“Foster Care vs. Family Preservation” Is the Wrong Debate

Recently The Chronicle of Social Change published a discussion between Sean Hughes and Richard Wexler. A good part of the discussion focused on the impact of IV-E being converted to a “block grant” versus remaining an entitlement.

But implicit in that discussion is another:  “Which works better to keep children safe: Foster care or family preservation?”

The question as framed presents a misleading dichotomy. When Richard Calica and I developed the Illinois Model of Practice in 1995, we purposely crafted the concept of emotional security and argued that child protection was both a matter of ensuring a child’s physical safety and emotional security.

We write that emotional security cannot exist without physical safety. But we also noted that emotional insecurity creates a sense of not feeling physically safe.

Emotional security is compromised when children are abused or neglected. At the same time a child’s emotional security is clearly damaged by the trauma experienced when the child is removed from the only caregiver the child has known. Since the emotional bonding process begins at birth, this can be true even for the youngest of infants. As a consequence, child protective services agencies must necessarily be concerned for both the physical safety and emotional security of children.

I contend that the concept of emotional security gets lost in the term family preservation, which sounds more like the preservation of a valued societal social structure than the protection of a child’s emotional security. In reality a primary reason for preserving the family rests with preserving the emotional security necessary for development of the capacity to trust and form lasting healthy relationships.

The failure of child welfare agencies to fully understand this is reflected in family assessments and case plans that focus almost exclusively on threats of harm (elimination of dangerous caregiver behavior) and hardly at all on strengthening the adaptive, nurturing and protective capacities of caregivers.

For children, trust, and hence learning to trust, is built through repetitive iterations of the cycle of need in which needs are expressed and met with a nurturing caregiver response.

Except for a very small number of cases, abusive and neglectful caregivers do not abuse or neglect every time a child expresses a need. If so, as Bowlby demonstrated, children would just wither and die. So, even in the more serious cases of abuse and neglect there is still a bond developed between child and caregiver, and a trust that that bond can never be broken…that is until child protection services (CPS) removes the child, which shatters that dream.

Removing a child to foster care violates the most basic trust existing in a child’s life that, whatever else may happen, the caregiver will be physically constant. Removal of very young children also happens at a time when they are struggling to establish object permanence (when the ball rolls under the sofa the ball does not cease to exist). In this case, when the caregiver is gone, the caregiver still exists and will return.

Once the child is removed, the child remains suspicious about the permanence of the caregiver even if returned home. If it happened once, it can happen again. I am not arguing that removal is  never necessary, rather that it must be balanced against the certain harm created by removal.

When I became director of the Department of Family Services in Clark County, Nev., in 2006, children dropped off at our shelter sat alone in the waiting room outside of the CPS intake center. No organized effort was made to immediately locate foster homes or relatives. As a result the shelter population reached 230 children while having a capacity for only 100.

With the aid of a charitable organization we constructed a reception center, staffed 24/7 to respond to the needs of these traumatized children and to place children with relatives or foster families in less than 24 hours. The average daily shelter population dropped from more than 200 to less than ten eventually. We could not take away the trauma, but we could address it more humanely. But the point is the trauma was evident and often serious.

The discussion of foster care versus family preservation as a safety issue only makes sense if we limit it to future maltreatment, if we assume that foster care always will be a safer option for the child physically, and if we choose to ignore the trauma and psychological damage of removal.

A center point of this discussion lies in the reality that current CPS safety tools have no established sensitivity or specificity, meaning the rates of true positives and true negatives is unknown. As a matter of social policy, “How many children are we willing to traumatize in order to protect a much smaller number of children who might be harmed if left at home?” And, if we decide to be over inclusive are we also willing to fund and provide the services these children will need in order to have a chance at future normal development?

My 46-year career in child welfare suggests that the answer the latter question is no. If social policy is presumptively satisfied at removal and assumes no concurrent responsibility for the psychological harm of the safety intervention, then we condemn thousands of children to an alternative and horrible fate.

Neither foster care nor family preservation is absolute in its safety outcomes. But we do know that, on balance, children who grow up in their families of origin fare better developmentally than children who enter foster care. We also know that some children left at home will be seriously harmed or may die. So will some children placed in foster care. These are tough choices, not to be resolved by demagoguery.

Morton

Thomas Morton most recently served as the child protection practice specialist for the Commission to Eliminate Child Abuse and Neglect Fatalities. Prior to that he served as director of the Clark County, Nevada Department of Family Services for five years and as founder, President and CEO of the Child Welfare Institute for 22 years. 

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3 Comments

  1. Going with meeting the emotional welfare of a child being of utmost importance then I have to add that when does the system consider the emotional welfare of a child who has established that bond with a foster parent and 1 year, 2 years, 3 years later is removed from the only parent they have ever known to be put with a relative they have never seen? Why does this happen? Because the bond between the caregiver isn’t based on blood, it is developed through love, caring, and having their needs met. But the system will remove a child who has been with the foster parent since birth at any age to put with an unknown family member because “family” is what matters. The system needs to put the kids first and not the adults. We need to meet the emotional, social and developmental needs of the children. If this means working with families to help them learn how to be a better parent I am all for this. But it has to then have the provision when a child has developed that bond with a foster parent, then in the best interest of the child that is their family and everything should be done to maintain that relationship too.

  2. Some children placed in foster care will be seriously harmed or may die as well. It happens. The numbers and statistics should be made available, as well as statistics on various criteria used for determining removal – how much that perceived threat really translates to actual threat, and how much the perceived safety really translates to actual safety or even the opposite.

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