Foster Child-Adult Relationship Enhancement (FosterCARE)
Category
Family Support
Child's Age
3-4 years, 4-5 years
Participant
Parents/Guardian
Languages
English
Brief Description
Foster Child-Adult Relationship Enhancement (FosterCARE) is an adaptation of CARE specifically designed to meet the needs of foster parents/caregivers. Foster parents/caregivers receive trauma-informed training to develop skills for improving attachment and/or strengthening relationships while reducing mild to moderate behavior concerns, and for increasing compliance. FosterCARE is a training course that follows the same curriculum as CARE but is specifically delivered with foster parents/caregivers. Trauma psychoeducation is incorporated in some of the skills taught to foster caregivers.
Expected Impact
- General increases in positive parenting
- General decreases in problem behaviors
Core Components for Model Fidelity
- Training: CARE blends lectures, activities, and live practice with trainer feedback to create a fast-paced, fun-filled training experience. All components are grounded in an understanding of the impact of trauma on relationships and behaviors.
Languages Materials are Available in
English
Delivery Mode
In-person for up to 30 participants and virtually for up to 10 participants.
Dosage
One 3-to-6-hour training session.
Consultation follow-up is available, and the training timeline can be modified to suit the organizations’ needs.
Infrastructure for Implementation
Materials: Handouts are provided at training sessions.
Space: In-person training is provided at the Center for Child & Family Health in Durham, NC, or in another community setting.
Staffing Requirements
FosterCARE training is provided by the Center for Child & Family Health and/or by approved CARE facilitators. FosterCARE facilitators can only be trained by the Center for Child & Family Health.
For sustainability, FosterCARE Facilitators and FosterCARE Coaches are recommended.
- FosterCARE Facilitator (train-the-trainer course): CARE Facilitators must be licensed mental health professionals and meet prerequisites mentioned above (refer to CCFH for more info). All facilitators complete the CARE Facilitator course (3-6 hours) and are certified in one of the models CARE is based on:
- Parent-Child Interaction Therapy (PCIT)
- Incredible Years (IY)
- Positive Parenting Program (Triple-P)
- Helping the Noncompliant Child (HNC)
- Parent Management Training – Oregon Model (PMTO)
- FosterCARE Coach: Coaches are optional staff members who serve as an extension of the FosterCARE Facilitator and provide one-on-one coaching. All coaches must complete the FosterCARE Coach Course (3-6 Hour Course).
NCPC strongly recommends staff receive training in the Standards of Quality for Family Support and Strengthening. Contact Positive Childhood Alliance North Carolina (PCANC) or National Family Support Network (NFSN) for more information, training, and certification.
Training for Model Fidelity
Organizations are encouraged to use a cohort approach when sending participants to be trained in CARE.
Every FosterCARE training participant can train anyone on a 1:1 basis. Only FosterCARE Trainers and FosterCARE Facilitators are eligible to train in a group format.
Contact Information
https://www.ccfhnc.org/programs/pcit-care-training/
Darden White, MEd, LCMHCS: Associate Director of PCIT & CARE Training; PCIT International Regional Trainer, CARE Trainer at the North Carolina Child Treatment Program – Center for Child & Family Health; darden.white@duke.edu
Cost Estimates
The cost for a CARE Workshop varies. The Center for Child & Family Health offers in-person CARE Workshops in Durham, NC for $100/person (cost is subject to change). The Center for Child & Family Health can also work with organizations to contract trainings in their area upon request. For more information and to contact the CARE training team, please use this link: https://www.ccfhnc.org/programs/pcit-care-training/.
Purpose Service Code (PSC)
5505 – Parent Education
Program Identifier (PID)
FosterCARE
Minimal Outputs for NCPC Reporting
FY 24-25:
- Number of parent/guardian's participating†
- Number of professionals participating
†Select Family Support Programs data collection will include basic demographic data for parent/guardian participants including Race, Ethnicity. Data on interpretation and transportation will be collected when appropriate.
Minimal Outcomes for NCPC Reporting
FY24-25:
- Increase in parent knowledge
Minimal Measures for NCPC Reporting
FY 24-25:
- CARE Evaluation- Smart Start Version (L&E can provide to LPs implementing)
NCPC Evidence Categorization
Evidence Based- 1 randomized controlled study and 1 quasi-experimental study with a historical comparison group.
Research Summary
The studies were chosen because of their relevance and strength of study. Wood et al. (2019)1 conducted a quasi-experimental study in which participants trained in CARE were compared to a historical cohort from the same two foster care agencies as the participants were recruited from. Caregivers of foster children (aged 3-8) were trained in CARE as part of their foster parent training. Results showed that preschool aged foster children with caregivers that received the training scored lower for externalizing behaviors and internalizing behaviors as measured by the Child Behavior Checklist. Overall, analysis showed a large effect size for the children’s total problem change scores. In Messer et al. (2018)2 the researchers conducted a randomized controlled trial comparing CARE training to the standard foster caregiver training. The caregivers that completed CARE training significantly improved the number of positive parenting statements given and were more likely to give positive parenting statements. They were also less likely to use negative parenting statements. The caregivers reported fewer anxiety-related behaviors in their children as well.
- ^ See Wood et al. (2019). Analysis was conducted on the 19 children in the intervention group using the Child Behavior Checklist measure. Scores were compared to 28 children in the historical comparison group where the same data was collected for a previous study. The caregivers and children were recruited from two foster care agencies and the study focused on children between the ages of 3 and 8. Data was collected at Baseline and a follow-up. The follow-up was generally conducted 6 to 7 months after baseline. During that time caregivers completed two sessions of training in CARE.
- ^ See Messer et al. (2018). The study was conducted as a randomized controlled trial with 15 foster caregivers assigned to receive CARE training and 16 assigned to the standard training. The caregivers were recruited from an urban foster care and adoption network and had a foster child between 3 and 12 years old. Data was collected using the Dyadic Parent Child Interactive Coding System and the Trauma Symptom Checklist for Young Children.
Researched Population
- Foster parents
- Participants from diverse racial and ethnic backgrounds
- Low-income populations
- Child ages ranged from 3-12 years
Messer, E.P., Greiner, M., Beal, S., Cassedy, A., Eismann, E., Gurwitch, R.H., Boat, B., Bensman, H., Bemerer, J., Greenwell, S., Eiler-Sims, P. (2018). Child Adult Relationship Enhancement (CARE): A brief, skills-building training for foster caregivers to increase positive parenting practices. Children and Youth Services Review, 90, 74-82. https://www.doi.org/10.1016/j.childyouth.2018.05.017
Wood, J., Dougherty, S. L., Long, J., Messer, E. P., & Rubin, D. M. (2019). A pilot investigation of a novel intervention to improve behavioral well-being for children in foster care. Journal of Emotional and Behavioral Disorders, 27(1), 3-13. https://doi.org/10.1177/1063426617733715
CARE offers multiple adaptations based on different delivery settings. Only CARE and FosterCARE meet Smart Start criteria for an evidence-based program eligible for Smart Start funding.
Local Partnerships Currently Implementing
Local Partnerships in purple have adopted Foster Child-Adult Relationship Enhancement (FosterCARE). Local Partnership contact information can be found here.