A happier transition

Child psychotherapist Sophie Boswell talks to David Eggboro about research she and her colleagues carried out which highlights a serious problem with the way some children are moved on from foster care

A child who is quiet and compliant during a big change in their life may be not actually be fine – they may be hiding deep feelings of pain and loss which too often go unrecognised.

This phenomenon provided the foundation for a recent piece of research by child psychotherapists, Sophie Boswell and Lynne Cudmore, which examines what happens to some children when they are moved from foster care into adoptive families.

‘One group of children who caused concern were those who were settled and attached in foster care placements but approved for adoption,’ Sophie says. ‘There was anxiety about how painful this loss might be for the children, and how best to help them and their carers manage it.’

One of their first such cases was Kyle (not his real name): Kyle was placed with his carer, Liz, at a few weeks old. A deep bond grew between them, and he clearly felt safe and loved. When he was three, adoptive parents were found for him. However, amid the excitement, both Kyle’s social worker and Liz expressed great anxiety about how he would cope with the separation.

Despite these worries it was decided that Kyle would move just 10 days after meeting his new parents and, to avoid confusing Kyle or undermining the adoptive placement, he would then have no contact with Liz for three months.

Throughout his last night with Liz, Kyle slept with his arms clasped around her neck. However, when the time came to say goodbye, he was surprisingly quiet and compliant. His new parents were left to make the decision about whether he would ever see Liz again.

‘Situations like this gave us serious misgivings about the way children were being routinely faced with such abrupt losses,’ Sophie says. ‘We felt it would leave them bewildered, distressed and fearful of future losses.’

Avoiding the blind spots

This prompted Sophie and Lynne’s research, carried out with two social work colleagues. ‘The Children Were Fine’: Acknowledging Complex Feelings in the Move from Foster Care into Adoption was first published in BAAF’s Adoption & Fostering journal in March 2014.

The research found that adults involved in the adoption process, despite their best intentions, were unable to identify the children’s distress because the children usually withdrew into a compliant state which adults took as evidence that they were fine. Sophie explains: ‘This “blind spot” is particularly prevalent where the adults themselves are dealing with huge amounts of stress.’

Their recommendation is for current policies to be brought in line with attachment theory. Wherever possible, the relationship between child and carer should be maintained and supported throughout the transition, and at least until the child has begun to settle and feel safe within their new family. They believe that more thoughtful transitions will be less traumatic for children and provide a better foundation for new relationships.

In Kyle’s case the adopters did arrange contact with Liz and went on to build up a positive relationship with her which continues today.

Keep Connected is The Fostering Network’s campaign about the importance of maintaining relationships between looked after children and their former foster carers. We are calling on the UK’s governments to develop guidance and regulations to help fostering services support this bond when children move to another home.

Click here to download a PDF of this article.

We are delighted to tell you that CoramBAAF has announced a major conference this October devoted to understanding and improving practice when children are moved into adoption.

The conference, entitled 'Ensuring good transitions into adoption – preparing and supporting children, their foster carers and prospective adopters' will take place in London on 20 October 2016.

​We will be presenting our research, together with expert speakers focusing on various areas of practice, including preparing and supporting children, foster carers and prospective adopters during the transition to placement, and looking at best practice in managing introductions. 

There will be an emphasis on sharing views and experiences across the field, with afternoon workshops covering preparing children for the move, making good introductions, supporting foster carers and their families and preparing adopters for transitions. 

Please click here for more details.

We believe this is a very positive development, and a chance to generate much-needed discussion about how we can bring about change in this long neglected area of policy. We hope to see you there!

Sophie Boswell and Lynne Cudmore explain how social workers can help adopted children maintain attachments

In the flurry of excitement before a child is moved to be adopted, the fact they are losing a parent figure seems to get overlooked.

​Our research showed that during this time levels of anxiety within the adopters and foster carers are extremely high. Despite the best intentions of professionals and others involved it is difficult for to keep in mind some fundamental facts about attachment and loss in young children. Such as:

• Losing a parent figure in childhood is always traumatic, particularly in the first four years of life.
• Children experiencing such a loss are likely to experience acute feelings of confusion, mistrust, fear and abandonment.
• How gradual or how abrupt the separation is and how much emotional support is given to the child at this time are crucial in deciding how traumatic this loss will be.
• As long as it is handled sensitively, the ongoing presence of an existing attachment figure can reassure children and reduce the trauma of sudden loss.
• Children can react to loss by becoming outwardly compliant and cut off from their feelings; this should not be taken as evidence that they are ‘fine’.
• Broken attachments can lead to low self-esteem and insecurity. Maintaining contact with carers can give children a powerful message of love and acceptance.

What can social workers do to prevent this from happening?

Many people are involved in decision-making during these moves, but there is no one person with overall responsibility for ensuring these principles are kept in mind. Social workers have a crucial role in providing clear guidance and support to foster carers and adopters so that the children’s emotional needs remain central during every stage of an adoptive move.

• The child’s relationship with their foster carer is important, and the loss of this relationship should be made as gradual as possible to avoid unnecessary trauma.

Social workers can help by providing a clear and consistent message that this is an important relationship and one that should not be abruptly broken. Transitions can be much more gradual, with clear plans for regular ongoing contact with former carers not just planned but actively supported.

Regular and frequent visits from former carers, probably quite short at first, should be taken as the norm. These should become less intensive over the following months as children settle and become attached to their new parents.

If adopters or foster carers become anxious about potential upset during or after a contact, social workers can gently remind them that it is better to support children with their feelings, rather than give a message that distress is better avoided or denied.

Where actual contact is not possible other ways can be found for ensuring the foster carer remains an ongoing presence in the children’s lives. In an ideal scenario the carers will gradually assume an ‘auntie’ or grandparent–like role.

• The relationship between foster carers and adopters should be understood as a long-term commitment to be supported and sustained over time.

A good relationship between carers and adopters is crucial in determining how thoughtful the transition will be, and whether or not ongoing contact is carried out in a mutually supportive way.

Sensitive ongoing support and guidance from a social worker can ensure foster carers and adopters take on the task of providing as much continuity and joined-up thinking as possible over the transition and beyond.

This will give the child the message that both old and new attachments are important and have a place in their life. It will also mitigate against the pain of torn loyalties or having to shut down memories of people they have loved.

• Foster carers and their families need support so they do not devalue or minimise their importance to the child.

We believe that the system inadvertently gives out the message that foster carers’ relationship with a child is no longer important after the move. Carers who question or show distress about this are too often seen as obstructive or unprofessional.

Foster carers should be encouraged to remain in children’s lives, albeit in the background. Social workers will have a crucial part to play in supporting foster carers who may find this upsetting, and in reminding all parties that this can help new attachments being formed with adoptive parents.

• Adopters need help in understanding the emotions of the child they have adopted, including if a child appears to be unaffected.

Adoptive parents often feel in the dark about the emotional impact the move has had on their child. At the same time they are being asked to make major decisions about contact and other issues.

Although they are trained in attachment and loss prior to placement, we suggest that social workers also provide adopters with extra help in understanding their children’s emotional needs post-placement. This should include recognition of the ‘compliant’ child who may appear to be fine but may have cut themselves off from their feelings, as described above.
​

• Social work professionals and managers involved should be trained to recognise and respond to a young child who appears to be ‘fine’ after a major loss.

Most people agree that a child who appears cut off or ‘fine’ after a major loss is usually more worrying than one who is able to communicate their distress. However, this quickly gets lost when adults are anxious or upset themselves and seek reassurance that a child is not unduly distressed.

Social workers can play a crucial role in holding this in mind and helping others to do so, resisting the temptation to be relieved rather than worried when a child in this situation appears to be ‘fine’.  A child who is not showing their feelings will need the support of sensitive, emotionally available adults who can be aware of, and hold on to, feelings that the child may be finding frightening or overwhelming.

Sophie Boswell and Lynne Cudmore are child psychotherapists and author of the report: ‘The children were fine': acknowledging complex feelings in the move from foster care into adoption.

​Source: Community Care

Dear Sophie and Lynn,

Thank you for moving forward the debate about this important issue. Most of my research has focused on adopted children’s contact with their birth relatives. However in my study of children placed into adoption under the age of four, it was apparent that for most children placed in this age range, their significant attachment relationships were with foster carers.

Adoptive parents gave very moving accounts of the intensely emotional nature of the child’s transition from the foster carers to their family, with feelings running high for all concerned, but especially for the children who in some cases experienced a profound sense of loss.

How children coped with this move seem to depend on their age and experience, but also crucially on how well both the foster carers and the adoptive parents could manage their own feelings and work together to reassure the child.

I know from my contacts with professionals in the field that there is a lot of uncertainty about exactly how to manage transitions, and about the advisability or otherwise of children’s contact with foster carers, and I agree with you that it’s time to reflect on and revise practice in this field.

Myself and my colleagues at UEA Prof Gillian Schofield and Dr Mary Beek have been working with John Simmonds from Coram BAAF and Prof Danya Glaser from Great Ormond Street Hospital to develop plans for a project in this area. We are planning to review all the relevant literature; consult with foster carers, adoptive parents, and practitioners already pioneering in this field; and develop and pilot some resources and frameworks that can be used to support practice around children’s transitions.

We would love to hear from any practitioners who have already started work on shaping and changing practice around foster to adoption transitions in their agencies, for example through developing training for foster carers and adopters, practice or assessment frameworks to help plan children’s moves, or who have developed ways of supporting children or adults with their feelings.

We would like to draw on people’s experience and expertise through sharing ideas about these initiatives, and we hope to recruit practitioners to join our stakeholder consultation group. I can be contacted at e.neil@uea.ac.uk and will be very pleased to hear from anyone interested in contributing to this project.

Beth Neil, Professor of Social Work at the University of East Anglia

I've just read your excellent research and the new report by The Fostering Network on continued contact. I will definitely be passing this on to foster carers and social workers. I've recently set-up a project in the local authority where I work looking at how we manage transitions in a more child-focused way so the reports will be very useful as part of this. The group will include social workers, foster carers, adopters and looked after young people/care leavers. 

I've worked as a social worker in fostering for many years (in addition to independent work) and written two therapeutic stories for children for CoramBAAF. I'm always interested in new research and child-centred practice. Good to discover your website.

Thank you

Jill

Ongoing contact between foster carers and their former foster children is not being supported, despite most kids wanting it.

A report by The Fostering Network found that 81% of 179 children in foster care felt maintaining relationships was important, yet 55% said their social workers did not support contact “at all”.

​More than 1,100 foster carers were also surveyed, and almost a third said their fostering service had not supported contact.

​Click here for the full report.

​I am a foster carer of 23 years and have facilitated 13 adoptions, I was so happy to receive 'the children were fine' from my Adoption Manager because at last I felt someone was looking out for the best interests of the children, and not for the best interests of the adopters. I do so hope the momentum carries on.

I have experienced some good transitions, but also some very distressing ones.