The Full Paper
'The children were fine': acknowledging complex feelings in the move from foster care into adoption
Published in Adoption and Fostering, 2014
When children move from foster care into adoption the transition tends to take place within a tight timeframe, usually between seven and fourteen days, with no contact between the child and the foster carer for several months after the move, if at all. Very little attention or research has been aimed at understanding the rationale for these procedures. Together with social work colleagues in a Looked After Children’s team, two child psychotherapists carried out a small piece of qualitative research, interviewing foster carers, adopters and social workers to analyse in detail five children’s moves into adoption.
We found that the emotional experience of the child, particularly their experience of losing their foster carer, loses its prominence in people’s minds during this transition. It is a highly anxious time for the adults, and in the grip of these anxieties they can lose sight of what is happening emotionally for the child. The children’s outward compliance with the move and lack of obvious emotion at losing their carers can be interpreted as signs that they are ‘fine’. These research findings are explored in the light of our understanding of attachment and loss in childhood, and of individual and organisational defences against pain and loss. Implications for future practice are discussed.
Key words: adoption, transition, foster carer, attachment, loss, organisational defence, contact, anxiety, grieving
Adoption involves huge long-term gains for children, but leaving the care of their previous home will also involve a major loss for them. For many children, especially those under three years old, their previous home will have been with a foster carer, often for a considerable length of time. For those who have spent time with their birth parents, these relationships will usually have been troubled and often characterised by neglect or abuse. So it is the foster carer and her family who will have provided them with the first period of consistent and safe parenting they have known. In spite of this, the significance of the foster carer relationship for the child’s emotional development is often forgotten when the focus falls on the other two parties in the adoption ‘triangle’, the birth parents and the adopters (Sorosky et al, 2008; Howe, 2000). This paper explores the missing relationship in the adoption triangle and why, despite everyone’s best efforts, it can so easily get overlooked.
From the child’s point of view it is vital that they feel safe enough to settle into their new family and start the process of forming a trusting and secure relationship with their new parents. The optimal conditions to enable this will include the presence of adults who recognise that a key attachment figure has been lost, and who are able to support the child emotionally by remaining attuned to the loss. However, with the intensity of feelings stirred up – in the foster carers, the adopters and the social workers - this can be exceptionally hard to do. It is a complex emotional task to hold in mind the loss of a meaningful relationship while nurturing a new one.
As child psychotherapists in a Child and Adolescent Mental Health Service (CAMHS) embedded in a Looked After Children’s team in children’s services, we became aware of how little guidance there was for understanding this key transition in a child’s life. Our social work colleagues also seemed unclear about the reasons why moves were carried out so quickly and there was confusion about when and indeed whether it was helpful for the child to see the foster carer again. Our own experience of being part of the multidisciplinary team around the child during this transition gave us first-hand experience of what an emotionally charged time it was for all the adults involved, and how difficult it was to think clearly and flexibly in the midst of this anxiety. We had seen how difficult it became to raise the issue of loss without being seen as ‘spoiling’ the positive feelings about the adoption.
Holding in mind the array of emotional experiences for the child was often made more complex as children were usually not able to show their feelings in obvious ways. Some of them were preverbal, while others did not have the vocabulary or capacity to put their feelings into words. Indeed, at whatever age, many gave no clear outward signs of being affected by the move from one carer to another.
Guidance for current practice
A preliminary literature search identified an absence of research into this area. Although a huge amount of research has been done exploring the impact of contact between adopted children and their birth families (including Quinton et al, 1997; Fratter, J, 1996; Neil, 2009), we could find almost nothing on contact with foster carers after adoption. Recent research on children in the care system has highlighted the benefits of remaining in contact with past carers, but there is almost nothing looking at ongoing contact with foster carers after adoption. Ian Sinclair included post-adoption contact with foster carers in his research into children in the care system, but inconclusive evidence and many complex variables led him to describe evidence on the benefits of such contact as ‘unsuitable to form the basis for change in policy’ (Sinclair, 2005).
In practice guidelines it has been argued that children who are vulnerable may need a longer transition time and that early contact with foster carers should be encouraged (for example Burnell, 1994, Fahlberg, 1994); but more often experts tend to cite how emotive these issues are for the adults involved, and the overriding consensus seems to be that given the complexities involved it is better to leave it to individuals to decide on a case-by-case basis (Byrne, 2000; Romaine, 2007; Sellick et al, 2004).
In order to gauge current practices in the field we carried out an audit of our own agency and a survey of adoption agencies across the UK. We asked about their current policies regarding speed of move and contact with carers post adoption and what they understood to be the rationale behind them. The responses we received from ten agencies showed that children are usually moved within seven to fourteen days of meeting their new parents and once moved will generally not see their foster carer again for at least three months, often longer, and that some will not have any contact. Younger children and babies tend to be moved more quickly. The overriding message from practitioners was that they were aware of very little guidance or research in this area.
Responses showed contradictory reasoning about contact; while some agencies felt that older children with a deeper attachment to their foster carer needed slightly earlier contact, others cited a strong attachment to the foster carer as a reason to avoid contact after the move for fear of distressing the child. Many of those we spoke to volunteered that they would welcome some research in this area to help guide their practice.
Our research project
We set up a small research project to explore what factors might be driving current procedures around speed of move and contact with foster carers after adoption. The research team comprised the authors, two child psychotherapists, and three social workers based in the family finding team. This gave us the perspectives of two disciplines and the experience gleaned from involvement in many adoptive moves. Although our sample size was inevitably small given our limited resources, our hope was to set in motion further research and discussion on this topic so that clearer and more considered guidelines could be developed in the future. The social workers on the team left the department before the writing-up stage, but their contribution to the research was invaluable.
We chose to use Interpersonal Interpretational Analysis (IPA) as it aims ‘to understand lived experience and how participants themselves make sense of their experiences’ (Smith, 2009). We were not seeking to identify the emotional experience of each child during their move, but to understand what informed the adults’ decision-making process. IPA, with its use of interviews and close analysis, allowed us to explore in depth the ways in which the key players experienced this very complex period of time and how their own responses and feelings affected the decisions they made on behalf of the children.
Choice of cases
We chose four cases from our own agency where the adoption order had been finalised at least one year but not more than two years prior to the interview. We wanted to look at cases where the new families were relatively settled so there would be space to think back over the transition period while the move was still relatively fresh in people’s minds. We also had to limit ourselves to cases where the social workers were available to be interviewed, as in several cases key social workers had already left the department.
As it happened, four of the five children in our cohort were between nine and fourteen months old when they moved, and one was just over two years old. Two of them were part of a sibling group. All of the adoptions were felt to have been relatively smooth. We had not intended to restrict ourselves to younger children or to smooth transitions and. I initially this seemed to impose another limitation in our research. However, we became aware that one question posed by our research was how adults sought to understand children’s reactions to the transition, particularly children who were preverbal or less able to show their feelings. It also emerged that babies and young children tend to be described as less ‘problematic’ and therefore less attention is given to their emotional state. We were interested in understanding this, and asking whether a young child or baby who did not cry or show major signs of upset was taken to be child who was not suffering; more generally, we wanted to understand whether a ‘smooth’ transition was seen as the most desirable kind.
As one might expect some of the children in the group had difficult backgrounds prior to adoption and they were a vulnerable group. Two had been with their carers from birth. One of these had been relinquished and placed with her carer from birth. The other was born with suspected foetal alcohol syndrome and experienced many feeding and health problems in infancy. Another child had lived with her parents for a few weeks but was then placed with a foster carer after experiencing neglect. In the sibling group one child had lived with her parents for nine months before being removed in traumatic circumstances and had lived with her foster carer for nine months. The second sibling had been removed at birth and placed with a foster carer for several months before being moved again to join his sister a month prior to adoption, thus experiencing two changes of carer within his first year of life.
We carried out semi-structured interviews with foster carers, adopters and two members of the social work team around each case - either the child’s social worker, the foster carer’s support worker and/or the social worker who supported the adoptive parents. Ideally we would have interviewed social work managers and independent reviewing officers but unfortunately time did not allow this.  With foster carers and adopters we invited both members of the couple, where relevant, and although the foster carers’ partners chose not to take part, all of the adoptive partners did participate. Three of the foster carers were highly experienced and had moved many babies into adoption, one was moving a baby for the first time. Three of the adopters were first-time adopters, one couple had already adopted. Wherever possible each interview was carried out by a child psychotherapist and a social worker together. Interview questions were kept brief and were designed to encourage participants to tell their story of this transition. Follow-up questions were used sparingly so that we could follow the interviewees’ train of thought. The questions centred on their initial thoughts and feelings about the speed of the move and contact with foster carers. We then asked them to describe what actually happened.
Once the data had been transposed verbatim we carried out our analysis under the consultation of an experienced IPA researcher. It soon became clear that the volume of data we had generated was far too large for the resources we had. So eventually, having looked closely at our material, we decided that for the first stage of this research we would analyse the interviews with the foster carers and adopters, and leave the social workers’ interviews for a later date. We did this reluctantly, but on reading through the social workers’ interviews had been struck by how much these case workers deferred to the needs and wishes of the foster carers and the adopters, and how much of the decision making and the drama actually took place between these two groups. We noted the comments the social workers made and where relevant have referred to them in our commentary.
As we analysed our data it became clear that people’s thoughts and feelings about the child’s relationship with their foster carer changed over different phases of the transition. We have therefore organised our findings chronologically, tracing the thread of where the child’s relationship to the carer was located in people’s minds before, during and after the move.
Early days: ‘It was like I’d given birth to her’
We looked first at the period before the formal ‘introductions meeting’ (where the concrete plans are made for the move). During this stage all of the adults were mindful of the emotional significance of the relationship between the child and the carer. Foster carers spoke with great warmth about the child within their family: the language was full of words such as ‘love’, ‘adored’, ‘part of the family’, ‘belonged’, ‘like my own baby’.
‘I don’t think they realise you’ve had her from a baby, and you end up loving them...You raise them like yours, you care for them like your own kids’ [foster carer]
‘It was like I’d given birth to her’ [foster carer]
‘I don’t think it’s a bad thing but we do get attached to every child who’s here. If we don’t get attached they don’t get attached, I’m not doing what I should be doing’ [foster carer]
Most foster carers were not only very in tune with how much they mattered to the child, but also acutely aware of these children’s troubled backgrounds, how vulnerable this made them, and how fragile they were when it came to separations:
‘Even short separations matter for babies, their emotions would be all over the place and for me to go off … I just couldn’t do it’ [foster carer]
The adopters too spoke warmly about how aware they were of the importance of this early period in the children’s lives, and of the bond between child and carer. Many of them expressed gratitude for the way in which the child had been cared for and loved.
‘They adored her, they really did. We could see that she was part of a very lovely family.’ [adoptive parent]
The strength of the bond between child and foster carer was generally agreed to be very important for the child developmentally. One adoptive parent expressed a worry that her child may not have been passionately attached to her foster carer, and wondered whether this might have an impact on the child’s capacity to attach later in life. Another couple expressed concern about having been told that their adopted child had shown no overt distress when he had to change foster carer at a few months old. The importance of the quality of these early attachments was very much in the adopters’ minds, and particularly so as some of these children had a history of instability with their birth parents. There was also a depth of emotion attributed to these children so that they came across as having their feelings understood and responded to by carers and prospective adopters alike.
Planning stage: ‘Not my baby’
However, from the formal planning meeting onwards, we were struck by how the tone of all of the adults changed, so that the language of procedures and plans began to dominate. The foster carer, in her own and other people’s eyes, became less of a ‘mother’ and more of a professional with a job to do. As the focus shifted to making plans for the introductory visits, it seemed more difficult to focus on the emotional complexity of the child’s experience during this upheaval in their lives. Although a great deal of attention was given to the need for continuity of routine – food, toys, smells, bedtime arrangements, life story books - it seemed much harder for the adults to remain fully in touch with the children’s emotional state.
As they told us about the lead-up to the move, it was clear that foster carers were processing some very painful feelings and many of them were explicit about how giving in to these feelings was incompatible with retaining a professional stance. Their language became more procedural, less intimate; the child was no longer a member of their family but a prospective member of someone else’s. This meant they no longer felt they had the right to feel possessive or passionate about the child. The more experienced carers spoke about a conscious decision to ‘stand back’ emotionally from the child as a prelude to ‘letting them go’.
‘And I was moving back because, that’s it now, this is the new family for that child… I have to move back’ [foster carer]
The most common reasoning behind this ‘moving back’ was the need to support the adopters in their role as new parents. All of the foster carers revealed an acute sensitivity to the feelings of the adopters, their need to feel empowered as parents and an awareness of how threatened or undermined they could feel if the carer were to bring attention to the bond between herself and the child:
‘You have to be very careful what you say to an adopter, you don’t want to come across as if, “You have taken my child”, because this has never been my child. People say, “How can you give her?” Well she’s not mine to give away, she’s never been mine you know, I’m looking after her. So saying to an adopter, “I’m really going to miss her and I don’t know what I’ll do without her and it’ll absolutely break my heart” – that’s not helpful.’ [foster carer]
This attitude was widely shared. Social workers spoke about the need for the foster carer to remain ‘professional’ and not let her emotions spill out publicly, to protect adoptive parents from being burdened with too much knowledge of the child’s attachment and impending loss. Adopters, although highly aware of the personal pain the foster carers were experiencing, were grateful to them for keeping it to themselves. Already in a state of high anxiety, they felt they could not have coped with the foster carer bombarding them with her own feelings of loss, or with the level of attachment between herself and the child. One couple told us about a previous adoption where a foster carer had confided in them about much the child was going to miss her, and they had been deeply shocked, describing this as unprofessional and undermining. In this context it is not surprising that adopters felt grateful to the network for guiding them through the process in an efficient and practical way, avoiding a flood of emotions.
‘It’s probably very good to focus on the practicalities, and to take all the emotion out of it because the week of transitions was going to be pretty emotional all round, so it was good to have a sort of business like approach to it all, and just focus on the practicalities.’ [adoptive parent]
There were occasional murmurs of discontent about the lack of emotion during this process. One of the carers, who was moving a baby for the first time, was troubled by the way that the network appeared to disapprove of her expressing her sad feelings.
‘It doesn’t give you any time to think and re-adjust. I found it difficult. Maybe I’m just – you know, there’s love involved. That’s why sometimes I think the professionals involved, you’re just a foster carer, so …‘ [foster carer]
Even though all of the adopters appreciated the formality of the planning process, some voiced ambivalence about how little room was given for the emotions involved:
‘That [the planning meeting] was an empty sort of debate … the rest of it was processed and there was nothing else in terms of the emotional aspect that were talked about.’ [adoptive parent]
With so much preoccupation with how the adults were managing their feelings, it seemed difficult for them to fully keep in mind the child as a separate person who was also experiencing a great change in their lives. In planning contact after adoption, most of the interviewees spoke of this as being done either for the sake of the foster carers who would be missing the children, or for the sake of the adopters who might benefit from the support of the carers.
Foster carer: I think what's discussed at the meetings is oh yeah the carer is, I suppose, for want of a better word is entitled to see the child a few months after they’ve left. … You wouldn’t really want to see the child before three months, you’ve got to give the child that …
Interviewer: Is that your view, or is that what you’ve heard?
Foster carer: No, but that’s the initial offer you would get, put it that way, you would get an offer of maybe one visit after the child’s gone.
‘If you were distressed about something, you would have felt you couldn’t call them under any circumstances because the 3 months isn’t up yet. So it was nice being told you could do that’ [adoptive parent]
What seemed more absent from people’s minds at this stage was the capacity to imagine what it might mean for the child to see their carer again after the move, or what it might feel like not to see her.
Moving homes: ‘It wasn’t a big deal’
It was during the actual move that we felt adults struggled the most to remain open to what was happening for the child emotionally. All of the children were moved from their foster carers’ to their adopters’ home in a period of between seven and ten days, in line with the national average. The adults all spoke of how quickly the time went, and although this was described as quite overwhelming and exhausting, there was an almost universal agreement that it was better not to drag things out.
Descriptions of the children suggested that they simply went along with what the adults expected of them, showing surprisingly little outward sign of having an emotional reaction. The adopters and carers - and in fact social workers too – clearly felt anxious about the child becoming openly distressed, and they put much effort into minimizing the disruption for the children, maintain continuity in every way possible; and described their relief when the children did not appear to be too upset by the move. Although prior to the move they had felt the children were deeply attached to their carers, at this stage for a child to appear unaffected emotionally by the separation was experienced as a great relief. Although all of the adults were still acutely aware of how much emotion was in play for the adults, this seemed to be in sharp contrast to the description of the children’s apparent state of mind, which appeared strikingly bland:
Foster carer: From the child’s point of view it wasn’t a big deal. She was quite relaxed and happy. She had only had one carer, me, and she was moving to another.
Interviewer: You mean, you could tell she was managing it at the time?
Foster carer: The attachment was just going to be transferred straight over and it did go straight over.
Foster carers and social workers often cited this idea that a child who has had a stable attachment to one carer will be able to attach more quickly to a new one, and appeared to derive some comfort from this.
Adopters, perhaps taking their cue from the foster carers, also tended to be relieved to find that the child appeared to be basically all right, while all too aware of the loss and separation experienced by the foster carer and her family:
Adoptive mother: I don’t know, the real challenge for them was always to remember that she is going to be leaving them one day. And throughout the transition week you could see the emotion.
Adoptive father: They were finding it really really difficult. …
Adoptive mother: I think you know she [foster carer] could steel herself but he [carer’s husband] was just totally besotted with the baby and I think he found it incredibly difficult. …I think it was incredibly difficult.
The moment of separation was described by adopters and foster carers as emotionally intense, and even the more experienced foster carers could not completely hide their feelings. In contrast the children were almost always described as ‘fine’. In the following excerpt, the foster carer spoke about the moment of saying goodbye for the last time, and the tears that were shed. It took the interviewer a while to understand that the tears were all being shed by the adults, not the two children.
Foster carer: There was a bit of tears too.
Interviewer: From you and them?
Foster carer: And them, yes.
Interviewer: Both of them?
Foster carer: No, not from the children, because they were used to that period, going and coming back.’
Interviewer: Oh. All the adults?
Foster carer: The adults. [laughs] They said, “Oh we’re taking the children from you”, and saying “We’re Mum and Dad now, we’ll look after them for the rest of their lives.”
Interviewer: Very emotional. But do you think the children were just, “We’re off ‘bye bye!”?
Foster carer: The children said, “Bye mummy, Bye, bye! … I can see the car going.’ [cries]
The language used to describe the children here was much less rich or emotionally complex than it had been when describing their life and their feelings prior to the transition; in fact, they came across as emotionally thin and lacking deep feelings. Again, the word most often used to describe them during the transition was ‘fine’.
‘She was fine, and she quite enjoyed her new high chair and stuff, so you know she was. Yeah it worked brilliantly, we just felt so incredibly fortunate because it just went so smoothly’ [adoptive parent]
We found that quite often we needed to ask follow-up questions to guide interviewees back to the child’s emotional state, as this quite often got lost.
Interviewer: Can we go back a little bit, how was [the child] during that week?
Adoptive mother: He was fine – he was never clingy, he never started screaming Mummy or asking for [his carer] when he was there.’
When there were flickers of being in touch with something happening at a deeper level for the child during the separation, this came across as very painful for foster carers, who tended to shy away from lingering on this, and comforted themselves with the fact that the move went ‘smoothly’ or the child didn’t ‘cling’. This appeared to feel like both a huge relief and also a sign that they had done their job properly.
Foster carer: The day he left we stood there and he saw my tears and [my husband] said, “Look at him, looking at you.”
Interviewer: Did he look sad himself?
Foster carer: Well, he did. It’s almost for a second he looked and the face changed … now I look back at the photo … he has this face as if it’s a recognition, it’s a recognition of me you know? And you can see it in the photograph. He all of a sudden had this look, it wasn’t smiling, not a smiley look, and I think he was probably, you know… A very knowing look. But still happy for me to pass him over. There was no clinging to take me back like that. He went over to them well.
After the move: ‘Let sleeping dogs lie’
After the heightened anxiety and tension described during the actual move, the foster carers, once alone, spoke of a sudden outpouring of suppressed grief and emotion. They spoke about the aftermath of losing the child on a personal level, very much like bereavement.
‘I cried for days when she left.’ [foster carer]
‘Once the child has gone I must admit I am exceptionally tired for the whole week. It’s like whoof because if you are working on that adrenalin and then once you have said goodbye you just sort of sit down and it all just comes out’. [foster carer]
In contrast, almost all of the foster carers told us that they did not imagine the child would be missing them. Adopters also tended to describe the emotions of the children as hard to read or as apparently quite bland, as if they were hardly affected at all – with one exception, a baby who cried for 6 weeks, would not be put down and clung to her adoptive mother, causing a lot of concern, but then settled down. More typical was this sort of account:
‘I thought they’d wake up in the morning and be crying because they wouldn’t know where they were but they were both standing up in their cots smiling at us and I thought this is a fluke. But they never ever cried, it was lovely.’ [adoptive parent]
There was a huge sense of relief that the child had not shown open distress or fear following the move. Nevertheless some adopters did describe a niggling sense of being in the dark about the child’s underlying emotional state. They appeared to be hoping for the best –that they were as ‘fine’ as they appeared – but in some cases unsure about whether this was really such a good thing, and wondering whether they were missing their carers or not:
‘I think the thing that got me was the first few nights with [the child] I had no concept of how she was feeling. ‘Cos she was nine months old and I couldn’t read her, you know she woke at night and I was anxious about that and I was thinking oh she’s missing her [foster carer] or it’s new or it’s different and I was trying to read the signs and a few pointers might have been good.’ [adopter]
The decision about contact with the foster carer was left with the adoptive parents. Most appeared uncertain about what was best for the child. They could not tell whether or not the child wanted to see their carer. Focussed on helping the child to settle, they feared that seeing the foster carer might disturb or confuse them. In the event, one set of adopters delayed the first contact for about six months; another family arranged a one-off contact after three months; and another family did not pursue contact at all. The one family who kept up an informal contact with the foster carer and her family described this as more for the adopter’s own sake than for the child’s.
The foster carers were probably the most adamant exponents of the need for a gap of several months prior to contact happening. Most expressed a fear of intruding, forcing themselves in and stirring up distress for the new family. Most of them spoke of themselves like unwelcome guests, using expressions like ‘stepping on the adopters’ toes’, ‘standing between’ the child and the new parents, not knowing when they weren’t wanted, perhaps burdening the happy family with their own feelings of grief.
‘So I leave it with them to contact me, it’s entirely up to them and I’m not going to say that they’re terrible people ‘cos they haven’t, ‘cos they’re dealing with their emotions with their new child, do they really have to worry about yours at the same time?’ [foster carer]
Again, all feelings of missing, of pining to see a lost person, are seen to reside with the carer and her family alone – not the child. As on the whole the children appeared to be fine, not showing signs of registering their loss, the prospect of a too-early contact with the carer raised fears of an uncontained outpouring of distress, images of a clinging, sobbing child. This was something that was felt to be unfair on the child and highly undermining and painful for the adopters and foster carers.
Foster carer: I mean I would hate to go and visit a child and the child is screaming and clinging on to me. I’d be horrified that I’d do that to a child, it means you’ve gone there too soon, it shouldn’t be happening.
Interviewer: So, do you mean that you think that first attachment has to be pretty much broken first?
Foster carer: Yeah. ‘Cos I think if you’re standing in the middle of the child and the couple or the child and the other person, the child gets very confused and I think that you’re taking that away from... Am I making it too complicated?
For those who decided to pursue contact some months down the line, both adopters and foster carers expressed relief if the child appeared to have forgotten the carer.
Foster carer: What I want to do is I want to go and visit that child and that child looks at me and goes, “Hmm, I think I know you, but I want my Mum,” and then I go, “Yes!” You know what I mean? My job’s done.
Interviewer: Do you want to go back sort of when they're not missing you any more?
Foster carer: Yeah. Maybe I'm protecting myself, I don’t know.
It was hard to untangle exactly whose feelings were being protected by this delay in contact, but it seemed to provide a retreat from having to witness unbearable displays of loss or grief. Among the adults, including social workers, there was a widely held belief that it was better, as one adoptive parent put it, to ‘let sleeping dogs lie’. The aim seemed to be to help the child to ‘forget’ as quickly as possible, hoping that ‘out of sight’ might mean ‘out of mind’.
Overall, there seemed to be a shared belief among adopters, foster carers and social workers that old attachments needed to be broken and forgotten about before new ones could be made, leaving any underlying grief to subside as quickly and quietly as possible. Some carers, some adopters and some social workers spoke more generally about the potential damage of cutting off attachments too abruptly, and the advantages to children of keeping past relationships alive; but in practice, and in this highly anxious period after the move, these beliefs lost their hold, and the need to throw off the old attachment in order to facilitate the new one tended to hold sway in everyone’s minds.
The Blind Spot
Our interviews threw up a rich and complex set of data, and gave us a very vivid picture of what was a highly complex, emotionally intense period for all the adults concerned. Our interviewees, foster carers and adopters, showed a clear capacity for sensitivity, warmth, thoughtfulness and concern for the children they spoke about. They had clearly thought deeply about the child’s loss of the foster carer and her family prior to the move. However, at the actual point of making decisions about the move, during the move itself and in the period immediately after the move, we felt that there was a heightened state of anxiety among the adults that created a sort of collective ‘blind spot’, hampering their capacity to retain the thoughtful, reflective state of mind essential to remaining in touch with what a young child might be feeling and the impact of what is happening to them.
Foster carers and adopters are all faced with a massive task in trying to pick their way through a maelstrom of emotions, the pain of loss and the excitement of becoming parents, with very little guidance available about what might be happening for the child. We believe that the following factors contributed:
Why does the system allow the child’s feelings to lose centre stage?
In thinking through why this might happen, we identified that no one takes an authoritative role in advocating for the importance of the relationship between child and carer for the child’s development, or the importance of maintaining this relationship, before, during and after the move takes place. At various points certain parties are looked to to provide guidance, but each of these groups is at the mercy of various complex factors, which make it hard for them to take on this role effectively.
The carers, often looked to for guidance during planning, almost always denigrated their own importance to the child from the planning meeting onwards through a fear of being seen as unprofessional and over attached, or entering into a rivalrous relationship with adopters.
The adopters, often left to make the final decision about contact after the move, report feeling reliant on carers or social workers to provide guidance about speed of move and post-placement contact. And once the child has moved their preoccupation tends to be with helping the child attach to them and feel as if they belong to their new family. Adopters expressed concern that the child may be negatively affected by contact – that it might ‘rock the boat’.
Although we did not analyse their interviews in depth, nevertheless many of the social workers spoke a great deal about being guided by the foster carers and adopters throughout the process. They tended to be very organised by the perceived need to protect the adopters from pain, distress or anything that might undermine their confidence – all for very good and sensitive reasons – but this appears to be an implicit reason for not highlighting the child’s loss, and by extension, not being firm about the possible need for a slow transition and possibly ongoing contact.
The children concerned were all under three, mostly pre-verbal and on the whole did not show signs of overt distress, so that it was difficult for adopters or social workers to identify how much/whether they were missing their carer or reacting in any way to having been separated from her. Passivity, lack of tears or any other obvious signs of unhappiness, led to an assumption that the child was coping well.
As well as this, support for adopters tends to be quite low-key during this period. The early training on attachment and loss appears to lose impetus during and after the move itself, and adopters are left to make key decisions even though this is the time when adopters are most in the dark, most anxious, and most in need of help and support in thinking through what is happening for the child.
Our knowledge base on the making and breaking of attachments
Our research has led us to identify a gap between our collective knowledge base, informed by a basic understanding of attachment and loss, and the way that children are currently moved from foster carer into adoptive families. Our collective knowledge base, a combination of theory, practice and accumulated experience, could be summarised in the following terms:
Implications for future practice
We hope that this research will serve as a starting point for further dialogue about how we can improve practice in this area, working towards a better integration of theory and practice so that we can become more sensitive to children’s experiences during adoption, or indeed any transition from one carer to another. Obviously all transitions are different, it is a highly emotive area and we are well aware of the tensions and vulnerabilities that can be stirred up during these moves. Nevertheless, we would like to suggest a set of guiding principles which we believe would help to keep the child’s attachment needs firmly in the centre of everyone’s minds.
A commitment to maintaining the child-foster carer relationship throughout the transition and beyond
This is not an easy task, and may involve significant logistical, practical and emotional challenges, but we believe that persevering with this is crucial in improving the child’s experience of this transition. It would make the separation for the child less traumatic and more gradual, giving them the chance to settle in with their new parents with the benign ongoing presence of their carer, available if needed rather than her suddenly disappearing from their lives. There is also evidence that when foster carers know they will stay in the children’s lives –as a kind of auntie or grandmotherly figure – they find it easier to commit to the child emotionally, and are less likely to withdraw emotionally to protect themselves from the pain of future separation (Dozier, 2007).
Promoting the foster carer/adopter relationship as an ongoing working relationship that needs to be supported and sustained over a longer period of time
Many interviewees cited a good relationship between carers and adopters as crucial in determining the ‘success’ of the transition and whether or not there was some form of ongoing contact. We believe this should not be left to chance. The network needs to create an environment in which the child is helped to mourn the loss of their first carer, while attaching to a new one. The ‘transition’ from one carer to another should not be seen as taking place in a finite period of time, but needs joined up thinking and support for the child over time, so that the child’s gains and losses are both held in mind, by both old and new attachment figures before, during and after the move.
Support and training for carer and family during and after transition
It is a great emotional and practical challenge for any foster carer to recognise the value and importance of her relationship with the child, while supporting the transition to adoption, bearing in mind the extent of her loss and of the child’s when the move takes place. We are asking carers and their families to commit to a deep and meaningful relationship with each child, and to bear the pain of letting the child go. Beyond that they will be asked to manage the ongoing challenges of being emotionally and practically available to each child, albeit in the background, to support and care for them as they gradually attach to their new families. In order to do this, we need to provide foster carers with a setting which accords a high status to their importance to the child, even after the move, and supports them in valuing this and understanding this, and in reflecting on what the separation means to themselves and to the children. Like the children, they will need a network which understands and is sympathetic to the feelings of loss involved, rather than one which gives a message that painful feelings cannot be tolerated.
Support and training for adopters on attachment and loss to be given not just before but after the period of transition
We are well aware that for new adopters, an offer of help from social services or from CAMHS can easily be experienced as a vote of ‘no confidence’, undermining of their competence as parents. We suggest that support and training should also be provided to adopters after the child has moved, and that it should be ‘normalised’ as far as possible, offered as standard practice – possibly in groups - and should include a training component on the emotional experience of the child post adoption. This would address the fact that adopters are facing a steep learning curve and will need help thinking about the complex feelings a child might bring, and – crucially - might not be showing in obvious ways.
More training across the network on recognising and responding to unspoken or latent feelings in a young child who appears to be ‘fine’
Children can be surprisingly ‘compliant’, but most of us are aware that a child who appears cut off or ‘fine’ after a major loss is more worrying than one who is overtly distressed. Looked-after children in particular can on the surface appear to adapt to new situations very quickly, not expressing the shock, distress, anger or confusion that we might have expected them to when face with sudden change. In these situations the whole network needs to be very sensitive to the feelings that are not being expressed, and resist the temptation to feel relieved when the children do not appear to mind or notice what is happening to them. This is a hard task and requires the whole system to be on board, but can have major implications for the child’s emotional health and trust in the adult world in the long run. We recommend more training and support for social workers, adopters and foster carers so that this becomes a central part of their mindset and is reinforced throughout the system.
Ongoing training in adoption agencies to ensure an awareness of organisational dynamics and defences
Remaining open to the primitive pain of a child’s distress when faced with traumatic loss is extremely difficult, especially for social workers and foster carers who are subjected to many such experiences over time. In adoption there is a particular challenge, as remaining in touch with the pain of loss and grieving, for foster carer and child alike, can feel like a ‘downer’ which spoils something that is essentially positive, and is often seen as the ‘happy ending’ side of a demanding job. From the top downwards we feel that an understanding of and regular training and consultation in the phenomenon of organisational defences against pain could help all involved to be more vigilant against the kind of ‘blind eye’ state of mind which cannot bear to see the losses amidst the happiness of a ‘forever family’.
Our research is not offering a prescriptive solution to how moves to adoption should be carried out – and of course, all children and all moves will be different. We are also aware of the small scale of this research, and believe that much more research in this field is urgently needed. However we do believe that current procedures are out of synch with some of the fundamental principles established in attachment theory, and we would urge for a re-thinking of these procedures to bring them into closer harmony with attachment theory. Ideally there should be an expectation that when babies and children are moved from foster carers to adoptive parents it should be done gradually, like a careful weaning, and that they should retain some sort of meaningful contact with these carers and their families; . Such separations should be treated as emotionally significant for the child, whether the child concerned is able to show feelings of distress or not.
Young children, and babies in particular, are unlikely to have the tools or the confidence to express the extent of their loss, during or after the move. It is our task to be emotionally attuned and responsive to the complex emotions they will be experiencing, and provide them with an environment that allows space and time for feelings of excitement and hope, but also for painful feelings of loss and mourning. If we cannot help them with this, there is a danger that they may shut down their more painful feelings and then fail to receive the comfort and reassurance of those caring for them. We strongly believe that this process of grieving and being comforted will be invaluable in helping them to develop even closer and more loving relationships with their new parents.
Sophie Boswell and Lynne Cudmore, 2013
We would like to thank the social workers who were part of our original research team: Meena Kumari, Amanda Slattery and Ruth Wienburg; also Nicholas Midgley, Beverley Tydeman and Giles Dhabalia who all offered invaluable advice and support along the way. We are indebted to Westminster Children’s Services for supporting this project over several years; and finally, our sincere thanks go out to all of the foster carers, adopters and social workers who so generously took part.
Ainsworth, Mary, et al (1978), Patterns of Attachment. Hillsdale, NJ
Aldgate, J. And Simmonds, J (eds) (1988), Direct Work with Children, BAAF
Bowlby, John (1980), Attachment and Loss, Vol 3: Loss, sadness and depression, New York: Basic Books
Brier et al (1988), Early parental loss and development of adult psychopathology. Archives of General Psychiatry 45.
Burnell, A et al (2009) ‘Planning Transitions for children moving to permanent placement: what do you do after you say hello?’ Family Futures Practice Paper
Dozier, M (2007), ‘Caregiver commitment in foster care’, in Attachment Theory in clinical work with children: Bridging the gap between research and practice, Guildford Press
Emanuel, L (2006), ‘The contribution of organizational dynamics to the triple deprivation of looked-after children’, in Creating New Families: Therapeutic Approaches to Fostering, Adoption and Kinship Care, Tavistock Clinic
Fahlberg, V (1994), A Child’s Journey Through Placement, BAAF
Fratter, J (1996), Adoption with Contact: implications for theory and practice, BAAF
Freeman, C (not yet published), Now and Then: reflections on relationship from adults who were in care and their carer
Freud, S (1917), ‘Mourning and Melancholia’, in The Standard Edition of the Complete Psychological Works of Sigmund Freud, Volume XIV (1914-1916)
Hindle, D and Shulman, G (eds), (2008) The Emotional Experience of Adoption: A Psychoanalytic Perspective. London: Routledge
Howe, D and Feast, J (2003), Adoption, Search and Reunion: The long-term experience of adopted adults The Children’s Society, 2000; republished by BAAF, 2003.
Howe, D et al (1999), Attachment Theory, Child Maltreatment and Family Support: a practice and assessment model, Macmillan
Kenrick, J (2009) Concurrent planning: A retrospective study of the continuities and discontinuities of care, and their impact on the development of infants and young children placed for adoption by the Coram Concurrent Planning Project, BAAF
Klein, M, (1940), ‘Mourning and its relation to manic-depressive states’, in International Journal of Psychoanalysis, vol 21
Lanyado, M (2003), ‘The Emotional Tasks of Moving from Fostering to Adoption: Transitions, Attachment, Separation and Loss’ in Journal of clinical child psychology and psychiatry, London, Sage Publications
Menzies Lyth, I (1988) Containing Anxiety in Institutions: Selected Essays. London, Free Association Books
Neil, E (2009) Post-Adoption Contact and Openness in Adoptive Parents’ Minds: Consequences for Children’s Development, British Journal of Social Work, vol 39
Quinton, D., Rushton, A., Dance, C. and Mayes, D. (1997) Contact between children placed away from home and their birth parents: Research issues and evidence, in Clinical Child Psychology and Psychiatry, 2 (3)
Robertson, J and J (1989), Separation and the Very Young, Free Association Books London
Romaine, 2007, Mary Romaine et al, 2007, Preparing for Permanence, BAAF
Rutter, M (1971), ‘Parent-child separation: psychological effects on the children’, in Journal of Child Psychology and Psychiatry, vol 12
Schofield, G and Simmonds, J (2011) ‘Contact for infants subject to care proceedings’, in Journal of Family Law, June 2011
Sellick, Thoburn et al (2004), ‘What works in adoption and foster care?’ Barnado’s Policy and Research Unit
Sinclair, I, et al (2005) Foster Children: Where They Go and How They Get On, London, Jessica Kingsley
Schoenberg et al (eds) (1970), Loss and grief, Columbia University Press, USA
Smith, Jonathan (2009), Interpretative Phenomenological Analysis: theory, method and research, London, Sage Publications
Wakelyn, J (2011) ‘Therapeutic observation of an infant in foster care’ in Journal of Child Psychotherapy, Vol 7, Routledge, 2011
Winnicott, C (2004) ‘Face to Face with Children’ in Working with children, London: Karnac
Winnicott, D (1986) Home is where we start from: essays by a psychoanalyst, New York: W W Norton & Company, p22
 A second phase of research is planned to focus specifically on social workers’ role in these transitions
 Concerns about contact with former carers may be conflated by research showing how frequent contact with birth parents can cause distress and confusion to young children (eg Kenrick, 2009, Schofield, 2011); however, we believe in that context contact is fraught with uncertainty, stress and confusion for all parties in a way that does not apply to adoptive placements.