Document Type



Doctor of Philosophy


Education, Educational Leadership & Policy Studies

Date of Defense


Graduate Advisor

Wolfgang Althof


Paulette Isaac-Savage

Curtis McMillen

Lee Smith


This study documented and analyzed the processes of mental health treatment decision-making, in the context of family support teams, within the foster care system. The research questions explored engagement, perceptions, and self-rated empowerment among family support teams that serve adolescent foster youth with mental health concerns. The sample consisted of 23 participants from core support teams and 36 other adolescent and adult team members who were involved in the study. Data collection methods included observations at family support team meetings and court hearings, 34 semi-structured individual interviews, a self-rated empowerment scale, and informal conversations in the field. Analysis of non-survey data included qualitative content analyses of meetings and grounded theory methods of analysis for the interviews. Three analytic categories were found in the data: the inter-related processes of decision-making, power, and mesosystem factors that support or hinder decisionmaking. The inter-related processes of decision-making was chosen as a conceptual label to capture the complexity of arriving at decisions. The second category was named power. Power was conceptualized as the ability to influence, or get another person to do something; also the ability to access and use resources. Power was further distinguished by the subcategories: qualities and responses to power. Mesosystem factors in this study were the factors within the Children’s Division and Court System that encourage or impede the youth and family support team’s deliberations. Mesosystem factors as a category was further differentiated into three subcategories: role, transparency, and standardization of practices and procedures. Three family support team exemplars are presented to illustrate these categories. The results of the study pointed to: a) a need to educate stakeholders about how to more fully engage in collaborative decision making and b) a need to provide more opportunities for problem-solving and open dialogue among the youth and their respective teams.