COMMUNICATION ABOUT SEXUAL HEALTH AND DECISION MAKING WITH ADOLESCENTS IN FOSTER CARE

Abstract

When in foster care, adolescents experience a disruption in the expected avenues through which they would receive sexual health information, such as through parents, school and peers. Adolescents that are placed in foster care come into contact with numerous professionals, and in particular, social workers. These professionals often serve as a gateway to information and resources such as mental and physical health, education, legal assistance, and life skills that are vital to youth in foster care (Bunger, Stiffman, Foster, & Shi, 2009). Social workers are tasked with serving and protecting adolescents in foster care, who are considered one of the United States' most vulnerable populations (Polit, Morrow-White, & Morton, 1987). Consequently, it is important that social workers are equipped with the knowledge and skills necessary as they are in a position of influence to communicate with adolescents about all their special needs including sexual health and decision making. Adolescents in foster care need increased access to aggressive sexual health education. We know that 93 percent of adolescents residing in foster care are sexually experienced, are less likely to use contraceptives, and commonly experience one or more forced sexual experiences (Becker & Barth, 2000; Child Trends Inc., 2009; James, Montgomery, Leslie, & Zhang, 2009). When social workers support adolescents in foster care, they must draw upon theoretical perspectives that in turn support models and skills designed to discuss issues regarding sexual health in straightforward, comprehensible language or risk giving adolescents the idea that what they are thinking and feeling about sexuality and their own development is disgraceful or morally wrong (Aiello, 1999). Because of the sexual health concerns facing adolescents residing in foster care, encouraging communication between child welfare workers and these adolescents may result in adolescents becoming more aware of the risks and becoming more aware of available options for promoting safe and healthy sexuality. This study will examine the relationships of child welfare workers' comfort regarding sexual issues, sexual health knowledge, and education level with their capacity to communicate with adolescents residing in foster care about their sexual health and decision making. This study utilized primarily quantitative methods to identify statistically significant models of communication between child welfare workers and adolescents residing in foster care regarding their sexual health and decision making. The comfort level of child welfare workers with sexual health issues was found to be a significant predictor of communication with adolescents residing in foster care in five out of six regression models. There is a clear relationship in the existing literature between adolescents residing in foster care and engagement in risk behaviors. Included among these identified behaviors are adolescents in foster care engaging in risk related sexual health behaviors. There is a limited amount of literature that focuses exclusively on the sexual health risk behaviors of adolescents residing in foster care. This study uses original data to identify predictors of communication between child welfare workers in the state of Kansas and the adolescents they serve who are residing in foster care regarding their sexual health and decision making. This study makes a contribution to the literature as it is the first to focus attention on certain attributes of child welfare workers in the state of Kansas that serve as predictors for communication with their current adolescent caseload regarding issues of sexual health and decision making. Additionally, this is the first study conducted in several decades to focus specifically on communication with adolescents residing in foster care regarding their sexual health and decision making.