Summer 2001 - IP; Consider this Niche: Working with Foster Parents and Foster Children

Daniel L. McIvor, Ph.D., and
George “Mac” McClelland

Introduction:

I (Dan) am a licensed psychologist in private practice who has opted-out of all managed care programs and most insurance companies, and focus my practice on providing clinical services for reasonable fees. I have worked on the edge of some foster families in the past when doing evaluations and therapy for the Bi-County Juvenile Justice Center. Through such work over the past 10 years, and especially the last two years, I have enjoyed working together with Mac, both with some very difficult children who as adults, are now in the penitentiary, as well as some delightful children who have thrived and succeeded in foster placement on up into adulthood.

I, (George [Mac] McClelland) was born November 11, 1945, to unknown parents, removed from biological parents at age three, placed in Children’s Home Society of Washington Orphanage, and was at the orphanage and in multiple foster homes until age six. I was adopted to the McClelland family and began elementary school in Bremerton, Washington. I was abused physically and mentally until I ran away from home at age 13 because I could not or would not accept the abuse any longer. I lived on the streets until I was picked up by the police and refused to return to my adopted parents, and placed into the Juvenile Detention for six months for running away. I was then placed in a boys home until I was 17 and began working on a dairy for room and board. I have been a foster parent for the State of Washington for four years, a therapeutic foster parent for a private agency for four years, and a Crisis Residential Center director for severely emotionally and behaviorally out of control teens for a year and a half. My wife, Rachel, and I have had direct foster care responsibilities for approximately 300 teens. We now have five foster children in our home, and we have recently taken guardianships out on all of the five children, the youngest 8 and the oldest 16. I am now also directly responsible for 27 State Foster Children 16 to 21 through another private agency, teaching them independent living and life skills, employment, housing, and cooking skills, to prepare them for aging out of foster care at the age of 18. I have been involved in this work for the past ten years.

Needs of the Market:

There is a chronic shortage of foster parents, and often, state funds are limited in providing professional consulting and clinical services for foster children and foster parents. The result is that some skilled foster parents get loaded-up with numerous foster children, often with a wide array of other needs in addition to a safe home and regular meals. Many of the foster children have been neglected, physically abused, and/or sexually abused. Some will also be coping with ADD, ADHD, PTSD, dyslexia, poor academic skills, medical disorders, mild retardation, and severe behavioral disorders.

Thus, this market has three branches to it:

First, the state workers usually have unrealistically huge caseloads, and need support in terms of assessment, case consultation, and treatment planning.

Second, the foster parents may need assistance in just learning about the history and needs of each child, what the relationship with the biological parents will be, and how best to support each individual child in terms of health needs (dental care, medical care, eyeglasses). When there are several foster children in one home, this creates unexpected dynamics and interactions between the foster children and foster parents. With each new foster child, the foster parents may need to learn about a new psychiatric disorder, or may be exposed to some new behavioral disorder.

For example, some biological parents give extremely strong but vacuous promises to their children: “I will come and get you! You will be coming home with me in two months!” Then never show up. Other biological parents manipulate their children during visits, telling them: “You don’t have to do what your foster parents say.

They aren’t your parents! The state is trying to tell me what to do, and nobody can tell me what to do. You be like that, too, and pretty soon they will let you come back home with me.” These are very complex and difficult dynamics for foster parents. Some biological parents forbid their children to bond with their foster parents. Thus, foster parents need to be able to debrief with someone, to discuss and problem-solve around such complex and emotionally charged challenges.

The third branch of this market has to do with providing direct clinical services to the children. Some children need diagnostic evaluations, so that the results can guide the foster parents and state workers in treatment planning as well as advocating for each student in school. Repeatedly, we have found that some battle-weary foster children come into foster care, then get their teeth fixed, get new glasses, get regular meals, new school clothes and school supplies, and just blossom into bright, creative, gifted children who soon learn to create areas of competence and success for themselves, that help them get their bearings and move forward confidently into high school land post-high school years.

On the other hand, some foster children lie, cheat, and steal, and sexually molest other foster children, creating havoc wherever they go, usually leaving a trail of unsatisfactory foster placements and juvenile arrests. Such children continue to need assistance, but so do their foster parents!

What the Market Needs from Psychologists:

1. The State Workers:

The state caseworkers tend to be overworked, under paid, and overwhelmed with calamity and crisis caseloads. What they appreciate from psychologists is that when a referral is made, the psychologist is quickly involved. Delayed responses create more stress and phone calls for caseworkers. It is also important for the psychologist to treat the caseworker with respect and support. Rarely do caseworkers hear “Thank you.” “You are doing a good job.” “I appreciate what you do for all these children and families.” The caseworkers are the gatekeepers for the psychologists. If you do a good job of meeting the caseworker’s needs, you will likely hear from this caseworker again.

When asked to do an evaluation for the caseworker, spend some time with the caseworker and draw out what questions need answering. What information will be used to help the caseworker make a decision? Clarify with the caseworker what sort of information will be helpful, and is the preference for a detailed report or a short report? When is the report needed? Be fair and realistic in saying when you can schedule sessions, do home visits, and get your report typed and back to the caseworker, so the caseworker can plan on using your report to make decisions.

As you listen to caseworkers discuss their caseload or your shared clients, be alert to see if the caseworker would like a specific article on the topic the caseworker expressed interest in: Munchausen’s Syndrome by Proxy. Why some people stay in abusive relationships. When children with Fetal Alcohol Syndrome mature, their facial features often become normal, but they still lie and show poor judgment. Why is this? What effect does a mother’s rape have on her 12 year old daughter?

After you have worked with a few gatekeepers at an agency, offer to the management that you will do a free 1/2 day “Thank You” staff training workshop for the caseworkers, on a topic of their choice (and present a menu of topics you feel you can present on).

2. The Foster Parents:

Keep in mind that if you do a good job with the foster children and the foster parents, they will sing your praises to the caseworkers and other foster parents. Your niche will multiply if you serve your market.
Foster parents select themselves for this task for a variety of reasons, but they rapidly discover that the daily grind of dealing with foster children requires special patience, selflessness, firmness, and humor. Often in a matter of a few weeks, they will know if they can do this special work or not.

There are great emotional and time demands on foster parents. Rarely do the children or anyone else say to a foster parent: “Thank you.” “You do a good job.” “Thank you for sharing your life, your privacy, your family, your home with these new children.” Foster parents are in fact giving a great deal of themselves, and they do deserve our respect and appreciation.

Mac makes the following suggestions:

Treat foster families with respect and as a member of the team helping the child.
Return the foster parent’s phone calls promptly.
Give them the information they have a need to know and a right to have to address the child’s needs and keep them safe while in their care.
Listen to them - they spend more time with the child than anyone else.
Say “Thank You” when they do a good job with a child, write them a note and pass on any praise you hear from others about how they are doing.
“To help a child” is the main reason most families do foster care. Encourage them to take time for their “own family” and themselves - it will keep them doing foster care longer if they take breaks once in a while to rejuvenate.
Psychologists need to validate the foster parents and their decisions. Express appreciation, and stand by them during difficult times.
Provide foster parents with brief, simple information which they can use to better understand their foster children. (Dan recently summarized a book, On Playing A Poor Hand Well [1997], by Mark Katz. New York: Norton. The four page summary hit the high points of the book, and gives foster parents food for positive thought.)
While foster parents understand that counseling with their foster children is confidential, they still would appreciate some feedback from the psychologist on how the child is doing and what they can do to help.

3. The Foster Children:

Many foster children are frightened and disoriented and feel out of control when they are placed in foster care. Many times, they are separated from their pets, from their friends, and from their toys (bicycles, computers, Game-Boy’s). In most cases, they have done nothing wrong. So their initial needs include some validation that they are stressed and have reason to be, and they need assistance to reduce and manage such stress. You can help by beginning to help the child identify some of the stressors, and begin to get information to reduce stress. You can assist the child in finding his or her own positive spin on the situation - so that it makes sense and gives them hope. You can demonstrate to the children ways to soothe themselves, calm themselves down, and praise themselves for surviving sometimes extreme trauma. You can begin to help them identify some stress buffers, and some ways to positively distract themselves. As you get to know each child, you can begin to identify their own sense of humor, and their strengths and skills. Always keep your word with a foster child. Across multiple supportive sessions, you can show the children and foster parents methods to shift from stress-ventilation-problem-identification-priority-setting-problem-solving, planning, and perseverance through the hard days.

The Pro’s and Con’s of Such Work:

Every hour you spend with the foster care system is an hour you have freed from managed care underpay and manipulation. You will usually have to provide 3-month reports, but once you have a template of what the caseworker needs to make decisions, such reports are easy to do on time. I prefer doing home visits, and do not charge for my driving time. Mileage is a deductible expense, and I listen to audio books for CPE credit while driving. When given multiple serious problem children to work with, be careful not to set unrealistic lofty goals that the child is not interested in. Keep in mind that some children will choose to misbehave and land in detention or jail.

Be patient with new foster parents. Some of them have been snubbed, demeaned, or falsely accused, and have often seen a revolving door of ever-changing, overworked, unavailable caseworkers and psychologists. But my experience has been that if you keep your word, respect the children, foster parents, and caseworkers, and provide consistent, quality, caring services over the months and years, you will be well-rewarded, especially by the children.

Useful References We have Valued:

Katz, Mark (1997). On playing a poor hand well. New York: W. W. Norton.

Taylor, John (1996). Answers to Attention Deficit Disorder. Salem, Oregon. (1-[800]-847-1233).

Wren, Carol (2000). Hanging by a twig. New York: W. W. Norton.

Taylor, John F. (1994). Helping your Hyperactive/Attention Deficit Child. Rocklin, CA: Prima Publishing. (1-[916]-632-4400).

Rief, Sandra (1997). The ADD/ADHD checklist. Paramus, N.J.: Prentice-Hall.

Daniel McIvor, Ph.D., is in private practice, 1776 Fowler, Suite 2, Richland, WA 99352, 509-783-1705, dananbarb@aol.com. Mac McClelland can be reached at maxdadde76@verizon.net or at (509)582-2729.

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Marketing

	Psychologists Can Help Deal With School Violence: A Model Letter and Talking Points/Division 42 Public Relations and Public Education Committee
	Helping People Age Well: A New Niche Market/Michael Brickey
	Consider this Niche: Working with Foster Parents and Foster Children/Daniel L. McIvor and George “Mac” McClelland
	Psychologists as Doctors in Primary Care Settings/Jack G. Wiggins

Consider this Niche: Working with Foster Parents and Foster Children

Daniel L. McIvor, Ph.D., and
George “Mac” McClelland

Introduction:

I (Dan) am a licensed psychologist in private practice who has opted-out of all managed care programs and most insurance companies, and focus my practice on providing clinical services for reasonable fees. I have worked on the edge of some foster families in the past when doing evaluations and therapy for the Bi-County Juvenile Justice Center. Through such work over the past 10 years, and especially the last two years, I have enjoyed working together with Mac, both with some very difficult children who as adults, are now in the penitentiary, as well as some delightful children who have thrived and succeeded in foster placement on up into adulthood.

I, (George [Mac] McClelland) was born November 11, 1945, to unknown parents, removed from biological parents at age three, placed in Children’s Home Society of Washington Orphanage, and was at the orphanage and in multiple foster homes until age six. I was adopted to the McClelland family and began elementary school in Bremerton, Washington. I was abused physically and mentally until I ran away from home at age 13 because I could not or would not accept the abuse any longer. I lived on the streets until I was picked up by the police and refused to return to my adopted parents, and placed into the Juvenile Detention for six months for running away. I was then placed in a boys home until I was 17 and began working on a dairy for room and board. I have been a foster parent for the State of Washington for four years, a therapeutic foster parent for a private agency for four years, and a Crisis Residential Center director for severely emotionally and behaviorally out of control teens for a year and a half. My wife, Rachel, and I have had direct foster care responsibilities for approximately 300 teens. We now have five foster children in our home, and we have recently taken guardianships out on all of the five children, the youngest 8 and the oldest 16. I am now also directly responsible for 27 State Foster Children 16 to 21 through another private agency, teaching them independent living and life skills, employment, housing, and cooking skills, to prepare them for aging out of foster care at the age of 18. I have been involved in this work for the past ten years.

Needs of the Market:

There is a chronic shortage of foster parents, and often, state funds are limited in providing professional consulting and clinical services for foster children and foster parents. The result is that some skilled foster parents get loaded-up with numerous foster children, often with a wide array of other needs in addition to a safe home and regular meals. Many of the foster children have been neglected, physically abused, and/or sexually abused. Some will also be coping with ADD, ADHD, PTSD, dyslexia, poor academic skills, medical disorders, mild retardation, and severe behavioral disorders.

Thus, this market has three branches to it:

First, the state workers usually have unrealistically huge caseloads, and need support in terms of assessment, case consultation, and treatment planning.

Second, the foster parents may need assistance in just learning about the history and needs of each child, what the relationship with the biological parents will be, and how best to support each individual child in terms of health needs (dental care, medical care, eyeglasses). When there are several foster children in one home, this creates unexpected dynamics and interactions between the foster children and foster parents. With each new foster child, the foster parents may need to learn about a new psychiatric disorder, or may be exposed to some new behavioral disorder.

For example, some biological parents give extremely strong but vacuous promises to their children: “I will come and get you! You will be coming home with me in two months!” Then never show up. Other biological parents manipulate their children during visits, telling them: “You don’t have to do what your foster parents say.

They aren’t your parents! The state is trying to tell me what to do, and nobody can tell me what to do. You be like that, too, and pretty soon they will let you come back home with me.” These are very complex and difficult dynamics for foster parents. Some biological parents forbid their children to bond with their foster parents. Thus, foster parents need to be able to debrief with someone, to discuss and problem-solve around such complex and emotionally charged challenges.

The third branch of this market has to do with providing direct clinical services to the children. Some children need diagnostic evaluations, so that the results can guide the foster parents and state workers in treatment planning as well as advocating for each student in school. Repeatedly, we have found that some battle-weary foster children come into foster care, then get their teeth fixed, get new glasses, get regular meals, new school clothes and school supplies, and just blossom into bright, creative, gifted children who soon learn to create areas of competence and success for themselves, that help them get their bearings and move forward confidently into high school land post-high school years.

On the other hand, some foster children lie, cheat, and steal, and sexually molest other foster children, creating havoc wherever they go, usually leaving a trail of unsatisfactory foster placements and juvenile arrests. Such children continue to need assistance, but so do their foster parents!

What the Market Needs from Psychologists:

1. The State Workers:

The state caseworkers tend to be overworked, under paid, and overwhelmed with calamity and crisis caseloads. What they appreciate from psychologists is that when a referral is made, the psychologist is quickly involved. Delayed responses create more stress and phone calls for caseworkers. It is also important for the psychologist to treat the caseworker with respect and support. Rarely do caseworkers hear “Thank you.” “You are doing a good job.” “I appreciate what you do for all these children and families.” The caseworkers are the gatekeepers for the psychologists. If you do a good job of meeting the caseworker’s needs, you will likely hear from this caseworker again.

When asked to do an evaluation for the caseworker, spend some time with the caseworker and draw out what questions need answering. What information will be used to help the caseworker make a decision? Clarify with the caseworker what sort of information will be helpful, and is the preference for a detailed report or a short report? When is the report needed? Be fair and realistic in saying when you can schedule sessions, do home visits, and get your report typed and back to the caseworker, so the caseworker can plan on using your report to make decisions.

As you listen to caseworkers discuss their caseload or your shared clients, be alert to see if the caseworker would like a specific article on the topic the caseworker expressed interest in: Munchausen’s Syndrome by Proxy. Why some people stay in abusive relationships. When children with Fetal Alcohol Syndrome mature, their facial features often become normal, but they still lie and show poor judgment. Why is this? What effect does a mother’s rape have on her 12 year old daughter?

After you have worked with a few gatekeepers at an agency, offer to the management that you will do a free 1/2 day “Thank You” staff training workshop for the caseworkers, on a topic of their choice (and present a menu of topics you feel you can present on).

2. The Foster Parents:

Keep in mind that if you do a good job with the foster children and the foster parents, they will sing your praises to the caseworkers and other foster parents. Your niche will multiply if you serve your market.
Foster parents select themselves for this task for a variety of reasons, but they rapidly discover that the daily grind of dealing with foster children requires special patience, selflessness, firmness, and humor. Often in a matter of a few weeks, they will know if they can do this special work or not.

There are great emotional and time demands on foster parents. Rarely do the children or anyone else say to a foster parent: “Thank you.” “You do a good job.” “Thank you for sharing your life, your privacy, your family, your home with these new children.” Foster parents are in fact giving a great deal of themselves, and they do deserve our respect and appreciation.

Mac makes the following suggestions:

Treat foster families with respect and as a member of the team helping the child.
Return the foster parent’s phone calls promptly.
Give them the information they have a need to know and a right to have to address the child’s needs and keep them safe while in their care.
Listen to them - they spend more time with the child than anyone else.
Say “Thank You” when they do a good job with a child, write them a note and pass on any praise you hear from others about how they are doing.
“To help a child” is the main reason most families do foster care. Encourage them to take time for their “own family” and themselves - it will keep them doing foster care longer if they take breaks once in a while to rejuvenate.
Psychologists need to validate the foster parents and their decisions. Express appreciation, and stand by them during difficult times.
Provide foster parents with brief, simple information which they can use to better understand their foster children. (Dan recently summarized a book, On Playing A Poor Hand Well [1997], by Mark Katz. New York: Norton. The four page summary hit the high points of the book, and gives foster parents food for positive thought.)
While foster parents understand that counseling with their foster children is confidential, they still would appreciate some feedback from the psychologist on how the child is doing and what they can do to help.

3. The Foster Children:

Many foster children are frightened and disoriented and feel out of control when they are placed in foster care. Many times, they are separated from their pets, from their friends, and from their toys (bicycles, computers, Game-Boy’s). In most cases, they have done nothing wrong. So their initial needs include some validation that they are stressed and have reason to be, and they need assistance to reduce and manage such stress. You can help by beginning to help the child identify some of the stressors, and begin to get information to reduce stress. You can assist the child in finding his or her own positive spin on the situation - so that it makes sense and gives them hope. You can demonstrate to the children ways to soothe themselves, calm themselves down, and praise themselves for surviving sometimes extreme trauma. You can begin to help them identify some stress buffers, and some ways to positively distract themselves. As you get to know each child, you can begin to identify their own sense of humor, and their strengths and skills. Always keep your word with a foster child. Across multiple supportive sessions, you can show the children and foster parents methods to shift from stress-ventilation-problem-identification-priority-setting-problem-solving, planning, and perseverance through the hard days.

The Pro’s and Con’s of Such Work:

Every hour you spend with the foster care system is an hour you have freed from managed care underpay and manipulation. You will usually have to provide 3-month reports, but once you have a template of what the caseworker needs to make decisions, such reports are easy to do on time. I prefer doing home visits, and do not charge for my driving time. Mileage is a deductible expense, and I listen to audio books for CPE credit while driving. When given multiple serious problem children to work with, be careful not to set unrealistic lofty goals that the child is not interested in. Keep in mind that some children will choose to misbehave and land in detention or jail.

Be patient with new foster parents. Some of them have been snubbed, demeaned, or falsely accused, and have often seen a revolving door of ever-changing, overworked, unavailable caseworkers and psychologists. But my experience has been that if you keep your word, respect the children, foster parents, and caseworkers, and provide consistent, quality, caring services over the months and years, you will be well-rewarded, especially by the children.

Useful References We have Valued:

Katz, Mark (1997). On playing a poor hand well. New York: W. W. Norton.

Taylor, John (1996). Answers to Attention Deficit Disorder. Salem, Oregon. (1-[800]-847-1233).

Wren, Carol (2000). Hanging by a twig. New York: W. W. Norton.

Taylor, John F. (1994). Helping your Hyperactive/Attention Deficit Child. Rocklin, CA: Prima Publishing. (1-[916]-632-4400).

Rief, Sandra (1997). The ADD/ADHD checklist. Paramus, N.J.: Prentice-Hall.

Daniel McIvor, Ph.D., is in private practice, 1776 Fowler, Suite 2, Richland, WA 99352, 509-783-1705, dananbarb@aol.com. Mac McClelland can be reached at maxdadde76@verizon.net or at (509)582-2729.

Discuss this and other articles at the IP Chat Discussion Board

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