When children enter the foster care system, there is inherent trauma in their lives. This trauma can be dealt with in many ways, with therapy being the most common and in Texas it is paid for by the state. But in addition to having to move an average of three to six times a year, foster care advocates say, these children also typically have to switch therapists.
That means they have to tell their story, which often includes abuse, over and over again, said Angela White, president and CEO of Child Advocates San Antonio (CASA). “They’ve said it so often to so many different people that [the child] says: I don’t do it anymore.
Switching therapists “doesn’t give them an opportunity to heal” and can retraumatize adopted children, White said.
CASA is partnering with Jewish Family Service of San Antonio, a nonprofit that focuses on mental health, and THRU Project, a nonprofit that serves young adults aging outside the foster care system, to fund therapists who they will stay with the same adopted children.
“If there’s one thing youth and young adults lack in the foster care system, it’s consistency,” said THRU Project CEO Courtney Laverty.
The two-year pilot program, called Project Launch, is not fully funded, organizers told the San Antonio Report, but they hope to begin in the coming months. CASA has requested more than $400,000 in federal coronavirus relief funds from the city of San Antonio and Jewish Family Service is seeking $550,000 from Bexar County.
“I’m definitely fundraising, trying to find the dollars to be able to do this,” said Jennifer Regnier, CEO of Jewish Family Service. “We’ll do it one way or another.”
Bexar County Judge Peter Sakai said he will seek funding from the county budget, which could include federal grants, for the pilot project.
“The more we proactively act upstream is how we can reduce costs downstream with the cost of prison, the cost of foster care, the cost of homelessness and human trafficking,” said Sakai, who as an associate justice of Bexar County Juvenile Court has presided over cases involving children in foster care.
“If there’s not enough intervention and rehabilitation to deal with the trauma they’ve been through, they often fall into those systems,” she said.
Ultimately, the partnership wants to use the project launch to demonstrate to the Texas Legislature that continuity of mental health care for foster children is worthy of state funding.
“It’s about being able to launch whole, beautiful people into the universe,” White said.
An ‘extremely complex’ system
Each year, approximately 8,000-10,000 children are in the foster care system in Bexar County, which is operated by Child Protective Services of Texas.
Treatment costs are covered by the state, but a child can only have one therapist at a time.
The system wasn’t designed to make kids switch therapists when they move, but that’s the result, White said. “There are several irons in the fire that make this difficult. … It is extremely complex.”
When a child first enters the system, it’s often an emergency situation, said Allison Martinez, CASA’s vice president of programs.
“Whether it’s like in the middle of the night or a very dramatic transfer, a lot of times their first stop will be at an emergency shelter,” Martinez said. “So the kids will start seeing that therapist.”
Typically, children stay in those shelters less than 60 days before being placed with a relative or foster family, at which point a new therapist is hired or assigned as needed.
So maybe the situation changes for the parent or foster family and the child is moved back to a home too far from the therapist, for example, she said.
And children who need hospitalization or inpatient treatment often fall out of an outpatient therapist’s schedule while being treated.
The project launch hopes to change that by hiring three Jewish Family Service therapists who will stay with their adopted child patients, about 17 to 25 each, regardless of where they are in Bexar County.
The partnership plans to seek arrangements with residential facilities and emergency shelters such as Clarity Child Guidance Center and Roy Maas Youth Alternatives to allow a project launch therapist to see their patients if they are admitted, White said.
It will also regularly monitor therapists and patients to measure the children’s progress, she said. “That gives us more of a case to then go to the Legislature and [Child Protective Services] and say, “Look, this is the impact it’s having,” and then you ask them for funding at that point.
Through their work with children and young adults in the foster care system, CASA and THRU Project will refer clients to Project Launch therapists who need them most, said Ryan Curran, clinical director of Jewish Family Service, who will oversee the project.
Not all children in foster care need ongoing therapy, Curran said, but the vast majority do.
“It’s repetitive trauma,” she said.
Heal broken relationships
Most children in foster care have many “broken relationships,” Curran said, because they have not only lost their parents or family, at least temporarily, but are typically placed in multiple foster homes.
“Every time that happens — that there’s a broken relationship — that really causes some current and future struggles with relationships and trust,” she said.
“Our goal is to have the same provider look after that child throughout their foster care journey – and also as they age out of [foster system] — to still have that person there that remains a constant,” she said. “Having that constant persona will benefit…every area you can imagine.”
According to the National Foster Youth Institute, about 20 percent of children who leave the foster care system at age 18 immediately become homeless. Only half are gainfully employed by age 24, and a quarter experience symptoms of PTSD. Nearly 60 percent of legally emancipated men aging outside the foster care system have been convicted of a felony, according to the institute.
Measuring success in mental health can be difficult because it’s not just about managing symptoms, Curran said.
“There will be some standardized clinical assessments that we will use,” he said. “But for this population, we don’t want to rely on symptom reduction alone. It’s more about maintaining the relationship, and then trusting the [process] and be vulnerable with us.
It can take several sessions before a therapist gains that confidence, Martinez said, and that’s where the project launch can make an impact.
“A lot of times therapists are just focused on making sure the placement is going well,” she said, “but really, these kids need in-depth trauma therapy so they can start healing from the things that have happened to them.”