Trauma exposure and traumatic stress in foster carers: a scoping review

Background: Foster carers provide care for children who have been removed from their primary caregivers due to serious adverse experiences. While considerable research focuses on trauma among foster children, little is known about the traumatic experiences and resulting (secondary) traumatic stress in foster carers themselves.Objective: To review existing literature on traumatic experiences and traumatic stress among foster carers. Methods: We conducted a scoping review following the methodological framework developed by the Joanna Briggs Institute [Peters, M. D. J., Marnie, C., Tricco, A. C., Pollock, D., Munn, Z., Alexander, L., McInerney, P., Godfrey, C. M., & Khalil, H. (2020). Updated methodological guidance for the conduct of scoping reviews. JBI Evidence Synthesis, 18(10), 2119-2126. https://doi.org/10.11124/JBIES-20-00167] and reported it in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) guidelines and checklist. We searched for literature in MEDLINE, Embase and PsycINFO.Results: We included nine studies (2005-2024) involving over 2,200 foster carers. Results indicate that (1) many foster carers have personally experienced adverse childhood experiences; (2) carers report indirect trauma exposure through their children's narratives and direct exposure, such as threats or violence; (3) a notable portion experience high levels of secondary traumatic stress; and (4) higher levels of trauma exposure are related to higher levels of secondary traumatic stress.Conclusions: The findings highlight the need for mental health screening, ongoing training, and systemic support for foster carers. Acknowledging carers as both caregivers and trauma-affected individuals is essential to trauma-informed care, as it contributes to the wellbeing of both foster children and foster carers, and helps ensure stable foster placements. Given the limited number of studies, future research should further explore the specific trauma foster carers encounter in their caregiving role, the nature and severity of their secondary traumatic stress symptoms, and how these factors influence their caregiving capacity and the stability of foster placements.