TST-FC: Helping Children in Foster Care Manage Their Feelings and Behavior

Posted October 3, 2017, By the Annie E. Casey Foundation

Blog tsthelpingchilreninfoster 2017

When a child who has experienced trauma melts down emotionally, kin and foster caregivers can struggle to identify triggers and help them calm down. The ramifications of this can be devastating.

“One of the top reasons that foster parents ask for a child to be removed is that they feel ill equipped, incompetent and unable to help,” says Kelly McCauley of KVC Health Systems, Inc. “Foster parents want new, practical tools that they can use to make the life of a child better.”

McCauley, in consultation with Dr. Glenn Saxe of NYU Langone Health, is the author of a powerful new tool called Trauma Systems Therapy for Foster Care (TST-FC) that aims to help caregivers meet the needs of kids and teenagers who have experienced trauma. The Casey-supported curriculum includes four interactive group sessions, where facilitators lead caregivers through role playing, hands-on exercises and reflective conversations to connect what has happened in a child’s life to his or her behavior. It also offers detailed facilitator guides, training presentations, handouts and a foster parent resource guide.

As part of the training, caregivers develop skills to manage each stage of The Four R’s:

  • Regulating, when a child is calm and engaged in his or her environment. Consistency in caregiving reduces children’s anxiety and is key to maintaining well-regulated emotions and behavior.
  • Revving, when a child is reminded of trauma and has feelings of fear, panic or anger. Caregiver calmness is one of most effective strategies for dealing with this state.
  • Re-experiencing, when a child has a “fight, flight or freeze” response to a reminder of past danger. The safety of the child and others in the home is paramount, and staying “neutral” — i.e., avoiding argument or disagreement — can help a child calm down.
  • Reconstituting, when a child begins to regain control of his or her emotions. Because of the risk of escalating back into the re-experiencing state, children should be completely calm before being asked to discuss the incident or receive appropriate discipline.

A constructive technique for disciplining children who have experienced abuse or neglect is a “time-in.” Unlike a time-out, which reinforces isolation from the family, a time-in involves close supervision by the caregiver and a calm discussion with the child about the situation. “Instead of sending the child away, we have the child in the room with us in a ‘let’s think about it spot,’” says McCauley. “A time-in says, ‘Okay, your behavior in the grocery store was really out of line. I want you to sit here and think about what you can do differently next time.’”

The TST-FC training curriculum has been tested by child welfare agencies and evaluated by the nonprofit research center Child Trends. It is available online, free of charge.

Go to the training curriculum

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