Bellamy et al aim to evaluate the effectiveness of outpatient mental healthservices on the externalizing and internalizing behavior problems of childrenin long-term foster care. The sample of children were selected using atwo-stage combined stratification and cluster design, which was used to controlfor potential confounders, which in turn minimizes the risk of internalvalidity. For outcomes, they engaged in externalizing and internalizingbehavior problems using the CBCL checklist.
The CBCL has been used frequentlythroughout research in foster care and mental health studies, making it anadequate tool to use in this study. They also used multiple imputation, MI, toaddress missing data, which again seemed reasonable because they stated that MIgenerally outperforms other approaches because it often does not lead to biasand false identification significant differences. The findings of this study suggest thatoutpatient mental health services provided to children who have experiencedlong-term foster care in the U.
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S. do not result in any improvement inchildren’s behavioral health. These findings can be generalizable across thelarger child and adolescent mental health system, which means this studycontains external validity. The researchers’ biggest limitation was that therewas a balance problem on the type of maltreatment. One limitation that they didnot address but that I believe is important was that they do not definemaltreatment. There are many different views of maltreatment. Therefore,defining it could have been more helpful to readers.
Burns et al aim to identify factorsrelated to the need for and the use of mental health services among youths withthe child welfare system. The data presented in this study is from the NationalSurvey of Child and Adolescent Well-Being, which is a nationally representativesample of youth who were subjects of maltreatment investigated by child welfareagencies. This makes the data and survey significant to the study’s aim becauseit is a nationally represented sample. The study’s design consisted of astratified two-stage sample which is appropriate for this study because it is alarge sample size which makes it more statistically significant because it morereliably reflects the population mean. Continuous t-tests were used to controlfor multiple comparisons, which I believe strengthened their internal validitybecause it is important to know if there was significant difference between themeans of the two groups. Their main findings were that one half or more ofyouths who come into child welfare have manifest emotional and/or behavioralproblems.
These findings are statistically significant because they areconsistent with existing literature on mental health need for maltreated youth. The authors identify fivelimitations. A couple of them are measurement issues and reliability andvalidity. To add on to their already mentioned limitations, when parents were reportingtheir children’s behavior, they could have been using social desirability. Adifferent way researchers could have approached this was maybe observing thechildren themselves so they avoid social desirability. Minnis et al aim to assess theprevalence of mental health problems in children in foster care.
The childrenwere included in either medium to long-term foster care or permanent fostercare, which is good because it makes the results more generalizable to childrenin long-term or permanent foster care, emphasizing its external validity. Thestudy has a strong randomized control trial. For measures, they used the Strengths andDifficulties Questionnaire which focused on both the positives and thenegatives. Some can argue that it is a strong tool to use for this specificstudy because it is well-validated. To control for internal consistency, theyused the Reactive Attachment Disorder Questionnaire. To control for potentialconfounders, they entered the confounders into the regression model one by one.Data were analyzed for female foster care mothers only, which may lead topotential bias because male caretakers were not included except if they weresingle parents. The main findings supported the authors’ hypothesis that almostall of the children had been abused or neglected and over half of them hadmental health problems.
The study’s biggest limitation wasthat the sample may be biased. While I do agree with the limitations, I dobelieve that there are more that were not mentioned. The biggest one was thefact that the SDQ could have been filled out by the parents, which can call forpotential bias and social desirability. Tarren-Sweeney aims to look at ratesof meaningful change in the mental health of children in long-term foster care.Researchers used the Children in Care Study epidemiological study of mentalhealth children in long-term foster care.
This was a good tool to use becauseit consisted of a baseline cross-sectional survey which included a follow upsurvey which is always good to have because it checks for consistency. Theyused the CBCL to measure child problem behavior. I agree with this checklist inthis study because it considers valid and reliable mental health aspects.
Tocontrol for internalizing and externalizing factors, they measured social,attention and thought problems. Results confirmed the research question:substantial proportions of children in care experience very different mentalhealth trajectories. The authors mention two limitations: high sample attritionand collection of data at only two points in time. A limitation I found was thesurvey procedure section.
It seemed unclear to me how and who conducted the surveys.Also, how they went about follow-up surveys remained unclear to me as well.