Q: How can we address the increase in opioid-related foster-care admissions?
A: The opioid abuse epidemic has had many negative outcomes, not just for those suffering from the disease, but on their children, as well. These children also are more likely to experience high levels of traumas related to physical and sexual abuse, neglect, and in many cases multiple separations from their parents by child welfare services.
Mirroring the dramatic increase in opioid abuse is an increase in foster care placements. Data published in July in the Journal of the American Medical Association Pediatrics indicated that 36% of foster care referrals in the U.S. were related to parent drug use — a more than 20% jump since 2000. Here in Philadelphia, the Pennsylvania Partnership for Children reports a 14% increase in the last five years, totaling more than 6,000 children currently in the city’s foster care system.
While in foster care, children require a therapeutic environment that ensures their physical, emotional and behavioral needs are met in a safe and caring way. Unfortunately, while the number of children in foster care has increased, available placements have decreased over the last several years. Thus, efforts must be made to not only increase and incentivize available foster parent placements, but also provide those parents with the appropriate amount of training and support on how best to care for children coming to their homes, many of whom have undergone significant trauma.
A critical aspect of this training is Positive Behavior Support (PBS), which uses evidence-based strategies to reduce problem behaviors. It emphasizes teaching the child skills and using high levels of reinforcement and prevention before problems grow and potentially result in the child’s removal. Two existing training programs, Multidimensional Treatment Foster Care program and Together Facing the Challenge, use a PBS approach to teach foster parents to help children feel safe and cared for.
Access to treatment programs as well as housing, employment and transportation are critical to helping parents reunify with their children, but funding for these programs remains relatively low.
The current influx of foster children related to the opioid epidemic is a complex issue, requiring a multifaceted approach. Only through these efforts can we help to support our foster parents and increase the number of children and families that can be healed and ultimately reunited.
Richard Allen is an assistant professor in the department of school psychology at Philadelphia College of Osteopathic Medicine.