Well-Being and Psychosocial Function of Youth in-Care and Young Adults with Foster Care Histories: Implications for Practice

Background:  Psychological functioning for youth in-care and out-of-care has generally been deemed as poor (see Burns, Phillips, Wagner, Barth, Kolko, & Campbell, 2004). Understanding well-being and overall psychosocial functioning for youth with current or previous involvement with the child welfare system will assist with preventive services for youth and trainings for child welfare workers and resource parents. The goal of the current study was to assess the overall functioning of youth in care and young adults with a previous foster care history.  

Methods: A mixed methods study included surveys and interviews. Youth in-care and youth out-of-care were assessed for overall substance use (AUDIT and DAST), psychological functioning (Symptom Assessment -45 [SA-45]), and self-esteem (Rosenberg Self Esteem Scale [RSE]). Additional employment and housing stability measures were assessed for youth out-of-care. Of the 46 youth in-care age 14-21 in the selected counties, 37 youth (80%) consented to participate (mean age=17).  Youth out-of-care were recruited with assistance from a non-profit group for former foster youth. In total, 254 youth completed the surveys (mean age=22).  To provide more in-depth information, we conducted 10 interviews with youth in-care and 15 with youth out-of-care.

Results: Descriptive analyses, one-way ANOVAs, and multiple regressions were used to evaluate survey findings and differences between the groups. Risks reported by youth out-of-care were high: 99% had stayed in a shelter or had stayed with friends since leaving child welfare; alcohol consumption patterns and substantial illicit drug use problems were in the highest ranges of concerning use for the AUDIT and DAST. Scores on the RSE indicated low self-esteem. Scores on the SA-45 suggest youth out-of-care were experiencing psychological distress.   

Youth in-care also reported substance usage with possible binge drinking patterns and low levels of illicit drug use. Scores on the RSE suggest average self-esteem. Overall findings on the SA-45 did not indicate problematic function. For all measures, youth out-of-care performed significantly worse than youth in-care.

Notable differences by sexual orientation were also present. Youth in-care who identified as non-heterosexual scored significantly higher on the SA-45 general symptom index,  indicating poorer functioning. Youth out-of-care who identified as non-heterosexual had higher drug usage (per the DAST) and more psychological distress (per the SA-45).

Qualitative findings from interviews for youth in-care suggest that youth perceive they are ready to age out-of-care in terms of education but are concerned about social support, connecting with family, and housing. Young adults out-of-care reported challenges with connecting with families of origin, housing, education, and employment and indicated they found “life after care” challenging.

Implications: Findings suggest that youth in-care are at risk for problematic substance use. Young adults with foster-care histories indicated problematic functioning in all areas and reported experiencing unstable housing. Based on findings from the evaluation, specific changes to life skills classes, training and preparation recommendations for older youth in foster care are proposed.