Children in foster care develop resilience through compassion

A new study shows that a therapeutic intervention called Cognitively-Based Compassion Training (CBCT) appears to improve the mental and physical health of adolescents in foster care. CBCT is a tool that provides strategies for people to develop more compassionate attitudes toward themselves and others.

It is well documented that children in foster care have a high prevalence of trauma in their lives. For many, circumstances that bring them into the foster care system are formidable — sexual abuse, parental neglect, family violence, homelessness, and exposure to drugs. In addition, they are separated from biological family and some are regularly moved around from one place to another.

Emory researchers conducted the study in collaboration with the Georgia Department of Human Services (DHS) and the Division of Family and Child Services (DFCS). The study was recently published online in the journals Psychoneuroendocrinology and Child and Family Studies.

“Children with early life adversity tend to have elevated levels of inflammation across their lifespan,” explains Thaddeus Pace, PhD, lead author on the paper in Psychoneuroendocrinology, and assistant professor in the Department of Psychiatry and Behavioral Sciences at Emory.

“Inflammation is known to play a fundamental role in the development of a number of chronic illnesses, including cardiovascular disease, type 2 diabetes, dementia, cancer and depression.”

The study finds that adolescents who practiced CBCT showed reductions in the inflammatory marker C-reactive protein (CRP), reduced anxiety and increased feelings of hopefulness. The more the study participants practiced, the greater the improvement observed in these measures.

“The beneficial effects of CBCT on anxiety and feelings of hopelessness suggest that this intervention may provide immediate benefit to foster children,” says Charles Raison, MD, corresponding author of the study in Neuroendocrinology, now at the University of Arizona.

“We are even more encouraged by the finding that CBCT reduced levels of inflammation. Our hope is that CBCT may help contribute to the long-term health and well being of foster care children, not only during childhood, but also as they move into their adult years.”

Additionally, an article recently published in the journal Pediatrics reported that a high proportion of children in foster care programs across the United States are on psychiatric medications, perhaps inappropriately.

“In light of the increasing concern that we may be over-medicating children in state custody, our findings that CBCT can help with behavioral and physical health issues may be especially timely,” says Linda Craighead, PhD, senior author for the paper published in Child and Family Studies, and professor of psychology at Emory.

The Study

CBCT is a multi-week program developed at Emory University by Geshe Lobsang Tenzin Negi, PhD, one of the study’s co-authors. Although derived from Tibetan Buddhist teachings on compassion, the CBCT program has been designed to be completely secular in nature.

The Georgia Department of Human Services and the Division of Family and Child Services identified 71 adolescents between the ages of 13 and 19 as eligible for study participation. All of the children lived in the greater metropolitan Atlanta area, and were in state custody (i.e. foster care) at the time of the study.

The participants were randomized to six weeks of Cognitvely-Based Compassion Training, or to a wait list control group. Before and after these interventions the adolescents were assessed on various measures of anxiety and hope about the future. They also provided saliva samples for the measurement of C-reactive protein.

The researchers found that within the CBCT group, participation in practice sessions during the study correlated with reduced CRP from baseline to the six-week assessment.

The researchers are careful to emphasize that further studies will be needed to determine if there are long-term benefits with CBCT.