Children sometimes come into foster care who are medically fragile, or have been severely emotionally damaged by their previous families. There will often be no plan to reunite them with their families. Foster parents may need to provide extensive medical or emotional support.
Some of these children may have been allowed to become delinquent, self-harming, abusers of other children, animals or adults, using drugs, prostituting themselves, or in deep trouble with the police. The last few decades have seen the development of a corps of highly-trained dedicated specialist foster parents to look after these children medium- or long-term and provide a treatment or therapeutic, safe environment for them which may supplement professional medical care and/or therapy. They will be very experienced, often having raised families of their own already. They will have had extensive education in techniques of dealing with very ill, troubled and/or difficult children. There is extensive contact with social workers and other professionals. As in long-term fostering, many of these children develop permanent parent-child relationships with their foster parents. Most states limit the number of children with treatment or therapeutic needs who can be placed in one home unless it is a licensed Group Home.