Kim, H. K. & L. D. Leve (2011). Substance use and delinquency among middle school girls in foster care: A three-year follow-up of a randomized controlled trial. Journal of Consulting and Clinical Psychology, 79(6): 740-750.
Adolescent girls in foster care are at increased risk of engaging in unhealthy behaviours such as substance misuse and delinquency yet little research has been done to evaluate the efficacy of interventions to reduce health-risking behaviours among this population. This study evaluated the Middle School Success Intervention Program, which is designed to promote prosocial skills and self-efficacy, and decrease levels of delinquency, substance use, and internalizing/externalizing symptoms among adolescent girls in foster care who are transitioning from elementary to middle school. The program included components for both the girls and their caregivers (foster parent). The girls’ curriculum included practicing sharing/cooperating with peers and meeting new people, talking to friends and teachers about what life is like in foster care, and gaining knowledge of accurate norms on substance abuse and risks of problem behaviours. The girls participated in six group sessions during the summer between elementary and middle school and weekly individual sessions with a training coach, who also served as a role model, during the first year of middle school. Foster parents participated in six group sessions, with curriculum aimed at increasing their ability to prevent adjustment problems (as the girls transitioned from elementary to middle school) and to encourage adaptive behaviours at home, in school, and within the community.
The authors used a randomized control trial design to evaluate the effects of the intervention at a 36-month follow-up period. The sample included (n = 100) girls, with a mean age of 11.54 years, and their caregivers. The girls were randomly assigned to the intervention (n = 48) or to regular foster care (n = 52). The authors hypothesized that girls assigned to the intervention would show lower levels of substance use, delinquent behaviours, and internalizing/externalizing symptoms than the girls in the control group. Results indicated that the girls in the intervention had significantly lower levels of substance abuse than did girls in the control group at 36 months post baseline and marginally significant lower levels of delinquency. The intervention was most effective in reducing risk for tobacco and marijuana use. Indirect effects of the intervention through an increase in prosocial behaviours resulted in a decrease in internalizing and externalizing symptoms.
Although the results of this study are promising, there are limitations worth noting such as the small sample size (n = 100), many of the variables relied on a single measure, and the lack of assessment of intervention effects on parenting behaviours. The authors also note that this is the first intervention they are aware of that focuses on middle school aged girls in foster care, and the majority (63%) of the girls in the study were European American. Thus, further studies with larger more ethnically diverse samples are required before recommendations can be drawn.