Impact of a Mentoring and Skills Group Program on Mental Health Outcomes for Maltreated Children in Foster Care

Abstract

OBJECTIVE: To evaluate the efficacy of the Fostering Healthy Futures program in reducing mental health problems and associated problems. DESIGN: Randomized controlled trial. SETTING: Denver metropolitan area. PARTICIPANTS: Children aged 9 to 11 years who were maltreated and placed in foster care. INTERVENTION: Children in the control group (n=77) received an assessment of their cognitive, educational, and mental health functioning. Children in the intervention group (n=79) received the assessment and participated in a 9-month mentoring and skills group program. MAIN OUTCOME MEASURES: Children and caregivers were interviewed at baseline prior to randomization, immediately following the intervention, and 6 months after the intervention. Teachers were interviewed 2 times after baseline. Measures included a multi-informant index of mental health problems, youth-reported symptoms of posttraumatic stress, dissociation, and quality of life, and caregiver- and youth-reported use of mental health services and psychotropic medications. RESULTS: After adjusting for covariates, intent-to-treat analyses demonstrated that the treatment group had fewer mental health problems on a multi-informant factor 6 months after the intervention (mean difference, -0.51; 95% confidence interval, -0.84 to -0.19), reported fewer symptoms of dissociation 6 months after the intervention (mean difference, -3.66; 95% confidence interval, -6.58 to -0.74), and reported better quality of life immediately following the intervention (mean difference, 0.11; 95% confidence interval, 0.03 to 0.19). Fewer youths in the intervention group than in the control group had received recent mental health therapy 6 months after the intervention according to youth report (53% vs 71%, respectively; relative risk=0.75; 95% confidence interval, 0.57 to 0.98). CONCLUSIONS: A 9-month mentoring and skills group intervention for children in foster care can be implemented with fidelity and high uptake rates, resulting in improved mental health outcomes. Trial Registration clinicaltrials.gov Identifier: NCT00809315.

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