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A model for successful foster child–foster parent relationships
ORIGINAL ARTICLE
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A Model for Successful Foster Child–Foster Parent Relationships D o n n a H a l l a s , P h D, R N , C S , C P N P
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ABSTRACT Introduction: The purpose of this study was to explore successful relationships between foster children and foster parents. Methods: Dyads of exemplary foster parents and foster children, identified by foster care experts, were interviewed to uncover the meaning of human bonding and attachment between the foster child and foster parent. Data were collected and analyzed with use of Colazzi’s phenomenologic methodology. Results: A sense of family/coming home was most important for both foster children and foster parents. The powerful desire of the foster child to attain family membership emerged from their experiences, both in and out of foster care. Discussion: The combination of a caring foster parent who worked patiently with the child to help him or her establish membership and a foster child who not only recognized caring behaviors but also was willing to respond to them created the foundation for a successful relationship. J Pediatr Health Care. (2002). 16, 112-118.
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n March 1999, 547,000 children were living in foster care in the United States (U.S. Department of Health and Human Services, 2000). Most of these children have been traumatized by their experiences and are victims of failed parenting. Once in foster care, the children are at risk for continued failure if the “damage” from this trauma is not “repaired.” This study was based on the assumption that a successful attachment relationship between a foster child and foster parent is necessary to help repair the damage or trauma experienced by the child. The purpose of this study was to explore successful relationships between foster children and foster parents. FOSTER CHILD–FOSTER PARENT RELATIONSHIPS The successful parent-child relationship creates a unique lifelong bond of affection between parent and child (Coffman, 1992; Klaus & Kennel, 1976). This attachment between parent and child has been identified as the strongest bond experienced by human beings (Klaus & Kennel, 1976). Research suggests that attachment relationships between the parent and child or between the child and his or her significant caregiver create the foundation from which the child builds all future relationships (George, Wulzyn, & Fanshel, 1994; Kemp, 1987). Furthermore, the bonds that a person makes throughout life have been found to be related to the way in which the person’s attachment behavior was initially organized (Gribsy, 1994). Although meaningful parent-child relationships are valued in our society, not all children are raised in an exemplary family structure. Some children live in families who experience violence, poverty, drug use, and homelessness. These children often require out-of-home care within the foster care system (American Academy of Pediatrics, 1994: Lindsey, 1991). The formation of an attachment relationship between the foster child and the
Donna Hallas is Assistant Professor, Pace University, Lienhard School of Nursing, Pleasantville, NY, and Pediatric Nurse Practitioner, Foster Care/Adoption Primary Care Clinic, St Vincent’s Catholic Medical Centers of Brooklyn and Queens, Jamaica, NY. Reprint requests: Donna Hallas, PhD, RN, CS, CPNP, Pace University, Lienhard School of Nursing, 861 Bedford Rd, Pleasantville, NY 10570. Copyright © 2002 by the National Association of Pediatric Nurse Practitioners. 0891-5245/2002/$35.00 + 0
25/1/117449
doi:10.1067/mph.2002.117449
May/June 2002
PH ORIGINAL ARTICLE C foster parent is one of the main goals of foster care (Fahlberg, 1981). However, although bonding and attachment have been extensively investigated in the mother-infant relationship (Ainsworth, 1973; Bowlby, 1969; Brazelton, 1963; Klaus & Kennel, 1976), the meaning of bonding and attachment for children in foster care has not been investigated. Clinicians have identified psychological, cognitive, and behavioral problems in foster children who have not had the experience of developing a normal attachment with another human being (Schatz & Faust, 1991). Schatz and Faust (1991) believe that attachment and bonding can be promoted by foster parents who accept the older child into their home. Fahlberg (1981) suggests that bonding can be promoted by the foster parent who initiates positive interactions with the child. Claiming behaviors, such as touching and holding the child and being attentive to the child, promote the attachment process (Schatz & Faust, 1991). Schatz and Faust (1991) also believe that nurturing behaviors by foster parents are effective in helping the adolescent develop an attachment relationship with the foster parents. Nurturing behaviors include touching, hugging, accepting the adolescent, and allowing the adolescent to express herself or himself. Although these behaviors have been identified through clinical observations, studies of the patterns and process of attachment between foster children and foster parents have not been reported. An understanding of the development and meaning of the attachment relationship for children in foster care is especially important for primary health care providers, including nurses, nurse practitioners, social workers, and physicians, because the emotional well-being of these children has been shown to be directly related to their physical growth, development, and overall health (Halfon, Mendoca, & Berkowitz, 1995; Simms & Halfon, 1994). The key to the repair process for a child in foster care may be the child’s resiliency or ability to bounce back or recover from a disappointment, obstacle, or setback and to successfully adapt in the face of adversity (Demos, 1989). Resilience involves a reasonable persistence on the part of the individual so that he or she avoids becoming overwhelmed by obstacles. The primary
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premise of this study was that the resilient foster child who is welcomed into a caring, nurturing family environment by foster parents who are cognizant of the developmental level of the child and encourage growth is most likely to succeed in establishing a meaningful relationship with the foster parent.
METHOD This qualitative study investigated what exemplary foster parents and exemplary adults who were raised as foster children perceived as a successful foster parent—foster child relationship.
N
urturing behaviors
include touching, hugging, accepting the adolescent, and allowing the adolescent to express herself or himself.
The following terms were defined for this study:
Attachment relationship. An attachment relationship is defined as “a unique relationship between two people that is specific and endures through time” (Klaus & Kennel, 1976, p. 2). For the purposes of this study, the participants, who included foster children and foster parents who identified themselves as having an attachment relationship with each other, were referred to as the parent/foster child dyads. Exemplary foster parent. An exemplary foster parent is a person who is a worthy model parent (Ehrlich, Flexner, Carruth, & Hawkins, 1980). This person was able to form close relationships with children and adults and viewed the foster child as a part of the family. The foster parent expressed a connection between himself or herself and the child and had maintained a relationship with the adult he or she raised as a child. For the purposes of
this study, an exemplary foster parent was one who was viewed as having these qualities and was nominated for participation in this study by an experienced foster care social worker and/ or health care provider.
Exemplary adult who was raised as a foster child. The exemplary adult, who was a foster child for at least 1 year of his or her childhood, was an adult who had established an attachment relationship with a foster parent and had maintained that relationship in adult life, contacting the adult foster parent in times of happiness and times of need. This person also established relationships with other adults and peers and identified himself or herself as one who feels connected, bonded, and/or attached to another human being. This adult was considered a worthy individual, one whom other foster children could view as a model, successful former foster child. For the purposes of this study, the exemplary adult former foster child was identified as having these characteristics by his or her foster parent and was nominated by the foster parent to participate in this study.
SAMPLE TECHNIQUE Experienced social workers and/or health care providers employed by a foster care/adoption agency were asked to nominate exemplary adults who were currently foster parents or who had been foster parents for possible participation in the study. Exemplary foster parents who agreed to participate in the study were contacted by the researcher and asked to nominate an adult, former foster child with whom they had developed an attachment relationship. The researcher then contacted the adult, former foster child and invited both the foster parent and the adult, former foster child to participate. Written informed consent was obtained from each participant. Individual 1-hour interviews were scheduled. Interviews with one foster parent and former foster child were completed, transcribed, and analyzed before the next interviews were scheduled. Interviews continued until data saturation was reached.
DATA ANALYSIS Data were analyzed with use of Colazzi’s (1978) qualitative phenomenologic methodology. This method was
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PH ORIGINAL ARTICLE C selected because phenomenology is a descriptive approach to research in which the objective of the research is identification of the essence of behavior and the purpose of the research is to promote an understanding of human beings wherever they may be found (Omery, 1983). Data analysis included the following steps as outlined by Colazzi (1978): 1. All tape-recorded interviews were transcribed by the researcher. 2. Each typed interview was then compared with the taped interview to ensure accuracy of transcription. 3. Each transcript was re-read a minimum of three more times to acquire a feeling for the words and to make sense of the interview. 4. Significant phrases or sentences pertaining to the attachment relationship between foster parents and foster children were extracted from the data and formulated into themes. 5. These themes were then organized into three categories: themes from adult, former foster children; themes from foster parents; and shared themes, that is, themes that emerged from both the foster parent and former foster child. 6. At the completion of 10 interviews, it was determined that no new themes were emerging and data saturation had occurred. 7. The data analyses were done in a narrative, which included vignettes for each foster parent/adult former foster child dyad, themes with supporting data, and a conclusion.
VALIDITY AND RELIABILITY In qualitative research, validity refers to “the extent to which the research findings represent reality” (Field & Morse, 1985, p. 139). Descriptive and interpretive validity as discussed by Maxwell (1992) were relevant to this research investigation. Descriptive validity, the foundation upon which qualitative research is built, refers to the report of the researcher concerning what was seen and heard during data collection (Maxwell, 1992). In this study, all interviews were taped and transcribed verbatim by the researcher, and field notes were taken during and after all interviews to document changes in voice tone and body language, thus making the description of the collected data a valid account of the interview.
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Interpretive validity is achieved when the data reflect the language of the individuals studied by use of the words and concepts of the study participants. In this study, the researcher used the words, concepts, and beliefs of the participants concerning the phenomenon and not the researcher’s perspective of the attachment relationship between the foster parent and foster child. According to Maxwell (1992), reliability is closely related to descriptive validity. Different observers or methods that produce different data or accounts of the same events would put into question the descriptive validity of the data, thus adversely affecting the reliability of the investigation. In this study the transcription of the taped interviews and the field notes were available to the doctoral committee members for review, thus controlling for reliability of the data.
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hemes derived from
the foster children’s narratives included caring, patience, and resilience.
FINDINGS Description of Subjects Each foster child in this study had experienced multiple unsuccessful placements before meeting the foster parents with whom he or she had a successful relationship. The foster child remained in the home of the foster parents for an average of 5 years and no less than 4 years, at which time he or she either grew too old to require care or moved into an independent living apartment. The adult former foster children who participated in this study ranged in age from 22 years to 34 years, with a median of 23 years. All of the participants had completed high school and one had completed college. All were employed. The data on foster parents were consistent with previously reported data on persons who are foster parents throughout the United States (Davies,
1994; Fanshel & Shinn, 1978; Fein, Maluccio, & Kluger, 1990; Gruber, 1978). Foster parents ranged in age from 42 to 67 years with a median age of 55 years, and they had from 9 to 32 years of experience as a foster parent.
THEMES Themes derived from the foster children’s narratives included caring, patience, and resilience. Themes derived from the foster parents’ narratives included protection, role model, and financial impact. Shared themes included fidelity/commitment/longevity, a sense of family/coming home, personal identification, bonding and attachment, meaningful relationships with biologic family members, and shared connectedness.
Themes derived from foster children’s narratives Caring. Genuinely caring for foster children was viewed by the foster children as an essential quality of foster parents. A caring relationship enabled the foster children to experience family life, often for the first time, and empowered the children to view themselves as having worth. Some of the statements by the foster children that support this theme include the following: “All of our heart-to-heart talks, no one else, just Mom (foster Mom) and me, and I really felt something, something warm, and I started to think that I was special.” “I entered foster care when I was 10 years old, and I had been in 12 homes—group homes and everything, before I was 12 years old. I bounced all over the place. I ran away from every foster home before I went to their home. But in their home, I never, not for 1 minute, felt like that. I was just so comfortable there…(they are) so nice, sweet, caring, and good-hearted.” Another foster child entered foster care at the age of 9 years and remained in foster care for 12 years, living in 6 different foster homes: “…this was the only foster home I ever stayed in and called it home…I never felt left out…She was always there…If I had problems, she would stay up late and talk with me.” The foster children immediately recognized a foster parent who genuinely
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PH ORIGINAL ARTICLE C cared for them. Caring behaviors identified by the foster children included dayto-day activities and interactions between the foster child and foster parent such as “heart-to-heart” talks, general acceptance of the child in family life, meeting the basic needs of the child, and participation in family trips and/or vacations. The foster child’s recognition that the foster parent cared for him or her became the internal basis for the capacity to experience human relationships.
Patience. Successful foster parents established rules for foster children and exhibited patience in dealing with them. The importance of having patience with the foster child as he or she attempted to conform to established rules emerged in all the interviews with former foster children.
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posed to parents who were addicted to alcohol or drugs, as well as unsuccessful placements in the foster care system. Some of the children were returned to their birth parents by court order, only to experience a second separation when the parent failed to properly care for the child and/or remain free of his or her addiction to alcohol. Given their family histories and preteen histories of repeated unsuccessful foster home placements, it would have been easy for these children to fail. However, the children bounced back and are successful today. Their stories showed that they had the inner strength and desire to succeed.
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hared themes included
“She was very kind—helpful—but she set the rules and made you obey them. She had patience with me and everyone.”
fidelity/commitment/
“Most foster parents shut out the foster children—they say they want to know you but they shut them out… what I learned was that you shouldn’t be rude…there’s no reason to be disrespectful…it took patience to teach me that.”
family/coming home,
“…when I was younger, no one understood me—she understood me more. She had patience with me.” By their own admission, breaking rules was easy for these foster children during their preteen years. It was expected, repetitive behavior displayed by foster children. For these children to learn to abide by rules required patience on the part of the foster parent. These valuable life lessons not only contributed to the repair process for the foster children, but the acceptance of house rules later translated into abiding by society’s rules and laws.
Resilience. Although the foster children in this study had similar experiences, that is, multiple unsuccessful placements and biologic parents who had failed at parenting, the phrase that echoed from the stories of every foster child was, “I am not your average foster child”…“I am stronger”…“I am different.” Thus, the theme resilience emerged. The foster children endured daily hardships in their early years while ex-
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longevity, a sense of
personal identification, bonding and attachment, meaningful relationships with biologic family members, and shared connectedness.
Themes Derived from Foster Parent Narratives Protector. Each foster parent expressed a need to protect the foster child. The need for protection was related to the place of residence of some foster families—thus some girls needed protection from the street, including interacting with males, or protection from drugs and alcohol, which were readily available in the neighborhood. Other children who lived in an uppermiddle-class neighborhood needed protection from neighbors who viewed foster children as different from their biologic children, and still other children needed protection from biologic
parents who were unable to overcome their drug and/or alcohol problems.
Role model. Foster parents felt responsible for providing the foster children with good role models, particularly with respect to parenting. In addition, they felt a responsibility to teach the children proper behavior and self-control. “…Both Mom and Dad (foster parents) believed in working and being responsible. They had values and taught all of us that.” One foster parent believed that she taught all of her foster children “how to survive.” She knew that if she did not provide the girls with specific skills, they would be unsuccessful adults. “Everybody has a job to do…you’ve got to earn it. You’ve got to work for yourself.” The foster child corroborated her words when, in a separate interview she said, “I learned how to survive here…everything I needed to know I learned here.” It is evident from the stories provided by these foster children and foster parents that the success of foster care depends not only on including the child into the family unit, but also on having foster parents who serve as positive role models.
Shared Themes: Foster Children and Foster Parents Fidelity/commitment/longevity. These foster parents felt a strong sense of commitment to these foster children, to other foster children, and to the foster care system. This sense of commitment was evidenced not only in their words but also in the number of years they had been foster parents. Thus, commitment emerged as a theme for foster parents. Each foster child in this study had experienced multiple placements and inevitably feared abandonment. The theme of fidelity emerged as the children described experiences that helped develop a successful foster child–foster parent relationship. One foster child said, “You lie or just do some usual kid things, like skip class, don’t go to school,…smoke, out you go, you can’t pack your bags fast enough. But with Mom (foster mother), it was different, we had family meetings…we would talk about what was right and what
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PH ORIGINAL ARTICLE C was wrong…I kept thinking I would be moved, but no matter what, I wasn’t moved. I knew they really cared about me. Then I settled down like a normal kid.” One foster parent said, “She knows that if something happened to her, she could always come back here…I’m always here for her.” The stories shared by foster children showed that they tested the foster parents by not doing well in school and by breaking the rules, and yet, these foster parents remained faithful to them. Once the foster child realized that fidelity and stability existed in the environment, he or she settled down and began to succeed. Thus, the fear of abandonment experienced by the foster child was “repaired” when the foster parent remained faithful to the child. The statements from both foster children and foster parents showed that developing a successful relationship took time. However, once a successful relationship was established, it endured. These data suggest that successful relationships for children in foster care depend on the successful establishment of trusting, faithful relationships with foster parents, and successful relationships require time.
Sense of family/coming home. Of all the themes that emerged from the data, the sense of family was the most powerful. Each foster child relayed experiences from previous foster home placements in which he or she had not been accepted as a part of a family, even though he or she had been placed in “family foster care.” Each child also described finding a foster home in which he or she was accepted as part of the family. In addition, each foster parent described his or her efforts to help the foster child become a part of the family. Referring to previous foster homes, one foster child said, “I just didn’t fit in…they didn’t let or probably want me to be part of their family…but it was different there. I knew it right away…I think it was just being accepted, feeling like a normal kid. I got that feeling by living with them as part of the family.” “I don’t feel like a foster child. I feel like I am her daughter coming into this house…actually every little thing in this house made me feel like it was home.”
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“This was the only foster home that I ever stayed in and called it home. I had my own room….I never felt left out.” One foster mother’s statement that supports this theme is, “…She came with a stigma, she came with an attitude. Because they are moving place to place, they have got to be a bit defensive.... She got to know the family around her (referring to the foster family) and that it was a place that she could feel comfortable with… and she became the oldest sister in the family and not the mother.”
A
Personal identification and bonding and attachment. Mom, dad, grandma, grandpa, aunt, son, and daughter are all words that denote a relationship between two individuals. In this study, these words had meaning not because of blood relationships but because of the development of meaningful bonds between two unrelated individuals interacting within a family unit. This identification was the necessary first step toward the development of emotional health and a positive self-image, both of which are essential for healthy bonding and attachment relationships (Ainsworth, 1973; Bowlby, 1969; Brazelton, 1963; Klaus & Kennel, 1976).
Meaningful relationships with biologic family members. All of the foster
caring relationship
enabled the foster children to experience family life, often for the first time, and empowered the children to view themselves as having worth.
The stories shared by these foster children depict an ardent desire to belong to a family. Placement of these foster children in a home that lacked a sense of family destined them to fail. The foster children said they “did not fit in”; however, their stories suggest that it was the foster parents who had no interest in making their home a “family foster home.” Each foster child in this study immediately recognized a parent who created a true sense of family…“just being accepted”…“every little thing in this house felt like home”… “the rules”…“fitting in”…“family dinners”…“never feeling left out.” From the positive interactions that occurred within this successful foster family unit, each child was able to repair previous insults to his or her physical and/or psychological being and move forward to emerge as an adult able to develop interpersonal relationships with others.
children interviewed for this study had a relationship with either their biologic parents or their biologic siblings when they grew too old to require care in the foster care system. Sibling relationships were strong whether or not the children lived in the same foster home, and they remained strong in the foster child’s adult life. However, the relationships between foster children and biologic parents were adversely affected by unresolved alcohol problems or the parents’ failure to provide a safe home environment for the child.
Shared connectedness. In each set of dyad interviews, the experience of connectedness was described by both the foster child and the foster parent as being meaningful in the relationship with each other. Connectedness is part of the support system that most individuals need to succeed. Connectedness means gaining a feeling of belonging and developing ties that can be used to overcome obstacles (Maeroff, 1998). One foster parent/foster child dyad each described their first Christmas together as the beginning of a connection between them. The child had never experienced Christmas before, and the foster father established Christmas as an important family holiday in their home. Another foster child/foster parent dyad each described the pregnancy and birth of the foster child’s first child as a meaningful connection between them. The foster child’s description of her efforts to place the first phone call to her foster parents to announce the
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birth of her son is a strong example of a sense of connectedness. The identical stories shared by individuals in the dyad interviews reflect their shared connectedness. This shared connectedness between the foster child and foster parent was the basis of the strong attachment each foster child and foster parent felt for one another. Furthermore, these data suggest that shared connectedness was the foundation for the development of human capital (Coleman, 1988) and the emergence of the successful foster child.
DISCUSSION In the review of the literature, no research studies were found that investigated the attachment relationship between foster care parents and foster children who were adolescents. Recently researchers investigated the selfimage of adolescents in foster care (Lyman & Bird, 1996) and health and mental health issues of adolescent foster children (Kools, 1999). Of significance to this study is Lyman and Bird’s (1996) conclusion that removal of the child from a high-conflict family situation and placement in foster care may provide the opportunity to develop supportive relationships with the adult foster parent that can be used to develop a positive self-image, leading to emotional health. What is known about relationships of adolescent foster children comes from the writings of adults who were raised as foster children and from journalists who interviewed former foster children. The desire to be loved and cared for emerged as the most consistent theme expressed by the former foster children, and the lack of being in a loving parent-child or foster parentchild relationship was frequently identified as a vexing part of being a foster child (Hicks, 1996; Jones, 1990; Lopez & Dworkin, 1996; Sharif, 1996; Stockwell, 1996; Toft, 1996). Lopez (Lopez & Dworkin, 1996) desperately wanted to be adopted. She wanted to be “rescued from her family-less-ness” (p. 153). She described her life in foster care as “foster-ness.” “The feeling of not quite being in solid. The sense of noncommitment. The state of temporary” (p. 62). In this research investigation, the data are consistent with this literature review in that the shared theme, a sense of family/coming home, was the most important issue to both foster children and
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FIGURE Model for successful foster child–foster parent relationships/coming home. foster parents. The powerful desire of foster children to attain family membership emerged from the descriptions of their preteen and teenage experiences both in and out of foster care. However, the difference is that the former foster children in this study had the opportunity to develop attachment relationships while in foster care and equated their success as adults to the development of these relationships. The message from these former foster children was clear. While in foster
care, children who are bounced from home to home were further victimized. Frequent foster home changes were viewed by these foster children as repetitive personal failures with the foster child experiencing another rejection, another loss. However, the data also revealed that this “damage” could be repaired. The combination of a caring foster parent who patiently worked with the child to help him or her establish family membership, and a foster child who not
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PH ORIGINAL ARTICLE C only recognized caring behaviors but also was willing to respond to them, created the foundation for a successful relationship between the foster child and the foster parent. A model for the successful foster child–foster parent relationship (Hallas, 2000) emerged from the data (Figure). “Repairing the damaged foster child” is a central component of the model. The foster parent who displays caring behaviors during interactions with the foster child aids the foster child in acknowledging his or her desires to be loved and cared for and to be successful. Resilient characteristics emerge as the foster child interacts with the foster parent. The foster child experiences a sense of family and resolution of the fear of abandonment when the foster parent remains faithful/committed to him or her. An attachment relationship develops as the foster child and foster parent share everyday experiences, which may include interactions with the child’s biologic parents and/or siblings. From this sense of shared connectedness, a strong reciprocal attachment relationship develops. Time is critical in this process of “repair.” Successful relationships between the foster child and foster parent occur over time. Some of the children in this study identified a year as the amount of time needed to become comfortable with their foster care parent, experience a sense of family, and attain family membership. Thus, the concept of longevity refers to the relationship that continues to grow and develop as the foster child reaches adult age. Longevity is a critical element for successful foster child–foster parent relationships. Caring behaviors, a reciprocal attachment relationship, and shared connectedness allowed the foster child to experience a sense of family, a “coming home.”
IMPLICATIONS The main implication for nurses and social workers that emerges from these data is that foster children with a history of failure in the foster care system, that is, failed reunifications with biologic parents and/or numerous unsuccessful foster care placements,
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can be rescued and the “damage” thus incurred can be “repaired.” The data clearly indicate that a successful foster child–foster parent relationship is a major factor in helping the foster child emerge as a successful adult. The successful foster child–foster parent match is crucial to the development of a successful foster child–foster parent relationship. The factors that create a successful match need to be identified through research efforts.
REFERENCES Ainsworth, M. D. (1973). The development of infant-mother attachment. In B. M. Caldwell & H. N. Riccuiti (Eds.), Review of child development research (pp. 1-94). Chicago: University of Chicago Press. American Academy of Pediatrics. (1994). Health care of children in foster care. Pediatrics, 93, 335-338. Bowlby, J. (1969). Attachment & loss, volume I: Attachment. New York: Basic Books. Brazelton, T. B. (1963). The early mother-infant adjustment. Pediatrics, 34, 931-937. Coffman, S. (1992). Parent and infant attachment: Review of nursing research 1981-1990. Pediatric Nursing, 18, 421-425. Colazzi, P. F. (1978). Psychological research as the phenomenologist views it. In R. Valle & M. King, Existential phenomenological alternatives for psychology (pp. 48-71). New York: Oxford Press. Coleman, J. S. (1988). Social capital in the creation of human capital. American Journal of Sociology, 94(Suppl 95), S95-S120. Davies, N. M. (1994). Foster care. New York: Franklin Watts. Demos, E. V. (1989). Resiliency in infancy. In T. F. Dugan & R. Coles (Eds.), The child in our times: Studies in the development of resiliency (pp. 3-22). New York: Brunner/Mazel. Ehrlich, E., Flexner, S. B., Carruth, G., & Hawkins, J. M. (1980). Oxford American dictionary. New York: Avon Books. Fahlberg, V. (1981). The child placement: Common behavior problems. Michigan: Department of Social Services. Fanshel, D., & Shinn, E. B. (1978). Children in foster care: A longitudinal investigation. New York: Columbia University Press. Fein, E., Maluccio, A. N., & Kluger, M. P. (Eds.). (1990). No more partings: An examination of long term foster family care. Washington, D.C.: Child Welfare League of America. Field, P. A., & Morse, J. M. (1985). Nursing research: The application of qualitative approaches. Rockville, MD: Aspen Publications. George, R., Wulzyn, F., & Fanshel, D. (1994). A foster care research agenda for the 90’s. Child Welfare, 73, 525-549. Gribsy, K. (1994). Maintaining attachment relationships among children in foster care. Journal of Contemporary Human Services, 16, 269-276.
Gruber, A. R. (1978). Children in foster care, destitute, neglected…betrayed. New York: Human Sciences Press. Halfon, N., Mendoca, A., & Berkowitz, G. (1995). Health status of children in foster care. Archives Pediatric Adolescent Medicine, 140, 386-391. Hallas, D. M. (2000). The attachment relationship between foster care parents and foster children. Doctoral dissertation, UMI No. 9949191. Ann Arbor, MI: UMI, Bell & Howell Co. Hicks, R. B. (1996). My experiences in foster care. In A. DeSetta (Ed.), The heart knows something different: Teenage voices from the foster care system (pp 30-33). New York: Persea Books. Jones, E. P. (1990). Where is home? Living through foster care. New York: Four Walls Eight Windows. Kemp, V. H. (1987). Mothers’ perception of children’s temperaments & mother child attachment. Scholarly Inquiry for Nursing Practice: An International Journal, 1, 51-68. Klaus, M. H., & Kennel, J. H. (1976). Maternalinfant bonding. St. Louis: Mosby. Kools, S. (1999). Self-protection in adolescents in foster care. Journal of Child and Adolescent Psychiatric Nursing, 12, 139-152. Lindsey, D. (1991). Factors affecting the foster care placement decision: An analysis of national survey data. American Journal of Orthopsychiatry, 61, 272-281. Lopez, C., & Dworkin, S. (1996). Lost in the system. New York: Simon & Schuster. Lyman, S. B., & Bird, G. W. (1996). A closer at selfimage in male foster care adolescents. Social Work, 41, 85-96. Maeroff, G. I. (1998). Altered destines: Making life better for school children in need. Phi Delta Kappan, 79, 425-432. Maxwell, J. A. (1992). Understanding and validity in qualitative research. Harvard Educational Review, 62, 279-300. Omery, A. (1983). Phenomenology: A method for nursing research. Advances in Nursing Science, 5, 49-63. Schatz, M. S., & Faust, T. P. (1991). Exploring attachment to primary care givers. Fostering families (pp. 1-52). Ft. Collins, CO: Department of Social Work, Colorado State University. Sharif, O. (1996). My foster mother is my best friend. In A. DeSetta (Ed.), The heart knows something different: Teenage voices from the foster care system (pp. 25-28). New York: Persea Books. Simms, M. D., & Halfon, N. (1994). The health care needs of children in foster care: A research agenda. Child Welfare, 73, 505-523. Stockwell, S. (1996). Questions without answers. In A. DeSetta, (Ed.), The heart knows something different: Teenage voices from the foster care system (pp. 2-15). New York: Persea Books. Toft, J. (1996). Orphans of the living: Stories of America’s children in foster care. New York: Simon & Schuster. U.S. Department of Health and Human Services, Administration for Children and Families, Administration on Children, Youth, and Families, Children’s Bureau. (2000). How many children were in foster care on March 31, 1999? [On-line]. Available: www.acf.dhhs.gov/programs/cb/publications/afcars/rpt0100/ar0100c.htm.
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A Model for Successful Foster Child–Foster Parent Relationships D o n n a H a l l a s , P h D, R N , C S , C P N P
I
ABSTRACT Introduction: The purpose of this study was to explore successful relationships between foster children and foster parents. Methods: Dyads of exemplary foster parents and foster children, identified by foster care experts, were interviewed to uncover the meaning of human bonding and attachment between the foster child and foster parent. Data were collected and analyzed with use of Colazzi’s phenomenologic methodology. Results: A sense of family/coming home was most important for both foster children and foster parents. The powerful desire of the foster child to attain family membership emerged from their experiences, both in and out of foster care. Discussion: The combination of a caring foster parent who worked patiently with the child to help him or her establish membership and a foster child who not only recognized caring behaviors but also was willing to respond to them created the foundation for a successful relationship. J Pediatr Health Care. (2002). 16, 112-118.
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n March 1999, 547,000 children were living in foster care in the United States (U.S. Department of Health and Human Services, 2000). Most of these children have been traumatized by their experiences and are victims of failed parenting. Once in foster care, the children are at risk for continued failure if the “damage” from this trauma is not “repaired.” This study was based on the assumption that a successful attachment relationship between a foster child and foster parent is necessary to help repair the damage or trauma experienced by the child. The purpose of this study was to explore successful relationships between foster children and foster parents. FOSTER CHILD–FOSTER PARENT RELATIONSHIPS The successful parent-child relationship creates a unique lifelong bond of affection between parent and child (Coffman, 1992; Klaus & Kennel, 1976). This attachment between parent and child has been identified as the strongest bond experienced by human beings (Klaus & Kennel, 1976). Research suggests that attachment relationships between the parent and child or between the child and his or her significant caregiver create the foundation from which the child builds all future relationships (George, Wulzyn, & Fanshel, 1994; Kemp, 1987). Furthermore, the bonds that a person makes throughout life have been found to be related to the way in which the person’s attachment behavior was initially organized (Gribsy, 1994). Although meaningful parent-child relationships are valued in our society, not all children are raised in an exemplary family structure. Some children live in families who experience violence, poverty, drug use, and homelessness. These children often require out-of-home care within the foster care system (American Academy of Pediatrics, 1994: Lindsey, 1991). The formation of an attachment relationship between the foster child and the
Donna Hallas is Assistant Professor, Pace University, Lienhard School of Nursing, Pleasantville, NY, and Pediatric Nurse Practitioner, Foster Care/Adoption Primary Care Clinic, St Vincent’s Catholic Medical Centers of Brooklyn and Queens, Jamaica, NY. Reprint requests: Donna Hallas, PhD, RN, CS, CPNP, Pace University, Lienhard School of Nursing, 861 Bedford Rd, Pleasantville, NY 10570. Copyright © 2002 by the National Association of Pediatric Nurse Practitioners. 0891-5245/2002/$35.00 + 0
25/1/117449
doi:10.1067/mph.2002.117449
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PH ORIGINAL ARTICLE C foster parent is one of the main goals of foster care (Fahlberg, 1981). However, although bonding and attachment have been extensively investigated in the mother-infant relationship (Ainsworth, 1973; Bowlby, 1969; Brazelton, 1963; Klaus & Kennel, 1976), the meaning of bonding and attachment for children in foster care has not been investigated. Clinicians have identified psychological, cognitive, and behavioral problems in foster children who have not had the experience of developing a normal attachment with another human being (Schatz & Faust, 1991). Schatz and Faust (1991) believe that attachment and bonding can be promoted by foster parents who accept the older child into their home. Fahlberg (1981) suggests that bonding can be promoted by the foster parent who initiates positive interactions with the child. Claiming behaviors, such as touching and holding the child and being attentive to the child, promote the attachment process (Schatz & Faust, 1991). Schatz and Faust (1991) also believe that nurturing behaviors by foster parents are effective in helping the adolescent develop an attachment relationship with the foster parents. Nurturing behaviors include touching, hugging, accepting the adolescent, and allowing the adolescent to express herself or himself. Although these behaviors have been identified through clinical observations, studies of the patterns and process of attachment between foster children and foster parents have not been reported. An understanding of the development and meaning of the attachment relationship for children in foster care is especially important for primary health care providers, including nurses, nurse practitioners, social workers, and physicians, because the emotional well-being of these children has been shown to be directly related to their physical growth, development, and overall health (Halfon, Mendoca, & Berkowitz, 1995; Simms & Halfon, 1994). The key to the repair process for a child in foster care may be the child’s resiliency or ability to bounce back or recover from a disappointment, obstacle, or setback and to successfully adapt in the face of adversity (Demos, 1989). Resilience involves a reasonable persistence on the part of the individual so that he or she avoids becoming overwhelmed by obstacles. The primary
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premise of this study was that the resilient foster child who is welcomed into a caring, nurturing family environment by foster parents who are cognizant of the developmental level of the child and encourage growth is most likely to succeed in establishing a meaningful relationship with the foster parent.
METHOD This qualitative study investigated what exemplary foster parents and exemplary adults who were raised as foster children perceived as a successful foster parent—foster child relationship.
N
urturing behaviors
include touching, hugging, accepting the adolescent, and allowing the adolescent to express herself or himself.
The following terms were defined for this study:
Attachment relationship. An attachment relationship is defined as “a unique relationship between two people that is specific and endures through time” (Klaus & Kennel, 1976, p. 2). For the purposes of this study, the participants, who included foster children and foster parents who identified themselves as having an attachment relationship with each other, were referred to as the parent/foster child dyads. Exemplary foster parent. An exemplary foster parent is a person who is a worthy model parent (Ehrlich, Flexner, Carruth, & Hawkins, 1980). This person was able to form close relationships with children and adults and viewed the foster child as a part of the family. The foster parent expressed a connection between himself or herself and the child and had maintained a relationship with the adult he or she raised as a child. For the purposes of
this study, an exemplary foster parent was one who was viewed as having these qualities and was nominated for participation in this study by an experienced foster care social worker and/ or health care provider.
Exemplary adult who was raised as a foster child. The exemplary adult, who was a foster child for at least 1 year of his or her childhood, was an adult who had established an attachment relationship with a foster parent and had maintained that relationship in adult life, contacting the adult foster parent in times of happiness and times of need. This person also established relationships with other adults and peers and identified himself or herself as one who feels connected, bonded, and/or attached to another human being. This adult was considered a worthy individual, one whom other foster children could view as a model, successful former foster child. For the purposes of this study, the exemplary adult former foster child was identified as having these characteristics by his or her foster parent and was nominated by the foster parent to participate in this study.
SAMPLE TECHNIQUE Experienced social workers and/or health care providers employed by a foster care/adoption agency were asked to nominate exemplary adults who were currently foster parents or who had been foster parents for possible participation in the study. Exemplary foster parents who agreed to participate in the study were contacted by the researcher and asked to nominate an adult, former foster child with whom they had developed an attachment relationship. The researcher then contacted the adult, former foster child and invited both the foster parent and the adult, former foster child to participate. Written informed consent was obtained from each participant. Individual 1-hour interviews were scheduled. Interviews with one foster parent and former foster child were completed, transcribed, and analyzed before the next interviews were scheduled. Interviews continued until data saturation was reached.
DATA ANALYSIS Data were analyzed with use of Colazzi’s (1978) qualitative phenomenologic methodology. This method was
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PH ORIGINAL ARTICLE C selected because phenomenology is a descriptive approach to research in which the objective of the research is identification of the essence of behavior and the purpose of the research is to promote an understanding of human beings wherever they may be found (Omery, 1983). Data analysis included the following steps as outlined by Colazzi (1978): 1. All tape-recorded interviews were transcribed by the researcher. 2. Each typed interview was then compared with the taped interview to ensure accuracy of transcription. 3. Each transcript was re-read a minimum of three more times to acquire a feeling for the words and to make sense of the interview. 4. Significant phrases or sentences pertaining to the attachment relationship between foster parents and foster children were extracted from the data and formulated into themes. 5. These themes were then organized into three categories: themes from adult, former foster children; themes from foster parents; and shared themes, that is, themes that emerged from both the foster parent and former foster child. 6. At the completion of 10 interviews, it was determined that no new themes were emerging and data saturation had occurred. 7. The data analyses were done in a narrative, which included vignettes for each foster parent/adult former foster child dyad, themes with supporting data, and a conclusion.
VALIDITY AND RELIABILITY In qualitative research, validity refers to “the extent to which the research findings represent reality” (Field & Morse, 1985, p. 139). Descriptive and interpretive validity as discussed by Maxwell (1992) were relevant to this research investigation. Descriptive validity, the foundation upon which qualitative research is built, refers to the report of the researcher concerning what was seen and heard during data collection (Maxwell, 1992). In this study, all interviews were taped and transcribed verbatim by the researcher, and field notes were taken during and after all interviews to document changes in voice tone and body language, thus making the description of the collected data a valid account of the interview.
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Interpretive validity is achieved when the data reflect the language of the individuals studied by use of the words and concepts of the study participants. In this study, the researcher used the words, concepts, and beliefs of the participants concerning the phenomenon and not the researcher’s perspective of the attachment relationship between the foster parent and foster child. According to Maxwell (1992), reliability is closely related to descriptive validity. Different observers or methods that produce different data or accounts of the same events would put into question the descriptive validity of the data, thus adversely affecting the reliability of the investigation. In this study the transcription of the taped interviews and the field notes were available to the doctoral committee members for review, thus controlling for reliability of the data.
T
hemes derived from
the foster children’s narratives included caring, patience, and resilience.
FINDINGS Description of Subjects Each foster child in this study had experienced multiple unsuccessful placements before meeting the foster parents with whom he or she had a successful relationship. The foster child remained in the home of the foster parents for an average of 5 years and no less than 4 years, at which time he or she either grew too old to require care or moved into an independent living apartment. The adult former foster children who participated in this study ranged in age from 22 years to 34 years, with a median of 23 years. All of the participants had completed high school and one had completed college. All were employed. The data on foster parents were consistent with previously reported data on persons who are foster parents throughout the United States (Davies,
1994; Fanshel & Shinn, 1978; Fein, Maluccio, & Kluger, 1990; Gruber, 1978). Foster parents ranged in age from 42 to 67 years with a median age of 55 years, and they had from 9 to 32 years of experience as a foster parent.
THEMES Themes derived from the foster children’s narratives included caring, patience, and resilience. Themes derived from the foster parents’ narratives included protection, role model, and financial impact. Shared themes included fidelity/commitment/longevity, a sense of family/coming home, personal identification, bonding and attachment, meaningful relationships with biologic family members, and shared connectedness.
Themes derived from foster children’s narratives Caring. Genuinely caring for foster children was viewed by the foster children as an essential quality of foster parents. A caring relationship enabled the foster children to experience family life, often for the first time, and empowered the children to view themselves as having worth. Some of the statements by the foster children that support this theme include the following: “All of our heart-to-heart talks, no one else, just Mom (foster Mom) and me, and I really felt something, something warm, and I started to think that I was special.” “I entered foster care when I was 10 years old, and I had been in 12 homes—group homes and everything, before I was 12 years old. I bounced all over the place. I ran away from every foster home before I went to their home. But in their home, I never, not for 1 minute, felt like that. I was just so comfortable there…(they are) so nice, sweet, caring, and good-hearted.” Another foster child entered foster care at the age of 9 years and remained in foster care for 12 years, living in 6 different foster homes: “…this was the only foster home I ever stayed in and called it home…I never felt left out…She was always there…If I had problems, she would stay up late and talk with me.” The foster children immediately recognized a foster parent who genuinely
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PH ORIGINAL ARTICLE C cared for them. Caring behaviors identified by the foster children included dayto-day activities and interactions between the foster child and foster parent such as “heart-to-heart” talks, general acceptance of the child in family life, meeting the basic needs of the child, and participation in family trips and/or vacations. The foster child’s recognition that the foster parent cared for him or her became the internal basis for the capacity to experience human relationships.
Patience. Successful foster parents established rules for foster children and exhibited patience in dealing with them. The importance of having patience with the foster child as he or she attempted to conform to established rules emerged in all the interviews with former foster children.
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posed to parents who were addicted to alcohol or drugs, as well as unsuccessful placements in the foster care system. Some of the children were returned to their birth parents by court order, only to experience a second separation when the parent failed to properly care for the child and/or remain free of his or her addiction to alcohol. Given their family histories and preteen histories of repeated unsuccessful foster home placements, it would have been easy for these children to fail. However, the children bounced back and are successful today. Their stories showed that they had the inner strength and desire to succeed.
S
hared themes included
“She was very kind—helpful—but she set the rules and made you obey them. She had patience with me and everyone.”
fidelity/commitment/
“Most foster parents shut out the foster children—they say they want to know you but they shut them out… what I learned was that you shouldn’t be rude…there’s no reason to be disrespectful…it took patience to teach me that.”
family/coming home,
“…when I was younger, no one understood me—she understood me more. She had patience with me.” By their own admission, breaking rules was easy for these foster children during their preteen years. It was expected, repetitive behavior displayed by foster children. For these children to learn to abide by rules required patience on the part of the foster parent. These valuable life lessons not only contributed to the repair process for the foster children, but the acceptance of house rules later translated into abiding by society’s rules and laws.
Resilience. Although the foster children in this study had similar experiences, that is, multiple unsuccessful placements and biologic parents who had failed at parenting, the phrase that echoed from the stories of every foster child was, “I am not your average foster child”…“I am stronger”…“I am different.” Thus, the theme resilience emerged. The foster children endured daily hardships in their early years while ex-
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longevity, a sense of
personal identification, bonding and attachment, meaningful relationships with biologic family members, and shared connectedness.
Themes Derived from Foster Parent Narratives Protector. Each foster parent expressed a need to protect the foster child. The need for protection was related to the place of residence of some foster families—thus some girls needed protection from the street, including interacting with males, or protection from drugs and alcohol, which were readily available in the neighborhood. Other children who lived in an uppermiddle-class neighborhood needed protection from neighbors who viewed foster children as different from their biologic children, and still other children needed protection from biologic
parents who were unable to overcome their drug and/or alcohol problems.
Role model. Foster parents felt responsible for providing the foster children with good role models, particularly with respect to parenting. In addition, they felt a responsibility to teach the children proper behavior and self-control. “…Both Mom and Dad (foster parents) believed in working and being responsible. They had values and taught all of us that.” One foster parent believed that she taught all of her foster children “how to survive.” She knew that if she did not provide the girls with specific skills, they would be unsuccessful adults. “Everybody has a job to do…you’ve got to earn it. You’ve got to work for yourself.” The foster child corroborated her words when, in a separate interview she said, “I learned how to survive here…everything I needed to know I learned here.” It is evident from the stories provided by these foster children and foster parents that the success of foster care depends not only on including the child into the family unit, but also on having foster parents who serve as positive role models.
Shared Themes: Foster Children and Foster Parents Fidelity/commitment/longevity. These foster parents felt a strong sense of commitment to these foster children, to other foster children, and to the foster care system. This sense of commitment was evidenced not only in their words but also in the number of years they had been foster parents. Thus, commitment emerged as a theme for foster parents. Each foster child in this study had experienced multiple placements and inevitably feared abandonment. The theme of fidelity emerged as the children described experiences that helped develop a successful foster child–foster parent relationship. One foster child said, “You lie or just do some usual kid things, like skip class, don’t go to school,…smoke, out you go, you can’t pack your bags fast enough. But with Mom (foster mother), it was different, we had family meetings…we would talk about what was right and what
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PH ORIGINAL ARTICLE C was wrong…I kept thinking I would be moved, but no matter what, I wasn’t moved. I knew they really cared about me. Then I settled down like a normal kid.” One foster parent said, “She knows that if something happened to her, she could always come back here…I’m always here for her.” The stories shared by foster children showed that they tested the foster parents by not doing well in school and by breaking the rules, and yet, these foster parents remained faithful to them. Once the foster child realized that fidelity and stability existed in the environment, he or she settled down and began to succeed. Thus, the fear of abandonment experienced by the foster child was “repaired” when the foster parent remained faithful to the child. The statements from both foster children and foster parents showed that developing a successful relationship took time. However, once a successful relationship was established, it endured. These data suggest that successful relationships for children in foster care depend on the successful establishment of trusting, faithful relationships with foster parents, and successful relationships require time.
Sense of family/coming home. Of all the themes that emerged from the data, the sense of family was the most powerful. Each foster child relayed experiences from previous foster home placements in which he or she had not been accepted as a part of a family, even though he or she had been placed in “family foster care.” Each child also described finding a foster home in which he or she was accepted as part of the family. In addition, each foster parent described his or her efforts to help the foster child become a part of the family. Referring to previous foster homes, one foster child said, “I just didn’t fit in…they didn’t let or probably want me to be part of their family…but it was different there. I knew it right away…I think it was just being accepted, feeling like a normal kid. I got that feeling by living with them as part of the family.” “I don’t feel like a foster child. I feel like I am her daughter coming into this house…actually every little thing in this house made me feel like it was home.”
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“This was the only foster home that I ever stayed in and called it home. I had my own room….I never felt left out.” One foster mother’s statement that supports this theme is, “…She came with a stigma, she came with an attitude. Because they are moving place to place, they have got to be a bit defensive.... She got to know the family around her (referring to the foster family) and that it was a place that she could feel comfortable with… and she became the oldest sister in the family and not the mother.”
A
Personal identification and bonding and attachment. Mom, dad, grandma, grandpa, aunt, son, and daughter are all words that denote a relationship between two individuals. In this study, these words had meaning not because of blood relationships but because of the development of meaningful bonds between two unrelated individuals interacting within a family unit. This identification was the necessary first step toward the development of emotional health and a positive self-image, both of which are essential for healthy bonding and attachment relationships (Ainsworth, 1973; Bowlby, 1969; Brazelton, 1963; Klaus & Kennel, 1976).
Meaningful relationships with biologic family members. All of the foster
caring relationship
enabled the foster children to experience family life, often for the first time, and empowered the children to view themselves as having worth.
The stories shared by these foster children depict an ardent desire to belong to a family. Placement of these foster children in a home that lacked a sense of family destined them to fail. The foster children said they “did not fit in”; however, their stories suggest that it was the foster parents who had no interest in making their home a “family foster home.” Each foster child in this study immediately recognized a parent who created a true sense of family…“just being accepted”…“every little thing in this house felt like home”… “the rules”…“fitting in”…“family dinners”…“never feeling left out.” From the positive interactions that occurred within this successful foster family unit, each child was able to repair previous insults to his or her physical and/or psychological being and move forward to emerge as an adult able to develop interpersonal relationships with others.
children interviewed for this study had a relationship with either their biologic parents or their biologic siblings when they grew too old to require care in the foster care system. Sibling relationships were strong whether or not the children lived in the same foster home, and they remained strong in the foster child’s adult life. However, the relationships between foster children and biologic parents were adversely affected by unresolved alcohol problems or the parents’ failure to provide a safe home environment for the child.
Shared connectedness. In each set of dyad interviews, the experience of connectedness was described by both the foster child and the foster parent as being meaningful in the relationship with each other. Connectedness is part of the support system that most individuals need to succeed. Connectedness means gaining a feeling of belonging and developing ties that can be used to overcome obstacles (Maeroff, 1998). One foster parent/foster child dyad each described their first Christmas together as the beginning of a connection between them. The child had never experienced Christmas before, and the foster father established Christmas as an important family holiday in their home. Another foster child/foster parent dyad each described the pregnancy and birth of the foster child’s first child as a meaningful connection between them. The foster child’s description of her efforts to place the first phone call to her foster parents to announce the
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birth of her son is a strong example of a sense of connectedness. The identical stories shared by individuals in the dyad interviews reflect their shared connectedness. This shared connectedness between the foster child and foster parent was the basis of the strong attachment each foster child and foster parent felt for one another. Furthermore, these data suggest that shared connectedness was the foundation for the development of human capital (Coleman, 1988) and the emergence of the successful foster child.
DISCUSSION In the review of the literature, no research studies were found that investigated the attachment relationship between foster care parents and foster children who were adolescents. Recently researchers investigated the selfimage of adolescents in foster care (Lyman & Bird, 1996) and health and mental health issues of adolescent foster children (Kools, 1999). Of significance to this study is Lyman and Bird’s (1996) conclusion that removal of the child from a high-conflict family situation and placement in foster care may provide the opportunity to develop supportive relationships with the adult foster parent that can be used to develop a positive self-image, leading to emotional health. What is known about relationships of adolescent foster children comes from the writings of adults who were raised as foster children and from journalists who interviewed former foster children. The desire to be loved and cared for emerged as the most consistent theme expressed by the former foster children, and the lack of being in a loving parent-child or foster parentchild relationship was frequently identified as a vexing part of being a foster child (Hicks, 1996; Jones, 1990; Lopez & Dworkin, 1996; Sharif, 1996; Stockwell, 1996; Toft, 1996). Lopez (Lopez & Dworkin, 1996) desperately wanted to be adopted. She wanted to be “rescued from her family-less-ness” (p. 153). She described her life in foster care as “foster-ness.” “The feeling of not quite being in solid. The sense of noncommitment. The state of temporary” (p. 62). In this research investigation, the data are consistent with this literature review in that the shared theme, a sense of family/coming home, was the most important issue to both foster children and
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FIGURE Model for successful foster child–foster parent relationships/coming home. foster parents. The powerful desire of foster children to attain family membership emerged from the descriptions of their preteen and teenage experiences both in and out of foster care. However, the difference is that the former foster children in this study had the opportunity to develop attachment relationships while in foster care and equated their success as adults to the development of these relationships. The message from these former foster children was clear. While in foster
care, children who are bounced from home to home were further victimized. Frequent foster home changes were viewed by these foster children as repetitive personal failures with the foster child experiencing another rejection, another loss. However, the data also revealed that this “damage” could be repaired. The combination of a caring foster parent who patiently worked with the child to help him or her establish family membership, and a foster child who not
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PH ORIGINAL ARTICLE C only recognized caring behaviors but also was willing to respond to them, created the foundation for a successful relationship between the foster child and the foster parent. A model for the successful foster child–foster parent relationship (Hallas, 2000) emerged from the data (Figure). “Repairing the damaged foster child” is a central component of the model. The foster parent who displays caring behaviors during interactions with the foster child aids the foster child in acknowledging his or her desires to be loved and cared for and to be successful. Resilient characteristics emerge as the foster child interacts with the foster parent. The foster child experiences a sense of family and resolution of the fear of abandonment when the foster parent remains faithful/committed to him or her. An attachment relationship develops as the foster child and foster parent share everyday experiences, which may include interactions with the child’s biologic parents and/or siblings. From this sense of shared connectedness, a strong reciprocal attachment relationship develops. Time is critical in this process of “repair.” Successful relationships between the foster child and foster parent occur over time. Some of the children in this study identified a year as the amount of time needed to become comfortable with their foster care parent, experience a sense of family, and attain family membership. Thus, the concept of longevity refers to the relationship that continues to grow and develop as the foster child reaches adult age. Longevity is a critical element for successful foster child–foster parent relationships. Caring behaviors, a reciprocal attachment relationship, and shared connectedness allowed the foster child to experience a sense of family, a “coming home.”
IMPLICATIONS The main implication for nurses and social workers that emerges from these data is that foster children with a history of failure in the foster care system, that is, failed reunifications with biologic parents and/or numerous unsuccessful foster care placements,
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can be rescued and the “damage” thus incurred can be “repaired.” The data clearly indicate that a successful foster child–foster parent relationship is a major factor in helping the foster child emerge as a successful adult. The successful foster child–foster parent match is crucial to the development of a successful foster child–foster parent relationship. The factors that create a successful match need to be identified through research efforts.
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