Canadian Journal of Counselling/Revue canadienne de counseling/1999, Vol. 33:1 13 Foster Parent Stress Graham Jones University of Alberta Patrick J. Morrissette Montana State University-Billings Abstract Counsellors in private practice, community agencies, or school systems frequently interact with foster children and foster parents. Without an understanding of the systemic repercussions associated with foster parent stress, counsellors may be at a clinical disadvantage. This paper discusses research findings pertaining to foster parent stress and the implications these findings have for counsellors and counsellor educators. Eleven significant themes were generated from the data and indicate that foster parents experience a wide range of stressful events affecting their personal well-being, their relationship with foster children, and the professionals with whom they interact. Résumé Les conseillers praticiens, les organismes communautaires et les écoles ont de fréquents rapports avec les enfants en famille d'accueil et leurs parents de famille d'accueil. La tâche clinique des conseillers peut être compliquée lorsqu'ils ne connaissent pas les conséquences généralisées associées au stress des parents de famille d'accueil. Cet article discute des résultats de recherches sur ce stress et des incidences sur le travail des conseillers praticiens et conseillers éducateurs. Les statistiques ont fait apparaître onze thèmes importants desquels il ressort que les parents de famille d'accueil sont soumis à divers et nombreux événements stressants ayant des répercussions sur leur santé, leurs relations avec les enfants dont ils ont la garde et les professionnels avec lesquels ils sont en relation. Although foster care remains very popular and is widely used throughoul Canada, a comprehensive review of the literature indicates that foster parenting within the Canadian scene has received virtually no attention. Available literature is dated, narrow in scope, and is restricted to basic administrative issues such as provincial funding and standards (e.g., Alberta Department of Social Services and Community Health, 1981; Ontario Ministry of Community and Social Services, 1981; British Columbia Federation of Foster Parent Associations, 1987) and program implementation (e.g., Morrissette, 1992; Orenstein, 1989). Based on the available literature, little is known about the experiences and ongoing needs of foster parents, and how counsellors and counsellor educators can be of help to this group. The purpose of this article is to discuss foster parent stress and the implications for counsellors and counsellor educators. An increasec awareness of the stresses experienced by foster parents, and the systemic repercussions of these stresses, can enable counsellors and counselloi educators to better understand foster parents. From the outset, it should be understood that the intent of this paper is not to imply an exhaustive list of foster parent stressful events. 14 Graham Jones and Patrick J. Morrissette SUBSTITUTE CARE PROVISION AND STRESS The systemic effect of stress on biological care-giving families has been extensively investigated in a number of areas including physically handicapped infants and children (e.g., Beckman, 1983; Frey, Greenberg, 8c Fewell, 1989; Goldberg, Morris, Simmons, Fowler, 8c Levison, 1990; Morrissette, Morrissette, 8c Naden, 1998; Patterson, 1985), mentally retarded children (e.g., Minnes, 1988; Crnic, Friedrich, & Greenberg, 1983; Baxter, 1989), pediatric terminal illness (e.g., Koch, 1985), and childhood death (e.g., Levac, Maison, Wright, & Bell, 1998; Weber 8c Fournier, 1985). In contrast, research pertaining to the stress experienced by non-biological care-giving families is scant. It can be speculated that the absence of research specific to foster parents is due to a lack of understanding regarding the daily challenges inherent in their work. It is also possible that foster parent issues are overshadowed by the ongoing needs and circumstances of foster children. One study concerned the effect of the primary caretaker's distress on sexually abused foster children (Lipton, 1997). Data from this study indicated strong differences between foster mother and biological mother distress and support as well as a strong relationship between distress of the caretaker and symptomology of the child. A second study investigated the stress among non-related home care providers and was limited to mentally retarded adults (Stoneman 8c Crapps, 1988). Find ings from this study demonstrated that cultivation of social support resources for care providers proved more important than training or client characteristics for managing stress. Although some of the research findings regarding biological family stress may be generalized to substi tute care-giver stress, salient differences merit careful consideration and include (a) non-guardianship status of foster parents, (b) designated time lines for care giving responsibilities, (c) available relief and respite care for foster parents, (d) foster parent financial remuneration, and (e) foster parent accessibility to clinical services. The absence of research specific to foster parent stress, and the conse quences associated with this stress, is perplexing considering that foster care has been described as a system in crisis (Gustavsson & Kopels, 1992) with foster parents generally stressed beyond limits by the demands of caring for disturbed foster children (Dore & Eisner, 1993; Eleanor, Rae- Grant, Ackland, 8c Avison, 1994). Part of the crisis may be attributed to the changing expectations placed on foster parents. Woolf (1990) asserts that the system is currently at a turning point in the history of foster care and that foster care is changing from a custodial system to one that is treatment oriented. What can be inferred is that foster parents are now perceived as performing an instrumental function within the treatment team and are responsible for implementing important aspects of the treatment plan. For many foster parents, this role is a departure from past Foster Parent Stress 15 responsibilities where they were required to provide shelter, supervision, and the transportation of young people. FOSTER PARENT STRESS: IMPLICATIONS AND CONSEQUENCES Aside from the staggering financial costs associated with a foster place ment breakdown (e.g., temporary institutionalization of the young per son, additional psychological support, foster parent recruitment and training), the emotional and physical costs can be devastating to the care givers, the young person, and his or her biological family (Charles & Matheson, 1990; Burgess, 1994; Goldstein, Freud, & Solnit, 1979). When foster parent stress is disregarded, there can be major social implications such as the maltreatment of children in care (e.g., Benedict, Zuravin, Somerfield, & Brandt, 1996; Benedict, Zuravin, Brandt, & Abbey, 1994; Bolton, Laner, 8c Gai, 1981; Rosenthal, Motz, Edmonson, Groze, 1991; Spencer & Knudsen, 1992; Zuravin, Benedict, & Somerfield, 1993), high rates of attrition among foster families (e.g., Block, 1981; Pardeck, 1983; Stone & Stone, 1983), and additional psychological impairment of foster children resulting from continued social and academic disruption. The fallout from foster parent stress is frequently observed by counsellors who provide clinical services to foster families and foster children. For exam ple, school counsellors are well acquainted with the emotional distress of foster children who experience multiple foster family and academic placements. Similarly, counsellors who work in treatment centres or group homes are accustomed to the unfortunate and self-defeating behaviours exhibited by youngsters who have been removed from a foster family or who are awaiting foster care placement. According to the literature, there are systemic implications associated with foster family stress. In a study of emotional problems of foster children in relation to multiple placements in care, Pardeck (1983) found a positive relationship between multiple placements and behav ioural problems. Proch and Taber (1987) examined adolescent place ment disruptions and determined that in order to prevent placement disruptions, focus must be placed on the ability of care givers to better understand the developmental needs of the young person. In an empiri cal study, Stone and Stone (1983) investigated the incidence and causes of foster placement deterioration. Findings from this research indicated that foster parents' rapport with program administrators was highly correlated with successful placement. Consequently, foster parent re search is critical for counsellors in their efforts to remain proactive in preventing or reducing care giver stress and enhancing clinical services to foster children. To contribute to the counselling literature in the area of foster care, this paper investigated stressful events identified by foster parents and discusses implications for counsellors and counsellor educators. A de- Iti Graham Jones and Patrick J. Morrissette scription of the research methodology that was utilized to determine stressful events follows. METHOD Participants Foster parents who participated in this study were members of the Alberta Foster Patent Association. The names of participants were pro vided by the Alberta Foster Parent Association. A total of 156 foster parents participated in this study. Demographic Information The length of fostering experience among participants who volunteered for this study ranged from 0.5 years to 30 years. The greatest percentage (nine) of foster parents had three years of experience. Thirty-three % had experience ranging from two to seven years. In terms of provincial foster home classification levels, 62% of participants met the advanced classification (designed to meet the needs of children who present with serious emotional or behavioural problems, medical conditions, physical or mental handicaps and are at risk for requiring institutional care), followed by 22% at the qualified level (designed to serve children who require both developmental care and professional resources to resolve or meet the needs of moderate disabilities), 12% at the approved level (designed to assist children who have minor disabilities or whose prob lems can be resolved with quality care and specific supports), and 3% at the specialized level (designed to accommodate children presenting with a multiplicity of problems that are frequent, intense, and enduring and would otherwise require placement in residential treatment or a medical facility). Information pertaining to marital status of foster par ents indicated that 87% were married and 61 % of the participants reported that the wife or a single female was the primary care provider. The average number of foster children residing in a foster home was 2 (35%) and the number of biological children simultaneously residing in the foster home was 1 (34%). The majority of participants (60%) resided in a rural area. PROCEDURE Rather than relying solely on one research orientation, this study em ployed both a quantitative and qualitative aspect in order to provide a more detailed and thorough overview. To obtain data, this dual orienta tion was selected in order to (a) avoid having the participants feel pressured or threatened, (b) gain a comprehensive list of stressful events, and (c) give statistical order to descriptive data. Foster Parent Stress 17 In order to collect the data, a two-stage information gathering process was utilized. The first stage entailed eliciting statements of stressful events from a random sample of 200 members of the Alberta Foster Care Association. Sixty responses were received, with a return rate of 30%. An initial introductory letter accompanied the first stage information gath ering process and included: a statement pertaining to the purpose and voluntary nature of the study, a request to identify stressful events, and a statement regarding the anonymity of the participants. The first group of research participants was provided with a focus statement which read: Please list the events of foster care that you find stressful. Try to be as clear as possible [italics added]. Participants were instructed to generate as many statements as possible that represented stressful events in their work. These events were then recorded by the authors to create a running list. Duplicate stressful events were removed from the list and some state ments were also re-worded for clarification purposes and to create a list whose length would encourage participation. This list was carefully edited by two experienced foster parents prior to the second stage. During this latter process minor changes were suggested to the wording of several statements. For example, three statements initially read: (a) Social workers quitting their job and moving, and (b) Workers always being replaced with new ones. These statements were combined to read: Rapid changeover of child welfare workers. The second stage of the information-gathering process involved the development of a questionnaire, based on the specific stressful events that were identified by the first group. It should be underscored that the second group of participants produced the data that was analyzed in this study. Approximately two months following receipt of the initial re sponses the actual questionnaire was mailed to another 200 members. Ninety-two completed questionnaires were returned, with a return rate of 46%. A letter explaining the study, its voluntary nature, and participant anonymity was again included. In actuality, the only instrument [italics added] that was used was the questionnaire that was developed to collect the data. The second group of participants provided demographic infor mation and did not identify any additional stressful events aside from those that had already been listed. Participants in the second group were informed that the stressful events that were listed had been generated by foster parents within their association. They were then asked to rate their stress level and frequency of involvement in the events described by the first group. Priority assigned to the stress level of the event, as well as the frequency of the event, were each done on a five-point Likert scale. Categories on the Likert scale for stress level ranking included ( 1 ) not stressful , (2) very little stress, (3) moderate level of stress, (4) very stressful, and (5) extremely stressful. Categories on the Likert scale for frequency rating included: (1) never occurs, (2) rarely occurs, (3) occa- 18 Graham Jones and Patrick J. Morrissette sionally occurs, (4) occurs quite often, and (5) occurs frequently. The focus statement for the second questionnaire read: As a foster parent you are asked to rate the following stressful events and the frequency with which these stressful events occur by circling the appropriate response [italics added]. Stressful events that were ranked on the Likert scale by the second group of participants were compiled into a list according to the priority of the stressful event and its corresponding frequency. Descriptive statis tics (means, standard deviations and frequency distributions) were calcu lated for participants' reports of the priority of the stressful event and of the frequency. The mean scores for both the frequency and priority ratings were rank ordered to present relative patterns. Extraction of Themes The process of extracting themes was conducted by both authors. The first author has over ten years of experience as a foster parent and is a graduate student in the field of educational psychology. The second author is a professor in the field of counselling with twenty years of experience in working with foster children and their families. Following a careful review of the participants' ranking of stressful events, the authors determined that a number of emergent themes were reflected in the data. The extraction process included each author independently reviewing all of the stressful events and identifying themes which they perceived as emerging from the data. Following this process, both au thors met to compare their findings, discuss their independent deci sions, and agree on the various themes that they considered to be reflected in the data. These themes were based on the interrelationship of the identified stressful events. For example, events that related to academic matters were classified under Academic Issues. To enhance credibility for the qualitative aspect of this study, a trian gulation process was conducted. This process involved two experienced foster parents who had a combined experience of over 20 years and an outside helping professional who had extensive experience in the area of foster care administration. Each individual reviewed the list of stressful events and themes, suggested minor revisions, and validated the list. The order of the following themes is not an indication of their importance. Rather, the thematic analysis is presented as a way of aggregating and presenting the data in an orderly manner for closer consideration. From the outset, it should be noted that attempting to designate events under specific themes was a subjective and challenging task and is not definitive by any means. Due to the nature and similarity of some responses, it is conceded that the current analysis may be disputed and therefore, result in a thematic re-configuration. Although the current analysis should be perceived sagaciously, it serves to provide a starting point to investigate foster parent stress. Foster Parent Stress 19 RESULTS Stressful events within each theme are organized in order from highest to lowest degree of stress and only those events demonstrating a mean score of three or higher on the five-point Likert scale will be addressed. This is not an indication that the other events are less important (a complete statistical analysis of the stressful events can be obtained from the second author). Theme #1: Foster Parents-Foster Child Relationship The most stressful events within this theme included (a) returning children to a perceived dysfunctional home, (b) witnessing children leave foster care prematurely, (c) grieving the departure of foster chil dren, (d) having to tell children that they cannot see their siblings, (e) continuously teaching basic values and personal hygiene to children, and (f) ineligibility of children for adoption after being in long-term foster care. Theme #2: Foster Child-Biological Family Relationship As indicated in the data, several factors related to the conflict between foster children and their biological parents contribute to foster parent stress. The two most stressful events included dealing with foster children when they are disappointed by their biological parents and biological parents not appearing for scheduled visits with foster children. Theme #3: Foster Parents-Biological Family Relationships The most stressful event within this theme related to the poor emotional and physical condition of children returning from a home visit. The perception that biological parents were not remaining responsible, or being held accountable, for the proper care of their children was identi fied as the second most stressful. The third most stressful event pertained to foster parents feeling caught between child welfare representatives and biological families. Finally, the poor quality and quantity of clothing returned with children following a home visit was identified as the fourth most stressful event. Theme #4: Foster Parents-Child Welfare Worker Relationship In contrast to the other stated themes, a substantial number of events appeared to fall into the foster parents-child welfare worker relationship theme; 12 events were classified in this theme. The most stressful events within this theme included (a) child welfare worker decisions that did not appear to be in the best interest of children, (b) child welfare workers believing foster children without confirming with foster parents, 20 Graham Jones and Patrick J. Morrissette (c) decisions made by inexperienced child welfare workers, (d) lack of child welfare workers' understanding and cooperation, (e) child welfare workers overruling foster parents authority, (f) poor communication between child welfare worker and foster parents, (g) child welfare worker not following up on requests, (h) unreasonable decisions made by child welfare workers, (i) foster parent's decisions undermined by child wel fare workers, (j) child welfare workers treating foster parents like clients, (k) unreasonable demands made by child welfare workers. Theme #5: Foster Child Aggression Toward Others and Property Foster children's manipulative, impulsive, and aggressive behaviour con tributed to foster parent stress in several ways. The most stressful events included (a) aggressive behaviour of children, (b) destruction of foster parent property, (c) manipulative behaviour of children, (d) inappropri ate sexual behaviour of children, (e) temper tantrums of adolescent children, (f) children wanting freedom but not wanting to assume re sponsibility, (g) allegations and investigations of abuse against foster family members, (h) having to remove children from public situations due to inappropriate behaviour, (i) children stealing, and (j) children physically abusing members of the foster family. Theme #6: Academic Issues Stressful, academically related events concerned school problems and/ or suspensions. Theme #7: Emotional Instability of the Foster Child Foster children's overall poor emotional disposition and self-defeating behaviours, that influenced normal behavioural patterns contributed to foster parent stress. More specifically, these events included (a) dis rupted sleeping habits of children, (b) children running away, and (c) substance abuse. Theme #8: Foster Parent Well-being Stressful events that influenced the well-being of foster parents pertained to three distinct issues including (a) the lack of respite and relief care, (b) foster family maintaining some personal life (e.g., vacation time), and (c) isolation and alienation within their own communities due to children's inappropriate behaviour. Theme #9: Administrative Issues When compared to the most stressful events, a larger number of events appeared to fit within the administrative issues theme than was true for Foster Parent Stress 21 the other themes; 17 events were classified within this theme while the largest number associated with other themes was 12. These included (a) rapid changeover of child welfare workers, (b) changing foster care policies with no input from foster parents, (c) removal of children from one foster home and placing them with another foster family, (d) child welfare workers assuming too much power, (e) dealing with financial issues involving children, (f) inconsistencies of child welfare workers regarding fostering policies, (g) dealing with legal issues, and (h) accu rate recording for daily foster family journals. What appeared to emerge from the statements regarding stressful events in this area pertained to an apparent lack of consistency and unity among child welfare adminis trators, child welfare workers, and foster parents. As reflected in the identified events, foster parents described a we-they [italics added] sce nario that resulted in foster parents feeling unimportant and ignored. Theme #10: Communication Issues Foster parents reported stress associated with the inadequate or excessive contact between foster children and delegated child welfare workers. For example, stressful events included (a) poor follow-up between children and foster parents following placement breakdown, (b) child welfare workers asking children leading questions, and (c) foster parent tele phone calls not being returned by child welfare workers. According to the data, inadequate contact was a stressful event that was more fre quently experienced. It could be hypothesized that when inadequate contact occurred, the foster parents have to contend with a child's displeasure and continual requests to meet with his or her child welfare worker. Theme #11: Clinical Issues A general sense of feeling excluded from children's treatment plan was apparent from the list of stressful events. Examples included (a) not being provided with background information regarding children, (b) children being removed from foster homes without their underlying needs being adequately addressed, (c) biological family visits that are not arranged in the best interest of children, (d) individual needs of children not being met, (e) child welfare workers not following through on case plans, and (f) not being given details about children-child welfare worker meetings. Additional themes included Planning/Scheduling Issues and Train ing Issues. However, these events scored below three on the five-point Likert scale and therefore, will not be discussed. 22 Graham Jones and Patrick J. Morrissette DISCUSSION The purpose of this study was to identify stressful events reported by foster parents and to discuss the implications this data has for counsellors and counsellor educators. As demonstrated in this study, foster parents encounter a myriad of stressful events that vary in degree and frequency and are not restricted to any one facet of care provision. A review of the top ten most stressful events revealed interesting findings. For example, it appears that stress is most prevalent regarding administrative issues. In other words, it is not the direct daily care of children that foster parents find most stressful but rather, it is the impact of child welfare policy and problematic communication between them selves and child welfare representatives. It should be mentioned, how ever, that events pertaining to children and their biological families were also identified as highly stressful. Furthermore, a high degree of stress was related to children's aggression and the unavailability of respite and relief care. In terms of the frequency of stressful events identified by foster par ents, there is some overlap with those events identified as most stressful. For example, administration related issues are not only identified as highly stressful but are also identified as occurring with a high degree of frequency. In addition, stress pertaining to children and their biological families and the unavailability of respite and relief care were also events that occurred frequently. A perceived lack of support from child welfare workers (e.g., having their authority overruled by child welfare workers, their decisions being undermined by child welfare workers) may amplify foster parents' experience of disrespect. What needs to be appreciated is the vital role foster parents play in the lives of foster children and their biological families. As demonstrated in the findings, the emotional needs of foster parents require constant attention. Stoneman and Crapps (1988) underscore the importance of cultivating social support re sources for caregiving families. These authors state that negative atti tudes of neighbors, for example, were associated with added stress and diminished confidence of caregiving families. As indicated in this cur rent study, foster parents experience stress when they find themselves socially isolated due to the inappropriate behaviour of children. What remains unclear, however, is whether foster parents intentionally with draw from social supports or if it is friends and relatives who distance themselves from the caregiving family. A notable divergence between the most stressful events and those listed as occurring frequently, pertained to children's behaviour. More specifically, although events relating to children's behaviours were re ported with a high degree of frequency, in general they were reported as being less stressful.