When children enter the foster care system, there is inherent trauma in their lives. This trauma can be dealt with in many ways, therapy being the most common, and in Texas, it’s paid for by the state. But on top of having to move anywhere from three to six times a year on average, foster advocates say, these kids also typically have to switch therapists.

This means they have to tell their story, which often includes abuse, over and over again, said Angela White, president and CEO of Child Advocates San Antonio (CASA). “They’ve said it so often to so many different people that [the child] says: I’m not doing this anymore.”

Switching therapists “doesn’t give them an opportunity to heal” and can retraumatize foster children, White said.

CASA is teaming up with Jewish Family Service of San Antonio, a nonprofit that focuses on mental health, and THRU Project, a nonprofit that serves young adults aging out of the foster system, to fund therapists who will stick with the same foster children.

“If there’s one thing that youth and young adults in the foster care system have been lacking, it’s consistency,” said Courtney Laverty, CEO of THRU Project.

The two-year pilot program, called Project Launch, isn’t fully funded, organizers told the San Antonio Report, but they hope to start in the coming months. CASA has applied for more than $400,000 in federal coronavirus relief funds from the City of San Antonio and Jewish Family Service is seeking $550,000 from Bexar County.

“I’m definitely fundraising, trying to find the dollars to be able to do it,” said Jennifer Regnier, CEO of Jewish Family Service. “We’re going to do it one way or another.”

Bexar County Judge Peter Sakai said he will look for funding in the county’s budget, which may include federal grants, for the pilot.

“The more we intervene in a proactive way upstream is how we can diminish the cost downstream with the cost of jail, the cost of foster care, the cost of homelessness and human trafficking,” said Sakai, who as associate judge of the Bexar County Children’s Court presided over cases involving foster children.

“If there’s not sufficient intervention and rehabilitation at dealing with the trauma that they have suffered, they often fall into those systems,” he said.

Ultimately, the partnership wants to use Project Launch to prove to the Texas Legislature that continuity of mental health care for foster kids is worthy of state funding.

“It is all about being able to launch whole, wonderful people into the universe,” White said.

An ‘extremely complex’ system

Each year, about 8,000-10,000 kids are in the foster care system in Bexar County, which is operated by Texas Child Protective Services.

Therapeutic costs are covered by the state, but a child can have only one therapist at a time.

The system wasn’t designed to have kids switch therapists when they relocate, but that’s the outcome, White said. “There are several irons in the fire that make this difficult. … It’s extremely complex.”

When a child first enters the system, it’s often an emergency situation, said Allison Martinez, CASA’s vice president of programs.

“If it’s like in the middle of the night or a very dramatic removal, a lot of times their first stop will be to an emergency shelter,” Martinez said. “So the kids will start seeing that therapist.”

Typically, children stay in those shelters less than 60 days before they’re placed with a relative or with a foster family — at which point a new therapist is hired or assigned if needed.

Then, perhaps the situation changes for the relative or foster family and the child is moved again to a home too far away from the therapist, for instance, she said.

And kids who need hospitalizations or in-patient care will often fall off of an outpatient therapist’s schedule while they are being treated.

Project Launch hopes to change that by hiring three Jewish Family Service therapists who will stick with their foster child patients, about 17-25 each, no matter where they are placed in Bexar County.

The partnership plans to seek agreements with residential facilities and emergency shelters such as Clarity Child Guidance Center and Roy Maas Youth Alternatives to allow a Project Launch therapist to see their patients if they are admitted, White said.

It also will check in regularly on therapists and patients to measure the children’s progress, she said. “That gives us more of a case to then go to the Legislature and [Child Protective Services] and say, ‘Look, this is the impact this is having,’ and then ask them for funding at that point.”

Through their work with children and young adults in the foster system, CASA and THRU Project will refer clients to Project Launch therapists who need it the most, said Ryan Curran, clinical director for Jewish Family Service, who will oversee the project.

Not all children in foster care need continued therapy, Curran said, but a vast majority do.

“It’s repetitive trauma,” he said.

Healing ruptured relationships

Most children in foster care have a lot of “ruptured relationships,” Curran said, because not only have they lost, at least temporarily, their parents or family, they typically are placed in multiple foster homes.

“Each time that happens — that there’s a ruptured relationship — that really causes some current and future struggles with relationships and trust,” he said.

“Our goal with this is to have the same provider follow that child through their foster care journey — and even when they age out of the [foster system] — to still have that person there that remains a constant,” he said. “Having that constant person is going to benefit … every area you can possibly imagine.”

About 20% of children who age out of the foster care system at 18 become instantly homeless, according to the National Foster Youth Institute. Only half are gainfully employed by the age of 24 and a quarter experience symptoms of post-traumatic stress disorder. Nearly 60% of legally emancipated men who age out of the foster care system have been convicted of a crime, according to the institute.

Measuring success in mental health can be difficult because it’s not just about managing symptoms, Curran said.

“There’s going to be some standardized clinical assessments that we’ll use,” he said. “But for this population, we don’t want to just rely on symptom reduction. It’s more about maintaining the relationship, and then trusting the [process] and being vulnerable with us.”

It can take several sessions for a therapist to gain that trust, Martinez said, and that’s where Project Launch can make an impact.

“A lot of times therapists are focused on just making sure that the placement is going well,” she said, “but truly these kids need in-depth trauma therapy so that they can start healing from the things that have happened to them.”

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Iris Dimmick

Senior Reporter Iris Dimmick covers public policy pertaining to social issues, ranging from affordable housing and economic disparity to policing reform and workforce development. Contact her at iris@sareport.org