Foster Families and Agencies Respond

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New York City's child welfare system is not the only place that has felt the effects of September 11, the anthrax scare, and the aftermath. Most child welfare systems are dealing with the effects of terror and trauma.

Washington, DC was not only affected by the Pentagon crash, but also by the anthrax scares and the evacuation of some federal facilities. Carolyn Russell Lander, ombudsperson for the District's Child and Family Services Agency reported, "Many of our parents-both birth and foster parents-if they are employed are federal workers. As a matter of fact, one of our foster parents, who was in the process of adopting her foster child, was killed in the Pentagon crash. As federal workers, some of our parents had to evacuate their work place. And when children's parents are in danger, children have a heightened state of anxiety. Our agency's workers are reporting that many of the children in care are exhibiting a heightened vigilance or even hyper-vigilance. They are much more aware of harm and violence and death."

In addition, problems for the District's agency were exacerbated by the fact that in the chaos of September 11, there was no existing plan for evacuating and closing the agency building. One supervisor said, "We didn't know what to do. There was no guidance from city officials, and we had many children in the building at the time federal offices, the White House, and the Capitol were being closed."

Effects on foster parents and children

The National Foster Parent's Association reported that the issue of terror, trauma, and stress was much on the minds and in the members' discussions at their recent national convention. When asked whether children in foster care were showing any effect after the events of September 11, the president of the Colorado Foster Parent's Association, Sherry Bethurum, said, "Many of the children in the system are suffering from undiagnosed post-traumatic stress disorder (PTSD). Something as major, unpredictable, and uncontrollable as the tragedy of September 11 just sets the children off again. We're seeing a range of stress behavior in the children, ranging from increased insecurity and clinginess to recurrent nightmares." She also explained that this increased stress in foster children makes foster parents' jobs harder. "Because the children are suffering from PTSD, many of the foster parents themselves begin to suffer from secondary trauma." Secondary trauma is the emotional and behavioral stress that is caused by directly or indirectly helping a traumatized or suffering individual or family. The frequent or prolonged exposure to such trauma creates secondary trauma stress (STS) for the helper that impacts personal well-being and professional effectiveness.

In Denver, one foster parent reported that her foster daughter regressed to her former psychosis-she was convinced that the airplanes that crashed into the World Trade Center and the Pentagon were really after her. Another foster parent observed, "In talking with some other foster parents, we're not seeing much reaction from the foster kids. In fact, we saw much more reaction from the children at the time of the Columbine shootings. But the foster parents are another matter. I've been fostering for 17 years and, you know, the children coming into care today are much more damaged than we saw 15 years ago, and fostering is harder. Some of our foster parents became depressed after September 11. It felt like one more burden on an already overburdened household."

In Des Moines, Roger Hart, a teacher at PACE Juvenile Justice Center, reports that many of the young people he works with, particularly those diagnosed as seriously emotionally disturbed (SED), are showing signs of increased stress. But the street kids hardly seem aware that anything even happened on September 11. "Their minds are still on the street," Hart said.

On the other hand, sometimes good can come from bad situations. Stephanie Eells, Clinical Director of Courthouse, Inc. in Denver, explained that in their group homes for adolescents (ages 12 to 18), staff let the teenagers watch the events unfold on television, but then took time to talk about it with them. Over the next days, the teenagers showed genuine resilience. They made flags and red, white, and blue beads for the staff, talked about how they wanted to help victims and their families, and the teens who had not yet done their community service asked if they could begin.

Effects of child welfare workers

But it's not just the families in the child welfare system who may experience additional stress in these trying times. As stated on page 1, close to half of American adults reported having one or more substantial symptoms of stress in the hours and days following the September 11 terrorist attacks, and nine out of ten had stress reactions to some degree. If this is true for the United States' general population, it's probably even more true for professionals who regularly work in high-stress situations and with clients who may have been traumatized.

A 1999 study assessed the prevalence and severity of secondary traumatic stress (STS) symptoms among a sample of child protective service (CPS) workers in the South. Using a survey research design, up to 37 percent of the respondents were found to be experiencing clinical levels of emotional distress associated with STS. In addition, levels of work exposure and work-related personal trauma were found to be strongly associated with the presence of those symptoms.

The events this fall probably have exacerbated this. For example, some Baltimore City child welfare supervisors reported that their workers seem more stressed and irritable. And this year, in contrast to previous years, few workers participated in the Thanksgiving holiday basket program for poor families. One worker said, "This year, I just couldn't add one more thing. My plate's too full, and I am feeling so numb."

What to do?

Based on the data and anecdotal information summarized here, child welfare agencies need to examine the needs of their own agency, workers, and children and families regarding terror, trauma, and stress. What plans are in place for emergencies? How can workers receive additional support? What additional support do families need?

Agencies have responded in different ways:
* Washington, DC's Child and Family Services Agency is developing an emergency plan to use if another crisis occurs.

* Colorado's Foster Parents Association held voluntary training opportunities for foster parents to help them deal with PTSD in their foster children and with their own personal secondary trauma stress.

* The Baltimore City child welfare system recently offered such a STS program and the workers' response was overwhelmingly positive. One worker responded, "This is the best training I've ever gotten. I gained a better understanding of what trauma is and the effects that it can have on you, your life, and your job."

As we continue to wrestle with the issues that surround the trauma of September 11, child welfare agencies can change a deficit into an opportunity. Staff and stakeholders can have deliberate discussions to determine how the agency can more regularly and effectively respond to the impact of trauma and stress on the agencies' children, families, and staff.
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