Guest Opinion Essay

New Types of Therapy Hold Promise at One Treatment Foster Care Program

therapy: Adult bearded man rejects advice of family psychologist; woman and child sit next to him looking upset

Freeograph/Shutterstock

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Vast, beautiful land coupled with a rich history and cultural allure solidify the reality of New Mexico as the “Land of Enchantment.” Beyond the beauty, reports about the state are often of broken systems, poverty, addiction, high crime rate and its status as the lowest-ranking state for overall child well-being. 

Child-serving agencies in the state are working tirelessly to improve the lives of New Mexico’s children. One treatment foster care (TFC) program in northwest New Mexico is determined to resist the negative outlook assumed of the New Mexican foster care system and instead focus on providing the children in its care with the best possible outcomes, including discharge to a lower level of care, zero restraints and shorter treatment timelines.

Childhaven has served the Four Corners region for 50 years through its children’s emergency shelter, children’s advocacy center, parent education, child and family therapy, CASA volunteer and treatment foster care (TFC) programs. The organization’s proximity to rural, tribal lands greatly influences the composition of its client population, approximately 50% of which are Native American children. 

therapy: Andrea Pena (headshot), development director of Childhaven Foundation, smiling woman with brown hair

Andrea Pena

Its TFC program, staffed by a majority Native American personnel, is the only therapeutic placement of its kind for traumatized children in the northwestern corner of New Mexico. The program makes every effort to keep sibling groups together, who might be split up if placed elsewhere. It also serves as an alternative to residential treatment centers, which do not offer a home-like environment. 

The organization’s experienced foster parents support the healing of their foster children in a variety of ways including accompanying them to therapy appointments, family-centered meetings and educational planning meetings. A group of program staff called treatment coordinators oversee this highly regulated Medicaid-funded program that provides 24/7 support to eight foster homes and can care for up to 19 children. 

Accountability is high in this program. Treatment coordinators conduct weekly check-ins at each home and visit with each child in their care to monitor treatment progress and overall well-being. Approximately 80% of the children placed in the program discharge to a lower level of care, assuring the least restrictive environment for children. Over the last five years, Childhaven has seen the length of stay among children in the program trend downward, showing the treatment methods are working to reunite children with permanent placements more quickly.

New types of treatment

Treatment foster parents undergo rigorous initial and ongoing training to support their foster child’s ability to overcome behavioral challenges and ultimately transition successfully out of the program and into a safe, permanent home. Recently, the program adopted a new treatment modality, the Nurtured Heart Approach (NHA). Previous models fell short in their ability to prepare caregivers to effectively support children with higher than average emotional and behavioral needs. 

Through the Nurtured Heart Approach, caregivers are trained to strengthen the caregiver-child relationship and improve the way the child relates to themselves and the world, thereby improving the child’s chance at a successful placement in the future. Childhaven is not the only organization in the state to transition to the NHA. Many others are doing so as well, with the hope of reducing foster care placement disruptions and, more generally, the removal of New Mexican children from their biological homes. 

As the majority of children in the program are Native American, the Indian Child Welfare Act applies and prioritizes permanent placements with Native American families. Childhaven employs a certified NHA trainer who assures the program’s foster parents, staff and future placement parents are well-versed in the approach. This has enabled the organization to enhance outcomes in their treatment foster care program and attract more prospective foster parents.  

Therapy is provided to the child at least weekly and the child’s biological parents, relatives or parents vying for guardianship are included in family therapy when the treatment team concurs the child is ready to move on to this step. This helps prepare the family to continue using the tools the child has learned in treatment. 

Currently, therapists are learning a new evidence-based model called Alternatives for Families, which uses cognitive behavioral techniques geared especially for families that have experienced trauma related to domestic violence, substance abuse, family conflicts, physical aggression, anger and all forms of child abuse. This trauma-informed approach is an intervention designed to improve the relationship between children and their caregivers by addressing individual and family problems. 

Perspective from a highly regulated TFC program utilizing evidence-based treatment modalities could seem inconsequential to some. However, the program serves as a lifeline of hope for many children in the Four Corners region of the United States in need of healing from the abuse, neglect and abandonment they did not deserve. 

Childhaven’s mission of “Lifting Children from Crisis to Hope” is their daily focus and method for navigating a system presumed to be broken. As valuable work and advocacy regarding child welfare and foster care continue in New Mexico, Childhaven will be among the organizations working to improve the overall health and well-being of children in the state. Its treatment philosophies and standards of best practice will continue to evolve alongside research in the field to give children in the area the best chance of achieving positive outcomes. 

Andrea Pena is the development director of the Childhaven Foundation.

Childhaven’s Erin Hourihan (CEO), Elex Portell (executive assistant), Amanda Litschke (foster care program director), Michelle Renaud (clinical supervisor) and Galadriel Currin (foster care liaison/treatment coordinator) contributed to this column.

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