Abstract: A Trauma-Informed Approach to Exploring the Mental Health and Sexual and Reproductive Health Needs of LGBTQ+ Youth in Foster Care (Society for Social Work and Research 28th Annual Conference - Recentering & Democratizing Knowledge: The Next 30 Years of Social Work Science)

Schedule:

Friday, January 12, 2024

Marquis BR Salon 13, ML 2 (Marriott Marquis Washington DC)

* noted as presenting author

Elizabeth Aparicio, PhD, Associate Professor, University of Maryland at College Park, College Park, MD

Jennifer Robinson, MPH, PhD Candidate, University of Maryland at College Park, MD

Swati Sah, MPH, PhD Student, University of Maryland at College Park

Michelle Jasczynski, PhD, Postdoctoral Faculty Assistant, University of Maryland at College Park, MD

Alexis Hunter, MA, PhD Student, University of Maryland at College Park

Francia Ximena Marin Gutierrez, MSW, Research Coordinator, University of Maryland at College Park, College Park, MD

Jessica Fish, PhD, Associate Professor, University of Maryland at College Park, MD

John Salerno, PhD, Provost's Postdoctoral Scientist, Columbia University, New York City, NY

Olivia Kachingwe, PhD, Assistant Professor, Yale University, MA

Claire Dormitzer, BA, Research Assistant, University of Maryland at College Park

Chloe Bernardi, MSW, LCSW-C, CEO and President, Hearts and Homes for Youth, Burtonsville, MD

Bradley Boekeloo, PhD, Professor, University of Maryland at College Park, MD

Background and Purpose: LGBTQ+ youth are heavily overrepresented in the foster care system, yet little is known about their specific mental health and sexual and reproductive health (SRH) needs. More generally, foster youth suffer from significant SRH inequities, including disproportionate burden of HIV/STIs and unintended pregnancies. Foster youth also experience unique barriers to receiving adequate SRH intervention, including disruptions in safe and healthy relationships within their families that are typically important purveyors of mental health and SRH information. Using SAMHSA’s trauma-informed care framework, the current study examined the intersection of mental health and SRH needs among LGBTQ+ youth in foster care.

Methods: Our team conducted 15 in-depth individual interviews with LGBTQ+ youth with foster care backgrounds (n=6, aged 16-26) and professionals and caregivers who work with LGBTQ+ youth in foster care (n=9). Youth and professionals were asked to share their experiences of how foster care systems are working to address safety; trustworthiness and transparency; peer support; collaboration and mutuality; empowerment, voice, and choice; and cultural, gender, and historical issues when addressing mental health and SRH with LGBTQ+ foster youth. We also explored opportunities for growth in each of these domains to improve systems and practice with LGBTQ+ foster youth. Data were transcribed verbatim and analyzed using thematic analysis.

Results: Youth and professionals shared concerns about LGBTQ+ foster youth across all domains of the trauma-informed care framework. They discussed stigma and misconceptions associated with sexual and gender identity from mental health providers, caseworkers, and foster families, such as assuming it is a “phase” or that it is a result of past sexual abuse. This lack of affirmation of their sexual and gender identities makes it difficult for youth to build trust with foster families and agencies who serve them. Promising approaches such as training for foster parents and practitioners on how to best support LGBTQ+ foster youth, inclusive mental and SRH education, and LGBTQ+-specific support groups were also discussed.

Conclusions and Implications: Given the unique challenges LGBTQ+ foster youth face, training for professionals should prepare them to address foster youths’ mental health and SRH needs holistically through trauma-informed and context-specific intervention. Mental health and SRH promotion models that address system level sexual orientation and gender identity-affirmative policies; increase providers’ competency, comfort, and skills; and improve interpersonal youth-professional relations are needed in order to help LGBTQ+ foster youth achieve mental health and SRH well-being.