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Intervening to improve outcomes for siblings in foster care: Conceptual,substantive, and methodological dimensions of a preventionscience framework

Bowen McBeath a,b,!, Brianne H. Kothari a,b, Jennifer Blakeslee a, Emilie Lamson-Siu a, Lew Bank a,b,L. Oriana Linares c, Jeffrey Waid a, Paul Sorenson a, Jessica Jimenez c, Eva Pearson c, Aron Shlonsky d

a Portland State University School of Social Work, P.O. Box 751, Portland, OR 97207, United Statesb Oregon Social Learning Center, P.O. Box 751, Portland, OR 97207, United Statesc Mt. Sinai School of Medicine, United Statesd University of Toronto School of Social Work, Canada

a b s t r a c ta r t i c l e i n f o

Article history:Received 28 August 2013Received in revised form 3 December 2013Accepted 3 December 2013Available online 18 December 2013

Keywords:SiblingsSibling relationshipFoster careChild welfarePreventionIntervention

In recent years, the child welfare !eld has devoted signi!cant attention to siblings in foster care. Policymakersand practitioners have supported efforts to connect siblings via shared foster placements and visitation while re-searchers have focused on illuminating the empirical foundations of sibling placement and sibling intervention inchild welfare. The current paper synthesizes literature on sibling relationship development and sibling issues inchild welfare in the service of presenting a typology of sibling-focused interventions for use with foster youth.The paper provides two examples of current intervention research studies focused on enhancing sibling develop-mental processes and understanding their connection to child welfare outcomes. The paper concludes by pre-senting an emerging agenda informing policy, practice, and research on siblings in foster care.

© 2013 Elsevier Ltd. All rights reserved.

1. Introduction

A historic concern within child welfare systems is the disruptionof sibling bonds when youth are removed from a home due to sub-stantiated child maltreatment. Roughly two-thirds of foster youthnationally have at least one sibling in foster care (Child WelfareInformation Gateway, 2013; Shlonsky, Elkins, Bellamy, & Ashare,2005), with many of these youth placed in separate residenceswhile in foster care. The importance of preserving and strengtheningsibling bonds is re"ected at the federal level in the Fostering Connec-tions to Success and Increasing Adoptions Act of 2008, which requiresreasonable efforts to co-place siblings in foster residences, as well asin Child and Family Service Review state indicators pertaining to siblingco-placement (McCormick, 2010). Over half of state child welfare sys-tems have policies prioritizing the placement of foster youth with sib-lings in the same physical residence in order to support the ability offoster youth to establish and maintain lifelong sibling ties (Gustavsson& MacEachron, 2010; Herrick & Piccus, 2005).

These federal and state policies undergird current child welfarepractices concerning sibling co-placement and relationship development.Foster care caseworkers commonly seek to place siblings in the same

physical residence upon the entry of youth into foster care, and this effortis generally understood to be themost common sibling-focused interven-tion undertaken in foster care. Estimates of the percentage of siblingswhocome into foster care at the same time and who are subsequently placedwith at least some of their siblings range from 59% (Tarren-Sweeney &Hazell, 2005) to 78% (Wulczyn & Zimmerman, 2005), although it isclear that older children and children removed from their biologicalhousehold at different time points are much less likely to be placedwith their siblings (Hegar, 2005). Relationships between siblings in fostercare are often critical in providing youthwith a sense of connection, emo-tional support, and continuity as they are removed frommuch that is fa-miliar to them (e.g., their home, biological parent(s), school, and peers)in the aftermath of child maltreatment and subsequent removal. Strongand consistent sibling relationships among foster youth have beenfound to be associated with enhanced reuni!cation (Akin, 2011; Albert& King, 2008; Webster, Shlonsky, Shaw, & Brookhart, 2005) and mentalhealth and well-being (Davidson-Arad & Klein, 2011; Linares, Li, Shrout,Brody, & Pettit, 2007; Tarren-Sweeney & Hazell, 2005).

The growth of sibling research in child welfare re"ects interdis-ciplinary attention to sibling investigation and in particular to un-derstanding the strength and nature of the sibling bond and itsconsequences for foster youth and other at-risk populations.Prosocial sibling relationships provide important opportunities foryouth to learn and practice social skills and to develop strategies

Children and Youth Services Review 39 (2014) 1–10

! Corresponding author. Tel.: +503 725 5006; fax: +503 725 5545.E-mail address: mcbeath@pdx.edu (B. McBeath).

0190-7409/$ – see front matter © 2013 Elsevier Ltd. All rights reserved.http://dx.doi.org/10.1016/j.childyouth.2013.12.004

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Children and Youth Services Review

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for negotiation, con"ict resolution, and cooperative activity in familiarand unfamiliar settings. Research on non-foster care populations !ndsthat the quality of sibling relationships may positively affect adolescentidentity, self-esteem, and peer relationships (Kramer & Bank, 2005) andmay be associatedwith decreased behavior problems and improved ed-ucational outcomes (Bank, Patterson, & Reid, 1996; Conger & Reuter,1996; Linares et al., 2007). This general sibling literature suggests thatsibling relationships can in"uence social and emotional development(Daniels, Dunn, Furstenberg, & Plomin, 1985; McHale & Gamble,1989) by serving as important contexts for social learning andgrowth (East & Khoo, 2005; Patterson, 1986). The sibling relationshipoften serves as a powerful vehicle of socialization (Bank, Burraston, &Snyder, 2004; Snyder, Bank, & Burraston, 2005); and the loss of oppor-tunities for sibling bonding may therefore be especially consequentialfor foster youth (Herrick & Piccus, 2005).

The current paper aims to enhance understanding of opportunitiesand methods for policy interventions (e.g., co-placement) and psycho-social intervention with siblings in foster care to promote sibling rela-tionship quality and related prosocial youth outcomes. The siblingrelationship may provide a non-stigmatizing point of entry into thefamily for prevention programming (Feinberg, Sakuma, Hostetler, &McHale, 2012). Due to the high levels of risk that foster youth face andthe potentially positive in"uences that sibling co-placement andrelationship development have, developing and testing promisinginterventions to facilitate and enhance the sibling experiences ofyouth in foster care is critically important. Our analysis of the childwelfare literature as well as interdisciplinary sibling researchsuggests a normative orientation towards (a) the development ofinterventions that may promote sibling relationship developmentregardless of co-placement and (b) testing and re!ning sibling-focused interventions with foster youth, with particular attentionto enhancing their immediate effects on sibling relationship qualityas well as more distal in"uences on youth mental health, education-al, and permanency outcomes. This orientation re"ects a preventionscience framework for developing, testing, and implementing childwelfare interventions that target essential levers of change for fosteryouth.

Our analysis is organized as follows. Section two provides a sum-mative review of the interdisciplinary literature on the importanceof sibling relationships for foster youth and the mechanisms throughwhich sibling co-placement and sibling relationship developmentare associated with bene!cial outcomes for at-risk youth. This sec-tion provides essential considerations for intervention developmentby suggesting that sibling co-placement alone should not be viewedas a proxy for prosocial sibling and/or peer relationship develop-ment. In section three, we develop a typology of preventive interven-tions focused on sibling relationship development and in particulardifferentiate between policy interventions focusing on sibling iden-ti!cation and placement versus those that promote the developmentand sustainment of prosocial bonds between siblings in foster care.Section four summarizes two psychosocial intervention studiesfocused on enhancing sibling relationship quality among fosteryouth. These studies exemplify current efforts to develop and test pre-ventive interventions with siblings in foster care. The !nal section

re"ects on knowledge gaps in research, policy, and practice with sib-lings in foster care, and presents an agenda for child welfare practiceand research that highlights the essential role of sibling interventionwith foster youth.

2. Contextualizing sibling relationships in foster care

Understanding of the sibling relationship in foster care and its valuemay be enhanced by examining: 1) de!nitions of “siblings” in fostercare and laws and policies concerning the sibling relationship in fostercare; 2) research on the experiences of siblings in foster care as wellas the perspectives of children on sibling contact; and 3) evidenceconcerning the consequences of high-quality interactions and relation-ships between siblings. These interrelated research and policy-practicedomains are summarized in Table 1.

2.1. Conceptual and administrative issues pertaining to siblings in fostercare

Siblings are commonly de!ned as individuals who share at leastone biological parent, and incorporated in some de!nitions is a re-quirement of living together for a period of time. No universally ac-cepted de!nition of siblings in foster care exists, and researchersand child welfare systems have employed different conceptual andoperational understandings in conducting sibling-focused investiga-tions. A review of sibling placement in foster care (Washington,2007) illustrated that many studies did not clearly describe how sib-lings were de!ned. Some studies (e.g., Wulczyn & Zimmerman,2005) used practical constraints that limited the de!nition of sibling(e.g., sharing the same biological mother) whereas others (e.g., Folman,1998; Gardner, 2004) did not specify who “brother” and “sister” were,thereby allowing individual participants to decide. An international re-view of sibling placement and adoption (Hegar, 2005) described howthe de!nition of a sibling varied across studies, with some silent onthe topic and others de!ning siblings however the agency de!nedthem at the time data were collected. State-level differences in the def-inition of siblings and in policies about sibling co-placement can alsopose a challenge for understanding and enhancing outcomes for sib-lings in foster care.

Despite the lack of de!nitional consensus, state child welfare sys-tems have generally sought to promote sibling placement. Somestates, such as California, Illinois, and New York, have recognizedthe importance of siblings through speci!c legislation prioritizingsibling placement. For example, in California a sibling is de!ned as “achild related to another person by blood, adoption, or af!nity througha common legal or biological parent” (California Legislative Counsel,2003); and California statute requires that caseworkers make “diligentefforts” to place siblings together or provide sibling contact (Shlonskyet al., 2005, p. 702).

A challenge that Lery, Shaw, and MacGruder (2005) highlight,however, is that youth (particularly half- and step-siblings) thatmeet these criteria may not always have been identi!ed as such bychild welfare systems. Administrative databases are often used todetermine whether sibling relationships exist for children in foster

Table 1A question-based rubric for promoting understanding of sibling relationships in foster care.

Dimension Key questions

Conceptualization and administration ! How are siblings de!ned, identi!ed, and tracked in foster care?! What policies and administrative efforts pertain speci!cally to siblings in foster care?

Sibling experiences ! How do siblings' living situations and foster care experiences differ?! What is the frequency and quality of interactions between siblings in foster care?! What do siblings hope for/want?Howdo siblings' preferences relate to the views of foster parents, caseworkers, andother adults in their lives?

The in"uence of sibling relationships ! What is known with con!dence concerning ways to support and promote healthy relationships between siblings?! In what ways can the sibling relationship serve as a vehicle for learning and practicing other important life skills?

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care, but the completeness and accuracy of these data depend on anumber of factors, including caseworkers' ability to collect andrecord detailed information, family members' provision of detailedinformation, and the development of speci!c routines for gatheringsibling-speci!c information (Lery et al., 2005). Additionally, admin-istrative databases are often constructed to collect information onprimary caregivers—who are usually mothers—and their children in-volved in the current episode of child maltreatment (e.g., Shlonsky,Webster, & Needell, 2003), with the implication that administratorsand researchers utilizing these particular databases may not be able toeasily identify all siblings and half-siblings. Data extraction approachesthat arti!cially limit the number of siblings available for any given anal-ysis may also reduce practitioners' and child welfare systems' under-standing of sibling groups (Lery et al., 2005).

2.2. Sibling experiences in foster care

Children in a sibling group do not always experience the samesubstitute care settings, and a large proportion of youth who entercare are separated from their siblings at one or more points duringtheir foster care stay (approximately two-thirds based on past andcurrent reports) (Kosonen, 1996; Wulczyn & Zimmerman, 2005).Siblings may not be placed in the same home initially and eachchild's placement may change over time and thereby be associatedwith different experiences and individual and family transitions(Drapeau, Simard, Beaudry, & Charbonneau, 2000). With recent re-search efforts focused on siblings' experiences as they relate to place-ment type, language has been developed to identify siblings who areliving together (intact), placed with some (i.e., “splintered”, in whichthe child has at least one sibling in the home) or removed from all(i.e., “split”, where the child has no siblings in the home) of their siblings(Hegar & Rosenthal, 2011). Additionally, when children become in-volved in the child welfare system and start living with a new family,they may encounter additional youth (e.g., foster siblings, cousins)who become part of their lives. These kin, non-kin, and even !ctive sib-ling relationshipsmay not always have a biological component butmayhold strong emotional and social importance to youth particularlywhen promoted by cultural norms and/or in multi-family living situa-tions (Sen & Broadhurst, 2011).

Although placement with or without siblings has been a focal pointof research, information on the frequency and quality of contactbetween siblings in foster care is much more limited. Lundstrom andSallnas (2012) describe the considerable body of research on parent–child contact in foster care and highlight the lack of attention that hasbeen devoted to contact between siblings in care. They also describehow the perspectives of children about their sibling relationships areessential yet often unconsidered. The variety of de!nitions used bystudies to understandwhat constitutes regular versus less frequent con-tact between siblings has made comparison of the information that hasbeen collected problematic and thus has hampered the development ofa basic understanding of opportunities for and frequency of siblinginteraction in foster care. Nevertheless, a strong theme emerging fromU.S. and international studies is that youth in foster care indicate thatthey desire more contact with their siblings (Biehal, Ellison, Baker, &Sinclair, 2010; Fernandez, 2006; Timms & Thoburn, 2003), with asmany as 77% of children wanting to see their siblings more often(Chapman, Wall, & Barth, 2004). Using data collected from youngadult foster alumni, Pecora (2010) demonstrated that these individualshad more frequent contact with their siblings than their parents. Con-sidered together, these studies emphasize the importance of siblingconnections for foster youth.

2.3. The importance of sibling relationship development

The general sibling literature provides child welfare researchers,practitioners, and policymakers with useful information about the

ways in which sibling relationships may help and harm. Feinberg,Solmeyer, and McHale (2012) note that as the third rail in family sys-tems, sibling relationships are universal, powerful, and drive devel-opment in positive and negative ways. For the past few decades,sociological and psychological studies have demonstrated the waysin which siblings serve as friends, advocates, allies, playmates, models,and socialization agents for positive and negative behavior (Brody,1996). Sibling relationships can in"uence social and emotional develop-ment (Daniels et al., 1985; McHale & Gamble, 1989) as well as serveas important contexts for individual learning (East & Khoo, 2005;Patterson, 1986). Although sibling relationships grow and changeover time, studies have shown that during some life stages (particu-larly during late childhood through adolescence) youth may reportspending more free time with their siblings than with friends,parents, or even by themselves (McHale & Crouter, 1996; Tucker,McHale, & Crouter, 2008).

While siblings may serve as essential socialization agents, siblingbonds have been studied much less frequently than parent–child rela-tionships. Sibling relationships have someparallels to parent–child rela-tionships in that siblings may serve as models or guides, but siblingbonds are also characterized with higher levels of reciprocity sincethey are relative equals. Because siblings are a subset of children'speers and often serve as the primary peer relationships in childhood,sibling relationships are also a starting point for developmental in"u-ence (Dunn, 2002). Pike, Coldwell, and Dunn (2005) have documentedthat sibling interactions provide unique opportunities for learningprosocial behaviors and developing positive skills such as offering com-panionship. Kramer (2010a,b) provides a list of criteria for judging thequality of prosocial sibling relationships, including: positive engage-ment; cohesion; shared experiences that build support, social and emo-tional understanding, and perspective taking; emotional regulation andbehavioral control; forming neutral or positive attributions; con"ictmanagement and problem solving; and responding to parental differen-tial treatment practices.

These essential components of successful sibling relationshipshave garnered support from studies of siblings across the earlychildhood-to-late adolescence developmental arc. Positive siblingrelationships, in particular, have the ability to provide opportunitiesfor learning and practicing prosocial skills, may serve as a buffer for thenegative emotions that accompany families in transition (Dennis, Cole,Wiggins, Cohen, & Zalewski, 2009), and may in"uence child and lateradult behavior and mental health (Waldinger, Valliant, & Orav, 2007).This is because positive social experiences among siblings frequentlygenerate positive emotions and provide opportunities to practicecoping strategies that are bene!cial to children during times of stress.Research has also demonstrated that sibling groups can provide emo-tional security and social support needed to adjust to unstable life situ-ations (Hegar, 1986; Kempton, Armistead, Wierson, & Forehand, 1991).

Con"ictual sibling relationships can also affect child outcomesand future adjustment, and the degree of sibling con"ict present dur-ing critical developmental transitions often determines whetherthese outcomes are positive or negative. Con"ict is a common facetof sibling relationships, and if youth have the skills to work throughinterpersonal dif!culties, exposure to this lower level of con"ict canbe viewed as constructive. In fact, some evidence suggests that sib-ling con"ict management may be linked to increases in social com-petence (Bedford, Volling, & Avioli, 2000), and some investigatorshave focused speci!cally on sibling con"icts as opportunities foryouth to practice problem solving strategies (Siddiqui & Ross,2004; Smith & Ross, 2007; Stormshak, Bellanti, & Bierman, 1996).When unmanaged, however, sibling con"ict may result in verbaland physical aggression and likely plays a role in the developmentof internalizing symptoms and externalizing behavior. In a series ofcarefully-controlled studies, Bank and colleagues determined thatthe effects of sibling con"ict during childhood and early adolescencecould be seen in poor outcomes across multiple domains (i.e., mental

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health, antisocial behavior, educational performance, criminal justiceinvolvement) and that these effects persisted in some instances overdecades (Bank&Burraston, 2001; Bank et al., 1996, 2004). These results,which reinforce those from other investigators (Patterson, 1982;Snyder & Stoolmiller, 2002), persisted even when controlling for keyparental processes such as discipline and supervision as well as otherpeer relationships. Thus, high levels of sibling con"ictmay be associatedwith different negative outcomes in childhood, adolescence, and earlyadulthood.

Different theoretical approaches may be used to understandingthe development of sibling relationships in the context of broaderchanges in family systems. Whiteman, McHale, and Soli (2011)apply psychoanalytic–evolutionary, social psychological, social learn-ing, and family–ecological systems perspectives to explain sibling rela-tionships in childhood and adolescence. Since sibling relationshipsoften evolve over the full developmental lifespan, Whiteman andcolleaguesmention other frameworks thatmay also be useful in under-standing this important family bond in adulthood including life-courseand feminist perspectives. Waid (forthcoming) argues that family–ecological and social learning-based approaches may be most usefulin understanding sibling relationships among children and youth infoster care given their unique needs. As family systems theory sug-gests, family processes and dynamics are best understood whenstudied holistically. The sibling subsystem is an important elementof the family system, and children and families operate within thelarger social environment and its multiple layers of proximal and dis-tal contextual factors. Social learning theory has commonly beenused to understand sibling relationship dynamics, but can also beused to explain interactive processes occurring between siblingsand their caregivers or other key adults and the consequences ofthese processes for individual and family outcomes.

These empirical and theoretical studies imply that interventionstargeted at reducing sibling con"ict and enhancing sibling relationshipquality may reduce youth problem behaviors and mitigate challengesin the home for foster youth (e.g., coercive foster parent–child interac-tions). When youth are placed into care, the sibling relationship is fre-quently the most viable ongoing relationship; and the developmentandmaintenance of a positive sibling relationshipmay serve as a sourceof resilience when other familial resources are unavailable (Feinberg,Sakuma, et al., 2012; Feinberg, Solmeyer, Hostetler, et al., 2012;Feinberg, Solmeyer, et al., 2012; Kramer, 2010a,b). The sibling relation-ship also provides a prototype for peer relationships, as sibling relation-ships are often a training ground for later peer relationships and anavenue for peer choice and in"uence (Lewin, Hops, Davis, & Dishion,1993; Stormshak et al., 1996). The promise of sibling intervention as aplatform for preventing and addressing foster youth problembehaviors,therefore, rests not only on the sibling relationship but on the bi-directional and complex linkages between sibling, parental, and peerin"uences.

3. Sibling relationship quality as a lever for intervention withfoster youth

Although the general sibling literature highlights attributes ofsibling relationships that may be bene!cial and/or detrimental forchildren, little research exists concerning promising interventionapproaches to support the relational needs of sibling in foster care.Classes of interventions focused on enhancing sibling relationshipquality can be understood through a prevention science frameworkapplied to youth in foster care settings. This section presents a typol-ogy of sibling-focused interventions based on the prevention sciencerubric of universal, selected, and indicated/targeted preventiveinterventions (Cavaleri, Olin, Kim, Hoagwood, & Burns, 2011) anddiscusses the possible applicability and value of sibling-focused in-terventions with youth in foster care.

3.1. Universal sibling placement strategies

As can be seen in Table 2, the dominant intervention approach withsiblings in foster care is co-placement and/or visitation, in which place-ment decisions re"ect federal and state childwelfare policies promotingthe maintenance of sibling bonds whenever feasible. These universalstrategies include co-placement and visitation policies and in some in-stances attention to the needs of siblings (via needs assessments). Inpractice, the application of these policies may be inconsistent andprone to systemic barriers including: court decisions preventing coter-minous co-placement; the lack of suitable foster homes allowing forthe housing of large sibling groups; placement changes and other per-manency transitions; and logistical limitations on the frequency of visi-tation between siblings who have positive relationships but are not co-placed (Child Welfare Information Gateway, 2013; McCormick, 2010).However, when successful, the application of co-placement and visita-tion policies can be considered a non-targeted and universal preventionapproach that indirectly seeks to enhance sibling bonds and permanen-cy (Akin, 2011; Albert & King, 2008; Holloway, 1997; Staff & Fein, 1992;Webster et al., 2005).

3.2. Selective prevention models for sibling relationship development

Selective preventive interventions focused directly on sibling rela-tionship development can re"ect and build on existing universal ap-proaches to improve or maintain positive sibling relationships innormative populations. These models often involve the application ofschool-based interventions for youth deemed at-risk for developingsocial–behavioral problems. For example, the Siblings Are Special (SAS)program is a school-based intervention targeting the relationshipbetween older and younger siblings in grade school through a 12-session weekly curriculum. SAS includes activities designed to improvesibling relational skills and cognitions in the sibling relationship context,with some separate parent training to reinforce these relational skills.The SAS intervention has been shown to be feasible (Feinberg,Sakuma, Hostetler, & McHale, 2012) and program participation hasbeen associatedwith positive sibling relationship quality aswell as sub-sequent child and parent outcomes (Feinberg, Solmeyer, Hostetler,Sakuma, et al., 2012). Another intervention, More Fun with Sisters andBrothers (Kennedy & Kramer, 2008), focused on improving relationshipquality with 4–8 year old siblings through development of emotionalregulation competencies and pro-social behaviors over !ve one-hourweekly sessions. In this program, siblings learned skills in small groupsessions and parents monitored the sessions and learned how to rein-force the curriculum. Findings showed improvement in emotional reg-ulation and sibling relationship quality for program participants, withmodest positive effects on warmth and reduced need for parent inter-vention (Kennedy & Kramer, 2008). In the context of foster care, suchmodels may be targeted to at-risk sibling dyads or groups, where theparent training components are designed to help relative or non-relative foster parents support prosocial sibling relationship mainte-nance and development in addition to preventative co-placement orregular sibling visitation efforts.

From a selective prevention standpoint, child welfare systems mayalso introduce targeted and therapeutic interventions that promote sib-ling relationship quality when co-placement and regular visitation arenot possible, or when co-placement and visitation are not consideredadvisable due to concerns about the nature of a particular sibling rela-tionship. In fact, out-of home placement may be viewed as a potentialstrategy for disrupting coercive patterns in the family system that mayhave led to sibling maltreatment. For positive sibling relationships,such selective intervention can prevent the deterioration of siblingbonds due to systemic factors. This approach assumes that the siblingrelationship can be a vehicle for positive growth and attainment oftransferable skills, particularly social skills that can be practiced andapplied to other sibling and/or peer relationships. Further, although

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“deviancy training” through the sibling relationship is a risk, Feinberg,Solmeyer, Hostetler, Sakuma, et al. (2012) argue that the possibility ofan iatrogenic effect may be limited by intervening with siblings priorto adolescence, when siblings may not yet be engaged in antisocial orcollusive behavior. Additionally, earlier intervention can focus on in-creasing relational warmth while also lowering sibling con"ict(Feinberg, Solmeyer, & McHale, 2012). In this situation, maltreatmentexposure and subsequent foster care placement may be considered arisk factor justifying targeted and therapeutic intervention.

One selective prevention model is designed to improve sibling re-lationship dynamics when there is an identi!ed older sibling withconduct problems (Bank, Snyder, Prescott, & Rains, 2002; Bank et al.,2004). In a randomized evaluation of parent training programs withand without a secondary sibling component, sibling dyads in the inter-vention group attended curriculum-based sessions focused on enhanc-ing the sibling relationship, increasing socially skilled behavior, andreducing con"ict and aggression. As with the normative interventionsdescribed above, parents were speci!cally trained to reinforce thesibling curriculum. Findings showed that adding the sibling sessionsto the parent management training model was associated with lowerparent-reported antisocial behavior, more academic progress, andmore positive peer associations (Bank et al., 2002, 2004). In an approachmore speci!c to foster placement-related risk factors, Gnaulati (2002)has argued for sibling co-therapy to strengthen sibling bonds in theface of family dissolution or reorganization due to divorce or placementin foster care. In these situations, co-therapy may help siblings processmaltreatment, loss, and uncertainty, and may enhance odds of reuni!-cation or co-placement (Gnaulati, 2002, p. 78). However, co-therapy iscontraindicated when siblings are at markedly different developmentalstages, or when a younger ormore submissive sibling idealizes a siblingwith antisocial tendencies (Gnaulati, 2002). Thus, targeted approachesto enhancing sibling relationships can be applied when foster place-ment is the identi!ed risk factor, particularly when there are systemicbarriers to relationship development or maintenance, but with thesame consideration of other risk factors speci!c to the sibling dyad orgroup that might make relationship development problematic.

3.3. Indicated/targeted interventions

In the case of potentially problematic sibling relationships and/orsiblings situated in particularly troubled family environments, targeted,therapeutic intervention focused in part on the sibling bondmay also beincorporated into comprehensive ormultilevel approaches. In these set-tings, family-based efforts may seek to enhance sibling relationship de-velopment in the context of parent and/or child focused programming.

Stormshak, Bullock, and Falkenstein (2009) present a "exible, intensive,and family-focused program model (EcoFIT and/or Family Check-Up)in terms of proximal effects on sibling relationship quality throughfamily management training with parents (e.g., managing siblingcollusion), but have not yet directly targeted or examined effectson sibling bonding. Similarly, Brotman et al. (2005) describe an in-tervention for pre-school siblings of adjudicated youth, focusedon parent–child interactions and concurrent group training. Thereis no direct intervention on sibling bonding or the older siblings' be-havior (although parents were encouraged use their new skills withthe older youth), but the authors found reductions in older siblingantisocial behavior and improved peer relations. Alternatively, aparent-only intervention approach developed by Ross and colleagues(Siddiqui & Ross, 2004; Smith & Ross, 2007) speci!cally trains parentsto use mediation to manage sibling con"ict. Overall, improved siblingrelationship quality may enhance the functioning of the larger familysystem, whether these are biological or foster family contexts, and anyof these approaches may be adapted as part of a comprehensive effortto manage challenging household dynamics involving problematicsibling relationships for foster youth.

Although selective and indicated intervention in the sibling con-text with foster youth has been limited, the approaches describedhere suggest that sibling relationships may be leveraged in waysthat improve individual sibling outcomes as well as interpersonal re-lational qualities between siblings, parents, and peers. In the contextof sibling relationship quality in foster care, this preventive approachassumes that bene!cial sibling qualities can be targeted and enhanced.Additionally, intervention assumes that detrimental relationshipqualities can be reduced with siblings in foster care. Therefore, prob-lematic sibling relationships are intervenable, whether siblings areco-placed or not. With the exception of sibling co-therapy, all ofthe approaches described here include parent training as a factor inthe delivery of the sibling-based intervention. This is an outstandingissue when considering how such interventions may work in fostercare settings, where a consistent, long-term parent relationship cannotbe assumed.

4. Foster care intervention models targeting siblingrelationship quality

This section describes two preventive interventions designed toimprove sibling relationship quality among youth in foster care.These intervention studies are summarized so as to provide examplesof intervention studies involving foster youth and being delivered inchild welfare contexts. Promoting Sibling Bonds is reviewed !rst given

Table 2A prevention science framework for sibling-focused interventions for foster youth.

Prevention level and focus Focal population Intervention approaches

Universal: interventions not targeted to speci!ctypes of siblings

General foster youth population ! Well-de!ned sibling co-placement policy.! Agency-based plans for facilitation and implementation of siblingvisitation.

! Agency-based implementation of needs assessment for siblinggroups.

! Trainings for caseworkers, foster parents, and other professionalsabout sibling issues.

! Sibling skill-building, either via group-based or one-on-one ses-sions focused on problem solving, con"ict resolution, etc.

Selective: psychosocial interventions for siblinggroups and/or individual siblings

Foster youth at risk for poor mental health and childwelfare outcomes and/or youthmost likely to bene!tfrom individualized treatment

! Curricularized interventions focused on sibling relationship skill-building.

! Sibling co-receipt of therapeutic services.! Avoiding sibling co-placement when advisable.

Indicated: comprehensive interventions targetingthe context of siblings

Foster youth demonstrating serious needs andbehaviors and who are likely to engage in furtherdisruptive behavior

! Parenting and whole-family interventions incorporating siblingrelational development.

! Connection of identi!ed siblings to appropriate community-basedsocial services.

! Sibling-focused inter-organizational coordination between socialservice agencies, law enforcement, courts, and corrections.

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its focus on younger foster child dyads between the ages of 5–11 and itspromising ef!cacy results. Supporting Siblings in Foster Care, which wasbegun more recently and which serves sibling dyads between 7 and15 years old, is then reviewed.

4.1. Promoting Sibling Bonds

Promoting Sibling Bonds (PSB) is a CDC-funded, 8-week preventiveintervention targeting maltreated sibling pairs ages 5–11 years placedin the same foster home. The intervention study was implementedacross three community-based child welfare agencies in New YorkCity. As a family-based intervention, PSB was developed to: (a) equipchildren with new prosocial competencies; (b) reinforce positiveparenting and train foster parents in con"ict mediation strategiesthat support their children's newly acquired competencies; and(c) promote skill generalization in the foster home. In a recent random-ized trial (Linares et al., in press), the authors evaluated programuptake(enrollment and retention for assessments and attendance) and short-term outcomes for youth randomly assigned to the PSB interventioncompared to youth receiving as-usual foster care services. Programgoals/outcomes included increasing sibling positive interaction, reduc-ing con"ict during play, and promoting con"ict mediation strategies.It was hypothesized that training in parent-assisted mediation wouldfacilitate con"ict resolution by siblings (e.g., helping them reach win–win scenarios) leading to less con"ict during interactive play and lesssibling aggression in the foster home.

4.1.1. Program curriculum and componentsSibling, parent, and joint sibling–parent program components are de-

livered in a package to single families at the foster agency by a trainedtwo-clinician team. The sibling component targets the following skillareas: cooperating, taking turns, and sharing; developing consistentconsequences for sibling aggression; emotional self-regulation (Take aBreak); developing prosocial behavior alternatives (Turn Your BehaviorAround); supporting your sibling and identify common ground; andproblem solving and !nding mutually-acceptable solutions. The parentcomponent focuses on: sibling cooperation and communication; consis-tent consequences for sibling aggression; the power of positive atten-tion; self-regulation for yourself and for the children; and developingan organized approach to problem solving/mediation (Get Ready toListen; Get the Story Straight and the Feelings Right; Help Children Namethe Problem; Brainstorm; and Try a Solution). The joint componenttargets: barriers in the home; tracking and applying consequences tospeci!c behaviors; controlled practice; and CanDo charts. Programstrategies are based on doing rather than talking, and are incentivizedthrough the frequent use of social and tangible rewards. Games andactivities are chosen based on their potential for dyadic success and de-velopmental appropriateness for siblings.

4.1.2. Study participant characteristicsThe samplewas drawn from age-eligible sibling pairs at three partic-

ipating childwelfare agencies during a two-year period starting in 2009.From 68 age-eligible sibling pairs, 20 pairs were found ineligible, 26declined participation, and 22 pairs were enrolled. From 22 enrolledsibling pairs, 13 pairs were randomized to the intervention group and9 pairs to a comparison as-usual care group. Children and foster parentsin both study groups continued to receive services as prescribed by theirfoster care agencies. Sibling pairs were between 7.2 and 9.7 years ofage; from ethnic minority backgrounds (Latino, African American, andmixed); 90% had experienced child neglect; and 57.3% showed elevated(T ! 60) CBCL externalizing scores.

4.1.3. Program uptakeEleven children completed 6 or more of the 8 sessions (M = 6.62,

S.D. = 2.79), while 8 foster parents completed at least 6 of the 8 ses-sions (M = 4.92, S.D. = 3.45) in an average duration of 10.72 weeks

(S.D. = 2.46). All intervention families completed assessments; onecomparison family dropped out of the study after the pre-interventionassessment. There was occasional missing data for speci!c measures.

4.1.4. MeasuresThe Sibling Interaction Quality (SIQ; Kramer, 2010a,b) instrument

was adapted to assess the dyadic quality of the sibling interaction andcon"ict in the foster home under two standard play conditions: "oorpuzzle and gameplay. Two observationalmeasureswere coded: positiveinteraction (! = 0.77) consisted of 18 items; and negative interaction(! = 0.94) was comprised of 15 items. Con!ict (de!ned as dyadsexhibiting three opposing interactive turn units) was coded based on5 items (compromise, win/lose, no resolution, reconciliation, requestsparent intervention). The Con!ict Checklist (Smith & Ross, 2007) wasadapted to assess parent intervention following sibling disputes in thefoster home. Using 10 codes, we coded for the number of mediationand non-mediation strategy types. The Sibling Aggression Scale (SAS;Linares, 2008) is a 13-item scale assessing verbal/indirect aggressiveacts (insult, swear, isolate, yell, destroy; ! = 0.63) and physical/direct(push, kick, threaten, grab, beat-up, throw, twist, slap; ! = 0 .74) ag-gressive acts administered separately for older and younger child asperpetrators.

4.1.5. Data analysesPreliminary analyses were conducted to assess for baseline inter-

vention vs. control group differences regarding child characteristics(including age, gender, ethnicity, length of placement in the currentfoster home, type of child maltreatment, elevated behavior prob-lems, and mental health services) and foster parent characteristics(including age, years of school completed, number of children inthe home, kinship status, and preferred spoken language). In prima-ry analyses and following an intent-to-treat methodology, PROCGLM analyses (SAS; version 9.2) were used to test groupmean differ-ences in dyadic-level measures (e.g., sibling interaction quality andnumber of parental strategies) assessed at the end of the intervention;logistic regression analyses were used to test dichotomous outcomemeasures (e.g., con"ict). For child-level measures, GLM analyses wereconducted separately for the older and the younger child. Baselinescores and child age were used as covariates in multivariate analyses.Due to the small sample size no moderator analyses were conducted.

4.1.6. ResultsAt post-intervention, intervention pairs showed lower con"ict during

the "oor puzzle activity than did comparison pairs (!2(1,17) = 4.39,p b 0.05). After adjusting for baseline scores and child age, foster parentsin the intervention group reported ahigher number of parentalmediationstrategies than those in the comparison group (F(17) = 4.75, p = 0.05).Foster parents in the intervention group reported lower sibling physicalaggression from the older child toward the younger child than fosterparents in the comparison group (F(20) = 4.78, p b 0.05). No signif-icant group differences were found for sibling interaction quality(positive or negative), con"ict during the game play condition, parentalnon-mediation, verbal aggression from older toward younger child, orverbal and physical aggression from younger to older child.

4.1.7. ConclusionProgram feasibility involving training needs, attendance, obser-

vational protocol, and study outcomes was promising. The feasibilityof master-level clinicians implementing the manualized and pre-scribed intervention in the highly unstable world of foster care isalso a program accomplishment. Staff training needs are critical indesigning a large clinical trial aimed at program sustainability.

Despite study limitations (i.e., a small sample size and no follow-updata), the Promoting Sibling Bonds program targets an important un-tapped family resource in foster care that deserves further scrutiny.Based on this pilot trial, increased programmatic efforts to address

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the needs of high-risk siblings in foster homes and evaluate the ef-fects of such programming on foster sibling dyads seem feasibleand warranted.

4.2. Supporting Siblings in Foster Care

Supporting Siblings in Foster Care (SIBS-FC) is an NIMH-fundedrandomized, community-based evaluation of a sibling relationshipdevelopment intervention for at-risk foster youth between the agesof 7–15. The intervention research study is ongoing across three ofthe largest counties in Oregon and will be completed in 2015. It in-volves a partnership between Portland State University, the OregonSocial Learning Center, and the Oregon Department of Human Ser-vices (OR DHS).

4.2.1. Basic intervention curriculum and componentsThe SIBS-FC intervention is provided in neighborhood of!ces, foster

homes, and project of!ces so as to be convenient for siblings and theirfoster families. The 12-session intervention was developed to enhancesibling relationships for foster youth by supporting socially skilled be-havior in individual siblings and reducing sibling dyad-based con"ict.Activity-based sessions address issues pertaining to social and self-regulatory skills that operate in sibling relationships and that may becritical for development (e.g., cooperation, communication, emotionalself-regulation, problem solving, con"ict abatement, and social relation-ship repair strategies). Two sessions provide speci!c practice inapproaching adult allies (e.g., foster parents, caseworkers, relatives, at-torneys, judges) to facilitate the youth–adult ally relationship and createopportunities for collaborative problem-solving.

The 12-session curriculum includes 8 skill-building sessions (focus-ing on introduction of skills) and 4 community-based activities that pro-vide opportunities for skills-based practice.

! Session 1: Introduction.! Session 2: Cooperation.! Session 3: Planning community activities.! Community activity 1: Practicing cooperation.! Session 4: Managing feelings (emotional regulation).! Session 5: Problem solving.! Community activity 2: Practicing supporting each other and incorpo-rating supportive adults into community activities.

! Session 6: Getting adult support.! Community Activity 3: Practicing building adult alliances.! Session 7: Asking people in foster care for support.! Community activity 4: Practicing advocating with DHS case worker.! Session 8: Staying connected.

Activities are designed to be age-appropriate and engaging, and toemphasize discovery, learning, and practice in the context of experienc-ing and doing rather than talking and listening. Each activity is accom-panied by speci!c behavior change strategies used by interventioniststo describe, model, and reinforce critical social relational skills in thecontext of natural sibling interaction. Home practice activities with pa-rental collaboration are designed to facilitate youth generalization ofskills to home and peer environments. The sessions include four addi-tional sessions with community activities planned by siblings with as-sistance from project interventionists, who accompany the youth andhelp facilitate activities. Additionally, parentmanagement training is of-fered to all foster parents with enrolled youth. The curriculum is de-signed to be useful for siblings co-located in the same foster residenceas well as those placed in separate homes.

4.2.2. Ef"cacy trial designThe ef!cacy trial involves the recruitment of 170 sibling dyads and

their foster parents and random assignment of the dyads to either theSIBS-FC intervention or the as-usual foster care control group. Eacholder sibling in the dyad is between the ages of 11–15, with the younger

sibling within 4 years of age of her/his older brother or sister. All par-ticipants are under the guardianship of Oregon DHS and have accu-mulated at least 90 days in care (this latter requirement is to avoidselecting youth who may have been placed in care under short-termemergency conditions and are returned to their biological familieswithin a few days or weeks). Randomization is conducted with yokedsibling dyads living in the same home versus yoked dyads in separatehome placements, including siblings living at considerable distancefrom one another. The yoked randomization procedure allows for test-ing of whether the interventionworks equallywell for siblings in differ-ent living situations. Recruitment of siblings and their foster parentstook place in three of the most densely populated Oregon counties inor contiguous to the Portland area.

4.2.3. Data collection and measurement strategyA multiple-agent, multiple-indicator strategy is being used to mea-

sure key constructs and gather information from youth, foster parents,caseworkers, and teachers at baseline, intervention termination(6-month post-baseline) and two follow-along points (at 6-monthand 12-month post-intervention completion, respectively). Concerningyouth data, study youth complete a face-to-face interview at each of thefour major assessment points focused on the central outcome domainsof mental health, educational success, quality of life, and sibling rela-tionship quality. Included in this interview is a videotaped, 30-minuteexercise aimed at exploring the sibling dyad's activity planningand problem solving skills through dialog. Foster parents are askedto register their perspectives through written assessment forms onthe same four major outcome domains included in the youth packetas well as to provide contextual information on the foster home itself(e.g., household income; parental education level, age, race/ethnicity,other adults/children in the home). Caseworker data are gatheredvia a web-based survey at each of the four major assessment pointsconcerning youth placement and caseworker changes. Teacher dataare also gathered via web-based survey with teachers reporting on thesame four major outcome domains as the youth and foster parent in-terviews. In addition, teachers provide their perspective on howyouth interact with peers and respond to classroom instructions andschool rules.

Additionally, administrative, archival data on youth historic andcurrent foster care experiences are being gathered from OR DHS oneach study participant. Brief bi-monthly phone interviews are alsobeing conducted with foster parents to track service utilization anduse of support services, and to collect global ratings of sibling rela-tionship quality, stressful events, academic success, peer activities,and contact with supportive adults and quality of life. A possible totalof ten phone interviews are conducted over the entire 18-month assess-ment period. Fidelity of implementation is being tracked on a per-session basis by interventionists to document adherence to interventionprotocols and so as to examine intervention components actively asso-ciated withmajor outcomes, as well as possible differences in active in-tervention components for siblings living together versus those livingapart. Finally, costs accrued throughout the intervention are trackedon a per-session basis by interventionists with the Intervention CostDisbursement Form (ICDF). This form captures the cost of hourly staff,transportation, and individual activity and session costs.

4.2.4. Study hypothesesThe intervention is directed at improving sibling relationship quality

for children and youth living in the same foster home as well as thoseliving apart. Youth assigned to the SIBS-FC intervention group are ex-pected to display greater improvements than those in the controlgroup in sibling relationship quality as well as in developmental tra-jectories of adjustment across the three key outcome domains ofmental health (including internalizing and externalizing behavior),academic success, and quality of life, regardless of whether they areplaced together or apart. Consistentwith prior sibling-focused research,

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it is anticipated that enhanced sibling relationship quality will be as-sociated with signi!cant reductions in internalizing (Compton,Snyder, Schrepferman, Bank, & Shortt, 2003; Lobato, Kao, & Plante,2005) and externalizing reports (Bank et al., 1996, 2004; Dunn,2005) common among foster youth, improvements in educationaloutcomes (Burraston, McBeath, Briggs, & Bank, under review; Lewinet al., 1993), and improved quality of life (Kramer & Bank, 2005).Thus, the intervention is hypothesized to have a strong proximal effecton the quality of the sibling relationship, which is then expected tomoderate the trajectories of later adjustment outcomes during theone-year post-intervention follow-up period. These hypotheses willbe tested using hierarchical linearmodels andmultiple regression anal-yses so as to statistically control for the in"uence of the intervention onkey proximal and distal outcome measured over time versus other keycovariates, including foster care placement (siblings together or apart),race/ethnicity, stability of placement, and age and gender.

5. Discussion

In recent years, the child welfare !eld has devoted signi!cant atten-tion to siblings in foster care. Policymakers and practitioners have sup-ported efforts to connect siblings via shared foster placements andvisitation while researchers have focused on illuminating the empiricalfoundations of sibling placement and sibling intervention in child wel-fare. The current paper has sought to synthesize literature on sibling re-lationship development and sibling issues in childwelfare in the serviceof presenting a typology of sibling-focused interventions for use withfoster youth. Promoting Sibling Bonds and Supporting Siblings in FosterCare are examples of prevention research studies focused on enhancingsibling developmental processes and understanding their connection tochild welfare outcomes. This !nal section presents an emerging agendainforming policy, practice, and research for siblings in foster care.

5.1. Implications for child welfare policymakers and practitioners

Despite policy and programmatic efforts to support universal sib-ling co-placement or visitation, sibling-focused child welfare effortsare challenged by conceptual and de!nitional ambiguities, cross-jurisdictional differences in policies, and lack of administrative sup-ports for the identi!cation of and practice with siblings in fostercare. Even when agencies and caseworkers are attuned to sibling is-sues, it may be dif!cult to place large sibling groups, mixed-gendergroups, or those containing adolescents. Additionally, if siblings areplaced apart, caseworkers and foster parents may have few re-sources to support sibling visitation over time. These challenges,which highlight the often-large gap between policy goals and front-line implementation, may inhibit rather than promote sibling rela-tional continuity unless child welfare systems devote suf!cientresources to universal sibling support programming.

Emphasis should therefore be placed on the development of co-herent policy and practice frameworks governing sibling relationalefforts in child welfare systems. These frameworks will need to pro-vide clarity on the following questions: What constitutes a sibling?;What relationships with other family members can help support themaintenance of sibling ties?; and, For the purposes of out-of-homeplacement and service planning, how are sibling relationships impor-tant for child permanency and well-being? To answer these questions,policymakers and child welfare administrators will need to developclear de!nitions of siblings in foster care and promulgate the use ofrapid, valid, and reliable assessment instruments to capture sibling in-formation (e.g., Groza, Maschmeier, Jamison, & Piccola, 2003). Childwelfare managers will need to ensure that frontline workers enter thisinformation systematically into administrative databases and use thisinformation to inform their practice with children and families.

Although positive sibling relationships contribute to child andadolescent development and well-being, sibling bonds can also be

characterized by con"ict and maladaptive behavior. Child welfaresystems may need to provide programmatic resources to help fosteryouth and adults manage sibling relationships and attend to siblings'relational needs. While they are the most common sibling-focusedinterventions for foster youth, sibling co-placement and visitationstrategies may not adequately address siblings' needs for positiveand permanent relationships unless foster parents, parents, andcaseworkers are able to work with siblings directly and skillfully(Gustavsson & MacEachron, 2010; James, Monn, Palinkas, & Leslie,2008; Lundstrom & Sallnas, 2012). Skilled sibling relationship man-agement is particularly important when siblings are separated prior toor while in foster care. A more robust approach to sibling-focused pro-gramming may rest on the availability of a continuum of services rang-ing from universal to more targeted approaches as seen in Table 2.Services should be developmentally- and culturally-appropriate andshould be suitable for sibling dyads, triads, and large sibling groups.

5.2. Implications for child welfare researchers

The promise of sibling-focused intervention rests in part on itspotential impact on child permanency and well-being. Much of theliterature on siblings in foster care has examined placement changesand outcomes for siblings in care (Akin, 2011; Albert & King, 2008;Holloway, 1997; Staff & Fein, 1992; Webster et al., 2005). In the ab-sence of focused intervention, research has also pointed to the riskof sibling placement disruption when one sibling exhibits a highlevel of externalizing problems (Linares et al., 2007). Evidence sug-gests that placing siblings together is often positive with siblingshaving fewer emotional and behavioral problems over time (Hegar,2005). Particularly when there is a positive sibling relationship, sib-lings may provide the emotional support and relational stability thatare so critical when youth are removed from their biological house-hold and/or foster home (Herrick & Piccus, 2005).

Ef!cacious sibling interventions for foster youth remain rare. Whilethe RCTs of Promoting Sibling Bonds and Supporting Siblings in FosterCarewill provide robust tests of thesemodels, the broad-scale effective-ness, cost, and feasibility of these and other sibling-focusedpsychosocialinterventions remain unexamined. Additionally, the full effects ofsibling intervention approaches on child welfare outcomes are un-clear. Can sibling-focused interventions enhance foster youths' senseof permanency and well-being through sibling relationship quality?Do youth placed with siblings integrate more fully into their fosterhomes, experience fewer placement changes, and develop more sup-portive social networks with kin and non-kin caregivers than otheryouth? These questions direct attention to how researchers evaluatethe impact of sibling interventions and examine criticalmediating path-ways of change for foster youth placed with or without siblings.

Regardless of whether they are engaged in intervention research orsecondary studies, child welfare researchers may face the followingchallenges posed by sibling-focused investigation:

! Inconsistent conceptualization and operationalization of “siblings”across studies make it dif!cult to draw comparisons and establishcross-study patterns. Similarly, the lack of valid, reliable administra-tive data on sibling issues impedes the development of large-scalestudies comparing sibling indicators across different child welfaresystems/jurisdictions and over time.

! Studies of siblings in foster care are rarely anchored to relevantdevelopmental theories (e.g., social learning theory, attachmenttheory) (McCormick, 2010), making it dif!cult to propose hy-potheses involving sibling interaction and growth and challengingto understand the contexts in which sibling relationships withpeers, kin, and other adults manifest themselves (James et al.,2008; Sen & Broadhurst, 2011).

! Gathering data from individuals on a shared construct such as thesibling relationship increases the cost of data collection substantially,

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making sibling studies expensive and at risk of being statisticallyunderpowered particularly in the presence of missing data. Simi-larly, cost and other pragmatic design considerations may pre-clude the gathering of data from each individual in large siblingconstellations, thus systematically biasing studies towards a dy-adic understanding of sibling dynamics.

! Gathering data from sibling dyads or groups in foster care makesdata collection efforts and study logistics muchmore challenging.In addition to collecting assents from youth, consents are oftenrequired from DHS, the foster parents and in some states, the bi-ological parents. Additional efforts are also needed for trackingplacement changes that occur for each sibling and consentingand collecting data from the adults involved in the lives of theseyoung people.

! Data collection efforts often focusmore on nominal, static indicatorsof placement (e.g., co-placed or not) than continuous, multidimen-sional and dynamic measures pertaining to sibling processes (e.g.,frequency, quality, and consequences of sibling contact) and trajec-tories, thereby reinforcing the current policy-practice emphasis onsibling placement as opposed to sibling relational development.

! Many sibling relationship measures have been developed usingnormative samples (e.g., Furman & Buhrmester, 1985) and maynot be appropriate when applied to diverse samples of fosteryouth. Developing valid sibling measures for use with child wel-fare populations may be dif!cult due to: the wide age rangesoften present in sibling groups and the consequent challenge ofdeveloping questions that are intelligible to youth at different agesand cognitive levels; and the reliance on youth self-report despitethe poor concordance often found when multi-agent studies com-pare youth vs. adult perceptions (Bank et al., 1996, 2004).

! Statistical issues associated with the non-independent, nestednature of sibling data have been described previously (Shlonskyet al., 2005; Webster et al., 2005). While different techniques in-cludingmultilevel and structural equationmodels may be used toaccount for clustering of observations by sibling (e.g., Newsom,2002; Raudenbush, Brennen, & Barnett, 1995), examples of sibling-focused child welfare investigations using these methods remainrare (e.g., Anderson & Linares, 2012; Jenkins, Dunn, O'Connor, &Rasbash, 2005).

These conceptual, theoretical, and methodological challenges todoing high-quality sibling research in child welfare are not insur-mountable, as evidenced by the interdisciplinary sibling literatureand prevention science literature. But they highlight the general im-portance of linking theory and researchmethodology to study essentialsibling processes for foster youth. To improve understanding of the roleand impact of siblings in child welfare, researchers will have to disen-tangle the relative in"uence of sibling co-placement and sibling rela-tionship development from other covariates of foster youth outcomes.Doing so in a manner that is attentive to the complex manner inwhich sibling relationships developwill require the collection and anal-ysis of longitudinal data from youth and adults yoked to a strong theo-retical framework explicating how, when, why, and for whom siblinginterventions and sibling interactions are expected to in"uence childwelfare outcomes such as permanency and well-being.

5.3. Conclusion

The promotion of sibling co-placement and sibling relationships inchild welfare has proceeded at the federal and state levels despite thelittle that is known conclusively concerning themanner inwhich siblingrelationships evolve and are impactful for foster youth. Sibling visitationis of high interest to policymakers and child welfare practitioners yet issupported by a research literature that has emphasized placement overdevelopmental and relational processes. Moreover, therapeutic inter-ventions focusing on the sibling relationship have only begun to be

developed and investigated, leaving child welfare agencies and practi-tioners searching for evidence-based practices for use with siblings infoster care with little guidance on how to assess, support, and intervenewith diverse sibling groups. This paper highlights essential consider-ations for the development and testing of preventive interventions forfoster youth, and proposes that child welfare systems invest resourcesto support the developmental needs of siblings in foster care. Ideally,sibling-focused foster care interventions should be feasible to imple-ment and responsive to the preferences of and diversity among siblingswithin and across families. Research is needed to develop amore coher-ent understanding of siblings' experiences in foster care and to ascertainthe pathways throughwhich siblings support one another across differ-ent foster care settings.

Acknowledgments

Research support is gratefully acknowledged from the NationalInstitute of Mental Health for the project, “Evaluation of Interventionfor Siblings in Foster Care,” (R01 MH085438, Lew Bank, PI) and fromthe National Center for Injury Prevention and Control of the Centersfor Disease Control (R01 CE001378, L. Oriana Linares, PI). The infor-mation reported herein re"ects solely the positions of the authors.

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