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.