Decision-making in foster care: A child-centered approach to reducing toxic stress in foster children

In the complex decisions involved in foster care, the needs of adult caregivers and the needs of children may sometimes reflect competing priorities. Foster children can be negatively impacted by adult-centered decisions that cause trauma beyond that which led to their entrance into the system. Though dictated by laws and policies meant to increase a child's well-being, foster care decisions often prioritize adult-centered concerns over a child's attachment needs. Utilizing case examples, this discussion paper examines foster care decisions that disrupt important child-caregiver relationships. Considerations for child-centered decision-making may help to reduce emotional trauma in foster children. •Examines foster care decisions that influence child-caregiver relationships.•Advocates a child-centered approach to reduce toxic stress in foster children•Case studies describe differences between child- and adult-centered decisions.•Proposes considerations to mitigate the effects of toxic stress