Placement breakdown in foster care: Reducing risks by a foster parent training program?

This thesis started by focusing on Dutch foster children’s well-being, emotional and behavioral functioning and placement stability. Subsequently, we attempted to identify how foster families who are considered to be at a high risk of placement breakdown could be given effective support. The findings from our studies demonstrate that a considerable proportion of foster children are functioning well, but that approximately half of the foster children suffer from problems at a clinical or borderline level, the level associated with placement breakdown. The transactional or bio-ecological perspective on foster child adjustment and foster family functioning, which acknowledges the importance of foster families’ different ecologies, was presented as a useful approach for systematically screening for risks and protective factors and subsequently organizing evidence based interventions to support foster families. Using a randomized controlled trial (n = 86), we examined the effectiveness of Parent Management Training Oregon (PMTO) for foster children (aged 4-12) with severe externalizing behavior problems in long-term foster arrangement. At the first sight, PMTO seems a promising direction for reducing foster care stress. However, the hypothesized added value of PMTO, above and beyond CAU, to improve parenting practices and child functioning could not be confirmed in this study. It is recognized that in these highly burdened foster families, many stressors have to be addressed effectively in order to reduce the risk of placement breakdown. This strategy is in need of thorough investigation, along with a number of related themes for future research outlined in this thesis.