Intensive Permanence Services Pilot Study: Preparing Foster Youth for Healthy, Nurturing Relationships

Background: Children and youth in foster care are vulnerable to chronic impermanence and high rates of trauma and childhood adversity (Bramlett & Radel, 2014; Unrau, Seita, & Putney, 2008).  Trauma-informed models to enhance connections with supportive adults are needed.  Intensive Permanence Services (IPS) integrates several approaches to support foster youth in building a supportive network of caring adults (Henry, 2005; Louisell, 2008).  IPS utilizes family findings strategies to identify and engage kin to support the youth in their path to permanency, while also preparing youth for healthy relationships by addressing unresolved issues of trauma, grief, and loss.  The aim of this pilot study was to identify the core components of the IPS model that impact permanency and well-being outcomes for youth. 

Methods: This pilot study included qualitative analysis of semi-structured interviews and surveys and with staff in the IPS program (N = 7).  The study sample included all current IPS program staff, including clinical, supervisory, and administrative staff.  Interview and survey questions focused on strategies for each phase of the IPS model that might lead to positive youth outcomes.  The data were transcribed and then analyzed using the qualitative analysis software, ATLAS.ti.  Data analysis began with an initial coding of the data using both deductive codes (developed from the literature and program materials) and inductive codes that emerged from the data.  After the initial coding, themes and patterns were identified. 

Results: For the youth who completed all four phases of the IPS pilot program (N=20), 80% achieved permanency (i.e., reunification with family or adoption).  Findings of this study indicated effective strategies for each of the four phases of IPS.  Phase 1 (trusting) strategies included consistency, trust-building, and exploration of youths’ interests and identities.  Phase 2 (healing) strategies included identifying healthy outlets for grief and pain, and teaching emotion regulation skills.  Phase 3 (connecting) strategies include coaching youth and supportive adults to heal past loss and grief and build healthy relationships.  Phase 4 (supporting) strategies sustain the permanency plan with the supportive adults.  Successful implementation of IPS is youth-driven and trauma-informed.  Youth have the power to “hire and fire” their workers, and workers model trauma-informed language while interacting with the youth’s team.  Weekly meetings with the youth’s team, who might include child welfare workers, mental health professionals, and caregivers, facilitate stakeholder buy-in. Also essential is a trauma-informed organizational culture that includes supervision models to provide both accountability and support of workers’ self-care.

Implications: The trusting, healing, connecting, and supporting strategies of the IPS program help to address issues faced by the children and youth who have suffered disrupted attachments and loss of personal agency when they entered the child welfare system. As family finding models are being implemented more widely, it is critically important to support youth in addressing past trauma and grief to help prepare them for successful permanency outcomes.  Results also highlight the benefits of integrating a trauma-informed approach into every aspect of the work with youth, caregivers, other service providers, and the organizational culture of child welfare agencies.