FFFFoster Care

No. 64; Updated March 2023


Over 500,000 children in the United States currently reside in some form of foster care. Placement in foster care can occur for a variety of reasons. Children who are victims of parental or caregiver abuse may be removed from their parent's home by a child welfare agency and placed in foster care. Other reasons for foster placement include severe behavioral problems in the child which the parents are not capable of managing and/or a variety of parental problems, such as illness (physical or emotional), incarceration, alcohol/substance abuse, intellectual disability, or unexpected death which leave the child without an appropriate caregiver. Foster care can occur in a relative's home, licensed foster care home, or a residential facility.

Reunification of children with their parents is often the desired outcome for foster care placement if the parent(s) are able to rectify the problems that prompted removal of the child from home. Over half of the children in foster care return to their parents or other family members. If parental rights have been terminated, then a child can be placed in a relative's home or adopted. A significant number can spend long periods of time in care awaiting adoption or other permanent arrangement. Making decisions about the future for a child in foster care is called permanency planning.

Options include:

  • returning the child to his/her birth parents
  • termination of parental rights (a formal legal procedure) to be followed, hopefully, by adoption
  • Long-term care with foster parents or relatives

Most states encourage efforts to provide the birth parents with support and needed services (e.g. mental health or drug/alcohol treatment, parent skills, training and assistance with child care, and/or adequate housing) so their child can be returned to them. When parental rights have been terminated by the court, most states will try to place children with relatives (kinship foster care or relative placement) which may lead to adoption by the relative.

Being removed from their home and placed in foster care is a difficult and stressful experience for any child. Many of these children have suffered some form of serious abuse or neglect. About 30% of children in foster care have severe emotional, behavioral, or developmental problems. Physical health problems are also common. Most children, however, show remarkable resiliency and determination to go on with their lives. Children in foster care often struggle with the following issues:

  • blaming themselves and feeling guilty about removal from their birth parents
  • wishing to return to birth parents even if they were abused by them
  • feeling unwanted if awaiting adoption for a long time
  • feeling helpless about multiple changes in foster parents over time
  • having mixed emotions about attaching to foster parents
  • feeling insecure and uncertain about their future
  • questioning positive feelings for foster parents

Foster parents open their homes to children in need of temporary care, a task both rewarding and challenging. Unfortunately, there has been a decrease in the number of foster parents (non-relative) available to care for children. This results in larger numbers of children remaining in institutional settings. Fortunately, the number of relative caregivers (kinship foster care) has increased.


Challenges for foster parents include:

  • understanding mixed feelings toward the child's birth parents
  • recognizing their difficulties in letting the child return to birth parents
  • dealing with the complex needs (emotional, physical, etc.) of children in their care
  • working with sponsoring social agencies
  • finding needed support services in the community
  • dealing with the child's emotions and behavior following visits with birth parents

Children in foster care who have severe emotional or behavioral problems can be referred for a psychiatric evaluation with the help of their child welfare agency. Child and adolescent psychiatrists provide comprehensive evaluations including diagnosis and treatment recommendations. Plans can include psychotherapy, family therapy, and psychiatric medication if indicated. Children in foster care have special and complex needs that are best addressed by a coordinated team that should include the birth parents, foster parents, mental health professionals, and child welfare staff to insure compliance and safe transition of care.

For additional information about foster care, contact:
Child Welfare League of America (CWLA)
440 First Street, NW, Third Floor
Washington, DC 20001-2085