Clinical Child Psychology
and Psychiatry
1–16
© The Author(s) 2014
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DOI: 10.1177/1359104514547597
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Clinical competencies for
the effective treatment of
foster children
Karen Zilberstein
1,2
and Sally Popper
1,3
1
A Home Within, USA
2
Smith College School for Social Work, USA
3
Treehouse Foundation, USA
Abstract
Despite a high level of documented mental health needs among children who have experienced
foster care, research indicates that treatment outcomes are often disappointing. In order to
improve outcomes, evidence-based treatments for attachment, trauma and behavioral difficulties
are often promoted for this population. However, little research exists on whether or not those
interventions effectively address the unique and complex mental health needs of many foster
children. While a rather robust literature exists on foster children’s multifaceted difficulties, most
treatments do not fully represent that range and complexity in their interventions. This article
attempts to begin to fill that gap by outlining the knowledge and skills clinicians must acquire if
they are to effectively treat foster children. Treatment of foster children should be seen as a
subspecialty within the field of child mental health, and trainings that help clinicians gain more
knowledge of foster children’s unique needs should be more available.
Keywords
Foster children, evidence-based treatment, comprehensive evaluation, mental health, advocacy
Introduction
Although foster children use mental health services at relatively high rates, many children in care
receive no services or services considered inappropriate or inadequate to their needs (Bellamy,
Goplan, & Traube, 2010; Cantos & Gries, 2010; Kerker & Dore, 2006; Oppenheim, Lee,
Lichenstein, Bledsoe, & Fisher, 2012). In a recent survey on the experiences of adoptive families
with the mental health system (many of whom had adopted foster children), only 27% of parents
and 14% of adopted persons believed the professionals with whom they worked were adoption-
competent. Furthermore, some felt that this lack of knowledge caused damage to their families
(C.A.S.E., 2012 reported in Brodzinsky, 2013). This is a startling finding because over 400,000
children lived in foster care in the United States in 2011 (US Department of Health and Human
Corresponding author:
Karen Zilberstein, 8 Trumbull Rd #205, Northampton, MA 01060, USA.
Email: ekaren@me.com
547597CCP 0 0 10.1177/1359104514547597Clinical Child Psychology and PsychiatryZilberstein and Popper
research-article 2014
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