Parent Management Training In Child Welfare: Urban Foster Parents' Perspectives

Background and Purpose: The primary goals of this research are to better understand foster parents' perceptions of Parent Management Training (PMT) components and to obtain information from foster parents about the feasibility of implementing PMT in an urban setting. Although entry into the child welfare system facilitates children's access to mental health services (Leslie et al., 2005), the quality of services provided to foster children is limited by low caregiver involvement even for behavioral disorders, which require caregiver participation for effective treatment (Horwitz et al, 2010). Understanding how to adapt evidence-based mental health treatments for foster children with behavior problems is essential, as they face increased risk of placement disruption and decreased likelihood of attaining permanency. Parent management training (PMT) has the most evidence for effectiveness in treating child behavior problems, but limited research has focused on its use with foster parents, and available research suggests particular challenges with urban parents.

Methods: Four focus groups were held at a large child welfare agency. Foster parents (N=38) reviewed information about a PMT intervention adapted from the Project KEEP group intervention (Chamberlain, 2002) and provided feedback about their perceptions of the content, their experiences parenting foster children, and their children's needs. Most of the foster parents (82%) were African American. Responses were recorded, transcribed verbatim, entered into Atlas-ti, and analyzed using grounded theory by two independent coders. In the open-coding phase, each line of the transcript was assigned a code. During the axial coding phase, codes were grouped into similar concepts that demonstrated relationships between codes. From these concepts, main themes emerged, and selective coding was used to review data to further explain participants' experiences and suggestions.

Results: Four strong themes emerged. First, foster parents discussed a need for more support and training in how to address children's behaviors and shared concerns that some PMT discipline techniques would be ineffective. Second, they described how staff communication skills and unfounded allegations of child abuse could affect parents' motivation to continue fostering. Third, they expressed a need for more detailed information about the child's history and foster children's visits with biological families, as the lack of information contributed to difficulty in meeting their children's needs. They suggested that joint training of foster parents and staff could improve their ability to work together to address behavior problems. Finally, they reported little to no involvement in child mental health services and doubted the effectiveness of services their children received.

Conclusions and Implications: Results suggest that while foster parents are interested in training to help manage behavior problems, better working relationships between the child welfare agency and foster parents, including information sharing and parent support, particularly around allegations of abuse, could improve their ability to parent. Lack of confidence in their children's mental health services also indicates a need to involve foster parents in caregiver-mediated treatments. Although most PMT components were endorsed, presentation of discipline strategies may require adaptation to address urban African American foster parents' perceptions of their relevance.