Social Support, Service Use, Psychological Flexibility, and Well-Being Among Israeli Foster and Biological Parents of Children with Disabilities

Abstract

Recognizing a dearth of understanding on the experiences of foster parents of children with disabilities, this study aimed to compare well-being, psychological flexibility, and social support among foster parents and biological parents of children with disabilities, as well as parents of children without disabilities, while exploring the impact of service use and social support on psychological flexibility and well-being. A convenience sample comprised 135 parents: 36 biological parents of children with disabilities, 32 foster parents of children with disabilities, and 67 biological parents of children without disabilities. Statistical analyses included one-way ANOVA, Pearson correlation, simple linear regression, and multiple linear regression. Results showed that foster parents of children with disabilities exhibited significantly higher psychological flexibility, well-being, and social support compared to biological parents of children with disabilities. Among biological parents of children with disabilities, psychological flexibility and well-being showed significant correlations with service satisfaction and social support, with social support explaining 62% of variance in psychological flexibility and 51% in well-being. Among foster parents of children with disabilities, neither service use nor social support significantly predicted psychological flexibility or well-being, suggesting different adaptive mechanisms. Among parents of children without disabilities, social support significantly predicted both psychological flexibility and well-being. The findings, which should be interpreted cautiously given the small sample size, highlight the need for targeted support interventions for biological parents of children with disabilities and further research into foster care families’ unique experiences.

1. Introduction

According to the World Health Organization, approximately 1.3 billion people, or 16% of the global population, experience severe disabilities [1]. In Israel, this figure is slightly higher, with more than 1.5 million people, or 17% of the population, living with disabilities [2].

Foster care serves as a protective system for children whose well-being cannot be ensured within their own families. It includes placements in non-parent households, emergency shelters, residential facilities, and group homes [3]. In Israel, over 4000 children are in the foster care system [4].

While extensive research has examined parenthood of children with disabilities, there is a significant gap in studies focusing on foster caregivers for these children. In the United States, 31% of children in foster care have disabilities [5]. In Israel, as of 2018, approximately 36,000 people with disabilities received state-sponsored housing services, including residential facilities, supported housing, or foster family placements. Of these, 800 individuals resided with foster families [6].

However, there is limited data on the prevalence of children with disabilities within foster care systems globally [5,7], and this knowledge gap extends to the Israeli context as well.

Grounded in Bronfenbrenner’s ecological theory and addressing a significant gap in the literature, this study examines the associations between service use, social support, psychological flexibility, and well-being among foster care parents of children with disabilities, in comparison to biological parents of children with disabilities and parents of children without disabilities.

1.1. Parents of Children with Disabilities

Parents of children with disabilities encounter multiple, intersecting challenges that affect their psychological well-being, social participation, economic stability, and family relationships. Research highlights heightened vulnerability in these domains compared to parents of children without disabilities.

Studies consistently show that biological parents of children with disabilities experience significantly higher levels of stress and depression compared to parents of children without disabilities [1,2,3,4]. Caregivers describe feelings of guilt, shame, frustration, and anxiety, particularly during the early stages of diagnosis and as their child develops [8]. Parents of children with intellectual disabilities also report strain in managing communication difficulties, delays in adaptive functioning, and comorbid health conditions, all of which heighten emotional vulnerability [9]. Continuous caregiving can lead to exhaustion, sadness, and a sense of helplessness [10].

Parents also face social stigma and negative societal attitudes, which contribute to isolation and distress [6]. Hurtful comments, misconceptions, and peer maltreatment directed toward children with disabilities have been reported by parents as particularly painful experiences [9]. Caregivers often withdraw from community activities because of time constraints or exclusion [10].

Economic challenges are a persistent concern [7]. Parents often struggle to afford therapies, medical care, and assistive devices, sometimes going into debt or taking multiple jobs to meet their child’s needs [9]. Caregiving demands may force parents to reduce work hours or leave employment altogether, leading to further financial instability [10].

Parenting a child with a disability also influences marital and family dynamics. Some couples experience instability, conflict, and unequal distribution of caregiving responsibilities, with mothers often feeling isolated or overburdened [5,8]. At the same time, other families report that co-parenting and shared responsibility strengthen their relationships and family bonds [9]. While these challenges are well-documented for biological parents, less is known about how they compare to the experiences of foster parents caring for children with disabilities.

1.2. Foster Care of Children with Disabilities

In general, foster care parents frequently report experiencing high levels of burden and stress. Additionally, they highlight challenges such as limited access to health services and inadequate support in caregiving for foster children [11,12]. Research also indicates that stress in foster care parents may be associated with the stress and externalizing problems exhibited by the foster children themselves [13]. However, there appears to be a significant knowledge gap regarding the unique characteristics and experiences of foster caregivers who care for children with disabilities.

Approximately one-third of children in the foster care system in the United States have disabilities. The increased likelihood of children with disabilities being placed in foster care may be attributed to challenging behaviors, such as drug and alcohol abuse, or parents’ inability to cope [5].

Children with disabilities in foster care may perceive their relationship with their caregivers as friendly, affectionate, and thoughtful. However, they may encounter difficulties in establishing a strong bond with their foster care caregivers [14]. The transition to adulthood after foster care can be particularly challenging for children, especially those with disabilities. They may face unmet mental health needs, societal barriers to disability awareness, difficulties meeting high school graduation requirements, a lack of positive social relationships, and challenges in securing a high-quality independent living arrangement [15,16,17].

Foster care parents of children with disabilities tend to encounter distinct challenges, including difficulties accessing services for their child, navigating the healthcare system, managing the financial costs associated with fostering a child with disabilities, and addressing challenging behaviors exhibited by the child. Additionally, these parents tend to face a lack of opportunities for self-care [18]. They also express a sense of inadequate support across various domains, including post-adoption support, disability-specific assistance, and educational support [19]. Furthermore, foster care parents express a desire for more training related to disabilities and effective strategies for supporting children with disabilities [20]. Support for foster care parents is pivotal in the care of children with disabilities. It is plausible that foster parents may be more inclined to care for children with disabilities if they have confidence that sufficient support will be available [21].

Gilad et al. [22] stressed the importance of supporting foster care families of children with disability and pointed out that the information regarding this topic needs to grow and be organized. Likewise, to the best of our knowledge, the contribution of service use and social support of foster-care parents of children with disabilities has not been studied.

1.3. Service Use

We use the term “Service Use” to refer to state-provided services intended for individuals with disabilities or their families. For foster care families of children with disabilities, this concept encompasses services specifically designed to support foster care families, including guidance meetings and support groups. In Israel, foster care caregivers receive a tax-deductible monthly payment for providing care to the child. Additionally, they receive supplementary payments covering various aspects, such as clothing, general equipment, school supplies, medical expenses (including insurance), leisure expenses, and special occasions and graduation parties [23].

Family-centered services have been shown to have a positive correlation with the psychological well-being of parents of children with disabilities [24]. In the context of foster care caregivers in general, reported findings indicate that support, including training, participation in support groups, and guidance from social workers, holds significant importance for caregivers [25,26]. Similarly, mental health training has been associated with caregivers experiencing increased efficacy in addressing the psychological and emotional needs of foster children [27].

In Israel, numerous agencies are tasked with providing services for individuals with disabilities and their families. Barlev et al. [6] note that the lack of organization concerning services for people with disabilities in Israel poses a challenge in collecting data and comprehending the impacts of these services on individuals with disabilities and their families. Similarly, the research field on foster care for children with disabilities in Israel is marked by a scarcity of information. Gilad et al. [22] documented that foster care services for children with disabilities include financial assistance (though often insufficient for lower socioeconomic families), dedicated coordinators, professional consultations, and training programs for foster families. Services for individuals with disabilities encompass educational support, rehabilitation, therapeutic interventions, and transition planning, delivered through multidisciplinary teams of social workers, medical professionals, and specialists. However, Gilad et al. [22] identified significant gaps in service coordination, specialized knowledge accessibility, communication support, and respite services.

1.4. Social Support

The essence of social support involves an individual’s sense of belonging to a mutually supportive social network, it includes the individual sense of being cared for and appreciated [28]. Social support not only plays a role in buffering from negative outcomes, but it may also promote positive outcomes of functioning and mental health [29,30]. Notably, for family members of individuals with disabilities, social support demonstrates a positive correlation with family resilience [31,32].

Despite its recognized benefits, families of children with disabilities often report lower levels of social support compared to families with children without disabilities [33]. In the context of parents of children with disabilities, a lack of social support has been linked to depressive symptoms [34,35], while the presence of social support is associated with increased happiness [36]. In a study focusing on parents of children with autism, it was found that social support proved more beneficial than formal support [37].

To the best of our knowledge, social support for foster parents of children with disabilities has not been thoroughly examined in existing research. However, in a related study on social support networks, Piel et al. [38] conducted interviews with foster care caregivers, organizing their findings within the framework of Bronfenbrenner’s [39] ecological theory. Their study revealed that these caregivers in general derive support from both the micro-level (e.g., from parents) and meso-level (e.g., community support). However, they also underscored the necessity for additional support at the macro-level (e.g., fostering a culture more accepting of unique family structures).

1.5. Well-Being

According to Diener and Suh [40], the concept of “Well-being” encapsulates the overall contentment of an individual’s life across various dimensions. These encompass, though are not confined to, interpersonal relationships, personal safety, a sense of belonging to a community, confidence in future stability, job satisfaction, standard of living, health, and achievements. Additionally, it involves the absence of negative experiences such as depression, stress, and anger Specifically, parents of children with disabilities often report a lower sense of well-being [41,42]. In the realm of foster care, the well-being of foster care parents is intricately tied to foster care training, parenting self-efficacy, and the quality of their relationship with the child [43]. Notably, the well-being of foster care parents of children with disabilities has not been thoroughly explored to date, and this study seeks to address and bridge that gap in our understanding.

1.6. Psychological Flexibility

Psychological flexibility can play a pivotal role in encompassing individuals’ capacity to navigate and overcome stressful circumstances and distress [44,45]. This concept revolves around a person’s ability to fully engage with the present, think openly, and move their life forward in ways that align with their personal values. psychological flexibility empowers individuals to confront life challenges by acknowledging that, often, the source of the challenge lies in elements that are profoundly meaningful to them [46]. It involves the adaptive process and a shift in perspective concerning thoughts, desires, and needs [47]. In the context of parents of children with disabilities, psychological flexibility can serve as a protective factor in various mental health aspects, including distress, anxiety, depression, stress, and burnout [48]. Notably, to our knowledge, psychological flexibility has not been studied among foster care parents of children with disabilities, making this study a significant and novel contribution to the field.

1.7. Theoretical Framework: Bronfenbrenner’s Ecological Systems Theory

This study is grounded in Bronfenbrenner’s ecological systems theory, which provides a comprehensive framework for understanding human development within environmental contexts [39]. The theory conceptualizes human development as influenced by five interconnected systems: the microsystem (immediate environments including family and direct caregiving relationships), mesosystem (connections between microsystems such as family-service provider relationships), exosystem (external systems that indirectly influence families, such as community agencies), macrosystem (broader cultural values and policy frameworks), and chronosystem (changes over time including caregiving transitions) [39].

This theoretical approach is particularly relevant for understanding foster and biological parents of children with disabilities, as these families must navigate multiple, interconnected systems that can either support or challenge their well-being and adaptive functioning.

1.8. The Study’s Rationale and Aims

This study addresses a significant gap in the literature by examining the associations between service use, social support, psychological flexibility, and well-being among foster care parents of children with disabilities, in comparison to biological parents of children with disabilities and parents of children without disabilities.

The selection of service use and social support as variables is grounded in Bronfenbrenner’s ecological theory [39]. This theory suggests that individuals’ experiences are related to interconnected social circles at various levels. Service use represents a macro-level factor, while social support operates at the meso-level. Psychological flexibility is included based on research showing its associations with positive outcomes for biological parents of children with disabilities [48]. This study extends this exploration to foster care parents. Well-being serves as an outcome variable, providing a comprehensive measure of parental adjustment and quality of life in challenging caregiving situations.

The objective of this study is twofold: firstly, to compare social support, psychological flexibility, and well-being across three groups: foster care parents of children with disabilities, biological parents of children with disabilities, and parents of children without disabilities. Secondly, this study aims to examine the associations between service use, social support, psychological flexibility, and well-being among foster care and biological parents of children with disabilities, as well as the associations between social support, psychological flexibility, and well-being among parents of children without disabilities. Through a cross-sectional correlational design employing correlational and linear regression analyses, the study examines the predictive relationships of these variables across all three groups.

2. Materials and Methods

This study employed a cross-sectional comparative design to examine differences in psychological flexibility, well-being, and social support across three distinct groups of parents: foster care parents of children with disabilities, biological parents of children with disabilities, and parents of children without disabilities. The design also investigates the relationships between service use, social support, and outcomes among the two groups of parents caring for children with disabilities.

2.1. Participants

Participants were recruited using a convenience sampling method. The study included 135 parents: 36 biological parents of children with disabilities, 32 foster care parents of children with disabilities, and 67 parents of children without disabilities. This study was conducted in Israel, and all participants were Jewish. Each participant represented a unique family unit, with no couples participating in the study, ensuring independence of observations. The sample size reflects the limited population of foster care parents of children with disabilities in Israel. Despite this constraint, the sample is sufficient for statistical analyses. The researchers maintained proportionally small sizes for comparison groups to avoid disparities that could skew analyses. Given the small population of foster parents of children with disabilities in Israel (800 individuals) and practical constraints in accessing participants through multiple agencies, convenience sampling was deemed the most feasible approach for this exploratory study, though this limits generalizability. Background characteristics of the three groups are presented in Table 1.

Table 1. Background Characteristics Among the Three Groups.

Characteristics	Biological Parents of Children with Disabilities (n = 36)	Foster Care Parents of Children with Disabilities (n = 32)	Comparison Group (n = 67)	p-Value
Parent’s Characteristics
Male	9 (25%)	4 (12.5%)	11 (16.4%)	χ2(2) = 1.98, p = 0.37
Female	27 (75%)	28 (87.5%)	56 (83.6%)
Parents’ Age	M = 47.4 SD = 8.75	M = 48.9 SD = 7.29	M = 44 SD = 10.71	F(2,132) = 3.38, p = 0.37
Children’s Characteristics
Male	22 (61.1%)	18 (56.3%)		χ2(1) = 1.17, p = 0.68
Female	14 (38.9%)	14 (43.8%)
Child’s Age	M = 16.01 SD = 12.63	M = 16.79 SD = 13.50		t(64) = −0.25, p = 0.81
Disability Type
Autism	16 (44.4%)	7 (21.9%)
Intellectual Disability	8 (22.2%)	8 (25%)
Mental Health	2 (5.6%)	1 (3.1%)
Sensory Disability	1 (2.8%)	2 (6.3%)
Physical Disability	3 (8.3%)	1 (3.1%)
Other	4 (11.1%)	13 (40.6%)
Disability Severity
Mild	20 (55.6%)	19 (59.4%)
Severe	16 (44.4%)	13 (40.6%)

2.2. Measurements

Service Use Index [49] was developed to measure the use of family-centered services by parents of children with disabilities from the local social services department and their satisfaction with these services. The two groups of parents of children with disabilities, foster, and biological parents, were administered different sets of support services tailored to the specific needs of each population. For biological parents, the measurement included 15 services (e.g., “parental counseling”), while foster parents were assessed on 20 services—the same 15 services plus 5 additional foster care-specific services (e.g., “tutoring”). This difference reflects the distinct service ecosystems available to each population. Participants were asked to indicate the services they had used and their level of satisfaction with these services on a 5-point Likert-type scale ranging from 1 (minimal satisfaction) to 5 (high level of satisfaction). Participants indicated only whether they had ever used each service (yes/no) and their satisfaction level; frequency of service use (how often services were accessed) was not measured in this study. The Service Use Index yields two separate scores rather than a combined index: (1) a utilization score calculated as the sum of services used (ranging from 0–15 for biological parents, 0–20 for foster parents), and (2) a satisfaction score calculated as the mean satisfaction rating across all services used (ranging from 1–5). Detailed service utilization frequencies and satisfaction ratings for both groups are provided in the Supplementary Materials. The satisfaction with services scale demonstrated good internal reliability for all groups, scoring α = 0.73 for foster care parents and α = 0.99 for biological parents. These were analyzed as separate variables in all statistical analyses.

Multidimensional Scale of Perceived Social Support [50] was used to assess social support. This measurement comprises 12 items graded on a Likert-type scale ranging from 1 (strongly disagree) to 7 (strongly agree). The total score was calculated as the mean score. The scale includes three sub-scales representing different sources of social support: (1) Family (e.g., “I get the emotional help and support I need from my family”), (2) Friends (e.g., “My friends really try to help me”), and (3) Significant Other (e.g., “There is a special person with whom I can share joys and sorrows”). In the current study, the total measurement demonstrated high reliability with an alpha coefficient of α = 0.93. Additionally, the individual subscales exhibited high reliability, with family social support scoring α = 0.92, friends social support scoring α = 0.93, and social support from a significant other scoring α = 0.85.

Psy-Flex [51] was utilized to assess psychological flexibility. Psy-Flex is a six-item, one-factor self-report questionnaire (e.g., “Even if I am somewhere else with my thoughts, I can focus on what’s going on in important moments”). Items are rated on a Likert-type scale from 5 (“very often”) to 1 (“very rarely”) and then summed. Higher scores indicate greater psychological flexibility. The use of Psyc-Flex as a measure of psychological flexibility is gaining traction in recent psychological research, with an increasing number of studies incorporating this relatively new instrument. Gur et al. [52], who validated the Hebrew version of the Psy-Flex (Psy-Flex-Heb), found that the reliability of Psy-Flex-Heb scores based on Cronbach’s alpha was 0.91. Confirmatory Factor Analysis showed that Psy-Flex-Heb fit a one-factor model. Their results strengthen the one-dimensional construct of psychological flexibility and show Psy-Flex-Heb is a reliable measure that can be useful in both research and practice. The Psy-Flex questionnaire was administered to all three groups in the study. In this study, the Psy-Flex questionnaire demonstrated good internal reliability with α = 0.88.

The Mental Health Continuum Short Form [53] was used to assess well-being. This questionnaire consists of 14 items measuring well-being, with participants rating their experiences over the past month on a Likert-type scale ranging from 1 (Not at all) to 6 (Every day). Mean scores were calculated to reflect overall well-being. The measurement comprises three subscales: emotional well-being (e.g., “happy”), social well-being (e.g., “ belonged to a community”), and psychological well-being (e.g., “Grown and become a better person”). This tool demonstrated high reliability with a score of α = 0.93. Subscales also exhibited good reliability scores, with emotional well-being scoring α = 0.84, social well-being scoring α = 0.85, and psychological well-being scoring α = 0.91.

Disability Severity was assessed through parental self-report using a 5-point scale ranging from 1 (mild) to 5 (severe). Parents were asked to rate their child’s disability severity based on their perception of the child’s functional limitations and support needs. For analysis purposes, responses were categorized as mild (ratings 1–2) and severe (ratings 4–5). No participants selected the midpoint rating of 3.

2.3. Procedure

After receiving approval from the Institutional Review Board (IRB) of Tel-Hai College and obtaining endorsement from the research department of the Ministry of Social Services and Social Affairs, an online survey was distributed across multiple settings in Israel. Social workers from local social services departments, disability support organizations, and foster care agencies throughout the country assisted in distributing the survey through professional instant messaging groups and to families in their caseloads. This targeted recruitment approach ensured access to the specialized populations of foster parents and biological parents of children with disabilities. Additionally, the survey was distributed through general social media platforms and parenting groups to recruit the comparison group of parents of children without disabilities. Participants were provided with essential information regarding the nature of the study. Each participant signed an informed consent form online. The questionnaires were anonymous.

2.4. Statistical Analysis

The statistical analysis included a one-way ANOVA to compare psychological flexibility, well-being, and social support among foster parents, biological parents of children with disabilities, and parents of children without disabilities. Pearson correlation analysis examined associations between psychological flexibility, well-being, service satisfaction, and social support for foster parents and biological parents of children with disabilities. For parents of children without disabilities, correlations were examined only between psychological flexibility, well-being, and social support, as service use variables are specific to families of children with disabilities. Multiple linear regression analyses assessed the collective contribution of service use and social support to psychological flexibility and well-being among foster parents and biological parents of children with disabilities. Simple linear regression analyses examined the contribution of social support to psychological flexibility and well-being among parents of children without disabilities. All statistical analyses were conducted using SPSS (version 28).

3. Results

3.1. Comparative Analysis of Psychological Flexibility, Well-Being, and Social Support Among Groups

Table 2 presents the mean, standard deviation, and F-value and post hoc tests for psychological flexibility, well-being, and social support.

Table 2. Comparing Psychological Flexibility, Well-being, and Social Support: One-Way Analysis of Variance Results Across Groups.

		Foster Care (n = 32)		Biological Caregivers (n = 36)		Comparison Group (n = 67)
		M	SD	M	SD	M	SD	F	ᶯ2	Post-Hoc
Psychological flexibility		25.12	4.43	21.91	4.84	24.70	3.79	6.13 **	0.09	2 < 1,3
Well-being	Total	4.88	0.78	3.89	1.01	4.23	0.96	9.03 ***	0.13	2,3 < 1
	Emotional	5.01	0.08	4.15	1.17	4.55	1.01	5.78 **	0.09	2 < 1
	Social	4.49	1.04	3.21	1.09	3.56	1.22	10.69 ***	0.15	2,3 < 1
	Psychological	5.14	0.79	4.34	1.15	4.64	0.98	5.25 **	0.08	2 < 1
Social support		5.87	1.09	5.01	1.34	5.97	0.94	9.04 ***	0.12	2 < 1,3
	Family	5.76	1.48	5.02	1.72	5.97	1.24	4.86 **	0.07	2 < 3
	Friends	5.63	1.42	4.61	1.61	5.58	1.24	6.25 ***	0.09	2 < 1,3
	Significant other	6.23	0.94	5.38	1.14	6.35	0.99	8.87 ***	0.12	2 < 1,3

Note: 1 = Foster care parents of children with disabilities; 2 = Biological parents of children with disabilities; 3 = Comparison group (parents of children without disabilities). Post-hoc column indicates which groups differ significantly, with the symbol < showing that the group number before it scored significantly lower than the group numbers after it. ** p < 0.01, *** p < 0.001.

Psychological Flexibility. The results indicate significant differences in psychological flexibility among groups (F = 6.13, p < 0.01). Specifically, biological parents of children with disabilities reported lower psychological flexibility compared to both foster care parents and the comparison group.

Well-Being. Similarly, the results revealed significant differences in well-being among groups (F = 9.03, p < 0.001). Foster care parents scored higher on total well-being compared to both biological parents of children with disabilities and the comparison group. When examining the sub-scales of well-being, significant differences emerged in emotional well-being among groups, with foster care parents scoring higher in both emotional well-being (F = 5.78, p < 0.01) and psychological well-being (F = 5.25, p < 0.01) than biological parents of children with disabilities. Regarding social well-being, significant differences were observed, indicating that both biological parents of children with disabilities and the comparison group exhibited lower social well-being compared to foster care parents (F = 10.69, p < 0.001).

Social Support. Concerning social support, the results indicate significant differences between groups, with biological parents of children with disabilities reporting lower total social support than both foster care parents and the comparison group (F = 9.04, p < 0.001). In the sub-scales, specifically regarding both friends’ social support and significant others’ social support, biological parents of children with disabilities reported lower friends’ social support (F = 6.25, p < 0.001) and significant others’ social support (F = 8.87, p < 0.001) compared to both foster care parents and parents of children without disabilities. Regarding family social support, significant differences were found between biological parents of children with disabilities and parents of children without disabilities, with biological parents of children with disabilities reporting less family social support than the comparison group (F = 4.86, p < 0.01).

Overall, these preliminary findings suggest a consistent pattern where biological parents of children with disabilities may experience greater challenges across multiple psychological domains compared to both foster parents and parents of children without disabilities. The observed differences appear particularly pronounced for social well-being, where foster parents demonstrated notably higher scores than both comparison groups. These patterns may indicate that biological parents of children with disabilities face unique psychological adjustment challenges, while foster parents appear to maintain relatively higher levels of psychological functioning despite caring for children with similar disability profiles.

3.2. Correlations Between Social Support, Service Use, Psychological Flexibility, and Well-Being Among Biological and Foster Parents of Children with Disabilities

Correlations between variables are presented in Table 3. The correlation among research variables for foster care parents (N = 32) is presented at the top, while the correlations among research variables for biological parents of children with disabilities (N = 36) is presented at the bottom. Results indicate that, for biological parents of children with disabilities, psychological flexibility and well-being were significantly correlated with service satisfaction and social support. However, service satisfaction was solely correlated with psychological flexibility and not well-being. Conversely, for foster care parents, psychological flexibility and well-being were significantly correlated. However, no significant correlations were observed between these variables and the number of services used, service satisfaction, or social support.

Table 3. Correlation Analysis of Research Variables Among Foster Care Parents (N = 32) and Biological Parents of Children with Disabilities (N = 36).

	Psychological Flexibility	Well-Being	Number of Services	Service Satisfaction	Social Support
Psychological flexibility	1	0.43 *	−0.1	−0.03	0.33
Well-being	0.73 ***	1	0.26	0.16	0.35
Number of services	−0.40 *	−0.19	1	−0.08	−0.09
Service satisfaction	0.39 *	0.49 **	−0.23	1	0.12
Social support	0.78 ***	0.68 ***	−0.38 *	0.43 *	1

* p < 0.05 ** p < 0. 01 *** p < 0.001. Note: Correlations above the diagonal represent foster care parents (N = 32); correlations below the diagonal represent biological parents of children with disabilities (N = 36).

These correlation analyses suggest potentially distinct adaptive patterns between the two parent groups. Among biological parents of children with disabilities, psychological adjustment appears to be closely linked to external support systems, with social support showing strong associations with both psychological flexibility and well-being. In contrast, foster parents’ psychological outcomes appear to operate more independently of service utilization and social support variables, suggesting they may draw upon internal resources or alternative adaptive strategies.

To provide a complete comparative picture, correlations were also examined among parents of children without disabilities (N = 67). Results indicated that social support was significantly correlated with both psychological flexibility (r = 0.37, p < 0.01) and well-being (r = 0.44, p < 0.001). Psychological flexibility and well-being were also significantly correlated (r = 0.60, p < 0.001). Service use variables were not assessed in this group as these services are specifically designed for families of children with disabilities.

3.3. Regression Analysis: Assessing the Contribution of Social Support and Service Use to Psychological Flexibility and Well-Being

Multiple linear regression analyses were conducted among foster parents of children with disabilities (N = 32) to examine whether service use and social support predicted psychological flexibility and well-being. For psychological flexibility, the overall regression model was not significant (R² = 0.12, F(3,28) = 1.22, p = 0.32), indicating that number of services, service satisfaction, and social support collectively did not significantly predict psychological flexibility. None of the individual predictors were significant: social support (β = 0.33, p = 0.08), number of services (β = −0.07, p = 0.69), or service satisfaction (β = −0.08, p = 0.68). For well-being, the overall regression model approached but did not reach significance (R² = 0.22, F(3,26) = 2.46, p = 0.085). Among the predictors, social support showed a marginally significant contribution (β = 0.36, p = 0.051), while number of services (β = 0.30, p = 0.10) and service satisfaction (β = 0.13, p = 0.48) were not significant.

In contrast, multiple linear regression analyses among biological parents of children with disabilities (N = 36) revealed significant predictive relationships. The results of the linear regression analysis for psychological flexibility revealed that the number of services, satisfaction with services, and social support were collectively accounted for 62% of the variance (R² = 0.62, F(2,29) = 15.59, p < 0.001). Notably, social support (β = 0.71) demonstrated a significant contribution to psychological flexibility, while the number of services and satisfaction with services did not exhibit significant contributions. Table 4 summarizes these regression findings. A post hoc power analysis was conducted using G*Power (version 3.1). With an alpha of 0.05, a sample size of 33, and 3 predictors, the achieved power was >0.9999 to detect an R² of 0.617. This indicates that the study had more than adequate statistical power to detect the observed effects. The results of the linear regression analysis for well-being indicated that two predictors explained 51% of the variance (R² = 0.51, F(3,28) = 9.8, p < 0.001). Specifically, social support (β = 0.57) was associated with well-being, while satisfaction with services was not. A post hoc power analysis was conducted. With an alpha of 0.05, a sample size of 32, and 2 predictors, the achieved power was very high (>0.99) to detect an R² of 0.500. These findings should be interpreted with caution given the relatively small sample size (N = 36 for biological parents), which may limit the generalizability of the results to the broader population of parents of children with disabilities.

Table 4. Linear Regression Analysis Summary: Predicting Psychological Flexibility and Well-being in Biological Parents of Children with Disabilities (N = 36).

Effect	Estimate	SE	95%CI		p
			LL	UL
Psychological Flexibility
Number of services	−0.13	0.04	−0.11	0.32	0.30
Satisfaction from services	0.37	0.14	−0.24	0.04	0.76
Social support	0.71	0.08	0.27	0.60	<0.001
Well-being
Satisfaction from services	0.23	0.19	−0.09	0.68	0.13
Social support	0.57	0.11	0.21	0.66	<0.001

The linear regression analyses reveal that social support emerges as the primary predictor of psychological adjustment among biological parents, accounting for substantial variance in both outcomes while formal service variables showed limited predictive value. This suggests that supportive relationships may be more critical than professional services for this population’s psychological resilience, though these preliminary findings require validation through larger studies.

To provide a complete comparative picture, simple linear regression analyses were also conducted among parents of children without disabilities to examine the contribution of social support to psychological flexibility and well-being. Service use variables were not included for this group as these services are specifically designed for families of children with disabilities. For psychological flexibility (N = 62), the regression model was significant (R² = 0.13, F(1,60) = 9.24, p = 0.004), with social support demonstrating a significant positive contribution (β = 0.37, p = 0.004). For well-being (N = 61), the regression model was also significant (R² = 0.20, F(1,59) = 14.45, p < 0.001), with social support showing a significant positive contribution (β = 0.44, p < 0.001). These findings indicate that social support predicts both outcomes among parents of children without disabilities, consistent with patterns observed in the biological parent group.

4. Discussion

The study addresses a substantial gap in the existing literature concerning foster care parents of children with disabilities, a population that forms a significant proportion within the foster care system [54]. Previous research underscores the considerable challenges and heightened stress experienced by parents of children with disabilities, emphasizing the critical role of social and service support in mitigating these challenges [41,42,55]. Despite this emphasis, there is a paucity of research comprehensively exploring the distinct experiences of foster care parents specifically caring for children with disabilities, especially when compared to biological parents [22]. This study seeks to fill this void by investigating the impact of service use and social support on the well-being and psychological flexibility of foster care parents of children with disabilities, in comparison to biological parents of children with disabilities and parents of children without disabilities. While this study provides important preliminary insights, the findings should be interpreted cautiously given the small sample size, which limits generalizability to the broader populations studied.

Foster care parents reported higher well-being than both biological parents of children with disabilities and parents of children without disabilities. It may be that individuals who choose to be foster care parents possess a high sense of confidence in their abilities and a strong sense of value, factors that are correlated with higher well-being [56,57]. Moreover, this observation aligns with existing research indicating lower reported well-being among biological parents of children with disabilities [41,42].

The findings indicate that foster care parents exhibit higher psychological flexibility compared to biological parents of children with disabilities, while not differing significantly from parents of children without disabilities. Psychological flexibility underscores the ability to adapt positively to challenging circumstances [44,45]. This aligns with a study conducted by Emerson et al. [57], which reported that mothers of children with disabilities tend to have lower psychological flexibility than mothers of children without disabilities. While both biological and foster care parents of children with disabilities encounter similar challenges in raising their children, the nature of their parenthood experiences differs significantly. Foster care parents choose to embark on the parenting journey with a child with a disability, whereas biological parents of children with disabilities find themselves placed into this parenting role involuntarily. For the latter, this experience, often accompanied by negative aspects such as loss of hope and grief [58,59,60,61]. This difference, for instance, may be explained in terms of affiliated stigma, as parents of children with disabilities often perceive blame and judgment from society regarding their child’s behavior and condition [62,63,64]. It stands to reason that such dynamics may not apply to foster care parents of children with disabilities.

Regarding social support, the findings showed that foster parents of children with disabilities report higher social support than biological parents of children with disabilities. This aligns with previous research [33], and may also be linked to the sense of stigmatization experienced by parents of children with disabilities [62,63,64].

These findings appear to contradict existing research that typically reports high levels of burden and stress among foster care parents [11,12,13]. While previous studies emphasize the challenges foster parents face, including limited access to health services and inadequate support in caregiving, our results suggest a more complex picture when examining foster parents specifically caring for children with disabilities.

Several factors may explain these unexpectedly positive findings among foster parents. First, social desirability bias may have influenced foster parents’ self-reported responses. Foster parents may feel pressure to present themselves as competent caregivers, particularly given potential concerns about evaluation by social services or their suitability as foster parents. This response bias could artificially inflate reports of well-being, psychological flexibility, and social support compared to biological parents, who may experience less external scrutiny regarding their caregiving adequacy.

Second, our sample of foster parents may represent a unique subset of the broader foster parent population. The voluntary nature of participation in research, combined with recruitment through social media and professional networks, may have attracted foster parents who are more confident in their roles, better connected to support systems, or experiencing more positive outcomes than typical foster parents. Foster parents caring for children with disabilities may represent an even more specialized group who have specifically chosen this challenging caregiving role, potentially indicating higher levels of preparedness, motivation, or resilience compared to the general foster parent population.

Among foster care parents, regression analyses revealed that neither service use nor social support significantly predicted psychological flexibility or well-being, suggesting that the variables measured in this study do not explain variance in these outcomes for foster parents. This distinction could be attributed to differences in the parenting context. Foster parents, who choose to take on the responsibility of caring for children with disabilities, may approach the challenges with a different level of preparedness. Unlike biological parents, foster parents may not face the same involuntary and unexpected circumstances that biological parents encounter when raising a child with a disability. Foster parents often undergo training and rigorous screening processes, potentially fostering a sense of preparedness and adaptability that differs from the experiences of biological parents.

While our study primarily focuses on foster care parents, it also yielded important findings about biological parents that are worth discussing, as they provide valuable context for understanding the unique experiences of foster care parents. Among biological parents of children with disabilities, it was found that psychological flexibility and well-being were associated with parents’ social support. This aligns with other studies that have shown social support can facilitate both psychological flexibility and well-being [65,66,67]. Regarding service use, service use showed a negative correlation with psychological flexibility but no correlation with well-being. The negative correlation noted between service use and psychological flexibility may indicate that biological parents of children with disabilities, using a greater number of services, might inherently possess lower psychological flexibility. This suggests that these parents may initially experience challenges in adapting to different circumstances, leading them to seek additional support services. However, service satisfaction exhibited a positive correlation with both psychological flexibility and well-being. These findings collectively underscore the crucial role of service satisfaction. Services that are perceived positively have the potential to enhance psychological flexibility and well-being, whereas those perceived negatively may fail to yield such positive contributions.

Among parents of children without disabilities, social support significantly predicted both psychological flexibility and well-being, mirroring the pattern observed in biological parents of children with disabilities. This consistency across both groups further emphasizes the distinctiveness of foster parents, for whom social support did not predict psychological outcomes. These findings suggest that foster parents may rely on different adaptive mechanisms that warrant further investigation.

These differences highlight the need to consider the distinct experiences of foster care parents, especially when caring for children with disabilities, in comparison to their biological counterparts. While biological parents may navigate challenges influenced by the involuntary nature of their parenthood, foster parents, who opt into the parenting journey, may bring a different set of strengths and resources to the table, contributing to the observed variations in associations between service use, psychological flexibility, and well-being.

4.1. Limitations

As an exploratory study of a rare population, this research has inherent methodological constraints that affect generalizability while contributing essential preliminary evidence to an understudied field. First, it is important to note that the sample size of foster care and biological parents of children with disabilities is relatively small, particularly the foster care parent sample (N = 32), which significantly limits the generalizability of findings to the broader populations studied. The findings should therefore be interpreted cautiously. Given that this study provides some of the first empirical data on foster parents of children with disabilities, these findings should be interpreted as preliminary rather than definitive, and replication with larger, more representative samples is essential. Second, the sample composition presents additional constraints, including the underrepresentation of fathers in this study, a constraint commonly observed in research on parents of children with disabilities [48]. Third, several methodological limitations affect generalizability. Our use of convenience sampling through social media platforms rather than systematic recruitment introduces multiple biases: it may exclude parents without internet access or social media engagement, potentially skewing results toward more technologically engaged participants, and participants who respond to social media recruitment may differ systematically from the broader population. Additionally, the lack of focus on specific disabilities further limits generalizability to particular disability contexts. Fourth, the lack of comprehensive data on the participants, including parents’ occupational and socioeconomic status, constrains our analysis. The study is also constrained by insufficient detail about disabilities categorized as “other,” potentially obscuring important distinctions within this group. Moreover, children’s characteristics data were not collected for the comparison group (parents of children without disabilities), which limits our ability to control for potential demographic differences between groups and may affect the interpretability of comparisons. Finally, all measures relied on self-report data, which may be subject to social desirability bias, recall bias, and subjective interpretation of items.

However, these limitations should be evaluated within the context of pioneering research on an extremely understudied population. These preliminary findings establish an essential empirical foundation for future research while providing immediate insights for practice and policy.

4.2. Implications for Future Research, Practice, and Policy

Future research should delve into the specific contributions of various services to psychological flexibility and well-being, exploring potential variations in these variables before and after the services use. Additionally, it is crucial to investigate these differences while considering and comparing parents of children with different types of disabilities. Despite the reported satisfaction among foster care parents with the provided services, this study found no significant contribution of these services to their psychological flexibility and well-being. Therefore, future investigations should prioritize understanding how the services offered contribute to the psychological flexibility and well-being of foster care parents and explore strategies to enhance this contribution. More broadly, given the complex and nuanced experiences revealed in this study, future qualitative research exploring the lived experiences of both biological and foster parents of children with disabilities could provide deeper insights into the mechanisms underlying these differential outcomes. Qualitative inquiry could help explain findings that quantitative measures alone cannot fully capture, such as understanding the specific factors that contribute to foster parents’ apparent resilience, the nature of support systems that are most meaningful to each population, and the day-to-day experiences that shape psychological flexibility and well-being in these caregiving contexts.

Service providers are encouraged to develop tailored support services for biological parents of children with disabilities, addressing their lower levels of psychological flexibility, well-being, and social support. Policymakers should allocate funding to services that have demonstrated benefits in these areas. Emphasizing service satisfaction is important for service providers, as it serves as a reliable indicator of a service’s potential to enhance psychological flexibility. Additionally, there should be a focus on family-centered interventions for biological parents of children with disabilities, given the reported low levels of familial social support. These interventions have the potential to significantly enhance family well-being and resilience [8]. Policymakers are encouraged to advocate for increased support and awareness for biological parents of children with disabilities, recognizing the unique challenges they face, which are significantly impacted by a lack of social support.

5. Conclusions

This study provides important preliminary insights into the distinct experiences of foster parents caring for children with disabilities compared to biological parents. Given the small sample size, findings should be interpreted cautiously and require replication with larger samples. The findings reveal that foster parents of children with disabilities demonstrate significantly higher levels of psychological flexibility, well-being, and social support than their biological counterparts. Notably, while social support and service satisfaction strongly predict psychological flexibility and well-being among biological parents of children with disabilities, these relationships are absent among foster parents, suggesting different adaptive mechanisms and support needs between these populations. The results highlight that biological parents of children with disabilities face unique challenges that may stem from the involuntary nature of their caregiving role, potentially compounded by stigmatization and grief processes. These findings underscore the need for targeted interventions and enhanced social support systems specifically designed for biological parents of children with disabilities. For practice and policy, the study emphasizes the importance of service satisfaction as a key indicator of intervention effectiveness and calls for family-centered approaches to support biological parents. Future research should explore the specific mechanisms underlying foster parents’ resilience and investigate how services can be optimized to better support both populations in their caregiving roles.