Foster Youth’s Resilience and Wellbeing During Placement Changes

Background: Resilience refers broadly to the dynamic process by which individuals maintain healthy functioning following exposure to significant adversity. One type of adversity that foster youth often experience is a placement change. The purpose of this study was to examine the association between resilience and wellbeing during placement transitions. Further, we sought to identify whether certain child welfare characteristics (i.e., amount of time in care, placement type, and number of previous placement changes) impact youths’ resilience.

Methods: Youth, ages 8-19 (M=14.20), were recruited during mandated foster care clinic visits, within one week of a placement change. Youth who agreed to participate (N=102, 50% female, 57% Black, 7% Hispanic) were administered the Patient-Reported Outcomes Measurement Information System Pediatric Global Health–7 (PGH-7) and the Child and Youth Resilience Measure-Revised (CYRM-R). The PGH-7 assessed overall health, quality of life, mental health, physical health, and social support. The CYRM-R provides a total resilience score, as well as intra/interpersonal (e.g., I know how to behave/act in different situations) and caregiver-based (e.g., My parent(s)/caregiver(s) know a lot about me) resilience subscales. Age, gender, race, ethnicity, and medical and mental health diagnoses were collected through the electronic health record. Time in foster care (M=24 months), number of placement changes (M=2.28), and placement setting (family-based [73%] vs. non-family) were collected from child welfare records.

Results: Higher total resilience scores were associated with better quality of life (B = .10, SE = .03, p < .01) and mental health (B = .07, SE = .02, p < .01) after accounting for demographic, health, and child welfare characteristics. Higher intra/interpersonal resilience was associated with better overall health (B = .09, SE = .04, p < .05), quality of life (B = .19, SE = .04, p < .01), physical health (B = .09, SE = .04, p < .05), mental health (B = .10, SE = .04, p < .01), and social support (B = .20, SE = .04, p < .01). In contrast, caregiver-based resilience was only associated with mental health (B = .09, SE = .04, p < .05). Accounting for demographic and health characteristics, hierarchical regression models indicated that youth in family-based settings reported higher caregiver-based resilience than youth in non-family settings (B = -1.30, SE = .10, p < .05). Time in foster care and number of previous placement changes were not significantly associated with any resilience indicators.

Conclusion: Resilience can bolster foster youths’ wellbeing during placement changes. Further, family-based placement settings may enhance youths’ resilience. Resilience was not impacted by custody duration or placement instability. Youth may benefit from pediatrician assessment of the support youth receive from new caregivers to identify opportunities to enhance caregiver resilience, particularly when youth are in non-family settings.