This study evaluates the impact of relationship-based therapy on a random sample of White and Black foster youth, as reported by semi-structured telephone interviews with their therapists at the start and end of treatment.
Repeated measures ANOVA revealed a significant difference in reported school problems between Black and White foster youth over the course of treatment, F(1,37) = 7.336, p=0.010. Black foster youth had significantly greater school problems (M=3.21, SD=1.35) compared to White foster youth (M=2.05, SD=1.39) at the start of treatment. Although school problems significantly improved throughout treatment (F(1,37) = 9.531, p=0.004), Black foster youth still had significantly greater school problems (M=2.42, SD=1.09) at the end of treatment.
Limitations of this study include a small sample size, potential bias of therapist informants, and lack of a comparison group. Future research should further examine ethnic differences in treatment outcomes among foster youth

Aguilar, Rosana M.

Clausen, June Madsen

Foster Care Research Group

Lemley, Breniel Q

Ruff, Saralyn C.

English

University of San Francisco

  Ethnic Differences in Therapy Outcome for Foster Youth  Breniel Q. Lemley, Rosana M. Aguilar, Saralyn C. Ruff, June M. Clausen  University of San Francisco   Children placed into foster care are at increased risk for multiple mental health problems. Children of color, particularly Black children, are overrepresented and have lower rates of mental health service use compared to all other ethnic groups in the foster care system. Ethnic differences in therapy outcome have not been examined among foster youth. The current study evaluates the impact of relationship-based therapy on a random sample of White and Black foster youth, as reported by semi-structured telephone interviews with their therapists at the start and end of treatment. Therapists (N=40) were predominantly female (80%), White (92.5%), middle aged (M=45.41 years, SD=10.99), psychologists (52.5%) who had an average of 10.43 years (SD=7.92) experience as licensed clinicians. Patients (N=40) were female (80%), White (n=20) or Black (n=20) school-aged foster youth (M=9.97, SD=4.78) who received treatment for an average of 3.55 years (SD=2.55). Most common reasons for entry to the foster care system included neglect (57.5%) and parent inability to caretake (45%).  As reported by therapists, anxiety (F(1,38) = 40.848, p=0.000), dissociative symptoms (F(1,36) = 10.119, p=0.003, peer relationship problems (F(1,38) = 10.039, p=0.003), aggression/violence (F(1,38) = 9.157, p=0.004), conduct problems (F(1,38) = 7.489, p=0.009), depression (F(1,38) = p=0.009), anger problems (F(1,20) = 7.198), p=0.014), and enuresis (F(1,33) = 6.292, p=0.017) significantly decreased over the course of treatment across the entire sample. Repeated measures ANOVA revealed a significant difference in reported school problems between Black and White foster youth over the course of treatment, F(1,37) = 7.336, p=0.010. Black foster youth had significantly greater school problems (M=3.21, SD=1.35) compared to White foster youth (M=2.05, SD=1.39) at the start of treatment and, even though school problems significantly improved throughout treatment (F(1,37) = 9.531, p=0.004), Black foster youth still had significantly greater school problems (M=2.42, SD=1.09) at the end of treatment. No other significant differences were found in mental health symptoms between White and Black foster youth. Limitations of this study include a small sample size, potential bias of therapist informants, and lack of a comparison group. Future research should address these issues and further examine ethnic differences in treatment outcomes among foster youth.  

Ethnic Differences in Therapy Outcome for Foster Youth

The University of San FranciscoUSF Scholarship: a digital repository @ Gleeson Library |Geschke CenterPsychology College of Arts and Sciences2014Ethnic Differences in Therapy Outcome for FosterYouthBreniel Q. LemleyUniversity of San Francisco, bqlemley@usfca.eduRosana M. AguilarUniversity of San Francisco, rmaguilar@usfca.eduSaralyn C. RuffUniversity of San Francisco, sruff2@usfca.eduJune Madsen ClausenUniversity of San FranciscoFoster Care Research GroupFollow this and additional works at: http://repository.usfca.edu/psycPart of the Psychology CommonsThis Poster is brought to you for free and open access by the College of Arts and Sciences at USF Scholarship: a digital repository @ Gleeson Library |Geschke Center. It has been accepted for inclusion in Psychology by an authorized administrator of USF Scholarship: a digital repository @ GleesonLibrary | Geschke Center. For more information, please contact repository@usfca.edu.Recommended CitationLemley, Breniel Q.; Aguilar, Rosana M.; Ruff, Saralyn C.; Clausen, June Madsen; and Foster Care Research Group, "Ethnic Differencesin Therapy Outcome for Foster Youth" (2014). Psychology. Paper 20.http://repository.usfca.edu/psyc/20.                           .                           . . Ethnic Differences in Therapy Outcome for Foster Youth Breniel Q. Lemley, Rosana M. Aguilar, Saralyn C. Ruff, Ph.D., June M. Clausen, Ph.D. •  Children placed into foster care are at increased risk for multiple mental health problems.  •  Children of color, particularly Black children, are overrepresented in the foster care system. •  Previous studies have shown lower rates of mental health service use among Black children compared to all other ethnic groups in the foster care system. •  Ethnic differences in therapy outcome have not been examined among foster youth.  •  Research has shown that Relationship-Based Therapy reduces many mental health symptoms in foster youth. •  The current study evaluates the impact of Relationship-Based Therapy on a random sample of Black and White foster youth receiving treatment through a national non-profit organization that provides pro-bono mental health treatment to current and former foster youth with one therapist “for as long as it takes.” BACKGROUND AND RATIONALE!RESULTS! DISCUSSION!•  This sample of Black and White foster youth, who were randomly selected from a group of foster youth who were removed from home for reasons of neglect, parent’s inability to caretake, and/or emotional abuse, and while in foster care, received long-term Relationship Based Therapy, demonstrated a variety of mental health symptoms and attended long-term weekly/bi-weekly psychotherapy for 3.5 years. •  Findings indicate that Relationship-Based Therapy significantly reduced symptoms of anxiety, dissociative symptoms, peer relationship problems, school problems, anger problems, depression, conduct problems, and enuresis in this sample of foster youth. •  Substance use problems increased over the course of treatment; this increase may be due to change in patient age over the course of long-term treatment. •  Although Relationship-Based Therapy revealed significant decreases in school problems (truancy, suspensions, expulsions) over the course of treatment, Black children had significantly higher school problems at the start and end of treatment; research suggests that ethnic differences in school problems may stem from a variety of sources including social support, cultural norms of behavior, access to resources, and attachment. •  Limitations of this study include a small sample size, potential bias of therapist informants, and lack of a comparison group. Future research should address these issues and further examine ethnic differences in treatment outcomes among foster youth. Ethnic Differences  •  Repeated measures ANOVA revealed a significant difference in reported school problems between Black and White foster youth over the course of treatment, F(1,37) = 7.336, p = 0.010. Black foster youth had significantly greater school problems (M = 3.21, SD = 1.35) compared to White foster youth (M = 2.05, SD = 1.39) at the start of treatment. At the end of treatment, Black foster youth still had significantly greater school problems (M = 2.42, SD = 1.34) compared to White foster youth (M = 1.60, SD = 1.09).  •  No other significant differences were found in mental health symptoms between White and Black foster youth. Measures Semi-structured telephone interviews at the beginning and end of treatment that include questions about therapist and patient demographics, patient symptoms, treatment parameters, and treatment progress.      Procedure •  Receive therapist contact information from non-profit organization •  Recruit therapist participants by sending letters and calling therapists about the study •  Conduct Initial Telephone Interview with therapists within three months of the start of treatment •  Conduct Exit Telephone Interview with therapists within three months of treatment termination METHOD!Patient Demographics (N = 40) •  Ethnicity: Black (n = 20) and White (n = 20)  •  80% female •  School-aged at start of treatment: M = 9.97 years (SD = 4.78 years, Range: 2.60 - 21.28 years) METHOD!Therapist Participants (N = 40) •  Mean Age: 45.41 years (SD = 10.99 years) •  80% Female •  92.5% White •  52.5% Licensed Psychologists •  Mean Clinical Experience = 10.43 years (SD = 7.92 years) Foster Care Research Group Department of Psychology (415) 422-5321 fcrg@usfca.edu Contact Information!0 5 10 15 20 25 Neglect Parent's Inability to Caretake Emotional Abuse Physical Abuse Sexual Abuse Positive Toxology Voluntary Placement Death of Caretaker Reasons for Entry into Foster Care 0 5 10 15 20 25 30 35 40 Psychodynamic Psychoanalytic Family Systems Cognitive Behavioral Humanistic Interpersonal Feminist Treatment Approach Parameters of Treatment •   Frequency of Treatment: 70% once per week;  20% once every other week •   Average Length of Treatment: 3.55 years (SD = 2.55 years, Range: 0.50 – 11.35 years)   Overall Changes in Mental Health Symptoms  Start of Treatment End of Treatment Symptoms n Mean SD Mean SD Sig. Value Anxiety 40 3.625 0.868 2.850 1.026 0.000 Dissociative Symptoms 38 2.289 1.137 1.842 0.945 0.003 Peer Relationship Problems 40 3.025 1.025 2.475 1.037 0.003 School Problems 39 2.615 1.480 2.000 1.277 0.004 Anger Problems 22 2.955 1.290 2.318 1.129 0.007 Depression 40 3.125 0.939 2.650 1.027 0.009 Conduct Problems 40 2.825 1.259 2.275 1.086 0.010 Enuresis 35 1.342 0.765 1.028 0.169 0.014 Substance Use/Abuse/Dependence 39 1.000 0.000 1.282 0.724 0.020 Problems with Current Living Situation 37 3.027 1.040 2.594 1.363 0.077 Sleep Problems 39 2.154 1.040 1.923 1.010 0.107 Problems with Family of Origin 38 3.053 1.576 2.737 1.518 0.172 Suicidality 39 1.154 0.432 1.282 0.560 0.230 Encopresis 36 1.056 0.333 1.028 0.167 0.324 Psychotic Thoughts/Behaviors 38 1.289 0.694 1.397 0.887 0.324 Legal Problems 40 1.275 1.025 1.400 1.037 0.376 Eating Problems 40 1.850 1.292 1.700 1.067 0.412 Hoarding Problems 22 1.409 0.854 1.318 0.716 0.427 Learning Problems 39 2.462 1.553 2.308 1.281 0.438 Self-Injurious Behavior 39 1.590 0.938 1.462 0.883 0.473 Sexual Behaviors 39 1.743 1.117 1.615 1.091 0.482 Eating Problems 40 1.185 1.129 1.700 1.067 0.412 Transiency 38 1.157 0.494 1.132 0.578 0.812 Risk Taking 38 2.000 1.162 1.974 1.103 0.906 RESULTS!

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Ethnic Differences in Therapy Outcome for Foster Youth

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