{"id":213053,"date":"2026-01-02T11:13:10","date_gmt":"2026-01-02T11:13:10","guid":{"rendered":"https:\/\/www.newsbeep.com\/nz\/213053\/"},"modified":"2026-01-02T11:13:10","modified_gmt":"2026-01-02T11:13:10","slug":"mental-health-care-for-philadelphia-foster-kids","status":"publish","type":"post","link":"https:\/\/www.newsbeep.com\/nz\/213053\/","title":{"rendered":"Mental health care for Philadelphia foster kids"},"content":{"rendered":"

From Philly and the Pa. suburbs to South Jersey and Delaware, what would you like WHYY News to cover? Let us know!<\/a>\n<\/p>\n

Studies estimate that up to 90% of children in foster care<\/a> have experienced trauma, and up to 80%<\/a> deal with significant mental health issues.\n<\/p>\n

Those backgrounds, combined with the experience of being uprooted from their homes, can lead to significant struggles for both foster children and their families.\n<\/p>\n

\u201cKids who are entering the foster care system are managing so many different transitions simultaneously,\u201d said Liz Gravallese-Anderson, a psychologist with the Safe Place Treatment and Support Program<\/a> at the Children\u2019s Hospital of Philadelphia, which offers services for children who\u2019ve experienced abuse and neglect.\n <\/p>\n

First and foremost, Gravallese-Anderson says, is the transition to a new home, which comes with new rules, new routines and new relationships, both with their foster parents and, potentially, foster siblings. On top of that, many kids have to switch schools, leaving their old friends behind, and they may find themselves worrying about the biological family they left behind.\n<\/p>\n

\u201cI think just one of those experiences alone can cause somebody to feel a significantly increased sense of loneliness and isolation,\u201d Gravallese-Anderson said. \u201cAnd when a child is experiencing all of these things at once, it can feel really overwhelming.\u201d\n<\/p>\n

What struggling looks like<\/p>\n

These struggles can manifest differently depending on the child\u2019s disposition. Some internalize their feelings, leading to withdrawal, depression and anxiety. Often, they lead to new behaviors like sleep problems, nightmares, changes in appetite, separation anxiety or even flashbacks to traumatic events.\n<\/p>\n

For children more prone to externalizing their feelings, they can lead to what Gravallese-Anderson calls \u201cacting out behaviors\u201d that tend more toward defiance.\n<\/p>\n

\u201cKids may behave more aggressively or might even refuse to go to school,\u201d she said. \u201cThey might attempt to elope. They might engage in behavior that we as adults might perceive as argumentative. This is how kids and how teenagers express their feelings when they don\u2019t have the ability to put words to what they\u2019re experiencing.\u201d\n<\/p>\n

Other symptoms are less obvious, but no less harmful \u2014 like difficulty forming healthy attachments, said Nancy Braveman, another psychologist at the Safe Place.\n<\/p>\n

\u201cSo that might look like difficulty developing trust within relationships, either with peers or caregivers or other authority figures,\u201d Braveman said. \u201cDistrust, withdrawal, discomfort in social situations, lack of social skills.\u201d\n<\/p>\n

At the other end of the spectrum are children with indiscriminate boundaries, who are prone to approaching strangers for conversation or even hugs.\n<\/p>\n

Another issue can be problems with focus and academic functioning, which are common symptoms of trauma that can be easily mistaken for ADHD.\n<\/p>\n

And those aren\u2019t the only symptoms of trauma that can be mistaken for something else.\n<\/p>\n

\u201cLike withdrawal, that can overlap and look like depression, or hypervigilance can look like anxiety,\u201d said Kristine Fortin, a pediatrician at CHOP and the medical director for its Fostering Health Program. \u201cSo that is really why it\u2019s important to have a trauma-trained provider that can help, because the treatment path is different.\u201d\n<\/p>\n

Seeking help: Trauma-focused cognitive behavioral therapy<\/p>\n

So what does trauma-informed care for foster children look like?\n<\/p>\n

One of the most effective tools in clinicians\u2019 arsenal is trauma-focused cognitive behavioral therapy<\/a>, or TF-CBT \u2014 a well-researched, evidence-based therapy for children and adolescents ages 3 to 18 who\u2019ve dealt with traumatic experiences.\n<\/p>\n

TF-CBT, which is a staple of the Safe Place\u2019s treatment program, comprises a highly structured protocol that begins with what\u2019s called the stabilization phase, in which children are taught coping skills to help them manage their trauma responses. These skills commonly include relaxation strategies, emotional expression techniques, and cognitive restructuring strategies, which involve becoming more aware of one\u2019s own thoughts and replacing unhelpful or distorted thoughts with productive, accurate ones.\n<\/p>\n

It also includes education for the child\u2019s caregivers about trauma and traumatic stress, which \u2014 hopefully, Braveman said \u2014 helps to strengthen and improve their bond.\n<\/p>\n

The goal is to help lay the groundwork for the next phase, in which children process their trauma.\n<\/p>\n

\u201cSo we\u2019re learning all these skills so that when we get to the direct work it can be done in a way that does not feel overwhelming and we can monitor and manage any associated distress the child may be feeling,\u201d Braveman said. \u201cSo we don\u2019t just jump into it from the beginning before we sort of build the capacity to do that and the trusting relationship.\u201d\n <\/p>\n","protected":false},"excerpt":{"rendered":"From Philly and the Pa. suburbs to South Jersey and Delaware, what would you like WHYY News to…\n","protected":false},"author":2,"featured_media":213054,"comment_status":"","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[10],"tags":[129173,129174,134,111,139,69],"class_list":{"0":"post-213053","1":"post","2":"type-post","3":"status-publish","4":"format-standard","5":"has-post-thumbnail","7":"category-health","8":"tag-caring-for-kids","9":"tag-foster-care","10":"tag-health","11":"tag-new-zealand","12":"tag-newzealand","13":"tag-nz"},"_links":{"self":[{"href":"https:\/\/www.newsbeep.com\/nz\/wp-json\/wp\/v2\/posts\/213053","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.newsbeep.com\/nz\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.newsbeep.com\/nz\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/nz\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/nz\/wp-json\/wp\/v2\/comments?post=213053"}],"version-history":[{"count":0,"href":"https:\/\/www.newsbeep.com\/nz\/wp-json\/wp\/v2\/posts\/213053\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/nz\/wp-json\/wp\/v2\/media\/213054"}],"wp:attachment":[{"href":"https:\/\/www.newsbeep.com\/nz\/wp-json\/wp\/v2\/media?parent=213053"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.newsbeep.com\/nz\/wp-json\/wp\/v2\/categories?post=213053"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.newsbeep.com\/nz\/wp-json\/wp\/v2\/tags?post=213053"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}