Therapy for Foster Children: What Helps and How Foster Parents Fit In.
Most children come into foster care after something painful: abuse, neglect, or being separated from the only family they've known. Many carry that hurt with them. According to the American Academy of Pediatrics, up to 80% of children entering foster care have a significant mental health need.
Therapy is often a big part of how these children heal. Foster parents aren't therapists, but they play a bigger role in a child's treatment than most people realize. Here's what therapy for foster children looks like, the types that help most, and how you can support it at home.
Why Do Foster Children Need Therapy?
Trauma changes how children see the world. A child who has been hurt by the adults meant to protect them may struggle to trust, sleep, focus at school or manage big feelings. Moving into a new home, even a safe and loving one, is another loss on top of everything else.
That hurt often shows up as behavior: tantrums, defiance, shutting down, or acting much younger than their age. Therapy helps children understand what happened to them, learn to cope, and rebuild their sense of safety. You can read more about emotional and behavioral challenges in foster children.
Not every child needs the same thing. Most children get a mental health assessment soon after coming into care, and the right treatment depends on their age, history and needs.
Types of Therapy That Help Foster Children
These are some of the most common and best-researched therapies for children who have experienced trauma. The California Evidence-Based Clearinghouse for Child Welfare rates how strong the research is behind each one.
Trauma-Focused Cognitive Behavioral Therapy (TF-CBT)
TF-CBT is one of the most widely used treatments for children and teens with trauma symptoms like nightmares, fear or anxiety. Over several months, children learn skills to calm their body and manage their feelings, then slowly work through what happened to them. Caregivers take part in sessions, too, so foster parents learn the same skills and can practice them at home. The Clearinghouse gives it its highest rating.
Parent-Child Interaction Therapy (PCIT)
PCIT is for children ages 2 to 7 with challenging behavior. A therapist coaches the caregiver in real time, often through an earpiece, while the caregiver plays with the child. Caregivers learn play-based skills that build the relationship and encourage good behavior, along with calm, consistent discipline. It also has the Clearinghouse's highest rating for behavior problems.
Child-Parent Psychotherapy (CPP)
CPP is for children from birth to age 5 who have experienced trauma, and it always includes a caregiver. It focuses on strengthening the bond between child and caregiver, helping young children feel safe enough to heal.
EMDR
Eye Movement Desensitization and Reprocessing (EMDR) helps children and teens process painful memories. While the child thinks about a memory, the therapist guides them through side-to-side eye movements, tapping or sounds, which can make the memory less upsetting over time.
Play Therapy
Young children often can't put trauma into words. In play therapy, a trained therapist uses toys, art and games to help children express feelings and work through experiences in a way that feels natural to them.
What Is Therapeutic Foster Care?
Some children need more support than a weekly therapy appointment can give. In therapeutic foster care, also called treatment foster care, the home itself is part of the treatment. Specially trained foster parents work alongside the child's case manager, therapist and school, using what they've learned to help the child heal every day, not just during sessions.
It's a way for children with emotional, behavioral or medical needs to grow up in a family instead of a group home or residential facility.
How Foster Parents Support Therapy at Home
A child spends an hour a week with their therapist and the rest of the week with you. What happens at home makes a big difference.
Show up. Get the child to every appointment, and join sessions when the therapist asks you to.
Share what you see. Tell the therapist about changes in sleep, eating, behavior or mood, and anything that seems to set the child off.
Practice the skills. Use the same calming and coping skills the child is learning in therapy, so they work at home too.
Keep things predictable. Steady routines help children feel safe enough to do the hard work therapy asks of them.
Don't push them to talk. Let the child share in their own time. If they open up to you, listen calmly and let the therapist know.
Protect their privacy. A child's history and treatment are theirs. Learn how to handle intrusive questions from friends and strangers.
Take care of yourself. Supporting a child through trauma is hard. Watch for signs of compassion fatigue and get support when you need it.
How Therapy Is Arranged and Paid For in Virginia
The local department of social services that has custody of the child arranges and approves the child's services, including therapy. Children in foster care who are eligible for Medicaid are enrolled in Virginia Medicaid managed care, which covers mental health care for children. Foster parents generally don't pay for a child's therapy themselves.
In treatment foster care, the child's case manager helps coordinate appointments and keeps everyone on the child's team working toward the same goals.
How Intercept Health TFC Supports Foster Parents
You don't need a background in mental health to become a treatment foster parent. Intercept Health TFC foster parents receive:
Pressley Ridge pre-service training before a child is placed, and monthly ongoing training after
A dedicated case manager
Access to mental health professionals and the child's therapy team
Could You Help a Child Heal?
Children in foster care need more than therapy. They need a safe, steady family to come home to. See every step to become a foster parent in Virginia, or take our short qualification quiz.
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