Exploring foster carers' experiences with children who have complex attachment problems

The aim of this research was to understand the key elements of effective therapeutic foster care for children who have complex attachment problems in order to enhance training and support mechanisms for foster carers. The host for the research project was a national independent fostering agency to whom the researcher has provided training and therapeutic support. An interview study of fourteen sets of foster carers was conducted to understand peak experiences and effective practice in fostering. Thematic analysis of interview data yielded thirty-six robust child behaviour codes that were combined into five themes: i) Developmental growth, ii) increased ability to manage emotions, iii) emergence of new positive behaviours, iv) developing confidence and v) the child showing that they are happy and safe. These themes were then mapped to nine carer behaviours including consistency and repetition, showing the child they are valued and important, caring for the child as an individual, showing kindness, inclusion in the family, maintaining hope and modelling good enough parenting. These findings suggest it is important to provide early focused training for foster carers that provides a trauma-informed guide to therapeutic fostering. Given the demands of effective fostering evident in the accounts of carers it became evident that training should be followed by regular and ongoing Practice Development and Therapeutic Support (PDTS) sessions involving carers, supervising social worker and therapeutic lead. The importance of effective foster carer behaviours and practice development and therapeutic support groups was illustrated through a single case study. Overall, the research findings accord with the literature that suggests that children exposed to chronic neglect in the early years require high levels of consistent, predictable, patterned, and highly repetitive interactions to address the harm caused. This suggests that therapeutic foster care requires relevant high quality training and regular ongoing support; and, that this type of training and service may allow for easier recruitment and retention of foster carers for these children. This document closes with a complete training and support package developed through this research that fulfills these criteria and that was enhanced through the findings of the present research.