When child care researcher Sarah Sullivan walked into a drop-in center for foster youth in Santa Clara County, California, she didn’t expect to see what she witnessed. It was early November, and the first morning of research for what would become the Aged Out report. 

Stepping through the door, Sarah noticed staff were taking down a Día de los Muertos (Day of the Dead) altar created to honor a young person who had passed away within the community. The altar observance had become an annual tradition, expanded by youth themselves to grieve in community with siblings, parents, and other loved ones. 

“The youth quickly used that event to address other grief and losses in their life,” said Sullivan on the Child Welfare Information Gateway Podcast. “People were showing up to recognize the loss of siblings or foster family members or aunts and uncles, and were bringing their other losses to the table.”

It was a small gesture but exactly what the youth needed. And in it, the moment encapsulated everything the system itself had never truly given them: a proper space to mourn.

‍The Día de los Muertos altar was one of the first signs of a fundamental insight that would soon animate the entire research effort: the foster care system is not designed to help young people heal from trauma. Yet, healing is the one thing it desperately needs to offer.

Published by Think of Us in partnership with Bloom Research, the Aged Out report draws from over 90 research engagements across five child welfare sites. The findings identified three core failures in the foster care system. Topping the list was an inability to support youth bombarded by trauma to heal. 

Aged Out was born out of a Think of Us-led initiative to develop a digital platform for foster youth to stay connected to their supportive networks or a trusted group of adults who could be there for them as they navigated life in and after care.

Building the technology didn’t work out as intended. The more Think of Us dug into it, the more the team realized something deeper was happening. It wasn’t about tech glitches or user interface. It was about trauma.

“Young people couldn’t even begin to think about activating a network or setting goals,” said Sixto Cancel, CEO of Think of Us, “because so many of them were stuck in a cycle of unprocessed grief, loss, and mistrust.”

So the organization pivoted. Instead of refining the app, they paused to listen. They launched an intensive participatory research initiative, and Aged Out was the result.

Trauma, Unacknowledged 

For transition-age youth, trauma is present every step of their lives. Entry into foster care is itself traumatic, being oftentimes prompted by family crises like domestic violence, neglect, or substance use. The system often compounds this trauma, from placement instability to overmedication – not to mention the looming backdrop that once they leave the system they will be expected to fend for themselves as completely independent adults. 

Despite the popularity of “trauma informed care” as a buzzword in the child welfare field, the reality is that trauma is still rarely centered in how we serve young people. There is no common language for addressing loss in the system. As a program staff in Santa Clara who wishes to remain anonymous put it, "At a funeral, you say 'I'm sorry for your loss.' But how do you say, 'I'm sorry you were removed from your family?' We don't have a way to talk about it."

The Aged Out report emphasizes that trauma often goes unnamed. This particularly manifests through what psychologists call "ambiguous loss:" when a person feels a profound sense of loss and sadness that is not directly associated with the death of a loved one, but instead derives from a lack of emotional closure from traumatic events. 

Instead of acknowledging the complexity of ambiguous loss and the need for adequate emotional support, trauma is often reduced to diagnoses by the system. But healing, as the report and youth themselves demonstrate, cannot be prescribed. It must come from active support for the youth.

The System-Induced Wound

Healing is complicated even further by the fact that much of the trauma youth have to deal with is system-induced. When you are removed from family and moved through a series of short-lived connections, every interaction with people within the foster system can become a reason for stress, anxiety, or even fear. Youth navigating the system often feel like their needs are too much, their behavior too disruptive, their pain too inconvenient.

Cancel noted that trauma in foster care is different from trauma caused by a single event like a car crash. "The trauma around being in foster care is relational," he said. "It’s the experience of being detached from your origin."

This means that healing in foster care does not only happen through access to therapy or services. It needs safe, stable relationships; it requires an entire culture shift within agencies— one that sees youth not as cases to manage, but as people with pain that should be acknowledged. 

Small Shifts, Huge Wins

Creating a culture of healing doesn’t require a complete reinvention of the system. But it does mean altering how frontline workers engage youth. Sullivan shared that one of the most consistent requests from young people was simple: that every adult start by asking, "How are you doing?"

Like the altar, it’s a small act, but one that builds connections, trust, community. Another recommendation: check in even when there’s no paperwork due. Show up not because you need something, but because you care.

Cancel offered an example of how this dynamic can unfold: “You no longer hear their tone as an attitude toward you. You no longer decide that they’re not worthy of that extra trip or gift card at Christmas. It becomes, ‘This is someone reacting appropriately to trauma.’”

Most importantly, offer young people options. Healing can take many forms. For some, it might mean talk therapy. For others, it's drawing, playing basketball, joining an online anime community, or even taking long showers. Youth in the study described developing their own healing practices because the system didn’t offer them any.

Agencies must also challenge how services are funded. Many supports are only reimbursable through Medicaid if a youth has a formal diagnosis. This creates a perverse incentive: to pathologize trauma instead of addressing it.

A New Mandate: To Heal

The child welfare system has long been governed by mandates: to investigate, to place, to supervise. What the Aged Out report makes clear is that it needs a new one: to heal.

Healing is not a luxury. It is a prerequisite to everything else: building relationships, securing housing, finishing school, getting a job. Without it, every support offered is standing on a fractured foundation.

The altar Sarah Sullivan witnessed that morning in Santa Clara County wasn’t just a moment of grief. It was a vision. A different way of being in relationship with foster youth. A system that sees them not as problems to be solved, but as people who have experienced profound loss, and who deserve to be met with presence, care, and the space to heal.

‍