Psychology Capstone – Conflict resolution and drug use in African American adolescents ages 10-19 in the foster care system

Conflict resolution and drug use in African American adolescents ages 10-19 in the foster care system
Learner’s Full Name (no credentials)


The study was conducted to determine how do foster African American adolescents with substance use and problem behaviors suggest ways to overcome these risks so that they can be successful in their lives. African American community has been subject to societal and institutional inequalities for much of our country’s history. Studies show there are higher risk behaviors among African teenagers than teenagers of other races in foster care systems. African teenagers in child welfare systems have disproportionately poor health, thus identifying risk behavior is vital and interventions to address these problems.  The literature review indicates that this group has unequal access to opportunities and resources compared with other ethnic groups. These factors could have contributed to African teenagers in foster care having higher rates of significant cases of neglect, abuse and poverty and the amount of time these children spend in the child welfare systems. This was a qualitative study which was constituted of forty-five African American adolescents who were involved in focus group discussions concerning what works in drug use and problem behaviors treatments with African American adolescents in foster care. the study identified three core domains that contributed to our knowledge regarding what works in drug use and problem behaviors among African American adolescents in foster care. Future research should cover nationwide issues and also the psychology profession should continue research in effective treatment approaches for adolescents with drug use and problem behavior issues, and not only African American adolescents.

Keywords: African American adolescents, foster care, drug use prevention, conflict resolution


Table of Contents

Background of the Study
Statement of the Problem
Purpose of the Study
Significance of the Study
Research Question
Definition of Terms
Research Design

Theoretical Orientation for the Study
Review of the Literature
Synthesis of the Research Findings
Critique of Previous Research Methods


Purpose of the Study
Research Question
Target Population
Recruitment Strategy
Sampling Design (purposive for qualitative)
Ethical Considerations


Methodological Strengths and Weaknesses
Suggestions for Future Research


1.1 Introduction

The chapter covered the background of the study, statement of the problem, the purpose of the study, the significance of the study, research question, the definition of terms, research design, and summary of the study.

1.2 Background of the Study

In the foster care system, social workers commit themselves to assist all families to achieve a sense of wellbeing, permanency, and safety. The objective is stated in all foster care center in New York.  But African American children seen to encounter more negative experiences in the foster care systems compared to children of other races (Long, S., Evans, et al., 2017). Such differing factors with the child foster care system span across all socioeconomic boundaries, with race identified as the key factor responsible for the difference.

African American children who enter out of home care encounter multiple losses and separations. This is coupled with the reasons associated with trauma which made the children removed from their family of origin. African children respond to enter foster care in various ways like feeling depressed and helpless to having no reaction at all. It is unfortunate that foster care placement is a common experience for several African children across New York county. Each year, there are more than ten thousand reports of African child maltreatment compared to children of other races. This includes cases of poverty, physical abuse, sexual abuse, physiological maltreatment, and neglect. Gabrielli, Jackson, and Brown (2016) defined child neglect and abuse as any recent failure to act on the part of a caretaker or parent that leads to exploitation, sexual abuse, serious emotional or physical harm or death of a child. If such issues of maltreatment are proved, child protective services intervene so that to ensure that African adolescents and children are provided with a stable and safe environment which foster the development of healthy relationships with proper role models. Abuse is a traumatic experience. But it can also be traumatic of the child to be removed from their home. Such cases happen, and placement is regarded as the most viable option to make the child’s safety is guaranteed.

It is unfortunate that foster care is not investigated in the eye of conflict resolution and drug use in African adolescents in foster care. Adolescence is a crucial time for personal and physical growth. As African adolescent transition to adulthood, they experience the physical, emotional, and social changes of reproductive and sexual development (Lee, Courtney, and Tajima, 2014). African adolescents require support to feel comfortable with their sexual identity, sexual orientation, and sexuality, develop health sexual relationships and positive sexual attributes, and have autonomy over reproductive and sexual health decisions, and have access to reproductive health care.  For African adolescents in foster care, the changes in adolescence happen in settings where they may lack awareness about health care resources, autonomy to make decisions about their wellbeing, or the support of a trusted adult.  This study is important to relevant stakeholders such as parents, forester care social support providers, and even government officials as supporting and understanding this groups of adolescents through such changes can assist to ensure their healthy transition to adulthood.

1.3 Statement of the Problem

There is more than double the number of African American children in the child welfare system than in the general population. In New York alone, the amount of African American adolescents quadruples the rate that is represented in the population. Disproportionality in the foster care system is not a new phenomenon. Issues such as socioeconomic factors, historical and racial discrimination are some of the concerns that explain the existence of such a high disparity (Rahamim & Mendes, 2016). Actually, social and institutional inequalities are much in the country. African American families have unequal access to opportunities and resources compared to the rest of the population. These factors contribute to African American adolescents having a higher rate of significant cases of neglect and abuse and the amount of time which these children spend in the foster care institutions.

In New York County, there are about 8,456 adolescents in foster care placements and 44% are African children, 23% white children, 21% Hispanic children, 11% other races. In foster care, African adolescents of 10-19 ages have greater incidences of poor health status than adolescents of other races in foster care systems (McDonald, Mariscal, Yan, and Brook, 2014). Access to care support for African youth in foster care is increasingly becoming sporadic and fragmented. Studies (Shpiegel, 2016; Jones, 2014; Lee, Courtney, & Tajima, 2014) have indicated that even though a complete or full exam is made on an African child upon entering into a foster care setting, most proper follow-up care does not occur.

In the past 10 years, unsafe sexual behavior and injury-related behaviors are African adolescent risky behaviors which are on the increase. Tobacco use, insufficient physical activity, and poor nutrition have remained the same while violence, alcohol use, and illegal drug use have increased. There has been the consistency of risky behaviors in African adolescents and the phenomena have resulted in morbidity in all foster care systems. According to Jones (2014), given both the high rates of mortality and morbidity and the prevalence of risky behaviors in African adolescents in foster care there is need to initiate prevention intervention in foster settings catering for the youth.

1.4 Purpose of the Study

This problem deserves new research to provide realistic intervention focused on the prevention of problem behaviors among African youth in foster care systems in New York County. Little is understood about problem and substance use among African adolescents who live in foster care settings.

Studies (Gabrielli, Jackson, & Brown, 2016; Lee, Courtney,& Tajima, 2014, and Jones, 2014) frequently look at foster care in terms of numbers and not specifically on conflict resolution and drug use in African adolescents. In its relatively easy to compile data on how many children have entered foster care, but there is a paucity of research on conflict resolution and drug use in African adolescents in the foster care (Shpiegel, 2016).

Therefore, this qualitative study aims to examine the efficacy of Conflict resolution and drug use prevention in addressing the increasing problem behaviors and substance use among African adolescents ages 10-19 in the foster care systems in New York County.

1.5 Significance of the Study

The study would enable prevention of reduction of African adolescent risky behaviors in a foster care setting in New York County. Preventing problem behaviors and substance use associated with the African youth in these settings is vital for many reasons (Shpiegel, 2016). First engaging in problem behaviors and drug abuse could set the stage whereby African adolescents engage in other risky behaviors. Furthermore, consistently engaging on such problem behaviors can undermine African youth’s progress towards positive educational goals like graduating in high schools on time and also can increase the likelihood that mental, physical, behavioral, and social health problems will develop later in life. For instance, heavy drinking and drug abuse in adolescence is linked with negative outcomes in adulthood like alcoholism, irresponsibility, and poor health (Shpiegel, 2016). Marijuana use among African adolescents has been connected with higher rates of aggressive behavior, stealing, isolation, and cognitive difficulties. And illicit drug use has been identified to heighten the chances of engaging in crime, drug abuse, risky sexual behaviors, and delinquency. Delinquency and aggressions have been recognized to predict a higher level of economic problems, mental health problems, and substance abuse, and lower levels of educational achievement (Gabrielli, Jackson, & Brown, 2016). Risky sexual behaviors influence African adolescents in danger of becoming a teen parent, having an unintended pregnancy, and contracting sexually transmitted infections.

The study is vital as it highlighted tasks associated with conflict resolution and drug use prevention to assist in eliminating or reducing the likelihood of victimization of others, self-injury, and other adverse consequences which might occur of the impact of such behaviors. Engaging in numerous problem behaviors places African adolescents to face a higher likelihood of poor outcomes such as acculturation stress, social-cognitive and social-emotional deficits, academic difficulties, crime and violent behaviors, and others. McDonald, Mariscal, Yan, & Brook (2014) opined that the African adolescents originate from multi-problem families and therefore they face increased risk of poverty, historical discrimination, substance abuse, injury-related risks, school failure, illicit sexual behaviors, pregnancy, and others.

In addition, the impact of this study extends a wider outcome which is specifically targeted (Jones, 2014). The new “conflict resolution and drug use prevention” interventions are designed in light of helping African adolescents eliminate multiple risky behaviors and develop knowledge of shared protective and risk factors.

1.6 Research Question

In this study, the research question is a naturalistic inquiry as it aims to inquire how African American adolescents suggest ways their social problems could be addressed. The research question is “how do foster African American adolescents with substance use and problem behaviors suggest ways to overcome these risks so that they can be successful in their lives?”

In this study, qualitative research questions include the following:

What are the experiences of African American adolescents in drug use and problem behaviors in foster care settings?

How do African American adolescents conceptualize factors contributing to their problem behaviors and drug use in a foster care setting?

What are the perceptions of African American adolescents about potential prevention programs for their problem behaviors and drug abuse in foster care?

1.7 Definition of Terms

In this study, the following terms were defined as:

Drug use: refers to the use of any drug for any other purpose other than the recommended one.

Substance abuse: refers to hazardous or harmful use of psychoactive substances like alcohol and other illicit drugs to stimulate behaviors

Adolescent: refers to a girl or boy between the ages of 11 and19 years.  also refers to as a teenager.

Drug use prevention: refers to any program made to boost protective factors and reduce or eliminate risk factors for drug use.

Conflict resolution: refers to a program made to impact individuals with conflict resolution skills to solve disputes and disagreements amicably and maintain their mutual relationships.

1.8 Research Design

The aim of this study was to investigate the perceptions of African American adolescents in foster care settings about how substance use and problem behaviors affecting them could be addressed. To gain important experiences and suggestions of African American adolescents in foster care, this study used a qualitative approach to research.  These adolescents were interviewed with open-ended questions in the form of focus groups which have been created by the researcher.  The focused group questions were believed to provide a subjective narrative of the African American adolescent’s perceptions and viewpoints about their substance use and problem behaviors.

In carrying out this study, the limitations included a small sample size.  This study hypothesized that there was a pattern among African American adolescents’ perspective about effective programs for reducing and eliminating drug use and problem behaviors among African American adolescents in foster care. By identifying a pattern for treatment among African American adolescents, the researcher hoped to understand how to improve future treatment approaches for African American adolescents.

1.9 Summary

Chapter one was significantly vital as it was the eye-opener of this study as the researcher successfully introduced the area of the study and explained its importance by looking at the statement problem, the purpose of the study, the relevance of the study, research question, and research design.




2.1 Introduction

When considering drug use and problem behaviors among African American adolescents and understanding possible interventions, it is vital to explore the literature which pertained to this subject.  This chapter synthesized, evaluated, and identified the relevant literature guided our knowledge of the problem of the study and how it pertained to the field of psychology. It highlighted what has already been done and what is the current state of thinking on this subject. This chapter covered theoretical orientation for the study, synthesis of the research findings, critiques of previous research methods, and summary.

2.2 Theoretical Orientation for the Study

To address the concern of risk factors, intervention with caregivers and African youth themselves will be necessary, highlighting a multiple component strategy.   To ensure that the elements of the strategy will complement one another, the intervention is grounded in the social development model, which is an integrated theoretical framework of human behavior (Woods, Farineau, & McWey, 2013). Risk behaviors studies are typically informed by the social development model that integrates knowledge about the impact of risk factors or empirically predictors, in the development of health risk behaviors. There is significant empirical evidence that social, psychological, and biological factors at multiple levels at varied social domains (community, peer group, school, family, and individual) contribute to different degrees to the development of health risk behaviors. Psychosocial risk factors for negative developmental outcomes include parental deviance and substance use, lack of parental monitoring, parental discord, poverty, child maltreatment, association with delinquent peers, violence exposure, and poor academic functioning (Cooley, Wojciak, Farineau, & Mullis, 2015).

Furthermore, attachment theory is vital in this study. According to Bowlby (1988), attachment is the emotional bond the teenager develops with caregivers, and that provides emotional security which is important for the sound development of the personality. That attachment will depend on the responsiveness and accessibility or availability of the primary attachment.  But such quality of attachment is adversely affected when the life of a child or teenagers is at risk due to poverty, parental mental health difficulties, exposure to domestic violence, neglect or other types of abuse, drug/alcohol taking, multiple and home placements, abandonment and family bereavement. There are four kinds of attachments such as fearful-avoidant, anxious-preoccupied, dismissive-avoidant, and secure (Bowlby, 1988). The first three styles are categorized under insecure attachment that is linked with impacts of individuals’ mental and physical health. Individuals develop insecure styles due to exposure to physical problems as they are characterized by the continuous presence of negative emotions. People with insecure styles tend to utilize maladaptive emotional regulation strategies like emotional suppression (e.g. dismissive-avoidant) in dealing with their issues, consequently increasing the risk of mental or physical illness. In the case of drug abuse and involvement in criminal behaviors, attachment theory explains that people use maladaptive strategy in coping with the insecurity of attachment and decrease the distress they cause in them (Bowlby, 1988). People with insecure attachment lack efficient coping strategies that make them vulnerable to involve in risky behaviors and drug use when they find themselves exposed to stressful life events.

Also, the social development model integrates “protective factors” that are hypothesized to moderate or mediate the impacts. Conflict resolution and drug abuse prevention are some of the common protective factors recognized in the literature. An explicit objective of resilience and risk studies is the development of empirically guided and targeted interventions to change risk trajectories and decrease the engagement of teenagers in risk-taking behaviors. According to Barn & Tan (2015), the social development model explains that strong bonds to foster care settings serves as a protective factor against health risk behaviors which violate socially accepted standards. Commitment (i.e. personal investment in the group) and attachment (i.e. a positive emotional connection) are components of such social bonds.   This theory explains that when social groups create strong bonds of commitment and attachment in members and promote clear standards for behavior, such groups increase consistency of behavior with such standards and prevent behaviors which violate them. This model suggests the need to provide financial aid to facilitate caregivers to provide conflict resolution and drug abuse prevention to African teenagers so that to promote bonding in foster care settings (Long, Evans, Fletcher, Hewitt, Murphy, et al., 2017). The financial aid can play a significant role in facilitating caregiver in providing training to African teenagers with skills for conflict resolution, substance abuse prevention and even social interaction to positive affect African adolescents’ attitudes towards moral upright, behaviors and academic achievement. Such changes will consequently set the African teenagers on a different observable developmental trajectory in fewer health risk behaviors and more positive outcomes in adolescence and transition to adulthood. The social development model guides the intervention to place African teenagers on a different developmental trajectory that leads to positive outcomes over the long-term.

Skinner and Skinner behaviorist theory identifies factors associated with antisocial behaviors in adolescents and children who abuse drugs and alcohol and involve with other risk behaviors. Barn & Tan (2015) explain that such factors include characteristics of the adolescent or child (e.g. favorable attitude toward drug use), the family (parental drug abuse, family conflict, poor discipline), peers (positive attitude towards delinquency and drug use), neighborhood (criminal subculture), and school (poor performance, dropout). According to behaviorist theory, children learn to exhibit aggressive behaviors because they observe others acting aggressively and can observe how such behaviors are reinforced over time. Young children imitate adults’ aggressive actions which they observe in contrived social settings. Therefore, aggressive behavior is thought to happen because it has been either reinforced or modeled over time.

Piaget cognitive theory concentrates on different conditions that caused risk behaviors to African American adolescents. The development of African American adolescents’ behaviors and moral thoughts play a role in drug use and risky behaviors. Parents are the dominant figure in children’s lives and consequently, they affect the children’s moral development Woods, Farineau, & McWey (2013) mentioned that lack of communication, security, and affection in children affect the children’s self-esteem, behavior, and social development. Children identify themselves with the act of the parents, but when shown a different aspect of dealing with different situations, children may start to have mood swings, anxiety attacks, and other disorder of behaviors.

Cognitive behavioral therapy (CBT) is one of the treatments for such behavioural issues. If prevention is not begun at an early age, the child may require severe treatments for more severe disorders. Cognitive behavioral therapies are used to create positive impacts on the child’s cognitive activities to develop a therapeutic change (Gabrielli, Jackson, & Brown, 2016). These changes occur in their behaviors, feeling, and thinking.   Sometimes, medication has to be given depending on the severity of the disorder or trauma.

Vygotsky sociocultural theory identifies that adolescent behaviors are seen from their beliefs and upbringing.  This sociocultural theory explains how a child mental functioning is related to historical, institutional, and cultural context. The therapist normally looks at the child’s parents’ upbringing, and how conflicts between the parents were worked out. Such information is utilized to analyze a child’s personality depending on whether or not the parents successfully maneuvered through all the stage of development (Jones, 2014). A parent who was unsuccessfully maneuvered in any stage may have mental issues which are passed to their children through the negative effect which may be caused through the successful stage of development.

On the other hand, Kohlberg moral development theory explains that adolescents in their childhood stage of development display preconventional moral reasoning.    These adolescents displaying preconventional moral reasoning have internalized basic culturally prescribed rules governing wrong and right behavior and tend to live according such rules but mainly for selfish reasons (Shpiegel, 2016). They appreciate their capability to create different kinds of choices, and also the reality of consequences related to such choices.  They act in a hedonistic way so that to maximize their personal pleasant consequences.

Furthermore, social reorientation theory explains that during adolescence, teenagers shift their dominant social network from the family to peers (author).  In part, such a shift is driven by developmentally appropriate changes in the salience of interactions with romantic partners and peers that assists in motivating adolescents to enter adulthood (Barn & Tan, 2015). Healthy-risking behavior, in part, are seen as a by-product of differences between what the caregiver/family network values and what the new peer group values, although the reasons for such value differences are not fully explained.

Furthermore, fuzzy trace theory is important as it explains the function of possible reduced sensitivity to uncertainty (i.e. risk) during adolescence.  This theory suggests that adolescents have yet to develop heuristics which appear to govern more experienced, adult decision making, and therefore are more willing to explore the full problem space (Gabrielli, Jackson, & Brown, 2016). This some outcomes of such exploration are negative consequences, then such exploration consequently health-risking behavior.  The fuzzy-trace theory explains that such exploration is a necessary developmental task in adolescence that allows adolescents to develop wisdom and expertise about the world they must engage with as adults.

Also, related to this a dual systems model that posits that in adolescence risky decision making is the product of an interaction between two neurobiological systems the cognitive control system (made up of the parietal and prefrontal cortices) and the socioemotional system (constituted of limbic regions including the orbitofrontal cortex, ventral striatum, medial prefrontal cortex, and amygdala (Lee, Courtney, & Tajima, 2014). Around the puberty time, the surge in dopaminergic activity in the socioemotional system causes increases in risky and sensation-seeking decision making, outpacing the engagement and development of the cognitive control system. This temporal gap contributes to increased vulnerability to such behaviors during adolescence.

The imbalance model explains that developmental changes in the functional, structural, and neurochemical composition of the brain proceed on different timelines: some brain regions show changes earlier in development than other brain regions. This causes an imbalance in how such regions bias behavior because of differential engagement across different stages of development. According to Leslie, James, et al (2010), this model has been applied to explain nonlinear changes in behavior during adolescence because regions implicated in reward (e.g., striatum) show greater engagement – in terms of behavioral bias and striatal activation toward reward – relative to regions critical for behavioral regulation (e.g., PFC). Unlike models which concentrate on specific brain regions, the aim of the imbalance model is to attribute adolescent behavior to the coordinated integration of multiple brain circuits.

On the other hand, the psychosocial model explains that teenagers engage in risky behaviors so that to achieve acceptance among peers and also to deal with negative emotions (Long,  Evans, Fletcher et al., 2017). The model explains that behaviors are influenced by psychological factors like expected consequences, perceived norms, intentions, and values.

Thomas and Kilmann (1974)’s conflict management style model explains that problem adolescents don’t know how to resolve conflict among themselves because they have acquired maladaptive conflict resolution styles (bad conflict management styles) which are associated with various maladaptive behaviors (McDonald, Mariscal, Yan, & Brook, 2014). Problems adolescents are less cooperative and more contentious in conflict situations with peers.  Maladaptive conflict resolution styles are linked to various externalizing behaviors including drinking, marijuana, cigarette smoking, and fighting and low academic achievement.

Substance use puts adolescents at risk of negative social and health outcomes impacting on their family and broader society. According to Rahamim & Mendes (2016), adolescence is a main period of experimentation and is the developmental periods of greatest risk for the commencement of problematic drug and alcohol use. Substance use among adolescents represent a transitory period of experimentation and it is commonly associated with involvement in delinquency and crime, unprotected and early sexual debut sex, academic underachievement and school exclusion, and mental health problems including psychosis, anxiety, and depression.

2.3 Review of the Literature

Thompson, & Auslander (2011) conducted a study to investigate the relationships between HIV sexual risk behaviors, mental health problems, and substance use among a sample of adolescents in the foster care system.  Data were gathered through structured baseline interviewers with 320 teenagers of ages 15 to 18 years old who lived in foster care placement who participated in a wider assessment study of an HIV prevention program. The final logistic regression model showed that marijuana use and delinquent behavior were the most prevalent predators of engaging in any HIV risk behavior. Adolescents showed marijuana use, alcohol use, and delinquent behaviors and who were females were more likely than males to engage in virginal sex without the use of a condom.

Leslie, James, et al (2010) conducted a study to investigate patterns and rates of health risk behaviors (e.g. substance use, depression/suicidality, delinquency, sexuality) among a national probability sample of youth resided in the child welfare system.  The authors used a baseline analysis of caseworkers, caregivers, and child interviews and evaluation data for a subsample of 993 of the youth of age 11-15 years of from the national survey of adolescents and child well-being, a national probability sample of adolescents and children undergoing investigation for neglect or abuse. Nearly half of the sample (46.4%) showed at least one health-risk behavior. On Poisson multivariate regression modeling, factors associated with higher rates of health risk behaviors included abuse history, limited caregiver monitoring, poor school engagement, deviant peers, older age, and female gender. Given the increased vulnerability of this population, early screening for health risk behaviors must be prioritized.

Knotta &Kirsten (2010) assessed the relationship between African American racial identity and foster care placement.  The author carried out secondary analyses of the 2005 National child abuse and neglect data system (NCANDS) on investigated reports of child neglect and abuse which received a maltreatment incident in 2005. The study sample was confined to 71,802 investigations of key substantiated maltreatment in 48 states in 2005. A logit model was utilized to investigate the relationship between racial identity and foster care placement. The study result identified that African American children had 44% higher odds of foster care placement when compared with white children.  The study, therefore, supports the cumulative evidence that the racial identity of African American is a significant predictor of foster care services.

Mélanie, Tessa, Elisa, & Louise (2011) conducted a study to investigate two common mental health concerns (i.e. substance use and depression) among 12-15 years old adolescents in out-of-home placements.  The author examined potential risk and protective factors among community, family, youth, maltreatment, and socio-demographic variables. The authors relied on data collection via AAR-C2, a Canadian needs assessments and outcome monitoring instrument. In a sample of 122 adolescents, 39.3% showed at least one mental health problems that indicated the presence of the substance and or alcohol use over the previous year. And 8.5% indicated struggling with mental health issues. The study findings from logistic regressions showed that adolescents females were at a higher risk of experiencing depression than males, and increasing age were related to increased risk for substance use. Regarding protective factors, the findings showed that the higher perceived quality of the caregiver-youth relationship, the lower risk for mental health difficulties (i.e. substance use, depression). Furthermore, participation in extracurricular activities seemed to protect youth against substance use or depression. The findings mean that participation in extracurricular activities and caregiver-youth relationship are vital areas to put into consideration to promote the wellbeing of maltreated children in out-of-home care.

Antonio & Mark (2011) conducted a study that investigated the prevalence of substance use and mental health disorders and service use among an ethnically and racially diverse group of youth in foster care. Self-reported data on service receipt and symptoms were utilized to recognize whether groups of teenagers identified by ethnicity and race were equally likely to obtain services given the presence of a substance use disorder or mental health.  The study results indicated that African Americans are more likely to obtain mental health services than Caucasians.

2.4 Synthesis of the Research Findings

The foster care has evolved over the previous century as an approach to providing protection and care to African adolescents and children removed from their family of origin because of poverty, neglect and/or abuse. The aim is to promote the well-being of African adolescents and children by offering for the permanency, stability, and safety. Stable placement in a nurturing kinship or foster setting is vital, though the actual objective of foster care is the accomplishment of permanency through alternative permanency arrangement (such as placement with relatives, guardianship, or adoption) or reunification (Knotta &Kirsten, 2010). Child welfare professionals are tasked with the role of assisting African youth who do not accomplish permanency to build a variety of skills required for successful independent living.

Each African adolescent in foster care settings come from the poor community. Authors indicate that poverty, trauma, abuse, and parental substance increase African teenager drug abuse. African American adolescents are more at risk of neglect and abuse as they are also facing discriminatory influences because of an oppressive history.  Historical discrimination has led to increased rates of child neglect and abuse among African Americans.  This has led to poor parenting skills and poor career outcomes that are passed down through multiple generations. Historical discrimination and poverty have increased negative environmental risks for African Americas that led to the increased removal of their children (Mélanie, Tessa, Elisa, & Louise, 2011). Poverty increase risk since it increases the level of stress on individual families. Poverty levels are higher for African Americans than other races in America. Furthermore, African Americans are more associated with criminal activities and gang affiliated, live in poverty and enter in the forester care system.   This explains that reason why African Americans are overrepresented in the child welfare system and prisons. Poverty is the main reason why more African American children enter in foster care systems. Poverty increases stress among households in daily lives.  And daily stress contributes to more fighting in households and more neglects of children. Many African American defoliants lives in poverty and they are subjected to high child maltreatment.

African adolescents living in foster care at great risk of having untreated health risk behaviors, reproductive health, and medical, psychosocial, and educational problems. In foster care settings, many African adolescents have risky behavioral issues such as petty criminal activity, school truancy, and other ungovernable behaviors), and most have endured sexual, physical, emotional abuse and neglect (Antonio & Mark, 2011). While some come to foster care as adolescents, some have grown up in the setting, and will or have experienced several foster care placements such as placements in the group and residential homes, drug rehabilitation or inpatient psychiatric settings, and juvenile justice settings.

African youth engage in more risky behaviors than their colleagues from other races in foster care. Also, African adolescents in these settings report high cases of drug abuse and violence exposure as well as weapon carrying as a measure of self-defense (Mélanie, Tessa, Elisa, & Louise, 2011).  They frequently associate themselves and engage in high-risk behaviors. Their school attendance frequently is interrupted leading to low levels of literacy and high rates of failure. Several African teenagers in these settings lack exposure to engage in ordinary activities due to poverty, lack of transportation barriers and insufficient funding.

Engaging in multiple risk behaviors like risky sexual activities, violence-related behaviors, and substance abuse during early adolescence is connected with various adverse outcomes like increased lifetime risks of major depressive disorder, antisocial personality disorder, and substance use disorder, and lower quality of life (Knotta &Kirsten, 2010). The identification of protective and risk factors linked to multiple health risk factors affecting African teenagers in foster care is vital both for widening the reach of health risk prevention efforts and for intervening efficiently to the group of multiple problems.

Though studies on African teenagers’ risk behaviors have recognized a host of vital factors like foster care setting influences or family environment, the key locus of intervention strategies which have been widely advocated is context-based programs. These consists of programs which fall under many wide categories such as conflict resolution, drug abuse prevention, and social-emotional learning (Leslie, James, et al., 2010). Both drug abuse prevention, conflict resolution, and emotional learning context-based programs have been identified to decrease health risk behaviors in adolescence and they commonly have a focus on promoting individual teenagers’ social competencies and skills such as building positive (respectful, caring) school/classroom and foster care climates and skills for managing interpersonal conflicts and relationships. The emphasis of a prevention program on teenager’s positive foster care/school/classroom environments and social skills underscore the pragmatic importance of such protective factors.

There is evidence which supports the emphasis on acquired competencies or skills as a protective factor for foster teenagers’ risk-taking. Some studies suggest that skills for managing interpersonal conflict may serve as a protective factor. Thompson & Auslander (2011) demonstrated the value of using a developmental framework for examining teenagers’ conflict resolution strategies. Leslie, James, et al (2010) examined the types of interpersonal resolution negotiation strategies (cooperative, unilateral, impulsive etc.) which are built by increasing the capability for developmentally ordered levels of social perspective coordination (developing capability for third, second, first personal social perspectives etc.,) and identified an important relationship with multiple health risk behaviors for adolescents at high risk.

2.5 Critique of Previous Research Methods

These studies significantly examined vital factors associated with problem behaviors and drug use among African adolescents. However, some o the studies were relatively general in nature as they generally talked about adolescents with substance abuse and other related problems, with some issues targeted at African adolescents. It is important that the studies recognized racial factors, peer influence, and familial issues as significant influential as adolescents are constantly interacting with their environment and imitating these behaviors. The studies highlighted some vital interventions demonstrated to be important when working with these adolescents.  Such treatments appear effective with this population due to the brief period of therapy and the role of social support providers in imparting the motivation of change in the adolescents. Therefore, understanding the background of concerns as these studies have outlines will assist relevant stakeholders such as psychologists, therapists, clinicians, educators, and even government officials implement the most effective treatment approaches to provide evidence-based services to these adolescents.

2.6 Summary

This chapter has provided a review of past studies carried out in the area of drug use and problem behaviors among African American adolescents in foster care. It has investigated various impacts of problems behaviors and substance use among these population.  While these studies provided a concise picture of the grave implications facing the population, they also suggested approaches in which these problems may be curbed. All of these studies have relevant background information on the problems specified, therefore making them significant in assisting in the foundation this study.




3.1 Introduction

This chapter discussed the methods which were used in conducting this research. In exploring how do foster African American adolescents with substance use and problem behaviors overcome these risks so that they can be successful in their lives, the study explained the sampling design of the study and the participants involved.   Furthermore, the study discussed how the data was collected, the procedures of the study, and the kind of tolls which used. Also, the researcher explained how the subjects involved were protected and the manner in which the data was analyzed.

3.2 Research Question

how do foster African American adolescents with substance use and problem behaviors suggest ways to overcome these risks so that they can be successful in their lives?

In this study, the qualitative research questions include the following:

What are the experiences of African American adolescents in drug use and problem behaviors in foster care settings?

How do African American adolescents conceptualize factors contributing to their problem behaviors and drug use in foster care setting?

What are the perceptions of African American adolescents about potential prevention programs for their problem behaviors and drug abuse in foster care?

3.3. Target Population

The target population was African American adolescents of age 10-19 in foster care settings in New York county. Based on assessment, African American adolescents of ages 10-19 and who have shown symptoms of adolescents experiencing violence, social conflicts, drug abuse problems, and other problems were included into the study. Others were excluded because they did not meet the inclusion requirements.

3.4 Recruitment strategy

The recruitment strategy was a specific plan that identified and enrolled potential, African American adolescents to participate in the study (Hesse-Biber & Leavy, 2011). This plan specified the criteria for screening the potential respondents, the number of the participants recruited, the targeted foster care settings within New York county, and the approached used. The researcher and the qualitative research team worked together in close consultation with the officials working in the forester care settings, local community leader, local government officials, and other stakeholders to develop the plan to identify and recruit potential participants for each selected foster care setting.

3.5 Sampling design (purposive for qualitative)

The researcher used purposive sampling design to group participants according to preselected criteria relevant to the specific research question, targeting African American adolescents in foster care settings in New York county. The sample sizes depended on the the time and resources available as well as the study’s objectives. The sampling technique was used to select 5 foster care settings from 24 foster care settings in New York county as the time of study.  The study was conducted in five foster care settings within New York county.  The first foster care setting was coded as PUU1, the second PUU2, the third PUU3, the fourth PUU4, and the fifth PUU5 to distinguish them in terms of their geographical situations (Hesse-Biber & Leavy, 2011). The technique enabled comparison because of variability in management approaches, availability of resources, and value system all of which influence effectiveness of intervention programs (Patton, 2002). African Americans Adolescents were selected among the population of children, age of 10-19 based on who were potential for cases of neglect, drug abuse, social conflict, violence, and other problem behaviors.

Table 1: Sampling techniques and sample size

Sampled foster care settings Adolescent population Categories of respondents (African Adolescents)
PUU1 857 15
PUU2 1009 15
PUU3 986 15
PUU4 644 15
PUU5 912 15


3.6 Procedure

Permission to conduct this study was obtained from our university’s faculty of health sciences higher degrees and ethics committees and also from the management of the selected foster care settings. After we identified which foster care settings we wanted to work with, we wrote formal letters of request to the management of each selected settings, attached to these letters was a document outlining what we intended to do and proof that permission to carry out the study was granted by the university (Nastasi & Schensul, 2005). Then we provided the management with the dates on which we intended to carry out the focus group discussions and they approved these dates and introduced us to potential candidates who were targeted to participate in the study.

An interview guide was used to organize the focus groups. During the focus groups, open-ended questions were verbally given to the focus groups as a discussion topic. A demographic survey that included respondents’ gender, ethnicity, education, age, family status and child welfare experience were given to the respondents via a paper survey before the beginning of the focus group.  The interview guide covered relevant topics that was developed particularly to African American adolescents with a key purpose of familiarize with these teenagers and identify problems associated with problem behaviors and drug use experience facing them (Nastasi & Schensul, 2005). Field representatives and social support providers help us to carry out face-to-face interviews and focus group sessions with selected African adolescents and biological parents at various selected foster care settings over a period of 12 months at four waves (baseline, 3 months, 6 months, 9 months, and 12 months). The researcher and the qualitive research team used various Instruments including audio and video recording equipment, pen and paper, observation journals, member-checking documents, and laptops for data preparation.

The participants were asked about their experiences regarding their problem behaviors and drug use. They were inquired about the contributing factors to their substance use and problem behaviors. And finally, they were asked to suggest potential prevention programing that could reduce and eliminate problem behaviors and drug abuse.

The open-ended questions were constructed and derived by the researchers. The instrument (interview/focus group guide questions) was constructed so that to avoid leading questions or bias. Being that the questions were non-leading, the researcher hoped to obtain a subjective perspective based on the participants’ personal experiences (Saldana, 2011). The instrument was tested at face validity as various psychologists and social support providers have reviewed the instrument while providing feedback for improvements. A limitation to this toll was that it has not been consistently used to measure what works in treatment for adolescents with problem behaviors and drug use issue. Also, it produced limited findings for the psychology field of practice.

When carrying out the focus groups, participants were given an informed consent document that provided the purpose of the study and expectations of the focus group discussions. When signing this document, participants agreed to be audio recorded and were informed that all their information was kept confidential (Patton, 2002). Also, they were given instructions on how to obtain the data findings, after the focus group discussions, participants were provided with compensations for their participation. Moreover, participants obtained a debriefing statement which provide them with an opportunity to obtain resources as needed.

  3.7 Analysis

After the focus group discussions were completed, the researchers listened to the recording multiple times to catch a glimpse of common themes in the responses of participants (Yin, 2011). These responses were divided into categories of common themes. These themes demonstrated similarities among participants’ personal experiences. Some of the responses were quoted directly in this project. These quotes validated the themes which came from conducting this analysis. The findings of the study were then inputted into table to create a graphic representation of the findings. Tables gives readers a visual representation of effective treatments for African American adolescents with problem behaviors and drug use issues. The study’s findings will be available at the university’s library in December 2019.

3.8 Ethical Considerations

Respondents were provided with an informed consent document before the focus group discussions. This document assured the respondents of complete anonymity while keeping their identity confidential. In carrying out this study, focus groups discussions were audio recorded on a voice-recording device. Researchers were able to identify respondents with a provided code. Respondents were assured that these voice-recordings were protected in a lock box and no one other than the researchers would have access to this data. Once the data was analyzed thoroughly, the voice records were deleted permanently. Any additional hand-written notes which were collected during focus group discussions were also destroyed permanently (Hesse-Biber & Leavy, 2011). At the conclusion of the focus group discussions respondents were given a debriefing statement with information on counseling services if required.




4.1 Introduction

This chapter presented the findings of the focus group discussions which were carried out for this study. The researchers chose to analyze the qualitative data by presenting the findings into tables. quotes were chosen which were believed to be the best representative of the participants’ subjective views. the data was condensed to include only valuable and significant participant quotations.   three core domains were established based on the research questions of the study. The following tables presented the three core domains for this study.

4.2 Presentation of the results

Table 1 indicated the demographic information of the respondents of the study.  the demographic characteristics included ethnicity, gender, and age.

Table 1: demographic characteristics

Frequency Percentage
Gender of participants
Male 24 52%
Female 21 48%
Age of participants
11-14 20 43.4%
15-19 25 56.6%
Ethnicity of participants
African Americans 45 100%


Table 2: the experiences of African American adolescents in drug use and problem behaviors

· “I strongly support the commonly held belief that African American children (adolescents) engage in problem behaviors and drug use than other ethnic communities. This is a true fact as there are more adolescents adversely affected by these problems including myself”

· “It is true…I know lots of my fellow African American colleagues who do drugs and are ruined by other bad behaviors”.

· “They are African Americans who use these illicit drugs and are on the streets loitering around looking for shelter and food. And to make the matter worse, these children are bright and do well in school, but they have become dropouts from school. It is really painful to me to such negative experience happening”.

· “I arrested for using illicit drugs and consequently was brought to child welfare care center”.

· “I’m a drug user and I have o admit it has negatively affected my life. But the problem is that I really want to abandon this habit, but I’m unable to leave. I think I need your help. I was a high achiever in school, but now I don’t go to school as I hang out frequently with my fellow bad black girls”.

· “I have had the very sad experience of seeing my fellow friends, especially my colleagues at this younger with ruined lives at the foster care center. I have seen once I started taking illicit drugs, my behaviors become totally weird and nowadays I’m naughty. But I really want to reform”

· “It’s pathetic to me that I’m 12 years old and now I’m struggling to recover from heroin addiction. I was in a good private school but now I’m in this child welfare center after I was rescued from the streets walking around with fellow bad black boys”. “I also need help as this is not the kind of life I should lead”.

· “It is true that we African American children, we have more psychosocial problems than other ethnic groups. I have seen that we are more physically aggressive, bullying others, physically violent, abusing others. In other words, we lack morals. And this problem is caused by running away from our homes and engage in illicit drugs”.

· “Actually, we really want to progress in life. I’ve been questioning my life. I touched drugs when I was 11 years old and now, I’m 17. I have never left taking drugs. and in the recent past, I was a victim at the juvenile justice system. Now I’m in foster care. I have not changed. I need to change my bad behaviors”.

· “It is not we don’t reflect upon our lives while in this foster care center. I usually think deeply about what is really good in my life. and I sometimes think that we African Americans children why are we so stubborn than other ethnic groups? why do we like disturbing other children? why do others associate us with bad things? and why are our numbers so many than others in the child welfare center? I have been thinking that there is some kind of “risk gene” ingrained in us that makes us depend on drugs and engage in bad behaviors. but we to change for a better life as I struggle to be”.


Table 3: How African American adolescents conceptualize factors contributing to their problem behaviors and drug use in a foster care setting

· “I was influenced to use illicit drugs because I used to see my parents using such drugs at home”.

· “I joined the bad group of boys on the local community because my parents neglected me and I had nowhere to live nor survive”.  That was why I joined by fellow black boys in the street”.

· “I started robbery due to poverty that struck my family. I joined a gang of black boys to execute our robbery activities.  And that’s how I ended in the foster care”.

· “I started using marijuana, cigarettes, and even alcohol to relieve my stress. I ran away from our home because of physical abuse I frequently experienced by my father”.

· “Because of parental neglect, I started living in the streets where I joined gang groups and started using harder drugs such as heroin, crack, or cocaine and behaving violently. But I gained significant positive progress after I was introduced to foster care”.

· “My delinquent act began as a result of parental neglect and consequently I started spending time with my fellow black girls in the street”.

· “I lived will illicit-using parents using drugs to manage their challenging personal experiences and they passed that coping behavior onto me and other siblings. I see this as a major cost to me as a result of a fault caused by my parents. My parents lack the opportunity to learn skills that afford them protection.”

· “Family stress and family conflict influenced me to run away from the home and I lived in the streets for more than one year and that how I found myself into this child welfare center.”  I was exposed to bad behaviors in the street”.

· “I was raised in a dysfunctional home with two parents having family conflicts and drug users. I became physically aggressive and drug user and learned bad behaviors as a result of my parents’ issues. my message is that these problems happen to the environment where children are brought”.

· “I came from a family that was not using illicit drugs. but the death of my parents left us with great problems. I was vulnerable and peer pressure influenced me into bad behaviors. and I regret now how I can reform myself though I’m in the foster care center”

· “I was brought to this child welfare center because I was helpless as a result of my parents’ death. I came here when I was innocent, but I learn bad behaviors as a result of shared foster care accommodation”.

· “Because of difficult in life as a result of my parents’ death, life became so difficult me and I developed multiple anxieties that influenced me to drugs after I started interacting with wrong crowed”.

· “I’m raised by a single parent, and I was placed in foster care after my mother became mentally ill.  And in foster care, I come to live and interact with other vulnerable African American teenagers, and that interaction, contact and staying together influenced significantly to develop delinquent behaviors”.

· “I was taken to foster care because my parents were poor, and shared living in foster care and longer period of school absence influenced me to risky behaviors and drug use among other fellow African teenagers in the forester care environment”.

· “I believe that the community and its environs played a role in shaping my drug use and bad behaviors”.


Table 4: the perceptions of African American adolescents about potential prevention programs for their problem behaviors and drug abuse

The researcher observed enthusiasm from the participants for a drug use prevention and other psychosocial interventions designed specifically for the African American community. Participants suggested that they would be more attracted to programs made specific for African Americans, but very few such programs exist.  Although drug use prevention was a clear intervention indicated from their views, their suggestions hinted that other psychosocial interventions were significantly important for their coping with day-to-day interactions.

· “I need prevention programs that engage our parents and value the idea of family-based programs”.

· “I prefer a program that is family-based because our parents should be involved as our parents don’t know much about drugs and other problem behaviors”

· “I love a program that should educate us well and advise us to overcome drug use and physical aggression and conflicts among us”

· “I hardly see my parents and they are not normally around enough to take an interest in what I do, and I would, therefore, suggest a program that would involve our parents in what we do”.

· “effective programs should target Africans, be catchy and brief and to the point, and should include interactive activities and be delivered in an interesting, engaging fashion”.

· “I higher prefer a program that would help us address conflicts that are common among us and colleagues such as bullying, aggressively dominating others, personal differences”.

· “I suggest a program that gives us education and tips on how to handle anxiety and stress as many of us still feel that they are the only with these issues”

· “I think a program that look at our attitudes, thinking, and behaviors could help me reform better.”





5.1 Implications

According to the study results, it is clear that family involvement is essential for successful treatment outcomes. This could imply that African American adolescents’ recovery could be accomplished through a natural support system and also the teens need the help of professionals. concentrating on the family as a unit can be cost-effective in assisting these adolescents with their recovery as individualized services would significantly help to address the needs of each family and the affected adolescent. Furthermore, these adolescents may be more apt to change if the family is involved in the treatment since family is the environment whereby the teen is in constant contact. If the adolescent can view a change in his or her environment, then it can increase the chances that they will be more able to make a change in their behavior (Long, Evans, Fletcher, et al., 2017). As psychology professionals, it is imperative to educate families in the recovery and how family involvement can create a positive effect in the treatment of these adolescents. education on family involvement should occur in foster care settings and school which serve these adolescents so that professionals can emphasize on family involvement in treatment.

In carrying out this study, the researcher understood drug use and problem behaviors to be related to both external and external factors which influence these adolescents. The influential factors which may facilitate drug use and problem behaviors are a means to avoid problems, cope with stress, socialization, boost their mood, familial drug use, and peer drug use. Adolescents at that age have difficulty with identifying a sense of self (Rahamim, & Mendes, 2016). understanding these factors contributing to drug use and problem behaviors, it becomes essential to facilitate a greater sense of self for the adolescents. Moreover, these adolescents should have positive role models who can assist in their identity development. Incorporating successful African American individuals like Serena Williams, Michele Obama, Barrack Obama, Oprah Winfrey, and others who are contributing to society in positive ways so that the adolescents and children have an expansive view of what success entails.

The participants’ views hinted the need for potential treatment approaches effective in working to address their problems. Motivational interviewing is a promising treatment of African American adolescents’ problem behavior and drug use as it’s directed at resolving and exploring these adolescents’ environment about changing their personal behaviors.  It emphasizes on reinforcing and exploring the adolescents’ intrinsic motivation towards healthy behaviors while supporting their autonomy. Besides that, conflict management skills are important to adolescents, thanks to the roles played by social support providers (Cooley, Wojciak, Farineau, & Mullis, 2015). Imparting conflict management skills to these adolescents is linked with many positive aptitudes include social understanding and perspective taking, negotiations allaying conflict and allows continued social interaction, and the maintenance and formation of friendships.

Another relevant treatment is cognitive behavioral therapy. Thoughts cause behaviors, and such thoughts determine the way in which African American adolescents interpret, perceive, and assign meaning to their environment. Therefore, cognitive behavioral therapy is helpful in changing the adolescents’ maladaptive behaviors by modifying their thought processes, even if their environment does not change (McDonald, Mariscal, Yan, & Brook, 2014). Cognitive behavioral therapy can significantly encourage these adolescents to build coping and self-regulation skills by teaching them to various strategies to avoid situations which may trigger the desire to use drugs and to develop skills for problem-solving and communication.

Furthermore, multidimensional family therapy can significantly target African American adolescents who exhibit problems behaviors and related substance use. This therapy can help to reduce symptoms associated with these problems behaviors and enhancing developmental functioning by facilitating changes in many behavioral domains. Therapists work concurrently in four interdependent treatment domains (the adolescent domain, the parent domain, family interactional domain, and the extrafamilial domain) depending on problem behaviors of the affected adolescent and his or her family (Barn, & Tan., 2015). Therapists meet alone with the affected adolescents, alone with their parents, and conjointly with parents and adolescents, depending on the treatment domain and problem behaviors being addressed.

Lastly, motivational enhancement therapy is a useful treatment method that can motivate change among African adolescents with drug use issues. This approach provides personalized feedback on drug use in combination with a motivational interviewing counseling style (Cooley, Wojciak, Farineau, & Mullis, 2015). The motivational enhancement therapy is a vital counselling approach which can help these adolescents to evoke internally and rapid and motivated change and resolve issues surrounding their environment.

5.2 Methodological Strengths and Weaknesses

The study lacked nationwide data on the prevalence of drug use and problem behaviors among teenagers of other races involved with foster care systems. This therefore warrants examination of this topic in the national representative sample (McDonald, Mariscal, Yan, & Brook, 2014). Although this showed a limitation of the study findings, this study illustrates a within-group perspective regarding problem behaviors and drug abuse in the sample of maltreated African teenagers in foster care systems in the county level.

5.3 Suggestions for Future Research

The current was specific to issues affecting African American adolescent in foster care in county level. Future research should cover nationwide issues and also the psychology profession should continue research in effective treatment approaches for adolescents with drug use and problem behavior issues, and not only African American adolescents.



Antonio & Mark (2011). Prevalence and Predictors of Service Utilization Among Racially and Ethnically Diverse Adolescents in Foster Care Diagnosed With Mental Health and Substance Abuse Disorders. Journal of Public Child Welfare, 5(5), 521-545.

Barn, R & Tan, J. (2015). Foster youth and drug use: exploring risk and protective factors. Children and youth services review, 56(2), 107-115.

Bowlby, J. (1988). A secure base: Clinical Applications of attachment theory. London, U.K.: Routledge.

Cooley, M., Wojciak, A., Farineau, H & Mullis, A. (2015). The association between perception of relationship with caregivers and behaviors of youth in foster care: a child and caregiver perspective. Journal of social work practice, 29(2), 205-221.

Gabrielli, J., Jackson, Y, & Brown, S. (2016). Associations between maltreatment history and severity of substance use behavior in youth in foster care. Child maltreatment, 21(4), 34-45.

Hesse-Biber, S. & Leavy, P. (2011). The practice of Qualitative Research. (2nd ed.). CA: Sage.

Jones, L. (2014). The role of social support in the transition from foster care to emerging adulthood. Journal of family social work, 17(1), 81-96.

Knotta &Kirsten (2010). Disproportionate representation of African-American children in foster care: Secondary analysis of the National Child Abuse and Neglect Data System, 2005. Children and youth services review, 32(5), 679-684.

Lee, J., Courtney, M & Tajima, E. (2014). Extended foster care support during the transition to adulthood: effect on the risk of arrest. Children and youth services review, 42(2), 34-42.

Leslie, James, et al (2010). Health-Risk Behaviors in Young Adolescents in the Child Welfare System. Journal of adolescent health, 47(1), 26-34.

Long, S., Evans, R., Fletcher, A., Hewitt, G., Murphy, S et al., (2017). Comparison of substance use, subjective well-being and interpersonal relationships among young people in foster care and private households: a cross sectional analysis of the School Health Research Network survey in Wales. BMJ open, 7(2), 23-43.

McDonald, T., Mariscal, S., Yan, Y & Brook, J. (2014). Substance use and abuse for youths in foster care: results from the communities that care nominative database. Journal of child and adolescent substance abuse, 23(4), 262-268.

Mélanie, Tessa, Elisa, & Louise (2011). Risk and protective factors for depression and substance use in an adolescent child welfare sample. Children and youth services review, 33(11), 2127-2137.

Nastasi, B,K., & Schensul, S.L.(Eds.) (2005). Contributions of qualitative research to the validity of intervention research. Special issue of Journal of Social Psychology, 43,177-195.

Patton Quinn, M. (2002). Qualitative Research & Evaluation Methods. 3rd ed. London, Sage Publications.

Rahamim, A & Mendes, P. (2016). Mental health supports and young people transitioning from out-of-home care in Victoria. Children Australia, 41(1), 59-68.

Saldana, J. (2011). Fundamentals of Qualitative Research: Understanding Qualitative research. New York. Oxford University Press.

Shpiegel, S. (2016). Resilience among older adolescents in foster care: the impact of risk and protective factors. International journal of mental health and addiction, 14(1), 6-22.

Thompson, R & Auslander, W. (2011). Substance Use and Mental Health Problems as Predictors of HIV Sexual Risk Behaviors among Adolescents in Foster Care. Health & Social Work, 36(1), 33–43.

Woods, S., Farineau, H & McWey, L. (2013). Physical health, mental health, and behavioral problems among early adolescents in foster care. Child: care, health and development, 39(2), 220-227.

Yin, R. K. (2011). Qualitative Research from Start to Finish. New York. The Guilford Press.