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Acceptance and Mindfulness Treatment for Children Adopted From Foster Care

Abstract

Children who have been adopted from the foster care system often face cumulative risk factors and are found to be more likely to exhibit higher levels of emotional dysregulation and behavior problems than non-adopted children (Pollack, 2008). Given this elevated risk for maladjustment, it is critical to develop treatments to best serve this vulnerable group and their families. The current study was the development and evaluation of a new 7-week treatment intervention for children (8-13 years old) adopted from foster care based on the principles of Acceptance and Commitment Therapy (ACT) and mindfulness practices. The overarching goal for the project was to determine whether this treatment model, Children Adapting Mindful Practices (CHAMP), is a feasible intervention for this group exhibiting or at risk for emotional dysregulation and externalizing behavior problems.

Twenty-eight children were recruited and participated in the study, which was held as a weekly group offered through TIES for Families, a program that promotes the successful adoption of children from foster care. Recruitment was expanded to include 4 children who were not adopted but also were exhibiting externalizing behavior problems. The initial design of the study was a randomized waitlist-control model, and this was partially modified to increase enrollment. The final sample included 7 waitlist participants and 21 immediate treatment participants.

Results supported the feasibility and acceptability of the program, with adequate levels of attendance and homework completion. There were not significant differences between the waitlist and immediate group outcomes. In the full group of study completers (n=25), parents reported significant decreases in avoidance of their children's emotional experiences from pre-test to post-test. Parents also reported significant decreases in child behavior problems, particularly internalizing problems, and ADHD symptoms. Two months post-treatment the gains in parental mindfulness were not maintained, but the decreases in behavior problems and ADHD symptoms were maintained at trend level or stronger. Additional significant improvements in parent-reported child behavior regulation and child-reported mindfulness and emotion regulation were identified at follow-up. These results suggest that the impact of the treatment may not be maximized until there is a period of applying the skills learned in the group.

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