Separation anxiety in foster care: Etiology, assessment, and intervention

Youth in foster care have high rates of abuse and neglect and are significantly more likely to be diagnosed with a mental health concern. Additionally, children in foster care often have experienced sudden and traumatic losses and have complex social situations. The development of separation anxiety disorder (SAD) in children in foster care is likely due to a complex interaction between disrupted attachment relationships, placement instability, and traumatic experiences. This chapter will provide an overview of the importance of comprehensive assessment and diagnosis, considering differential diagnoses to distinguish between SAD, normative anxiety, and trauma-related symptoms. Furthermore, the chapter discusses evidence-based treatments like Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) and Parent-Child Interaction Therapy (PCIT), highlighting modifications for the foster care context. Legal, ethical, and cultural considerations are also addressed, underscoring the need for trauma-informed care and the involvement of child welfare systems in the therapeutic process.