Therapeutic Child Care: An Underused Tool in Family Preservation and Foster Care

Michael Beaver • May 11, 2021

FILED  2/ 16/ 2016

BY MARIE K. COHEN

We know that chronic abuse and neglect can interrupt a young child’s brain development and result in developmental delays and behavioral problems. We also know that early intervention can mitigate the consequences of early adversity. Yet we are investing almost nothing in early childhood programs to mitigate the effects of abuse and neglect for young children.

When an abused or neglected infant, toddler or preschooler is removed from home, he or she is often placed in child care for up to 12 hours a day within a day or two of being placed with a foster family. And, at least in the District of Columbia, all that is required is that the provider be licensed and available.

For children who are found to be abused or neglected but are kept at home, states are emphasizing therapy or parenting skills training for the parents. But rarely do they invest in early childhood programs designed to mitigate the past and ongoing effects of the adversity these children are experiencing.

Seattle’s Childhaven program is one of few programs that provide therapeutic child care for children who have experienced abuse or neglect. The program provides therapeutic day care for infants, toddlers and preschoolers who have experienced trauma. At the same time, it teaches parents the skills to break the cycle of child abuse and neglect.

A study  of children who started at Childhaven between 1980 and 1982 found strong positive effects twelve years later. They were six times less likely to have committed a violent crime and two-and-a-half times less likely to use drugs. Moreover, they used 50 percent less public benefits.

Children are referred to Childhaven by child welfare services agencies, drug treatment services, public health, and welfare departments. Some are at risk of being removed from abusive or neglected homes; others have already been removed and are in foster care.

The children receive individualized, therapeutic care for six hours per day, including two healthy meals and a snack. Highly trained and experienced staff and low child-teacher ratios–3:1 for children up to two years of age and 5:1 for children aged three to five–means that staff can implement an individual treatment plan for each child.

The program achieves its therapeutic effect through consistency, structured routine, attentive listening, the opportunity for children to make their own choices, and clear limits and boundaries. Transportation is provided daily by the teachers—on a rotating basis— which allows daily check-ins with the parents.

“Childhaven is basically a trauma therapy center disguised as a day care facility, so children can have a happy, fun place to come,” Childhaven CEO Maria Wilcox told the Seattle Times.

Program staff work with parents and children together to coach parents in appropriate interactions with their children. This occurs at the center, where parents are encouraged to visit as often as they like, and where staff can model and coach parents in playing with their children. It also occurs during monthly home visits.

Childhaven offers periodic parent support group meetings to discuss issues of interest to parents. It also offers four different evidence-based parent skill-building programs for parents who are willing and able to participate.

It is easy to see why states are not investing in therapeutic child care programs. The average cost of Childhaven is $36,720 per child, per year. But remember that government money is already being spent on child care for children in foster care as well as children of low- income working mothers. And states are beginning to invest in pre-K for four-year-olds as well—money that could be funneled into therapeutic programs for children who need them.

Moreover, the cost of continuing to ignore this opportunity to help traumatized children before they enter school means continuing to incur future costs in terms of crime, drug abuse, mental illness, and public assistance.

I hope that private funders—including the new Blue Meridian Partners initiative recently covered by The Chronicle — will consider replicating this program including a randomized controlled trial to include a cost-benefit analysis. This approach may be expensive, but doing without will ultimately cost  more.

ABOUT THE AUTHOR
Marie Cohen is a child advocate, researcher, and policy analyst. She worked as social worker in the District of Columbia’s child welfare system for five years. She is a member of the Citizen’s Review Committee for the DC Child and Family Services Agency and the DC Child Fatality Review Commission and a mentor to a foster youth. Follow her blog at fosteringreform.blogspot.org, on Facebook at Fostering Reform or on Twitter@fosteringreform.

Lincoln and Jasmine's Story

By A Child's Haven • 20 Jul, 2022
Twins, Lincoln and Jasmine, were three years old when referred to A Child’s Haven (ACH) by their Early Interventionist (EI) for speech delays and extreme separation anxiety. Lincoln and Jasmine’s mother, Jessica, shared with their EI that she was struggling with her husband’s death and needed help. Her EI had just attended a Lunch and Learn at ACH and knew Jessica and this family could benefit from our multigenerational treatment services. During their ACH intake, Jessica revealed Lincoln and Jasmine’s father passed away shortly after their second birthday. After their father’s death, the twins had very different reactions. Jasmine developed extreme separation anxiety, and Lincoln went from a boy full of personality to not talking at all. The first few weeks of drop offs were extremely tough for the twins. Emotions ran high, and you could feel the children’s despair and insecurity. Our clinical team showered them with patience and support, and Jessica’s Child and Family Therapist walked her through different ways to comfort and help Lincoln and Jasmine with this transition. Once the children became more comfortable with coming to ACH, a transformation began. Our clinical team helped Jasmine identify her anxiety and taught her healthy coping strategies. Lincoln learned other ways to communicate, starting with basic sign language, until he gained the confidence to speak simple words like, “Yes”, “No”, and “Thank you.” After several months, Lincoln was speaking in full sentences again. The twins weren’t the only ones making progress. Jessica had major breakthroughs during Family Therapy sessions with their Child and Family Therapist. She worked through a lot of her grief, learned better routines that would help their family at home, and practiced coping skills with her children. Lincoln and Jasmine are now five years old and getting ready for Kindergarten this fall. The whole family continues making progress each day. An investment in A Child’s Haven is an investment in a child and family’s mental health. Donate today.

Inaugural 4K Graduation

By A Child's Haven • 07 Jun, 2022
A Child’s Haven (ACH) hosted its inaugural 4K graduation Friday, June 3, 2022 in collaboration with South Carolina First Steps (SCFS). Family members, ACH staff, community members, and Miss South Carolina USA, Meera Bhonsle, were all present for the celebration. ACH was the fourth SCFS 4K program in Greenville County and launched in August 2021. ACH also provides Therapeutic Child Care to young children suffering from trauma or abuse. The SCFS 4K program adds a traditional academic component and further ensures a child’s success when they enter a public-school classroom. ACH Program Director, Coraretta Smalls, leads the initiative with support from other clinical staff. The SCFS 4K Program enhances the ACH program as a model for Therapeutic Child Care in South Carolina. ACH Executive Director, Tanya Camunas, commented that, “We are thrilled to be graduating our first 4K class this year. Our children will enter public school having overcome their trauma and prepared to be great learners.” South Carolina First Steps is the state’s only dedicated, comprehensive early childhood initiative focused on getting children ready for school and life success. Martha M. Strickland, South Carolina First Steps 4K State Director said, “We are grateful to A Child’s Haven for partnering with First Steps 4K so that all students are fully prepared for kindergarten. SC First Steps 4K gives families the opportunity to enroll their eligible child in a free, high-quality 4K program of their choice as part of South Carolina’s Child Early Reading Development and Education Program (CERDEP).” About A Childs Haven: Founded in 1992 by Eva P. Hunt, ACH is a nonprofit 501(c)(3) that provides healing therapy for Greater Greenville’s developmentally challenged at-risk preschoolers, while fortifying vulnerable families and strengthening our community. It is one of only two Therapeutic Child Care service providers in the state. https://achildshaven.org/ About South Carolina First Steps: South Carolina First Steps to School Readiness (SCFS) is both a nonprofit and state agency and is the only dedicated comprehensive early childhood agency in South Carolina focused on getting children ready for school and life success. We serve more than 30,000 children in 81 school districts across 46 counties. https://scfirststeps.org/

ACH Receives CARF Re-Accreditation for the Fourth Consecutive Time

By A Child's Haven • 07 Jun, 2022
A Child’s Haven (ACH) recently earned our fourth consecutive Three-Year Accreditation from the Commission of Accreditation of Rehabilitation Facilities International (CARF). ACH is accredited until March 31, 2025 for Intense Family Based Services: Family Services (Children and Adolescent); with Board Governance Standards applied. CARF’s decision represents the highest level of accreditation that can be given to an organization and demonstrates ACH’s conformance to CARF standards. The process involved a rigorous peer review by a team of surveyors during an on-site visit, and the outcome affirmed ACH’s commitment to offer programs and services that are measurable, accountable, and of the highest quality. “CARF commends A Child’s Haven’s commitment and consistent efforts to improve the quality of tis programs and services and looks forward to working with the organization in its ongoing pursuit of excellence,” said President and CEO of CARF, Brian J. Boon, Ph.D. This achievement came as ACH celebrates their 30 th anniversary of providing healing therapy to children and families who have suffered from trauma. Executive Director, Tanya Camunas, said this about their recent accomplishment, “We are extremely proud of achieving the highest level of accreditation that CARF offers. This further distinguishes A Child’s Haven as an organization that is dedicated to improving the quality of lives of children and families in our community.” Learn more about ACH’s services and how you can get involved at www.achildshaven.org About A Child’s Haven: Founded in 1992 by Eva P. Hunt, ACH is a nonprofit 501(c)(3) that provides healing therapy for Greater Greenville’s developmentally challenged at-risk preschoolers, while fortifying vulnerable families and strengthening our community. It is one of only two Therapeutic Child Care service providers in South Carolina. https://achildshaven.org/ About CARF: CARF is an independent, nonprofit accrediting body whose mission is to promote the quality, value, and optimal outcomes of services through a consultative accreditation process and continuous improvement services that center on enhancing the lives of the persons served. Founded in 1966 as the Commission on Accreditation of Rehabilitation Facilities, and now known as CARF International, the accrediting body establishes consumer-focused standards to help organizations measure and improve the quality of their programs and services. For more information about the accreditation process, please visit the CARF website at www.carf.org .
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