Behavioural and cognitive behavioural training interventions for assisting foster carers in the management of difficult behaviour

  • Review
  • Intervention




The provision of training for foster carers is now seen as an important factor contributing to the successful outcome of foster care placements. Since the late 1960s, foster carer training programs have proliferated, and few of the many published and unpublished training curricula have been systematically evaluated. The advent of cognitive-behavioural therapy (CBT) and the research evidence demonstrating its effectiveness as a psychotherapeutic treatment of choice for a range of emotional and behavioural problems, has prompted the development of CBT-based training programmes. CBT approaches to foster care training derive from a 'skill-based' training format that also seeks to identify and correct problematic thinking patterns that are associated with dysfunctional behaviour by changing and/or challenging maladaptive thoughts and beliefs.


To assess the effectiveness of cognitive-behavioural training interventions in improving a) looked-after children's behavioural/relationship problems, b) foster carers' psychological well-being and functioning, c) foster family functioning, d) foster agency outcomes.

Search methods

We searched databases including: CENTRAL (Cochrane Library Issue 3, 2006), MEDLINE (January 1966 to September 2006), EMBASE (January 1980 to September 2006), CINAHL (January 1982 to September 2006), PsycINFO (January 1872 to September 2006), ASSIA (January 1987 to September 2006), LILACS (up to September 2006), ERIC (January 1965 to September 2006), Sociological Abstracts (January 1963 to September 2006), and the National Research Register 2006 (Issue 3). We contacted experts in the field concerning current research.

Selection criteria

Random or quasi randomised studies comparing behavioural or cognitive-behavioural-based training intervention (in a group or one-to-one settings or both) versus a no-treatment or wait-list control, for foster parents/carers.

Data collection and analysis

Two authors independently assessed trial quality and extracted data. We contacted study authors for additional information.

Main results

Six trials involving 463 foster carers were included. Behavioural and cognitive-behavioural training interventions evaluated to date appear to have very little effect on outcomes relating to looked-after children, assessed in relation to psychological functioning, extent of behavioural problems and interpersonal functioning. Results relating to foster carer(s) outcomes also show no evidence of effectiveness in measures of behavioural management skills, attitudes and psychological functioning. Analysis pertaining to fostering agency outcomes did not show any significant results. However, caution is needed in interpreting these findings as their confidence intervals are wide.

Authors' conclusions

There is currently little evidence about the efficacy of behavioural or cognitive-behavioural training intervention for foster carers. The need for further research in this area is highlighted.




對寄養照顧者提供訓練,目前已經被視為成功的寄養安置的一個重要因素。60年代後期以來,寄養照顧者的培訓計劃蓬勃發展,而在很多發表及未發表的培訓課程之中,只有少數經過系統性的評估。認知行為治療(CBT)的進步,且研究證據也顯示其對於廣泛的情緒和行為問題,可作為心理治療介入的選擇,促使CBT的訓練方案的發展。 CBT取向的寄養照顧者訓練,是從「技巧為基礎」的訓練模式衍生,以改變和/或挑戰不良適應的思考和信念的方式,來發現和改正和失能行為相關的有問題的思考模式。


為了評估認知行為訓練介入,在改善 a)被照顧的兒童之行為/關係問題,b)寄養照顧者的心理安適感及功能,c)寄養家庭的功能,d)寄養機構的成果等方面之成效。


我們搜尋了以下資料庫,包括:CENTRAL(Cochrane Library第3期,2006年)、MEDLINE(1966年1月至2006年9月)、EMBASE(1980年1月至2006年9月)、CINAHL(1982年1月至2006年9月)、PsycINFO(1872年1月至2006年9月)、ASSIA(1987年1月至2006年9月)、LILACS(截至2006年9月)、ERIC(1965年1月至2006年9月)、Sociological Abstracts(1963年1月至2006年9月)和2006年 National Research Register(第3期)。我們也聯繫此領域的專家以取得最近的研究。











此翻譯計畫由臺灣國家衛生研究院 (National Health Research Institutes, Taiwan) 統籌。



Plain language summary

Behavioural and cognitive behavioural training interventions for assisting foster carers in the management of difficult behaviour

Providing training for foster carers is thought to enhance caring attitudes and skills, help foster carers deal more effectively with foster children's behaviour, and decrease foster carer attrition. Although training programs have proliferated, there has been minimal evaluative research to determine whether they are effective.
This review attempted to determine the effectiveness of cognitive-behavioural training interventions. Only six trials involving 463 foster carers were included. Results suggest little evidence of effect on looked-after children, foster carers and fostering agency outcomes.