Providing a Nurturing Foster Home to Reduce the Impact of Trauma Among Siblings in Foster Care

Background and Purpose: Children in foster care disproportionally experience symptoms of posttraumatic stress as compared with children who are not involved in foster care (McCrae, 2009; Ritner et al. 2012).  Research supports the idea that placing siblings together in foster homes is beneficial (Leathers, 2005).  Less is known around the impact of those foster homes and foster parents’ efforts at creating a nurturing environment. To expand on current research, this paper explores how providing a nurturing home environment is related to symptoms of posttraumatic stress (PTS) among siblings in care.

Methods: Data were collected via face-to-face interviews from 123 Oregon siblings in foster care and their primary foster parent.  Seventy-six percent of the siblings lived together.  Average age of the older siblings was 12.83 (SD=1.26); average age of the younger siblings was 10.37 (SD=1.46).  Youth completed the Child Report of Posttraumatic Stress (CROPS) (Greenwald & Rubin, 1996; alpha=.86) and a four-item measure of warmth and inclusion in the foster home (alpha=.74) (e.g., “To what extent to you feel that you are treated with kindness in your foster home?”). Foster parents completed a nine-item scale related to their efforts to create a warm and inclusive environment (alpha=.86) (e.g., “How easy is it to encourage this child during tough times?”).  A multivariate multi-level model was used to examine (1) how a child’s perception of the foster home environment being warm and inclusive was associated with posttraumatic stress symptoms, (2) how foster parents’ efforts to create a warm and inclusive environment would relate to posttraumatic stress levels, and (3) similarities among siblings on posttraumatic stress scores.

Results: On average, foster children reported moderate levels of posttraumatic stress symptoms (M=20.37, SD=9.67).  When controlling for sibling order, age, gender, and living situation, perceived warmth and inclusion was significantly and inversely related to PTS symptoms (B=-.45, p<.01); additionally, foster parent efforts approached significance (B=-.23, p=.13).  A model excluding foster parent efforts and living situation indicated an intra-class correlation of .31 (p<.05) for average CROPS scores among sibling dyads.  When foster parent effort was included, the ICC fell to .27 (p<.05), suggesting that foster parent effort accounted for approximately 13% of explained variance in average CROPS scores among sibling dyads.

Conclusion: A child’s perception of a warm and inclusive environment is associated with reduced PTS symptoms above and beyond the perceived efforts of the foster parent to create such an environment.  Perhaps more salient is the relatedness of trauma outcomes between siblings regardless of living situation. These findings suggest that (1) interventions should take into account how the child perceives the home environment by encouraging the child to identify environmental needs, and (2) that the similarities in reported symptoms among siblings support the need for interventions at a dyad-level.  Further research is needed to better understand how dyadic treatment may improve symptoms of PTS above and beyond individual-level interventions as well as better understand the impact of foster parent efforts.