Mindfulness training: A promising approach for addressing the needs of child welfare system children and families

Foster children often demonstrate intensive clinical needs and evidence risk for long-term difficulties as a result of adversity and maltreatment. Addressing their diverse and intensive needs can be challenging for foster caregivers and complex for their providers. Although intervention research over the past decades has yielded a number of evidence-based treatment approaches for foster children and their caregivers, enhancement and individualization continues to be needed.As the field advances, more attention is being paid to critical skills that increase competence and resilience as protective factors versus the more traditional focus on pathology. Particularly, self-regulation and attention are becoming increasingly salient foci for scientists and practitioners seeking to improve treatment effectiveness and favorable outcomes.Mindfulness-oriented interventions pose a forum for uniquely targeting these outcomes and have the potential to (1) promote the development of self-regulation and attentional focus in foster children, (2) increase the effect of already robust therapies, (3) enhance risk prevention efforts for children whose lives are characterized by adversity, (4) address obstacles to effective and consistent implementation of therapeutic parenting strategies, and (5) increase overall well-being and quality of life for foster children and their caregivers. In this chapter, the following topics are discussed: (1) the presenting issues among foster children and their need for effective and individualized treatments, (2) the interplay of stress and neurobiology on the development critical skills, (3) current intervention trends, and (4) applications for mindfulness-oriented therapies in research and practice.The presence of over one-half million children in out-of-home care in the United States represents a national public health concern given that the vast majority of these placements result from abuse or neglect (Kendall, Dale, and Plakitsis, 1995; Stein, 1997). Over the past 20 years, the foster care population has grown considerably. Increases over time in the size of the foster care population, which until recently was growing by an average of 10% annually, are attributable to numerous factors. These include changes in child abuse and neglect reporting requirements, higher foster care entrance versus exit rates, and the impact of poverty, homelessness, adolescent parenthood, family violence, mental illness, and substance abuse. The issues are further exacerbated by flat or decreasing budgets for social services (Barbell, 1997; Barbell and Freundlich, 2001). In a national survey, states reported that funding for family support services has not kept pace with need, resulting in foster children languishing in care (U.S. General Accounting Office, 2007). As of 2008, there were more 463,000 foster children nationwide. Fortunately, the size of the population appears to have stabilized at around one-half million children in the past five years, and the most recent estimates indicate a decreasing trend (U.S. Department of Health and Human Services, 2009).In this chapter, we will explore four areas related to foster children. First, we review the disparities in well-being among foster children. Second, we explore the impact of adversity and stress on specific neurodevelopmental processes that may help to account for some of these disparities. Third, we discuss current trends in intervention practices with foster children and their caregivers, emphasizing evidence-based interventions designed specifically for this population. Lastly, we explore a new trend in emotional and behavioral health with great promise for the foster care populations: specifically, interventions designed to impact the domain of mindfulness. We suggest that, given the unique sequelae resulting from maltreatment and early adversity, mindfulness-oriented treatments for foster children and their caregivers pose a unique and promising approach for remediating critical deficits and addressing persistent obstacles to the implementation of more effective practices in the child welfare system.