Queensland couple Stephen and Joanne Grosser have fostered three children over the past three years.
Warning: This story contains references to suicide
They are part of a foster program that hails from the US state of Oregon, designed to remove vulnerable children from government-run residential care, treated for their trauma and returned to their family.
"A lot of the kids have either physical, emotional or sexual abuse in their past so when they come into the program, it can be quite challenging," Mr Grosser said.
But when they see positive changes to their social skills or schooling, it was worth the challenge.
"The little boy we have at the moment, when we got him, he was attending school two hours a day — that was all he could cope with," Mrs Grosser said.
"After a few months in the program, that increased to half days and the occasional suspension.
"This year, the behaviour at school has improved so much. He's doing full days and not one suspension."
Children are placed in the program for up to nine months, and carers are supported by around-the-clock access to therapists, skills coaches, experts and teachers to help tackle their complex needs.
Carers are paid up to $75,000 per year tax-free, as they cannot hold another job.
Mr Grosser said the program was a "game-changer" and he could see the children becoming more confident over time and start to "hold their head up high".
"What we're doing is just providing them with a loving, caring environment to help foster that, to help grow that, and coach them and to see how they've matured over nine-to-12 months is incredible," he said.
On the east coast, 54 children have graduated from the OzChild-run Treatment Foster Care Oregon (TFCO) program.
Treatment program being trialled in SA
It is now being trialled in South Australia. So far, two teenagers have put up their hand, with more going through the assessment process.
"They're probably the toughest of kids, but to come into the program voluntarily means they really want to make a positive change," OzChild chief executive Dr Lisa Griffiths said.
The child protection system in South Australia is currently under the microscope after the suspected neglect deaths of seven-year-old Makai and six-year-old Charlie in February and July respectively.
Those deaths are being investigated by police, but the state government is also awaiting a crucial report into the foster and kinship care sector, which is expected later this month.
Commissioner for Aboriginal Children and Young People, April Lawrie, is also conducting her own Royal Commission-style inquiry into the removal and placement of Indigenous children in South Australia.
The number of children in state care has jumped by almost 28 per cent over the past five years, with 4,724 children currently in the system.
More than 85 per cent of those children are living with a family member, close friend or a foster family.
But there are still 693 children living in government-run group homes.
Dr Griffiths said the decline in foster carers across South Australia and the rest of the nation was concerning.
"We're not seeing a huge influx of new carers anywhere in Australia – there's nearly 50,000 children in out-of-home care around the nation," she said.
She said foster placements were "continuing to shrink" and one of the main reasons was a failure by governments to adequately compensate families to cover the cost of the child.
"There's a recent study just completed in Victoria, and the report outlined the value of foster care at $847 million worth of voluntary hours," she said.
"If they didn't have that system in place then the government would have to pick up the tab, so we need to pay attention and we need to invest in re-imagining foster care."
In South Australia, a foster carer is given an allowance of up to $33 a day for a primary-school-aged child and up to $56 a day for a teenager to cover the cost of their food, clothing, travel, sport and medical appointments.
Allowances go up for a child with special needs.
But according to the latest Productivity Commission report, it costs $302 per night – or more than $110,000 per year – to house a child in government-run group homes across South Australia.
Advocates call for better allowances
The lack of financial support was highlighted during the 2021 inquest into the death of Zhane Chilcott in Adelaide.
The 13-year-old took his own life after returning to residential care because his foster father asked for a bigger allowance so he could continue to support Zhane – but DCP declined the request.
State Coroner David Whittle is yet to release his report into the death.
Connecting Foster and Kinship Care SA chief executive Fiona Endacott said the child protection sector was facing "the greatest challenge it's ever had".
She said barriers facing the system included poor allowances, support and training.
"The reimbursements do not cover the majority of what it takes to care for children and young people," she said.
"They chose to care because they want to give back so they're not going to say no to pay for something if it is going to benefit the child's development or therapeutic needs.
"Carers are a bit over a barrel."
The state government increased foster carer allowances late last year, but Ms Endacott said it "certainly didn't meet the need of what the day-to-day costs of caring for a child are".
She said the cost of living was rising, and allowances needed to reflect that.
Anglicare SA is currently managing 390 children across 346 foster care families.
Community services general manager Nancy Penna said the number of foster carers had declined because some older carers had retired, and others had left the system after their foster child turned 18.
"With more children entering care, we always need more foster carers," she said.
DCP deputy chief executive Fiona Ward said another challenge was finding a placement for multiple children who cannot be separated with 100 groups of siblings currently in government group homes.
"There is a strong need for carers who are able to provide a home for sibling groups, or a group of carers who live in close proximity who could ensure siblings remain connected," she said.
