Psychosocial factors and behavioral health outcomes among children in Foster and Kinship care: A systematic review

National data indicate recent increases in the number of children in foster and kinship care placements. Children in out-of-home placements are at elevated risk for behavioral problems, often stemming from maltreatment or trauma exposure before placement. Behavioral problems are associated with placement disruptions, delinquency, and substance use; long-term data show children with histories of foster and kinship care disproportionately experience these negative outcomes. Thus, research is needed to identify factors that can be targeted in prevention and intervention efforts to improve behavioral health outcomes among this vulnerable population. To fill this knowledge gap, we conducted a systematic review with the aim of developing a better understanding of the psychosocial factors associated with the behavioral health of children in foster and kinship care. Guided by the PRISMA protocol for systematic reviews, we identified relevant literature through searches of 3 electronic databases: Social Work Abstracts, Social Service Abstracts, and PsycINFO. Criteria for review inclusion were study samples of children in foster or kinship care; studies published between 2010 and 2016; and study focus on behavioral health outcomes, with psychosocial factors as the predictor variables. Studies were evaluated for risk of bias. The final sample included 40 studies, from which we identified almost 50 psychosocial factors associated with the behavioral health of children in foster and kinship care, including the most frequently examined psychosocial factors of caregivers' parenting practices and placement type. Additionally, we found positive psychosocial factors (e.g., positive parenting practices; healthy family functioning) predicted fewer behavioral problems. Practitioners should consider placement types and parenting interventions as a means to reduce problem behaviors. Given the substantial number of racial/ethnic minority samples in the reviewed literature, future research should focus on the direct and indirect influences of race/ethnicity and cultural competencies on children's behavioral health outcomes.