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Why is Therapy Often Helpful for Children in Foster Care?

By Fraser Clinical Program Manager Melissa Macklin and Pam Dewey • foster care, children in foster care, kids in foster care, foster family, foster families, biological parents, birth parents, foster care and therapy, trauma, therapy for trauma, kids and trauma, therapy for children in foster care, trauma and foster care • January 05, 2023

Foster care provides an important service for children and families in Minnesota. It offers a temporary safe haven for children with families who are dealing with illness, substance abuse, housing insecurity and other issues.

According to the Minnesota Department of Human Services, “On any given day in Minnesota, approximately 7,700 children and youth are in foster care While Minnesota families adopted 991 children from foster care [in 2021], 569 are still waiting for permanent families.”

Many children and young people in foster care often deal with mental health and behavior issues.  

The Fraser Adoption Permanency Team counsels children and foster parents referred to Fraser. All team members have completed the Permanency and Adoption Competency Certificate at the University of Minnesota. The program aims to “increase the number of qualified permanency and adoption mental health and child welfare professionals in Minnesota who are able to work in collaborative, cross-disciplinary and multicultural contexts.”

Fraser Clinical Program Manager Melissa Macklin is on the Fraser Adoption Permanency Team. Some common issues for children in foster care, says Macklin, are acting out with different behaviors, questions about identity, navigating visits with their biological family, processing the loss of a sibling or family member and trauma.

Trauma can change a child’s brain and delay development

Research shows that when a child experiences trauma during key developmental years, from ages 0-5, it changes the way their brain works. Children may start to perceive things as scary and threatening that aren’t. Macklin also says a child’s attachment pattern may become disrupted, or kids as young as 4 may think they need to start taking care of themselves. It can also cause kids to lose skills or slow their development.

“When trauma happens pre-verbal, it often comes out sideways. So a child may manifest their trauma as anger or a physical behavior,” says Macklin. “We try to help them understand why anger is their go-to reaction. We explore the root cause and the feelings that lie underneath and then work off of that.”

Play can help children work through trauma and feelings

Therapy often involves a lot of play, says Macklin. It can help young children, and even some older children, work through traumatic events. Because trauma can cause delayed development, play can be beneficial for some older kids.

“We explore feelings and play through these. A child might play that people are fighting, people are getting hurt or police are showing up,” says Macklin. “We take the child’s lead and look at it through a trauma lens. Therapists will think about what questions are coming up for us, and then we can explore with the social worker, foster parent and the child.”

Therapists might also do yoga with kids, focusing on breathing and stretching. Breathing exercises and stretching help kids relax and regulate. They also might do meditation with older kids, which involves scanning their bodies, so when they experience emotions, they learn to recognize how it feels in their bodies. That way, they can better understand those feelings and respond appropriately.

Foster families also benefit from therapy

Macklin says they also encourage foster families to be involved in therapy, so families learn how to respond and better support their foster kids.

“We help them understand where a child is coming from, why their foster child is having certain feelings and also why they might be dealing with increased behaviors after visits with the child’s birth family,” says Macklin. “We let them know how the child is acting isn’t about them and reassure them that they’re doing all the right things. We also educate families about trauma and mental health issues.”

Many groups of people can be involved with foster children, including social workers, Child Protective Services and, of course, the birth family. That means there are a lot of layers and people to consider when discussing what has been uncovered in therapy and how a child needs support going forward. Therapists try to include everyone in the process, as needed.

Therapy provides a safe, judgment-free zone

Macklin says it’s most important for a therapist to form a relationship with the child, and be that consistent, safe person in their life. Therapists try to give kids some control back, and let them say and feel however they want.

“It’s helpful for kids to have an outsider know their story and know their ‘yuck,’” says Macklin. “We sit down and play together, and we don’t make a big deal out of the scary thing that happened to them. We tell them no kid should go through what they went through, and that all of the people around them now are there to keep them safe.”

You can email the Fraser Adoption Permanency Team at