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July/August 2014 Issue

Natural Mentoring of Older Foster Care Youths — Behavioral Health Benefits
By Johanna K. P. Greeson, PhD, MSS, MLSP; Allison E. Thompson, MSS, LSW; and Susan Kinnevy, PhD, MSW
Social Work Today
Vol. 14 No. 4 P. 10

Mentoring older youths can promote resiliency as they prepare to exit foster care.

According to the U.S. Department of Health and Human Services, more than 23,000 older youths were emancipated from foster care in 2012 without a legally permanent adult connection, and this cohort represented 10% of all foster care exits.

Many people refer to this process of emancipation as “aging out” because youths often are forced to leave care based on their age rather than their readiness for adulthood. Such transitions to adulthood are considered to be off-time because youths must assume the roles and responsibilities associated with adulthood when they are not ready to do so (Hogan & Astone, 1986). For example, many youths who age out of foster care lack the concrete resources, independent life skills, and social networks and relationships to be successful. As a result, youths who age out face multiple challenges and have poorer outcomes across a host of domains compared with their same-age peers in the general population (Courtney, Dworsky, Cusick, Havlicek, Perez, & Keller, 2007).

Such challenges are exemplified in the Midwest Evaluation of the Adult Functioning of Former Foster Youth, a longitudinal study that has followed a group of emerging adults who aged out of foster care (Courtney et al.). This study frames their experiences in relation to those from a nationally representative sample of young people from the general population. The results paint a bleak picture for a cohort of nearly six hundred 21-year-old youths formerly in foster care.

For example, in the study, roughly one in four youths formerly in foster care did not possess a high school diploma compared with one in 10 among their nonfoster peers. Although the majority of both groups were employed, the average income from youths in the general population was 43% higher than the average earnings from youths previously placed in foster care. Roughly 27% of youths formerly in foster care reported that they did not have enough money to pay their rent, and 8% experienced an eviction by the age of 21 vs. only 9% and 1%, respectively, from the general population (Courtney et al.).

More than one-half of the males previously placed in foster care experienced an arrest as an adult as opposed to only 7.5% of their nonfoster male peers. The pregnancy rate among the females formerly in foster care was more than double that of the general population (71% vs. 34%). Furthermore, approximately 23% of males and 9% of females formerly in foster care had a diagnosis of alcohol/drug abuse, and 14% of females and 5% of males had a mental health diagnosis at the time of the study (Courtney et al.).

Based on these statistics, the projected pathway for young people preparing to exit foster care appears grim and can be daunting.

Resilience and Natural Mentoring
Resilience theory provides a hopeful lens through which to view the many obstacles youths face as they prepare to exit foster care. This theory supports the idea that young people, including those in foster care, can experience “good outcomes in spite of serious threats to adaptations or development” (Masten, 2001, p. 228).

So how might older youths in foster care experience more of these good outcomes despite the looming threats? There is increasing evidence that successful outcomes may be associated with the presence of growth-fostering relationships with natural mentors for adolescent youths in foster care (Britner, Randall, & Ahrens, 2013). The term “natural mentor” refers to nonparental, caring adults whom youths select from their existing social networks, such as teachers, coaches, pastors, or adult relatives. Unlike programmatic or formal mentors (e.g., Big Brothers Big Sisters), who are unfamiliar to the youths, natural mentors are adults with whom the youths already are connected.

Particularly for adolescent youths in foster care, there are several potential benefits of natural mentoring over programmatic mentoring. First, youths residing in out-of-home placements invariably have suffered loss and often experience difficulty with forming trust-based relationships. Thus, natural mentoring capitalizes on the fact that youths possess enduring relationships from their communities of origin that can be strengthened and enhanced. Because these relationships are preexisting, youths do not have to work through the challenges involved with establishing and building a foundation of trust. Additionally, these relationships are more likely to continue over time, as they formed organically and did not originate in an agency setting.

Second, by definition, natural mentoring is a youth-led process and relies on the decision-making power of the youths to identify their natural mentors. In a system where so many decisions are made for youths, young people in foster care often feel powerless and out of control. Natural mentoring puts the control back in the hands of youths by allowing them to self-nominate an adult whom they determine to be important.

Third, natural mentoring may be a more culturally sensitive approach for adolescents in foster care because it seeks to strengthen their existing social support networks rather than imposing another outside relationship on them. Youths in foster care determine the important adults in their own lives as opposed to a potentially impersonal matching system.

Behavioral Health Outcomes
Research also suggests that natural mentoring relationships may reverse some of the negative outcomes for which vulnerable youth, including those in foster care, are at risk. Medical researchers have discussed the impact of natural mentoring relationships for at-risk youth from a neurobiological perspective and propose that youth resilience may be enhanced when brain pathways change over time due to repeated positive experiences within a mentee/mentor relationship. They further suggest that natural mentors may serve as buffers against the development of certain mental health conditions, such as depression and anxiety, for at-risk adolescent populations (Southwick, Morgan, Vythilingam, & Charney, 2005).

Several studies corroborate this claim among adolescent youths in foster care. For example, one study found that natural mentoring was associated with fewer depressive symptoms, lower levels of stress, and higher life satisfaction among older youths in foster care (Munson & McMillen, 2009). Another study found that adolescent youths in foster care were less likely to report suicidal ideation and experienced decreased aggressive behaviors with the presence of a natural mentoring relationship (Ahrens, DuBois, Richardson, Fan, & Lozano, 2008).

Qualitative studies also have shown that youths in foster care subjectively believe that natural mentors are helpful, and in one study, youths in care reported that the most important characteristics of their natural mentoring relationships were trust, love, and care and being similar to a parent-child relationship (Greeson & Bowen, 2008).

Consistent with these findings, the following passage describes the experiences and feelings of one older youth in foster care with regard to the role his natural mentor has played throughout his life. This information comes from an interview with a high school senior residing in foster care: “My uncle, he taught me a lot. Ever since my dad got incarcerated, he just, like, he taught me everything. He taught me how to respect women and then he took his time, like, really to be with me. He just took me under his wing and showed me what’s right and what’s wrong, just trying to lead me in the right direction. As he says, he doesn’t want me to be like my dad, you know. That’s why I’m thankful for him. If it wasn’t for him, I would probably be somewhere else, like seriously, and he really cares about me. I called my uncle my dad. I remember one time, my eighth-grade graduation, I looked in the stands and [my uncle] was there. It was just him and my mom and that made me happy, made me feel, like, it was overwhelming because I really wanted to see my dad, but he was there. He filled in that spot, so I was thankful for that.” (Note: Portions of this excerpt were redacted to preserve confidentiality.)

This student’s memories confirm what a growing body of research reveals: Natural mentoring relationships may function protectively and improve the quality of life for at-risk older youths exiting foster care. Unfortunately, nearly one-half of all adolescent youths with previous foster care experience report not being connected with a natural mentor (Ahrens et al.; Greeson & Bowen). Additionally, systematic, evidence-based interventions that support youths in foster care with the identification and navigation of a natural mentoring relationship do not presently exist.

Caring Adults ‘R’ Everywhere
As a doctoral student, Johanna K. P. Greeson, PhD, MSS, MLSP, became aware of the promising impact that natural mentoring could have in the lives of young people in foster care. However, she quickly realized that little was being done to support the development of such relationships for youth in care.

While working toward her doctorate at the University of North Carolina in 2007, she created the first iteration of Caring Adults ‘R’ Everywhere (C.A.R.E.), a child welfare–based natural mentoring intervention. But until last year, C.A.R.E. had been vetted only by academics in university settings. So when Greeson was appointed as an assistant professor at the University of Pennsylvania two years ago, one of her first priorities was to organize a series of focus groups with child welfare professionals and older youths in foster care to garner feedback about her natural mentoring intervention.

She and several research assistants completed focus groups with 20 child welfare professionals last year and now have wrapped up additional focus groups with approximately 20 youths in foster care. Both the child welfare professionals and youths have been receptive to the implementation of C.A.R.E. within a child welfare–based context and have provided excellent suggestions pertaining to its implementation.

Based on the feedback from the focus group participants and further conceptualization, Greeson made changes to the initial iteration of C.A.R.E., which is scheduled to be piloted for the first time in the fall of 2014 within Philadelphia’s child welfare system, the Department of Human Services (DHS).

C.A.R.E. is a manualized 12-week, child welfare–based intervention designed to support the development of growth-fostering relationships between youths preparing to exit foster care and their self-selected natural mentors. An interventionist administers all C.A.R.E.-related activities so as not to further burden direct caseworkers who already are responsible for a spectrum of services.

Prior to the program’s start, the interventionist meets individually with the youth in an effort to identify an appropriate natural mentor. Once the natural mentors have been screened and approved, they undergo a trauma-informed training to better understand adolescent development, the role of trauma and loss in the lives of youths in foster care, the importance of self-care, and the expectations associated with being a natural mentor.

During the intervention, youths and their natural mentors participate in a variety of group activities as well as supportive one-on-one sessions with the interventionist. Natural mentors are expected to meet with mentees on a weekly basis outside of the program’s activities for at least two hours, and during this time provide hands-on life skills training (e.g., budgeting, cooking, apartment searching).

At the end of the 12 weeks, there is a formal dinner/graduation for all of the youths and their natural mentors during which each pair celebrates the development of their relationship. Aftercare sessions are available as needed for the youths and their natural mentors to further support and sustain the relationships over time.

DHS Partnership
The C.A.R.E. pilot in Philadelphia will be funded through a partnership between the University of Pennsylvania and the DHS. In September 2013, the DHS was awarded a planning grant from the U.S. Department of Health and Human Services’ Administration for Children and Families (ACF) to develop a model intervention for older youths with child welfare involvement at risk of homelessness. This grant, known as the Pipeline Up to Stable Housing (PUSH), is designed to support promising interventions that do not yet have an evidence base but seek to impact well-being outcomes for at-risk older youth in foster care in danger of homelessness. Specifically, PUSH grant recipients are charged with improving stable housing, permanent connections, education/employment outcomes, and social-emotional well-being for older youths at risk of emancipating from child protective services. The C.A.R.E. intervention was chosen to address the permanent connections piece of the PUSH grant for this vulnerable population of youths.

The first year of the grant is intended for planning and start-up activities, and the second year is designated for implementation. Thus, in the fall of 2014, C.A.R.E. will be piloted as a randomized control trial among 40 youths in two geographical areas of the city. Twenty older youths in foster care at risk of aging out will receive the C.A.R.E. intervention, and 20 demographically similar youths will serve as a control group, receiving only treatment as usual, consisting of case management services and classroom-based life skills training. This experimental design is ideal because it will allow for testing the effectiveness of C.A.R.E. by comparing outcomes between youths in the intervention and control groups.

Following the two-year planning grant, the ACF will invite a select group of current grantees to take their interventions full scale, furthering the array of evidence-based practices available for children and youths in foster care.

The partnership with the City of Philadelphia presents a strong first step in the implementation of a theory-based and research-supported natural mentoring intervention for older youths at risk of aging out of foster care. All youths deserve supportive, enduring relationships with caring, nonparental adults, and C.A.R.E. provides one possible way to make this happen for older youths in foster care.

As one older youth in foster care recently stated during an interview, “I think everybody should have a mentor. That’s someone they should look up to.”

— Johanna K. P. Greeson, PhD, MSS, MLSP, is an assistant professor in the University of Pennsylvania School of Social Policy & Practice.

— Allison E. Thompson, MSS, LSW, is a doctoral student in the University of Pennsylvania School of Social Policy & Practice.

— Susan Kinnevy, PhD, MSW, is director of special projects for the Philadelphia Department of Human Services.

Ahrens, K. R., DuBois, D. L., Richardson, L. P., Fan, M. Y., & Lozano, P. (2008). Youth in foster care with adult mentors during adolescence have improved adult outcomes. Pediatrics, 121(2), e246-e252.

Britner, P. A., Randall, K. G., & Ahrens, K. R. (2013). Youth in foster care. In D. L. DuBois & M. J. Karcher (Eds.). The handbook of youth mentoring (pp. 341-354). Thousand Oaks, CA: Sage Publications.

Courtney, M. E., Dworsky, A., Cusick, G. R., Havlicek, J., Perez, A., & Keller, T. (2007). Midwest evaluation of adult functioning of former foster youth: Outcomes at age 21. Chicago, IL: Chapin Hall Center for Children at the University of Chicago.

Greeson, J. K., & Bowen, N. K. (2008). “She holds my hand”: The experiences of foster youth with their natural mentors. Children and Youth Services Review, 30, 1178-1188.

Hogan, D. P., & Astone, N. M. (1986). The transition to adulthood. Annual Review of Sociology, 12, 109-130.

Masten, A. S. (2001). Ordinary magic: Resilience process in development. American Psychologist, 56(3), 227-238.

Munson, M. R., & McMillen, J. C. (2009). Natural mentoring and psychosocial outcomes among older youth transitioning from foster care. Children and Youth Services Review, 31(1), 104-111.

Southwick, S. M., Morgan III, C. A., Vythilingam, M., & Charney, D. (2007). Mentors enhance resilience in at-risk children and adolescents. Psychoanalytic Inquiry, 26(4), 577-584.