PIECING IT TOGETHER: YOUTH PERCEPTIONS OF THE LINKAGES BETWEEN COMMUNICATION AND ADJUSTMENT TO OUT-OF-HOME PLACEMENT By Jennifer Marie Bak A DISSERTATION Submitted to Michigan State University in partial fulfillment of the requirements for the degree of DOCTOR OF PHILOSOPHY Human Development and Family Studies 2011       ABSTRACT PIECING IT TOGETHER: YOUTH PERCEPTIONS OF THE LINKAGES BETWEEN COMMUNICATION AND ADJUSTMENT TO OUT-OF-HOME PLACEMENT By Jennifer Marie Bak This qualitative study used a modified grounded theory approach to build a framework of the process by which communication from the child welfare and biological family systems influences adjustment to out-of-home placement. Semi-structured indepth interview, demographic, and eco-map data were collected from 14 youth between the ages of 18 and 24 who entered foster care at least once after the age of 8. The youth interviewed shared their experiences of piecing together information from various sources in order to develop a more cohesive understanding of the reasons for entry and what would happen during their time in foster care. The youth engaged in a dynamic process of accessing information and forming perceptions that influenced coping and adjustment to out-of-home placement. The data suggest that sources of communication are more or less influential depending upon youth perceptions of who is most responsible for providing explanations. The extent to which communication met the informational needs of the youth and the quality of the caseworker-youth relationship strongly influenced perceptions of out-of-home placement and foster care. Communication from biological family influenced adjustment through indirect avenues of perceived support and feelings of loyalty to biological parents.       Copyright by Jennifer Marie Bak 2011     TABLE OF CONTENTS   LIST OF TABLES ................................................................................................. ix LIST OF FIGURES ................................................................................................x CHAPTER ONE: INTRODUCTION ...................................................................... 1 Background of the Problem .................................................................................. 1 Theoretical Framework......................................................................................... 4 Social Construction ...................................................................................... 6 Feminist Multicultural Perspective ................................................................ 7 Human Ecology Theory ................................................................................ 8 Conceptual Framework ...................................................................................... 17 Purpose of the Study .......................................................................................... 19 Summary ............................................................................................................ 20 Research Questions ........................................................................................... 24 CHAPTER TWO: REVIEW OF LITERATURE ................................................... 25 Introduction ........................................................................................................ 25 Ecological Perspective of the Emotional Well-Being of Youth in the Foster Care System ...................................................................................................... 25 Communication & Child Welfare Service Delivery .............................................. 28 Family Communication & the Child Welfare System .......................................... 30 Adjustment to Out-of-Home Placement .............................................................. 32 Perceptions of Out-of-Home Placement .................................................. 32 Coping Strategies ............................................................................................... 36 Communication: Youth Suggestions & Current Placement ................................ 37 Conclusions........................................................................................................ 42 CHAPTER THREE: RESEARCH DESIGN & METHOD..................................... 44 Introduction ........................................................................................................ 44 Research Design ................................................................................................ 44 Rationale for Qualitative Methodology................................................................ 45 Demograhpic Questionnaire & Eco-Map ............................................................ 46 Grounded Theory & Interview Method................................................................ 47 Sampling ............................................................................................................ 53 Participants ........................................................................................................ 56 Compensation .................................................................................................... 58 Data Collection ................................................................................................... 58 Data Analysis ..................................................................................................... 60 Trustworthiness .................................................................................................. 64 Summary ............................................................................................................ 66   CHAPTER FOUR: FINDINGS ............................................................................ 68 iv       Introduction ........................................................................................................ 68 Research Qeustion 1: What is the Relationship of Communication from the Child Welfare System and Biological Family to Youth Adjustment to Out-ofHome Placement? .............................................................................................. 68 Piecing Together an Understanding ................................................................... 70 Experience of Removal ........................................................................... 72 Sources of Communication ..................................................................... 72 Informational Needs & Perceptions of Relationships.......................................... 74 Empowerment vs. Disempowerment ....................................................... 76 Perceptions of Out-of-Home Placement .................................................. 77 Coping: Learning to Play the Game ........................................................ 78 Adjustment ......................................................................................................... 81 Summary ............................................................................................................ 84 Research Question 2: How is Information about Reason for Entry into Care and What will Happen Next Communicated to Youth Entering Foster Care? ..... 86 Experience of Removal ...................................................................................... 86 Fast ........................................................................................................ 87 Scary ...................................................................................................... 87 Angry ...................................................................................................... 88 Confused ................................................................................................ 88 Communication during the Process of Removal ................................................ 89 Preparation ............................................................................................. 90 Directive: CPS Workers and Police Officers ........................................... 91 Descriptive: Caseworkers, Family, Foster Caregivers, & GALs.............. 92 No Explanation ....................................................................................... 94 Aware but Unaware: Understanding of Environment Prior to Care .................... 95 Summary ............................................................................................................ 97 Research Question 3: What Roles do Caseworkers, Therapists, Foster Caregivers, and Biological Parents Play in Communicating Important Information About the Reason for Entry Into Care and What Will Happen Next? ................................................................................................................ 98 Piecing it Together ............................................................................................. 99 Who is Responsible for Providing Explanations? ............................................. 101 First Contact: CPS or Caseworker ........................................................ 102 Collaborative Effort ................................................................................ 103 Parent .................................................................................................... 103 Former Foster Youth ............................................................................. 103 Roles in Providing Important Information ......................................................... 104 Role of Caseworker ............................................................................... 104 Role of Biolgical Parents and Family Members ..................................... 106 Role of Foster Caregivers ..................................................................... 107 Role of Mental Health Service Providers ............................................... 108 Summary .......................................................................................................... 108 Research Question 4: How Does Communication from the Child Welfare -of-Home Placement v     Environment? ................................................................................................... 109 Communication from Caseworkers & Perceptions ........................................... 110 Strong Caseworker Relationship ........................................................... 110 Weak Caseworker Relationship............................................................. 113 Communication from Foster Caregivers & Perceptions.................................... 115 Strong Foster Caregiver Relationship .................................................... 116 Weak Foster Caregiver Relationship ..................................................... 117 Roles & Rules ........................................................................................ 119 Communication from Mental Health Service Providers & Perceptions ............. 120 Strong Relationship with Mental Health Service Providers .................... 121 Weak Relationship with Mental Health Service Providers ..................... 122 Summary .......................................................................................................... 123 Research Question 5: How Does Communciation from the Biological Family Out-of-Home Placement Environment? ....... 124 Communication from Parents & Perceptions.................................................... 125 Loyalty .................................................................................................. 125 Communication from Siblings & Perceptions ................................................... 127 Explanations .......................................................................................... 128 Support .................................................................................................. 128 Communication from Relative Caregivers & Perceptions ................................. 129 Strong Relationship with Relative Caregivers ........................................ 129 Weak Relationship with Relative Caregivers ......................................... 132 Roles & Rules ........................................................................................ 133 Summary .......................................................................................................... 135 Research Question 6: What Strategies do Youth use for Coping with the Transition to Out-of-Home Placement? ............................................................ 135 Keep True Feelings Inside ............................................................................... 136 Avoidance ........................................................................................................ 137 Self-Harm ......................................................................................................... 137 Acting Out ........................................................................................................ 138 Social Support .................................................................................................. 139 Creative Outlets ............................................................................................... 139 Sharing their Stories ......................................................................................... 140 Therapy ............................................................................................................ 141 Physical Activity ............................................................................................... 141 Summary .......................................................................................................... 142 Research Question 7: How do Youth View Race, Ethnicity, Culture, Religion, Gender, and Sexual Orientation in Relation to their Experiences of Communication and Adjustment to Foster care? ............................................. 142 Race/Ethnicity/Culture ...................................................................................... 143 .............................................................................. 143 Race Does Matter ................................................................................. 144 Culture ................................................................................................... 146 Thoughts on Adjustment ....................................................................... 147 vi     Gender ............................................................................................................. 147 Female .................................................................................................. 148 Male ....................................................................................................... 149 No Difference......................................................................................... 150 Religion ............................................................................................................ 151 Rules ..................................................................................................... 151 Support from Foster Parent ................................................................... 151 Source of Strength & Support ................................................................ 152 Questioning God.................................................................................... 152 Self-disclosure .................................................................................................. 153 Not Free to Be Me ................................................................................. 153 Feeling Different ............................................................................................... 154 Stereotypes ........................................................................................... 124 Shame ................................................................................................... 155 School .................................................................................................. 156 Summary .......................................................................................................... 157 Chapter Summary ............................................................................................ 158   CHAPTER FIVE: CONCLUSION ..................................................................... 165 Introduction ...................................................................................................... 165 Linkages between Communcation and Adjustment to Out-of-Home Placement ........................................................................................................ 166 Discussion of Key Findings .............................................................................. 170 Lasting Impressions of Removal............................................................ 171 Communication with the Child Welfare System ..................................... 174 Caseworkers................................................................................... 174 Foster Caregivers ........................................................................... 177 Mental Health Service Providers .................................................... 178 Communication with the Biological Family System................................ 179 Perceptions of Out-of-Home Placement ................................................ 182 Coping ................................................................................................... 183 Adjustment............................................................................................. 185 Implications ...................................................................................................... 186 Removal ................................................................................................ 187 Communication & Perceptions .............................................................. 188 Coping & Adjustment ............................................................................. 191 MFTS Involved in Multidisciplinary Child Welfare Service Delivery ....... 193 Limitations ........................................................................................................ 194 Directions for Future Research ........................................................................ 195 Researcher Reflections .................................................................................... 196 Conclusion ....................................................................................................... 197 APPENDICES .................................................................................................. 202 APPENDIX A: Interview Guide ......................................................................... 203 APPENDIX B: Demographics Questionnaire ................................................... 205 vii     APPENDIX C: Eco-Map Instructions ................................................................ 208 APPENDIX D: Recruitment Flyer ..................................................................... 210 APPENDIX E: Informed Consent ..................................................................... 211   REFERENCES ................................................................................................. 215 viii     LIST OF TABLES Table 1: Linking Frameworks & Research Questions ........................................ 22 Table 2: Likages between Elements of the Interview Guide, Research Questions & Proposed Frameworks ................................................................... 48 Table 3: Major Categories & Sub-Categories for Research Question 1 ............. 69 Table 4: Major Categories & Sub-Categories for Research Question 2 ............. 86   Table 5: Major Categories & Sub-Categories for Research Question 3 ............. 98 Table 6: Major Categories & Sub-Categories for Research Question 4 .......... 109 Table 7: Major Categories & Sub-Categories for Research Question 5 ........... 124 Table 8: Major Categories & Sub-Categories for Research Question 6 ........... 136 Table 9: Major Categories & Sub-Categories for Research Question 7 ........... 142 ix     LIST OF FIGURES Figure 1.1: Theoretical Map ................................................................................. 5 Figure 1.2: Conceptual Map ............................................................................... 18 Figure 4.1: Communication Appraisal Process .................................................. 71 Figure 5.1: Revised Concept Map .................................................................... 167     x     CHAPTER ONE INTRODUCTION Background of the Problem Most children who enter foster care are not well informed about why they entered care and what will happen to them (Cashmore, 2002; Folman, 1998; Gil, 1982a, Lee & Whiting, 2007). The overwhelming majority of children who have participated in foster care research characterize their entry into care as confusing, frightening, destabilizing, shameful, traumatic and in some instances damaging (Bass, Shields, & Behrman, 2004; Bogolub, 2008; Clausen, Landsverk, Ganger, Chadwick, & Litrownik, 1998; Festinger, 1983; Folman 1998; Gil & Bogart, 1982a, 1982b; Holody & Maher, 1996; Johnson, Yoken, & Voss, 1995; Mitchell & Kuczynski; 2010; Nesbit, 2000; Pecora & Maluccio, 2000; Sieta, Mitchell, & Tobin, 1996; Whiting & Lee, 2003). Interviews with children in foster care have revealed that even when children do not debate the necessity of child welfare intervention they continue to grapple with feelings of loss while remaining confused about what is happening to them and what their futures hold (Barber & Delfabbro , 2004; Bogolub, 2008; Ellerman, 2007; Folman,1998; Lee & Whiting, 2007; Nesbit, 2000; Samuels, 2009; Schneider, 2005; Whiting & Lee, 2003). Research has documented gaps in communicating important information to children about why they are in care, what will happen to them, their families, and placement decisions (Cashmore, 2002; Chapman et al., 2004; Festinger, 1983; Gilligan, 2000; Gil & Bogart, 1982a, 1982b; Johnson et al., 1995; Scannapieco, Connell-Carrick, & Painter, 2007; Shin, 2004). Child welfare researchers and practitioners have warned that failure to communicate such information holds critical implications for child well1     being, adjustment to care, and then perpetuates a cycle of disempowerment that does not privilege the ways in which children view their world (Bruskas, 2008;Gil & Bogart, 1982a,1982b; Sieta, 2000; Skivenes, & Strandbu, 2006; Whiting & Lee, 2003). Children in foster care have voiced a desire to understand the decisions being made about their lives and have suggested that some type of preparation for placement in out-of-home care would be helpful during times of transition (Barber & Delfabbro, 2004; Cashmore, 2002; Folman, 1998). The child welfare community has also suggested the benefit of developing programs to assist parents, children, and foster caregivers during periods of transition (Bruskas, 2008; Cashmore, 2002; Ellerman, 2007; Folman, 1998; Fox, Berrick, & Frasch, 2008; Gil, 1982a, 1982b; Holody & Maher, 1996; Jones Harden, 2004; Kemp, Marcenko, Hoagwood, & Vesneski, 2009). Bruskas (2008) suggests that children entering foster care be given an orientation to the system In fact, some of these strategies have already made their way into child welfare procedures. In South Wales, procedures are in place that incorporate steps to provide full information about reason for entry into care and expected duration, as well as accompaniment and extended stay with the child as she is introduced to a new placement (Barber & Delfabbro, 2004). Although it is a widely accepted belief that such preparation can ease anxiety, reduce self-blame, being during the transition to a new environment, there has been little research exploring the influence of placement preparation on placement outcomes (Barber & Delfabbro, 2004, Cashmore 2002; Festinger, 1983). Specifically, understanding how 2     - communicating with children about what is happening to them influences their adjustment to of out-of-home placement. can influence subsequent interactions and relationships with child welfare supports. In a landmark study of the foster care experience, Festinger (1983) interviewed 277 former foster youth who had aged out of care in order to provide a detailed picture of youth who were aging out of care and to understand their experience of the foster care system and suggestions for improvement. Among the many findings, Festinger uncovered the unfortunate reality that 50% of those who were interviewed felt that they had no roots and were not given adequate information about why they were placed, why it had come about, their ethnic background, and medical history. To compound matters, child welfare workers were perceived to be evasive when asked questions about this type of information and their behavior was often interpreted as a lack of caring. Youth explained that they were aware that the information may have been upsetting but they felt that the imaginary information they developed to fill in the gaps was far more damaging. Gil and Bogart (1982a) found that well-intentioned professionals commonly did not share background information because they hoped to prevent upsetting the child. Unfortunately, these trends have continued to surface in the research literature over time (Bruskas, 2008; Casey Family Programs, 2005; Cashmore, 2002; Ellerman, 2007; Fanshel & Shinn, 1978; Folman, 1998; Fox et al., 2008; Jenkins, 2008; Johnson et al., 1995, Lay, 2000; Lee & Whiting, 2007; Nesbit, 2000; Pecora & Maluccio, 2000; Seita, Mitchell, & Tobin, 1996; Whiting & Lee, 2003; Wilson & Conroy, 1999). Whether intentional or unintentional, 3     history and future increases a sense of powerlessness (Bruskas, 2008; Lee & Whiting, 2007). In order to combat this disempowering dynamic, we must gain knowledge of how we are communicating with children entering into care and seek to understand the complex constellation of factors that may play a role in the relationship between communication of reason for entry and what will happen next and adjustment to care. t-of-home care is challenging because each foster placement is different and each child has her own unique characteristics and experiences (Chapman & Christ, 2008). We also face the additional challenge of disentangling the relationship between child emotional well-being and foster care (Orme & Buehler, 2001; Gil & Bogart, 1982a). The literature has demonstrates findings that out-of-home placement is beneficial and that out-of-home placement poses many challenges (Chapman & Christ, 2008; Lawrence, Carlson, & Egeland, 2006). More specifically, it is uncertain whether children develop more problems as a result of entering the foster care system or whether those problems were pre-existing (Jones Harden, 2004). The ways in which we conceptualize the experience of children in foster care emotional, social, and behavioral adjustment to new environments. The following discussion outlines the theoretical and conceptual frameworks, purpose, and research questions guiding this research. Theoretical Framework The proposed theoretical framework (see Figure 1.1) situates human ecological theory within a broader context of social constructionist and feminist multicultural 4     Figure 1.1 Theoretical Map Macrosystem Societal Beliefs, Norms, Values, Culture, Policy, & Laws Social Construction Meaning emerges through complex webs of interaction, relationships, and social processes. Socially constructed understandings directly influence the ways individuals perceive and respond to their environments Our beliefs influence our behavior Exosystem DHS, Service Workplace, Supports, Jail/Prison Mesosystem Home, Foster Placement, School, Peers   Microsystem Developing Child Gender is an organizing principle of family and social life. Consciousness of issues of power. Awareness of the oppression of those with less social power- both internalized and externalized. Commitment to broad social and ecological change. Chronosystem Amount of time in foster care - Adjustment Consistency of Relationships - Developmental Process 5     Feminist Multicultural Perspective paradigms. This conceptualization addresses two critical factors not uniformly accounted for by other theories. First, maltreating families involved in the foster care system are diverse in structure, stage of the life cycle, ethnicity, culture, race, sexual orientation and circumstance (Boyd-Franklin & Hafer Bry, 2000). Second, fragmentation of knowledge and services must be avoided (Bolen, McWey, & Schlee, 2008; Bubolz & Sontag, 1993; Orme & Buehler, 2001). Each element of the model carries distinctive features however, in concert they provide a cohesive unifying framework for understanding the multidimensional nature of the experience of children and families in the foster care system. Social Construction   Social constructionism is a way of being and knowing that informs a perspective (Mills & Sprenkle, 1995). A social constructionist perspective proposes that meaning and knowledge are constructed in the context of social interactions, social processes, and relationships. Though simply stated, this principle implies a number of powerful assumptions. First, objective reality, meaning and explanation do not exist (Waldegrave, 1998). Because all reality, meaning, and knowledge are considered to be produced through interaction, reality, meaning, and knowledge can change as interactions change. Past experience, background, culture, historical context, and social interaction influence our knowledge and understanding of the world (Mills & Sprenkle, 1995). In essence, the world can be understood in multiple ways and reality varies from person to person. Second, our understanding directly influences the ways we perceive and respond to environments (Laird, 1998). What we believe influences how we behave. Third, popular 6     understandings within a given field may become dominant because they are useful (Laird, 1998). Feminist Multicultural Perspective A feminist multicultural perspective shares many of these same beliefs but also draws our attention to issues that pertain to the ways in which knowledge understanding, and social interaction are affected by language, power, gender, culture, race, ethnicity, and sexual orientation (Freeman & Couchonnal, 2006). Feminist theory centers on the idea that gender is socially constructed and an organizing principle of family and social life for of all people (Hare-Mustin, 1989). In a similar vein, culture is believed to be dynamic and reflective of the fluidity of social construction (Laird, 1998). Culture encompasses established social structures of themselves, the world, and themselves in relation to the world (Freeman & Couchonnal, A feminist multicultural perspective also represents a commitment to broad social and ecological change and giving voice to oppressed social groups. When considering an intervention such as the placement of a child into foster care it is important to consider beliefs and attitudes in ecological context and recognize power inequities that affect relationships between children, families, and the larger child services society will set up to respond to these problems (p.xiii)." 7     The foster care system is a socially constructed system that is intended to provide care and aid to children when it is deemed unsafe for them to remain in the care of their biological parent(s). Child safety is the primary concern of the foster care system. It is also intended to provide aid and services to biological parents in order to create a safe environment for the children to return to. Viewing foster care as a socially constructed institution challenges us to examine the subjective nature of the policies, laws and practices of professionals involved in the larger child welfare system. The children and families involved in the system often feel at the mercy of those in positions of power. Professionals within the system base decisions about whether or not a family will be reunified upon their own interpretations of observed behaviors. Such interpretations are influenced by understanding of the law, social location, previous experiences, and values and beliefs about parenting, abuse/neglect, behavior, gender, race, culture, and sexual orientation. The feminist multicultural perspective calls us to consider children in ecological context in order to see how oppression and marginalization of groups such as single-mothers, lesbian couples, and children of color occur and can be maintained, and perpetuated by various interactions within the system. Human Ecology Theory Many researchers and practitioners are in consensus that an ecological perspective is necessary in order to advance child maltreatment prevention and treatment research (Bolen, McWey, & Schlee, 2008). Human ecological theory is particularly well-suited for informing a comprehensive yet cohesive view of the complexities children and families experience in the foster care system (Boyd-Franklin & 8     Hafer Bry, 2000; Orme & Buehler, 2001; Voydanoff, 1995). The ecological systems model provides a framework for viewing the reciprocal nature of the relationship between within family process and conditions and environments outside of the family system (Bubolz & Sontag, 1993;Nickols, 2003; Schweiger & O'Brien, 2005). Development is considered in the context of a series of interrelated systems that articulate important dimensions of the relationship between others, the developing Thomas, 2005). Bronfenbrenner illustrated environment as consisting of systems nested within one another. These systems are known as the microsystem, mesosystem, exsosystem, macrosystem, and chronosystem. The microsystem is the most basic unit of analysis. Development takes place through the mutual interactions between people, objects, and symbols in the immediate environment. The principle microstystem is typically identified as the family (Bubolz & Sontag, 1993). Biological families involved in the foster care system are often considered multi-stressed (Voydanoff, 1995). Poverty, substance abuse, mental health, incarceration, and generational histories of maltreatment are common issues that many multi-stressed families are faced with (Erikson & Egeland, 2002; Vandivere, Chalk, & Anderson Moore, 2003). Children involved in the foster care system frequently experience unpredictable and rapid microsystem changes as a result of removal from 2004; Clausen, Landsverk, Ganger, Chadwick, & Litrownik, 1998; Ellerman, 2007; Folman, 1998). 9     The mesosystem characterizes the connections and processes between microsystems that contain the developing person. The mesosystem considers such things as the reduction in time able to spend together as a family, feelings biological parents and foster parents may have towa - of-home foster placement, and the child's performance at school. Perhaps the largest change is the restriction placed on a family's ability to spend time together. Parents typically have a schedule for visitation. Depending on the circumstances of the case, parents may have unsupervised visitation or may be required to be supervised during the times that they see their children. Sometimes visitation is not allowed at all or for as little time as one hour per week. Parental visitation is extremely important in the maintenance of the parent-child relationships and increases the likelihood of family reunification (Leathers, 2003). During the time that children maintain status as temporary wards of the state, biological parents no longer exercise the ability to take part in everyday decision making regarding their child(ren). The foster parent whether a relative, fictive kin, or unrelated caregiver, assumes the role of primary caregiver. This means changes in rules, roles, opinions of what is acceptable/unacceptable behavior, routines, schedules, practices of hygiene, and who lives in the child's primary residence. The characteristics of the biological parent - foster caregiver relationship can vary widely. Many children experience confusing feelings toward their biological family. Many still feel love for their parent(s) and recall positive memories but also endure the memory of abuse/neglect, and subsequent break up of siblings and parents (Whiting & Lee, 2003). Similarly, foster children describe mixed feelings toward their foster families. 10     On one hand, many feel happy to have a family that supports and provides for them, but they also feel a loyalty conflict in recognizing that the foster family is not their "real" family (Leathers, 2003; Whiting & Lee, 2003). Leathers (2003) found that many children in foster care experience confusion about who will be in the caregiver role more permanently. The mesosystem also captures aspects of children's adjustment to out-of-home placement. Many children demonstrate great progress when placed in a consistent and supportive environment. However, many children have experienced challenges to their development that in turn present a host of challenges for caregivers (Barber, Delfabbro, & Cooper, 2001). Infants and toddlers are at high risk for impairments of neurological and cognitive development while diagnosable behavioral and emotional problems affect almost half of school-aged children (Bass, Shields, & Behrman, 2004; Chalk, Gibbons, & Scarupa, 2002; Vandivere et al., 2003). While there are risk factors for behavioral and emotional problems associated with the biological family, the foster placement itself may too pose as a risk factor (Bass et al., 2004; Chapman & Christ, 2008; Orme & Buehler, 2001). The relationship between child behavior problems and foster placement has not been well established in the literature (Orme & Buehler, 2001). This is however an important topic because child emotional and behavioral problems are often associated with increased difficulty adjusting to out-of-home placement and more frequent changes in placement (Vandivere et al., 2003). Foster parents reserve the right to request that a child be removed from their care. The exosystem encompasses how the processes and connections of settings not containing the developing person influence the processes and connections in the 11     developing person's immediate setting. The relationship between the family and the Department of Human Services (DHS) is perhaps one of the most important relationships to explore when considering the experience of children and families involved with the foster care system (Foster Care Review Board, 2006). Parental perspectives on the foster care process as well as perceptions of involvement with services are critical in every case (Alpert. 2005; Bolen et al., 2008; Forrester, McCambridge, Waissbein, & Rollnick, 2008; Zell, 2006). Unfortunately, parents' perspective of their involvement with the child welfare system has been identified as a largely understudied topic in the field (Alpert, 2005). Ultimately parents' perceptions of adequacy of services are very much connected with the state of the workforce with which they interact (Forrester et al., 2008; Kapp & Propp, 2002; Kemp, Marcenko, Hoagwood, & Vesneski, 2009; Lee & Ayon, 2004). The Michigan Foster Care Review Board (FCRB) (2008) identified the establishment of a supportive and trusting relationship with children, parents, and foster parents as a necessary factor in the provision of effective casework. Caseworkers are also held to the responsibility to assess the needs and progress of children and their parents, support parents through crises, aid in navigating the complexities of the foster care system, and devote substantial amounts of time to multidisciplinary collaboration in order to effectively evaluate progress to be represented in court recommendations (FCRB, 2006, 2008; Seita, 2000; Zell, 2006). However, a number of barriers exist to establishing adequacy for workers and families within the system. Workforce issues such as high volume-caseload/inability to control workload and case intake, disruption of relational trust with key parties due to caseworker turnover, and new workers lacking 12     the educational training, expertise, and cultural competence required to fulfill the responsibility to assist in establishing timely and safe permanency for foster children (FCRB, 2006). The macrosystem represents the attitudes, practices, and convictions of the larger society and culture. Social norms, societal beliefs, policy, law, and culture are all part of the macrosystem. Societal beliefs about child maltreatment and the foster care system heavily influence how lawmakers and communities understand these issues and perceive families and children involved in the foster care system (Bass et al., 2004; Wrisley, 2005). These beliefs influence our understanding of the foster care system, the way in which children and families involved in the system are portrayed in television, movies, literature, and public awareness campaigns, and the extent to which these portrayals occur in the media (Baker, 2007; Wrisley, 2005). Recent public opinion polls have illustrated that the public is simultaneously highly critical of the foster care system and largely uninformed (Bass et al, 2004). The Binsfeld amendments and the Adoption and Safe Families Act (ASFA) are two legislative efforts that warrant attention in this discussion of the foster care experience. The laws resulting from these efforts were spurred by the increased awareness of the number of children experiencing frequent changes in placement and remaining in foster care for unreasonable lengths of time with no progress being made on the legal status of their cases (Tacoma, 2005). Tacoma (2005) identified the unintended result of the Binsfeld amendments and the ASFA as an "increase in involuntary termination of parental rights by the state, with a secondary consequence 13     that we now have more rootless children without any legal family ties, than we had in the entire child protection system prior to these laws (p.1)." An additional consideration is that, at present, decision making in all states is guided by the best interest of the child standard. This standard designates that child welfare workers balance considerations of parent benefit of services, short-term and long-term needs of the child, and progress toward treatment goals when making decisions or recommendations of what is best for the child (Scott, Pearlmuter & Groza, 2004). Workers can be influenced by supervisors, organizational context, and the larger sociocultural context when making decisions (Scott, Pearlmuter, & Groza, 2004). Lastly, the chronosystem acknowledges the role of time, transitions over lifetime as well as development. It is important to recognize that the amount of time a family is involved with the foster care system is dependent upon many factors including legislation, planning, court hearings, progress to be made, and the best interest of the child. Even with increased efforts for permanency, many children remain in the system until phasing out of care. Whiting and Lee (2003) also draw attention to the consideration of transition, development, and preadolescent's construction of life stories over time. Using an interview process with 23 preadolescent foster children, these researchers gave voice to stories of confusion, loss, social ambivalence, poverty, racism, drugs, violence, crime, and resilience. These children's stories incorporated the past, present, and future. Many of the children faced uncertainty about the reasons that they had come into foster care and who was responsible for this. Themes of self-blame and difficulty speculating about the future surfaced in many of the stories. It is important to consider the lasting implications of looming uncertainty, confusion, and self-blame 14     associated entry into the foster care system. Bronfenbrenner activities, transitions, and roles in the developmental process are of particular importance for this research. Activities are ongoing behavioral interactions that possess a sense of enduring motivation to reach a goal or complete a task perceived as meaningful by the participants in the setting. An example of an activity relevant to this research is carrying on a conversation. A conversation typically has purpose, such as communicating important information. Conversations also have an intention to convey a message and the participants experience a persistence to want to complete and resist interruption until the message is conveyed and an understanding is developed. Relationships involve one person in any given setting observing or participating in the activities of another. Relationships between two people (parent and child or caseworker and child) are the basic foundation of the microsystem and serve as a vital context for development. Two primary types of relationships exist. Observational relationships are characterized by one person paying attention to the activity of another who recognizes the interest being given. Joint activity relationships include two people who perceive themselves as doing something together. Both people do not have to be doing same thing, but their activities are working toward a common goal and are reciprocal. Relationships also involve a balance of power and commonly one person may be more influential than the other. Roles are a set of activities and expected relationships of a person holding a particular position in society. Roles are typically determined by societal beliefs associated with age, sex, kinship relation, occupation, ethnicity, religion, and social 15     status. Although roles serve a critical function in microsystem relationships, they are really rooted in the broader social expectations, ideologies, and institutional structures of the macrosystem. Bronfenbrenner (1979) explained: The placement of a person in a role tends to evoke perceptions, activities, and patterns of interpersonal relation consistent with expectations associated with that role as they pertain to behavior both of the person occupying the role and of others with respect to that person (p Human ecological theory emphasizes the way what is perceived, desired, feared, to and interaction with the environment. The ecological transition of entry into foster care provides an example of extreme disruption/change of roles and settings. When a caseworker and subsequent variety of professionals who aim to support goals set forth by the state. As a result, the child experiences a change in her role in the parent-child relationship and may gain new roles as a child in out-of-home placement, potential witness in court, client of therapy, new student (if school changes), and new child in the neighborhood (if required to move to a new area). the environment which in turn influences the way she thinks, feels, behaves, and is treated. It is the openness and fluidity of social interconnections between settings that provides the foundation from which a setting becomes and effective context for development. This principle of human ecology theory emphasizes questioning how 16     knowledge affects the subsequent course of behavior and development in new settings (Bronfenbrenner, 1979). Conceptual Framework Figure 1.2 depicts a conceptual map modeling the way in which communication about adjustment to out-of-home placement. The child, considered in developmental context, encounters communication regarding entry into foster care from two critical sources: 1) the child welfare system, and 2) the biological family system. Each of these sources is comprised of interconnections between various systems. The cumulative experience of communication refers to the extent to which information is clearly and collaboratively shared between the parties involved in the system and thus conveyed in a developmentally appropriate way to the child. The child encounters a cumulative experience of communication from the child welfare system that encompasses length of time in care, circumstances of placement, permanency plans and the extent to which case history knowledge and information is actively and effectively communicated between critical parties such as: Child Protective Services (CPS), law enforcement, Department of Human Services (DHS) caseworkers, foster placement, judges, guardians ad litem (GAL), and outsider service providers such as Marriage & Family Therapists (MFTs), psychologists, substance abuse counselors, physicians, and educators. Secondly, the child encounters a cumulative experience of family communication regarding the child welfare system that encompasses the biological biological parents, siblings, extended family, and fictive kin while in out-of-home 17     Figure 1.2. Conceptual Framework       CPS Investigation & Circumstances of Removal DHS Caseworker   Stage of Development                       Courts Outside Service Providers Cumulative Experience of Communication for Child Welfare Service Delivery     Characteristics of Foster Placement            Abuse / Neglect   Perception of Environment       Race/Ethnicity/Gender   Child   Cumulative Experience of Family Communication regarding Child Welfare System             Bioexperience with the System Cultural Beliefs Contact with Bio-Parent(s) Contact with Siblings 18     Available Coping Strategies Adjustment to Out-ofHome Placement Contact with Extended Family & Fictive Kin   placement. Consideration of family communication is imperative because the family is a primary social context for influencing and shaping attitudes regarding engagement and use of services (Kemp et al., 2009). This conceptual framework proposes a conceptualization of an interactional process through which communication about reason for entry and what will happen next contributes to perception, understanding, and adjustment to out-of-home placement. It ethnicity, culture, religion, sexual orientation, and gender. Children, along with their contextual histories, become engaged in communication processes with both the child welfare and family systems upon entering the foster care system. The extent to which children are informed about reason for entry, what will happen during their time in care, and given the opportunity to ask questions affects their perception of the environment. The perception of the environment influences coping and the observable strategies that children demonstrate are considered as indicators of how they are adjusting to care. For instance, a child who is demonstrating few behavioral problems, is doing well in school, and making new peer connections may be viewed as adjusting well whereas a child demonstrating behavioral problems and resisting social connections may be viewed in a less positive light. These observable indicators of adjustment then influence the ways in which child welfare professionals and family members communicate information, creating a continuous dynamic cycle of interaction. Purpose of the Study Although evidence of gaps in the process of communicating information about entry into care and future plans exists, it is very limited. This issue has commonly been 19     addressed as a component of larger research endeavors and rarely has been fully explored as the primary subject of research (Bogolub, 2008; Folman, 1998). Our lack of understanding of how children experience removal and entry into care poses an obstacle to developing interventions and programs that can aid and support healthy coping (Folman, 1998). Further attention is warranted given the consistent concern regarding implications for adjustment to care, child and family well-being, and disempowerment (Bruskas, 2008; Collins, Spencer, & Ward, 2010; Coll, Stewart, & Morse, 2010; Gil & Bogart, 1982a,1982b; Sieta, 2000; Skivenes, & Strandbu, 2006; Whiting & Lee, 2003). Research has consistently documented that children entering foster care experience a substantial amount of confusion. However, what we know less about is how current child welfare practices are addressing it. We continue to know very little about how children experience support for their well-being from the child welfare system (Silver et al., 1999). The child welfare community has stated the benefit of gaining knowledge about the process of adjustment to out-of-home care (Chapman & Christ, 2008). The purpose of this research is thus twofold. First is to contribute further to our understanding of the types of communication processes taking place with children who are entering foster care. Secondl communication affected their adjustment to out-of-home placement. Summary The proposed theoretical framework (Figure 1.1) integrates human ecology theory and social constructionist and feminist multicultural paradigms. Human ecology theory provides a context for understanding the multidimensional nature of the foster 20     care experience. The nested systems model accounts for interactions within and between systems across time. The feminist multicultural and social constructionist paradigms serve as a lens for viewing the socially constructed nature of reality that balances attention to the individual and context. All three elements taken together provide a comprehensive framework that balances the complexity of the foster care experience and attention to issues of race, ethnicity, culture, gender, and sexual orientation. The conceptual framework (Figure 1.2) uses these elements to inform a conceptualization of the relationship between communication regarding reason for entry and what will happen next and adjustment to out-of-home care. Many researchers and practitioners have voiced concern about the implications of not adequately informing youth about why they entered care and what will happen to them (Bruskas, 2008; Cashmore, 2002; Collins, Spencer, & Ward, 2010; Coll, Stewart, & Morse, 2010; Folman, 1998; Gil, 1982a, 1982b; Lee & Whiting, 2007; Sieta, 2000; Skivenes, & Strandbu, 2006; Whiting & Lee, 2003). More research is needed to shed light on the process of adjustment to out-of-home placement (Chapman & Christ, 2008). Guided by the linkages between the theoretical and conceptual frameworks, the proposed research questions relationship between communication regarding reason for entry and what will happen next and adjustment to out-of-home care. 21     Table 1. Linking Frameworks & Research Questions Element of Conceptual Framework Element of Theoretical Framework Research Questions Child in developmental context Human ecology theory Social Construction Feminist multicultural perspective How is information about reason for entry into care and what will happen next communicated to youth entering foster care? How do youth view race, ethnicity, culture, religion, gender, and sexual orientation in relation to their experiences of communication and adjustment to foster care? Cumulative experience of communication for child welfare service delivery Social construction Feminist multicultural perspective How is information about reason for entry into care and what will happen next communicated to youth entering foster care? What roles do caseworkers, therapists, foster parents, and biological parents play in communicating important information about the reason for entry into care and what will happen next? How do youth view race, ethnicity, culture, religion, gender, and sexual orientation in relation to their experiences of communication and adjustment to foster care?               22     Cumulative experience of family communication regarding child welfare system Social construction Feminist multicultural perspective How is information about reason for entry into care and what will happen next communicated to youth entering foster care? What roles do caseworkers, therapists, foster parents, and biological parents play in communicating important information about the reason for entry into care and what will happen next? How do youth view race, ethnicity, culture, religion, gender, and sexual orientation in relation to their experiences of communication and adjustment to foster care? Perception of environment Human ecology theory Social construction How does communication from the perception of the out-of-home placement environment? How does communication from the perception of the out-of-home placement environment? available coping strategies Adjustment to out of home placement Human ecology theory What strategies do youth use for coping with the transition to out-ofhome placement? Human ecology theory Social construction What is the relationship of communication from the child welfare system and biological family to youth adjustment to out- of- home placement? 23     Research Questions 1) What is the relationship of communication from the child welfare system and biological family to youth adjustment to out- of- home placement? 2) How is information about reason for entry into care and what will happen next communicated to youth entering foster care? 3) What roles do caseworkers, therapists, foster caregivers, and biological parents play in communicating important information about the reason for entry into care and what will happen next? 4) How does comm the out-of-home placement environment? 5) out-of-home placement environment? 6) What strategies do youth use for coping with the transition to out-of-home placement? 7) How do youth view race, ethnicity, culture, religion, gender, and sexual orientation in relation to their experiences of communication and adjustment to foster care? 24     CHAPTER TWO REVIEW OF THE LITERATURE Introduction Child welfare researchers and practitioners have stated that communicating information about reason for entry and what will happen next holds critical implications for child well-being and adjustment to care (Bruskas, 2008;Gil & Bogart, 1982a,1982b; Sieta, 2000; Skivenes, & Strandbu, 2006; Whiting & Lee, 2003). However, it is important to be mindful that offering background information does not necessarily mean that it is accessible and understandable to children (Cashmore, 2002). Communication is a process involving understanding the thoughts and feelings of a child and responding in a helpful way (Richman, 2003). The extent to which the information is received by the child depends upon many developmental and environmental factors (Gil. 2006; Richman, 2003). Chapter two reviews current literature regarding the developmental aspects of youth emotional well-being, communication and the child welfare and family systems, perception of out-of-home placement, coping, and adjustment to out-of-home placement. It concludes with an overview of suggestions from youth and best practices for communicating with youth entering foster care. Ecological Perspective of the Emotional Well-being of Youth in the Foster Care System Removal from the biological home and separation from parents has been associated with short- and long- term biopsychosocial problems (Clausen et al., 1998; Craven & Lee, 2006; Ellerman, 2007; Kools, 1999). Youth who have aged out of the foster care system have expressed that a variety of factors threaten psychological and 25     emotional well-being. Ellerman (2007) found that youth believed that stress from frequent placement changes, confusion about the system, lost relationships, varying communication styles among foster caregivers and professionals, and feeling different Though strides have been made, our definitions and understanding of child wellbeing continues to evolve (Brown & Anderson Moore, 2009; Levitt, 2009). Typically, the well-being of youth in foster care encapsulates indicators such as safety, permanency, health, education, and mental health. However, many outcomes and measures of social contexts affecting development have been poorly measured and guided by deficit-based models (Brown & Anderson Moore, 2009). Further, it is challenging to develop a holistic understanding of child well-being because much of the available research has tended to focus on descriptions of what a child is or does rather than on perceptions of experience (Alpert, 2005). Consequently, the debate about the effectiveness of foster care continues. Some research indicates positive strides in development following placement while other research points to higher incidence of internalizing and externalizing problems and negative impact on socio-emotional development (Lawrence et al., 2006; Vig, Chintz, & Shulman, 2005). Although many children who enter foster care have experienced adverse experiences due to maltreatment, the significant disruption of the home environment can pose additional developmental risk. Lawrence et al. (2006) contend that school, social, and family changes paired with lack of comprehensive services, inadequate training of foster caregivers difficulty processing the foster care experience. 26     Vandivere, Chalk, and Anderson Moore (2003) provided an overview of how children in the foster care system are faring using two nationally representative surveys: 1) the National Survey of Child and Adolescent Well-Being (NSCAW), and 2) the National Survey of America's Families (NSAF). The authors used the NSCAW to review within group variation among foster children who were reviewed in the longitudinal survey. The NSAF was a cross-sectional survey of households in the U.S. that allowed the authors to compare the well-being of foster children with that of children in the general population. When compared with children who are not in care, children in foster care have lower levels of engagement and achievement at school. Additionally, foster children are more likely to demonstrate behavioral and emotional problems as compared to other children. These data suggest that nearly 50% of school aged children in foster care experienced diagnosable behavioral and emotional problems. Youth in contact with child welfare are considered 2.4 times more likely than children in the general population to have mental health problems (Levitt, 2009; Morrison & Mishna, 2006). Some statistics suggest that children who demonstrate mental health problems are nearly eight times more likely to experience placement instability during the first three to four months of placement (Barber et al., 2001). This statistic becomes even bleaker when considered in conjunction with the reality that children in foster care experience more behavioral, emotional, educational, and mental health problems than children living in other settings (Barber & Delfabbro, 2004; Bogolub, 2008; Casey Family Programs, 2005; Clausen et al., 1998). Finding ways to 27     stability which appears to have a large positive effect on mental health outcomes (Casey Family Programs, 2005; Jones Harden, 2004). Communication & Child Welfare Service Delivery Ideally, all children entering foster care would have strengths and needs assessed prior to placement, experience collaborative case planning, and maintain contact with their families during a culturally competent supported transition to care (Child Welfare League of America as cited by Barber & Delfabbro, 2004). It is the hope that such screening would better identify children who are struggling emotionally and behaviorally (Pecora, Jensen, Romanelli, Jackson, & Ortiz, 2009).  Though early assessment of needs is recommended, it is often overlooked during the early stages of foster care intervention and reaching consistent and successful implementation takes time and often requires system wide changes. Sadly, many children experience a tumultuous transition to foster care. When a children are removed from their natural family and community environments they will likely experience feelings of instability that create a variety of mixed emotions (Kirven, 2000). Children are forced to adapt to a new family structure and try to fit in with new friends, school, and community. Helping children transition to care becomes a critical responsibility of the DHS because when a child is removed, the government is making the statement that the system can better protect and provide for the child than the parent(s). The system thus takes on the helping children to understand and cope with the emotional experience of being removed from their homes and entering the foster care system (Bass et al., 2004). Clear communication between caseworkers, children, families, service providers, 28     foster caregivers, and courts can help ensure continuous coordinated care that supports -of-home placement (Kletzak & Siegfried, 2008; Kufeldt, Armstrong, & Dorosh, 1995). Strong client-worker relationships have been associated with better outcomes for mandated child abuse cases (Lee & Ayon, 2004). It is the allow them the opportunity to form opinions and share them (Skivenes & Strandbu, 2006). Giving children the chance to participate in the decision-making process, and explaining how placement decisions are reached and what they mean empowers children to feel like active participants in their own lives (Scannapieco, Connell-Carrick, & Painter, 2007; Skivenes & Strandbu, 2006). In order to do so, child welfare professionals must convey pertinent information in a developmentally appropriate way and maintain persistence in providing ongoing updates about decisions being made that Good communication is also necessary for maintaining relationships with both the biological and foster families (Kufeldt, Armstrong, & Dorosh, 1995). Family can be defined in a variety of ways and for children in foster care, family often includes a wide array of members such as birthparents, siblings, extended relatives, fictive kin, and foster caregivers (Fox et al., 2008). It is important to remember that parents and family members also need help navigating the system. Maintaining a close relationship with the biological family is particularly important to most children in foster care and contributes to the development of a sense of being loved, cared for, and part of a family (Kufeldt et al., 1995; Samuels, 2009). Unfortunately, this important sense of belonging is sometimes paired with feeling penalized for wanting to spend time with their biological 29     families (Scannapieco et al., 2009). Child welfare professionals must find educational and empowering approaches to fostering collaborative connections between youth, biological parents, foster caregivers and service providers (Forrester, McCambridge, Waissbein, & Rollnick, 2008; Jager, Bozek, & Bak, 2009; Jager et al., 2009; Kemp et al., 2009). Facilitating ongoing communication among child welfare professionals, children, youth, and families is a tall order given the high rates of turnover and disruption as a result of placement changes. To a certain degree, disruption in service has a negative into therapy when they were not ready and believed that having to re-explain their life story repeatedly every time there was a change was detrimental. Scannapieco et al. (2007) conducted focus groups with youth who had formerly been in care, caseworkers, and foster caregivers and found that all three groups identified difficulty communicating as a significant problem. Disagreement between providers, lack of consensus, and absence of collaborative decision-making contribute to disconnected communication between child welfare professionals (Zell, 2006). Unfortunately, caseworkers are overworked and commonly managing caseloads well above national guidelines. High turnover rates and large caseload size often translate to infrequent and inconsistent communication and contact with children and youth (Scannapieco et al., 2007). In addition, some caseworkers may not see it as their role to identify and assess mental health needs (Levitt, 2009). Family Communication & the Child Welfare System Parents are also facing a host of challenging life circumstances. Indicators of 30     foster children's well-being are inextricably linked with early childhood experience and the development of enduring relationships with parents and caregivers. Many of the parents involved with the foster care system have also been victims of abuse/neglect during childhood. The traumatizing experience of abuse can influence how a person relates to herself and to others. Evidence of this exists in the family systems, parenting, social relationships, and community connections of survivors (Jager & Carolan, 2009; Jager, 2002). As a group, these parents experience higher rates of mental health disorders, substance abuse, poverty, and incarceration (Vandivere, Chalk, & Anderson Moore, 2003). With regard to their experiences with the system, parents have been largely overlooked (Alpert, 2005). In her review, Alpert (2005) identified a myriad of system barriers. First, parents who re-entered the system after reunification were likely to be rated by caseworkers as having low social support, fair to poor parenting, and experiencing incomplete service delivery. Similar to many children, parents also experienced feelings of confusion and disappointment with the foster care system related to issues of poor communication, lack of respect, limited availability, and lack of opportunity for involvement in decision-making (Kapp & Propp, 2002). Family re-entry into the system has been associated with parental unemployment, low social support, and inadequate housing. Parental substance abuse, mental health issues, employment, noncompliance with planning, inadequate housing, limited ability, and lack of coping skills have been identified as barriers to reunification (FCRB, 2006; Alpert, 2003). In recent literature the concept of ambiguous loss has been applied to the foster care experience. It has been suggested that the ambiguity of family reuinification vs. 31     termination of rights associated with out-of-home placement may contribute to et al., 2006). Youth in foster care commonly experience confusion about why they are in care and what will happen in the future (Lee & Whiting, 2007). Researchers have drawn attention to the many ambiguities involved with being in care. Particularly, family membership, what is happening in the lives of family members, transitions, physical presence/psychological absence of the family, and psychological presence/physical absence of the family (Lee & Whiting, 2007). In response to ambiguity of care, Samuels (2009) proposed a multidimensional view of the family biological, legal, and relational. Even if family is not physically providing permanence, they provide a sense of relational permanence as a member of a family. Even when in long-term placements, many children feel uncertainty about their future permanence and hold on to the hope that they will be reunified with their parents (Fox et al., 2008). Interestingly, youth in kinship placements had a significantly stronger self-concept, performance, and personal attribute scores than youth places with unrelated caregivers (Metzger, 2008). Children in kinship care tend to be visited by their parents more frequently. Increased visitation was associated with increased selfconcept scores (Metzger, 2008). Metzger (2008) suggested that increased contact and support from extended family and kin help children more successfully cope. Addressing the relational aspects of family can prove beneficial for well-being and identity development (Samuels, 2009). Adjustment to Out-of-Home Placement Perceptions of Out-of-Home Placement 32     Nesbit (2000) presented stories of young adults who had grown up in foster care. The stories were permeated with references to feelings of confusion, powerlessness, trauma, loss, fear, helplessness, not belonging, guilt, self-blame, and not knowing how to ask for help. The children were often told by caseworkers that their removal was going to be temporary and that they would be going to a better place. When children enter foster care they are faced with a variety of changes such as attending a new school, making new friends, new lifestyle, new house, and new rules (Pew Commission on Children in Foster Care, 2003). While there is wide variation in the circumstances of each case, there is some continuity in the presence of sudden dramatic changes in a -ofhome placement can ameliorate or intensify pre-existing difficulties. Support, communication, consistency, and understanding are needed to support adjustment as they transition into foster care. Bogart (1982a) interviewed 100 children in foster care to explore their understandings of why they lived in foster care rather than their biological homes. Many children had a relatively good idea about why they were in care but a number of children did not know why they were in care. This somber finding does not stand alone. Research across time continues to uncover instances where a small but significant number of children do not know why they are in foster care (Cashmore, 2002; Fanshel & Shin, 1978; Festinger, 1983; Folman, 1998; Johnson et al., 1995; Jenkins, 2008). Interviews with children and youth have revealed that explanations of entry and transition into care come from caseworkers, child protective services investigators, and 33     parents (Bogolub, 2008; Fanshel & Shin, 1978; Festinger, 1983; Folman, 1998; Gil & Bogart, 1982a, 1982b; Johnson et al. into care appear to vary depending on the age of the child at entry, circumstances of placement, number of placements, client-worker relationship, amount of contact with biological family, comfort with out-of-home caregivers, comfort with the neighborhood and school, and length of time in care (Bogolub, 2008; Chapman et al., 2004; McDonald, Allen, Westerfelt, &Piliavin, 1996; Minty, 1999). Many children experience feelings of insecurity and confusion about loyalty conflicts, remembering caseworkers, investigators, and other various professionals, knowing what will happen next, and understanding court proceedings (Bogolub, 2008; Jenkins, 2008; Leathers, 2003). Wilson and Conroy (1999) interviewed 1,100 children in out-of-home-placement about their satisfaction with services and placement. Children did not feel that they were listened to by the courts and fewer than 1/3 were included in deciding permanency goals. Children disliked not getting to see their family, feeling a loss of freedom, being teased by other children, and the physical aspects of the home and neighborhood. Additionally, some children expressed worry about the stigma of being a child in foster care and had taken steps to develop a cover story to keep peers from knowing (Bogolub, 2008; Ellerman, 2007; Festinger, 1983; Wilson & Conroy, 1999). Festinger (1983) found satisfaction with foster care to be a function of who had come to terms with the need for placement and who had an adequate justification for why it had occurred. Those who saw their placement into foster care as necessary, for contact with their biological parents, siblings, and relatives were more satisfied with their 34     experience in foster care. Unfortunately, many children enter foster care and do not receive information that can help them cope (Folman, 1998). Children actively engage in a process of trying to make sense of what is happening to them (Gil, 2006). Folman lives could not be trusted, and invalidated their feelings of pain, loss, and fear. Some believe that providing ongoing adequate explanations of where a child is going and what will be happening can significantly ameliorate the fear, sadness, confusion, and loss associated with removal and entry into foster care (Folman, 1998). over time and what factors were associated with these changes using data from the National Survey of Child and Adolescent Well-being (NSCAW). The authors identified three classes of youth, those who: 1) want to return home, 2) may want to stay but also hold out hope that things would be different if they were to return to their biological families, and 3) are content in care. At the time of entering care, 58% of the study population was likely to be in the want to return home class, 26% in happy but hopeful, and 16% in content in care. After 18 months, 42% wanted to return home, 31% were happy but hopeful, and 27% were content in care. The majority of children stayed in the same class over time 62.9% for children in want to go home class, 55.4% in the happy but hopeful class, and 100% of the children in the content in care class. The probability was highest for children to move from less content to more content in care over time. However, most of the children did not change classes in the 18 month time period considered. Younger children were more likely to stay content in care over time. 35     Children who were in stable placements were more likely to stay happy but hopeful when compared to children in unstable placements. Children who were in the nonclinical range on the Child Behavior Checklist at the second measurement were less likely to remain in the want to go home group and more likely to move to happy but hopeful. There were also gender differences that surfaced. Boys were more likely to move to or stay in positive classes than girls. Relationship quality between child and foster parent, previous patterns of attachment and school/neighborhood contexts were thought to contribute to perception of environment. There is a lot of heterogeneity of perceptions and feelings among youth in foster care. Chapman et al. (2004) suggest that practitioners help youth to address the complex feelings that youth have about their foster caregivers and biological families. Coping Strategies Ellerman (2007) found that youth commonly identified the coping strategies they used as self-destructive, ineffective, and self-protective. One youth described misbehavior as motivated by a desire to change placements or go back home with their parents. Ultimately, the majority felt that enduring feelings of anger, loss, confusion, and lack of control over life changes negatively affected self-esteem, security, and identity. Hyde and Kammerer (200 commonly did not know how to respond these types of feelings. Adults sometimes make the mistake of thinking that young children cannot d what is going on around them. We must understand, from a developmental standpoint, that children and youth may not express their anger, fear, worry, frustration and confusion through well 36     articulated conversation. Instead, they find ways to cope with their experience based on what they know and have seen modeled by important people in their environment. By considering emotional and behavioral problems in context we are able to see past the observable problem behaviors and begin to inform a more balanced view of how that behavior came to be and the ways in which it may have been protective and adaptive in a different environment. A child who is acting out in foster care is not necessarily a defiant child but instead may be a child struggling to make sense of her situation and longing to go home to her family. As a result, we have to consider social structures and personal narratives when making judgments and decisions in child welfare practice (Warner, 2003). Communication: Youth Suggestions & Current Practices approach to care is a complex process of considering the broad range of conditions of placement, family history, and expressed problems (Racusin, Maerlender, Sengupta, Isquith, & Strauss, 2005). Best practices have moved to acknowledge the diverse characteristics and experiences of youth entering the foster care system and encourage meeting the unique needs of each child through individualized care. Children who enter foster care are dually challenged with the traumatic experience of maltreatment and with removal from their home. Each child experiences varying degrees of stability, conflict, acceptance, confusion, worry, loss, and understanding. The heterogeneous nature of the foster care experience does not lend itself to a one-size-fits-all approach. Instead, developmental stage, gender, culture, age, interests, and talents (Gil, 2006). It is 37     necessary to view children as a unique individuals with their own set of perceptions, feelings, and behaviors. Children in foster care deserve to have the opportunity to build self-esteem and confidence by having their thoughts and ideas heard, respected, and taken seriously (Cashmore, 2002; Kirven, 2000; Skivenes & Strandbu, 2006). Foster care intervention must be flexible in order to meet individualized needs (Morrison & Mishna, 2006). However, there is concern about the lack of comprehensive screening and inadequacy of access to mental health services. It is the hope that such screening would better identify children who are struggling emotionally and behaviorally (Pecora, Jensen, Romanelli, Jackson, & Ortiz, 2009). To gain insight into this issue the Casey Family Programs Northwest Foster Care Alumni study (2005) interviewed 479 adults between the ages of 20 and 33 who had been placed in foster care between 1988 and 1998. The foster care alumni reported that youth need emotional support, mental health challenges to be normalized, and to learn to understand common problems among foster youth. They also described needing to be allowed to discuss positive aspects of their biological family and to process the grief they felt over entering care. When asked for suggestions for improving foster care, the alumni suggested implementing culturally competent treatment approaches to help grieve losses, understand thoughts and feelings, and learn ways of coping. In 2007 The Casey Clinical Foster Care Research and Development Project began consensus development work to enhance and build upon the guidelines on improving policy and practices developed by the foster care mental health values subcommittee formed by the American Academy of Child and Adolescent Psychiatry (AACAP) and the Child Welfare League of America (CWLA). It was determined that 38     services for children and families need to be child and family centered, community based, and culturally competent (Pecora et al., 2009). Romanelli et al. (2009) presented best practice guidelines for mental health in child welfare. Among their suggestions are youth advocate involvement, multicultural competence, and youth understanding their rights and entitlements. Youth advocates would be peers who have dealt with similar issues and could help mentor youth who are entering care by answering questions and providing a sense of community. Multicultural competence in practice supports and promotes the development of healthy identities that are in line with the biological family and community culture. Particularly, multicultural competence acknowledges race, religion, gender, and sexual orientation. Lastly, we must engage youth in communication about their rights and opportunities in developmentally appropriate ways. Many believe that accomplishing such improvements starts with comprehensive mental health screening and collaborative empowering models of service delivery (Bass et al., 2004; Leslie et al., 2005; Levitt, 2009; McWey, Henderson, & Tice, 2006; Romanelli et al., 2009; Silver et al., 1999) Initial interventions need to address feelings associated with foster care and incorporate psychoeducation that involves all stakeholders who play a part in the placement plan (Bruskas, 2008; Jenkins, 2008; Kletzak & Siegfried, 2008; Lee & Whiting, 2007; Pecora & Maluccio, 2000). Holody and Maher (1996) also emphasize the necessity of an individualized approach for each child. They proposed a here-and-now process model using lifebooks to answer questions, address misconceptions, and reframe the past in an understandable way. The practice of providing information about the reasons for placement and meaning of 39     being in foster care has been associated with better adjustment (Pecora & Maluccio, 2000). Doing so can improve mental health, educational, and developmental outcomes (Silver et al., 1999). Some youth who have experienced foster care have come forward to give voice to their struggles and suggestions for change. Lay (2000) called attention to the challenges affecting relationships. He urges child welfare professionals to reframe problems, power, struggles, and resistance in ways that highlight potential, dignity, and respect. This type of feedback is critical for understanding the challenging relational dynamics that youth and professionals engage in. Professionals need to let youth connect with them on their own terms, not force it. He also urges professionals to understand how feeli - blame, and protecting self by not caring can influence perceptions of others and their environment. This challenges us to re-inform ways of thinking about youth in care and embrace approaches that seek to empower. Sieta (2000) has proposed reframing youth in positive empowering ways and guiding work with principles of connectedness, continuity, dignity, and opportunity. These principles would be implemented in a context of shifted policy and practice that reclaims youth, emphasizes community, and values principles of caring rather than specific programs. Connectedness represents the promotion of close positive relationships. Dignity refers to building feelings of self-worth, understanding, respect, courtesy, and safety. Sie refers to establishing a focus on existing strengths, striving to build new strengths, and 40     creating a vision for the future. Continuity refers to building a sense of continuous belonging. At its core, empowering children involves seeking their input and valuing their opinions (Wilson & Conroy, 1999). In order to empower children to put painful memories in the past, we must first help them acknowledge and understand them (Gil, 2006). Therapists can help explain the ways in which the losses parents and children face can present as worsened functioning following placement (McWey, Henderson, & Tice, 2006). A large part of psychological adjustment is dependent upon the coping strategies that youth employ. Loss seems to be a key issue associated with feelings of psychological distress. It is children and youth were strongly impacted by the disruptive nature of removal from their biological family and feeling as though they had no control over what was happening to them. Schneider suggests that mental health professionals shift focus from promoting healthy coping to answering questions, normalizing feelings, and build resources. Resources of particular utility include problem solving skills, interpersonal skills, building self-esteem and building a network of social support (Schneider, 2005; Sieta, 2000). Gil and Bogart (1982a) believe that aiding children in the process of understanding the reason for placement and coming to terms with their experience can promote a sense of self-worth and reduce feelings of guilt and self-blame. The history and context of the case can affect the relationships between children, parents, foster caregivers and child welfare professionals (Haight et al., 2002). Child welfare uncertainties in order to tailor services to meet the needs of the child, family, and foster 41     caregiver (Fox et al., 200 perspectives may exacerbate commonly experienced feelings of powerlessness and ultimately undermine attempts to establish trusting relationships. Ultimately, children and youth deserve information, knowledge, and explanations their experience (Bruskas, 2008; Cashmore, 2002; Folman, 1998; Gil & Bogart, 1982a, 1982b). Providing this type of support can help a child interpret her experience and environment in ways that reduce confusion, fear, anxiety, stress, and sadness (Bruskas, 2008; Holody & Maher, 1996). Child welfare professionals and families can be a network of supports working together to help youth understand their experience of entry into foster care. Changing the perception of relationships with child welfare professionals can influence how youth perceive the foster care environment and may contribute to better adjustment in out-of-home placement. Conclusions Concerns about the effects of failing to communicate explanations of the ambiguities associated with removal and entry into care persist in the child welfare literature (Bruskas, 2008;Ellerman, 2007; Folman, 1998;Levitt, 2009; Lee & Whiting, 2007; Samuels, 2009). It is imperative to conduct research that assesses youth perceptions of the relationship between communication regarding reason for entry and what will happen next and adjustment to out-of-home care (Bogolub, 2008; Newton, Litrownik, & Landsverk, 2000; Silver et al., 1999; Lawrence et al., 2006). Gaining an understanding of the types of communication processes taking place with youth who are entering foster care can help child welfare professionals better address the needs of 42     youth entering care. 43     CHAPTER THREE RESEARCH DESIGN & METHOD Introduction This chapter describes the research procedures for the study and addresses the rational for qualitative methodology, research design and method, data collection and analysis. Research Design serve as a key component in child welfare intervention development (Craven & Lee, 2006). Although children can be considered the most important stakeholders, their input is often left out of discussion of program and policy development (Fox et al., 2008). The voices of youth in foster care continue to be underrepresented in research intending to improve service delivery and support well-being (Fox & Berrick, 2007). The perceptions of youth who were in foster care may elucidate psychological and interpersonal characteristics of communication processes that affect adjustment to out-of-home placement (Haight et al., 2002). of communication at the time of entry into foster care. This research aimed to contribute further to our understanding of the types of communication processes taking place with children who are entering foster care. Youth who had entered foster care at least once after reaching the age of 8 were interviewed. All youth participated in one individual, semi-structured in-depth interview and completed a demographics questionnaire and eco-map. 44     The interview protocol (see Appendix A) was designed to explore whether communication at the time of entry into foster care affects adjustment to out-of-home placement. Interview questions were types of information they received, how they received it, how communication from the child welfare and biological family systems affected perceptions of the environment, and how such communication affected adjustment to out-of-home placement. In addition, the interviews also explored of race, ethnicity, culture, gender, religion, sexual orientation, and experience of maltreatment in relation to communication with child welfare professionals and family. The interview data were audio-recorded, transcribed, and analyzed. Rationale for Qualitative Methodology Qualitative methodology is particularly well suited for research that seeks to holistically study constructed realities, subjective understandings, and interpretations (Marshall & Rossman, 2006). Qualitative research and human ecological theory share a holistic perspective that embraces complexity, context, multiple perspectives, individual difference, the concept of circularity, and attentiveness to issues of epistemology (Gehart et al., 2001; Moon, Dillon, & Sprenkle, 1990; Pratt & Dolbin-MacNab, 2003). It affords researchers the opportunity to describe complex phenomena, discover new relationships, and navigate subjective meaning, understanding, and perceptions as they related to children, youth, and families (Eisner, 2003; Sprenkle, 1994). The qualitative research tradition is also compatible with social constructionist and feminist multicultural paradigms. This is demonstrated through attentiveness to the relationship between researcher and the researched, context shaped inquiry, and 45     unique epistemologies and experiences (Atkinson, Heath, & Chenail, 1991; Denzin & Lincoln, 2005; Gehart, Ratliff, & Lyle, 2001; Marshall & Rossman, 2006). In essence, we cannot understand human action unless we understand the meaning that humans attach to it (Marshall & Rossman, 2006). It is important to access youth perceptions and interpretations rather than relying solely on adult interpretation of what youth may be experiencing (Eder & Fingerson, 2002). Demographic Questionnaire & Eco-Map Every child entering the foster care system has her own unique set of circumstances and experiences which poses unique challenges for child welfare researchers. Recent research has indicated that c removal may be influenced by factors such as gender, maltreatment type, placement type, and satisfaction with caregiver and placement (Dunn, Culhane, & Taussig, 2010). In order to best address this type of complexity this study triangulated multiple sources of data in order to elaborate and elucidate integral elements of the communication process (Marshall & Rossman, 2006). The demographic questionnaire (see Appendix B) was designed to gather case history information pertaining to reason for entry, number of caseworkers, length of time in care, placement history, outcome, and frequency of contact with family and fictive kin while in care. The eco-map exercise (see Appendix C) was designed to provide a visual illustration of the specific systems each participant was involved with while in care. This exercise allowed the researcher to see the resources made available to youth and their relationships with those resources. Such systems included the child welfare system, courts, law enforcement, family, friends, service providers, schools, neighbors, and church communities. 46     Grounded Theory & Interview Method A modified grounded theory approach was used to explore the relationships between the concepts identified in the conceptual framework. A modified grounded theory approach fits well with the proposed research questions because of its roots in social construction and interest in studying social process over time (Charmaz, 2006; Morse & Richards, 2002). Using a modified grounded theory methodology will facilitate a process of building a framework for understanding the process by which communication about reason for entry and what will happen while in care influences adjustment to out-of-home placement. A semi-structured interview guide was developed and informed by the presented theoretical and conceptual frameworks. Table 2 presents the linkages between the research questions, corresponding interview questions, and conceptual and theoretical frameworks. Interviews provide youth the opportunity to express their own thoughts and perceptions, and interpretations in their own words (Eder & Fingerson, 2002). Interviewing offers the opportunity to generate rich descriptive information that can contribute to building a stronger understanding of the ways in which communicating important information influences adjustment to out-of-home placement. This study was planned with flexibility and adaptability in mind so that it could be responsive to situational change during the research process (Marshall & Rossman, 2006; Morse & Richards, 2002). Semi-structured interviews allowed the researcher to explore specific constructs stemming from theoretical knowledge while also maintaining flexibility for new questions to emerge based on what youth shared during the research process (Morse & Richards, 2002). 47     Table 2. Linkages between Elements of the Interview guide, Research Questions, & Proposed Frameworks Element of Interview Guide & Possible Probes Childhood experience before foster care Possible Probes: o What was life like before being removed? o What was your relationship with your family before placement? Research Question(s) addressed How does communication from the biological family perception of the outof-home placement environment? What roles do caseworkers, therapists, foster parents, and biological parents play in communicating important information about the reason for entry into care and what will happen next?   48     Element of Conceptual & Theoretical Frameworks Conceptual : Child in developmental context. Theoretical: Human Ecological Theory Social Construction Entering the foster care system Possible Probes: o How did you enter the foster care system? o Who came to take you? o Did you know that you were going to be removed? What did you think about what was happening to you? How did you feel at the time? How does communication from the child welfare perception of the outof-home placement environment? What roles do caseworkers, therapists, foster parents, and biological parents play in communicating important information about the reason for entry into care and what will happen next? How is information about reason for entry into care and what will happen next communicated to youth entering foster care?   49     Conceptual: Child in developmental context Theoretical: Human Ecological Theory Social Construction Feminist Multicultural Perspective Experience of family (biological parent(s), siblings, extended family, fictive kin) ld welfare service delivery (caseworkers, foster parents, law enforcement, courts, & therapists) Possible Probes: o Who talked to you when you entered foster care? o Who helped you to understand what was happening? o What kind of information/explanatio n(s) were you given? o Did you feel that the person was being truthful? o Was there anything said that made things better? Worse? o Who is responsible for explaining things to kids who are entering care? o How did you talk to them? How does communication from the child welfare perception of the outof-home placement environment? How does communication from the biological family perception of the out-of-home placement environment? What roles do caseworkers, therapists, foster parents, and biological parents play in communicating important information about the reason for entry into care and what will happen next? How is information about reason for entry into care and what will happen next communicated to youth entering foster care?   50     Conceptual: Cumulative experience of communication for child welfare service delivery. Cumulative experience of family communication regarding child welfare system. Theoretical: Human Ecological Theory Social Construction Feminist Multicultural Perspective Perception of environment Possible Probes: o What was your first day of out-of-home placement like? o What messages did you receive? Expectations? o Who talked to you about what would be happening? o What was your foster caregiver like? o How did that way he/she talked to you affect your view of out-of-home placement? What roles do caseworkers, therapists, foster parents, and biological parents play in communicating important information about the reason for entry into care and what will happen next? How is information about reason for entry into care and what will happen next communicated to youth entering foster care? Conceptual: Perception of the environment Identity (race/ethnicity, culture, religion, gender, sexual orientation) Possible Probes: o What types of messages did you receive? From who? o How did these messages affect the way others talked to you? You to them? How do youth view race, ethnicity, culture, religion, gender, and sexual orientation in relation to their experiences of communication and adjustment to foster care? Conceptual: Child in developmental context 51     Theoretical: Human Ecological Theory Social Construction Theoretical: Human Ecological Theory Social Construction Feminist Multicultural Perspective Coping Possible Probes: o How did you deal with the changes in your life? (neighborhood, school, friends) o Who understood you? o Has your understanding of your experience changed over time? What strategies do youth use for coping with the transition to out-of-home placement? Conceptual: Available coping strategies Adjustment Possible Probes: o How do you think the system viewed your behavior/adjustment? o How do you think your family viewed your behavior/adjustment? o In what ways did their views affect how they talked to you? You to them? How does communication from the biological family Conceptual: Adjustment to out-ofhome placement perception of the outof-home placement environment? What is the relationship of communication from the child welfare system and biological family to youth adjustment to out- ofhome placement? What roles do caseworkers, therapists, foster parents, and biological parents play in communicating important information about the reason for entry into care and what will happen next? Theoretical: Human Ecological Theory Social Construction 52     Theoretical: Human Ecological Theory Social Construction Children have inherently less power than adults. Researchers have more power than the children and youth they interview because of age and control of the research project itself. Gender, race, ethnicity, culture, and sexual orientation of the researcher and participant can introduce additional power dynamics to be attentive to. During interviews the researcher is able to acknowledge and address these power differentials (Eder & Fingerson, 2002; Reinharz, 1992; Ribbens & Edwards, 1998). Sampling Due to the difficult nature of identifying and accessing youth who have been in foster care, this study employed both criterion and purposive sampling. Fourteen youth between the ages of 18 and 24 who had entered foster care at least once after reaching the age of 8 were interviewed. The age of 8 was chosen as the minimum age for entry because it represents the youngest point in middle childhood that children gain the ability to reflect on their experiences. Youth possess the developmental cognitive ability to integrate and synthesize relational information and reflect upon their experiences. Youth are able to make connections between experience and outcome. Participants were recruited through a variety of community-based avenues. The doctoral student researcher recruited participants through existing collaborative relationships with: 1) a community based prevention program that serves youth and families at-risk for involvement with the juvenile justice system, 2) a community organization that focuses on supporting foster care outreach, education, and system reform, and 3) mental health professionals with expertise in the area of child abuse & neglect. In addition, participants were recruited through two community-based programs that offer support services for youth who are transitioning out of foster care: 1) Youth 53     Advisory Boards comprised of former foster youth who are working toward supported system reform that incorporates feedback and suggestions from youth who have been in foster care, and 2) a summer camp offered at a local University for youth who are transitioning out of foster care. Due to the demands of managing high numbers of appointments, meetings, and variety of daily tasks each day, academic faculty, mental health professionals, and staff in community-based organizations are rarely readily available on a drop-in basis. As a result, the researcher aimed to share information about the study in a way that was quick, to-the-point, and was accommodating for busy schedules. The process targeted two categories of professionals, those with whom the researcher had an existing relationship and those with whom there was no existing relationship. For existing researcher and thus followed. For all others the researcher organized a 3-phase system of e-mail contact. The various professionals identified for aiding in recruitment were first contacted via e-mail. An initial email briefly explained the purpose of the study, who could participate, compensation and requested to arrange a phone call or meeting to talk about the study and ask for help recruiting participants. For those who responded to the initial e-mail, a second thank-you e-mail was sent that answered any posed questions. The e-mail also emphasized the res directly) if that was most comfortable for the youth and 2) her willingness to travel to meet participants at locations that they felt were convenient and comfortable for them. A 54     second follow-up e-mail was also sent to those who did not respond. It thanked the professional for considering taking the time to help share the opportunity for former foster youth to participate in the study. Followelapsed from the most recent e-mail. The follow-up emails were discontinued after 3 contacts had been attempted. All e-mails included a recruitment flyer (see Appendix D) that could be provided to potential participants to take home or be placed in office waiting rooms. The recruitment effort yielded quick responses from two professionals who actively worked with foster youth. These professionals were leaders for Youth Advisory Boards in Southeast and Mid-Michigan counties. These professionals ultimately ended up as key informants who provided contact information for all of the youth who participated in the study. The Mid-Michigan Youth Board leader provided contact information for three youth and the Southeast Michigan leader provided contact intention to have all participants be either past or current members of a Youth Advisory Board. It was not the intention of the researcher to have a sample where the majority of the participants had aged-out of foster care. Eight of the participants aged-out of foster care. Four youth were still in care with a goal of aging out. One participant was reunified with a parent and one was adopted. Due to the foster care status, close relationship, and close proximity of research participants the researcher has attempted to best All participants had expressed interest after being approached by the professional who had been in contact with the researcher. All participants requested to 55     have their contact information passed along to the researcher rather than contacting the researcher directly. The researcher followed a 3-phase system of contact for possible participants. However, all possible participants were contacted via phone rather than email. For those that the researcher was able to make direct contact with, arrangements were made to meet at a location convenient to the participant and preference of gas or preference for phone calls vs. text messages and subsequently used the indicated method for providing a reminder contact 24 hours in advance of the interview date and time. For those that the researcher was not able to reach directly a brief voicemail message, mentioning the name of the recruitment source, was left asking for a return call if still interested in participating. Follow-up calls were made at one week intervals and stopped after three contacts had been attempted. Of the possible 18 participants, 14 responded and participated in the study. All interviews were conducted in settings that were collaboratively decided upon between t convenient locations within her community that were considered comfort and conducive for conducting the interview. In total, one interview took place at a library, two interviews took place at coffee/food establishments, and 11 interviews took place at the date as a result of the participant receiving a phone call regarding an unforeseen crisis that was not related to participation in the research study. Participants 56     Fourteen youth participated in the study. The sample consisted of 10 female and 4 male participants from Southeast and Mid- Michigan counties. The average age of participants was 19, with the youngest age being 18 and the oldest being 23. Three participants were African American, three participants were Multiracial, and eight participants were Caucasian. The reason(s) for entering foster care included physical neglect (9), emotional neglect (7), emotional/verbal abuse (5), physical abuse (5), death of a parent (2), substance abuse (2). Though only two participants indicated substance abuse as a primary reason for entry into care, 12 of the 14 participants disclosed parental substance abuse as a contributing factor in their removal. The majority of the youth (10) indicated that they entered foster care as a result of a combination of abuse and neglect. All of the participants were either past or current members of a Youth Advisory Board. Eight of the participants aged-out of foster care. Four youth were still in care with a goal of aging out. One participant was reunified with a parent and one was adopted. The youth who participated in the study were in foster care, on average, for about 6 years. The majority of the youth (10) entered foster care only once, one youth entered twice, and three youth entered three times. The average age at the time of first entering foster care was 11. The average age at the time of second entry was 13, and the average age for third entry was 15. While in care these youth had an average of 5 caseworkers and 5 placements. The youth experienced a variety of placement types including foster homes (10), relative placements (13), residential facilities (8), fictive-kin placements (6), and group homes (1). The average age of exit was 18, however 4 were still in foster care at the time of the interview. At the time of the interview six youth had 57     completed some college, four had completed high school, two were still in high school, and two dropped out of high school in ninth and tenth grade. During the time the youth were in care they participated in individual therapy (13), family therapy (7), educational/skill building classes (5), and eight reported receiving regular medical treatment (annual physicals, check-ups, office visits). All participants indicated having contact with biological parents, siblings, extended family, and fictive kin. However, the frequency at which these contacts occurred varied. All participants were asked to indicate the frequency of contact using a 5-point Likert scale anchored by 1 (often), 3 (sometimes) and 5 (never). Overall, youth felt that they were able to sometimes see their parents (3.8), sometimes have contact with extended family (3), and often had contact with fictive kin (2.5). Compensation Youth who participate in the study were given a $20 gift card (gas or grocery) as a symbol of appreciation for their participation. At the time that the interview date and time were arranged the participant was asked for her preference of type of gift card. Gas gift cards were limited to 3 large gas station chains that sold cards in $20 increments. Grocery gift cards were limited to 3 large grocery chains that had locations in each of the communities where interviews took place. Data Collection Qualitative inquiry involves the collection of rich data that reflect the experiences, perceptions, and points-of-view of the people involved. Obtaining these types of data require the researcher to establish and maintain a level of connectedness and mindfulness with participants. In doing so, researchers are personally vested in the topic 58     of study and develop close relationships with people and situations. Qualitative researchers are also called to be attentive to the transactional, ever-changing nature of processes and dynamics. Data were collected using a demographic questionnaire, ecomap, and face-to-face semi-structured in-depth interviews with youth who have entered the foster care system. Each interview began with the participant independently completing a brief demographics questionnaire pertaining to her foster care case history. During the course of the project a few participants indicated that two questions on the questionnaire were challenging to answer. These two questions asked the participants to rate the frequency of contact with their caseworker and their siblings. With regard to contact with caseworkers, these participants found it hard to give an overall rating of frequency of contact due to the extreme difference between multiple caseworkers. In this case, the participants indicated a separate rating for each caseworker. For two participants, the frequency of contact with siblings was challenging to answer because they had multiple siblings and varying amount of contact with each. In these two instances the participants preferred to indicate a separate rating for each sibling or sibling group. Next, participants completed the semi-structured in-depth interview regarding their foster care experience. Interviews were designed to elicit retrospective narratives about each youth s experiences of communication about reason for entry and what will happen next and adjustment to out-of-home placement. All originally designed interview questions remained intact however the sequence in which the questions was asked was modified to optimize overall flow of the interview. Similarly the wording and prompts that 59     proved most understandable and approachable to participants evolved over the course of data collection. All interviews were audio-recorded and later transcribed verbatim by the researcher. The researcher maintained dated memos tracking reflections, thoughts, and feelings pertinent to the analytic process. Interviews ranged in length from 1 to 2 hours. Lastly, the researcher guided a collaborative process of constructing an eco-map to visually depict all of the systems in which each participant was involved with while in care. Each eco-map was created using a worksheet comprised of several circles connected to one central circle. The central circle represented the participant. The surrounding circles represented the systems that the participant was involved with while in care. Each surrounding circle is connected to the central circle by a line indicating the direction of influence. During data collection, the researcher filled in an eco-map worksheet to reflect the unique combination of people and systems that each participant identified. The strength of each relationship and the flow (resource helping the participant vs. participant helping the resource) of energy was indicated for each resource. One participant requested to complete two separate eco-maps, one for each time she was in care. The remaining 13 participants preferred to complete one eco-map that reflected their overall experience of foster care over time. All participants fully completed informed consent (see Appendix E), a demographics questionnaire, semi-structured in-depth interview, and collaboratively constructed an eco-map with the researcher. Data Analysis 60     The analysis of qualitative data considers a respect for the uniqueness of each individual case. Qualitative researchers immerse themselves in their data, carefully exploring and confirming details, specifics, themes, patterns, and relationships (Marshall & Rossman, 2006). Qualitative analysis strategies consider the implications of social, cultural, and historical context for their evaluation findings, consciously thinking holistically (Patton, 2002). Grounded theory involves a constant interchange between the data collection and analytic processes (Strauss & Corbin, 1994). The ultimate goal of this research was to develop an integrated view of the process linking communication about reason for entry and what will happen next and adjustment to out-of-home placement. The researcher followed a modified grounded theory approach in order to accomplish this goal. It differed from a traditional grounded theory approach in that the research questions were informed by current literature, theory and a prior conceptualization (see Figure 2) of the process in question. In turn, the research questions and theoretical and conceptual underpinnings closely informed the questions that guided the interview process. It was important to conduct a process of constant comparison that would allow a theory to emerge from the data rather than from previously conceived ideas. The constant comparative process began at the onset of data collection. The researcher engaged in an active process of note-taking following each interview. Notes identified initial problematic wording of interview questions and issues of flow and described thoughts about emerging themes as well as elements to explore in subsequent interviews. The note-taking process was used as a time to reflect and compare each interview session. This was done in an effort to be attentive and 61     committed to the data determining the elements that played a role in the communication process for the youth in this sample. Three types of data were collected and analyzed. Descriptive data from the demographic questionnaires offered case history information pertaining to reason for entry, number of caseworkers, length of time in care, placement history, outcome, and frequency of contact with family and fictive kin while in care. Eco map data allowed the researcher to see the types of resources made available to youth and their relationships with those resources. Interview data reflected the thoughts, feelings, and perceptions of comparative process. Data analysis began by coding each interview using Qualrus Qualitative Data Analysis software. The interview data were first coded, line by line, for initial descriptors that pertained to major events, the child welfare system, the family system, perceptions, and emotional and behavioral responses. The first round of coding yielded 93 initial codes. In the next stage of coding, the researcher reviewed the initial codes for emergent themes that described the major events, common patterns, emotional/behavioral responses, and personal/environmental characteristics that were identified. This was accomplished by reviewing the coded data in multiple ways. First, using Qualrus data analysis software, the researcher was able to view the frequency that codes occurred and could identify the frequency at which various codes co-occurred. This identification served as one starting point for determining themes and categories that appeared to be prevalent across interviews. The data could then be organized in a way that coded segments of text could be compiled into lists so that the 62     researcher could check the consistency and accuracy of the extent to which the code described what was taking place. Following this same process frequently occurring code-pairs could be reviewed and used to aid the process of understanding how various codes were related. Second, the researcher compared the data from an additional organizational stand-point. Interview data were also collated into groupings based on responses to areas of questioning that were informed by the linkages between the research questions, conceptual map, research questions and interview guide. These categories were 1) childhood experience before foster care, 2) entering foster care, 3) experience of communication, 4) perception of the environment, 5) coping, 6) adjustment, and 7) identity. Also organizing the data in this way offered an additional opportunity to search for similarities and differences between the experiences of the youth interviewed. The researcher actively memoed thoughts, ideas, and impressions as she reviewed the data in order maintain the comparison process at all stages of coding. Comparing data from different organizational vantage points aided the researcher in developing questions and identifying patterns among the themes that consistently emerged in the interview data. The initial 93 codes were collapsed into 24 codes that served as sub-categories to five larger categories that described major events, perceptions, and emotional/behavioral responses. Once saturation was achieved for each of the categories a final round of selective coding was conducted. This coding process formulated an integrated storyline of the connections between categories, sub-categories and emergent themes (Echevarria-Doan & Tubbs, 2005). 63     This final storyline is presented in Chapter 4 as a discussion of responses addressing each research question. Data from the demographics questionnaires and eco-maps were used throughout the coding process to elaborate, confirm, and illuminate emergent themes in the interview data. Responses to the questions on the demographic questionnaire were compiled in order to attain a basic summary of elements of case history and provide a basic description of the sample. Eco-maps were reviewed to determine the: 1) types of resources youth engaged with, 2) the strength and flow of energy for each resource, 3) a comparison of the number of resources identified across participants, and 4) a comparison of the number of strong vs. weak relationships identified across participants. Throughout every aspect of analysis, the researcher sought to balance reflexivity about her own voice and perspective while striving to present findings authentically and with trustworthiness (Marshall & Rossman, 2006; Morse & Richards, 2002). Trustworthiness Qualitative researchers are inextricably embedded in the research process as is reflected in the comm Marshall & Rossman, 2006; Morse & Richards, 2002; Patton, 2002). Research questions, choices, and writings are intrinsically contextual (Richardson, 1990). Qualitative researchers bring with them their own epistemologies and experiences (Atkinson, Heath, & Chenail, 1991; Denzin & Lincoln, 2005; Gehart, Ratliff, & Lyle, 2001; Marshall & Rossman, 2006). The questions we ask, the words we choose, the audience we reach, and the stories we tell reflect the essence of expanding ways in 64     which we view the constructions of the world, our work as researchers and practitioners, and of lived experience (Marshall & Rossman, 2006; Richardson, 1990). In this way, each researcher brings a unique perspective and contribution to research and practice. There is emphasis on the centrality of relationships and context in qualitative research (deMarrais, 2004; Lincoln, 1995; Patton, 2002). Qualitative researchers work in close proximity with participants and establish collaborative relationships where both researcher and participant work together to understand social problems (Denzin & Lincoln, 2005; Marshall & Rossman, 2006; Olesen, 1994, 2005). Ultimately, the qualitative research endeavor is an active and dynamic process that challenges assumptions and casts them in a new light (Morse & Richards, 2002). In an effort to adhere to these principles, the researcher built a three part approach to enhance the trustworthiness of this research. First, the researcher triangulated qualitative interview data with demographic questionnaire and eco-map data. The triangulation process allowed the researcher to integrate various forms of data in order to further elucidate the connections between communication processes and adjustment to out-of-home placement. Secondly, in order to be transparent, the researcher provided a reflexive response regarding biases that may have influenced the interpretations and an overall reflection on the research process in Chapter 5. Transparency was an integral component of every aspect of this endeavor. Over the course of the study, the researcher maintained an audit trail documenting thoughts, feelings, and decisions throughout the data collection and analytic process. A specific component of the audit 65     trail involved memoing during the coding process in order to track decisions, thoughts, and interpretations. Finally, in order to balance the reflective aspect of constructing an audit trail the researcher also engaged in consultation with her faculty advisor to discuss coding decisions and interpretations of the data. When full integration was reached, the researcher shared the study finding with all participants who provide consent to be contacted at the conclusion of the study. Summary A modified grounded theory approach was used to facilitate a process of building a framework for understanding the process by which communication about reason for entry and what will happen while in care influences adjustment to out-of-home placement. Due to the difficult nature of identifying and accessing youth who have been in foster care, this study employed convenience sampling. Two child welfare professionals who were leaders for Youth Advisory Boards in Southeast and MidMichigan counties served as key informants who provided contact information for all of the youth who participated in the study. Fourteen youth between the ages of 18 and 24 who had entered foster care at least once after reaching the age of 8 were interviewed. Eight of the participants aged-out of foster care. Four youth were still in care with a goal of aging out. One participant was reunified with a parent and one was adopted. All participants received a $20 gas or grocery gift card as a symbol of appreciation for their participation. Three types of data were collected and analyzed. Descriptive data from the demographic questionnaires offered case history information pertaining to reason for 66     entry, number of caseworkers, length of time in care, placement history, outcome, and frequency of contact with family and fictive kin while in care. Eco-map data allowed the researcher to see the types of resources made available to youth and their relationships with those resources. Interview data reflected the thoughts, feelings, and perceptions of par length. All participants fully completed a demographic questionnaire, eco-map, and semi-structured interview. Interview data were coded using Qualrus Qualitative Data Analysis software. The interview data were first coded, line by line, for initial descriptors that pertained to major events, the child welfare system, the family system, perceptions, and emotional and behavioral responses. In the next stage of coding, the researcher reviewed the initial codes for emergent themes that described categories of major events, common patterns, emotional/behavioral responses, and personal/environmental characteristics that were identified. A final round of selective coding was conducted in order to formulate an integrated storyline of the connections between categories, subcategories, and emergent themes (Echevarria-Doan & Tubbs, 2005). Data from the demographics questionnaires and eco-maps were used throughout the coding process to elaborate, confirm, and illuminate emergent themes in the interview data. Steps to ensure trustworthiness included the triangulation of qualitative interview data with demographic questionnaire and eco-map data, a reflexive response from the researcher, audit trail of note-taking and memoing, and consultation with faculty advisor. The findings of the study are presented in Chapter 4 as responses addressing each of the seven research question. 67     CHAPTER FOUR FINDINGS Introduction Interview data revealed five categories that described major events, perceptions, and emotional/behavioral responses in the communication process. These categories were: significant events, communication with the child welfare system, communication with biological family, perceptions, and adjustment. This chapter presents elements of these findings as responses to each of the seven research questions explored in the study. Quotations from interview data and references to eco-map and demographic data are woven into responses to provide support, give context and to illuminate emergent categories and themes. The response to the first research question presents a model illustrating how the elements of the communication process affected adjustment to out-of-home placement for the youth in this study. Responses to the remaining six research questions provide an expanded discussion of findings that pertain to specific elements of the six categories that describe how explanations about reason(s) for entry and what will happen while in care were communicated to the youth in this sample. Each response begins with a table outlining the categories and sub-categories addressed and conclude with a summary. Research Question 1: What is the Relationship of Communication from the Child Welfare System and Biological Family to Youth Adjustment to Out-of-Home Placement? Table 3 identifies the major categories and sub-categories of the communication 68     process that are addressed by research question 1. Table 3. Major Categories & Sub-Categories for Research Question 1 Major Category Significant Events Communication with the Child Welfare System Communication with Biological Family Sub-categories Removal Placement Understanding of environment prior to care. Type of Communication Content of Communication Timing of Communication Police Child Protective Services (CPS) Caseworkers Foster Caregivers Mental Health Service Providers GAL Type of Communication Content of Communication Timing of Communication Parents Siblings Relative caregiver Perceptions Characteristics of Relationships with Biological Family System. Characteristics of Relationships within the Child Welfare System Out-of-Home Placement Adjustment Coping as an indicator of adjustment: o Learning to play the game: What to say o Who to be o What to do 69     Several important themes highlighted the connections between the six elements of the communication process. Figure 4.1 illustrates the interconnections between experiences of communication from family and child welfare sources, youth perceptions, and coping in order to adjust to out-of-home placement. An explanation of the model   and its relation to adjustment to foster care are discussed. An expanded discussion of these elements and the ways in which they are interconnected is addressed in subsequent responses to each of the research questions. Piecing Together an Understanding The youth interviewed shared their experience of piecing together information from various sources in order to develop a more cohesive understanding of the reasons they entered care and what would happen while they were in care. The concept of piecing things together appeared to hold true for all youth interviewed, even those who had received explanations in preparation and at the time of removal. The youth in this study engaged in an active process forming opinions based on perceptions of the people who communicated with them and the information they provided. For members of the child welfare system, the youth evaluated the extent to which they received information, whether they were able to understand what was being explained, and whether their questions were answered. Communication strongly influenced impressions of members of the child welfare system. For biological family members, communication influenced feelings of belonging, hurt, loyalty, and support. Due to the complexities inherent in the child welfare system, youth encountered a number of caseworkers, foster caregivers, and mental health service providers. Also, the frequency of contact with biological parents, extended family, and fictive kin varie 70     Figure 4.1 Communication Appraisal Process Adjustment                 Event Source of Communication Caseworker Foster Caregiver (unrelated & related) MH Service Provider GAL Experience of: Removal Placement Informational needs not met & Caring not Conveyed Sibling Explanations & Support     71   Coping Play the Game What to say Identity Who to be Perception of out-ofhome placement     Disempowerment Growing Distrust     Loyalty & Emotions Source of Communication Empowerment Ask Questions Perception of Relationship Weak/ Unhelpful Biological Parent       Source of Communication     Perception of Relationship Strong/ Helpful Informational needs met & Caring Conveyed Behavior What to do across time. As such, youth pieced together information over time as they developed new relationships with members of the child welfare system and came in contact with family members. The youth engaged in a dynamic process of accessing information and forming perceptions that influenced behavioral choices. The following sections describe each element of this communication appraisal process. The process is represented in Figure 4.1. Experience of Removal The removal experience made a lasting impression that often set the initial tone for how foster care came to be viewed. For most of the youth in this study, the day they were removed marked their first introduction to the foster care system. It also was the first opportunity for communication from members within the system. The removal process for these youth was generally quick and was characterized by feelings of fear, anger, and some degree of surprise and confusion upon formally entering the foster care system. At the time of removal some youth received explanations regarding the reason(s) for entry and what would happen while in care and some did not. Sources of Communication Caseworkers, biological family, foster parents, mental health service providers, and GALs played roles in providing explanations to the youth in this study. However, youth did not hold each of these sources of communication equally responsible for providing explanations. All but two youth interviewed believed that it was solely the duty and responsibility of caseworkers to provide explanations to foster youth. Caseworkers who did not provide explanations were viewed as having failed to do their job. Biological family and mental health service providers provided explanations to youth but their role 72     was believed to be secondary to that of the caseworker. As such, the caseworker relationship was the strongest influence on youth views of the foster care system. Youth who received explanations from both the system and family members had a more positive view of the foster care system. Youth who received explanations from parents   or siblings but not from system maintained a more negative view of foster care. The youth who participated in this study received communication from a variety of different members of their biological family. The youth in this sample did not identify much direct communication from family members at the time of removal. Some youth did however receive explanations about the reason(s) for entering foster care or explanations about what would happen after having been placed in foster care. For the youth in this study most explanations from family members occurred after being placed into care with a related caregiver. Youth commonly described family members helping   them to understand the circumstances that their parents were facing and how that led to entering foster care.   Related caregivers were seen as members of the family as well as members of   the foster care system and thus could offer insight in both areas. For the youth in this study, communication from related foster caregivers followed the same pattern as communication from unrelated caregivers. As a result, they are included as sources of communication from the child welfare system in Figure 4.1. The majority of the youth in this study did not report receiving much explanation from parents about the reason(s) for entering foster care or what would happen during the time they were in care. Siblings were not always able to provide much explanation but older siblings commonly 73     attempted to provide clarification and explanations of what they understood to younger siblings. Informational Needs & Perceptions of Relationships Communication from police officers, Child Protective Services workers, caseworkers, foster caregivers, mental health service providers, GALs, and biological family members met the informational needs of youth to varying degrees. Youth who felt their informational needs were met typically described receiving concise and ageappropriate explanations about why they were entering foster care, what it meant to be in foster care, and where they would be going. Others remained confused about why they were removed and what it meant to be in foster care until their informational needs were met. For these youth, sometimes no explanation was provided and other times explanations were given but the youth did not understand what was being explained. For example, one young woman described having been provided an explanation that she was going to be placed into foster care and that her mother would be expected to participate in services such as a substance abuse support group and parenting classes. Though the explanation was simple and to-the-point, the young woman did not understand what foster care was or what substance abuse services referred to. It became evident that explanations were only helpful to the extent that they were understood. Early and ongoing communication from caseworkers was described as establishing a foundation of trust and respect and conveyed a sense of caring that positively influenced adjustment to out-of-home placement. Youth who perceived their 74     caseworkers to be caring also perceived having strong and helpful relationships. Youth who did not feel informed described struggles with feelings of confusion, anger, and frustration. When caseworkers did not provide explanations they were viewed as not caring and unhelpful. This evaluation process took place with each introduction of a member of the child welfare system. The communication process with parents, siblings and other biological family members did not mimic the evaluative nature of relationships within the Child Welfare System. This was true for two primary reasons. First, the youth already had identities as members of their family systems. There was no need to evaluate the trustworthiness or level of caring because there was already an existing relationship and inherent sense of belonging. Second, youth perceived biological family members to hold less responsibility in providing explanations because it was the system that took them away, not their parents. In other words, if the system had not intervened they would still be with their parents. Though parents were not always physically present and did not provide much in the form of explanations for these youth interviews revealed that parents were very psychologically present for the youth in this study. Many of the youth maintained strong feelings of loyalty for their parents throughout their time in care and struggled with conflicting feelings. Siblings consistently served as a source of familiar support during uncertain times. Siblings who were placed together would share their thoughts, feelings, and attempted to gain clarification and explanations by comparing what they collectively understood. Notably, older siblings consistently assumed a role of providing 75     explanations to younger siblings and providing reassurance that everything would be alright. Empowerment vs. Disempowerment Some youth in this study who did not think that their informational needs were met began a process of seeking out information from resources that were perceived as most able to answer their questions. For the youth in this study the strength of the caseworker relationship often played a large role in determining whether youth felt it was ok to ask questions in an effort to piece together an understanding over time. Youth who perceived strong and helpful relationships with their caseworkers commonly described their caseworkers ongoing communication as a symbol of caring that helped them to feel as though their thoughts and opinions were valued. Youth who had this type of relationship were more likely to be open with their caseworkers about their thoughts and feelings about out-of-home placements. The presence of a strong caring relationship empowered youth to feel as though they could ask questions and become self-advocates during their time in foster care. The youth who viewed their relationships with caseworkers as weak and unhelpful more often felt reluctant to ask questions or communicate their concerns about out-of-home placement because they did not trust that their caseworkers would help them. Typically, a sense of growing distrust was maintained and reinforced in interactions within the system until someone proved to be an exception. The absence of a trusted relationship within the system enabled a cycle of disempowerment where youth felt as though they had no say in the decisions that affected their lives in foster care. For the youth in this study, communication played a powerful role in affecting 76     perceptions of caseworkers, foster caregivers, mental health service providers, GALs, and the larger child welfare system. Perceptions of Out-of-Home Placement Perceptions of out-of home placement were affected by communication from the influence followed different pathways. Communication from members of the child welfare system, specifically caseworkers, strongly influenced youth perceptions of relationship quality. The quality of the relationship in turn influenced perceptions of outof-home placement. The youth in this study described relationships and perceptions in terms of dichotomous pathways. When relationships were positive communication was more often viewed as truthful and helpful. Youth were more empowered to ask questions, advocate for themselves, and perceptions of out-of-home placement tended to be positively influenced. Youth who experienced these types of relationships commonly believed that the communication they received enabled them to understand what was happening in foster care. When relationships were negative communication was more likely to be viewed as unreliable and unhelpful. Youth were less likely to ask questions, share thoughts, and perceptions of out-of-home placement were negatively influenced. Youth who experienced these types of relationships commonly did understand why they were in care of what was happening. The family system followed a different chain of influence because the perceptions of relationship quality did not apply as they did for the child welfare system. The youth already had a sense of belonging and membership as a part of the family system. Some of the youth in this study were placed with relatives or fictive kin. In these instances the 77     placement was familiar and for some was viewed as less disruptive than being placed with an unknown foster caregiver. Many youth described feeling a strong sense of loyalty to biological parents. Those who maintained a strong desire to be reunified described more struggles with out-of-home placement than those who believed that foster care was their best option. Some youth who did not clearly understand why they when youth understood what was happening they struggled with feeling loyal to their parents yet angry with them for their actions. Some youth struggled with feeling unwanted. The extent to which youth felt connected, supported, wanted, hurt, and confused influenced perceptions of all relationships and environments. Strong feelings of loyalty also affected perceptions by influencing coming to terms with being in foster care. Ultimately, the emotional response surrounding issues of family influenced perceptions of out-of-home placement more strongly than direct communication from family members. Coping: Learning to Play the Game The youth in this study employed a variety of coping strategies. For the youth in this study, coping pertained to adapting to the foster care environment. A predominant theme emerged with respect to how youth interpreted various pieces of information over time in order to cope. Youth commonly observed caseworkers, foster caregivers, mental health service providers, and other foster youth in order to piece together an ay the service providers wanted to hear. Many of the youth viewed this as a survival strategy 78     that was a necessary part of ensuring or preventing particular outcomes such as placement changes. Learning to play the game encompassed determining what to say, who to be, and what to do. Choices pertaining to these three elements commonly fed back into a process of maintaining ongoing communication with a trusted and helpful source or seeking out other sources of communication in order to gain new information. The communication that youth received from caseworkers, foster parents, and mental health service providers was carefully observed and interpreted in order to learn how to navigate the system. By the time I was 14 I understood clearly everything. Everything around me I was starting to know the ins and outs, loopholes a list of stuff. How to work my way, kinda talk my way out of things. By the time I was 14 I developed more street smarts and I started looking into the system more and started kinda doing a little bit of research on the computer about DHS and some of the rules and the ins and outs le explanation thing is kinda like hard because me There was a strong prevalence of the mindset of doing what you have to do to survive. This sentiment was described by yo professionals within the child welfare system wanted to hear in order to attain a certain outcome. them what they need to hear and keep playing the game with them and tell them what they wanted to hear constantly and keep 79     terminated: forget this. I went to my new foster home and my mom she gave me a photo album and e knew From what I've seen and heard from other kids it's basically like the way they've acted and actually spoke their mind and said what they had to say or told the truth and stuff they've ended up in worse places or things didn't happen the way through and to finally then just be done with it. Youth were in a constant process of determining who to be in their out-of-home placements. The youth believed that it was difficult to adjust to foster care on its own and every little difference in the environment contributed to the challenge of getting used to something new. Some youth explained that racism, discrimination, and feeling out of place contributed to feeling uncomfortable. The youth in this study were faced with making decisions about whether to embrace their own cultures or the cultures of their placements. They encountered messages regarding gender, religion, roles, and rules. The youth were constantly managing feeling different from their peers. Ultimately, many feared that sharing their true thoughts, feelings, and beliefs would bring about negative consequences in their placement environments. 80     Learning to play the game also meant that what was observable from the outside was not always consistent with what feelings were taking place on the inside. Some coping strategies offered the appearance of doing well but really youth were keeping true feelings i were faced with making decisions to act a certain way in order to get emotional, physical, and informational needs met. In order to be left alone or to reduce the frequency of counseling sessions, some youth would say the right things and be on their good behavior so that caseworkers, caregivers, and mental health service providers would think they were doing well. Some who felt unheard and ignored would make choices to act out or harm themselves because it was the fastest way to get their system interpreted these observable behaviors as indicators of how well youth were adjusting to foster care. Adjustment In this study, there was no imposed definition of adjustment. Instead, the definition emerged in the narratives of the youth in the sample. Adjustment was discussed from two vantage points. First, from an outside perspective, youth discussed how they thought others viewed their adjustment. The youth in this study frequently described members of the child welfare and biological family systems considering observable aspects of coping behaviors as indicators of adjustment. For instance, a child who was demonstrating few behavioral problems, was doing well in school, and made new peer connections may have been viewed as adjusting well whereas a child demonstrating behavioral problems and resisting social connections may have been 81     viewed in a less positive light. These observable indicators of adjustment ultimately influenced the ways in which child welfare professionals and family members communicated information, creating a continuous dynamic cycle of interaction. One young woman described how lack of communication negatively influenced her perceptions of caseworkers, out-of-home-placement, and how others viewed her. She reflected on what would have been different had she received explanations about why she was in care and what would happen while in care. My attitude probably would have been different towards where I was staying and how I acted towards them and everything. I wouldn't have judged so many people that took us in because it wasn't their fault why we were there. When we did always go places we always blamed them and treated them like we don't want to be here, but you're the reason why we're here. It wasn't their fault but we never knew that then. So it would've been a lot different if it would have been explained to us so we wouldn't have acted that way towards them. Another young woman described that receiving ongoing communication allowed her to be more open-minded about what members of the child welfare system had to say. have been like so Second, from a self-reflective standpoint, adjustment was commonly described as a process of coming to terms with being in foster care. The youth commonly evaluated their adjustment in terms of how well they believed they managed their emotional responses associated with removal and being in the system. The youth discussed if and how they were able to come to terms with being in foster care. Some 82     youth reached a point of acceptance, believing that they were better off being in foster care. why and I know that it was for my well-being and that I know that my mom just is not healthy. into care and actually see you know what family is. me with my mom I probably A few youth remained neutral in their opinion of foster care. They did not necessarily describe their adjustment in terms of being better or worse off. They described getting used to things over time. I got used to being in foster care. It kinda seemed natural after a while. I'm like oh yeah I'm used to this, yeah this person has to come over and talk to me it's nothing new like it's just like came as process that I'm doing. Guess you say, something I was used to in my life over time because at first it was like oh really, like oh come one and I was like ok this is what I have to do so I just got more, more adjusted and more open to it. Others were unsure that they ever fully adjusted to being in foster care. Two young women described their private struggles. it was like a struggle within myself. 83     t's hard to change something that you had no control over and I know now even with this being done and over with, physically it can't effect me but mentally it effects me every day. I mean every day I think about, every day I just think about how much more I know if I had a been in a stable home, how much pain I wouldn't have felt if I had a mom that was there every day, how much better I would have felt. Like now I say like I wish I had could call my dad and we have a decent conversation but that's not gonna happen. It's just different stuff like I know that I didn't adjust, I didn't adjust to foster care or just to life that I was livin at all because it was all just faking. It was never like let's try to deal with what's going on with you. Summary The youth in this study engaged in a dynamic process of gathering pieces of information from a variety of sources over time. The information was pieced together in order to develop a cohesive understanding of the reason(s) for entering foster care and what would happen while in care. The youth described a communication appraisal process (Figure 4.1) that evaluated perceptions of removal, child welfare professionals, quality of communication, and out-of-home placement. Youth who received explanations commonly perceived strong and helpful relationships with caseworkers, felt empowered to ask questions, communicate thoughts and feelings, and were more open to positive views of aspects of foster care. Youth who did not received explanations commonly perceived weak and unhelpful relationships with caseworkers felt disempowered and maintained a growing sense of distrust with the system until meeting someone caring who proved to be an exception. 84     Caseworkers were consistently identified to have the primary responsibility of providing explanations to children and youth entering foster care. As a result, communication from caseworkers played a critical role in influencing youth perceptions of out-of-home placement. Communication from the biological family was secondary to communication from caseworkers because family members were not considered to be responsible for providing explanations. Family indirectly influenced perceptions of outof-home placement through the extent to which youth felt family support and loyalty to biological parents. Youth encountered a variety of sources of communication and received explanations and information that answered their questions to varying degrees. They faced challenges to make decisions about what to say, who to be, and what to do in order to adapt to the foster care environment. The youth termed this learning to play the game. The observable behaviors associated with coping strategies were thought to be judged by members of the child welfare and family systems as indicators of how well youth were adjusting. Adjustment was considered to be the process of coming to terms with being in foster care and managing the emotional response to removal and being in the system. Some youth in the study felt they were better off being in foster care, some got used to aspects of the foster care experience, and others remained tormented by struggles with anger, frustration, hurt, and confusion. Ultimately observable aspects of coping and adjustment influenced the ways in which child welfare professionals and family members communicated information, creating a continuous dynamic cycle of interaction. 85     Research Question 2: How is Information about Reason for Entry into Care and what will Happen Next Communicated to Youth Entering Foster Care? Experience of Removal Table 4 identifies the major categories and sub-categories of the communication process addressed by research question 2. Table 4. Major Categories & Sub-Categories for Research Question 2 Major Category Significant Events Communication with the Child Welfare System Communication with Biological Family Perceptions Sub-categories Removal Placement Understanding of environment prior to care. Type of Communication Content of Communication Timing of Communication Police Child Protective Services (CPS) Caseworkers Foster Caregivers Mental Health Service Providers GAL Type of Communication Content of Communication Timing of Communication Parents Siblings Relative caregiver Characteristics of Relationships with Biological Family System. Characteristics of Relationships within the Child Welfare System Out-of-Home Placement 86     The youth who participated in this study shared many memories about their entry into foster care. It quickly became apparent that the removal experience made a lasting impression that often set the initial tone for how foster care came to be viewed. The removal process for these youth was generally quick and was characterized by feelings of fear, anger, and some degree of surprise and confusion upon formally entering the foster care system. The majority of the youth felt that their removal was a complete surprise however some of the youth had been told that the removal was coming or knew that it was a possibility due to repeated or ongoing involvement with Child Protective Services. Interestingly, even youth who had had some degree of preparation for the removal still felt surprised. In general, feelings of confusion pertained to not understanding exactly what was happening and when they would be returning home. Fast Well I got the phone call, would be about 3:00 and we were out the door by about 4:00 I didn't know anything about foster care. I had no clue, I was too young. I was only 10 at the time and it was all kind a fuzzy. Like nobody really explained to me what was happening because it happened so fast. It was like a last minute type of thing. And it all happened so fast to where I didn't even have time to ask questions. It was get your stuff and go. about 5 minutes later uh CPS came knocking on the door with two police officers and then they waited till my younger sister and younger brother got out of elementary school and then they took us away. Scary 87     It was scary because we didn't know, me and my sisters, didn't know what was going on. No one would tell us they basically put us in the car and drove us to the foster home and we didn't know and they wouldn't tell us when we were going back or if my mom was making any process of getting us back. So it was scary and like being in the house with a whole bunch of people you don't know. I was scared. I was scared I was anxious leaving for a few days just so our mom could get some things worked out and then we would be going back. Angry the day she came to remove me from my home I pretty much told her to fuck off. Like I locked myself into the bathroom and she was like you really need to come out. And I was like I'm not coming out I hate you and you are a bitch so needless to say I hated the PS worker at one point in time. body coming to take my picture because kids always run away in foster care and all that did was piss me off like cuz I wanted to go hang out with my friends you know like I didn't care about what was going on really I just wanted to not be in it but I don't think anybody really told me, I just knew. Confused I just thought that we would be leaving for a few days just so our mom could get some things worked out and then we would be going back. The caseworker came I was sitting at the table and my brother was sitting at the table and my aunt and uncle were sitting at the table and there was a lady 88     in the doorway and she said she was coming to pick us up and I was like where am I going, where am I going? I kept asking where am I going? And then this lady and my aunt and my uncle are just like throwing our bags, our bikes, all of our stuff in the back of this big white van and I remember just crying hysterically because I didn't know what was going on, what was happening, where they were taking me. They didn't say anything to me. They talked to only my aunt and uncle. when I got put into care it was really like a shocker I guess because I didn't really know what was going to happen where I was going, I didn't have any idea. I was a little lost. Didn't understand what was really going on. There was like all these things happening all at I didn't quite understand any of it. It w oing back to our family but we ended up going to a juvenile detention facility, cr Communication during the Removal Process Initial explanations were typically provided during the removal process. It is used to describe the event of removal from the home up to the point of placement. Some youth were in a respite (temporary/short-term) placement that took place overnight or up to a few days. This was still considered to be part of the initial removal process. The timing of these explanations ranged from happening in preparation before removal, at the time of removal, at drop off, and up to a few days into temporary placement. 89     Nine youth had some type of explanation upon entering foster care however the extensiveness of the explanations varied. Five youth indicated that they did not receive any type of explanation at the time of removal. In order to better understand the nuances of how information was communicated the types of information being communicated to youth and the sources of the explanations were identified. Preparation Explanations that were provided in preparation for removal typically came from Child Protective Services (CPS) workers in conjunction with school counselors/social workers, parent( I was actually up north when me and my sister and my dad got a call from Child Protective Services saying that he gots to bring us in to the DHS and he said we had to leave early from being up north and he was driving us and we thought we were going home and on the car ride home he told us we were getting tooken away and we had to go to Child Protective Services and they took us to DHS. was actually coming to my school and meeting with me and I was meeting with the school counselor and she was kinda giving me a heads up of what is going to happen hey explained to us why they had to call. Because they had two kids that was not related to them living in they house and they didn't want anything that we brought up with them being like as far as kidnapping or whatever so know that's why they had to get involved and the second reason was because we really 90     didn't have nowhere to go so they had called and then we met with our, you know they explained to us what was the problem. The problem was that we had a mom but really she wasn't doin her job as a parent. Directive: CPS Workers and Police Officers. Child Protective Services and the police frequently worked together during the removal process. Both police officers and CPS workers were described as directing the removal and they most often were remembered as telling youth what to do in the moment. For the youth in this sample, police officers only provided direct communication when they were the first point of contact and CPS was not on the scene. car you guys are going somewhere for a while. I asked the police if I could like stay with him or stay with my mom's mom and they were like no they have to be blood because my mom's adopted so it wasn't her real mom Yeah. He told my aunt to just take me there that night cuz there is no point in me staying there my mom is obviously like very angry so it wouldn't have done nothing for me to be there. CPS workers were most often remembered as providing brief statements that directed youth to pack a few things and that they would be going home soon. 91     he CPS worker she told us to pack for a few days that we would be back home soon. And so I packed a bag and then I told my younger brother and sister to pack When CPS came or whatever um I was just told to go with them and then I was drove to the youth home for the night and next morning and mind you they didn't foster home. ht be gone for a couple Descriptive: Caseworkers, Family, Foster Caregivers, and GALs Youth who received some type of explanation from their caseworkers described receiving information about placements, caseworker goals, and reasons for being placed in foster care. he was like ok well you're staying with your sister you know you participate, go to school, go to court, if your mom participates you'll be returned back to her. She kinda explained to us what she was tryin to do, she explained to us that she was tryin to find my mama and was explaining to us what was going on, why we was in the juvenile detention facility place and you know she was tellin us like she was going to try to recommend that we go somewhere else and stuff like that. She said that um..you're going to be staying with my aunt and eventually hopefully as the time went on my mother would communicate with them and we would be placed back with her. That was the objective anyway. 92     At least 3 days later um our DHS worker came stopped by for at that time it was FIA. She stopped by and told us she just told us that uh she didn't want to get into graphic details because my younger brother so she just explained that our dad got arrested because he did some bad things and that our mom knew about em and she just has to work out a few things and that we'd be going home soon. Family members were not remembered as having much involvement in providing explanations during the removal process. Youth in this sample recalled parents telling them that they loved them and in one instance a father told his daughters that they were going to be removed. about that time while my younger brothers were packing uh our mom came home from court and she was crying and everything uh she gave us a hug and told us that she loved us and everything and then uh the police had to pull her off of us as we were leaving. On the way home my dad's like your sisters and stuff had got taken away, you guys have to, I have to take you to the DHS office and stuff In other instances, youth received explanations from older siblings who were able to describe what was happening. [brothers] say that my mom wasn't great at all. They said they was she so you never knew about it. Foster caregivers who offered respite care sometimes communicated with youth about various aspects of the process of being in foster care. 93     She told me that my worker would be um wanting me in therapy which I didn't really care as long as I had a good therapist. She told me if I went to residential she told me a lot about what residential was like about some places have uniforms some places don't you go to school either at the place or at a real oh my gosh that's scary y foster parent just told me that uh pretty much once you're uh we find out who your caseworker is you're going to more or less find out what exactly happened. hat's up you know here am I going tomorrow?-type thing and that was what I was told, I was going home. Early communication from GALs was a very uncommon occurrence for the youth in this sample. However, one young woman had the experience of receiving an explanation from her GAL when he came to see her during the time she was in a respite placement. to happen at court and things like that. And my lawyer wanted to talk to me because I was like the older one and my brother couldn't quite understand what was going on so he had no clue. My brother was very confused at what was going on like cuz he was younger than I was. Like he was 10 and I was 11 and like he, he probably wouldn't have got it at the time. No Explanation Youth who did not receive explanations at the time of removal remained confused about their circumstance for varying lengths of time. The youth interviewed 94     indicated waiting for an explanation anywhere from a few weeks or months up to a year. In two instances, the youth did not believe they ever received a formal explanation from anyone at any point during their time in foster care. When I went through the front nobody said anything to me. It was kind of weird. Like nobody said anything and they acted like they didn't even see me so I was like ok you know I'm safe but I walk in to my mom just like help me, help me, help me, and just begging for me and they took my mom away and my dad said get all of your stuff together, pack everything you can. until she is like op here is a new caseworker. So I really only met her like twice and that was in like in like a span of like 3 months. was going on. No one would tell us they basically put us in the car and drove us going back or if my mom was making a process of getting us back. Aware but Unaware: Understanding of Environment Prior to Care In this sample, the confusion of removal process was consistently linked with a sense of being aware but at the same time unaware of the problematic elements of the home environment. The family environment prior to entry into care was commonly viewed as normal because it was all that they had known. The youth had an awareness of what was going on (i.e. drug use, abuse, domestic violence, neglect) however they 95     had no frame of reference for knowing that these things were not typical of family life. This contributed to feelings of confusion because the youth did not always understand at the time that the family environment was risky and or harmful to their well being. Yeah, like I understood like they did something, my parents did something wrong and they needed to change before we could go back but then again I didn't understand like, really I didn't understand a lot so you could say that my dad was smoking cigarettes and he is going to jail for it and I would be like why is ? marijuana and beating my mom and stuff was a bad thing because that was normal for me to see. I didn't really have much just cuz like everything that I did have like my mom used to go into dumpsters and go in to get stuff for me and that was like her thing like she'd wash everything and you know and I was like when I was younger I didn't think it was that bad but now that I am grown up I know the difference. I was still young so I didn't know what was going on. I think pretty good but my n't. I just Some youth came to understand the experience of the family environment as risky/harmful through explanation. In these instances caseworkers helped the youth to understand why certain aspects of their experience posed a risk to their overall wellbeing through careful and simple explanation. 96     Everything that was going on with my mom, that was normal to me. I was ok. I made it day to day. But my caseworker explained to me that these are the risks of stuff that was going on and this is why things need to go this way that made sense to me what I think is normal it was really bad for me but at the same time it was normal to me too. For others, this realization occurred over time as they were exposed to different environments. I didn't um until after I was placed back with my mom I didn't like really see what was going on or that my dad was the bad guy like, I didn't know that . cuz I didn't want to believe that my parents were bad guys or whatever so. Summary These data reflected four different types of communication taking place during the process of removal: 1) preparative, 2) directive, 3) descriptive, and 4) no explanation. Child welfare system professionals typically relayed information pertaining to the processes they were facilitating or directly involved in. Police and CPS workers relayed directive explanations regarding the process of removal. They directed youth to for entry, what would happen, rules at placements, and what was going on with the case. Communication from the court system and GALs was very specific to explaining the court process and court orders. Members of the family system typically relayed information that describe for removal) and their thoughts and feelings about their family member being in foster 97     care. It is important to note that though these types of information were shared, all of these topics were not necessarily explained to each youth in the study. Most youth received explanations regarding some combination of these elements but not necessarily all. Some youth received no explanation whatsoever during the process of removal. Research Question 3: What Roles do Caseowkers, Therapists, Foster Caregivers, and Biological Parents Play in Communicating Important Information about the Reason for Entry into Care and what will Happen Next? Table 5 identifies the major categories and sub-categories of the communication process that are addressed by research question 3. Table 5. Major Categories & Sub-Categories for Research Question 3 Major Category Significant Events Communication with the Child Welfare System Sub-categories Removal Placement Understanding of family environment prior to care. Type of Communication Content of Communication Timing of Communication Police Child Protective Services (CPS) Caseworkers Foster Caregivers Mental Health Service Providers GAL 98     Communication with Biological Family Type of Communication Content of Communication Timing of Communication Parents Siblings Relative caregiver Perceptions Characteristics of Relationships with Biological Family System. Characteristics of Relationships within the Child Welfare System Out-of-Home Placement The earlier discussion of the types of communication taking place during the process of removal reflected that youth received explanations from a variety sources: CPS workers, caseworkers, foster parents (family, fictive kin, and unrelated), therapists, GALs, biological parents, and older siblings. Though the majority of the youth interviewed received some type of explanation at the time of removal many were still left with unanswered questions and feelings of confusion. The youth in this study received explanations from many different combinations of people over time. For many youth, the process of gathering information became a learned skill. Piecing it Together Overall, all youth, regardless of receiving an explanation upon entry or not, felt as though their understanding developed as they received various pieces of information over time. 99     Yeah we figured it out on our own, we all, we all had to mature a lot faster, just growing up in general and we had figured it out in our own ways through asking whomever and finding out and putting pieces together. We never really were sat down and told well your mother has a drug problem and we are taking you ey basically just ok, take us and we think everything is fine you know. Like he [counselor] took more time and I don't know he just seemed to help me piece things together. I was still wondering like if I'm going home and then my brothers set down told me that I have to start learning it piece by piece and I gotta start growin up more. t wasn't so much as like everyone in my home like, they kind of learned as I learned as well. And that's me hearing from the caseworkers and trying to put two and two together. The process of piecing together an understanding required youth to acquire knowledge from a variety of sources. For some, information seemed readily offered by Child Welfare Service providers and family members. For others, acquiring knowledge required an active process of pursing information from those who were perceived to be best suited to answer their questions. For youth who did not have a caseworker who initiated explanations, unanswered questions and feelings of confusion appeared to persist until the youth gained confidence to begin asking questions. I was little so I wanted my mama and my dad and I start asking questions 100     Well we were younger so it was just like I don't know, I had questions but I didn't know how to ask them to them. They just didn't they didn' Youth who entered foster care at younger ages believed that few explanations were provided to them because they felt perceived as being too young to understand. would just ask when I was going to see my mom. That was just the main question t I asked them [foster parents] and they said well we have to hear from your worker. Worker? I don't know what a worker is so I didn't know anything about that e being younger I feel like you know they weren't telling me everything Youth who entered foster care as teens commonly believed that few explanations were provided to them because they felt perceived as being old enough to understand what was going on. ow that I'm, we're all older we ask more questions, we weren't afraid to ask questions we knew how to a Yeah I mean we kinda knew everything that was going on or I kinda knew everything that was going on with my case because I was older and they had like certain stuff like I could ask questions because I kinda knew like different stuff that was going on. So as far as like the foster care part I don't I don't really think that I had a bad time with getting information from that or had a bad experience with getting information from it. Who is Responsible for Providing Explanations? 101     When asked whose role it is to provide explanations to youth entering foster care all but two youth believed that caseworkers have the primary responsibility to provide explanations about the reason for entry into care and what will happen while in care. Multiple youth referenced that it would be beneficial to include other key players such as foster parents and biological parents in the process of providing explanations. One youth believed that the biological parent should be primarily responsible and one youth believed that the responsibility would be best handled by former foster youth. All youth indicated that children entering foster care should be provided an explanation of what is going to happen, why it is happening, and what it means to be in foster care. The majority of participants believed that explanations should be provided by Child Protective Services or caseworkers at the time of removal. First Contact: CPS or Caseworker. worker or the DHS worker. Like rig Yeah it's gonna be traumatic but not knowing what is going on I think that would be worse. I think it should be their either PS worker or actual caseworkers once they get moved in to care. So that that way there no like lost even though their probably not going to believe them at the time they should at least like explain a little bit so then to where they understand what is happening so that they are not completely in the dark about it. I'd say they worker cuz that's they job to do that and not nobody else's job I think the next day they should come back out there and explain to why they can't see their mama. 102     Either the worker, the investigator, the person who takes them away, or say they should be informed right when it happens or if not before. Because it really, it really messes with your head wondering why when you have questions that are unanswered. Collaborative Effort Well I could say who is like most of the time is caseworker but... people who should, they should try it's the caseworker, the caregivers, and maybe someo time like you should be able to get like 3 different points of views and be able to ask different people different questions if you're not you know too-understanding what's going on. And I feel that would be beneficial. I know it. The DHS worker should be there, should explain it to you or your parents should get a chance Probably either they should probably fair warn you that you're about to go into foster care and either have the DHS worker and your mom there to try to discuss it with you and tell you full honest truth. Parent It's the parent's responsibility to explain everything to em so that they can actually admit to them that what they did was wrong. Former Foster Youth I guess other teenagers that went through it. They can explain it to em and tell ke going into foster care is not a bad thing cuz you get a lot of stuff out of it, not saying money and stuff, but you get a lot of stuff out of it. Or that you can use in the future or whatever. But I think 103     if anybody should talk to somebody that's bout to be in foster care or going through foster care it should be somebody that's been through it and knows what's going on. All but one participant believed that explanations should take place at the time of removal. She shared her rationale: I don't think it should take place right then and there cuz when you come into foster care you angry, you really don't want to talk to nobody, you don't want to hear what they gotta say. None of that. You don't want to be bothered with nobody, you just want to be where y like not sayin that it's a bad thing to have somebody come talk to you right away but most people like myself I wouldn't want somebody to come talk to me as soon as I'm entering in and I don't know what's about to take place, I really don't care to know cuz all I want to know is why I'm not at where I'm used to being at, why I'm not at home. Roles in Providing Important Information Role of Caseworkers Beliefs about who was responsible for providing explanations were consistent with lived experiences. Caseworkers were most commonly identified as playing the primary role in providing explanations about the reason for entry into foster care and what would happen to the youth in this study. Explanations provided to the youth in this sample were descriptive of the reason(s) for entering foster care and what actions were being taken. For some youth these descriptions also helped with understanding why certain elements of the home environment were unsafe. For the 104     youth in this study, explanations were provided at the time of removal as well as at later points during the time they were in foster care. he just explained that our dad got arrested because he did some bad things and that our mom knew about em and she just has to work out a few things and that we'd be going home soon. She kinda explained to us what she was tryin to do. She explained to us that she was tryin to find my mama and was explaining to us what was going on, why we was in the juvenile detention facility place and you know she was tellin us like she was going to try to recommend that we go somewhere else and stuff like that. my biggest thing I always say is what you think is not normal that's what's normal to m Caseworkers also played the role in describing what would happen while in care by explaining case goals. She explained that they would have to go to court a lot for us and we could only see our mom under supervision and that uh we weren't allowed to go back to my s back like do all her classes my worker at the time explained to me that my mom had to take all these classes in order to get us back and find a place to live and have a consistent job. Some youth did not receive explanations from their caseworkers. When this was the case, caseworkers were perceived as not doing their job. These youth shared their beliefs about the role caseworkers should play in providing explanations. 105     Listen to the kids that is going into foster. Listen to they side of the story. Most of em don't do that. judgment. Explain everything that's I guess just talk to them on their level. Sometimes you can't talk to the kids, you have to kinda get a feel for what they're like and then be able to kinda talk to them a little bit. Like let them express themselves a little bit, tell them who they are, like have the kid tell a little bit about themselves to get an idea what the child is like the child. Role of Biological Parents and Family Members For the youth in this sample, biological parents and family members did not play a primary role in providing explanations at the time of removal. Most explanations occurred after youth were placed into foster care. For these youth family members commonly helped them understand the circumstances that their parents were facing and how that led to entering foster care. She [aunt] told me that they'd watched the relationship between me and my mom and my mom going downhill for like the last couple of years and she felt guilty that no one, like she didn't step in earlier but no one knew how to handle it really so. She [grandma] mainly told me um my mom she was a good person at first and she had let some guy in her life ruin it she said um we weren't eatin good and um 106     sure we had clothes and shoes on our back. they [aunt & uncle] explained that uh that our grandfather was caught doing something with our sister and that while he was at the police station he said that our dad ended up molesting our sisters and then uh then our mom knew about it because uh our grandfather turns out he actually molested like 8 little girls including his own daughter and so everyone basically our whole family knew about it uh except for my aunt and uncle who I lived with. Anyone who had girls knew about it. So our mom was told by my aunt who got molested by him that he molests girls and all that and we were told that and that was about it I didn't really want to like I didn't want to hear everything but at the time it was like alright well I mean now I know why we can't live there. Role of Foster Caregivers Some foster parents explained the reason(s) for entering foster care. didn't really explain details of my case, they just told me like why I was in foster care And, it was helpful because it was like I didn't really know like I just didn't want me anymore. Foster parents more commonly played a role in providing explanations about what would happen related to placement and what would happen while in care. Foster parents provided these types of explanations while youth were in temporary placements during the removal process and at later times. She told me that my worker would be um wanting me in therapy which I didn't really care as long as I had a good therapist. She told me if I went to residential 107     she told me a lot about what residential was like about some places have uniforms some places don't you go to school either at the place or at a real Role of Mental Health Service Providers Therapists and counselors were not identified as playing a role in providing explanations at the time of removal. Instead, youth who became involved in therapy or counseling services sometimes received explanations about the reason(s) for entering care and what it meant to be in foster care when it was seen as relevant to treatment goals. The youth who had received explanations from therapists or counselors had been in care for an extended period of time before treatment began. He [counselor] played a big role. He explained things to me better than my aunt and uncle and he took the time to talk with me about em. Like he took more time and I don't know he just seemed to help me piece things together Yeah she was helpful she tried to explain us where the social workers were coming from and like their poi It helped because it gave us because we me and my sisters had a lot of hatred toward the workers and it helped us understand why they are doing what they are doing and really some of the anger and stuff. It helped it gave us a chance to let out what we had build up inside and stuff. Summary The youth interviewed shared their experience of piecing together information from various sources in order to develop a more cohesive understanding of the reasons 108     they entered care and what would happen while they were in care. The concept of piecing things together appeared to hold true for all youth interviewed, even those who had received explanations in preparation and at the time of removal. The youth in this study held a strong belief that it was solely the duty and responsibility of caseworkers to provide explanations to foster youth. Those who were not provided any explanation from a caseworker believed that their caseworkers had failed at doing their job. Foster caregivers, mental health service providers and biological family members also provided explanations to youth but their role was believed to be secondary to that of the caseworker. All participants expressed the belief that all youth entering foster care deserve an explanation of what is going to happen, why it is happening, and what it means to be in foster care. The majority of participants believed that explanations should be provided by caseworkers at the time of removal. Some youth believed that providing explanations should be a collaborative effort between caseworkers, foster parents, and biological parents. However, they maintained the belief that it was the caseworkers responsibility to facilitate such a process. Research Question 4: How does Communication from the Child Welfare System -of-Home Placement Environment? Table 6 identifies the major categories and sub-categories of the communication process that are addressed by research question 4. Table 6. Major Categories & Sub-Categories for Research Question 4 Major Category Communication with the Child Welfare System Sub-categories Type of Communication Content of Communication 109     Timing of Communication Police Child Protective Services (CPS) Caseworkers Foster Caregivers Mental Health Service Providers GAL Perceptions Characteristics of Relationships within the Child Welfare System Out-of-Home Placement Communication from Caseworkers & Perceptions One participant had only one caseworker while the majority worked with multiple caseworkers during their time in care (ranging from 2-15). Eco-map data revealed that seven of the youth interviewed viewed their overall relationship with caseworkers as strong while eight youth viewed their overall relationship with caseworkers as weak. Strong relationships most commonly reflected the flow of energy being reciprocal however, three youth shared their belief that their caseworker(s) put more energy into the relationship. The youth in this sample believed that it was the primary responsibility of the caseworker to explain the reason(s) they had entered care and what was going to happen while in care. Caseworkers were perceived as doing a good job and conveying a sense of caring when they communicated explanations to the youth in this sample. A predominant theme was that having a caring person from the system changed views of foster care. Strong Caseworker Relationship 110     The youth interviewed described becoming open to more favorable views toward various aspects of foster care at the time that a caring relationship with someone from within the system developed. she like she really does care it's not like it's her job you know she doesn't go about it like that. Like I know that I know as a person she actually cares about me you She has been a lot of help. Like um I didn't even meet her until like right before I left foster care she was our youth board member but since I was leaving foster care she was going to become my worker. She taught me a lot through last year and even when I met her. She like really caring. She actually cares she doesn't do it as a job. I feel like she is like my fairy godmother or something. She is really been there for me. I think it was about I don't know there was a, I got a caseworker and she seemed to make everything better. She seemed to be really good and so I think it was more the caseworker who changed my views on foster care and everything Youth commonly identified that act of keeping in touch as an essential element of conveying caring. It offered an opportunity to build a relationship over time. I'd see her at least once per month or she'd come and pick me up from school and we'd go out and have soda or something just so she could touch base with me so she could make sure everything was fine. She answers my phone calls for one and if she doesn't she calls me back you know. And, she like she really does care it's not like it's her job you know she doesn't go about it like that. Like I know that I know as a person she actually 111     cares about me you know  The way she helps me with things she really tries her hardest you know to do what she can and if she can't do something she explains to me why she can't do it. A sense of caring was also conveyed through the act of listening to the thoughts, questions, and concerns that youth expressed. Just being really understanding and um just talking to us one on one and just listening to us and everything. I knew I could say anything to my caseworker without it actually coming back to me cuz some of the stuff I did say that was actually tooken care of without, without me being the one that said something or without me being immediately moved. he listened, don't a lot of people listen. They don't listen to my side when I do open up to talk. I mean like if I told her I needed something she was there, if I didn't understand something you know she explained it to me just even coming out to just be around us it always it didn't look when she came out she never made me feel like she was coming out for a job. The youth in this study who identified strong and helpful relationship with their caseworkers described feeling more empowered to share thoughts and concerns about their placements because they trusted that their caseworkers would help them. I can um share more information and personal information with her than I would with somebody else and I like I since I have respect for her. I ask for her opinion in like um in what I should do in certain circumstances cuz I trust that she is 112     gonna say something that is actually gonna help me compared to other people where I didn't believe they cared. Weak Caseworker Relationship Eight youth experienced weak relationships with their caseworker(s). They described many variations in the flow of energy in these relationships. Five youth believed that the relationships were mutually weak and believed that both parties put little effort into the relationship. Some described the relationship as merely existing. One participant believed that the caseworker(s) put more energy into the relationship while two youth felt that they committed more energy to the relationship than their caseworkers. This occurrence usually resulted when the youth believed they always had to pursue their caseworkers. Communication from caseworkers appeared to negatively affect youth perceptions of out-of-home placement when youth did not feel as though they understood what was happening or why it was happening. Youth who did not receive explanations or received explanations that left them feeling confused tended to have a more negative view of the foster care system. Youth seemed to maintain a generally negative outlook until they met someone from within the system who changed their opinion. The youth in this study viewed communication as unhelpful when caseworkers were perceived as not caring. they don't get that they a couple workers that I had that just did not she came for a home visit she pretty much popped in and oopp like your 113     The youth in this study perceived their caseworkers as unhelpful and not caring when they were not in contact regularly or very difficult to get a hold of. Like it was hard to get in contact with them and if I did get in contact with them I got attitude from some of them they didn't care or the other ones they didn't get it. Like I tried to explain what was going on and they want to use like what to do like by the book and it didn't help nothing it just messed things up. We never really seen them that much. Just basically when we were being taken away. That was it literally. A worker didn't come see me until I already lived there and she was like I didn't see her that often she they always sent another worker in her place because she was having personal issues or something so I never saw her. So if I ever needed anything like I called her supervisor. Another aspect of unhelpful and weak relationships was frequent caseworker changes. All but one participant experienced multiple caseworker relationships during their time in foster care. On average the youth in this sample had 5 caseworkers. One young man had as many as 15. e'd get comfortable with one caseworker and then we'd get a new one. The youth in this study who identified weak and unhelpful relationships with their caseworkers commonly described being on the offensive to make certain to only say Many of the youth also interpreted placement moves being used as punishment and did not believe that they could trust their caseworkers to confidentially address their concerns. For example, youth were reluctant to share concerns about foster parents or staff at residential 114     placements because of prior experiences where caseworkers confronted the person(s) and the youth were later punished by the person after the caseworker left. It's just most of the time that they're afraid they'll tell them something and then they ask the foster parent about these allegations and then they totally deny them and then they get in trouble for it and so you why say anything if you're just going to get in trouble for it, just keep your mouth shut, that's what it's like. I remember like visiting her [mother] over the summertime a few times like going to spend the night and um I remember her yelling at me about something and I told my caseworker and she called my mom and my mom like told her like it wasn't a big deal it was over something small and stuff like that and they made it hat it was. From what I've seen and heard from other kids it's basically like the way they've acted and actually spoke their mind and said what they had to say or told the truth and stuff they've ended up in worse places or things didn't happen the way through and to finally then just be done with it. Communication from Foster Caregivers & Perceptions The youth who participated in this study experienced, on average, five placements during their time in care (ranged from 1-11). Only one participant remained in his initial placement for the entire duration of time in foster care. Eleven of the youth experienced a variety of placement types such as foster homes, relative placements, residential facilities, fictive kin placements, and group homes. The remaining 3 youth remained in one type of placement. Two were always placed with relatives and one 115     always remained in foster homes with unrelated caregivers. Eco-map data indicated that the majority (10) of youth in this sample had overall strong relationships with foster caregivers. Strong Foster Caregiver Relationship Youth described communication as positively influencing their perceptions of outof-home placements when it prepared them for what foster care would be like. She didn't give me all the details because she didn't want to scare me out of going to residential she wanted me to th she told me that she had a foster girl that she had for like a couple years just recently go to a residential place and she told me about how her experience was there. A young woman described gaining respect for her foster mother after she shared her experience as a former foster youth. We got to talk to em more and understand why they was foster parents and why they wanted to help us and stuff like that. So that kinda helped out a It was good to know because most of the time people don't do you right and the other people just want you to be there for the money or whatever and it was good to know that our foster mom, I don't know about our foster dad, but our foster mom um she had like a I remember her tellin us a story that her mom was with a guy who really didn't want to be bothered with kids so they lived in one house and the mom and and the boyfriend lived in a house down the street so that was like neglect but you know she was there but she wasn't and she was just sayin like she always wanted to like help out other kids who went through stuff like that. 116     Youth believed that this type of communication conveyed credible knowledge of the system and provided an opportunity for connecting on a more personal level that made them feel more comfortable. Perceiving foster caregivers as caring positively influenced perceptions of out-of-home placement. I remember that day was actually one of the best days we had down there cuz it got us to understand why she was doin what she doin and it showed me that day that she really did care about us bein there. Weak Foster Caregiver Relationship Four youth experienced weak relationships with foster parents. Some youth expressed feeling unwanted because of statements made by caregivers. At times, foster caregivers communicated frustrations with issues of money, age and behavior. Um I was only at this lady's house for about 4 weeks and she said I wasn't old enough yet and she didn't want to take on the responsibility of me and then I was moved I was 15 minutes late past curfew and they yelled at me like for 25 minutes and I just I was like whatever you know what, I'm over it and I started yelling back and I'm like I'm done, I'm sick of you guys yelling at me, you're not my mom and dad, that Monday I was moved placements. The first one they were just cruel and mean and in it for the money and I just e gonna quit, we were gonna quit, we were gonna quit, we were gonna quit, 117     that is not my problem that you took me in. That was your choice like don't throw that in my face. Oh you can't go on this family vacation because I'm here well Im In some instances these issues resulted in placement changes that were perceived to come about very quickly and without their knowing. I didn't know that all of our stuff was packed and ready to move to this lady's house that day. I had absolutely no clue whatsoever. And, I guess it was all done while Youth who had weak relationships with foster caregivers commonly described caregiver communication making them feel unwanted. This type of communication negatively influenced perceptions of out-of-home placement. One young woman succinctly summed up how many youth felt. I just thought it was that easy for people to just up and move people or kids. I was under the impression that there was really no place that I was going to be permanent at. Youth who had been placed in residential facilities expressed feeling as though they were being punished. They wanted to sen I told them I would A-wall if they tried to put me there and I'm not the type to A-wall but I'm not going to [residential facility] e al criminals or like really really bad and I was skipping school because I didn't know why. So that didn't really make sense to me but it was easy for them because whatever and I'd be there forever because you can't get out of there you know. 118     It was like you were in jail or Juvenile and it wasn't even our fault that we were in foster care and they treat you like you are the reason you're in here. So it was Like they really treated the people, the kids in those places like they are really mentally crazy. I'm like I'm not mentally crazy. I'm gonna turn mentally crazy if you don't get me outta here. I shouldn't be behind locked doors. I should be a normal kid in a normal setting and being able to be me. hat place sucked, it's like it's really like jail so when I was there I was always sad cuz it's like I'm being punished for something that I had no control over. Roles & Rules The youth in this sample described a mixed bag of reactions to foster caregivers communications about expectations or beliefs about new roles and rules. Some youth had difficulty adjusting to a new role of being a child given their roles as caretakers and protectors in their family systems. Many youth described feeling power struggles at some placements because they were not used to having someone be in charge and tell them what to do. She would say you're not his mother, you don't have to do that and you need to stop acting like that and act like a child. And I was like I protect my brother and that's just the way I was. I protected my brother and like I helped him out and acting like his mom and act like his sister. And I didn't know how to do that. She threw away a lot of our toys cuz she was like all about church. She was 119     and she ripped up all our Yugioh cards and she took all my brother's wrestlers and like threw em like just threw em like in a box and put them in the garage to let them sit there and like a lot of my clothes she like threw away cuz she thought that it was like inappropriate. Regardless of the strength of relationships, youth described this element of out-of-home of parents or younger siblings before foster care often perceived this element of out-ofhome placement to be very challenging. There was different rules at each place like obviously the placement we had more stricter rules and then like from living at my grandma's which was somewhat just basically make sure you're not failing any classes and just keep in contact basically but then when we moved here it was like rule city and I was kinda older so it was, it was harder to adjust. Communication from Mental Health Service Providers & Perceptions All but one participant was involved in therapy services at some point during their time in foster care. Thirteen youth were in individual therapy and 7 of those 13 were also involved in family therapy services. Five youth were also involved in skill building educational classes or groups. In contrast to the generally positive view of caseworker and foster parent relationships, the youth in this study expressed a general dislike for therapy services and the therapists that they worked with. Eco-map data showed that nine youth considered their experience with therapists and counselors to be weak and only three youth believed that they experienced a strong relationship with their therapist. 120     Strong Relationship with Mental Health Service Providers For the youth in this study, communication from mental health service providers did not usually pertain directly to out-of-home placement. Instead, communication from therapists and counselors affected elements of perceptions of the out-of-home placement in indirect ways. Therapists and counselors sometimes helped youth to understand elements of their foster care experience and on some occasions provided consistent supportive relationships. Finally they said well she doesn't need to be in here. She's perfectly fine, now. It's just she's going through some traumatic times which she's gonna need therapy for and they tried to diagnose me with bipolar at the age of 10. Mental health service providers were sometimes able to establish a comfortable treatment environment that youth found to be helpful. I felt I could talk to her. And I wish she would have kept coming out and visiting while I was staying with my mom my eighth grade year because it would have made it easier because I would have been out of that situation earlier. He just seemed to explain things and he made me feel comfortable while I was there. He would offer me popcorn, pop, a few times we watched a movie because it somehow fit in with what we were talking about. I don't know how but he just made me feel comfortable and everything. When mental health service providers were able to help youth better understand their life experience and why their caseworkers did the things they did their perceptions of out-of-home placement were positively influenced. 121     me and my sisters had a lot of hatred toward the workers and it helped us understand why they are doing what they are doing and really some of the anger and stuff. Weak Relationship with Mental Health Service Providers Weak relationships with mental health service providers shared many similar elements with weak caseworker relationships. Specifically, youth sometimes felt unheard and labeled by the professionals that they worked with. Two young women felt as though they did not have a voice in the treatment process and that their concerns about medication were not listened to. I'm the type of person I don't want to take medicine to rely on my problems so they thought the best was taking medication and it put me in the hospital psychiatric hospital 8 times. That's how to the point how bad it got. And when I went to the psychiatric hospital they prescribed new medicine and they messed me up more. Well we were at a TDM, a team decision meeting, and um I don't remember exactly the conversation but it was something about how I kept having changed my meds and it was really annoying and why do I even need em and you guys just put everyone on meds because that's just what you're supposed to do and they were like you are gonna need medication the rest of your life and I was like really? And I've been off my med was crying, I was confused. Nobody was explaining anything to me and I'm 122     sitting there in this small room in front of all these administrative people at the hospital and they're like ask me all these questions One young woman expressed her frustration of feeling that diagnoses were labels that followed youth and changed how foster parents perceived them. hitting people and wetting the bed. Maybe he fought with his little brother once bedwetter now. Summary Youth illustrated elements of their relationships with caseworkers using examples of unhelpful and helpful caseworker actions. The youth in this study who identified weak and unhelpful relationships with their caseworkers commonly described being on the offensive to make certain trouble. Many of the youth also interpreted placement moves being used as punishment and did not believe that they could trust their caseworkers to confidentially address their concerns. Some foster caregivers tried to prepare youth for what foster care would be like and shared personal experiences. This type of communication was perceived as an opportunity for connecting on a more personal level and made them feel more comfortable. Foster caregivers also communicated expectations about rules and roles. Some youth had difficulty adjusting to a new role of being a child given their roles as 123     caretakers and protectors in their family systems. Youth who had been placed in residential facilities expressed feeling as though they were being punished. Communication from mental health service providers seemed to indirectly affect elements of perceptions of the out-of-home placement by helping youth understand their experience and where caseworkers were coming from. Communications regarding diagnoses were sometimes viewed as detrimental labels that changed how caseworkers and foster caregivers viewed youth. Research Question 5: How does Communication from the Biological Family he Out-of-Home Placement Environment? Table 7 identifies the major categories and sub-categories of the communication process that are addressed by research question 5. Table 7. Major Categories & Sub-Categories for Research Question 5 Major Category Communication with Biological Family Perceptions Sub-categories Type of Communication Content of Communication Timing of Communication Parents Siblings Relative caregiver Characteristics of Relationships with Biological Family System. Out-of-Home Placement Parents were the most identified eco-map resource among the youth who participated in this study. Although the majority of the sample repeatedly entered the system and ultimately aged-out of foster care, nine of the 14 participants indicated 124     having a strong relationship with their parent(s) during their time in foster care. Eleven of the youth in this study maintained some level of contact with their parent(s). Two Communication from Parents & Perceptions The youth in this study identified parents as a strong resource during their time in care however interview data showed that biological parent(s) did not play much role in providing explanations about the reason(s) for entering care and what would happen while in care. The youth in this sample did not identify any type of direct communication from biological parents that influenced their perception of out-of-home placement. Instead, biological parents influenced perceptions of out-of-home placement as a result of strong feelings of loyalty that youth maintained throughout their time in care. Many of the youth referenced continuing the struggle with feelings of hurt but this did not change the simple fact that their mom was their mom. Loyalty I kinda was close with my mom but you know it's my mom when I was a child, I'm going to be close to her even though I didn't like her so much for what she did to me at that point. don't care who you is or what your parents do it still something inside of you that always make you love them and c Like alls I knew was that my mom loved me and that was my mom, I didn't have another mom, nobody else I could call mom or anything like that 125     For some youth, it was hard to accept the truth of the circumstances that brought them use and abuse to her caseworker. Um..I was told that my mom obviously abused me which I already knew. And at that point I was in denial and was like she never would have done that that probably like 16 or 17 and I still believed that my mom didn't have a problem. So that was like a big thing for me was that I was pretty much in denial just because I didn't know why they took me out of the home and then when I was told that she was also using drugs I didn't believe it until I seen it for myself. So it was, I had to see things in order to believe it I guess. One young man explained wanting to try to maintain some sort of connection with his biological family even after being adopted. technical term my step-dad's last name, and I didn't want to get rid of it cuz of when I found out he was my biological dad that also cemented me in not changing my last name I guess. So it was like it was like keeping something after him I guess. Communication from parents did not necessarily influence the perception of out-ofhome placement positively or negatively for the youth in this sample. Rather, perceptions of out-of-home placements were influenced by the extent youth hoped to be reunited with parents or they extent to which they felt that being in foster care was 126     the best option. Youth who did not fully understand why they were in foster care struggled with making sense of why their parents would leave them. what Youth who did understand why they were in care also struggled with feelings of hurt but they seemed to pertain more to anger and frustrations about specific actions such as substance abuse. my whole life was screwed up because you chose to be on drugs and right now act that my heart and my like no matter how hard I try it just it still always come back. Communication from Siblings & Perceptions Twelve of the youth interviewed had siblings. Nine of these youth had been together with siblings in at least one placement. One young woman had a brother but did not have a relationship with him because he was placed in foster care in another state before she was born. Three youth had siblings but did not live with them at the time of removal and were never placed together. Two youth did not have siblings. Ecomap data showed that nine youth who had siblings believed they had a strong relationship with them. The prominence of sibling relationships was also clearly reflected in the interview data. 127     The content of sibling communication was predominantly described as providing explanations of what was going on and providing support to one another. Typically communication between siblings was initiated by older siblings who were trying to help younger siblings. Explanation We just talked about like kinda how we felt a little bit and what we thought would happen. y brothers set down told me that I have to start learning it piece by piece and I gotta start growin up more. they say that my mom wasn't great at all. They said they was, she was ime so you never knew about it. y sisters would know more stuff than I would know or I would know more than they would so we were like Perhaps the most notable element of sibling communication was the strong sense of support that it provided. Siblings were able to have familiar companionship as they entered unfamiliar territory. Support when we were in there, we would talk a lot because we shared a room together. We talked and we cried and you know and we Me and my older brother we would talk sometimes and like it got to the point where he wanted to run away and like we'd be like well we want to be together so 128     we can't really you know. Don't say anything. We want to be together. We were scared, where else were we going to go at that time? It was like hardly nowhere for us to go. Some youth who were the eldest of the siblings felt a sense of obligation to stay strong for their younger siblings even when if it meant putting their own needs aside. One young woman shared how challenging it was for her. We talked to each other all the time but the thing is the thing was was even with us talking I still just always felt like I ain't have nobody to talk to that I can just be totally honest with. Like today I feel like my whole world is gone and I don't want to live anymore or because I didn't want my sister to get like that cuz she would feel like that too. Communication from siblings did not necessarily influence the perception of out-ofhome placement positively or negatively. Instead, ongoing communication about what was going on and how each other were feeling affected youth by providing a sense of getting through foster care together. They were not alone. Communication from Relative Caregivers & Perceptions Communication from relative caregivers existed in a variety of forms and purposes. The youth in this sample described types of communication that positively affected perceptions of out-of-home placement and negatively affected out-of-home placement. Strong Relationship with Relative Caregivers Youth described communication as positively influencing their perceptions of outof-home placement when it explained what was going on with their case and offered a 129     family perspective of the circumstances that brought them into care. Youth sometimes received explanations that helped to shed light on the circumstances that brought them into care. told me that she like they'd watched the relationship between me and my mom going downhill for like the last couple of years and she felt guilty that no one like she didn't step in earlier but no one knew how to handle it really. Some relative caregivers provided ongoing communication about the court process, placement details, and untangling misinformation. hey would just tell me like well we had court today and this is what happened or if they went. Well she [Grandma] just basically would tell us like that they are they don't know when you're getting out. She would tell us the truth. You know don't believe what getting out and then we never got out that day and then it would be prolonged. She just basically sat there and helped us with the would talk to her about it but they wouldn't talk to us about it. Well she would like talk to my worker and um she would tell me well this is what the social worker said. We had plenty of talks about everything all of the whole little processes and how I felt Some youth had very positive experiences with relative caregivers and felt that entering foster care was not as disruptive because they were with people they were used to. Youth who experienced relative placements sometimes described the familiar environment as helpful in easing the transition into foster care. 130     because I was like always with family or friends One young woman believed that she would have been worse off had she not been placed with relatives. worse off. But I would probably wouldn't be headed where I'm headed. Like they helped me a lot you know because I till I was staying with them or the right support Another young woman described relatives providing reassurance that they wanted to keep her with the family. me more and they feel I shouldn't have to go through it and they would say oh well if I had the ability or if I could take you in I would. You shouldn't have to be going through that or whatever. I think my aunt she's more passionate she's because it's a cycle basically. I was always placed with relatives or close kin or feel like maybe I sometimes it was a hassle for them but they always told me A young woman and young man also explained that having family members keep in touch and maintain a relationship with them helped them to adjust. 131     I probably would've felt more emotionally distressed you know like or felt like no one cared about me or something like that cuz I know that is a big issue for a lot of people in foster care but it wasn't so much for me because I knew that back at my real home I still had people there that cared about me. I started understanding like what was going on so I started like spending time with my family and with my aunt and uncle and my brother and started hanging out with like kids in the neighborhood and everything so I out of my shell. Youth believed that explanations and communicating a desire to maintain a relationship provided opportunities for connecting on a personal level that made them feel loved, supported, and comfortable in their placements. Weak Relationship with Relative Caregivers Youth who had weak relationships with foster caregivers commonly described caregiver communication making them feel unwanted or as if they were a burden. This type of communication negatively influenced perceptions of out-of-home placement.   Some youth described receiving messages from their relative caregivers that indicated that they were too much to handle. At times, youth described that caregivers communicated frustrations with issues of behavior and money, and judged them.   I was cutting and smoking weed and being promiscuous with boys and so my aunt and uncle were like oh my gosh what's wrong with this girl and they after about a year they were like alright um we can't deal with her we don't know how to help her basically was it and so I went to this foster home for about a month. 132     Some youth in the sample reported having to constantly manage feeling unwanted or as if they were a burden. Well my uncle said that he want, that he could take us and he didn't mind having us come down here and live with him and so we did but we got down here and it took it to like more of a money issue more than anything cuz always said like my family they was more, most of them was more on the money issue side or just couldn't help us at all , it wasn't even about affordin. it was just sad to know that like I said the people that supposed to love you, mama, daddy, auntie, uncle, whoever nobody really did and then I just felt like people was blaming me for stuff that I really had no control over. Like I used to always sit and think like I didn't ask to be born um..why I had to be born into this family? and just stuff like that. A handful of participants expressed feeling judged by their relatives. just allow it. We would tell her they were doin it and she wouldn't do nothing being fast. Which I'm not fast, I didn't start having sex till I was damn near grown. I felt like we were judged a lot more so with family just because of our parents and their situations. I felt like we were always judged upon about their actions or what they've done that we're gonna be like that This type of communication negatively influenced perceptions of out-of-home placement because it made youth feel unwanted or as if they were a burden. Roles & Rules 133     Communication regarding changing roles was also mentioned by the youth in this study. Youth and their relatives experienced a shift in the roles they played in each denly, sisters and aunts were acting as mothers and uncles as fathers. Some youth described the challenges of looking at their relatives in a new light. I knew my stepsister since I was little so I like knew like the little things like growing up I knew the little things that my sister got in trouble with school with so like I knew that if I threw somebody into a locker at school I could say well you did it when you were in school and I could just throw it in her face like how are you much better than me? The first time it was like ok I'm here with my cousins, I'm here with my aunt e like we started having to do more chores, or we saw a little favoritism kind of as far as self-esteem. One young woman described her struggle to make sense of her aunt as the person responsible for reporting her mother and the person who was taking care of her. Well my Auntie that put us out she's like still to this day she be like your Auntie tell you or she make it like she tried to prevent us from going to foster care but she really made it harder for us. I mean she made it so that we go there because she wasn't getting what she wanted so she didn't want us. She didn't care. The youth in communications about expectations or beliefs about new roles and rules. Regardless of the strength of relationships, youth described this element of out-of-home placement as a challenge. 134     Summary The youth did not identify much direct communication from parents about the reason(s) for entering foster care or explaining what would happen while in care. Many youth described their struggles with feelings of hurt that stemmed from the actions of their parent(s) that brought them into care. In addition, youth reported loyalties to their parents that persisted throughout their time in care. Siblings played an active role in providing explanations of reason(s) for entry and what would happen while in care. Siblings usually did this by regularly sharing their understandings and impressions of what was going on with other siblings who had a lesser understanding. Sibling communication also appeared to serve as a form of support. Siblings could understand what each other were going through. Relative caregivers such as grandparents, aunts, uncles, and older siblings also communicated their perceptions of the reason(s) for entering foster care and made attempts to keep youth updated of court proceedings and placement decisions that were being made in their cases. Youth described this type of communication as positively influencing their adjustment because it conveyed a sense of love and support that made youth feel comfortable. Some relative caregivers also communicated frustrations about behaviors and money, and passed judgments. Youth expressed that this type of communication affected their perception of out-of-home placement by making them feel unwanted. Research Question 6: What Strategies do Youth use for Coping with the Transition to Out-of-Home Placement? Table 8 identifies the major categories and sub-categories of the communication process that are addressed by research question 6. 135     Table 8. Major Categories & Sub-Categories for Research Question 6 Major Category Sub-categories Adjustment Coping as an indicator of adjustment: o Learning to play the game: What to say o Who to be o What to do The youth interviewed identified many different coping strategies to adapt to foster care. Some youth described believing that the coping strategies they used were detrimental to overall well being. Keeping true feelings inside, avoidance, acting out, and self harm were often described to have worked temporarily but feelings persisted over time. Youth also accessed social supports and therapy services, found creative outlets, exercised, shared their story with others. Keep True Feelings Inside Many youth shared that they often used strategies for masking how they were really feeling. Keeping their feelings inside was characterized by isolating oneself, not wanting to feel pain, and being strong for younger siblings. Homework or sleeping, just kinda isolating myself. I really just tried to block everything out. I became cold like I didn't want to think about it or feel any of the pain that was going on. instead of being like why am I here his is the worst thing that has ever happened to me like crying about it or getting mad about it like I just kept it all inside just did what I had to do. I was strong for my sister. That's why like sometimes I just sit here and I just think I feel like I missed out on a lotta stuff and like that's the type of stuff 136     that sometimes it makes me mad because I had to sacrifice stuff that I need like I need an education, I need to know what I'm doing to make it in like everyday life and I feel like I got cheated that stuff because I had to work extra hard to make my sister feel like we gonna be safe or extra hard to pretend like everything ok when really it wasn't. Avoidance For some youth, attempts were made to avoid feelings altogether. Despite their efforts, feelings persisted even if they were able at times to be temporarily ignored. ng depressed and suicidal at one point. Fake it. Laugh when laugh when I want to cry act like stuff ain't wrong I mean I guess when I got depressed I would just act like everything was ok when it wasn't. Or Just being uh I mean like when you feel alone it is a different thing in itself and we feel like it ain't nobody else I mean there's nobody you can talk to that is hard to do. I mean I carried that for a long time it cuz it goes beyond a point of being in foster care this is like my whole life. It was my whole life for my mama to be gone at weeks at a time and don't come back and I don't know if she gonna come back. I really didn't deal with it. Like I said I was still angry, I'm still angry today. I still haven't dealt with it. The issues I have within myself but one day I'll deal with em. Self- Harm A few youth used self-harm strategies as a way of coping with feelings they experienced during their transition to foster care. Cutting was a common strategy and 137     three youth had been actively suicidal at some point during their time in foster care. I was cutting and but like smoking weed and being promiscuous with boys henever I would be mad or sad or anything I would cut myself. Then I was like alright this is getting old and I keep getting in trouble so I should probably stop. I get depressed real quick, real easy. I had a nervous breakdown. But I get depresse I have tried hurting myself through all this that I have been through. I did say I like, I don't want to live because I can't be with my mom and if I can't be with my mom I just want to die. I didn't mean to say that but that's how I felt cuz like I felt like I was dying. I felt like I was dying without my mom cuz through it all my mom was there no matter what even when she was abusive. But when the medications came in it made me act on suicide. Acting Out Acting out occurred in a variety of forms. Acting out of anger and frustration was described as stemming from feeling unloved, lacking attention, and losing hope. I would've just lashed out with anger. Like everything would change, one moment Everything good you have in your life goes away so it's like you just get to the point where you have no expectations for anything good in your life. I would skip class a lot or I would skip school like go to school and then leave with my boyfriend who like graduated 138     that's only because I went through this I don't care phase, whatever I'm a do whatever, oh well, who cares not me. And then with drinking I used to drink but every time I got drunk I just remember how sad I was or how like I remember how I loved everybody but it ain't seem like nobody love me. they [older boyfriends] showed me the attention my sister couldn't give me. Like my sister didn't have time to just sit down and hold me and tell me everything Social Support Many of the youth interviewed accessed social supports to find an outlet for Confiding in, feeling heard, and feeling understood by someone. So just kind of like I've always had a constant someone there. I changed schools, I also changed friends but when I changed friends they were just school friends I just enjoyed my time with you know my friends and family that I did get to see. my best friend that I made there she was in foster care because she got pregnant and her dad couldn't take care of he our experiences weren't similar but you know just talking about it with each other and just like laughing and joking around and like having good times between us like it helped us a lot I think. I had gotta say that going to church was the most positive thing out of everything because when I would go to church it had start teaching really hated a lot of things and a lot of people when I was younger Creative Outlets 139     I Youth engaged in a number of creative activities to provide distraction and a way to express their feelings. I used to have a diary and I used to write everything down or I'd write music. I'm more artsy than anything so I like to show my emotions out and so that was kind of a big thing like I just be able to you know write down how I felt or show how I felt or draw. o writing really helped. I don't really write much anymore although I am writing a book and it s gonna be basically about all of my experiences. like I'm the person to collect cars. Ok. So that is mostly what I'd be doing- collect cars to make me feel much bett I read books. I would just read to get my mind off things. I would write in a journal some times. Listening to music helped a ed so I did po Sharing their Stories Many of the participating youth felt empowered by sharing their story with other foster youth. Sharing their story allowed an opportunity to feel helpful to others in the same situation and to recognize that they were not alone. Well I took the experiences that I was going through and I started helping others. I was telling my story. If I've been through that situation I'd tell them how I dealt so I took whatever the situation was and looked for a positive outcome out of it. Like what I could a done better or what helped me get through that and I would like, a lot of the girls in the 140     placement would come to me for advice because like I always had a story to tell. Like I always had a story in my life that could relate to what they were going through so I was able to uh help them out. I was more open like as I got older and kind of like learned to share my story and that it could help other people by knowing like what I've been through like the same thing had happened to them or their kids or whatever. So that was a big thing for me - actually realizing that I'm not the only person that it happened to and that I'm not a statistic. That's now I want to achieve and I can overcome it. That was a big thing for me, realizing that I'm not the only person. Therapy Overall, most of the youth interviewed did not have favorable views of therapy. However, a few youth found that therapy was a helpful experience. I agreed when my foster mom and my worker told me that I really need to work on deep issues with my therapist at the residential facility because I didn't want to carry that baggage around anymore. fter I became suicidal in 7th grade I got put into counseling and then I started doing counseling like 2 times a week every week and I think that really helped. Physical Activity One participant identified running as a very important strategy for coping with her experience. When my mom passed away I joined track and I ran track through the school so I would have alone time where I could think about my mom or think whatever I wanted to think and I just finally got really upset or thought something I could just 141     run fast or slow down or I could cry and like nobody's really gonna pay attention you re on the track running all by yourself. Summary The youth in this study employed a variety of coping strategies. Some of these strategies were healthy and adaptive in the process of adjusting to the foster care experience. Youth accessed social supports and therapy services, found creative outlets, shared their story, and exercised. Some strategies were more detrimental to overall well being. Keeping true feelings inside and avoidance often worked temporarily but feelings persisted over time. Self harm and acting out presented physical risks to the youth. In more severe instances attempted suicide threatened the possibility of death. Research Question 7: How do Youth View Race, Ethnicity, Culture, Religion, Gender, and Sexual Orientation in Relation to their Experiences of Communication and Adjustment to Foster Care? Table 9 identifies the major categories and sub-categories of communication that are addressed in research question 7. Table 9. Major Categories & Sub-Categories for Research Question 7 Major Category Communication with the Child Welfare System Perceptions Sub-categories Type of Communication Content of Communication Caseworkers Foster Caregivers Characteristics of Relationships with Biological Family System. Characteristics of Relationships within the Child Welfare System 142     Table 9 (Cont d) Out-of-Home Placement Adjustment Coping as an indicator of adjustment: o Learning to play the game: What to say o Who to be o What to do Race/Ethnicity/Culture Fourteen youth participated in the study. The sample consisted of 10 female and 4 male participants from Southeast and Mid- Michigan counties. The average age of participants was 19, with the youngest being 18 and the oldest being 23. Eight participants were Caucasian, three participants were African American, two participants identified as multiracial: Caucasian and African American, and one participant identified as multiracial: Caucasian and American Indian. Over the course of the interview process youth often felt that they could only speak to their own lived experiences and did not know if youth of races other than their own had a different experience. African American, Caucasian, and Multiracial youth who remained in primarily relative placements or placements with a caregiver of the same race tended to share the opinion that all foster youth are treated the same. An African American young woman shared her belief that youth of different races did not have different experiences in foster care because all foster youth were treated poorly. 143     Everybody get treated the same in foster care. We all go through the same stuff. basically feel the same way like nobody really care we just got threw up in the system, nobody really cared about us. We all feel the same, it ain't a Black kids get treated worse or none of that, it's just everybody, all the kids. One African American and two Caucasion young women expressed the belief that race did not affect adjustment as much as other factors such as emotions, beliefs and poverty. I have friends and they have different races and stuff like that and at the end of the day being in foster care the first thing that's going to come is what did I do? The second thing is nobody is going to love me and that is regardless to race, gender, whatever. Those be the main two things, what did I do and why don't nobody want me or Depends on their family's beliefs and stuff and how they do things. I just believe that every family is different and not really so much the race and everything else. Well when I was in the Residential facility, I was the minority for a while because there are more Black girls. There was never any other mix, there was never Mexican or Indian or anything like that it was always Black and White and every single girl there had some family in the system or some fam I don't know if it has to do so much with the race there as it did with like poverty because I mean just because you're Black doesn't mean you're poor and just because you're poor doesn't mean you're Black. I think it has more to do with 144     financial than it did with race but you know maybe it was just a coincidence that you know that they all had all these problems Race Does Matter Most of the youth who expressed beliefs that race did affect adjustment had experienced placements with caregivers of races other than their own or were placed in a neighborhood that had different racial compositions from their original neighborhood. In this sample, all youth who had this experience were Caucasian. All of my friends were like preppy little white kids you know and I went to a new city and new school with like 3,000 Black kids that I never like associated with in my life. So I had no friends, no one wanted to talk to me they were just like what are you doing here? So I just went to school did my work and then came back. Because first I'm a 14 year old white girl in an all Black neighborhood so they're gonna automatically think probably a hooker or a little, another little slut on the street Another reason why I was truanting was because I lived with an all Black family and of course I'm a white girl in this black family and they don't kinda take too kindly to it. Like I asked them do you go to church they said yes, I said oh cool like can I go to church with you you know and it was always you don't have the right stuff to wear for church people are going to look at us if we bring you to church with us , you know things like that. couldn't even walk down the street without people going , little girl and they're like trying to shout out at me and say degrading things about me. 145     One Caucasian young woman explained her frustration with beliefs held by a foster parent. he's not racist but I don't know how you can not want a Black person dating a white person and then say you're not racist so he was like that and then of course every Black guy in the world seemed to be attractive to me. So I did that kind of rebellion thing and um I was getting into trouble with the boys. Not just being with them, just dating them or liking them was a problem. Culture. Some youth expressed that cultural changes such as the types of food people eat, the music they listen to, and the kinds of clothes they wear affect adjustment to foster care. These changes occurred both within the placement and at school. This belief was held regardless of placement type, race, and gender. sometimes people eat different food that maybe the foster parents don't eat or uh the different clothes that they wear or their different lifestyles and kids get teased for all that stuff because we're just all unique and we come from different backgrounds and a lot of people don't see that. And even foster parents, they don't understand that. There were already cultural differences in the school. It was different races and different people acted different ways and I just felt like uh ok and I'm stuck between maybe three or four people like I don't know I wasn't used to like different cliques. And different as far as like probably races and stuff that was something new. Or people how they looked at you when you said certain . 146     I knew certain things were tradition for my family and everything like that but then when I moved in with my foster parents I learned how to cook certain things which now I still make. So I have an eclectic like cookbook of everybody's little stuff that they used to make. Thoughts on Adjustment A multiracial young woman shared her thoughts about the ways race and culture can affect adjustment to foster care. If you are used to one certain way like even an environment and then you go to a whole different environment and a whole different amount of people there they are going to have like a harder time adjusting. For me growing up in a city and like being around a city, like if you would have took me out to a rural city or something I would have been like culture shock you know. Like help I'm not used to this ut yeah, I figure like the background and the environments definitely does have a toll on how they adjust and different experiences because it also like with race it might be discrimination or you know might feel out of place even with cultures. If you're..you have a different culture than those around you, you might be picked on or they might not understand or you might feel like out of place or maybe you shouldn't embrace your own culture and you should pick up theirs and it's a lot of confusion affects us a lot even if you were placed with the same culture. It affects you then, it affects them different cuz you're like this is something I'm not used to. Are they going to act different towards me? Or do I have to start doing what they are doing? Like even 147     different foods, different types of clothes, different types of music. Every little thing affects you. Gender The sample consisted of 10 female and 4 male participants. Female participants were asked to reflect on their own experience and their thoughts about the experiences of youth of the opposite gender. Female participants commonly thought about male peers who had been in foster care and shared their thoughts about how they responded in similar and different ways. Male participants demonstrated much more difficulty in this process and all but one reported being unable to speak to the experience of female foster youth. As a result, all quotations regarding the experience of female foster youth are from female participants. Quotations regarding the experience of male foster youth are a combination of both male and female responses. All youth responses pertained to how youth cope with being in foster care. Some youth reported gender differences in the ways that male and female youth cope with being in foster care. Some youth believed that there was no difference. Female I guess would be like going out with boys and drinking and stuff like that. Girls probably do experience it differently because uh like um uh residential placement there's more residential facilities for females than there are for males. There's only like one or two in the state for b I just think I just learned this in sociology because more females they tend to irls are always you know more the like emotional type you know more caring 148     I think being female you still look for that stuff that you lacking...Mainly just the Cuz either you gonna look for it or you gonna block it out and either way it's not good. And then just missing out on like having my mom there to be there and just talk to me about stuff that only a mom would know the answers to. I took more of the guys approach, I just shut down, I know I did. I let myself really feel like I was a part of their lives. I called these were my siblings and I let myself do that and my foster brother was not like that. Male a lot of em a lot of em had a more rebellious time than I did. They lashed out more and they you know they got in trouble more or they experimented more wit I think boys want to feel more independent, they'd rather not have to deal with this they'd rather just go out on their own and take care of themselves. I think that the adjustment things are different because I mean a boy is not going to just sit there and cry or you know I think they're going to find, maybe they might resort to anger or they might have find a different technique. I mean I know guys shut down The feelings and emotions or they do stuff to just really don't make sense or develop like a care free heart. uys can handle it more which isn't always true I have seen guys cry plenty of times and show emotion as they portray themselves all the time. 149     everybody can be as strong ell as far as like my brother I mean he was there, he wanted to be well I don't know, he wanted to be protector over me He didn't call our foster mom mom, he didn't like he would refer to us as his brother's and sister's when he was like joking or like at school where he came from, he's older...I guess he didn't want to settle down because he wanted his own thing. He didn't want to be a part their life, he wanted to be his own life. No Difference I think we all feel the same because the way I've seen people who've been in foster care, like boys and stuff, they seems like they have to same emotions and like the way I've talked to them and stuff they seem like they they feel the same exact way throughout the whole process and everything that they've felt the same way. I don't want to say there's really a difference between I mean you know genderwise there's not much of a difference, the difference are so much between person to person it's almost like it's irrelevant for the most part. actually no, there really is no difference because there is no difference because some girls they try to do that too but some boys will probably stick it out wants to come out and succeed and be on their own. One young man thought that the gender of the foster caregiver might play a role for both male and female foster youth. 150     t depends on like who they get a sent with. Like whether its maybe they're just a single parent maybe if it's a mother then a boy won't really have a father figure to talk to and if it's a girl and a parent is a father and stuff like that. Religion Youth described religion influencing communication and adjustment to foster care in a number of ways. Some youth shared their experience of how the religious beliefs of their placement affected their lives. Influences seemed to be conveyed in the form of rules about the types of belongings youth could have or rules about church attendance. Rules he threw away a lot of our toys cuz she was like all about church. She She was like all like this is the devil and this is the devil At my first home religion was a really big thing. When I was a different placement after that they were like the same way but they didn't force you. If you wanted to go, you go. If you didn't, you stay I mean the girls home like they would try to pressure us to go to church a lot but I didn't want to go to their church, it was different than mine it wasn't like a different religion it was just a different atmosphere it was just I didn't want to go. Support from Foster Parent A few youth described their foster placement supporting their participation in church as well as spiritual growth. 151     verall here is really good especially spiritually for me. I can grow here more I was really like into church for real and only time I missed out on going to church was when we had to go to another city and I missed a couple of times but my foster mom did drive us down for church service...she drove us down for church service one day and then one time she drove us down to pick up my best friend and we went to the church because they had some afternoon/evening activities going on. The influences of religion on adjustment also were expressed in forms that were more personal to youth. Some youth described religious beliefs and church participation as a source of strength and a strategy for coping while others questioned God. Source of Strength & Support I think when I was younger I think I was going just to get out the house or have something to do. I d for the fun of it. it but at the same time I grew really close to God while I was there which helped everything because he was my priority and not where am I going to live after this and so that helped I started going to church. That was a positive thing because it just helped me get stronger in just life. I really didn't like start understanding what real love was and just the definition of being happy and not worrying about a lot of the stuff until I really started until I really started getting to church. 152     Questioning God Probably most of the kids who are even thinking about religion are probably claiming to be atheist because they are so mad about what's going on. So, if that's the case like I'm just thinking about a random boy in a random foster home like Christians alright, and he's like I hate God I'm not going to ch I don't think they'd let him stay home, he'd probably have to go and he'd probably just be sulking but oh well that's what you do. I remember when my mom would go out I would sit in the room and I would read a verse from like the Bible and a couple times it would seem like when I would do that she would come home. So I always felt like if I did that it would make her come home which it sometimes which when it didn't work I would be upset and I would be more mad like why god? Self Disclosure As with earlier responses about race and gender, youth expressed difficulty speaking to sexual orientation and adjustment to foster care because all youth in the study identified as heterosexual. As a result, the researcher asked a broader question of whether youth in foster care were free to be their true selves. This broad question yielded a variety of responses that appeared to converge around fears that sharing their true identity, thoughts, feelings, and beliefs would bring about negative consequences in their placement environments. Not Free to Be Me 153     like myself after being in a foster home. I'd feel like I was someone else instead of myself. I feel there is a lot of stuff that that you can't say, you can't do and you have to keep it that way because you don't want to get into trouble. You don't wanna lose trust you don't want to get judged upon. There's a lot of things that kids, kids are afraid to say to people or tell or talk about because of what they are afraid of. They either wanted you to be a certain way, get good grades and you know be basically you beco you have to follow their religion, you have to be what they are and do what they do and see things how they see It was hard because you have certain beliefs and like you have to go by what their beliefs are and it like hurts cuz like you have certain beliefs and you don't want to go against them but you have to. I just would keep my beliefs like inside and just always remember them even though I was doing other stuff I would just know in the back of my head what I truly believed in. F But like its kinda hard because place. , It's kinda hard. Feeling Different 154     a stable Youth further explained that constantly feeling different from their peers affected their relationships with others. Youth described a variety of stereotypes that they had encountered at school and in the community. Stereotypes Some youth felt that others sometimes assumed they were juvenile delinquents, runaways, orphans, or stupid. eople view you differently like if you let em know you are in foster care and because most people think foster youth are juvenile delinquents and stuff or runaways or something like that. ome people might look at them like they must have done something , it's probably their parents' fault I was teased growing up. I was called an orphan. I was, people would talk about They would just and the main thing was we get called orphans because we don't live with our parents. That's what, like a lot of outside kids that haven't been through it they, they look at us as if you're an orphan, you know. You don't have parents because you don't live with them. Well I do have parents how do you think I got here? Most people don't know what foster care is. They still think about orphans and like oh well did you, are you like an orphan people are so ignorant to the fact about foster care that they make misjudgments or stereotypes and they say oh 155     well they must be a bad kid if you're in foster care, no. Or you must be stupid or Shame Some youth described restricting what they told people or even avoiding certain social situations because of feeling shame about revealing that they were in foster care. I didn't really tell too many people. Like I didn't, I was ashamed to tell anybody like oh you're foster care. Or people like when they do find out they try to be like try turning you into a charity case. hat was a big struggle like and a lot of kids get judged because they can't do anything. They are pretty much secluded from a lot of things. School The youth interviewed described difficulty making friends because of frequent moves that resulted in school changes. after a while cuz I'm like what's the point of making friends, I'm a have to move again or there's no point in you really getting to know me, I'm not really gonna say too much, no point in you knowing me cuz I'm gonna leave soon. Youth also indicated having experienced different treatment from the teachers who were aware that they were in foster care. When they would come up to our schools and stuff all of our teachers would know and stuff and felt like they were all like tryin to like feel bad for us or some 156     of em I was always like I don't want to be treated different because or let that slide, like no I want everything to be strictly how it should be. Like I want to be graded upon my effort and what I've done not because you feel bad that I have i they were judging us based on everything they had known and were informed. I felt judged when, if my teachers found out they knew or they would be like more sensitive towards me and that's not what I wanted I want to be treated like the rest of the kids. I didn't want to be different. I didn't want to feel that I was being babied or special because of something that has happened that shouldn't a I shouldn't have been special for it because I didn't feel special for it. Summary African American, Caucasian, and Multiracial youth who primarily remained in relative placements or placements with a caregiver of the same race tended to share the opinion that all foster youth are treated the same. Youth who expressed beliefs that race did affect adjustment had experienced placements with caregivers of races other than their own or were placed in a neighborhood that had different racial compositions from their original neighborhood. Some youth expressed that cultural changes such as the types of food people eat, the music they listen to, and the kinds of clothes they wear affect adjustment to foster care. Youth who had described race and culture as affecting the process of adjustment to foster care indicated feeling as though they had experienced confusion and discomfort in their environment. The youth believed that it 157     was difficult to adjust to foster care on its own and every little difference in the environment contributes to the challenge of getting used to something new. Some youth explained that racism, discrimination, and feeling out of place contributed to feeling uncomfortable. One young woman referenced the confusion of trying to decide whether to embrace her own culture of the culture of the placement. Some youth reported gender differences in the ways that male and female youth cope with being in foster care. Some youth believed that there was no difference. Female youth were described as more emotional, more open to foster caregivers, and searching for love. Male youth were described as independent, shutting down emotionally, and more likely to rebel. Some youth shared their experience of how the religious beliefs of their placement affected their lives in the form of rules about the types of belongings they could have or rules about church attendance. Some youth described religious beliefs and church participation as a positive source of strength and strategy for coping. Others questioned or were mad at God because of being in foster care. Youth expressed difficulty responding to the question of whether sexual orientation influences adjustment to foster care because all youth in the study identified as heterosexual. As a result, the researcher asked a broader question of whether youth in foster care are free to be their true selves. This broad question yielded a variety of responses that appeared to converge around fears that sharing their true thoughts, feelings, and beliefs would bring about negative consequences in their placement environments. Youth further explained that they were also constantly managing feeling different from their peers. Chapter Summary 158     All participants expressed the belief that all youth entering foster care deserve an explanation of what is going to happen, why it is happening, and what it means to be in foster care during the process of removal. The youth interviewed shared their experiences of piecing together information from various sources in order to develop a more cohesive understanding of the reasons they entered care and what would happen while in care. The youth in this sample received explanations from caseworkers, unrelated and related foster caregivers, GALs, mental health service providers, and family members. The concept of piecing things together appeared to hold true for all youth interviewed, even those who had received explanations in preparation and at the time of removal. Youth felt the need to piece things together because their informational needs were met to varying degrees. Some youth were merely directed what to do, some youth received extensive explanations, and some youth believed they never received formal explanations during their time in foster care. This appeared to partly exist because the sources of communication from the child welfare system generally spoke to the processes they were involved with. And family members typically relayed for removal) and their thoughts and feelings about their family member being in foster care. In a similar fashion, youth commonly translated their pieced together knowledge into an understanding of how to navigate the system. Youth shared that they observed caseworkers, foster caregivers, mental health service providers, and other foster youth child welfare system wanted to hear. Many of the youth viewed this as an adjustment 159     survival strategy that was a necessary part of ensuring or preventing particular outcomes such as placement changes. Relationships with caseworkers were a critical element in this process because the youth in this study held a strong belief that it was solely the duty and responsibility of caseworkers to provide explanations to foster youth. Those who were not provided any explanation from a caseworker believed that their caseworkers had failed at doing their job. As a result perceptions of caseworkers often influenced perceptions of the larger foster care system and out-of-home placements. Foster caregivers, mental health service providers and biological family members also provided explanations to youth but their role was believed to be secondary to that of the caseworker. Youth illustrated elements of their relationships with caseworkers using examples of unhelpful and helpful caseworker actions. The youth in this study who identified weak and unhelpful relationships with their caseworkers commonly described being on the back to get them in trouble. Many of the youth also interpreted placement moves being used as punishment and did not believe that they could trust their caseworkers to confidentially address their concerns. Some foster caregivers tried to prepare youth for what foster care would be like and shared personal experiences. This type of communication was perceived as an opportunity for connecting on a more personal level and made them feel more comfortable. Foster caregivers also communicated expectations about rules and roles. Some youth had difficulty adjusting to a new role of being a child given their roles as caretakers and protectors in their family systems. Youth who had been placed in residential facilities expressed feeling as though they were being punished. 160     Communication from mental health service providers seemed to indirectly affect elements of perceptions of the out-of-home placement by helping youth understand their experience and where caseworkers were coming from. Communications regarding diagnoses were sometimes viewed as detrimental labels that changed how caseworkers and foster caregivers viewed youth. The youth did not identify much direct communication from parents about the reason(s) for entering foster care or explaining what would happen while in care. Many youth described their struggles with feelings of hurt that stemmed from the actions of their parent(s) that brought them into care. Many youth reported various examples of loyalties to their parents that persisted throughout their time in care even though they did not play a central role in providing explanations. Siblings played an active role in providing explanations of reason(s) for entry and what would happen while in care. Siblings usually did this by regularly sharing their understandings and impressions of what was going on with other siblings who had a lesser understanding. Sibling communication also appeared to serve as a form of support. Siblings could understand what each other were going through. Communication from parents and siblings did not necessarily affect perceptions of out-of-home placements positively or negatively. Instead, they seemed to play a role in the extent to which youth felt supported and accepting of foster care. Relative caregivers such as grandparents, aunts, uncles, and older siblings also communicated their perceptions of the reason(s) for entering foster care and made attempts to keep youth updated of court proceedings and placement decisions that were being made in their cases. Youth described this type of communication as positively influencing their adjustment because it conveyed a sense 161     of love and support that made youth feel comfortable. Some relative caregivers also communicated frustrations about behaviors and money, and passed judgments. Youth expressed that this type of communication affected their perception of out-of-home placement by making them feel unwanted. challenges related to building a sense of self while in foster care. Youth were faced with questions of who to be and how to act. Some youth shared that they acted a certain way or agreed with beliefs that were not their own in order to get by in the out-of-home placements. Some of these strategies were healthy and adaptive in the process of adjusting to the foster care experience. Youth accessed social supports and therapy services, found creative outlets, shared their story, and exercised. Some strategies were more detrimental to overall well being. Keeping true feelings inside and avoidance often worked temporarily but feelings persisted over time. Self harm and acting out presented physical risks to the youth. In more severe instances attempted suicide threatened the possibility of death. Youth expressed that cultural changes such as the types of food people eat, the music they listen to, and the kinds of clothes they wear affect adjustment to foster care. Youth who had described race and culture as affecting the process of adjustment to foster care indicated feeling as though they had experienced confusion and discomfort in their environment. The youth believed that it was difficult to adjust to foster care on its own and every little difference in the environment contributes to the challenge of getting used to something new. Some youth explained that racism, discrimination, and feeling out of place contributed to feeling uncomfortable. One young woman referenced the 162     confusion of trying to decide whether to embrace her own culture of the culture of the placement. Some youth reported gender differences in the ways that male and female youth cope with being in foster care. Youth who primarily remained in relative placements or placements with a caregiver of the same race tended to share the opinion that all foster youth are treated the same. Youth who expressed beliefs that race did affect adjustment had experienced placements with caregivers of races other than their own or were placed in a neighborhood that had different racial compositions from their original neighborhood. Some youth believed that there was no difference. Female youth were described as more emotional, more open to foster caregivers, and searching for love. Male youth were described as independent, shutting down emotionally, and more likely to rebel. Youth were faced with learning what to say, how to act, and who to be with respect to religious beliefs as well. Religious influences of placements affected the lives of youth in the form of rules about the types of belongings they could have or rules about church attendance. Some youth described religious beliefs and church participation as a positive source of strength and strategy for coping. Others questioned or were mad at God because of being in foster care. Youth expressed difficulty responding to the question of whether sexual orientation influences adjustment to foster care because all youth in the study identified as heterosexual. As a result, the researcher asked a broader question of whether youth in foster care are free to be their true selves. Many youth in this study shared the belief that foster youth commonly fear that sharing their true thoughts, feelings, and beliefs would bring about negative 163     consequences in their placement environments. Ultimately, youth described constantly having to manage feeling different. Chapter five provides a discussion of these findings in relation to the existing body of literature. Implications and limitations of this research are also presented. 164     CHAPTER FIVE CONCLUSION Introduction Existing literature suggests that most children who enter foster care are not well informed about reasons for entry and what will happen while in care (Cashmore, 2002; Folman, 1998; Gil, 1982a, Lee & Whiting, 2007). Though it is a widely accepted belief that preparation and providing explanations can ease anxiety, reduce self-blame, and -being during the transition to a new environment, there has been little research exploring the influence of such communication on placement outcomes (Barber & Delfabbro, 2004, Cashmore 2002; Festinger, 1983). Child welfare researchers and practitioners have warned that failure to communicate such information holds critical implications for child well-being, adjustment to care, and perpetuates a cycle of disempowerment (Bruskas, 2008;Gil & Bogart, 1982a,1982b; Sieta, 2000; Skivenes, & Strandbu, 2006; Whiting & Lee, 2003). However, it continues to remain a largely understudied area. This qualitative study provides a critical advancement in understanding the importance of early and ongoing communication. Youth perceptions of the linkages between communication and adjustment to out-of-home placement were explored. Semi-structured interview, demographic, and eco-map data were collected from 14 youth between the ages of 18 and 24 who had entered foster care at least once after reaching the age of 8. Key findings from these data informed the development of a revised conceptual map (Figure 5.1) that models the ways in which communication influenced adjustment to out-of-home placement for the youth in this study. An 165     explanation of the revised concept map (Figure 5.1) is provided first and is followed by an expanded discussion of the key findings supporting each aspect of the model. Implications, limitations, researcher reflections, and suggested directions for future research are identified. Linkages between Communication & Adjustment to Out-of-Home Placement Figure 5.1 begins by considering the child in developmental context considering gender, race, ethnicity, abuse history, and stage of development. The heterogeneous nature of the foster care experience requires researchers and practitioners to consider every mental stage, gender, culture, age, interests, and talents (Gil, 2006). These contextual factors serve as a reminder that children entering foster care bring their own unique understandings of their experiences of life before coming into care and of removal. During and after the removal process youth experience varying degrees of communication from the child welfare system and family system. Early experiences of communication from caseworkers often set the tone for how youth perceived relationships within the foster care system. As a result, communication with caseworkers is depicted as the first and most critical point of contact with the child welfare system. Communication from other members of the child welfare system such as foster caregivers, mental health service provider, and GALs also contributed to perceptions of out-of-home placement but on a level secondary to that of caseworkers. This suggests that a cumulative nature of communication appears to exist but not in the way originally conceptualized. In the original model (Figure 1.2) youth were thought to develop a cumulative experience of communication. This element referred to the extent 166     Figure 5.1 Revised Concept Map Foster Caregivers Courts MH Service Providers Adjustment   Perception of relationship with Child Welfare System Professionals Empowered Vs. Disempowered Stage of Development Communication with Caseworker   Abuse / Neglect Race/Ethnicity/ Gender Experience of Removal Communication with Family Perception of Out-ofhome Placement Environment Support & Loyalty Siblings 167       Play the game What to say Identity Who to be Behavior What to do Child BioParent(s) Coping Extended Family & Fictive Kin to which information was clearly and collaboratively shared between the parties involved in the system and thus conveyed in a developmentally appropriate way to the child. The original framework thought that children would construct an overall view of communication that considered all sources. However, findings from this study suggest that some sources of communication are more or less influential depending on youth perceptions of the role that person plays in communicating explanations. For example not receiving an explanation from a caseworker would be more detrimental than a GAL not providing explanations because caseworkers are perceived as primarily responsible for providing explanations. The extent to which youth felt informed and cared for by someone within the system influenced their perceptions of the strength of that relationship. For the youth in this study, perceptions of relationships within the child welfare system fell into dichotomous categories. Youth who believed that their informational needs were met felt cared for by child welfare professionals and in turn perceived strong/helpful relationships. Youth who perceived strong relationships often felt empowered to ask questions and become active participants in their care. Youth who believed their informational needs were not met did not feel cared for, thought professionals were not doing their jobs and in turn perceived weak/unhelpful relationships. Youth who perceived weak relationships often felt disempowered by the foster care system and maintained a growing distrust of child welfare professionals until someone proved to be an exception. This appraisal process (Figure 4.1) was applied with each person who was involved with the child welfare system: caseworkers, foster caregivers (related & unrelated), mental health service providers, and GALs. 168     This process was different with respect to biological parents, siblings, extended family, and fictive kin. Because there was already a known relationship, youth did not have to develop a new perception of the strength of the relationships with their family members. It is also important to note that youth did not hold family members responsible for providing explanations. When informational needs were not met, family members were not considered to be at fault. In contrast to communication from the child welfare system, communication from the family system did not always come from a primary source. In fact the family system did not play a primary role in providing explanations during the process of removal. However, communication from family did influence perceptions of the degree to which youth felt supported and maintained loyalty to biological parents. Youth felt supported when parents, siblings, extended family or fictive kin communicated a desire to help, offered explanations of the circumstances that brought them into care, and made them feel wanted. Siblings who were placed together youth expressed having feelings of loyalty toward biological parents during the time they were in foster care. These feelings were not always the result of direct communication but they existed in relation to the degree to which youth had come to terms with being in foster care. Youth who felt foster care was the best place for them experienced lesser feelings of loyalty while youth who believed they should never have been removed had stronger feelings of loyalty. Perceptions of relationships from both the child welfare system and the family system influenced perceptions of out-of-home placement. Youth engage in a feedback loop of communication for each source. With regard to the child welfare system youth 169     assessed the extent to which the person was helpful or unhelpful. The extent to which children were informed about reason for entry, what would happen during their time in care, and empowered to ask questions affected their perceptions of relationships and out-of-home placement. Youth who received enough information to feel able to understand what was happening and why viewed placements very differently than youth who did not understand why they were in care of what was happening to them. Youth perceived strong relationships they were also more likely to share their thoughts and concerns about out-of-home placement. Youth who perceived weak relationships did not trust that anyone from the system would help them. In contrast, perceptions of out-of-home placement were not always affected directly by family communication. Instead, perceptions were affected by the extent to which youth felt emotionally supported, loyal to parents, or conflicted. The assessments of the child welfare and family systems then informed perceptions of out-of-home placements and strategies for coping and adjustment. These observable aspects of behavior then influenced the ways in which child welfare professionals and family members communicate information, creating a continuous dynamic cycle of interaction. The youth in this study seemed to continue to engage in this reciprocal process with each person that they encountered, seeking to fill in information gaps by asking questions or observing their environment.   Discussion of Key Findings This study provides further evidence that d adjustment into care may vary depending on a number of factors such as the age of the child at entry, circumstances of placement, number of placements, client-worker 170     relationships, amount of contact with biological family, comfort with out-of-home caregivers, comfort with the neighborhood and school, and length of time in care (Bogolub, 2008; Chapman et al., 2004; McDonald, Allen, Westerfelt, &Piliavin, 1996; Minty, 1999). Beginning to explore youth perceptions of communication during the foster care experience has offered an opportunity to understand how these various factors interconnect in meaningful ways to affect adjustment. The following discussion of key findings provides a more in-depth explanation of the ways in which the elements of Figure 5.1 are rooted in the data and supported by existing research. Lasting Impressions of Removal The removal experience made a lasting impression for the youth who participated in this study. When the youth in this study were removed from their biological families and community environments they experienced feelings of instability that created a variety of mixed emotions (Kirven, 2000). Children who have participated in foster care research consistently characterize their entry into care as confusing, frightening, destabilizing, shameful, traumatic and in some instances damaging (Bass, Shields, & Behrman, 2004; Bogolub, 2008; Clausen, Landsverk, Ganger, Chadwick, & Litrownik, 1998; Festinger, 1983; Folman 1998; Gil & Bogart, 1982a, 1982b; Holody & Maher, 1996; Johnson, Yoken, & Voss, 1995; Mitchell & Kuczynski; 2010; Nesbit, 2000; Pecora & Maluccio, 2000; Sieta, Mitchell, & Tobin, 1996; Whiting & Lee, 2003). This unfortunate trend also surfaced in this study. The removal process for the youth who participated was generally quick and characterized by feelings of fear, anger, and some degree of surprise and confusion. The youth in this study gave voice to a few important 171     nuances of the emotional experience of being removed from their homes and entering the foster care system (Bass et al., 2004). First, for this sample, the shock and confusion of removal was consistently linked with a sense of being aware but at the same time unaware of the problematic elements of the home environment. Many youth had an awareness of what was going on in the home however it was viewed as normal because it was all they had know. As a result, some youth remained confused about the reason(s) for entry into care because they did not understand that the family environment was risky or harmful to their well-being. The however it parallels researcher sentiments that the extent to which the information is received by children depends upon developmental and environmental factors (Gil. 2006; Richman, 2003). Cashmore (2002) cautioned that offering background information does not necessarily mean that it is accessible and understandable to children. For the youth in this study, receiving an explanation did not always equate an understanding of what was happening. Some youth came to understand that elements of their family environment were risky or harmful when they were offered careful and simple explanations that illustrated how and why certain aspects of their experience posed risks to their overall well-being. For others, this realization was pieced together over time as they were exposed to different environments and sources of communication. Second, this study confirmed that explanations regarding entry and transition into care came from a variety of sources including, but not limited to, caseworkers, child protective services investigators, and parents (Bogolub, 2008; Fanshel & Shin, 1978; Festinger, 1983; Folman, 1998; Gil & Bogart, 1982a, 1982b; Johnson et al., 1995). Also, 172     communication comes in a variety of forms. The youth in this study commonly experienced four different types of communication taking place during the process of removal and entry into care: 1) preparative, 2) directive, 3) descriptive, and 4) no explanation. Child welfare system professionals typically relayed information pertaining to the processes they were facilitating or directly involved in. Explanations that were provided as preparation for removal usually came from CPS workers in conjunction with school social workers during visits that occurred during the school day. Parents and caregivers were also sometimes sources of preparative communication. Police and CPS workers relayed directive explanations regarding the process of removal. They Research has demonstrated that being told that removal was going to be temporary is common during the removal process even when that is not the case (Folman, 1998; Nesbit, 2000). Caseworkers and foster caregivers commonly provided descriptive explanations of reason for entry, what would happen, rules at placements, and what was going on with cases. Though communication from the court system and GALs was identified during the removal process it was very limited and specific to explaining the court process and court orders. Only one young woman indicated having a formal explanation from her GAL about the reason she came into care and what would happen to her. The youth in this sample did not describe biological parents as offering much explanation during the removal process. Two sisters were the only participants who received an explanation from their father that prepared them for removal. Youth most commonly received information from family members when they were placed with a relative 173     caregiver. Relative caregivers typically relayed information that described their personal feelings about their family member being in foster care. Older siblings also played a part in offering explanations of what they understood to younger siblings. Third, it is important to note that though these types of information were communicated, all of these topics were not necessarily explained to each youth. Most youth received explanations regarding some combination of these elements but not necessarily all and some youth received no explanation whatsoever during the process of removal. The youth interviewed indicated waiting for explanations anywhere from a few days, weeks, months, or up to a year. This fragmented experience of receiving information is consistent with documented gaps in communicating important information to children about why they are in care, what will happen while in care (Cashmore, 2002; Chapman et al., 2004; Festinger, 1983; Gilligan, 2000; Gil & Bogart, 1982a, 1982b; Johnson et al., 1995; Scannapieco, Connell-Carrick, & Painter, 2007; Shin, 2004). Ultimately, youth actively engaged in a process of piecing together information to try to making sense of their experience. Communication with the Child Welfare System Caseworkers. The youth interviewed shared their experience of piecing together information from various sources in order to develop a more cohesive understanding of the reasons they entered care and what would happen while they were in care. The concept of piecing things together appeared to hold true for all youth interviewed, even those who had received explanations in preparation and at the time of removal. All youth interviewed expressed the belief that all youth entering foster care deserve an 174     explanation of what is going to happen, why it is happening, and what it means to be in foster care. The majority of participants believed that explanations should be provided by caseworkers at the time of removal. However, some youth believed that providing explanations should be a collaborative effort among those involved in their care. This research shed light on the roles that caseworkers, foster caregivers, mental health service providers played in the process of communicating explanations. Caseworkers were the most common source of explanations and were viewed by youth to be the central representative of the child welfare system. Caseworkers that provided explanations to youth typically offered descriptions of the reason(s) for entry, actions being taken by the system, case goals, and placement options. All but two youth interviewed believed that it was the duty and responsibility of caseworkers to provide explanations to foster youth. Early and ongoing communication from caseworkers was described as establishing a foundation of trust and respect. The youth in this study believed that receiving explanations from caseworkers positively influenced adjustment to out-of-home placement. For these youth, communication from caseworkers appeared to carry considerable weight in informing perceptions of the foster care system and out-of-home placement. The belief that caseworkers hold primary responsibility to inform youth served as a reference point in determining how well caseworkers did their job. Youth who received an explanation at some point from a caseworker felt as though they were able to adapt to out-of-home placement more readily because they had a working knowledge of what was going on with their case. Examples of this included not feeling tormented by false hope that they would be going home and being able to sleep at night 175     because they did not have to worry about surprises. The findings of this study confirm that providing ongoing adequate explanations of where a child is going and what will be happening can ameliorate the fear, sadness, confusion, and loss associated with removal and entry into foster care (Folman, 1998). Whether intentional or unintentional, not sharing information and knowledge about a chil sense of powerlessness for the youth in this study (Bruskas, 2008; Ellerman, 2007; Lee & Whiting, 2007). Youth who did not feel informed described struggles with feelings of self-blame, confusion, anger, and frustration. One participant described having an attitude toward foster caregivers because she thought it was their fault that she was in foster care. For the youth in this study, these types of feelings often translated into acting out behaviors that were intended to get the attention they were lacking. Youth commonly illustrated elements of their relationships with caseworkers using examples of unhelpful and helpful caseworker actions. Youth who perceived weak caseworker relationships described caseworkers as being hard to get a hold of, never around, having attitude, and frequent turnover. These youth also described feeling as hand, youth who perceived strong caseworker relationships described caseworkers as keeping in contact, returning calls, listening, being friendly, following through, and providing explanations when they were unable to do something. These actions were interpreted by youth as demonstrating a sense of caring. Youth who expressed feeling cared about explained that this sometimes changed their view of foster care for the better and opened the doors for establishing a trust and respect in their relationships with their 176     caseworkers. The findings of this study provide further support that giving children the chance to participate in the decision-making process, and explaining how placement decisions are reached and what they mean empowers children to feel like active participants in their own lives (Scannapieco, Connell-Carrick, & Painter, 2007; Skivenes & Strandbu, 2006). Foster caregivers and mental health service providers also provided explanations to youth but their role was believed to be secondary to that of the caseworker. Foster caregivers. The youth in the study had encountered a variety of foster caregivers during their time in foster care. The majority spent a number of years in care and had been in multiple placements over the course of that time. Many youth recalled feeling scared in anticipation of what placement would be like and were frightened by the unfamiliarity of the environment. Communication from foster caregivers was delivered in a number of forms. Some communication was descriptive of processes associated with entering care. One young woman explained that her foster mother tried to prepare her for placement in a residential facility by sharing stories of other youth who had been in a similar placement. In another instance, another young woman and been in foster care. In both of these scenarios the communication was believed to convey credible knowledge of the system. It also provided an opportunity for connecting on a more personal level that made them feel more comfortable. Foster caregivers also communicated expectations about rules and roles. Some youth had difficulty adjusting to new roles as children given their roles as caretakers and protectors in their family systems. Many youth described feeling power struggles at 177     some of their placements because they were not used to having someone be in charge and tell them what to do. Many youth shared that their foster caregivers would describe these power struggles to caseworkers as concerns about behavior and possible placement changes. Youth did not always feel informed of this communication until something happened in the environment to make them aware of it. For example, some youth experienced surprise placement changes that happened quickly. These youth were able to recognize signs that communication had taken place (i.e. bags packed ahead of time) however they were not made aware of it. One young woman described such occurrences as making her feel as though no placement would be permanent. All youth who had been placed in residential facilities felt punished. Many expressed frustration with feeling as though they were being punished for something that was outside of their control (i.e. s). Some youth expressed that comments and actions taken by foster caregivers made them feel unwanted. This finding corroborates the regrettable trend in the literature that even when in long-term placements youth feel uncertainty about their future permanence (Fox et al., 2008). Mental health service providers. The youth in this study shared that caseworkers and foster caregivers were often instrumental in initiating therapy services. The youth explained that some caseworkers and foster caregivers communicated their opinions that therapy could be beneficial for them. The youth in this study had varied experiences with mental health professionals but the majority held a generally negative view of therapy. Most commonly the youth had been involved in therapy or counseling services however a few of the participants shared their experiences with psychiatric hospitals. For the youth in this study, services were perceived to be scary when they were not 178     understood. Additionally, services were considered to be pointless by youth who did not want to go, had frequent therapist changes, or limited their engagement with therapists. Communication from mental health service providers seemed to indirectly affect elements of perceptions of the out-of-home placement by helping youth understand their experiences and providing consistent supportive relationships. Mental health service providers also influenced perceptions of out-of-home placement in less positive ways. Some youth felt that diagnoses were detrimental labels that changed the way caseworkers and foster caregivers viewed them. Communication with the Biological Family System Parents, siblings, aunts, uncles, and grandparents were participants in providing explanations to the youth in this study. Family members most commonly shared their perspective of the circumstances that led to removal. Relative foster caregivers and older siblings provided reassurance through emotional support and providing updates on what was going on with their case. The youth did not identify much direct communication from parents about the reason(s) for entering foster care or explaining what would happen while in care. The majority of the participants maintained relationships with their parents and described their struggles with feelings of hurt that stemmed from the actions of their parent(s) that brought them into care. Other research with children in foster care has revealed that even when children do not debate the necessity of child welfare intervention they continue to grapple with feelings of loss (Barber & Delfabbro , 2004; Bogolub, 2008; Ellerman, 2007; Folman,1998; Lee & Whiting, 2007; Nesbit, 2000; Samuels, 2009; Schneider, 2005; Whiting & Lee, 2003). Some youth expressed difficulty balancing conflicting feelings toward their biological 179     family. Many of the youth in this sample still felt love for their parent(s) and recalled positive memories but also endured the memory of abuse/neglect and the subsequent breakup of their families (Whiting & Lee, 2003). In recent literature the concept of ambiguous loss has been applied to the foster care experience. It has been suggested that the ambiguity of family reunification vs. termination of rights associated with out-ofdifficulties processing the experience (Lawrence et al., 2006). Some of the youth in this sample who were younger at the time of entry and did not receive explanations kept a hope of wanting to go home. CPS communication about going home soon gone for a few weeks also stuck with many of the youth and they felt confused and betrayed by the system when that did not come true. Researchers have drawn attention to the many ambiguities involved with being in care. Particularly, family membership, what is happening in the lives of family members, transitions, physical presence/psychological absence of the family, and psychological presence/physical absence of the family (Lee & Whiting, 2007). Some youth in this study reported loyalties to their parents that persisted throughout their time in care. Some youth shared feeling as though they should have never been removed while others came to accept the removal but wanted to maintain strong ties to their biological families in some way. On the one hand, youth felt a sense of loyalty to parents the only family they had known. While on the other hand, as youth got older they became more aware of the circumstances that brought them into care and often were angry, frustrated and hurt. Overall, many youth in this study felt that even though biological 180     parents were not physically providing explanations or permanence, they did provide a sense of relational permanence as a member of a family. Siblings played an active role in providing explanations of reason(s) for entry and what would happen while in care. Siblings usually did this by regularly sharing their understandings and impressions of what was going on with other siblings who had a lesser understanding. Sibling communication also appeared to serve as a form of support. Siblings could understand what each other were going through. Older siblings also shared examples of putting their own needs aside in order to be strong for their younger siblings. Relative caregivers such as grandparents, aunts, uncles, and older siblings also communicated their perceptions of the reason(s) for entering foster care and made attempts to keep youth updated of court proceedings and placement decisions that were being made in their cases. Youth described this type of communication as positively influencing their adjustment because it conveyed a sense of love and support that made youth feel comfortable. Metzger (2008) suggested that increased contact and support from extended family and kin help children more successfully cope. This appeared to hold true for youth who felt supported and wanted by their relative caregivers. Some youth had very positive experiences with relative caregivers and felt that entering foster care was not as disruptive because they were with people they were used to. Youth who experienced relative placements sometimes described the familiar environment as helpful in easing the transition into foster care. However, some relative caregivers also communicated frustrations about behaviors and money, and passed judgments. Youth expressed that this type of communication affected their perception of 181     out-of-home placement by making them feel unwanted or as a burden. The influences of communication from relative caregivers closely mirrored the process of influence demonstrated by unrelated caregivers. Youth engaged in a similar process of appraising the extent to which informational needs were met, caring was conveyed, and the strength of the relationship because they were learning to see their relatives in a new role as a parent. Youth who perceived a strong and helpful relationship with their relative caregivers were more likely to perceive out-of-home placement in a more positive light. Perceptions of Out-of-Home Placement Perceptions of out-of home placement were affected by communication from influence followed different pathways. Communication from members of the child welfare system, specifically caseworkers, strongly influenced youth perceptions of relationship quality. The quality of the relationship in turn influenced perceptions of outof-home placement. The youth in this study described relationships and perceptions in terms of dichotomous pathways. When relationships were positive communication was more often viewed as truthful and helpful. Youth were more empowered to ask questions, advocate for themselves, and perceptions of out-of-home placement tended to be positively influenced. Youth who experienced these types of relationships commonly believed that the communication they received enabled them to understand what was happening in foster care. When relationships were negative communication was more likely to be viewed as unreliable and unhelpful. Youth were less likely to ask questions, share thoughts, and perceptions of out-of-home placement were negatively 182     understand why they were in care of what was happening. The family system followed a different chain of influence because the perceptions of relationship quality did not apply as they did for the child welfare system. The youth already had a sense of belonging and membership as a part of the family system. Some of the youth in this study were placed with relatives or fictive kin. In these instances the placement was familiar and for some was viewed as less disruptive than being placed with an unknown foster caregiver. Many youth described feeling a strong sense of loyalty to biological parents. Those who maintained a strong desire to be reunified described more struggles with out-of-home placement than those who believed that foster care was their best option. Some youth who did not clearly understand why they were in foster care s when youth understood what was happening they struggled with feeling loyal to their parents yet angry with them for their actions. Some youth struggled with feeling unwanted. The extent to which youth felt connected, supported, wanted, hurt, and confused influenced perceptions of all relationships and environments. Strong feelings of loyalty also affected perceptions by influencing coming to terms with being in foster care. Ultimately, the emotional response surrounding issues of family influenced perceptions of out-of-home placement more strongly than direct communication from family members. Coping The youth in this study employed a variety of coping strategies. For the youth in this study, coping pertained to adapting to the foster care environment. A predominant 183     theme emerged with respect to how youth interpreted various pieces of information over time in order to cope. The communication that youth received from caseworkers, foster parents, and mental health service providers was carefully observed and interpreted in order to piece together an understanding of how to navigate the system. Youth parents, and mental health service providers wanted to hear. Many of the youth viewed this as a survival strategy that was a necessary part of ensuring or preventing particular outcomes such as placement changes. Learning to play the game encompassed determining what to say, who to be, and what to do in the foster care environment. Choices pertaining to these three elements commonly fed back into a process of maintaining ongoing communication with a trusted and helpful source or seeking out other sources of communication in order to gain new information. Youth in this study explained that they were constantly managing feeling different from their peers (Ellerman, 2007). Youth described struggles with conflicting emotions, stereotypes, shame, and feeling treated differently at school. Findings from this study provided further evidence that children are affected by the stigma of being in foster care and some even taken steps to develop a cover story to keep peers from knowing (Bogolub, 2008; Ellerman, 2007; Festinger, 1983; Wilson & Conroy, 1999). Some youth accessed social supports and therapy services, found creative outlets, exercised, and shared their story with others. Other youth in the study believed in hindsight that the coping strategies that they used to try to deal with these struggles were not effective for improving their overall well-being. One young woman illustrated this process well by 184     observing her environment and dete act in a way that caseworkers and family perceived her to be adjusting well. Self harming and acting out presented physical risks and, in severe instances, the possibility of death. Youth commonly described acting out as a result of feeling unheard. Demonstrating behavioral problems or engaging in self harmful behaviors received attention quickly. For youth who did this, attention was usually received but they were then faced with consequences related to being viewed as unstable or in need of psychiatric care. Choices such as keeping true feelings inside, avoidance, acting out, and self-harm were adaptive and protective in the context of foster care. However, the youth in this study shared ongoing struggles with feelings that persisted over time even after exiting the system. Ultimately, the youth in this study faced the challenge of balancing emotional struggles with removal and entry into care with physical and behavioral struggles with changing environments. Adjustment The definition of adjustment emerged in the narratives of the youth in the sample. Adjustment was discussed from two vantage points. From the first vantage point, the youth discussed how they thought others viewed their adjustment. They frequently described members of the child welfare and biological family systems considering observable aspects of coping behaviors as indicators of adjustment. For instance, a child who was demonstrating few behavioral problems, was doing well in school, and made new peer connections may have been viewed as adjusting well whereas a child demonstrating behavioral problems and resisting social connections may have been 185     viewed in a less positive light. These observable behaviors were not always consistent with how they were really adjusting. From the second vantage point, youth described adjustment as a process of coming to terms with being in foster care. The youth commonly evaluated their adjustment in terms of how well they believed they managed their emotional responses associated with removal and being in the system. The youth discussed if and how they were able to come to terms with being in foster care. Some youth reached a point of acceptance, believing that they were better off being in foster care while others remained unsure that they ever fully adjusted to being in care. This orientation to thinking about adjustment was consistent with youth satisfaction with foster care was a function of who had come to terms with the need for placement and who had an adequate justification for why it had occurred. This study provided further evidence that youth who saw their placement into foster care as necessary or the best option tended to be more satisfied with their foster care experience. Implications At the onset, the focus of this study was on communication at the time of entry. However, it became clear during interviews that communication at the time of entry was dynamic and changing with every encounter. Entering the system looked different for all participants depending on their unique family circumstances. Information was not communicated at any consistent time or in a consistent way. Initial explanation for some took place at the time of entry and for others it was weeks or months after being in care. The stories of the youth who participated in this study brought to life the meaningful 186     linkages between communication and adjustment to out-of-home placement. The linkages between communication and removal, perceptions, coping, and adjustment offer important implications for practice. Removal An overwhelming majority of youth who have participated in foster care research have characterized removal as destabilizing, scary, fast, and confusing. For many of the youth in this study, removal was a traumatic experience that left lasting impressions. Even youth who received communication in preparation for removal still felt some degree of surprise and confusion. In order to best meet the needs of children and youth entering foster care we must begin to rethink the way we inform our communication with them. In order to effectively communicate with youth entering foster care it is imperative to begin first by understanding the thoughts and feelings of the child. Every child brings her own knowledge and understanding of family circumstances. By taking time to can ensure that the information and explanations we provide are communicated in a helpful way (Richman, 2003).In order to accomplish this, foster care intervention must be flexible to meet individualized needs (Morrison & Mishna, 2006). All participants shared their belief that youth entering foster care should be provided an explanation of what is going to happen, why it is happening, and what it means to be in foster care at the time of removal. It is important for child welfare professionals to be conscious that even seemingly basic explanations may not be understood. The youth in this study highlighted that not all explanations were created equal. Considering a basic example, a caseworker may introduce herself, state that she 187     is a caseworker and explain to a child that she is going to be in foster care while her parent gets help. While the explanation is presented in a simple way, it will not be caseworker or what a caseworker does. It is necessary that all child welfare professionals communicate explanations that developmentally appropriate ways. To ensure that explanations are provided in a helpful way, we must begin by accordingly. This entails discussing what removal is, why the child is being removed, and what will happen as a result. Some youth in this study described feeling confused at the time of removal because they were aware of what was happening in their home environment but unaware that what was happening was not ok. Child welfare professionals who are involved in the removal process need to help children understand the reason for removal by explaining why certain aspects of their home environments posed a risk to their well-being. It is imperative to be honest. If certain particulars of the case or placement are uncertain say so. It is important to be clear about what has been decided, what is still uncertain, and what is known at any given time. Many youth in this study believed that not knowing was more damaging than knowing the truth about what was happening and why. Communication & Perceptions For youth in this study, communication regarding reason(s) for entry and what would happen while in care influenced perceptions of relationships and the environment which in turn influenced thinking, feeling, and behavior in out-of-home placements. This 188     is not to suggest that communication is the principal element influencing adjustment to care. Instead, this research suggests that explaining reasons for entry and what will happen while in care offers an opportunity for child welfare professionals to convey a sense of caring that can positively influence the way youth view the foster care system. Caseworkers and foster caregivers can give youth the opportunity to build self-esteem and confidence by having their questions and thoughts heard, respected, and taken seriously (Cashmore, 2002; Kirven, 2000; Skivenes & Strandbu, 2006). The youth in this study developed perceptions of caseworkers and foster caregivers based in part on how they communicated with them. Offering explanations and keeping youth updated about the decisions made about their lives can be one step in building a foundation of respect that may open the doors to develop trusting relationships. This involves recognizing youth as unique individuals with their own set of perceptions, feelings, and behaviors. The findings of this study suggest that communicating explanations at the time of entry into foster care can be powerful and transformative in shaping perceptions that influence the transition to foster care. All youth in this study expressed the desire to interest to others. Initial communication and interactions often set the tone for how youth came to view child welfare professionals and the larger foster care system. Unfortunately, the fragmented nature of communication during the removal process exacerbates feelings of fear and confusion, leaving youth feeling isolated in their experience. To combat this, we must develop a more deliberate process of 189     communicating explanations to youth entering foster care that facilitates building a sense of connectedness and community upon entering care. Improving the transition to care begins with collaborative and empowering models of service delivery (Bass et al., 2004; Leslie et al., 2005; Levitt, 2009; McWey, Henderson, & Tice, 2006; Romanelli et al., 2009; Silver et al., 1999) Initial interventions need to address feelings associated with foster care and incorporate psychoeducation that involves stakeholders who play a part in the placement plan (Bruskas, 2008; Jenkins, 2008; Kletzak & Siegfried, 2008; Lee & Whiting, 2007; Pecora & Maluccio, 2000). Explanations can be a collaborative effort between caseworkers, foster parents, and biological parents. Cohesive explanations incorporate a description of the reason(s) for entry, what is known about where the child will be staying (temporary respite/foster family home/residential), how long they will be staying there, and a description of the the key players can afford the opportunity for youth to receive collaborative explanations. The youth in this study who entered foster care as teens also highlighted the importance of having access to other foster youth who have had similar experiences. Former foster youth were believed to have a credibility that child welfare professionals they had lived through it. Meeting others who had been in foster care can also help youth feel as though they are not alone. Creating an orientation for youth entering foster care as teens could include a panel of current or former foster youth who can answer questions and share their stories can empower youth to be active participants in their own care. 190     Coping & Adjustment Helping to placement stability which appears to have a large positive effect on mental health outcomes (Casey Family Programs, 2005; Jones Harden, 2004). This and other research has shown that youth desire to understand what is happening and believe that providing explanations to youth can reduce feelings of fear, sadness, confusion associated with removal and entry into foster care (Folman, 1998; Gil & Bogart 1982a). It is important to avoid assumptions that youth have an understanding of what is going on just because they do not ask questions. Professionals need to maintain a consciousness that each child is grappling with her own emotional response to removal and entering foster care. Offering ongoing explanations conveys a sense of caring and respect that allows youth to connect with child welfare professionals and foster caregivers on their own terms. The youth in this study gave light to their desires for members of the child welfare system to be honest, consistent, and follow-through on what they say they are going to do. Perhaps most importantly, it is imperative to get to know youth through meaningful interaction rather than through a case files. Entering foster care can be a very tumultuous experience. It is necessary to are forced to quickly neighborhood, and new friends while still trying to develop their own sense of self. In addition to changes in the physical environment, youth experienced changes related to race, culture, religion, and feeling different from their peers. Youth were forced into environments where people ate different types of foods, listened to different music, and 191     wore different types of clothing. Some youth felt confused about whether to embrace their own cultures or the cultures of their placements. Youth in foster care face the challenge of developing a sense of self-identity while in an ever-changing environment. Child welfare professionals must address feelings of confusion, discomfort, and uncertainty in culturally competent ways. Maintaining a relationship with the biological family was important for many of the youth in this study. For some, connections with family and kin contributed to the development of a sense of being loved, supported, and identity as a member of a family (Kufeldt et al., 1995; Samuels, 2009). Child welfare professionals must find educational and empowering approaches to fostering collaborative connections between youth, biological parents, foster caregivers and service providers (Forrester, McCambridge, Waissbein, & Rollnick, 2008; Jager, Bozek, & Bak, 2009; Jager et al., 2009; Kemp et al., 2009;Samuels, 2009). Youth experience a natural connection with their parents. Parents do not have to work the same way child welfare professionals do to establish a relationship. While some youth come to terms with being in foster care other are tormented by feelings of loss, loyalty, and conflicting feelings toward parents. The youth in this sample often gra that brought them into care. Despite this hurt, their mom was their mom. Youth had to manage feelings of loyalty to their parents while trying to come to terms with being in foster care. Having contact with family members such as siblings, relative caregivers (aunts, uncles, grandparents) offered youth the opportunity to transition to care while sustaining a feeling of connectedness with their families. These findings serve as a reminder to always consider emotional and behavioral problems in context. Doing so 192     allows us to see past the observable behaviors and begin to inform a more balanced view of how children may be responding to being separated from their parents. It also serves as a reminder that the ways in which a child is responding has been protective and adaptive in different environments. A child who is acting out in foster care is not necessarily a defiant child but instead may be a child struggling to make sense of her situation and longing to go home to her family. It is necessary to always consider social structures and personal narratives when making judgments and decisions in child welfare practice (Warner, 2003). MFTs Involved in Multidisciplinary Child Welfare Service Delivery MFTs are particularly well-suited for working with the complexities faced by children and families involved with the foster care system. MFTs have given voice to the importance of considering parent-child connections, increasing protective factors to support development, providing holistic assessment, empowerment and trauma recovery in child welfare research and practice (Jager, 2002; Jager, et al., 2009; Jager & Carolan, 2009). Though MFTs are not typically involved in the process of removal they are involved with youth who are referred for therapy services after entering foster care. The systemic perspective inherent in MFT training balances the recognition of the individual developing child within the context of multiple interconnected systems. MFTs can serve an important role in facilitating collaborative strength-based therapy services that empower youth to feel involved, respected, and heard during their time in foster care. MFTs can support youth as they develop a sense of self in relation to both their families and the foster care system. 193     MFTs have the opportunity to empower youth to be active participants in their own care through supported and structured collaboration with the biological family and other child welfare professionals. In the therapy setting, MFTs have the opportunity to spend the one-on-one time necessary to connect with youth on their own terms and to not force the relationship in any particular direction. Conveying a sense of caring and genuine interest in the thoughts and feelings of youth in care can create opportunities for establishing a foundation of respect and trust in the therapeutic relationship. Understanding previous experiences with mental health services and taking care to establish a safe, trusting, and respectful therapeutic environment can open new avenues for conversation about struggles with family loyalties, determining who to be, how to act, and what to say in order to adjust to foster care. Limitations There are a few notable limitations to this study. Due to the small sample size, it is difficult to generalize the finding of this study. In addition, the sample was comprised of primarily youth who had aged out of foster care or planned to age out. As a result, these youth had typically entered and exited the system multiple times and on average spent a number of years in care. Youth who entered foster care only once and spent shorter lengths of time in care may have had an entirely different experience of communication. Though the youth in this study had a lot to share about their experiences of communication while in care, their accounts were entirely retrospective. As a result, it is important to acknowledge that the interviews took place a number of years after the first time entering the foster care system. The youth in this study were also all involved with youth boards at some point during their time in foster care. They 194     were able to regularly engage with other foster youth who had shared similar experiences. Not all foster youth have this type of ongoing support. Lastly, with respect to questions regarding race, culture, gender, and sexual orientation many of the youth in this study had difficulty developing thoughts about the experience of others and only felt comfortable to speak to what they had personally experienced. It is suspected that this is largely due to the relative stage of development of the youth in this study. Some youth were able to consider the experience of others in relation to their own when they were faced with feeling different. For example, youth who had experienced placements with caregivers of a race other than their own became more aware of race than youth who had not experienced being placed with a family of another race. Directions for Future Research Gaining an understanding of the types of communication processes taking place with youth who are entering foster care can help child welfare professionals better address the needs of youth entering care. This type of research is critical because a tem can influence subsequent interactions and relationships with child welfare supports. Some researchers have suggested that initial interventions need to address feelings associated with foster care and incorporate psychoeducation that involves all stakeholders who play a part in the placement plan (Bruskas, 2008; Jenkins, 2008; Kletzak & Siegfried, 2008; Lee & Whiting, 2007; Pecora & Maluccio, 2000). More research is needed to determine the content and potential benefit of developing programs to assist parents, children, and foster caregivers during periods of transition (Bruskas, 2008; Cashmore, 2002; Ellerman, 2007; Folman, 1998; 195     Fox, Berrick, & Frasch, 2008; Gil, 1982a, 1982b; Holody & Maher, 1996; Jones Harden, 2004; Kemp et al., 2009). In order for such interventions to be relevant and effective we must learn more about how communication affects the adjustment of youth at different ages and stages in the foster care experience. It would also be interesting to see whether consistencies and inconsistencies exist between youth perceptions of caseworker roles and caseworker perceptions of caseworker roles in providing explanations. Researcher Reflections This project has been a journey of discovery. I would like to be transparent about the fact that the concept stemmed from my experiences as a therapist. A few years ago I was honored with the opportunity to work with the Families In Transition (FIT) program which offered community-based family therapy to families with substantiated abuse/neglect petitions through a service provision contract with the state child welfare system. Over time, I came to realize that many of the children and families involved with FIT were navigating a system that they felt had treated them unfairly, had stripped them of their confidence, enabled hopelessness, and exacerbated power differentials. I saw the pain in the eyes of a parent who realized for the first time that her child called another caregiver mom. I also saw the sincerity of genuine warm interactions; hugs, smiles, and excitement. Needless to say, my work with children and families involved with the child welfare system has made a lifelong impression. My interest in the influence of communicating explanations to youth entering care was spurred during my time with the FIT program. It seemed that more often than not the children and parents that I was working with faced confusion about many aspects of 196     their foster care experience. Like many of the researchers I have cited, I believe in the importance of helping children in foster care understand what is happening to them and why. However, I quickly realized how little we know about what communication at the time of entry into foster care looks like. The youth who participated in this study were truly inspiring and generous in sharing their experiences with me. Their stories brought this research to life and helped me look at the influence of communication in new ways. Conclusion Concerns about the effects of failing to communicate explanations of the ambiguities associated with removal and entry into care persist in the child welfare literature (Bruskas, 2008;Ellerman, 2007; Folman, 1998;Levitt, 2009; Lee & Whiting, 2007; Samuels, 2009). This study explored the relationship between communication and adjustment in an effort to begin building a foundation from which more research can grow. The stories of the youth in this study have offered a glimpse at a complex constellation of factors that make every foster care experience unique. These youth shared experiences of varying degrees of stability, conflict, acceptance, confusion, worry, loss, and understanding. All youth in this study felt that every child entering foster care deserves information, knowledge, and explanations that address what to expect, what is happening, s (Bruskas, 2008; Cashmore, 2002; Folman, 1998; Gil & Bogart, 1982a, 1982b). The youth interviewed shared their experience of piecing together information from various sources in order to develop a more cohesive understanding of the reasons they entered care and what would happen while they were in care. The concept of 197     piecing things together appeared to hold true for all youth interviewed, even those who had received explanations in preparation and at the time of removal. Caseworkers, biological family, foster parents, and mental health service providers played roles in providing explanations to the youth in this study. The youth interviewed consistently identified caseworkers as having the responsibility of providing explanations to youth in foster care. Early and ongoing communication from caseworkers was described as establishing a foundation of trust and respect. Youth who received explanations about the reason(s) for entering care and what would happen while in care reported feeling freed from the torment of maintaining false hope that they would be going home and being able to sleep at night because they did not have to worry about surprises. Conversely, youth who did not feel informed described struggles with feelings of confusion, anger, and frustration. The extent to which youth felt informed and cared for by someone within the system influenced their perceptions of the strength of the relationship and out-of-home placement. Youth who believed that their informational needs were met felt cared for by child welfare professionals and in turn perceived strong/helpful relationships. These youth commonly felt empowered to ask questions and become advocates for their own care. Youth who believed their informational needs were not me did not feel cared for, thought professionals were not doing their jobs and in turn perceived weak/unhelpful relationships. These youth were more likely to maintain a growing sense of distrust and felt disempowered by the system. This appraisal process was used with each person who was involved with the child welfare system: caseworkers, foster caregivers (related & unrelated), mental health service providers, and GALs. Perceptions of child welfare 198     professionals as unhelpful persisted until someone proved to be an exception. Youth who had negative views of the foster care system became open to more positive views of the system upon developing a relationship with a caring person from within the system. This process was different with respect to biological parents and siblings. Because there was already a known relationship as a family, youth did consider the strength of the relationships with their parents and siblings. Also, youth did not hold parents and siblings responsible for providing explanations. So when informational needs were not met, parents and siblings were not considered to be at fault. Perceptions of out-of-home placement were not always affected negatively or positively as a result of parent or sibling communication. Instead, perceptions were affected by the extent to which youth felt loyalty or conflicting emotions toward their parents and the extent to which siblings offered emotional and informational support to one another. Observations of communication from child welfare professionals and other foster youth informed survival strategies that characterized adapting to the out-of-home placement environment for youth in this study. Observations were pieced together to form an understanding of how to navigate the health service providers wanted to hear. Some youth were in a constant process of determining who to be in their out-of-home placements in order to meet expectations or fit in. Coping strategies were often observed as indicators of adjustment. Youth were faced with decisions about acting a certain way in order to get needs met. Many of the youth viewed these observation-informed choices as a survival strategy that was a 199     necessary part of ensuring or preventing particular outcomes such as placement changes. Ultimately, the youth in this study faced the challenge of balancing emotional struggles with removal and entry into care with the physical and behavioral struggles of changing environments. The youth commonly evaluated their adjustment in terms of how well they believed they managed their emotional responses associated with removal and being in the system. The youth discussed if and how they were able to come to terms with being in foster care. Some youth reached a point of acceptance, believing that they were better off being in foster care while others remained unsure that they ever fully adjusted to being in care. This orientation to thinking about adjustment was consistent with youth satisfaction with foster care was a function of who had come to terms with the need for placement and who had an adequate justification for why it had occurred. This study provided further evidence that youth who saw their placement into foster care as necessary or the best option tended to be more satisfied with their foster care experience. The youth in the sample also discussed adjustment in terms of how they thought others viewed their adjustment. The youth believed that members of the child welfare and family systems considered observable aspects of coping behaviors as indicators of adjustment. For instance, a child who was demonstrating few behavioral problems, was doing well in school, and made new peer connections may have been viewed as adjusting well whereas a child demonstrating behavioral problems and resisting social connections may have been viewed in a less positive light. These observable behaviors were not always consistent with how they were really adjusting. 200     The findings of this study suggest that communicating explanations at the time of entry into foster care can be powerful and transformative in shaping perceptions that influence the transition to foster care. All youth entering foster care should be provided an explanation of what is going to happen, why it is happening, and what it means to be in foster care at the time of removal. Child welfare professionals and families can be a network of supports working together to empower youth by helping them understand their experience of entry into foster care. thoughts, feelings, and questions at the time of removal we can ensure that the information and explanations we provide are communicated in helpful ways (Richman, 2003). 201     APPENDICES 202     APPENDIX A Interview Guide 1. Childhood experience before foster care Possible Probes: o What was life like before being removed? o What was your relationship with your family before placement? 2. Entering the foster care system Possible Probes: o How did you enter the foster care system? o Who came to take you? o Did you know that you were going to be removed? What did you think about what was happening to you? How did you feel at the time? 3. Experience of communication from family (biological parent(s), siblings, extended family, fictive kin) for child welfare service delivery (caseworkers, foster parents, law enforcement, courts, & therapists) a. Possible Probes: i. Who talked to you when you entered foster care? ii. Who helped you to understand what was happening? 1. What kind of information/explanation(s) were you given? 2. Did you feel that the person was being truthful? 3. Was there anything said that made things better? Worse? 4. Who is responsible for explaining things to kids who are entering care? 5. How did you talk to them? 4. Perception of environment a. Possible Probes: 1. What was your first day of out-of-home placement like? ii. What messages did you receive? Expectations? 1. Who talked to you about what would be happening? 2. What was your foster caregiver like? 3. How did that way he/she talked to you affect your view of out-of-home placement? 5. Identity (race/ethnicity, culture, religion, gender, sexual orientation) a. Possible Probes: 1. What types of messages did you receive? From who? 2. How did these messages affect the way others talked to you? You to them? 6. Coping 203     a. Possible Probes: 1. How did you deal with the changes in your life? (neighborhood, school, friends) 2. Who understood you? 3. Has your understanding of your experience changed over time? 7. Adjustment Possible Probes: o How do you think the system viewed your behavior/adjustment? o How do you think your family viewed your behavior/adjustment? o In what ways did their views affect how they talked to you? You to them? 8. Anything else 204     APPENDIX B Demographics Questionnaire Age: _______ Gender: Male Female Highest Level of education completed: Elementary school Middle School High School or equivalent Vocational/technical school (2 year) Some college Other: _______________________________________________________ What race/ethnicity do you consider yourself to be (check all that apply)? American Indian Arab Asian-American/Pacific Islander Black/African American Caucasian/White Hispanic Mexican American/Chicano Puerto Rican Indigenous or Aboriginal Latino Multiracial Would rather not say Other:__________________________________ In what MI County do you currently reside? Oakland Macomb Ingham Wayne Other: _________________________________ 205     Reason for entering into foster care: (check all that apply) Physical abuse Sexual abuse Emotional/verbal abuse Physical neglect Emotional neglect Unsure Other:______________________________________________________ Age at time of entry into foster care: __________ Age at time of exit from foster care: __________ Length of time in foster care: ___________________ Number of caseworkers assigned to your case: _____________________ How often did you have contact with your caseworker(s) while in foster care? 1 Often 2 3 Sometimes 4 5 Never Number of foster placements: ______________________ Type of out-of-home placement(s): Foster home with foster parent Placed with a relative Placed with kin (friend of the family) Residential facility Group home Other: ___________________________________________________________ How often did you have contact with parents while in foster care? 1 Often 2 3 Sometimes 4 5 Never How often did you have contact with siblings? 1 Often 2 3 Sometimes 4 5 Never How often did you have contact with extended family? 206     1 Often 2 3 Sometimes 4 5 Never How often did you have contact with fictive kin (persons you consider to be family but are not blood relation)? 1 Often 2 3 Sometimes 4 5 Never Services involve with while in care: (check all that apply) Individual therapy Family therapy Educational classes Medical treatment Other: ___________________________________________________________ Final status of your foster care case: Reunified with parent(s) parental rights terminated adopted aged-out Other: ___________________________________________________________ 207     APPENDIX C Eco-Map Instructions (Guide for researcher while explaining the process of completing an eco-map) What is an Eco-Map? An ecosystems. For kids in foster care, this also means learning about the resources made available to youth and their relationships with those resources. Some examples are family, friends, service providers, schools, neighbors, and church communities. The ecosystems while in foster care. What does an Eco-Map look like? The central circle represents the person participating in the study. The surrounding circles represent systems that the participant was involved with while in care. Each surrounding circle is connected to the central circle by a line that will indicate the direction of influence. Instructions 1. Identify people and/or systems/resources that the participant felt connected to while in foster care. Indicate these in the circles surrounding the central circle representing the participant. 2. For each person/resource/system indicate, on the line connecting the circles, the strength of the relationship and flow (resource helping the participant vs. participant helping the resource). Strength of relationship - strong relationship (red colored pencil) Weak relationship (green colored pencil) Flow directional arrow: - Pointing to the central circle = system helping participant - Pointing to the outer circle = participant helping the system - Bidirectional arrow = mutual helping between system & participant. 208     Eco- Map Notes: ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ 209     APPENDIX D Recruitment Flyer Have you been in Foster Care? Want to share your story? Take part in a study seeking to learn about the ways that talking about why kids are going into foster care and what will happen while in care affects how they adjust to foster placement. Who can Participate Must be 18-24 years old Must have entered foster care when you were 8 or older How long will the interview take? 1-2 hours Where will the interview take place? $20 gift card (Grocery or Gas) for participating Contact: (248) 462-3627 Jennifer Bak, M.A., LMFT 210     APPENDIX E RESEARCH PARTI CI PANT I NFORM ATI ON AND CONSENT FORM RESEARCH STUDY: Youth perceptions of the linkages between communication and adjustment to out-of-home placement. Thank you for thinking of participating in this study. The purpose of this study is to gain a better understanding of communication taking place with children when they enter foster care. From this study, the researcher hopes to learn about how caseworkers, foster parents, courts, police officers, therapists, family, and friends talk to kids about why they are going into foster care and what will happen to them during the time they are in care. WHAT YOUR PARTI CI PATI ON WI LL I NVOLVE: By signing this consent form you are giving permission to take part in a one-on-one interview and complete a questionnaire and eco-map. All interviews will be audio-taped. You may ask to have the recording stopped or have certain statements omitted however, you will not be permitted to participate in the study without being taped. The interview will focus on your experience of how caseworkers, foster parents, courts, police officers, therapists, family, and friends talked to you about why you were going into foster care and what would happen to you while you were in care. The eco-map completed as part of this while in foster care. This involves visually mapping out the resources made available to youth and their relationships with those resources. Some examples are family, friends, service providers, schools, neighbors, and church communities. Your participation will involve: An explanation of the research study and the informed consent form. One meeting with the researcher to complete a questionnaire, eco-map and one-on-one interview. The meeting will only take one to two hours of your time. With your permission, the researcher will contact you at the end of the study to share the study findings. You do not have to agree to be contacted to participate in this study. Today, I will explain this research study and the informed consent form with you and then you will be asked to participate in the study. Upon the completion of the questionnaire, eco-map and interview you will be given a $20 gift card. YOUR RI GHTS TO PARTI CI PATE, SAY NO, OR WI THDRAW: The goal of the research study is to build a better understanding the ways that talking with kids about why they are going into foster care and what will happen to them while they are in care 211     affects how kids adjust to foster placement. Your participation in this research project is completely voluntary. You can refuse to answer any questions that you do not wish to answer. Each interview will be audio-taped and you may refuse to be taped or request at any time that the audio-taping be stopped. You may also withdraw your participation at any time without penalty or loss of benefits to which the subjects is otherwise entitled. You have the right to say no. You can stop participating at any time by telling the interviewer that you no longer want to participate. POTENTI AL RI SKS & BENEFI TS: There is the potential for minimal risk involved with participating in this project. Some psychological discomfort may be experienced from revealing personal information or thinking about things that are related to your past. You are able to take a break at any point during the interview process, and you are able to refuse to answer any questions that make you uncomfortable. After the interview, should you feel overwhelmed or stressed please contact the researcher and she will provide a referral for the MSU Couple & Family Clinic or resources in your local community. There are some potential benefits. You may receive indirect benefits from your participation in this study by sharing your experience with others. A goal of this project is to give voice to the experiences of youth who have been in foster care and to use this knowledge to help caseworkers, foster parents, courts, police officers, therapists, and families to better support children and youths in foster care. RECORDI NG: With your consent, your interview will be audio-taped. You will not be permitted to participate in the study without being taped. Only the researchers will have access to the recordings. The recordings will be transcribed (typed word for word) and deleted once the typed transcripts are checked for accuracy. Neither your name nor any other identifying information will be associated with the recording or the transcript. Transcripts of your interview may be reproduced in whole or in part for use in presentations or written products related to the study. Neither your name nor any other identifying information (such as your voice) will be used in presentations or in written products resulting from this study. Immediately following the interview you will be given the opportunity to have the recording deleted if you wish to withdraw your consent to participate in this study. By consenting to record you are agreeing to have your interview recorded, to having the recording transcribed and to the use of the written transcripts in presentations and written products. CONFI DENTI ALI TY: The data for this project will be kept confidential and all information that refers to you, or can be identified with you will be kept confidential to the maximum extent allowable by law. If you choose to sign this consent form, you are also giving consent to have the interview audio-taped, so that the researchers have complete and correct information from the interview. You may request at any time to have the taping stopped and you can refuse to be taped at all. As audio212     recordings are transcribed (written word for word), all identifying information will be deleted (i.e., names of people or places) so that you cannot be identified. Typed transcripts of your interview will be kept as password protected files, and access to the information will be limited to the researcher, the research team members and the Michigan State University Institutional Review Board (IRB). Michigan State University may review your research records. All research data for this study will be kept in password protected files at the primary ddress for a minimum of 3 years after the conclusion of the project. Transcripts of your interview may be reproduced in whole or in part for use in presentations or written products related to the study. Neither your name nor any other identifying information (such as your voice) will be used in presentations or in written products resulting from this study. Immediately following the interview, you will be given the opportunity to have the recording deleted if you wish to withdraw your consent to participate in this study. Other than this form, all questionnaires and data will be identified with a pseudonym (a fake name). A list linking your name to the pseudonym will be kept in a locked file for the duration of the study. Once all the data are collected and analyzed, the list linking the names to the pseudonyms will be destroyed. CONTACT I NFORM ATI ON FOR QUESTI ONS AND CONCERNS: If you have concerns or questions about this study, such as scientific issues, how to do any part of it, or to report an injury, please contact the researchers: Jennifer Bak, M.A., LLMFT Marsha Carolan, PhD., LMFT 7 Human Ecology Building Michigan State University East Lansing, MI 48824 aragona1@msu.edu or carolan@msu.edu (248) 462-3627 or (517) 432-3327 If you have questions or concerns about your role and rights as a research participant, would like to obtain information or offer input, or would like to register a complaint about this study, you Protection Program at 517-355-2180, Fax 517-432-4503, or e-mail irb@msu.edu or regular mail at 207 Olds Hall, MSU, East Lansing, MI 48824. YOU HAVE READ THE CONSENT FORM. YOUR QUESTIONS HAVE BEEN ANSWERED. YOUR SIGNATURE ON THIS FORM MEANS THAT YOU CONSENT TO PARTICIPATE IN THIS STUDY. YOU ALSO CERTIFY THAT YOU ARE 18 YEARS OF AGE OR OLDER. 213     DOCUM ENTATI ON OF I NFORM ED CONSENT: I voluntarily agree to participate in an interview and complete a questionnaire & ecomap. __________ Initials I voluntarily agree to allow the researcher to contact me at the end of research project to share the findings of the study. __________ Initials Your signature below means that you voluntarily agree to participate in this research study. ___________________________________ _______________________________________ Signature of Participant Signature of Researcher ___________________________________ ________________________________________ Typed/Printed Name of Participant Typed/Printed Name of Researcher ___________________________________ ________________________________________ Date Date You will be given a copy of this form to keep. 214     REFERENCES 215     REFERENCES - a missing element in research on foster care case outcomes. Child and Family Social Work, 10, 361-366. Anastas, J.W. (2004). Quality in qualitative evaluation: Issues and possible answers. Research on Social Work Practice, 14(1), 57-65. Atkinson, B., Heath, A., & Chenail, R. (1991). Qualitative research and the legitimization of knowledge. Journal of Marital and Family Therapy, 17(2), 175180. Baker, A.J.L. (2007). Fostering stories: Why caseworkers, foster parents, and foster children should read stories about being in foster care. The American Journal of Family Therapy, 35, 151-165. Barber, J.B., & Delfabbro, P.H. (2004). Children in foster care. London: Routledge. Barber, J.B., Delfabbro, P.H., & Cooper, L.L. (2001). The predictors of unsuccessful transition to foster care. Journal of Child Psychology and Psychiatry, 42(6), 785-790. Bass, S., Shields, M.K., & Behrman, R.E. (2004). Children, families, and foster care: Analysis and recommendations. The Future of Children, 14(1), 5-29. out-of-home care: Methodological challenges and opportunities. Social Work Research, 24(2), 119-127. Bogolub, E.B. (2008). Child protective services investigations and the transition Families in Society, 89(1), 90-97. Bogolub, E.B. (2006). The impact of recruitment-generated bias on qualitative research interviews with foster children. Families in Society, 87(1), 140143. Bolen, M.G, McWey, L.M., & Schlee, B.M. (2008). Are at-risk parents getting what they need? Perspectives of parents involved with child protective services. Clinical Social Work Journal, 36, 341-354. Boyd-Franklin, N., & Hafer Bry, B. (2000). Reaching out in family therapy. New York: Guilford Press. 216     Brent, E., Slusarz, P., & Thompson, A. (2002). Qualrus : The intelligent qualitative analysis program [Computer software and manual]. Columbia, MO: Idea Works, Inc. Bronfenbrenner, U. (1979). The ecology of human development: Experiments by nature and design. Cambridge, MA: Harvard University Press. Brown, B., & Anderson Moore, K. (2009). What gets measured gets done: High well-being. Child Trends, A white paper for the Annie E. Casey Foundation. Retrieved from http://www.childtrends.org/Files//Child_Trends2009_02_10_FR_WPaperChildWBeing.pdf Bruskas, D. (2008). Children in foster care: A vulnerable population at risk. Journal of Child and Adolescent Psychiatric Nursing, 21(2), 70-77. Bubolz, M., & Sontag, S. (1993). Human Ecology Theory. In Boss, P.G., Doherty, W.J., LaRossa, R., Schumm, W.R., & Steinmetz, S.K. (Eds.), Sourcebook of family theory and methods: A contextual approach (pp. 419-448). New York: Plenum. Casey Family Programs (2005). Improving family foster care: Findings from the Northwest Foster Care Alumni Study. Retrieved March 16, 2008, from http://www.casey.org/NR/rdonlyres/4E1E7C77-7624-4260-A253892C5A6CB9E1/375/CaseyAlumniStudyupdated082006.pdf Cashmore, J. (2002). Promoting the participation of children and young people in care. Child Abuse & Neglect, 26(8), 837-847. Chalk, R., Gibbons, A. & Scarupa, H.J. (2002). The multiple dimensions of child abuse and neglect: New insights into an old problem. Child Trends Research Brief. Retrieved September 26, 2007, from www.childtrends.org. perceptions of children in foster care. American Journal of Orthopsychiatry, 74(3), 293-304. Chapman, M.V., & Christ, S.L. (2008). Attitudes toward out-of-home care over 18 months: Changing perceptions of youths in foster care. Social Work Research, 32(3), 135-145. Charmaz, K. (2006). Constructing grounded theory: A practical guide through qualitative analysis. Thousand Oaks, CA: Sage. 217     Clausen, J.M., Landsverk, J., Ganger, W., Chadwick, D., & Litrownik, A. (1998). Mental health problems of children in foster care. Journal of Child and Family Studies, 7(3), 283-296. Collins, M.E., Spencer, R., & Ward, R. (2010). Supporting youth in the transition from foster care: Formal and informal connections. Child Welfare, 89(1), 125143. Coll, K.M., Stewart, R.A., & Morse, R. (2010). The value of coordinated services with court-referred clients and their families: An outcome study. Child Welfare, 89(1), 61-79. Craven, P.A., & Lee, R.E. (2006). Therapeutic interventions for foster children. A systematic research synthesis. Research on Social Work Practice, 16, 287-304. deMarrias, K. (2004). Elegant communications: Sharing qualitative research with communities, collegues, and critics. Qualitative Inquiry, 10(2), 281-297. Denzin, N.K., & Lincoln, Y.S. (2005). Introduction: The discipline and practice of qualitative research. In N.K. Denzin & Y.S. Lincoln (Eds.), Handbook of qualitative research (3rd ed., pp. 1-32). Thousand Oaks, CA: Sage. experiences in out-of-home care. Children and Youth Services Review, 32, 13241330. Echevarriaded: Family therapy research and grounded theory. In D.H. Sprenkle and F.P. Piercy (Eds.), Research methods in family therapy (pp. 41-62). New York: Guilford Press. Eder, D., & Fingerson, L. (2002). Interviewing children and adolescents. In J.F. Gubrium and J.A. Holstein (Eds.) Handbook of interview research: Context and method (pp.181-202). Thousand Oaks, CA: Sage. Eisner, E.W. (2003). On the art and science of qualitative research in psychology. In P.M. Camic, J.E. Rhodes, & L. Yardley (Eds.), Qualitative research in psychology: Expanding perspectives in methodology and design (pp.17-30). Washington, DC: American Psychological Association. Ellermann, C.R. (2007). Influences on the mental health of children placed in foster care. Family Community Health, 30(2S), S23-S32. Erikson, M.F., & Egeland, B. (2002). Child abuse prevention: Accomplishments 218     and challenges. In J.E.B. Myers, L. Berliner, J.Briere, C.T. Hendrix, C. Jenny & T. A. Reid (Eds.), The APSAC handbook on child maltreatment (2nd ed) (pp. 3-20). Thousand Oaks, CA: Sage. Fanshel, D., & Shinn, E.B. (1978). Children in foster care: A longitudinal investigation. New York: Columbia University Press. Festinger, T. (1983). York: Columbia University Press. New parents preliminary to placement into foster care. Adoption Quarterly, 2(2), 7-35. Forrester, D., McCambridge, J., Waissbein, C., & Rollnick, S. (2008). How do child and family social workers talk to parents about child welfare concerns? Child Abuse Review, 17, 23-35. Foster Care Review Board (2006). Michigan Foster Care Review Board 2006 annual report 2006. Michigan Supreme Court State Administrative Office. Retrieved January 30, 2010 from http://courts.michigan.gov/scao//resources/publications/reports/fcrb/fcrb_ar06.pdf Foster Care Review Board (2008). Michigan Foster Care Review Board 2006 annual report 2006. Michigan Supreme Court State Administrative Office. Retrieved January 30, 2010 from http://courts.michigan.gov/scao//resources/publications/reports/fcrb/fcrb_ar08.pdf Fox, A., Berrick, J.D., & Frasch, K. (2008). Safety, family, permanency, and child well-being: What we can learn from children. Child Welfare, 87(1), 63-90. Fox, A., & Berrick, J.D. (2007). A response to no one ever asked us: A review of -of-home care. Child and Adolescent Social Work Journal, 24(1), 23-52. Freeman, E.M., & Couchonnal, G. (2006). Narrative and culturally based approaches in practice with families. Families in Society, 87(2), 198-208. Gehart, D., Ratliff, D.A., & Lyle, R.R. (2001). Qualitative research in family therapy: A substantive and methodological review. Journal of Marital and Family Therapy, 27(2), 261-274. Gil, E. (2006). Helping abused and traumatized children: Integrating directive and nondirective approaches. New York: Guilford Press. Gil, E., & Bogart, K. (1982a). An exploratory study of self-esteem and quality of 219     care of 100 children in foster care. Children and Youth Services Review, 4(4), 351-363. perceptions of foster care. Children Today, 11(1), 7-9. Haight, W.L., Black, J.E., Mangelsdorf, S., Giorgio, G., Tata, L., Schoppe, S.J., et al. (2002). Making visits better: The perspectives of parents, foster parents, and child welfare workers. Child Welfare, 81(2), 173-202. Hare-Mustin, R.T. (1989). The problem of gender in family therapy theory. In M. McGoldrick, C.M. Anderson, and F. Walsh (Eds.), Women in families: A framework for family therapy. New York: Norton Holody, R., & Maher, S. (1996). Using lifebooks with children in family foster care: A here-and-now process model. Child Welfare, 75(4), 321-335. moves and congregate settings: Complex and cumulative instabilities in out-ofhome care. Children and Youth Services Review, 31, 265-273. Jager, K.B., Bak, J., Barber, A., Bozek, K., Bocknek, E.L., & Weir, G. (2009). Qualitative inquiry and family therapist identity construction through communitybased child welfare practice. Journal of Feminist Family Therapy, 21(1), 39-57. Jager, K.B., Bozek, K., & Bak, J. (2009). Biological parents experiences in the MI. Jager, K.B., & Carolan, M. (2009). Locat of rauma, recovery, and empowerment. Qualitative Inquiry, 15(2), 297-307. Jager, K.B. (2002). Connecting trauma survival and family empowerment: A qualitative inquiry of the implication for family based services. Michigan State University. Jenkins, J.J. (2008). Listen to me! Empowering youth and courts through increased youth participation in dependency hearings. Family Court Review, 46(1), 163-179. Johnson, P.R., Yoken, D., & Voss, R. (1995). Family foster care placement: The Child Welfare, 74(5), 959-974. Jones Harden, B. (2004). Safety and stability for foster children: A developmental 220     perspective. The Future of Children, 14(1), 31-47. Kapp, S.A. & Propp, J. (2002). Client satisfaction methods: Input from parents with children in foster care. Child & Adolescent Social Work Journal, 19, 227-245. Kemp, S.P., Marcenko, M.O., Hoagwood, K., & Vesneski, W. (2009). Engaging parents in child welfare services: Bridging family needs and child welfare mandates. Child Welfae, 88(1), 101-126. Kirven, J. (2000). Building on strengths of minority adolescents in foster care: A narrative-holistic approach. Child & Youth Forum, 29(4), 247-263. Kletzak, N.T., & Siegfried, C. (2008). Helping children in the child welfare system heal from trauma: A systems integration approach. Juvenile and Family Court Journal, 59(4), 7-20. Kools, S. (1999). Self-protection in adolescents in foster care. Journal of Child and Adolescent Psychiatric Nursing, 12(4), 139-152. Kufeldt, K., Armstrong, J., & Dorosh, M. (1995).How children in care view their own and their foster families: A research study. Child Welfare, 74(3), 695-715. Laird, J. (1998). Theorizing culture: Narrative ideas and practice principles. In M. McGoldrick (Ed.), Re-Visioning family therapy. Race, culture, and gender in clinical practice (pp.20-36). New York: Guilford Press. Lawrence, C.R., Carlson, E.A., & Egeland, B. (2006). The impact of foster care on development. Development and Psychopathology, 18, 57-76. Lay, J. (2000). The person behind the file number. Reclaiming Children and Youth, 9(2), 68-69. Leathers, S.J. (2003). Parental visiting, conflicting allegiances, and emotional and behavioral problems among foster children. Family Relations, 52(1), 53-63. Lee, C.D., & Ayon, C. (2004). Is the client-worker relationship associated with better outcomes in mandated child abuse cases? Research on Social Work Practice, 14(5), 351-357. Lee, R.E., & Whiting, J.B. (2007). Foster chil loss. The American Journal of Family Therapy, 35, 417-428. Leslie, L.K., Gordon, J.N., Lambros, K., Premji, K., Peoples, J., & Gist, K. (2005). Addressing the developmental and mental health needs of young children 221     in foster care. Developmental and Behavioral Pediatrics, 26(2), 140-151. Levitt, J.M. (2009). Identification of mental health service need among youth in child welfare. Child Welfare, 88(1), 28-48. Marshall, C., & Rossman, G.B. (2006). Designing Qualitative Research (4th ed.). Thousand Oaks, CA: Sage. Mitchell, M.B., & Kuczynski, L. (2010). Does anyone know what is going on? Children and Youth Services Review, 32, 437-444. McDonald, T.P., Allen, R.I., Westerfelt, A., & Piliavin, I. (1996). Assessing the long-term effects of foster care: A research synthesis. Washington, D.C.: Child Welfare League of America. McGoldrick, M. (Ed.)(1998). Re-Visioning family therapy. Race, culture, and gender in clinical practice (pp.3-19). New York: Guilford Press. McWey, L.M., Henderson, T.L., & Tice, S.N. (2006). Mental health issues and the foster care system: An examination of the impact of the adoption and safe families act. Journal of Marital and Family Therapy, 32(2), 195-214. Metzger, J. (2008). Resiliency in children and youth in kinship care and family foster care. Child Welfare, 87(6), 115- 140. Mills, S.D., & Sprenkle, D.H. (1995). Family therapy in the postmodern era. Family Relations, 44, 368-376. Minty, B. (1999). Outcomes in long-term foster care. Journal of Child Psychology and Psychiatry, 40(7), 991-999. Moon, S.M., Dillon, D.R., & Sprenkle, D.H. (1990). Family therapy and qualitative research. Journal of Marital and Family Therapy, 16(4), 357-373. Morrison, J., & Mishna, F. (2006). Knowing the child: An ecological approach to the treatment of children in foster care. Clinical Social Work Journal, 34(4), 467481. Morse, J.M., & Richards, L. (2002). Read me first for methods. Thousand Oaks, CA: Sage. Nesbit, C. (Ed.). (2000). A dream deferred a joy achieved: Foster care stories of survival and triumph. Largo, MD: Strebor Books. 222     Newton, R.R., Litrownik, A.J., & Landsverk, J.A. (2000). Children and youth in foster care: disentangling the relationship between problem behaviors and number of placements. Child Abuse & Neglect, 24(10), 1363-1374. Nickols, S. (2003). Human eco-system theory: A tool for working with families. Journal of Family and Consumer Sciences, 95, 15-18. Olesen, V. (1994). Feminisms and models of qualitative research. In N.K. Denzin & Y.S. Lincoln (Eds.), Handbook of qualitative research (pp. 158-174). Thousand Oaks, CA: Sage. Olesen, V. (2005). Early millennial feminist qualitative research: Challenges and contours. In N.K. Denzin & Y.S. Lincoln (Eds.), Handbook of qualitative research (3rd ed., pp. 235-278). Thousand Oaks, CA: Sage. Orme, J.G., & Buehler, C. (2001). Foster family characteristics and behavioral and emotional problems of foster children: A narrative review. Family Relations, 50(1), 3-15. Patton, M.Q. (2002). Qualitative research and evaluation methods. Thousand Oaks, CA: Sage. Pecora, P.J., Jensen, P.S., Romanelli, L.H., Jackson, L.J., & Ortiz, A. (2009). Mental health services for children placed in foster care: An overview of current challenges. Child Welfare, 88(1), 5-26. Pecora, P.J. & Maluccio, A.N. (2000). What works in family foster care. In M.P. Kluger, G. Alexander, & P.A. Curtis (Eds.), What works in child welfare (pp. 139158). Washington, D.C.: Child Welfare League of America. Pew Commission on Children in Foster Care (2003). the child welfare system. Retrieved March 16, 2009, from http://pewfostercare.org/research/docs/journey.pdf Pratt, D.M., & Dolbin-MacNab, M.L. (2003). Marriage & family therapy students learning qualitative research: Frameworks identified through participatoryobservation. The Qualitative Report, 8(3), 333-352. Racusin, R., Maerlender, A.C., Sengupta, A., Isquith, P.K., & Straus, M.B. (2005). Psychosocial treatment of children in foster care: A review. Community Mental Health Journal, 41(2), 199-221. Reinharz, S. (1992). Feminist methods in social research. New York: Oxford Press. 223     Ribbens, J. & Edwards, R. (Eds.)(1998). Feminist dilemmas in qualitative research: Public knowledge and private lives. Thousand Oaks, CA: Sage. Richardson, L. (1990). Writing strategies: Reaching diverse audiences. Qualitative research methods (Vol. 21). Newbury Park, CA: Sage. Richman, N. (1993). Communicating with children: Helping children in distress. London: Save the Children. Romanelli, L.H., Hoagwood, K.E., Kaplan, S.J., Kemp, S.P., Hartman, R.L., Trupin, C., et al. (2009). Best practices for mental health in child welfare: Parent support and youth empowerment guidelines. Child Welfare, 88(1), 189-218. Samuels, G.M. (2009). Ambiguous loss of home: The experience of familial (im)permanence among young adults with foster care backgrounds. Children and Youth Services Review, 31, 1229-1239. Scannapieco, M., Connell-Carrick, K., & Painter, K. (2007). In their own words: Challenges facing youth aging out of foster care. Child and Adolescent Social Work Journal, 24. 423-435. Schneider, K.M. (2005). Coping with parental loss because of termination of parental rights. Child Welfare, 84(6), 819-842. Shin, S.H. (2004). Developmental outcomes of vulnerable youth in the child welfare system. Journal of Human Behavior in the Social Environment, 9(1-2), 39-56. Seita, J.R. (2000). In our best interest: Three necessary shifts for child welfare workers and children. Child Welfare, 79(1), 77-92. Seita, J.R., Mitchell, M., & Tobin, C. (1996). odyssey, a nati Elizabethtown, PA: Continental Press. Silver, J., DiLorenzo, P., Zukoski, M., Ross, P.E., Amster, B.J., & Schiegel, D. (1999). Starting young: Improving the health and developmental outcomes of infants and toddlers in the child welfare system. Child Welfare, 78(1), 148-165. participation. Children, Youth, and Environments, 16(2), 10-27. Tacoma, K.L. (2005). Lost and alone on some forgotten highway: ASFA, Binsfeld and the law of unintended consequences. Retrieved January 30, 210 from http://courts.michigan.gov/scao/services/fcrb/Tacoma.pdf 224     Thomas, M. (2005). Comparing theories of child development (6th ed.).Belmont: Thomson Wadsworth. Vandivere, S., Chalk, R., & Anderson Moore, K. (2003). Children in foster homes: How are they faring? Child Trends Research Brief. Retrieved September 26, 2007, from www.childtrends.org. Vig, S., Chinitz, S., & Shulman, L. (2005). Young children in foster care: Multiple vulnerabilities and complex service needs. Infants & Young Children, 18(2), 147160. Voydanoff, P. (1995). A family perspective on services integration. Family Relations, 44(1), 63-68. Waldegrave, C. (1998). The challenges of culture to psychology and postmodern thinking. In M. McGoldrick (Ed.), Re-Visioning family therapy. Race, culture, and gender in clinical practice (pp.404-413). New York: Guilford Press. Warner, S. (2003). Critical reflections on communicating with children: Making the tactics of training and intervention in child protection explicit. Educational and Child Psychology, 20(1), 109- 123. Whiting, JB., & Lee, R.E. (2003). Voices from the system: A qualitative study of Family Relations, 52(3), 288-295. Wilson, L., & Conroy, J. (1999). Satisfaction of children in out-of-home care. Child Welfare, 78(1), 53-70. Wrisley, B.A. (2005). Reframing the issue: A new child maltreatment prevention message. North Carolina Medical Journal, 66(5), 367-369. Zell, M.C. (2006). Child welfare workers: Who they are and how they view the child welfare system. Child Welfare, 85(1), 83-103. 225