Colleges and universities are grappling to determine how best to address the increased mental health needs presented by students as they pursue their undergraduate or graduate degrees (Brown, 2020). Emotional and behavioral symptoms associated with anxiety and depression have only increased since the introduction of the COVID-19 pandemic in 2020 (Hoyt et al., 2021; Santomauro et al., 2021; Seitz et al., 2021). Based on our own observations, this is particularly true for students who enter post-secondary education with a history of trauma. There are aspects of college that can mirror and trigger post-traumatic stress symptoms, an experience that is even more common for students who come to college with a background in foster care. White et al. (2005) found that one of the most common explanations given by students who have experienced foster care for leaving university was emotional and behavioral challenges. Meeting the mental health needs of students who have foster care experience, which includes both those young people who age-out of foster care and those who have a prior history of foster care but may have achieved permanency before turning 18, offers a unique opportunity to address trauma and activate the process of resilience.

Over the past decade, the number of campus-based support programs that seek to increase the recruitment and retention of young people with a background in foster care in post-secondary education has substantially increased (Fostering Success Michigan, 2022; Geiger et al., 2018). A recent review of college websites suggests there are now over 100 programs that were designed to improve the educational outcomes for this population. Similar to other institutions, in response to state legislation that was passed offering a tuition waiver or scholarships to young people who experienced the foster care system after age 14 in this state, a group of faculty and staff created Bridging Success, Arizona State University’s campus-based support program for students who have foster care experience (Arizona State University Bridging Success, 2022; Lietz, 2021). The Bridging Success program offers services to support the transition of young people to Arizona State University while also providing coaching throughout a student’s academic journey to degree completion. Although this program has been an important part of the strategy for increasing the recruitment, retention, and persistence of these undergraduate students, it became clear that more was needed to meet the mental health needs of this population. As a result, ASuPIRE, a strengths-based, trauma-informed counseling program was created and implemented in 2020. This article will provide a brief overview of student support programs and research recognizing the need for more campus-based mental health interventions. It will further summarize ASuPIRE program elements allowing other colleges and universities to consider adopting this model to supplement campus-based support programs for students who have foster care experience that are being created or are already in existence. Initial feedback from students regarding this program is promising, however, more research is needed to evaluate the effectiveness of this program overtime and across multiple universities.

The latter half of this article will use a case study example to better illustrate how a program like ASuPIRE can support students who have foster care experience as they pursue their undergraduate degree. Case studies are often used in social work to encourage critical thinking and the application of intervention tools in a practice setting. The case study provided draws upon observations and interactions of both the ASuPIRE clinician and Bridging Success staff working with students who have foster care experience, integrating common scenarios involving the social-emotional challenges they may face, as well as ways a practitioner can activate and/or cultivate the protective factors of resiliency.

Educational Outcomes for Students with Foster Care Experience

When a young person reaches the age of majority while remaining in foster care, they “age-out” of the system. Research suggests the outcomes for young people who age-out of foster care are concerning, citing higher levels of emotional and behavioral symptomatology such as anxiety, depression, PTSD, and suicidality (Courtney et al., 2005; Landsverk et al., 2006; McMillen et al., 2005; Okpych & Courtney, 2018). Students who have foster care experience are more likely than their peers to end up homeless, incarcerated, or to become involved in the child welfare system as a parent (Courtney & Heuring, 2005; Courtney et al., 2011, 2012; Hernandez & Lee, 2020). Although there are a variety of explanations that range from systemic discrimination to micro-level experiences, what is clear is that young people with a background in foster care, whether they aged-out of care or achieved permanency prior to turning 18, have experienced trauma (Engler et al., 2022; Hallett et al., 2018; Hambrick et al., 2016; Morton, 2018; Okpych & Courtney, 2018).

A recent systematic review by Engler et al. (2022) stated that trauma associated with events that led to placement in foster care and the foster care experience itself can contribute to poor mental health outcomes, with children who experience foster care having a 3–4 times higher likelihood of a mental health diagnosis than their non-foster counterparts (Engler et al., 2022). Copeland et al., (2018) demonstrated that, in general, higher rates of traumatic events prior to age 16 were associated with statistically significant higher rates of adult mental health diagnosis and poor functioning such as holding a job or building a social support network. An additional systematic review concluded that early life stress, such as physical abuse, sexual abuse, or emotional abuse and/or neglect are predictors of mental health diagnosis in adulthood (Carr et al., 2013). Considering the occurrence of traumatic events among children and youth in foster care, it is understandable that this population would have poorer, mental health outcomes than the general population.

Maltreatment by the hands of a caregiver is one of the most devasting examples of trauma a human being can experience. Children and youth in foster care also experience removal from their family of origin, the potential of leaving not just family, but also friends and a sense of belonging to a community. They may also face multiple placements, and a series of emotional ups and downs and losses that are associated with every transition. This level of trauma can impact a young person’s emotional wellbeing, and it can also affect academic achievement. According to a study by Okpych and Courtney (2018), these factors can negatively impact a child or youth’s ability to experience positive attachment with others, which in turn may limit their help seeking behaviors while attending school and adversely impact their educational progress.

The educational outcomes for children and youth in K-12 education are concerning, as are the outcomes for students who have foster care experience in post-secondary education. Children and youth in foster care face more school changes than their peers and are more likely to repeat classes and/or grades (Allen & Vacca, 2010; Clemens et al., 2018; O’Higgins et al., 2017; Okpych & Courtney, 2017; Pears et al., 2015; Ryan et al., 2018), and their education can be impacted by trauma as it is more difficult to pay attention and retain concepts when facing loss and fear about one’s future (Daly et al., 2017; Mothes et al., 2015; Shonkoff & Garner, 2012). Many young people in care may continue to experience abuse while in foster care which can further impair academic success (Morton, 2015a).

These concerns are of particular significance in racial/ethnic or sexual minority communities. Racial/ethnic minorities are disproportionately represented in the foster care system and are more likely to be placed in foster care than their white peers (Children’s Bureau, 2016; O’Higgins et al., 2017; Puzzanchera & Taylor, 2020; Watt & Kim, 2019). This disproportionality can be attributed to several factors, with low socioeconomic status, lack of social supports, and racial bias of child welfare workers often cited (Dettlaff et al., 2011; Ward & Booth, 2021). Black children and youth are more likely to attend low performing schools that lack needed resources and are more likely to face disciplinary action (United States Government Accountability Office, 2018; Ward & Booth, 2021). LGBTQ youth in foster care face additional challenges as they are three to five times more likely to experience depression, twice as likely to have significant behavioral problems, three times more likely to have a substance use disorder, and six times more likely to have experienced clinically significant trauma than their non-sexual minority peers (Dettlaff & Washburn., 2021; Grooms, 2020; Ward & Booth, 2021).

When this constellation of factors is considered, achievement in K-12 for students with foster care experience is hindered and far fewer of these young people are prepared for or consider college than their non-foster care peers (Day et al., 2011; Kirk et al., 2011; Morton, 2015b; Okpych & Courtney, 2017; Rios & Rocco, 2014). For those who do consider college, their outcomes remain a concern (Day et al., 2011). Current research suggests that roughly 3–11% of students who have foster care experience will earn an undergraduate degree (Courtney et al., 2011; Davis, 2006; Pecora, 2012; Wolanin, 2005). Attainment of a college degree is correlated with several outcomes including initial and lifelong earning potential, level of civic engagement as it relates to voting and volunteerism, and availability to support children should they chose to become parents (Ma et al., 2020). Improving the educational outcomes of students who have foster care experience offers real potential to change not just the life of a student, but also the trajectory of their future and that of their future family.

When young people age-out of foster care in the U.S., that means the state is no longer their legal guardian upon turning 18. We see the ability to influence educational outcomes as not just practical but also ethical, in that taking responsibility for the development of a young person should not cease at 18, instead, ongoing support is needed for this population similar to what is typically available to their peers. This argument has supported the passing of federal and state legislation extending the period of time young people can remain in care (The Fostering Connections to Success & Increasing Adoptions Act, 2008; The Annie E. Casey Foundation, 2021) providing ongoing access to services, and local legislation now available in 35 states offering a tuition waiver or other type of scholarship program (University of Washington, 2022). We also agree with the idea that all college students with a background in foster care should be supported throughout their post-secondary experience. Supporting both those who aged-out and those who were in care but may have achieved permanency is important.

As mentioned earlier, a number of programs have been created to increase access to and persistence at institutions of higher education. However, researchers and practitioners are still identifying best practices to understand which aspects of a program impact student success and increase graduation rates. Geiger et al. (2018) identified key services offered by a variety of 2-year and 4-year institutions, but these authors acknowledge that each campus-based support program for students who have foster care experience is different. A consistent theme in the literature points to the need for programing beyond academics that includes a strong element of mental health support (Geenen et al., 2018; Geiger et al., 2018; Hallett et al., 2018; Miller et al., 2020; Morton, 2018; Okpych & Courtney, 2018; Salazar, 2012).

Although efforts associated with implementing campus-based, support programs are leading to improved educational outcomes for some, it is our contention that they remain insufficient as many of these programs are not meeting the mental health needs of this population overall. Without appropriate access to trauma-informed counseling, some students with a background in foster care will not be able to persist in college despite the presence of important services provided by campus-based support programs.

Mental Health Needs of Students with Foster Care Experience

Young people with a background in foster care are more likely to experience mental health symptoms (Barnett et al., 2016; Courtney & Dworsky, 2006; Garcia et al., 2015; Zlotnick et al., 2012). A study of recently emancipated ethnic-racial minority foster youth by Tyrell et al. (2019) showed strong associations between trauma, placement disruption, and ethic-racial identity (ERI) and mental health outcomes such as depression, anxiety, and low self-esteem. Trauma theory suggests emotional and behavioral challenges are a direct result of one incident or ongoing experience with disturbing events in which one’s safety and wellbeing is threatened (Alisic et al., 2011; Substance Abuse & Mental Health Services Administration, 2014). The Adverse Childhood Experiences (ACEs) research offers an assessment regarding the type and severity of traumatic events, and how these experiences are related to long-term negative impacts on one’s health (Centers for Disease Control and Prevention [CDC], 2021). Considering children and youth in foster care often experience ongoing trauma during their development, research suggests their physical and mental health are impacted (Leslie et al., 2005; Morton, 2018; Okpych & Courtney, 2018; Rebbe et al., 2017).

Coming to college creates an opportunity for students who have foster care experience to achieve an undergraduate degree prompting the potential for positive life outcomes. Salazar (2013) found that students with foster care experience who have graduated, when compared to general population graduates, had similar individual income and employment rates. These findings were supported by additional research conducted by Okpych and Courtney (2014) which found that as higher levels of education were achieved, students who have foster care experience and the young adult general population employment and earnings were comparable. Salazar and Schelbe (2021) demonstrated that campus-based support programs that used the It’s My Life (Casey Family Programs, 2001) framework could have a positive impact on post-graduation success. The most significantly impactful domains were supportive relationships and community connections, life skills, and physical and mental health were strong predictors of post-graduation life outcomes.

However, after many years of supporting students who have a foster care history at our institution, we noticed that several aspects of college can indeed trigger traumatic events experienced as a child or youth when they were in foster care. For example, while moving into residential halls is a highlight for many college students, for a young person who grew up in foster care, it may remind them of moving into a group home if congregate care was a part of their foster care journey. The misuse of alcohol and other substances is more common on college campuses as some students experiment with risky behaviors. For these students, seeing other students return to their resident halls intoxicated can bring back memories of observing addiction of a parent. As other students return home for holiday breaks, some students who have foster care experience find themselves left behind, igniting feelings of loss and loneliness experienced as a child. Finally, having to navigate a college or university system can be overwhelming considering children and youth in foster care are, at times, not empowered to make decisions on their own behalf or develop skills to do so, leaving many to feel unprepared to navigate the child welfare and juvenile justice systems effectively. Being in college is an exciting time, but it is also stressful even for students without a trauma history. For college students with a background in foster care, the experiences can trigger thoughts and behaviors associated with their trauma. These direct experiences with students who have a history of foster care, coupled with prior research of these students in higher education, motived us to prioritize the development of a mental health intervention model that can better meet the mental health needs of this student population.

Developing a Strengths-Based, Trauma-Informed Counseling Program for Students with Foster Care Experience

ASuPIRE is a mental health counseling program that was created at Arizona State University specifically for college students with a background in foster care (Lietz, 2021). Pronounced aspire, the acronym comes from its four primary objectives. First, to prepare (P) for the expectations associated with attaining an undergraduate degree. Second, to imagine (I) one’s potential and combat negative internalized beliefs that can hinder academic success. Recognizing the difficult history that young people experienced while in foster care, the third objective is to help students recover (R) from the trauma they experienced that may be retriggered by the college experience. Finally, the program seeks to help students excel (E) in their academic program by activating the process of resilience. The program consists of three components: (a) time-limited individual counseling that is embedded within the university’s counseling services program, (b) a set of four one-credit student success courses, and (c) an 11-week text-based intervention.

The program is grounded in five theories that are integrated to meet the program objectives. Having a theoretical basis to this work is important, because theories offer an explanation to the causes of problems in human behavior while describing a potential mechanism for change. As a result, theories can be used to inform both the assessment and intervention that is provided in the counseling, student success courses, and text-based intervention. In ASuPIRE, underpinnings from attachment theory, cognitive theory, trans-theoretical stages of change theory, self-authorship, and trauma theory provide the foundation for everything included in the model. In addition to these theories, ASuPIRE is strengths-based and framed in resilience research that describes a process of coping and adaptation that can be activated and cultivated through the presence of ten protective factors that are provided (Cheung et al., 2019; Lietz et al., 2016; Lietz et al., 2011).

Resilience is a process of coping and adaptation. This construct builds upon a risk perspective that indicates the presence of a high-level of risk factors increases one’s likelihood of negative outcomes, often related to one’s physical, emotional, and behavioral wellbeing (Luthar et al., 2000). Understanding the factors that predict negative outcomes is important, because this risk-focused research provides important opportunities for prevention (Werner & Smith, 2001). If social services can prevent loss, trauma, and adversity, these programs can positively impact social-emotional wellbeing. However, many people experience high levels of loss, trauma, or other adversity that has already occurred or remains unpreventable such as the sudden and unexpected death of a parent. Only focusing on risk factors fails to provide intervention options for the situations that are not preventable.

The construct of resilience is important, because it involves examining the times at which people were at-risk for negative outcomes, and maintained healthy functioning anyway (Luthar et al., 2000; Nunez et al., 2022; Werner & Smith, 2001). By uncovering these examples of resilience, a set of protective factors has been identified that can help to activate the process of coping and adaptation when risk is present (Lietz, ). Resilience research helps to uncover the ways protective factors or strengths can moderate the negative outcomes associated with risk which is particularly important for people who have already experienced a high level of adversity. Building up the protective factors can help to hinder the potential negative effects of risk, something that is particularly relevant for young people in foster care (Cheung et al., 2019 ; Hass et al., 2014; Hines et al., 2005; Neal, 2017).

The combination of being self-reliant, needing to find support/seek help, addressing mental and social-emotional needs, and balancing the demands of transitioning to adulthood and college can prove overwhelming and negatively impact a young person with a foster care background’s ability to successfully complete their post-secondary education (Dumais & Spence, 2020; Jones & Dean, 2020; Miller et al., 2020; Morton, 2017; Samuels & Pryce, 2008). A recent qualitative study by Jones and Dean (2020) explored the experiences of students who have a history of foster care as they transitioned to college. Findings indicate that students who had experienced foster care believed their trauma and foster care background both helped and hindered their transition to college. Although participants felt more prepared for higher education, citing their higher level of maturity, self-awareness, and ability to address challenges independent of others, they also described feeling disconnected and different from their non-foster peers. Similar findings were reported by Hines et al. (2005), with participants describing their sense of being different because of their family dynamic, history of abuse and neglect, and involvement in foster care. The participants further acknowledged difficulty with their mental and emotional health, impacting their ability to form relationships, cope with the pressures of attending college, and manage life as an adult. However, they also stated that their background required that they adapt and build personal resilience (Hines et al., 2005). These findings acknowledge both the resiliency of these young people who have faced adversity but found coping skills to help them overcome challenges, but also reinforces the need of programs that support mental and emotional wellbeing through cultivating and activating additional resiliency protective factors.

Activating protective factors involves labeling and drawing out current strengths a student presents with at the onset of counseling. Cultivating resilience involves building up new protective factors, to increase the strengths students can draw from as they face challenges during their academic programs. The ten specific protective factors ASuPIRE is seeking to activate or cultivate are provided in Table 1. In summary, ASuPIRE is a strengths-based, trauma-informed counseling program created to address the mental health needs of students with a background in foster care as they pursue post-secondary education.

Table 1 Strengths/protective factors
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ASuPIRE’s Theoretical Framework

As seen in Fig. 1, ASuPIRE integrates fives theories and ten protective factors to accomplish its four primary objectives. These theories were chosen, because they are particularly relevant for students with a background in foster care and for use in a postsecondary education setting. The resilience framework is important, because it helps to describe the change process, meaning, the theoretically-informed and/or evidence-based interventions are intentionally designed to activate and cultivate the process of resilience.

Fig. 1
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ASuPIRE theoretical framework

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Attachment Theory was created by John Bowlby (1977) and contends an infant’s strong attachment to a primary caregiver as a fundamental human need. The theory explains that a lack of safety and security in infancy and early childhood caused by a poor attachment can lead to psychological and relationship problems that extend into adulthood. The ideas were further developed by Ainsworth (1985) who categorized attachments as: secure, ambivalent, avoidant, or disorganized. For some young people who grew up in foster care, their capacity for a secure attachment was hindered as a result of neglect and/or physical, emotional, or sexual abuse. Social skill training is a key component of the program in recognition that attachment concerns can lead to problems in one’s professional and personal relationships potentially undermining their success in college. Content regarding healthy relationships and concepts such as hierarchy, equality, boundaries, connection, and communication are integrated throughout the counseling services and included in one of the four student success courses. Attachment theory serves as a foundation to ASuPIRE leading to interventions that are designed specifically to enhance relationship skills for students with a background in foster care.

Research in the field of students who have foster care experience in higher education supports the use of attachment theory in the development of ASuPIRE. A recent study by Okpych and Courtney (2018) found that for 17/18-year old foster youth, there was a strong association between maltreatment and relational instability with avoidant attachment (an adaptive self-protective response to previous maltreatment and abuse), which in turn decreased the likelihood of these students to persist and complete their postsecondary education. Bederian-Gardner et al. (2018) further found that residential and school instability contributed significantly to a young person’s ability to form attachments.

Cognitive Theory suggests that negative and unrealistic interpretations can drive emotions and behavior. First developed by Albert Ellis (1962), the ABC triangle demonstrated how an initial event would be interpreted based on one’s beliefs or thoughts about the event, then leading to a person’s emotional and behavioral response. This theory created the foundation for cognitive restructuring, an evidence-based intervention that changes emotions and behavior by recognizing automatic thoughts and then uncovering and reframing deeply held schemas (Beck, 1976). Overtime, behavioral theory was integrated with cognitive theory leading to the development of Cognitive and Behavioral Therapy (CBT) which offers evidence-based treatments that have been found to effectively reduce symptoms associated with depression, anxiety and other mental health symptoms (Beck, 2021). CBT is an important component of ASuPIRE, because it introduces important interventions such as thought records, cognitive restructuring, emotional regulation, activity scheduling, and imagery based-exposure into the treatment program. CBT can be effective in short-term, time-limited counseling making it another important fit for this program (Beck, 2021).

Motivational Interviewing (MI) is a client-centered, evidence-based intervention developed by Miller and Rollnick (2013). The process involves assessing a student’s level of motivation based on the Transtheoretical Stages of Change Theory (Prochasca & DiClimente, 1983). This model suggests the change process involves the following five phases: pre-contemplation; contemplation; preparation; action; and maintenance. Assessing one’s placement on this continuum of motivation according to this theory allows an ASuPIRE counselor to tailor interventions to meet students where they are as they begin the counseling program. Once their level of motivation is assessed, ASuPIRE counselors can use the intervention of MI to: identify students’ goals, recognize any inherent resistance to the change process, and then help to overcome ambivalence so that students are empowered to meet their own self-determined objective. Integrating MI into ASuPIRE offers another evidence-based intervention and seems particularly relevant regarding this setting considering motivation is so important to academic achievement.

Another important theory integrated into the ASuPIRE program model is self-authorship, a student development theory that is centered on the early works of Robert Kegan and self- evolution (Kegan, 1982). Baxter Magolda elaborated on Kegan’s work and developed the theory of self-authorship, a seminal theory in higher education (Baxter Magolda, 2001). It was important to include a student development theory such as this one considering higher education is the context for this counseling program. Self-authorship is focused on recognizing how young people develop their individual identity during and after post-secondary education. It defines a set of developmental tasks which include: determining what knowledge, relationships, and identity they want to create for themselves (Baxter Magolda, 2001, 2009). This theory sets up the use of narrative interventions that help students think about what it means to be the author of their own stories by valuing exploration, making sense of the world, determining one’s personal path or goals, and taking steps to move that path forward. Narrative interventions, grounded in social construction, also acknowledge how macro influences can lead to internalized negative self-image and beliefs (White & Epston, 1992), something particularly relevant for young people with a background in foster care. Creating space for students to tell their own stories, externalize negative influences, and be empowered to appraise and attach meaning to their experiences is an important contribution stemming from self-authorship theory.

Finally, as mentioned earlier, trauma theory suggests that exposure to ongoing trauma increases the likelihood of experiencing anxiety, depression and other emotional or behavioral disturbances (Barnett et al., 2016; Courtney & Dworsky, 2006; Garcia et al., 2015; Zlotnik et al., 2012). Ongoing exposure to events that threaten one’s safety, security, or wellbeing can lead to long-term negative implications for health and mental health functioning (CDC, 2021; Rebbe et al., 2017; Leslie et al., 2005). Taking a trauma-informed approach means that ASuPIRE counselors recognize that presenting symptoms are often a result of past trauma. As a result, trauma is validated and a safe space is created for students to share their experiences without judgement. Special attention is also given to self-determination ensuring students are the drivers of their own treatment. To address the trauma, mindfulness interventions are incorporated into ASuPIRE to help students recognize their emotional, physical and behavioral reactions to the past and current events. This increased awareness and capacity for emotion regulation can help students to cope with the implications of their past trauma. It is our contention that integrating a trauma-informed approach with a strengths-based, resiliency approach is essential. Focusing only on trauma, while validating, can give students the message that growth is not possible. We find this a short-sighted view of what is possible and potentially dangerous for young people who are emerging adults in the process of developing their identity. Validating past trauma and its consequences while concurrently presenting the process of resilience is fundamental to ASuPIRE.

Case Study

The following is a hypothetical case study of what engagement with ASuPIRE might look like for students who have foster care experience. It is meant to provide an example of how various campus-based supports for students who have foster care experience work together to address mental health needs. It also helps practitioners, evaluators, and policy decision makers explore a complex idea in the real-life setting of a student with a foster care history engaged in higher education.

Jesse Valenzuela is a 20-year-old undergraduate student studying business who transferred from community college after earning his associate’s degree. Jesse is a bright young man who demonstrated a high level of success in community college. Prior to community college, Jesse attended five different high schools as he was moved from a relative foster care placement at his grandfather’s home to four different group homes during his adolescence after the unexpected death of his “papa”. He underperformed in high school, and his academic achievement in community college surprised not only his high school counselors, but even himself. Jesse came to a large university hopeful about his ability to continue this positive trajectory. However, within the first semester, he was placed on academic probation, because Jesse failed four of his five courses. Jesse informed his Bridging Success coach, Teresa, about his academic standing. He expressed his desire to leave college but said that he did not have any place to live if he were to move out of the residence hall.

Teresa talked to Jesse about how his choices were impacting his academic standing, but he said he was too overwhelmed and depressed to focus on his studies at this time. Teresa worked with Jesse to address some of his immediate financial needs, and she made connections with the tutoring center. Recognizing that meeting his immediate needs was insufficient considering his presentation of mental health symptoms, she also referred Jesse to ASuPIRE.

Jesse told Teresa that he would follow-up, but he missed the first two appointments that were scheduled over winter break. When classes resumed in the spring semester, Jesse again continued a pattern of not attending his classes. This prompted a referral to the Dean of Student’s Office who connected with the Office of Student Housing to see if Jesse had vacated his room. His lack of attendance caused university officials to believe he had left college. When the resident assistant knocked on his door, Jesse reluctantly opened it. He was informed that he needed to attend class and participate in university activities if he was to maintain his residence on campus.

Jesse called his Bridging Success coach in a panic, and she again encouraged him to follow-through on the referral to ASuPIRE. This time, he did. During the first session, Jesse completed the intake documentation and assessment process. During the assessment, Jesse explained that he was not “cut-out” for college, but that he needed to stay in college to maintain his housing. His ASuPIRE counselor, Jake, asked Jesse about his goals. Jesse said he wanted to work in accounting, because he felt that would provide him a good income and stability, but he felt this was unlikely because he “was incapable of being successful at a university.” Very quickly, the ambivalence regarding his goals became clear when considering the stages of change theory. Jesse wanted to remain in housing. Yet, his housing was dependent on his status as a student.

The counselor asked about his past academic experience and while he acknowledged his challenges in high school, Jesse spoke with great pride about his success in community college. The counselor was curious to know what was different now, and Jesse explained that he knew he “wasn’t college material,” a direct contradiction to his recent achievements, potentially illustrating a cognitive distortion. Digging deeper, Jesse talked about being a first-generation student and not having any family members who attended college. This provided further evidence to him that he did not belong in a college environment. He also talked about messages he received from a high school advisor and one particular group home staff member who reinforced the idea that he “should get a job,” because he likely “would not be successful in college.”

Jake decided to continue to explore this thought process with Jesse. After further exploration, it became clear that Jesse’s academic status was not a result of his performance on assignments and tests, but instead, a result of him not turning in assignments and skipping exams. His counselor assessed that the comments were internalized and created automatic negative beliefs stemming from a deeply held schema that caused Jesse to feel insecure about his academic potential, thereby leading to avoidance. His insecurity was driving his behavior, which resulted in poor academic performance. This assessment suggested CBT might be helpful to restructure the negative cognitions. Some narrative interventions might also be helpful in externalizing negative experiences and empowering Jesse to author a new story.

Taking a trauma-informed approach, Jake also recognized the importance of respecting Jesse’s agency regarding goal-setting. It was clear that initially, his goal was housing, not academic achievement. At the same time, Jesse presented as an insightful, intelligent young person. He understood that the two things were inextricably linked. Focusing on Jesse’s goals, Jake asked, “Would you be willing to commit to attending classes over the next few weeks while we start your counseling program to ensure there is no disruption to your housing? This is the best way to ensure you have housing as you make decisions about your next steps.” Jesse agreed.

As counseling continued, the counselor was able to learn more about Jesse. He was working two jobs and visited his younger brother who was placed at a group home over an hour from campus. Not having other transportation, Jesse had to transfer three times on public transportation to visit his brother each week, a commitment he was not willing to miss, illustrating an important protective factor. Although Jesse aged-out of child welfare, he maintained relationships with his mother, uncle, and three cousins. His mother would ask Jesse for financial help from time to time, and Jesse, at one point, gave a large portion of his student loan to his mother as she was facing eviction. What became clear is that Jesse is a caring, committed person who has taken on a great deal of responsibility. He demonstrates the protective factors of commitment and initiative but may need increased capacity in the protective factor, boundary setting.

As time went on, Jesse described the domestic violence that occurred between his parents and at times, involved other family members, that was serious enough to lead to his father’s long-term incarceration. His mother struggled with drug addiction and came in and out of Jesse’s life. Although Jesse was committed to supporting his brother and would at times financially support his mother, his social support was not reciprocal. He was giving far more support than he was receiving, an important thing for Jake to address in counseling considering social support is such an important protective factor. At one point, Jesse was quite tearful when talking about the incident that involved witnessing his father shoot and injure a family member leading to his incarceration. Taking a trauma-informed approach, Jake created a safe space for Jesse to recall details of this very difficult event. Later, Jesse said that he had never recounted this experienced to anyone since after the trial. Jake closed this session by teaching Jesse how to engage in mindful breathing, and they discussed ways to settle his thoughts as the retelling of this experience brought a flood of emotions. To ensure safety, Jake asked Jesse to call the counseling center anytime between sessions if he noticed emotions he could not contain through these exercises. Jesse thanked him and acknowledged a sense of relief at the end of this session.

When Jesse returned the next week, Jake talked to him about enrolling in one of the student success courses that was starting in March. At this point, Jesse had consistently been attending classes for five weeks and only missed turning in one assignment. Jake integrated open questioning, affirmations, reflective listening and summary reflections (OARS) from motivational interviewing as he revisited Jesse’s goals regarding his academic program. His mid-term reports were positive, but Jesse still questioned whether he “was college material.” Jesse started attending the student success course that was focused on healthy relationships. This ended up being another important turning point in his counseling, because Jesse was able to bring content about boundaries, connection, and power into his counseling sessions with Jake. He also connected with one of the other students in the course. Their shared experience not only created a friendship, it helped both young men to find another person with a similar background. Jesse said it was the first time he felt that “he belonged.” Jake asked, “The first time you feel that you belong in college?” Jesse said, “No, the first time I feel I belong anywhere.”

By the end of the semester, Jesse’s 15 sessions for this academic year were completed. He also completed one student success course, and the text-based intervention that focused on the protective factors. Jake reminded him that the weekly tips are still available and that he can enroll in any of the three additional courses. He is also eligible to sign-up for counseling again in a new academic year. Jesse agreed and thanked him. It was a hard good-bye. Termination of services and letting go of professional relationships like the one developed between Jake and Jesse is not easy, particularly for young people with a background in foster care for whom previous endings felt more like a rejection, than a planned ending.

Over the next three years, Jesse engaged in services intermittently. Like many students who have foster care experience, he continued to experience challenges both in his personal life and in college. At one point, Jesse’s mother was arrested for drug possession, and he found himself spiraling back into a depression. He missed a week of class, but this time, demonstrating insight developed through ASuPIRE, he quickly re-engaged with counseling services to get back on track. He also reached out to his friend who provided a listening ear, illustrating not just the giving, but also the receiving of social support. It took him a bit longer to graduate considering the challenges of his first semester, but he did complete his undergraduate degree in business, although he ended up changing his major from accounting to human resources, as he had become very interested in human behavior as a result of all he had faced. When asked about his greatest accomplishment, surprisingly, it was not his own graduation that he cited. Instead, he noted the fact that his younger brother was starting college next fall as the thing that brought him the most pride.

Jesse experienced lots of ups and downs throughout his time in college. College is not easy nor is emerging as an adult when someone carries the level of responsibility Jesse did along with the pain and loss he experienced during his adolescence. With that said, Jesse did not just graduate from college. He gained new life skills. He developed stronger interpersonal skills. He learned to look to his strengths when facing a problem. He worked through negative thought patterns, even though these cognitions would come up again time and again. And, most importantly, he set bigger goals for himself. His initial goal of maintaining housing changed to a goal of graduating and finding employment that would provide him security and choice for his future that he felt he lacked as a child. By creating a safe space to reframe negative cognitions, work through resistance by focusing on change talk, acknowledge trauma and build new coping skills, enhance social skills, and help Jesse author a new story, these interventions provided the support needed so that Jesse could accomplish his goals.

Implications and Conclusions

Creating campus-based programs that support young people with a background in foster care as they transition to and persist in college remains an important opportunity to impact their long-term academic success. With that said, these goals may be undermined without specific attention to meeting the mental health needs of students who have foster care experience. As universities consider this, designing evidence-based, theoretically-informed interventions remains essential. Additionally, universities/colleges, counseling services, and campus-based programs for students who have foster care experience may also need to consider the creation or adaptation of policies that impact the delivery of mental health services.

Implementing a program such as ASuPIRE may be challenging given that many campus-based support programs for students who have foster care experience have limited resources such as personnel, funding, and capacity to provide expanded services. Considering the ASuPIRE intervention model is made up of three components: (a) time-limited individual counseling that is embedded within the university’s counseling services program, (b) a set of four one-credit student success courses, and (c) a 12-week text-based intervention, leaders at institutions can think creatively about what might be possible given their unique circumstances. Choosing one, two, or all three elements of ASuPIRE moves the needle forward in meeting the mental health needs of students with foster care experience.

Providing individual counseling is optimal, as many students who have foster care experience may have receiving past mental health services that were not positive and did not understand the connection between being a college student and their symptomology. Bridging Success was fortunate in that we had an existing positive relationship with the leaders overseeing counseling services. We were able to leverage our shared interest in meeting the mental health needs of students at the university, while explaining the unique needs of students who have foster care experience. We also shared ownership of ASuPIRE with counseling services and worked through this process as a shared partnership. For example, counseling services provided the ASuPIRE service provider with office space and administrative support, Bridging Success secured philanthropic funding to cover the salary and benefits-related expenses associated with hiring a full-time counselor. An alternative approach might be to identify someone within an institution’s counseling services that can be a designated therapist for students who have foster care experience and provide specialized training to build their knowledge base of the student population.

The design of the one-credit student success courses was based on a pre-existing model used by the university to support incoming students and/or students on academic probation. Most colleges and universities use similar first year success classes that can be easily adapted to meet the needs of students who have foster care experience. We were able to integrate topics that students have expressed interest in such as developing personal wellness habits, skills for authoring and redefining personal narratives, developing a growth mindset, and how to navigate and build healthy/helpful relationships. It was beneficial to reach out to experts in the topics that were employed at the university. We found that once we explained the need to faculty and staff, they were more than happy to help us build the curriculum. It is important to note that we offered contributors financial compensation for their efforts.

Lastly, and maybe the most manageable element of ASuPIRE that an institution can implement, is the creation of a weekly text-based mental health intervention. Because most young people are comfortable with technology and use it as a primary source of information, creating a text-based intervention was a natural extension of ASuPIRE. It was important to us to find contributors with lived foster care experience. Seeing and hearing other students share personal, and at times vulnerable stories, of facing challenges and overcoming them by intentionally activating their resilience skills brings this important content to life. The creation of the actual text/videos required us to collaborate with the university’s marketing and website design teams because our staff did not have the technological skills needed to produce them ourselves. Students who have foster care experience wishing to receive the ASuPIRE text messages can sign up to receive them through the foster youth section of the university’s website.

The authors acknowledge that it may be challenging to implement all or parts of the ASuPIRE program due to limited resources, financial supports, and institutional capacity to provide such services. Many institutions of higher education may offer only limited counseling services and could require policy changes that provide for more robust mental health interventions. Additional funding would also be needed to fulfill such a policy change. Campus support program for students who have a foster care background can advocate for such policy changes.

Formal evaluation of ASuPIRE is anticipated in the next year and will likely examine the usefulness/impact of program elements on improvement of mental health outcomes using validated tools that measure symptomology over time. These findings will be viewed in conjunction with retention and persistence rates of participants. We acknowledge this scope of evaluation will be limited, because graduation rates are based on a six-year timeframe, and it would not be possible to evaluate the impact of ASuPIRE on graduation outcomes for several years.

Although formal evaluation is pending, the initial group of students who participated in ASuPIRE offer positive feedback about the experience. For example, on an anonymous feedback survey, one student stated, “Counseling offered me a safe-space to share my feelings with a supportive figure. I never realized the benefits of this until now. It has been a perspective-shifting experience and one that I will never forget,” and another shared that from counseling, he would remember, “to continually practice self-care and to promote my overall wellbeing. I will remember that it is not a weakness to ask for help. My counseling experience helped me to solidify that my thoughts and feelings are valid and should be listened to.” Students also appreciated the student success courses. For example, one concluded:

Growing up, I did not have healthy boundaries. And you know it is hard to determine what exactly is a healthy relationship or not, because that has never been modeled for me. When [the instructor] modeled healthy relationships, and all their different forms, it really stood out to me.

Although the early feedback is promising, more research is needed to implement the program with high fidelity at multiple sites to adequately evaluate its effectiveness in improving wellbeing and increased college persistence and graduation rates. The opportunity is larger than graduation – providing these services at this particular point in a young person’s development can offer skill building that, when coupled with a college education, can go a long way in preparing students who have foster care experience for their next steps beyond college.

We are working on publishing a manual that describes the program elements in great detail about how to implement our campus-based, support program for students who have foster care experience which includes ASuPIRE. Once this manual is available, these programs can easily be translated to other colleges and universities. As colleges and universities consider how best to support students with a background in foster care, implementing increased services through a holistic campus-based support program is the first step. Being intentional about having part of the programming focus on meeting the mental health needs of students who have foster care experience is also beneficial.

When considering implementation of programs such as ASuPIRE on a college or university campus, advocates can investigate existing policies and practices for addressing mental health concerns for students. At the local level, health centers located at colleges and universities can consider accepting Medicaid so that the cost of counseling can be covered under the insurance system often used by students with a history of foster care. At the state level, there are still many states that do not offer a tuition waiver for these students. Considering legislation that will not just require the waiver, but also appropriate resources to fund these programs can ensure colleges and universities are incentivized to offer services that can assist this population. At the federal level, legislation that allows young people to extend their time in foster care has been influential in providing ongoing support for these emerging adults. Including funding for mental health services as part of federal legislation could reduce the likelihood childhood trauma being left untreated. More research is needed to evaluate the effectiveness of this program. Those findings will offer implications for policy and practice as best practices are more fully informed through evidence.