When a child enters the foster care system in the United States, often the child’s functional, emotional, and behavioral needs are not fully known at initial placement. After the needs of the child are determined and if the child needs a higher level of care, the child may be referred to what is called “therapeutic foster care.” In some states and agencies, this may also be referred to as “specialized homes,” or “treatment foster care.”

Sometimes, when people hear the word “therapeutic,” they think it refers to medical foster care. While some of the children in therapeutic care may have medical needs, typically, the kids in these types of homes have significant emotional and behavioral challenges. Here are a few things to know about therapeutic foster care:

1) Therapeutic foster families are specially trained to care for children with high needs. They are often asked to complete more pre-service training hours than required for a more traditional foster home. They may also be asked to complete a substantial amount of ongoing training hours per their licensure requirements as a therapeutic foster home.

2) Therapeutic foster families should familiarize themselves with trauma-informed care and how trauma affects the development of a child. Knowledge is power, and the more a foster family knows, the better equipped the foster parents are at being able to provide intentional nurturing, discipline, and care to children.

3) Some of the children in therapeutic foster care have had multiple disruptions and placement moves. Children in need of therapeutic foster care have struggled to make it in a more traditional foster home, are at great risk for being hospitalized or placed in a residential setting, or have are transitioning out of residential settings into the family home environment.

4) The reimbursement rate is sometimes higher than traditional foster care. Therapeutic foster care requires more out of a foster family than traditional care. Because of this, the rate of reimbursement may be higher (please note this may vary from state to state). In some programs, one parent (if it’s a two-parent home) can stay at home full time to better meet the needs of the children.

5) Agencies may limit the number of children allowed in a therapeutic foster home. Due to the special needs of children in therapeutic foster care, the number of children allowed in a foster home may be set lower than is allowed in a traditional foster home. This is intentionally done for the family to be able to better meet the individual needs of the children in their home.

6) There is a great need for families who are willing to become licensed and approved. One struggle that licensing agencies face is the challenge of approving families who desire to foster high-needs children with behavioral and emotional challenges. Child welfare agencies are thrilled when families step up to foster kids in need of therapeutic foster care.

It is challenging to be a therapeutic foster parent, but also extremely rewarding. Foster parents who choose to provide care to higher needs kids can make incredible differences in the lives of foster children who so desperately need it. It takes a tremendous amount of patience, resilience, creativity, resourcefulness, humor, and love. When these things are poured into a young life, healing begins.



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