Clearly, there are circumstances requiring out-of family placement for children. Foster care in the U. S. and orphanages in numerous countries remain available or the only alternative for care of some children at-risk. The mental status of children while in alternative care has received little research attention while much research has focused on the post-care, long-term negative consequences of such care, including developmental delays or impairment (Norman & Park, 2009; Pearce & Pearce, 2001). Research suggests a significant negative psychological impact for children raised in orphanages. While foster care has been viewed as an improvement in the care of vulnerable children, research also indicates long-term psychological problems for children raised in foster care. Neither foster nor orphanage care provide the conditions for adequate social and emotional adjustment of children later in life. Renewed attention must focus on improving the care of vulnerable children.