Family Builders: Best Practice for Serving LGBTQ Youth in Foster Care

The Adoption and Safe Families Act (ASFA) of 1997 assures the permanency, safety, and well-being for all children and youth in the foster care system. These three tenets serve as the framework upon, which the COA accredited organization, Family Builders works to help find permanent, loving families for children and youth in foster care. Their Youth Acceptance Project (YAP), one impressive program among the many they provide, is designed to help one of the most vulnerable, overrepresented populations in foster care: LGBTQ and gender non-conforming children and youth. YAP provides a continuum of services to support LGBTQ and gender non-conforming youth and their families to ensure stable, permanent placements. Jill Jacobs, their executive director, talked with COA about Family Builder’s experiences with serving LGBTQ and gender expressive youth and how it led to the creation of YAP.

History and need

There are more than 400,000 youth in foster care in the United States, according to Adoption and Foster Care Analysis and Reporting Systems. A survey by the Williams Institute found that approximately 1 in 5 foster youth in Los Angeles identify as LGBTQ, twice the estimated percentage of youth not in foster care. Many LGBTQ youth in the child welfare systemare there because of rejection from their biological families as a result of making their sexual orientation, gender identity, or expression (SOGIE) known.  This rejection places LGBTQ youth at a greater risk for negative life outcomes, including increased chances of health and mental health challenges, homelessness, lower self-esteem, illegal drug use, HIV and STI’s, depression and suicide.

LGBTQ youth often encounter challenges as they navigate the child welfare system. One challenge often encountered is foster families returning the youth to care after they come out; this leads to negative outcomes such as being less likely to achieve permanency and having multiple placements. Other challenges include being more likely to be sexually abused and more likely to face discrimination, including harassment and violence in group placements.

Research has shown that family acceptance is an important protective factor for the long-term wellbeing of LGBTQ and gender non-conforming children and youth. According to a report in the Journal of Child and Adolescent Psychiatric Nursing, accepting behavior (supportive responses, positive family interactions, open communication, expressing unconditional love) is positively correlated with a myriad of mental and physical health indicators including increased self-esteem, social support, and general health status, as well as decreased depression, substance abuse, and suicidal ideation and behaviors among LGBTQ youth. 

Youth Acceptance Project (YAP)

In 2013, Family Builders launched the YAP, which has since grown to become an effective strategy to break down some of the barriers facing LGBTQ and gender non-conforming youth in the foster care system. The program is designed to keep LGBTQ youth safe in their family homes (family reunification/family preservation) and to advocate for safe and equitable permanency of LGBTQ youth when family reunification is not possible. Jill describes the intervention as “kitchen table social work”, working with parents and caregivers of children either in care or at risk of entering in order to increase acceptance of LGBTQ children among their support systems.

YAP Family Advocates are trained Masters’ level social workers that provide advocacy and therapeutic-style support to youth and their families around issues related to the youth’s SOGIE. Family advocates use a psycho-educational model and a harm-reduction framework to address the misinformation, resistance, fear, and grief that families often struggle with; ultimately moving families to a place of acceptance of their child with an emphasis on individualized, culturally responsive supports for caregivers and important adults. The project recognizes that caregivers often experience complex emotions, but with support and education they can become the affirming advocates that LGBTQ youth need. The model of intervention works by building on little changes that then culminate into bigger changes and acceptance, which creates better outcomes for LGBTQ youth. The result is families that become accepting and affirming of their children. The YAP intervention reduces the time that children spend in foster care and reunites children with their families.

YAP outreach

The work of The YAP is expanding across the country. Family Builders currently provides YAP direct services in two Bay Area counties: Alameda and Santa Clara, but is working on expanding their model. For counties and states outside of the Bay Area that are interested in developing a Youth Acceptance Project, Family Builders provides training and consultation services. Family Builders is currently working with Alleghany County’s Children, Family, and Youth Services and the Division of Cuyahoga County Children and Family Services to develop, integrate, and sustain best practices and programs that improve outcomes for LGBTQ and gender non-conforming children and youth in foster care.

Family Builder’s capacity to expand their program and consult with other agencies is due, in part, to the aid of a Children’s Bureau grant. The grant has allowed for them to develop an intensive program designed to prepare clinicians to deliver culturally-competent, ethical, effective support programs to gender expansive and LGBTQ youth and their families and offer follow-up consultation to help support clinicians and agency team members in implementing the program model. In addition to program implementation, the grant will also provide Family Builders the necessary tools and resources to collect data, ensure fidelity, and create a comprehensive evaluation for the YAP model.

Lessons for the field

Jill encourages practitioners to collect data on who is in their system, identify their specific needs, and use that information to inform the delivery of services. “The data has informed Family Builders that LGBTQ kids are overrepresented in our care so we need to include them in our conversations in order to best serve them.” According to Jill, all agency conversations, from supervisions, to case reviews, and file audits, need to have a SOGIE lens. By having conversations that include a SOGIE lens and using data to inform services, agencies are taking steps to ensure everyone in their care is honored, accepted, and affirmed for who they are. “If you’re not looking for LGBTQ kids in your care, then you’re not seeing them, and if you’re not seeing them, you’re harming them.”

This project is funded by the National Quality Improvement Center on Tailored Services, Placement Stability and Permanency for Lesbian, Gay, Bisexual, Transgender, Questioning, and Two-Spirit Children and Youth in Foster Care (QIC-LGBTQ2S) at the University of Maryland Baltimore School of Social Work. The QIC-LGBTQ2S is funded by the U.S. Department of Health and Human Services, Administration for Children, Youth and Families, Children’s Bureau under grant #90CW1145. The contents of this document do not necessarily reflect the views or policies of the funders, nor does mention of trade names, commercial products, or organizations imply endorsement by the U.S. Department of Health and Human Services.

Direct services in CA are funded by Alameda County Social Services Agency and the Walter S. Johnson Foundation.

The views, information and opinions expressed herein are those of the author; they do not necessarily reflect those of the Council on Accreditation (COA). COA invites guest authors to contribute to the COA blog due to COA’s confidence in their knowledge on the subject matter and their expertise in their chosen field.