Misconceptions about therapeutic foster care are not uncommon. The children who are placed in therapeutic foster care may have many of the same or comparable requirements as children who are placed in normal care; nonetheless, it is typically judged that these children require additional support. Every child who is in foster care has been through a traumatic event. Every child who is placed in foster care will have requirements that must be satisfied by the foster parents, in addition to the resources and services available to them.
What does it mean to receive therapeutic foster care? Where does this stand in comparison to the more traditional forms of foster care?
There is a great deal of confusion surrounding the concept of therapeutic foster care. The word “therapeutic” has an ominous, weighty, and threatening tone about it. There is frequently reluctance to take action. The same things happen to children when they are placed in foster care; they have been through the same traumatic experiences, the same abuse and neglect. However, sometimes there are some known additional needs—emotionally, behaviorally, or medically—before they are placed in foster care, and these children are placed in therapeutic foster care. It’s possible that the family or the Department of Social Services provided that information. Sometimes when they are placed in care and they begin showing certain behaviors or needs, a certain assessment can be done here in our office that would make them or deem them “therapeutic” to place them in a therapeutic home to place them in a therapeutic home because therapeutic foster parents are trained and equipped to deal with some of these higher needs. Sometimes when they are placed in care and they begin showing certain behaviors or needs, a certain assessment can be done here in our office that would make them or deem them “therapeutic The kid might be moved to a therapeutic foster home, or the child’s current foster family might decide to get certified to provide therapeutic foster care instead of traditional foster care. As frequent foster parents, each one of us has been in the position in which the trauma becomes very palpable and we begin to observe certain behaviors from the child. Even though a child is put in a typical foster home, this does not mean that they do not have any additional requirements to fulfill. Therefore, one of the advantages of therapeutic foster care is that additional assistance is provided to ensure that the family receives the services they require. It’s the same kids, but at different stages in the process of becoming adults.
Who are those kids in therapeutic foster care? What do they need?
When you say “therapeutic foster care,” most people think of a child in a wheelchair, a child who can’t go to regular school, or a child with no social skills at all. In reality, though, many of our kids are the same ones who are in regular foster care. Same thing with adults, trauma and abuse can sometimes show up in different ways. Sometimes our kids have a little bit more to deal with than usual, and they need a little bit more help. They’re still the same kids at the end of the day.
There are different kinds of therapeutic foster care and different levels of care. We do have medically fragile children as young as infants, children with autism or down syndrome, and children with conditions that will last their whole lives. Then, there are levels of children, which basically mean what the foster parent will need to give the child. Children in level one may have therapy once a week or every two weeks. We sometimes see signs of ADHD, or they may act out in ways that many kids do. At the second level, they might have two therapies a week. So it kind of adds to that; there are many different kinds. Not everyone is sick or has special needs.
During the initial licensing process, we walk a foster family through the process with them. We talk about what they do each week. Can they deal with two treatments a week? Are they a parent who works? Do they stay home all day? Most of our parents work. Probably 90% of them do. A family can tell us what makes them feel at ease. Some families have been nurses, and they love kids who are sick or have special needs. This is their area of expertise, so we can put those kids with them. But many families, including mine, work full time, and the tubes and medical equipment are scary, so that wouldn’t work. We figure out what the family can handle, and they do the same. We never want to send a child to a home that won’t be good for him or her.
Who makes a great therapeutic family?
A lot of our foster parents are a lot like great regular foster parents in a lot of ways. Someone who has the space and time to do it. You can have a busy schedule and work full-time. Most of our families have a lot on their plates. The best trait is being able to look at a child and see their potential, even if they’ve been through a lot. We strongly believe that a child can’t tell you they’re sad, so they have to show you. That happens a lot in therapeutic foster care, so foster parents need to be able to see the kids’ potential and really stick with them.
It’s not about the money, but the stipend for therapeutic foster care is different from the stipend for regular foster homes. Every foster parent gets paid for taking care of a child. The state sets a set board rate per day, per child, for all standard foster homes. This is true whether you got your license through DSS or a private agency. That’s not the case with therapeutic foster care. One thing that makes us different is that most of our money comes from Medicaid. Some of our extra trainings are also meant to help with this. We do have a higher board rate to help cover the costs of driving farther to appointments, going to more parent-teacher conferences, and missing work. There are sometimes extra costs with therapeutic foster care, so it makes sense that the rate is higher. Because each therapeutic foster care licensing agency is private, there is no set rate for room and board for all therapeutic families. The amount of the stipend depends on the child’s needs or level.
What kinds of resources and help are there for therapeutic foster families?
The treatment coordinator is the main thing that makes therapeutic foster care different. When a child moves into one of our homes, a treatment coordinator visits them once a month. They will often also go with the foster parents to doctor appointments, therapy, school meetings, and meetings of the Foster Care Review Board. You can call them 24/7, even late at night or on the weekend. There is a support line that is open all the time. You can always reach someone who is on call. We have that set up for sure. You don’t need to do it by yourself. It’s fine if you haven’t done this before. That’s what the person in charge of treatment does.
The agency offers training for people who want to work there. We like to be there for families from the beginning to the end of the process. The training goes into great detail about therapeutic foster care and what will be needed. Most of the pre-service training is the same as for regular pre-service, but there are some extra pieces of training for therapeutic foster care when working with Medicaid. We need CPR, and SCYAP gives it to us for free. You have to get recertified every two years. You need 16 hours per year, which isn’t much different from regular foster care. I know that sounds like a pause. You think to yourself, “I’m going to have this child who will have a few more needs. What will the agency have to do to continue fostering?” We break that down through training and then give a lot of help.
Why do you think therapeutic foster care is a good idea?
Foster care has taken over my whole life. I’ve wanted to be a foster parent since I was 12 years old. I wanted my mom to do it, but she refused, so I did it myself. We started fostering with my husband, and two months later, I started working with SCYAP. I learned about the world of foster care at home and at work. We had a license to foster regularly for two and a half years. We had a child who was diagnosed with autism and needed more help, so we gave our license to an agency that helps people. We got our license changed so that we could keep that child in our home and get more help and services. Since then, we haven’t looked back. The help has been important.