Retaining foster carers during challenging times: the benefits of embedding reflective practice into the foster care role

Abstract

Retaining high quality foster carers and helping them to manage the intense emotional impact of caring for young traumatised children is still a major challenge. While foster carer training helps in the short term, international findings suggest that training and support structures alone may not sustain foster carers when times get tough. This article considers the benefits of embedding reflective practice into the role of foster carers. It draws on a qualitative study of five foster carers and two birth mothers receiving specialist help whose children have experienced severe trauma, early neglect and/or abuse and who attend a residential special school for primary-aged children where staff reflective practice is at the core of its work. The carers of all new pupils during a 12-month period were interviewed at the start of placement and one year later and the emerging themes were identified. All of the foster carers reported that after the first year children were less violent and aggressive and more able to verbalise their feelings. Some also began to change their perception of their child’s difficulties. The birth parents also reported improvements but the focus of their concerns and details of the benefits were different. The article argues that in addition to training, all carers who look after severely traumatised children would benefit from regular opportunities to genuinely reflect on the impact that their caring role has on them and that their children’s development will be enhanced by the reduction in challenging behaviour and the risk of placement disruption. However, within the reflective process, different groups of carers will have their own particular concerns.

Effects of Mentalization-based Interventions on Mental Health of Youths in Foster Care

“…The young person's rejection and mistrust may impair the parent's mentalizing capability, leading to vicious circles in which the parent, in turn, misrepresents the child's mental states leading to further relational problems (Ensink et al, 2016;Onions, 2018;Redfern et al, 2018). In addition, if the foster parent's capacity to reflect on the young person's mental states is impaired, the parent may not notice changes in mental health of the young person, being preoccupied by regulating their own troubled affects.…”

“…Parental caregiving is linked to mentalizing; i. e. the parents' ability to reflect on their own mental states and their child's mental states (Ensink, Normandia, Plamondon, Berthelot, & Fonagy, 2016;Feeney & Woodhouse, 2016). Mentalizing, operationalized as reflective functioning, is one important component of the caregiving system (Ensink et al, 2016;Feeney & Woodhouse, 2016;Onions, 2018). Improvements in reflective functioning has been linked to improvements in caregiving quality (Suchman, DeCoste, Leigh, & Borelli, 2010).…”

“…Improvements in reflective functioning has been linked to improvements in caregiving quality (Suchman, DeCoste, Leigh, & Borelli, 2010). To support and develop parental mentalizing is thus important for retaining high-quality foster parenting as well as helping foster parents to manage the intense emotional impact of caring for traumatized children (Midgley et al, 2017;Onions, 2018;Redfern et al, 2018). Clinical experience suggests that even foster parents with relatively stable mentalizing ability can find that their capacity to reflect is impaired in their caregiving interaction with a disorganized foster child.…”

Carer perceptions of a specialist mental health service for children and young people in care

“…As a result, carers often experience higher anxiety, depression and stress than the general population (Farmer, 2005). Research has shown that to retain high-quality carers, support structures need to be implemented to assist carers with the emotional impact of caring for a child with challenging behaviours (Onions, 2018).…”

The child psychotherapists’ role in consultation work with the professional network around looked after children

“…In terms of child psychotherapists' consultancy work with foster carers, Ironside (2004Ironside ( , 2009Ironside ( , 2012 adapted the psychoanalytic infant observation method for use with foster carer groups, finding that it helped carers to recognise and separate their own feelings from instances when children were projecting emotions into them, and how to respond to their behaviour. More recently, Onions (2018) has written about the embedding of a reflective practice culture with foster carers at the residential Mulberry Bush School, finding that after 12 months' support the carers reported feeling less overwhelmed and that their child was easier to parent.…”