Fostering Healthy Futures: A New Evidence-Based Program for Preadolescent Youth in Foster Care

Youth with a history of maltreatment are at risk for a host of mental health, behavioral, and social problems, resulting in adverse life-course outcomes of great public health significance. Innovative preventive interventions are needed to mitigate the risk for poor outcomes. Fostering Healthy Futures (FHF) is a 10-year federally-funded randomized controlled trial (RCT) of a program designed to promote prosocial development, and to reduce problem behaviors in children who have been maltreated and placed in foster care.

The 9-month intervention consists of 3 components: 1) evaluations of children’s mental health, cognitive, and academic functioning, 2) one-on-one mentoring, and 3) weekly therapeutic skills groups. All eligible children (N = 426, 9-11 year olds) receive the evaluation and about half of the children are randomized to the intervention (n = 231, 51.1% male) or control group (n = 195, 54.1% male). Mentoring is provided by graduate students who meet weekly for 3-4 hours with their mentees. Thirty weekly skills groups are implemented which combine traditional cognitive-behavioral activities with process-oriented material. Participants are assessed at baseline and at follow-up time points, using reports from youth, their parents/caregivers, and teachers.

This presentation will include an overview of the program and describe the mental health, placement, and permanency outcomes. Using intent-to-treat analyses, and controlling for key covariates, data from the first 5 years of the RCT demonstrated that the intervention group had fewer mental health problems on a multi-informant index of trauma symptoms and internalizing problems measured 6-months post-intervention (mean difference, −0.51; 95% CI, −0.84 to −0.19). In addition, FHF participants reported fewer symptoms of dissociation (mean difference, −3.66; 95% CI, −6.58 to −0.74) 6-months post-intervention, and better quality of life post-intervention (mean difference, 0.11; 95% CI, 0.03 to 0.19). Similarly, after controlling for baseline functioning and placement history, intervention youth were 71% less likely to be placed in residential treatment one year post-intervention. This presentation will include a summary of those results, as well as results from the final 5 years that are currently being analyzed to replicate and extend these findings.

FHF is a contextually-relevant intervention that has demonstrated positive effects with a high-risk population. It has been named an evidence- and research-based program by the California Evidence-Based Clearinghouse for Child Welfare and the Washington State Institute for Public Policy. The goal of this research is to design more efficacious interventions, thereby reducing disability, morbidity, and mortality for high-risk youth.