Promoting Healthy Relationships in Foster Care—“If I Had Seen What a Healthy Relationship Looks Like, that Would Have Changed My Perspective”

Introduction

Romantic relationships with high levels of intimacy, support, affection, and satisfaction, contribute to social emotional wellbeing and a sense of self-worth and competence (Collins et al., 2009). Indeed young adults with a history in foster care report that having a romantic partner is the social connection that most significantly increases their perception of social support and wellbeing (Zinn et al., 2017). However, high levels of intimate partner violence (IPV) among youth and young adults with history in foster care (Herrman et al., 2016) can perpetuate the generational cycle of violence and abuse. A majority of youth in the foster care system have experienced multiple forms of victimization across social contexts (Cyr et al., 2012) that increase their risk for IPV. The intervention of the child welfare system, the removal from their birth family, relationships with foster caregivers and child welfare professionals, and eventually the transition out of the child welfare system pose a unique set of opportunities and challenges. It is therefore important to understand how the experience of growing up in foster care impacts youths’ understanding and formation of intimate relationships. The present study centered the perspectives of young adults and investigated what they learned about relationships through interactions with foster caregivers and child welfare professionals and how their understanding of themselves and intimate relationships evolved in emerging adulthood.

Risk and Protective Factors for IPV in the Lives of Youth in Foster Care

According to the Adoption and Foster Care Analysis and Reporting System (AFCARS), there were 391,098 children in foster care at the end of Fiscal Year 2021, among them 110,230 youth ages 13 and older (DHHS, 2022). Foster care, also known as out-of-home care for children who have been removed from their families, includes relative and non-relative foster family homes, pre-adoptive homes, and congregate care settings such as shelters, group homes and residential treatment centers. Black youth (Cénat et al., 2021) and lesbian, gay, bisexual, transgender, questioning, and queer (LGBTQ+) youth (Baams et al., 2019) are overrepresented among youth in foster care, stay in foster care longer, and are more likely to live in congregate care than their peers.

Youth in foster care experience significantly elevated rates of IPV victimization, which can include physical violence, sexual violence, stalking, or psychological harm by a current or former partner. Herrman et al. (2016) found that 36% of youth in out-of-home care who were dating had experienced physical and sexual IPV in the past 12 months compared to 12% of youth nationally (Basile et al., 2020). When emotional and verbal IPV were included, several studies demonstrated that between 40% and 90% of youth in out-of-home care experienced some form of victimization in the past 12 months (Manseau et al., 2008Taussig & Garrido, 2017).

IPV victimization in adolescence is a risk factor for continuing IPV in adulthood (Exner-Cortens et al., 2017) and approximately 21% of foster care alumni reported some type of physical or sexual IPV at age 23/24 (Katz et al., 2020). Consequences of IPV victimization include missed educational and career opportunities, housing and economic instability, negative health and mental health outcomes, injury, and death (Niolon et al., 2017). IPV also impacts sexual and reproductive health. Reproductive coercion, comprised of behaviors such as birth control sabotage, pregnancy coercion, and condom manipulation, is associated with sexually transmitted infections and unintended pregnancies (Miller et al., 2014). The high prevalence of IPV and the associated consequences call for the development of effective prevention and intervention strategies that target specific risk and protective factors among youth in foster care. Existing research points to intersecting risk factors at the individual, interpersonal, and systems levels that include persistent trauma symptoms, placement instability and lack of connections with caregivers, and restrictive practices and policies in the child welfare system.

Persistent Trauma Symptoms and Negative Self-Concept

Children and youth who enter the child welfare system typically have a history of inconsistent, neglectful, or abusive relationships. In addition, their experiences might include peer, school, and community violence and immigration related violence all of which are frequently underreported in the child welfare system (Cyr et al., 2012Loomis et al., 2020). A majority of children in the child welfare system have experienced poly-victimization (Cyr et al., 2012), which is highly predictive of experiencing complex trauma symptoms (Finkelhor et al., 2015) that include an impairment in core capacities for affect regulation, behavioral regulation, cognitive and executive functioning, self-concept, and interpersonal relatedness (Cook et al., 2005). Several studies have found an association between persistent trauma symptoms and increased risk for chronic victimization and IPV in adolescence and emerging adulthood (Taussig & Garrido, 2017Wekerle et al., 2009). Other studies have explained the link between childhood exposure to violence and IPV perpetration and victimization in adulthood from a social learning perspective. Children who experience violence and abuse across multiple social contexts, learn and internalize abusive relationship models, accept coercive and power-based norms as ways for regulating conflict, and may seek peers and partners with similar experiences, thus continuing the cycle of abuse (Ehrensaft et al., 2003). Exposure to violence also impacts the formation of a child’s self-concept. Childhood sexual abuse, in particular, is associated with negative self-perceptions, stigma, shame, self-blame, and feelings of powerlessness (Hébert et al., 2017). Taken together these negative self-perceptions may make it difficult for youth to communicate assertively, set sexual boundaries, or negotiate condom use and birth control (Thompson et al., 2017), and increase the risk of experiencing severe violence (Collin-Vézina et al., 2006). Histories of child sexual abuse are common among youth in foster care (Ahrens et al., 2012) and are associated with transactional sex and sexual victimization later in life.

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