Caregiver Experiences with a Trauma-Informed Parenting Program: Examining the Resource Parent Curriculum

Abstract

Background

Young people in out-of-home care often have trauma histories that negatively impact their development and well-being. As a result, resource parents often face challenges meeting the needs of these youth, which can be addressed by ensuring access to effective trauma-informed training.

Objective

This qualitative study examined the impacts and helpfulness of a trauma-informed program (Resource Parent Curriculum (RPC)) designed for resource parents who care for a young person involved with child welfare.

Methods

Twenty resource parents from two child welfare agencies in Ontario, Canada participated in focus groups and interviews after completing the RPC program.

Results

Results of a thematic analysis indicated that, through use of relevant materials from the program, resource parents reported a better understanding of trauma reactions in their resource child. This improved understanding influenced their parenting approach when addressing their child’s behaviours through consideration of their underlying needs.

Conclusions

The findings can be used to support trauma-informed programming for resource parents within child welfare.

Introduction

Young people with lived experience in the child welfare system often have complex needs due to their frequently-documented histories of developmental trauma. Resource parents (foster, kinship, adoptive, or customary caregivers1) who care for young people would benefit from additional training opportunities to better understand and manage these complex needs. For example, caregiving challenges can be mitigated by providing resource parents with access to training in trauma-informed parenting (National Child Traumatic Stress Network, 2018a). Although trauma-informed care has been recognized as a beneficial framework for resource parents, there is currently no mandated in-service trauma-informed training for resource parents in the province of Ontario, Canada. The Resource Parent Curriculum (RPC) is one example of a trauma-informed parenting program developed by the National Child Traumatic Stress Network in 2010. Previous research has found that resource parents who participated in RPC reported improved parenting outcomes, such as increased knowledge of and beliefs in trauma-informed parenting, improved parenting self-efficacy, and higher tolerance of challenging youth behaviours (Murray et al., 2019; Sullivan et al., 2016). This study is the first to utilize qualitative methods to examine resource parents’ perspectives of RPC and is part of a larger quasi-experimental evaluation of the RPC program within a Canadian context.

Literature Review

Child Welfare in Ontario

In Ontario, Canada, there are currently 50 Children’s Aid Societies, including 12 Indigenous Child and Family Well-Being agencies, governed by the Ministry of Children, Community, and Social Services. It is estimated that 2.8/1,000 young people aged 17 years and younger are currently living in out-of-home care (Sistovaris et al., 2020). Incidence data show that, of the substantiated cases in Ontario in 2018, exposure to intimate partner violence was the most common type of maltreatment (45%), followed by neglect (21%), physical abuse (12%), emotional harm (12%), and sexual abuse (3%; Fallon et al., 2020).

Many young people involved with child welfare have complex needs due to their histories of developmental trauma. Developmental trauma is a form of chronic trauma that occurs during early childhood when children’s brains are rapidly developing. It includes ongoing exposure to adverse events, such as maltreatment, neglect, and/or violence in the home environment, typically involving an individual in a caregiving role (van der Kolk, 2005). The effects of developmental trauma can be exacerbated through child welfare involvement (e.g., removal from the home and placement in out-of-home care), which can cause additional instability and loss (National Child Traumatic Stress Network, 2018b). Depending on the nature of a young person’s traumatic experiences, along with their risk and protective factors, developmental trauma may lead to difficulties with attachment, interpersonal relationships, emotion regulation, physical health, mental health, as well as cognition and learning (Kisiel et al., 2009; National Child Traumatic Stress Network, 2018b).

The Importance of Training for Resource Parents

Resource parents have the important and challenging responsibility of caring for young people with complex needs, all while receiving limited training and ongoing support (Whenan et al., 2009). Caregivers who feel unprepared in parenting these young people often report being less satisfied in their role as resource parents, which can result in such negative outcomes for the young person as a placement breakdown (Farmer et al., 2005). Effective training has been related to more positive youth and resource parent outcomes that include placement stability and permanency, as well as greater resource parent retention and satisfaction (Konijn et al., 2019; Littlewood et al., 2020; Piescher et al., 2008; Price et al., 2008).

In Canada, provinces and territories govern their own child welfare systems and thus, training requirements for resource parents are not consistent across the country (Provincial and Territorial Child Protection Legislation and Policy, 2018, 2019). Training opportunities can also differ between agencies within the same province and territory. In Ontario, prospective resource parents are required to complete either the Parent Resource for Information, Development, and Education (PRIDE) training or the Helping Establish Able Resource-Homes Together (HEART) along with the Strong Parent Indigenous Relationships Information Training (SPIRIT) training (i.e., PRIDE or HEART and SPIRIT together). PRIDE training is a 27-hour pre-service educational training which covers topics related to child welfare systems, attachment and loss, effects of trauma, forming connections, and using trauma-informed parenting practices (Child Welfare League of Ontario, 2020; Ontario Association of Children’s Aid Societies, 2022). As of 2020, resource parents in Ontario also have the option of completing the HEART and SPIRIT training, as an alternative to PRIDE, to support Indigenous families. This training is grounded in Indigenous teachings and provides supports to resource parents in caring for an Indigenous young person (Association of Native Child and Family Services of Ontario, 2022). Although these pre-service trainings provide a preliminary introduction to important trauma-informed concepts, resource parents often require more comprehensive training and support once they begin caring for a young person, with a particular need for topics related to trauma-informed care.

Trauma-Informed Resource Parent Programs

Trauma-informed care (TIC) is a systems approach that acknowledges and addresses the high prevalence of trauma within our communities, promotes recognition regarding the signs of trauma, provides contextual and developmentally appropriate treatment strategies, and reduces the risk of re-traumatization (National Child Traumatic Stress Network, 2018a). It is a holistic framework that includes all levels of service providers with the collective goal of creating an environment, for all involved, that is emotionally safe. TIC can be beneficial for different fields, such as healthcare, social work, child welfare, and criminal justice systems, all of which have begun to adopt greater trauma-informed practices (Centre on the Developing Child, n.d.).

Several trauma-informed programs have been developed to address the needs of resource parents who care for young people with histories of developmental trauma. These programs include: (1) Fostering Connections: The Trauma-Informed Foster Parent Program; (2) ARC Reflections Training Program (based on the Attachment, Regulation, and Competency Framework); (3) Pathways to Permanence 2: Parenting Children who have Experienced Trauma and Loss (Pathways); and (4) Resource Parent Curriculum (RPC). While it is beyond the scope of the current study to provide a detailed review of existing in-service resource parent training programs, in this study, we focused on the implementation of RPC for three reasons: (1) future sustainability of the program (i.e., freely available materials and facilitator training), (2) program components have been shown to be important for effective resource parent training (Kemmis-Riggs et al., 2018), and (3) there have been several initial evaluations of the RPC program that have shown promising results, but no previous qualitative research has been conducted thus far.

Resource Parent Curriculum (RPC)

RPC is a trauma-informed parenting program for resource parents developed by the National Child Traumatic Stress Network in 2010. The goals of this program are to: (1) Support resource parents in adopting a trauma-informed lens to promote healing; (2) Support the maintenance of stable placements for a young person in care; (3) Increase parenting self-efficacy; and (4) Acknowledge the importance of self-care and connections with other resource parents (Grillo et al., 2010; The California Evidence-Based Clearinghouse for Child Welfare, 2018). The program includes eight modules and is delivered in a group format, ideally on a weekly basis for 2 h per week. Through the presentation of materials by two facilitators as well as group discussions, resource parents learn about the effects of developmental trauma, tangible caregiving strategies, advocacy for the young person in their care, and the practice of self-care. The eight modules covered in RPC include: Module 1- Welcome and introductions; Module 2- Trauma 101; Module 3- Understanding trauma’s effects; Module 4- Building a safe place; Module 5- Dealing with feelings and behaviours; Module 6- Connections and healing; Module 7- Becoming an advocate; and Module 8- Taking care of yourself (Grillo et al., 2010). The program includes free and accessible materials including manuals for the facilitators and participants through the National Traumatic Stress Network (NCTSN) website (www.nctsn.org). Learning objectives for each module are outlined in Table 1.

Table 1.

RPC Learning Objectives (Grillo et al., 2010)

Module	Topic and Learning Objectives
1	Introductions Describe the concept of trauma-informed parenting and its benefits Review the essential elements of trauma-informed parenting and myths to avoid
2	Trauma 101 Define child trauma and describe how children may respond to traumatic events Define resilience and describe how you can promote resilience in your children
3	Understanding Trauma’s Effects Describe the ways in which trauma can interfere with children’s development and functioning Describe how children of different ages may respond to trauma Describe the “invisible suitcase” and how trauma-informed parenting can “repack” the suitcase
4	Building a Safe Space Describe key components of a safety message and how to deliver an effective safety message to children who have experienced trauma Define trauma reminders and give an example of a trauma reminder and reaction List at least three ways you can help children to cope with trauma reminders
5	Dealing with Feelings and Behaviours Describe the cognitive triangle and apply it to a child who has experienced trauma Identify at least three reasons why children who have experienced trauma may act out Describe at least three ways you can help children develop new emotional skills and positive behaviours
6	Connections and Healing Identify at least three important connections in your child’s life and ways in which you can support and maintain these connections Describe how trauma can affect children’s view of themselves and their future List at least three ways in which you can help your child feel safe when talking about trauma
7	Becoming an Advocate List at least three of the basic elements of trauma-informed advocacy List at least four indicators that a child may need the support of trauma-informed therapists Describe specific actions you can take with an actual member of your child’s team
8	Taking Care of Yourself Define and list the warning signs of compassion fatigue and secondary traumatic stress Identify specific self-care techniques that can help prevent compassion fatigue and secondary traumatic stress Describe at least three coping strategies you can use when a child’s trauma is a reminder of your own past trauma

The RPC program’s effectiveness has been evaluated through several pre-post empirical studies (Angelow et al., 2023; Gigengack et al., 2019; Murray et al., 2019; Stenason & Romano, 2022; Strolin-Goltzman et al., 2018; Sullivan et al., 2016) that indicated enhanced knowledge of trauma-informed parenting. These studies found that resource parents reported improved parenting self-efficacy, increased knowledge of trauma-informed parenting practices and attitudes, reduced parenting stress, increased recognition of their youth’s post-traumatic stress symptoms, and greater tolerance of challenging youth behaviours after participating in RPC.

A recent, quasi-experimental evaluation of RPC (Stenason & Romano, 2022) collected parent self-reported data at pre-program, post-program, and 2-month follow-up. This study was conducted in Ontario, Canada with resource parents (22 in the experimental group and 21 in the waitlist control) who attended the program virtually (because of COVID-19 pandemic protections). Compared to the waitlist control, parents who completed RPC reported statistically significant improvements in knowledge of and beliefs in trauma-informed parenting, and these improvements were maintained at the 2-month follow-up. Although not statistically significant, potential effects were reported for improved tolerance of challenging youth behaviours and parenting self-efficacy. Non-significant potential effects were also noted for improvements in the attachment relationship with their youth and increased social supports (Stenason & Romano, 2022). As part of this quasi-experimental evaluation, caregivers completed qualitative post-program feedback questionnaires and module evaluations. Caregivers discussed impactful program aspects including exercises that helped them develop further empathy with their youth by understanding the connections between a youth’s behaviour, emotions, and thoughts/beliefs (Romano & Stenason, 2022). Caregivers also highlighted the importance of the self-care module and the need to take care of themselves (Romano & Stenason, 2022).

Study Objectives

The RPC program provides resource parents with both theoretical knowledge to promote greater understanding, along with practical caregiving skills. This study sought to supplement quantitative information about the program’s impact by gathering resource parents’ perspectives through a qualitative lens. As such, focus groups and interviews were conducted to gather resource parents’ perspectives regarding RPC’s content, including the impact and utility of the program, helpful aspects of the program, and suggestions for improvement. To our knowledge, there is currently no other Canadian or qualitative research on the RPC program.

Methodology

Participants and Procedures

A pilot quasi-experimental mixed methods program evaluation of RPC was conducted, and the current study focused on the qualitative evaluation component. Ethics approval was granted by our university’s Office of Research Ethics and Integrity. Resource parents were recruited through collaboration with two Ontario child welfare agencies and through social media outlets. To enrol in the program, participants had to be resource parents in Ontario currently providing care for a young person involved with child welfare. Resource parents were able to participate in the program without being involved in the research. Resource parents in the research were asked not to participate in other parenting programs for the duration of the RPC program. The program was delivered virtually to 92 resource parents due to COVID-19 public health protections (43 research participants with 22 in the experimental group and 21 in the waitlist control). Six groups were delivered between March 2020 and August 2021 (three experimental groups and three waitlist control groups). Five groups were delivered once per week for eight weeks, and one group was delivered twice per week for four weeks to accommodate scheduling constraints. As per the NCTSN guidelines, the training was delivered by one facilitator and a co-facilitator. The facilitator was the lead investigator of the program evaluation and was a clinical psychology doctoral candidate (second author). There were two co-facilitators, both of whom were employees in the child welfare sector and one of whom had lived experience as a resource parent. One group was delivered without a co-facilitator due to scheduling issues. All program modules were subject to fidelity monitoring by a trained, graduate-level research assistant.

Once resource parents completed the program, they were invited to participate in a virtual focus group or individual interview to discuss their perspectives of the program. Twenty resource parents agreed to participate (22% of all resource parents who engaged in the program). The interviews/focus groups were conducted virtually and were facilitated by a trained, graduate-level research assistant (first author). A total of five focus groups were conducted. According to Hennick and Kaiser (2022), 4–8 focus groups is considered sufficient to achieve an optimal range of saturation for qualitative research. Due to feasibility and the availability of resource parents, the number of participants in each focus group varied. Two focus groups had six resource parents, three focus groups had two resource parents, and two resource parents participated in individual interviews because of scheduling issues. Data collection occurred approximately one week after program completion and took 45 to 90 min. Prior to the focus group or individual interview, participants were guided through the informed consent process (e.g., purpose of the research, confidentiality, data usage and storage). Focus group and interview content were audio-recorded, transcribed, and de-identified by a graduate-level research assistant in preparation for analysis.

Demographic information on resource parents (n = 20) who participated in the focus groups and interviews was not collected. Some of these participants may have been involved in other aspects of the larger quasi-experimental program evaluation (n = 92), for which demographic information was collected; however, the data could not be linked. Demographic information for the quasi-experimental evaluation can be found in (Stenason & Romano, 2022).

Measure

The focus group/interview adopted a semi-structured approach with open-ended questions that covered the following sections: overall program impacts (e.g., Because of what you’ve learned in this program, what do you think has changed for your child in care? ); perspectives from each module (i.e., helpful and less helpful aspects of the module, and suggestions for improvement); and general questions about the program as a whole (e.g., What were some positive things about being in a group with other resource parents? What were some challenges? ). Due to the semi-structured nature of the discussion, the facilitator followed up on resource parents’ responses to gather greater detail or specific examples when needed. Prior to questions on each module, resource parents were provided with a brief summary of the learning objectives that were covered to orient them to the content of a particular module. Participants were also asked questions pertaining to the delivery of the program and suggestions for program improvement. However, analyses of these data were beyond the scope of the current study.

Analysis

Once all focus group and interviews were completed, transcriptions were created from the audio files and prepared for analysis. Transcriptions were examined through a descriptive thematic analysis guided by a hybrid approach to deductive and inductive coding (Fereday & Muir-Cochrane, 2006). First, taking a deductive approach, an a priori coding manual was developed based on the semi-structured interview questions. The categories included: overall program impacts; Modules 2/3 (Trauma 101 and Understanding Trauma’s Effects); Module 4 (Building a Safe Space); Module 5 (Dealing with Feelings and Behaviours); Module 6 (Connections and Healing); Module 7 (Becoming an Advocate); Module 8 (Taking Care of Yourself); and general questions about the program (e.g., how was your experience with the facilitators? ). Taking an inductive approach, transcriptions were then reviewed to identify additional code categories that may have emerged beyond the semi-structured interview questions. Next, themes were identified that fit within each of these categories and frequencies were applied to each endorsed theme. Each transcription was reviewed by two coders (first two study authors) for inter-rater reliability, who came up with individual coded categories which were later re-worked in collaboration until a consensus was reached. Considering the abundance of responses, only themes endorsed by three or more participants were included in the analysis.

Both researchers/coders engaged in a process of reflexivity throughout the duration of the research study (Finlay, 2002). This process included acknowledging our biases and positions in the context of this study and removing these preconceived notions as much as possible. Both authors involved in the coding process have experience working with child welfare involved families in both research and clinical settings. Personal demographic factors that were considered included coder race, gender, sexual orientation, socioeconomic status, and lived experience in the child welfare system. We also acknowledge possible biases as one author (second author) was involved as a facilitator of the program for purposes of her doctoral dissertation. However, the first author was not directly involved in the selection or implementation of the RPC program. Thus, it is possible that a potential bias could include favouring positive feedback from participants. To maintain the validity of the study, we engaged in active journaling and created memos throughout each stage of the study, which we used as reflection tools to re-examine and challenge our assumptions during interactions with participants and when interpreting the results.

Results

Overall Program Impact

Improved Parent-Youth Connection due to a Better Understanding of Young People’s Underlying Needs

Five resource parents noted that after participating in RPC, they felt a deeper connection with the youth in their care because the program helped them to better understand their youth’s underlying needs. For example, RPC taught resource parents to look underneath the behaviour and identify its root cause so that they could better address the youth’s underlying needs. Through understanding their youth’s underlying needs, resource parents reported that they felt better able to tolerate challenging behaviours. One resource parent commented: “… seeing them through a different lens at this age was pretty eye opening for me, just trying to, um, evaluate their responses through their [invisible] suitcase as well and not just ages and stages but trauma past and current (see “The Invisible Suitcase Metaphor” section below for a description of the Invisible Suitcase).” Two resource parents expressed that other relationships in their life have improved since RPC because they have extended these trauma-informed principles beyond the parent-youth relationship. One resource parent shared: “So, but I [want to] tell you yes, the relationship has really improved and in my mind, you know what I’m doing right now? I didn’t just apply the principles to my foster children, I do it to my family members as well.”

A Validating Refresher that Allowed Reflection and that Reinforced Trauma-Informed Parenting Practices Already in Use

Ten resource parents revealed that much of RPC’s content reinforced their existing knowledge. Nonetheless, most resource parents shared that they appreciated the training because it was a validating refresher that reinforced their current parenting approaches. One resource parent commented: “This whole trauma parenting thing is something that a lot of us have all evolved into, and having what [RPC facilitator] has done for us is keep it fresh in our mind because it’s easy to get stuck in a rut. So, this is that and you know, day after day so for me, it definitely freshens things up.” Another resource parent said: “You know I’ve been on that sort of learning process for a long time so I would say that the program really kind of moved me along the path, so to speak, with really thinking through whether it was the types of trauma or understanding the impact and exploring once again the fight flight collapse, you know… but just really excellent reminders at this point in my fostering journey with this trip, with this child.”

One parent also revealed that they enjoyed the training because, although they felt they knew some of the information, it provided concrete terminology for some of the concepts and evidence-based content to confirm they were on the right track with their youth.

Youth in Care Benefit from a Unique Parenting Approach

Five resource parents revealed that RPC helped them realize that parenting a young person in the child welfare system requires a unique set of knowledge and strategies, compared to parenting a child without such trauma histories. One resource parent commented: “… this is really huge knowing that [effects of trauma], because you’re not sometimes sure as a parent, like am I doing something wrong with this one? Because I’ve done something different with my own kids…this really seeing their behaviours change and knowing that something significant has gone on and it’s not you [laughs].”

Overall Training

In terms of the overall program, resource parents identified two main themes: (1) Learning tangible and practical strategies and (2) The use of case examples.

Tangible Practical Strategies

When resource parents were asked to reflect on the overall program, four individuals revealed that they appreciated learning practical strategies and tools that could easily be implemented in their homes. For instance, RPC provided specific guidelines for responding to a young person’s trauma reminders and disclosures and for giving a safety message (Module 4: Building a Safe Place; Grillo et al., 2010). Two resource parents mentioned that, while past trainings may have provided depth of information and theoretical background, there often were limited tangible and concrete strategies that could be easily applied by resource parents. One resource parent commented: “We’re getting an awful lot of training and we walk out of the training thinking OK but I need tools, how do I deal with that, how do I work with that, how can I help to change that? This training absolutely did that for us so yeah, the tools piece is very, very much needed in foster care and adoptive training.”

One resource parent shared that such trainings are offered infrequently, and they appreciated having a workbook that could be continually referenced even after the program ended. This parent commented: “We don’t get these types of trainings often so to have this [RPC program] and to have the book and when something, you know, terrible happens, we can look back and go OK yeah, this makes sense now because when you’re in the moment, sometimes it’s a little trickier. So, this is tangible.”

The Use of Case Examples

Four resource parents revealed that the use of specific case examples helped illustrate the concepts covered in RPC. Throughout the program, the stories of several children and families were followed to apply the information learned. Facilitators also tied in their own clinical experiences throughout the modules when describing various concepts and techniques. One parent shared that these examples were “invaluable” as some of resource parents were relatively new to working with young people in care. One resource parent noted: “The discussions and examples that both [RPC facilitators] brought, I mean were just invaluable as far as I was concerned, and I was really happy for some of the other participants because you could see in their comments that a lot of this stuff was brand new for them and super, super helpful.”

Modules Addressing the Impact of Trauma

The following themes addressed resource parents’ perspectives from Module 2 (Trauma 101) and 3 (Understanding Trauma’s Effects). Four concepts resource parents found most helpful included: (1) Learning about the types of trauma; (2) Understanding the impact of trauma on different domains of development; (3) the Invisible Suitcase; and (4) Learning about opportunities for healing.

Types of Trauma

Three resource parents identified that learning about the different types of trauma was particularly helpful. Resource parents learned the differences between various forms of trauma including acute, chronic, and complex (Grillo et al., 2010). For example, there was discussion of how complex trauma includes exposure to multiple traumatic events which are often invasive and interpersonal in nature and which often occur alongside other forms of adversity (NCTSN, 2024). There was information about the ways in which these experiences can have a wide-ranging impact on children’s development, including attachment, physical and cognitive development, sense of safety and stability (NCTSN, 2024). Resource parents also learned about the different types of complex trauma relevant to child welfare involved youth, including physical abuse, sexual abuse, emotional abuse, and neglect (Grillo et al., 2010). Resource parents noted that learning about the types of trauma served as a reminder to reflect on the histories of the youth in their care. One resource parent noted: “I found the discussion of the types of trauma very useful and was reminded once again that the child in my care has experienced all of the types of trauma that were described.”

Impact of Trauma on Different Developmental Domains

Four resource parents shared that they appreciated learning about the impact of trauma on different areas of functioning, including brain development and the stress response system, as well as learning about how trauma presents across developmental stages. Resource parents reported that they reflected on the youth in their care, which helped them better understand their youth’s challenges. One resource parent commented: “…understanding trauma’s effect and particularly, I mean I had heard often about fight or flight and I knew about freeze but the collapse, I had some early experience with [dissociation] and some other things so, at the time I had no training to understand what that was all about, it was you know, very frightening so, to have a program that really spoke to that, I very much appreciated.”

The Invisible Suitcase Metaphor

Nine resource parents identified the concept of the “Invisible Suitcase” as one of the most helpful concepts covered in the program (Grillo et al., 2010). The Invisible Suitcase is a metaphor used to describe the beliefs and expectations a young person develops about themselves (e.g., I am not worth taking care of), others (e.g., adults cannot be trusted), and the world in general (e.g., the world is not a safe place) as a result of their past experiences. Resource parents learned this metaphor through the use of a case example and had an opportunity to apply this concept to a young person in their care. Through these examples, resource parents brainstormed ways in which they could help the young person “repack” their suitcase to have more positive beliefs and experiences. One resource parent commented: “We talked about the [invisible] suitcases and how that sort of brought to mind what was going on in her head…I thought to myself ‘oh my goodness, just how much trauma was in this nine-year old’s brain’ that would be the first thing she would do you know, when she had to have her quiet time was pack her stuff.”

Module 4 (Building a Safe Place)

From Module 4, resource parents identified four overall themes as the most helpful in caring for their young person: (1) Reinforced the importance of stability and consistency in their young person’s life; (2) Learning about emotional “hot spots”; (3) Distinguishing between psychological and physical safety; and (4) The Emotional Container.

Reinforced the Importance of Stability and Consistency

Three resource parents revealed that Module 4: Building a Safe Place reinforced the importance of providing a safe, stable, and consistent home for their youth. Several resource parents highlighted that many of their youth grew up in unpredictable environments, and RPC reinforced the need to provide a sense of routine and stability so that young people can begin to feel physically and psychologically safe. One resource parent commented: “I wish I probably knew some things a bit differently that I did, but I think routine is so…and stability, because they come from such instability than they’re lost. Little or big, they’re lost and they don’t know who’s coming next, or what’s going to happen next or what’s going to happen to them.”

Emotional “Hot Spots”

Three resource parents identified that learning about emotional “hot spots” (e.g., common challenges youth in care experience) was helpful in caring for their youth. The emotional “hot spots” covered in RPC consisted of physical boundaries, food/meal times, and sleep/bedtime (Grillo et al., 2010). RPC provided psychoeducation on understanding these common difficulties (e.g., how food insecurity or neglect may result in food hoarding) and addressed strategies to manage these hot spots (e.g., consider the child’s history, set consistent meal times, accommodate the child’s food preferences). One resource parent commented: “Managing of emotional hotspots was a big one for us… I call it an onion, started to peel and we got down layer by layer of different layers of her trauma and it was an emotional hotspot … dinner, that was also a really good one…”.

Distinguishing between Physical and Psychological Safety

Three resource parents noted that they appreciated learning about the differences between physical and psychological safety. For instance, resource parents learned that while youth may be physically safe when they enter their homes, they still may not feel psychologically safe due to their experiences of trauma. This concept helped resource parents not only maintain a physically safe environment but also facilitate emotional safety (Grillo et al., 2010). One resource parent discussed how they created a safe space as soon as a youth come into their home: “Safety is a big thing and think of a youth when they come into care, they may be [coming from the streets], no rules, no regulations…free access do what they want…regardless of the dangers…I go over basic things you know bedtime…the most important safety things…I discuss with them it’s to keep them safe while they’re here…”.

Emotional Container

Five resource parents shared that they appreciated learning about the “emotional container.” The emotional container is a concept to address the difficulties young people with trauma histories often have in understanding, expressing, and managing their emotions. As a result of their overwhelming feelings, new stressors, unfamiliar situations, and trauma reminders, these young people may unconsciously try to “confirm” their beliefs in their Invisible Suitcase by behaving in ways that elicit the responses they expect from others. When resource parents encounter these behaviours, they learn through RPC to be an “emotional container” for the young person by responding calmly and ‘being with’ the young person during difficult moments (Grillo et al., 2010). One resource parent commented: “A good reminder was the whole notion of an emotional container and a reminder that I need to tolerate strong emotional reactions calmy and think about what’s in their suitcase that may be giving rise to whatever it is that I’m seeing. So, I think that I mean some of the other stuff about structure and routine and how clear house rules and all of that kind of thing, good reminders as well but I think the emotional container concept was most relevant for me right now.”

Module 5 (Dealing with Feelings and Behaviours)

From Module 5, resources parents found two concepts to be the most beneficial to caring for their young person in care: (1) The Cognitive Triangle and (2) Balancing Corrections and Encouragement.

Cognitive Triangle

Five resource parents identified the Cognitive Triangle as a particularly helpful concept. The Cognitive Triangle refers to the connections among one’s emotions, thoughts, and behaviours. Resource parents learned how trauma can impact a young person’s ability to notice the relationships among their thoughts, emotions, and behaviours; understand and express their emotions; read others’ emotional cues; and understand their quick reactions to any perceived threat. Resource parents learned that these reactions are not ‘manipulative’, but rather unconscious (e.g., understanding how certain difficult behaviours can be considered survival strategies that were once adaptive). Resource parents followed a case example and applied the Cognitive Triangle to a child in their care (Grillo et al., 2010). One resource parent commented: “This we call it the triangle, is an amazing tool where you know, you have to be aware of their thoughts and their behaviours and their feelings. In other words, you’re going to step outside of yourself and try to understand where they are at.”

Balancing Correction and Encouragement

Seven resource parents identified learning about the balance of corrections (e.g., telling the child to do or not do something) and encouragement (e.g., fostering the child’s talents, providing choices, praise) as particularly helpful. Resource parents were led through an experiential exercise where they reflected on how frequently they engaged in corrections and encouragement during the previous week. Resource parents reflected on the proportion of corrections and encouragement in which they had engaged, and facilitators addressed various strategies for striking this balance (Grillo et al., 2010). One resource parent commented: “…found one of the best things for me was that visual cueing of positive rather than negative behaviours because sometimes I think that we get stuck in a rut of what we’re doing daily and for some kids it doesn’t work.”

Theme 6: Module 6 (Connections and Healing)

From Module 6, resources parent identified two themes as being helpful in addressing the needs of their young people in care: (1) Using case examples and (2) Identifying connections.

Using Case Examples

While case examples were utilized during all modules, seven resource parents identified that the case example covered in Module 6 (Connections and Healing) was particularly impactful. This case example followed a family coping with trauma and separation, and the group discussed how each individual in the family may have experienced the events differently. It addressed the various perspectives of different members of the family system, including the resource parent, children, and biological family members (Grillo et al., 2010). One resource parent commented: “It was through the stories … that was something that kind of brought it home to us because that’s what we do, and we know how important it is for the kids.”

Identifying Connections

Four resource parents appreciated the “name your connections” activity during this particular module. Specifically, resource parents were asked to write down five of the most important connections in their life (e.g., family members, friends, children) and label them 1 to 5. They were then asked to choose one connection to give up, and the facilitator asked them to cross off three more connections until they had only one left. It should be noted that this exercise was adapted slightly from the facilitator manual to adjust to the virtual format (Grillo et al., 2010). Resource parents were then asked to imagine what it would be like to lose each of these connections and reflect on their feelings throughout the exercise. The group then connected this exercise to the experiences of youth in care (e.g., separation from siblings, biological parents). One resource parent shared how this exercise led them to become emotional as they imagined what it would feel like to lose these connections in their life, which allowed them to better understand their youth: “I was really choking back my tears trying to even cross one thing off of the list and in the end, we had to cross [almost] everything off and just that activity really helped me to, in a small way, try to understand what it’s like for a child in my care who has lost connection to a biological parent or siblings, community, school, friends.”

Becoming an Advocate

From Module 7, resource parents identified two overall themes that helped contribute to caring for their young person in care: (1) Building collaborative relationships and (2) Knowing when to seek further supports.

Collaborative Relationships

In this module, resource parents learned about the community and team surrounding the youth. Six resource parents revealed that this module helped them to build greater awareness for various members of the young person’s team and to advocate and collaborate effectively. One parent shared that they learned practical skills and tools that they have already started to apply when working with their youth’s team: “So, it really helped me, I think from this [module], I was able to make a plan and it helped me to be able to call a meeting with the school and be able to have the tools that I need to be able to discuss what the needs are.”

When to Seek Further Supports

In this module, resource parents learned how to know when their youth needs support, learned about trauma-informed assessment and therapy, and covered specific questions to ask to their circle of care to better understand the services their youth is receiving. Three resource parents revealed that, from this module, they better understood the signs that a young person may need more support as well as the benefit of receiving adequate supports. One resource parent shared that this module resulted in the reflection on past experiences with young people in their care and what they would have done differently with this new information: “Now going back, I go, oh yes, there was probably some very significant trauma that happened here and would have probably pushed a little bit more for some more outside help.”

Module 8 (Taking Care of Yourself)

From Module 8, resource parents identified 4 overall themes they found beneficial to caring for themselves and their young people in care: (1) Importance of self-care; (2) Self-care check-up; (3) Understanding and addressing compassion fatigue and vicarious trauma; and (4) Dedicating time within the training for self-care.

Importance of Self-Care

Six resource parents shared how this module reiterated the importance of engaging in self-care practices for their own well-being, as well as the modelling of this behaviour for their youth. During this module, various self-care practices were discussed and two case examples were followed to illustrate the concepts of compassion fatigue and vicarious trauma (Grillo et al., 2010). One resource parent shared that the child welfare system is often more child-focused and does not always take into consideration the needs of resource parents, which is critical for resource parent retention and satisfaction: “The system is so focused on the children and the case management, the adults are too often taken for granted and overlooked. Recognizing the need of caring for the caregivers is so important.” Another resource parent noted: “Sometimes we forget, we’re so focused on you know, the best needs of the child. So, we kind of forget about taking care of yourself…that it’s just as important to take care of yourself as the child as well and so I found that really stuck out in this particular module.”

Self-Care Checkup

Resource parents completed a short self-assessment questionnaire on different areas of self-care. Three resource parents found this activity particularly helpful in acknowledging the amount of self-care they currently engage in. One parent shared this activity allowed them to see how they can improve in this practice: “This was…helpful to see you know, what things you can do if you’re not doing, or where you’re doing well.”

Understanding and Addressing Compassion Fatigue and Vicarious Trauma

Four resource parents shared that they appreciated learning about the impact of caring for a young person who has experienced trauma. Resource parents specifically mentioned the impact of compassion fatigue, vicarious trauma, and, for resource parents with their own trauma histories, the importance of recognizing when their youth’s trauma is reminder of their own. One parent shared: “The one thing I took note of was reminding yourself the children are now safe. Look at the bigger picture, separate your stuff from their stuff and build on strengths.”

Within this module, resource parents learned different strategies to improve their self-care practices. Three resource parents shared that they appreciated learning some of these different strategies, including modeling self-care, relying on a community of supports, and using respite/relief. One parent revealed that this module reiterated that it is natural to be affected by their youth’s past and that they can still be supportive caregivers while allowing themselves to take breaks and respite when needed: “Self-care is such a big thing…and we don’t think about it, especially as mothers we’re always like go, go, go, go always are full with our cup but understanding how we get affected by the kids and then it’s OK to be affected by the kids, I think it’s super important. So, I’m glad that she covered that piece really well um and then it’s OK to have a break from your kids, you’re not a failed parent right?”

Sufficient Time Dedicated to Self-Care

Three resource parents revealed that they appreciated that there was an entire module dedicated to self-care and two noted that this is not often covered in other trainings. One resource parent shared that they found it beneficial to end the training with self-care, as they can now reflect on how to apply the tools they have learned not only for their youth, but also for themselves: “I really appreciated that the class ended with self-care…that there was a whole [module] dedicated to, you know, the impact that parenting our children have on us and how perhaps to mitigate that and ensure that you know, we’re taking care of ourselves as well.”

Discussion

Resource parents take on the important and challenging role of caring for young people involved in the child welfare system. Due to their experiences of developmental trauma, young people in care often have complex needs and require a parenting approach that considers their histories and lived experiences. RPC is a trauma-informed program that aims to provide resource parents with the knowledge and skills needed to effectively care for young people. The program was developed to support resource parents by promoting healing, supporting stable placements, increasing parenting self-efficacy, and promoting connections with other resource parents (The California Evidence-Based Clearinghouse for Child Welfare, 2018). In the current study, we used qualitative methods to gather resource parents’ perspectives around the content of the RPC program, including the impact and utility of the program, beneficial aspects of the program, and suggestions for improvement. To the best of our knowledge, there are no published qualitative findings on the RPC program. This study was part of a larger quasi-experimental program evaluation of the RPC program within a Canadian context.

In terms of program impact and utility, findings indicated that, through identified relevant program materials, resource parents’ approach to caring for the young people in their home was positively impacted. Overall, resource parents reported that they developed a better understanding of different trauma-related reactions and approaches to address these difficulties by considering the child’s underlying needs. For example, resource parents learned how trauma impacts brain development and the stress response system across different developmental stages and learned parenting strategies that are developmentally appropriate and take into account the child’s trauma history. Resource parents identified that beneficial aspects of the program included learning to look below the behavioural surface of their youth’s challenging behaviours and identify the root cause; this approach made it easier to cope with challenging youth behaviours. These results are in line with some previous quantitative findings that found the RPC program was associated with improved knowledge and beliefs regarding trauma-informed parenting, greater tolerance for challenging youth behaviours, and increased recognition of young people’s post-traumatic stress symptoms (Gigengack et al., 2019; Murray et al., 2019; Strolin-Goltzman et al., 2018; Sullivan et al., 2016).

Overall, results suggest that the RPC program had a number of beneficial aspects. They noted that, unlike other trainings in which they have engaged, RPC not only offered relevant theoretical information but also provided practical strategies for integrating the teachings into their current parenting practices. Many resource parents also revealed that much of theoretical background addressed in the program was aligned with what they had learned through their own lived experiences caring for youth in care. However, they appreciated refreshing their knowledge and noted that RPC validated and reinforced their current approaches. Resource parents identified that the program helped them recognize the need for a unique parenting approach that young people in care require due to their trauma histories. Although the focus groups and interviews took place only a week after the training ended, many resource parents revealed that some of the resulting changes to their parenting practices had already led to a better connection and relationship with the young person in their care. This finding is in line with previous research showing that when resource parents have access to evidence-based training, it positively impacts their relationship with their youth in care, which can lead to more positive outcomes including placement stability, as well as resource parent retention and satisfaction (Konijn et al., 2019; Littlewood et al., 2020; Piescher et al., 2008; Price et al., 2008).

Another promising overall finding was that the themes identified by resource parents as being beneficial are consistent with the core fundamentals of a trauma-informed program (National Child Traumatic Stress Network, 2018b). These include recognizing the importance of: learning about the different types of trauma and its impacts (Module 2–3); creating psychological safety (Module 4); promoting connections within a young person’s life (Module 6); advocating and working collaboratively with other members of a young person’s team to need their needs (Module 7); and implementing self-care practices to better care for young people in care (Module 8). By specifically identifying the benefits of these key principles, resource parents validated the utility of this trauma-informed training.

Finally, resource parents identified other beneficial aspects of the program including several teaching methods that supported their learning and skill development. Many appreciated the case examples to illustrate important concepts throughout the training. Resource parents were able to draw from the clinical and lived experiences of the facilitators, along with their fellow resource parents to help understand and apply key concepts. Resource parents also identified that the use of metaphors and experiential activities allowed them to better understand the perspectives of the young people in their care. For example, resource parents appreciated concepts such as the Invisible Suitcase (Module 3) and Name Your Connections (Module 6) activity. These findings indicate resource parents not only benefit from factual information, but experiential activities and case examples to help the content “come alive.”

Limitations

Due to the group nature of the focus groups as well as the sensitive nature of the topic of trauma, one study limitation might have been that resource parents did not feel comfortable discussing more critical perspectives. Resource parents also perhaps did not feel comfortable sharing personal information about themselves or the young people person in their care despite being assured their responses were de-identified and confidential. It should be noted that the focus groups/interviews were not conducted by an RPC facilitator so resource parents could feel comfortable providing honest feedback about what was and was not helpful about the program. Another limitation is that the sample is not generalizable to all resource parents in Ontario. Resource parents self-selected to both the program and the focus groups/interviews, and not all resource parents who attended the program participated in this research study. Thus, the participating resource parents may have already understood the importance of implementing trauma-informed care into their parenting practices and perhaps were the individuals who enjoyed the program the most. It is possible that resource parents who were dissatisfied with the program chose not to engage in the focus group/interviews, despite efforts and encouragement from the facilitators that suggest these perspectives were important to gather. Results may have been different if there were more variability in the previous knowledge of trauma-informed care within this sample of resource parents. Third, demographic information was not collected for participants involved in the focus groups, and so it was not possible to use this information to further contextualize the findings or examine differences between groups of participants (e.g., foster, kinship, adoptive). Although resource parents of all types care for young people with trauma histories, the nature of their relationships with young people would differ. Finally, resource parent perspectives may have been different if the focus groups/interview had taken place after a longer post-program follow-up period. It would be of interest to further investigate how these perspectives on the program may differ depending on the different roles of resource parents and after a longer follow-up period.

Implications

Advancement of Knowledge

By gathering perspectives from resource parents, this study shed light on specific concepts and “ingredients” that were found to be most impactful following completion of a trauma-informed parenting program. Resource parents were also asked about less helpful aspects of the program and suggestions for improvement, but the feedback was overwhelmingly positive. As updates are underway for the RPC program, our study findings will provide important information on the concepts that resonated with resource parents and made the biggest impact on their parenting. Findings provide direct insight from resource parents that will help inform decisions on potential adaptations. Findings gathered from resource parents could also inform similar parenting programs that target families involved with child welfare by indicating beneficial techniques to learning program materials. As the importance of trauma-informed practices becomes more prevalent within child welfare settings, these findings will support the need for evidence-based trauma-informed programs.

Implications for Practice

Results from this study demonstrate the need for effective supports and training opportunities for resource parents. In the province of Ontario (Canada), aside from the mandatory PRIDE and HEART + SPIRIT training received at the initial stages of becoming a resource parent, there is no mandatory in-service training that is systematically offered. The vast majority of the feedback gathered from resource parents was positive, and the consensus was that they were satisfied with having participated in the training. Resource parents reported an improved relationship with their youth in care following the program as understanding their youth’s underlying needs created a deeper connection with them. Other findings within this study that would suggest a more positive caregiver-child relationship include resource parents acting as an “emotional container” when youth display challenging behaviours. Because of the program, resource parents reported learning to remain calm and “be with” their youth, to identify/manage “emotional hot spots”, to create a psychologically safe space, and to practice self-care. All of these program concepts were revealed as beneficial and would likely lead to an improved caregiver-child relationship over time. These changes to the caregiver-child relationship could support placement permanency as resource parents are more likely to commit to a placement when they have a strong bond with their youth in care (Leathers, 2006).

Author Contributions

All authors contributed to the study conception and design. Materials preparation, data collection, and analysis were performed by Sarah Zak, Lauren Stenason and Elisa Romano. The first draft of the manuscript was written by Sarah Zak and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Funding

No funding was received for conducting this study.

Data Availability

The data analysed during the current study are available from the corresponding author on reasonable request.

Declarations

Ethics Approval

Ethics approval was granted by the University of Ottawa’s Office of Research Ethics and Integrity.

Consent to Participate/Consent to Publish

Informed Consent was obtained from all individual participants included in the study. Participants also signed informed consent regarding publishing their data.

Competing Interests

The authors have no competing interests to declare that are relevant to the content of this article.