Promoting Infant Mental Health in Foster Care

Infants who enter foster care are at risk for developing multiple social and emotional
problems later in life. These behavioral issues often result in foster children being placed
with multiple different families during their childhoods. In turn, an unstable family life
can lead to serious conduct disorders and mental health problems. The infants' loss of their
first attachment relationship heightens the risks for developing these problems, even if the
quality of care was poor prior to removal. Infants' reactions to this loss, combined with
other vulnerabilities, complicate the development of new secure attachments to their foster
care families. Garnering a secure attachment relationship between foster parents and foster
infants may reduce the infant's risk for developing problematic mental health and conduct
issues. PFR is a family therapy intervention focused on aiding foster care parents to
cultivate secure attachments with their foster infants. This study will evaluate the
effectiveness of the PFR program versus an EES program in promoting attachment security and
infant well-being, preventing emotional and behavioral problems, countering developmental
delay, and reducing placement instability in young foster care children.

Participants in this single-blind study will be randomly assigned to receive either PFR or
EES. Both interventions will be administered by a trained staff member of a community
agency. Participants assigned to PFR will receive ten weekly home visits that will focus on
promoting the development of a secure attachment between foster parents and infants. EES
will consist of three monthly home visits, during which infants will be assessed and
referred for additional care if necessary. EES participants will not receive any training.
Outcomes will be assessed at 1, 6, and 12 months post-intervention for all participants.