you know, so

it’s like we’re searching for, we’re searching for manhood almost our whole lives but nobody gonna ever fill that void that your father burnt. So it was always like we’re trying to get it on our own, that’s why I feel as though like we’re losing the identity, like what it really is to be a man … I mean, I lost my dad when I was young so I’m still searching for somebody that could be there for me, you know, so, I mean, I, it’s not really too much to say because I’m still searching and ain’t nobody there and I’m just lost a little bit. I’m still looking.” 26

Identifying Natural Mentors

• Trust is required to assist youth with identifying their natural mentors – Trust may take time – Trust could be broken if the identification process circumvents

the youth (e.g., case file reviews without the youth)

• “You got to really get to know that person, you got to really

like put everything aside, not worry about no paperwork or nothing like that and just try to get to know them even if you just sit and observe them for a couple days and then slowly, slowly find something that they might have in common with you and start a conversation from that and then move on slowly from that.”

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Benefits of Support for NM Relationships

• Youth affirmed the benefit of a third-party support from the interventionist for the dyads

• Youth liked the idea of peer support groups for youth and NMs in receiving C.A.R.E.

• “They could offer each other different ways on how to be better mentors or, you know, the kids can, they could open up doors, like make a kid want to open up to their mentor more because maybe they’re seeing that the other kid is changing or becoming a better person from actually taking heed to what their mentor said.”

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Life Skills Development for Youth in Foster Care

• Overall, the youth preferred the development of life skills in a relational context over a classroom setting

• Some youth had a difficult time conceptualizing relational context as a place of learning, suggesting it may represent a culture-shift

• “The hands-on is way better, I think better because you could sit in a classroom and somebody could tell you something repeatedly over and over again and you never could hear it. But that way it’s going to be easier because you’re going to actually be able to go out into the community and do it. You’re not going to be stuck, like I had to read about it. You know how to do it like the back of your hand, the hands-on part is, is better.”

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Challenges of Implementing a NM Intervention for Youth in Foster Care

• Youth across focus groups stated that securing youth buy-in and forming trust with the youth would pose the greatest challenges

• “I think everything else will be fine like trying to get them to participate and listen shouldn’t be difficult, but trying to get them to really open up about how they really feel about foster care, ‘cause I know when my foster parent asked me `So how do you feel about me,’ I’m not going to say anything that’s going to hurt your feelings ‘cause you’re not going to send me back. I’m going to say everything you want to hear.”

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Limitations & Conclusions • Non-representative sample • Participants self-selected for the focus groups • Participant bias unlikely

– Both supports and concerns were openly shared – Use of outside research staff – Only participants and research staff were present

• A first step in examining a contextual setting for NM programming

• The 2013 Handbook of Youth Mentoring – “…mobilize and incorporate natural mentors more

systematically into services for youth in foster care (e.g., care coordination and transition planning), particularly for older youth for whom formal, programmatic relationships may be potentially less effective or difficult to establish.”

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Looking Ahead: Pilot RCT Effectiveness Study

• Randomized Controlled Trial (RCT) in partnership with Philadelphia Dept. of Human Services – Comparison of 20 youth receiving C.A.R.E. with 20

demographically similar youth not receiving C.A.R.E. – Inclusion criteria

• Youth ages 18-20.5 in out-of-home placement with DHS • Actively involved in the Achieving Independence Center

– Random selection – Recruitment – Enrollment & consent process – Random assignment – Data collection (pre- and post- intervention, 3-month f/u) – 12-week intervention

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Published Studies

• Greeson, J. K., Thompson, A. E., Evans-Chase, M., & Ali, S. (2015). Child welfare professionals’ attitudes and beliefs about child welfare-based natural mentoring for older youth in foster care. Journal of Social Service Research, 41, 93-112.

• Greeson, J. K., Thompson, A. E., Ali, S., & Wenger, R. S.

(2015). It's good to know that you got somebody that's not going anywhere: Attitudes and beliefs of older youth in foster care about child welfare-based natural mentoring. Children and Youth Services Review, 48, 140-149.

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References • Ahrens, K. R., DuBois, D. L., Garrison, M., Spencer, R., Richardson, L. P., & Lozano, P. (2011).

Qualitative exploration of relationships with important non-parental adults in the lives of youth in foster care. Children and youth services review, 33, 1012-1023.

• Britner, P.A., Randall, K.G., & Ahrens, K.R. (2013). Youth in foster care. In D.L. DuBois & M.J. Karcher (Eds.), The handbook of youth mentoring (pp. 341-354). Thousand Oaks, CA: Sage Publications, Inc.

• Courtney, M. E., & Dworsky, A. (2006). Early outcomes for young adults transitioning from out‐of‐home care in the USA. Child & family social work, 11, 209-219.

• Greeson, J. K. P. (2013). Foster youth and the transition to adulthood: The theoretical and conceptual basis for natural mentoring. Emerging Adulthood, 1, 40-51.

• Greeson, J. K. P., Usher, L., & Grinstein-Weiss, M. (2010). One adult who is crazy about you: Can natural mentoring relationships increase assets among young adults with and without foster care experience? Children and Youth Services Review, 32, 565–577.

• Greeson, J. K., & Bowen, N. K. (2008). “She holds my hand” The experiences of foster youth with their natural mentors. Children and Youth Services Review, 30, 1178-1188.

• McMillen, J. C., & Raghavan, R. (2009). Pediatric to adult mental health service use of young people leaving the foster care system. Journal of Adolescent Health, 44, 7-13.

• Munson, M.R. & McMillen, J.C. (2009). Natural mentoring and psychosocial outcomes among older youth transitioning from foster care. Children & Youth Service Review, 31, 104-111.

• Munson, M. R., Smalling, S. E., Spencer, R., Scott, L. D., & Tracy, E. M. (2010). A steady presence in the midst of change: Non-kin natural mentors in the lives of older youth exiting foster care. Children and Youth Services Review, 32, 527-535.

• U.S. Department of Health and Human Services, Administration for Children and Families, Administration on Children, Youth and Families, Children's Bureau. (2013). The AFCARS report - Preliminary FY 2012 Estimates as of July 31, 2013 (No.20).

• Zimmerman, M.A, Stoddard, S.A., Eisman, A.B., Caldwell, C.H., Aiyer, S.M., & Miller, A. (2013). Adolescent resilience: Promotive factors that inform prevention. Child Development Perspectives, 0, 1-6. 34

QUESTIONS?

Contact Information: Johanna Greeson, PhD, MSS, MLSP Assistant Professor Co-Director, Child Well-Being & Child Welfare Specialization Sequence Chair, Macro Social Work Practice School of Social Policy & Practice UNIVERSITY OF PENNSYLVANIA 3701 Locust Walk, Philadelphia, PA 19104 Phone: 215-898-7540 | Fax: 215-573-2099 jgreeson@sp2.upenn.edu | http://tinyurl.com/Greeson

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