DOCUMENT RESUME ED 330 175 EC 300 147 AUTHOR Stroul, Beth A. TITLE Therapeutic Foster Care. Volume III. Series on Community-Based Services for Childen and Adolescents Who Are Severely Emotionally Disturbed. INSTITUTION Georgetown Univ. Child Development Center, Washington, DC. CASSP Technical Assistance Center. SPONS AGENCY National Inst. of Mental Health (DHHS), Rockville, MD. Child and Adolescent Service System Program. PUB DATE Sep 89 NOTE 258p.; For related documents, see EC 300 144-148,, AVAILABLE FROMCASSP Technical Assistance Center, Georgetown University Child Development Center, 3800 Reservoir Rd., N.W., Washington, DC 20007 ($10.00; $25.00 Volumes I-III). PUB TYPE Reports - Descriptive (141) -- Information Analyses (070) -- Guides - Non-Classroom Use (055) EDRS PRICE MF01/PC11 Plus Postage. DESCRIPTORS Adolescents; Children; Child Welfare; Community Services; Delivery Systems; *Emotional Disturbances; Family Influence; Family Relationship; Family Role; *Foster Care; Foster Family; Intervention; *Mental Health Programs; Models; Program Descriptions; Psychiatric Services; *Psychoeducational Methods; Severe Disabilities; *Therapeutic Environment IDENTIFIERS Lee Mental Health Center FL; Pressley Ridge Youth Development Extension PA ABSTRACT This document is part of a series of monographson community-based services for children and adolescents whoare severely emotionally disturbed. The series is the product ofa national study of community-based service approaches which identified over 200 programs serving emotionally disturbed children and included visits to several programs representing a variety of service delivery approaches. This volume begins with present, ,m1 of a model system of care, along with principles for service delivery. A literature- and program-based review of therapeutic foster care servicesIs then presented, focusing on: definition and terminology; history; philosophy and goals; characteristics; variables suchas treatment intensity and treatment approach; specific services suchas preplacement, intervention, discharge, and follow-up; services to natural families; linkages; clients; staffing; treatment parents; resources; evaluation; and major advantages and challenges. Two programs are described in detail--the Family Network Program of the Lee Mental Health Center (Fort Myers. Florida) and PressleyRidge Youth Development Extension (Pittsburgh, Pennsylvania.) One-page profiles of 32 therapeutic foster care programs are also provided.An appendix contains "The Story of Amanda,"a case study of a 10-year-old emotionally disturbed child successfully treated ina therapeutic foster care home. (JDD) Serieson Community-Based Services CeDc' for Children and Adolescents Who Are Severely Emotionally Disturbed ;4 VOWME III: THERAPEUTIC FOSTER CARE 11111111,11111.1111111r .411111 U S DE PARTAREN r OF EDUCATION ATInNt.1 10 !,(),,H(.,1:-, OTIMATION Il DIU o.!ht. r,prr,e1, f1,1,1f 1(1111 loon ,11,a,.fv OP(1,1;1,11, (11PI pi Ipoi" y MIML robe. 1 IMMO BM COPY AVAILABLE i'rv-par4A1 Bcth :1.twili, h.,..111!,(,1! t Ci;t1t(11 itt4(.11i,1,1,, ))L\(.11111111CISS ;!1,1'," ::6%.,11:i .'1;`,1Cliktit :\ 11'1'0,11)it.4iii} dod !-;rtice cAskin 4,0 lIWANSMAINACCAME1141PLY,ITIAL.7:45,1011.thISVO/S/M4SHialele10111h121.2./.,4(1.410.ads. *r bar Mau.. SERIES ON COMMUNITY-BASEDSERVICES FOR CHILDREN & ADOLESCENTSWHO ARE SEVERELY EMOTIONALLY DISTURBED: VOLUME I.": THERAPEUTIC FOSTERCARE Prepared By: Beth A. Stroul, M.Ed. CASSP Technical Assistance Center Georgetown University Child DevelopmentCenter 38(K) Reservoir Road, N.W. Washington, D.C. 20007 202-687-8635 Funded by the National Institute ofMental Health Child and Adolescent ServiceSystem Program (CASSP) September 1989 ACKNOWLEDGMENTS This series of monographs isthe major product of a study of community-basedservices for children and adolescents who are severely emotionally disturbed.The study was conducted by Sybil K. Goklman, M.S.W., Beth A. Strout, M.Ed., and PhyllisR. Magrab, Ph.D. of the CASSP Technical Assistance Center at the Georgetown University ChildDevelopment Center. The following individuals contributed to the developmentof this document by servingon the Advisory Committee kr the study.Their guidance throughout the project is acknowledgedand appreciated: Mareasa Isaacs, Ph.D., District of Columbia Commissionon Mental Health Judith Jacobs, Dr.P.II., National Institute of Mental Health Ellen Kagen, M.S.W., CASSP Technical Assistance Center Judith Katz-Leavy, M.Ed., National Institute of MentalHealth Roxane Kaufmann, Georgetown University Child DevelopmentCenter Jane Knitzer, Ed.D., Bank Street College of Education, NewYork Ira Lourie, M.D., National Institute of Mental Health Gary Macbeth, M.S.W., Virginia Department of Mental Healthand Retardation W. Douglas McCoard, M.S.W., Huckleberry House, Ohio M.R. Newton, South Carolina Department of Mental Health Ron Sharp, Ed.D., Alternative Rehabilitative Communities,Pennsylvania Milton Shore, M.D., Independent Practice, Maryland Thanks arc due to tho staff of the Florida Researchand Training Center for Children's Mental Healthforthcir review of this monograph series andforthcirinsightful comments, Robert Friedman, Ph.D., Al Duchnowski, Ph.D., and Susan Ye Iton,M.S.W. Specialrecognition and appreciationarc given toIraLouric, M.D. and JudithKatz-Leavy, M.Ed.ofthcNationalInstituteof Mental Health,Child and AdolescentService System Program fortheirguidanceand supportthroughoutthisprojectandfortheircontinucd nationalleadershipinthc effortto improve servicesforemotionally disturbed children and their families. Finally, administrators and staff of theprograms visited during the study provided a wealth of knowledge, information, and experience withoutwhich this monograph series wouldnot have been possible. Youth, families, foster families, and staff fromothcr community agencies also generously shared theirunigtm.:perspectives withus. The willingness of these agencies and individualstogive oftheirtimeandexpertisetoassistinthisproject isgratefully acknowledged: Child and Adolescent Emergency Service and RespiteHouse South Shore Mental Health Center Quincy, MA Children's Crisis Intervention Service Transitional Residence Independence Service(TRIS) Sicklerville, NJ Family Advocate Project Counseling Service of Addison County Middlebury, VT Family Network and Individual Residential Treatment Lee Mental Health Center Fort Myers, FL Homcbuilders Behavioral Sciences Institutc Federal Way, WA Huckleberry House Columbus, OH Pressley Ridge Youth Development Extension (PRYDE) The Pressley Ridge Schools Pittsburgh, PA Satellite Family Outreach Program Kaleidoscope Chicago, IL Ventura County Children's Mental Health Demonstration Project Ventura County Mental Health Department Ventura, CA Wake County Juvenile Treatment System Raleigh, NC Family and Children's Services of the Ka laynazoo Area Kalamazoo County Community Mental Health Board Kalamazoo, MI For VolumeIIIoftheseries,ontherapeuticfostercare,specialacknowledgmentand appreciation go to Bett Roberts, Director of Communications and E. Mary Grcalish, Director of PRYDE Model Implementation of The Pressley Ridge Schools for preparing "The Storyof Amanda" which is included as Appendix A.Amanda's story, based upon an actual case history, dramatizesinaverypoignant and personal way theentirerange ofissuesinvolvedin developing and operating a therapeutic foster care piogram.Amanda's story demonstrates how highly intensive and individualized treatment for a severely disturbcd child can be providedin the context of a family environment. TABLE OF CONTENTS PAGE NUMBER PREFACE i INTRODUCTION iii I. A SYSTEM OF CARE FOR CHILDREN AND ADOLESCENTS 1 WHO ARE SEVERELY EMOTIONALLY DISTURBED II. THERAPEUTIC FOSTER CARE 13 III. PROGRAM DESCRIPTIONS 100 IV. PROFILES OF THERAPEUTIC FOSTER CARE PROGRAMS 154 APPENDIX A:THE STORY OF AMANDA APPENDIX B:LIST OF PROGRAMS RESPONDING TO SURVEY 6 PREFACE The system of care for severely emotionally disturbed children and adolescentshas been of greatinterest over thelastseveral years.The conceptualization of this system has beena major focus inthe advancement of theavailability and appropriateness of ser.'cesfor this underserved population. In1982, JaneKnitzer estimated m her seminalstudy, Unclaimed Children,thatofthcthreemillionchildrenwithseriousemotionaldisturbancesinthis country,twomillionwerereceivingnotreatmentwhatsoeverandcountlessotherswere receivinginappropriatelyrestrictivecarebecauseofthelackofcommunity-basedservice alternatives. Knitzer documented that only 21 states hada child and adolescent administrative unitwithintheir departments of mental health and assertedthatthisdearth of leadership, lack of appropriate child mental health services, and fragmentation ofsr tems has resulted in literally millions of children with serious emotional problems "falling through thecracks." In 1986, Leonard Saxe performed a study for the Office of TechnologyAssessment (OTA) of the United States Congress, which confirmed Knitzer's findings.Saxe introduced this report, Children's Mental Health: Problems and Services, to Congress with the statement: "Mental health problems arc a source of suffering for children, difficulties for theirfamilies, and great loss for society.Though such problems arc sometimes tragic,an even greater tragedy may be thatwecurrently know moreabouthowtopreventandtreatchildren'smentalhealth problems than is reflected in the care available." Saxe presented three major conclusions: o Many children do not receivethefullrange of necessary and appropriate services to