Is It Ethical for RTC Staff to Subsequently Foster their RTC Clients?

Okay, this one I am absolutely compelled to post. This is an example of the kind of thinking that I believe too oft plagues those in management and clinical positions in residential treatment care (RTC) programs.

I recently had a conversation with someone who is a staff supervisor in an RTC program. We engaged in a minor debate about the appropriateness of direct care staff subsequently fostering any of the children they cared for while in RTC placement.

The super is against staff subsequently fostering their RTC clients because of these reasons:

• It's a conflict of interest within the agency (she did not elaborate on this point).
  
  
• It provides an unfair advantage to the staff, as foster parents, in that they can "pick and choose" who they get to foster instead of having to blindly choose an unknown child as other foster parents must do.

My argument, in stark and passionate contrast, is thus:

• If it's a conflict of interest to provide a continuum of care from RTC into a staff's home, why is it not a conflict of interest to discharge a client from an RTC program and then admit that client directly and immediately into another program (e.g., Day Treatment) run by the same agency? Isn't the "conflict of interest" argument a bit hypocritical when made by a representative of an agency that indeed does just that?
  
  
• Who cares if the staff has an unfair advantage over other foster parents in the choosing of a foster child? What is in the best interest of the child? Isn't it to be placed in a home that we know offers a significant chance for success? Or would it be better to roll the dice and place that child in an unknown commodity—and risk another Marcus Fiesel incident?
  
  
• If we truly have that child's best interest at heart, won't we choose the home we know is very safe and adequately equipped?
  
  
• Foster parents with RTC experience are undoubtedly able to provide superior care compared with foster parents that possess no to moderate fostering experience.
  
  
• Furthermore, the staff knows the child intimately and therefore knows what behaviors to expect and is prepared to address those behaviors with greater proficiency that anyone else.
  
  
• As well, children passing through the revolving door of RTC are not "typical" foster children. They usually have behaviors—often learned or exacerbated during RTC placements—that make them some of the most challenging children in the child welfare system. They usually end up in RTC because they couldn't make it in a foster home. Do we want to send them to yet another foster home very likely ill-prepared to cope with their disruptive and destructive behaviors? Or do we want to increase their chances of success by sending them to a home we know is willing and indeed able to accept, support, and love them unconditionally—flaws and all?
  
  
• Finally, one of the main reasons behind unsuccessful foster care placements is the foster child's inability to bond appropriately with his or her foster family. So, if a staff and an RTC client naturally develop a strong bond (i.e., a "kinship" bond), this should significantly increase the child's ability to adjust to and succeed in foster care if placed in that staff's home.
  
  
• Why prohibit the natural progression into that staff's home and break the bond the child has with an adult yet again, thereby fomenting more grief and loss in that child's life?
  
  
• What could be crueler than saying (even silently), "Sorry, honey, somebody safe and competent, with whom you are closely bonded, actually wants to care for you, and this person is fully capable of addressing your full range of needs and issues ... But too bad, so sad, we're not going to let it happen because that staff's deep concern for your welfare somehow falls within our ambiguous 'conflict of interest' policy" (translation: "I am disguising my own personal bias by hiding it behind a veil of disingenuous quasi-policy").
  

In summary, who gives a flip about some kind of "unfair advantage" over others to do greater good in the world? If cutting in line means no one loses yet a child wins, what's the big deal?

Don't we have a moral obligation to aspire to achieve the best interests of the children we serve? It's inconceivable to me to believe that an "unfair advantage" trumps the best interests of a child in need. What a tragedy it is that this kind of thinking plagues the RTC system and prevents RTC staff from doing further good work in the world.

Anyway ... What are YOUR thoughts on this debate? I welcome any comments.

Thank you.

- David Lee Cummings

© 2008 David Lee Cummings / Healing Embrace