Looked after children represent a vulnerable group in society, many of whom are exposed to maltreatment, particularly in the form of relational trauma, prior to placement with a foster family. Challenging behaviours can place foster placements at risk and looked after children often confront the possibility of placement breakdown. A carer's capacity to retain a robust understanding of the children in their care as autonomous individuals with needs, feelings and thoughts may reveal to be important in enabling them to respond more effectively to the worrying or disruptive behaviour they might experience. The Reflective Fostering Programme (RFP) is a new group-based programme aiming to support foster carers of children aged 4-11.This innovative development follows calls by NICE and other organisations to help improve outcomes for children in care, by improving resources to their carers. The RFP is rooted in evidence drawn from the field of contemporary attachment and mentalizing research, which indicates that children who have a carer high in reflective functioning tend to have more favourable outcomes in terms of social-emotional wellbeing. It also draws on the evidence that looking after a child who has impaired capacity to mentalize as a result of early relational trauma has an impact on the carer's capacity to mentalize and respond sensitively to the child (Ensink et al., 2015). This paper sets out the rationale for the RFP, outlines its key elements, and concludes by outlining future service implementation and a planned feasibility study examining this approach.
Key wordsMentalization, reflective fostering, foster carers, looked after children, interventions
IntroductionThe number of looked after children in England and Wales has been growing steadily in the last few years. In March 2016 there were 70,440 children in care, up by 5% compared to 2012 2 (Department for Education [DfE], 2016). Additionally, there has been a move away from residential and toward fostering placements, with three-quarters of looked after children placed with foster carers (DfE, 2016). This is in recognition of the fact that children develop best in the context of stable, predictable relationships, with present and available caregivers, and that foster care is in many ways the most important 'intervention' that can be offered to a child who is not able to live with their birth family (National Institute for Health and Care Excellence [NICE], 2013).Despite the clear advantages of foster care, children in such placements can place great demand on carers, who aren't always provided with sufficient training and ongoing support to cope with the various demands of the role (Bunday et al., 2015; Gurney-Smith et al., 2017;Schofield et al., 2000;Sinclair et al., 2000). More than 45% of looked after children have a diagnosable mental health disorder-five times the prevalence of mental health disorder among children in the general population (NICE, 2013). Experiences of neglect and trauma are common within this group of children, but...
