The Efficacy of Structured Foster Care in Serving Hard-to-Place Foster Care Youth in the U.S.A.


What Is A “Hard-to-Place Foster Child?”

Definitions vary, but hard-to-place foster children tend to be nine years or older and often experience behavioral and emotional challenges as a result of personal trauma. Many foster parents favor adopting younger children because of challenges that can come with caring for older children. As a result, the system often struggles to find placements for older young people. According to a 2019 AFCARS report, 34% of foster children in the U.S. are over age nine.

Hard-to-place foster youth are often placed in residential facilities when other options are not available. However, these facilities are not ideal for the average foster teenager and can do more harm than good. A KIDS COUNT study found that there were more than 1,000 foster kids in residential facilities. This means that instead of receiving familial support, these young people are placed in programs with treatment that potentially isn’t meant for them.

The Effective Strategies of Structured Foster Care

Possible placements for a foster youth fall on a scale from high levels of relationship and low levels of structure to low levels of relationship and high levels of structure. Typical foster homes fall on the high relationship side of the scale. Here, foster youth develop emotional connections that will aid them wherever their lives lead them next. If a given youth requires more care than the average foster parent can provide, however, this option can sometimes fall short. On the other end of the spectrum, group homes and residential facilities, highly structured environments, provide fewer avenues for relational development.

Structured foster care is a variant in which a foster family receives additional therapeutic assistance and support, striking a balance between structure and relationship. Although this concept has only come along more recently, studies have consistently affirmed the value of a structured foster care approach.

Parental Assistance

Nearly half of all new foster parents step away from fostering in their first or second year. This occurs because of a lack of support for foster parents as they work to help teenagers with unique needs. While the Department of Child Services offers monetary support, they only tend to cover about half of the typical cost of caring for a child. For this reason, we aim to help foster parents find financial aid. We also provide free counseling and a monthly support group.

Other areas in which foster parents tend to lack resources are emotional support and specialized training. The Foster and Adopt Care Coalition in St. Louis, Missouri, has employed both strategies and has raised the foster family retention rate to 97 percent through these efforts. Training helps foster parents understand a foster child’s experience and helps them understand how to respond to their children’s different behavioral patterns as their caretakers.


A foster child’s mental development, including the way they navigate and cope with their circumstances, can be heavily affected when they come from what might be considered a more unstable home life background. This results in unhealthy coping mechanisms. A report by AFCARS found neglect, abuse, and abandonment to be common, overlapping issues leading to children ending up in the foster system. One in four foster youth are likely to develop PTSD, which is double the likelihood for U.S. veterans. Over half live with behavioral or social-emotional challenges, and many also struggle with attachment and separation issues. Each of these requires frequent and qualified care that the average foster home cannot provide without a support structure like ours.

Life Skills and Support

A Children and Youth Services Review found that more than a third of youth who had aged out of the foster system reported an unmet need. Of the unmet needs reported, the needs most frequently reported were in the areas of personal finance and social support. Since young people often learn basic life skills such as personal finance, self-sufficiency, and social skills from their parents and peers, older foster youth without stable homes tend to lack resources to help meet these needs. Furthermore, foster youth in schools, no matter their status, tend to struggle more than their non-foster peers. These difficulties act as roadblocks that keep hard-to-place foster youth from succeeding in and out of the system. To address these needs, LSM’s structured foster care program includes mentoring and vocational aid. Since 50% of foster youth have no earnings or support system four years after aging out, this component is critical. LSM also provides spiritual support, which is endorsed even by secular studies. In summary, our approach is consistent with industry cutting-edge research.

LSM provides therapy and guidance for foster youth and parents through a model that emphasizes vocational training, counseling support, and healthy structure through our BrickHouse program. Through our efforts, we have provided free therapeutic services for 58 clients, ranging from addressing trauma-affected foster youth with our unique Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) approach and also by educating parents about this area.

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