Thinking Psychologically About Children Who Are Looked After and Adopted: Space for Reflection - Softcover

Softcover

ISBN 10: 0470092017 ISBN 13: 9780470092019

Publisher: Wiley, 2006

Synopsis

Assessment, intervention and living with children who are looked after or adopted all require an understanding of psychology and its application.

This innovative collection makes thinking psychologically about looked after and adopted children accessible and, in doing so, provides an insight into the world of these children. Informed by research, practice and psychological theory, this volume provides an overview of the area and considers the context for helping children change and develop. It goes on to describe in detail the techniques and approaches used by clinicians, and explains how interventions can be developed and adapted for children and young people living in residential, foster and adoptive care. Careful consideration is also given to carers and families living with these children.

With its multi-disciplinary approach, Thinking Psychologically About Children Who Are Looked After and Adopted will appeal to all professionals involved in the care and education of placed children. It will also be of interest to policy makers and lecturers and students of social work.

About this title

About the Author

Kim S. Golding, BSC (Hons), MSc (Clinical Psychology), DClinPsy
Kim is a chartered clinical psychologist, employed by Wyre Forest Primary Care Trust inWorcestershire, providing clinical leadership for the Integrated Service for Looked After Children (ISL). She was part of a small group who developed the Primary Care and Support Team (now part of ISL). The team provides support and training for foster, adoptive and residential carers. Kim has a longstanding interest in parenting, and collaborating with parents or carers to develop their parenting skills tailored to the particular needs of the children they are caring for. Within ISL she has developed a group for foster carers based on attachment theory, and has carried out research exploring the use of the consultation service.Kimcoordinated a national network for clinical psychologists working with looked after and adopted children for a number of years. Additional to her clinical work Kim was, for 15 years, an associate lecturer for the Open University teaching Introduction to Psychology and Child Development.
Contact details: Integrated Service for Looked After Children, The Pines, Bilford Road, Worcester, WR3 8PU.
Email: kim.golding@tiscali.co.uk

Helen R. Dent, BA (Hons), MPhil, PhD
Helen is a chartered clinical and forensic psychologist, currently employed as Programme Director of the Doctorate in Clinical Psychology at the Universities of Staffordshire and Keele. Her previous post was Consultant Clinical Psychologist in an Inter-Agency team with children looked after by the local authority. She is continuing her work in this area, and has a contract with North Staffordshire Combined Healthcare NHS trust as Honorary Consultant Clinical Psychologist. She is particularly interested in strategic and systemic interventions,andin neuropsychological development. Prior to training as a clinical psychologist at the Institute of Psychiatry, Helen gained a PhD from the University of Nottingham, for which she carried out pioneering research into children as witnesses. She has held various academic and clinical appointments and has edited three previous books, including Children asWitnesses (1992) with Rhona Flin, published by JohnWiley & Sons.
Contact details: Shropshire and Staffordshire Clinical Psychology Training Programme, Faculty of Health and Sciences, Staffordshire University, Mellor Building, College Road, Stoke-on-Trent ST4 2DE.
Email: helen.dent@staffs.ac.uk

Ruth Nissim, BA (Hons,) MEd, PhD
Ruth is a consultant clinical psychologist and UKCP registered family therapist who has been in practice since qualifying in 1977. Since the early 1980s she has specialized in children living away from home in substitute families and in residential care. She has worked in all three agencies: Education, Social Services and the NHS, as well as for a private adoption agency. Since taking early retirement Ruth has worked on a freelance basis with a particular focus on supporting adoptive families. In 1999 she completed a research doctorate looking at the outcomes for children placed in adoptive or foster families longer-term.
Contact details: Dores Cottage, 17, High St, Finstock, Oxon OX7 3DA.

Liz Stott, MSc (Hons), MSc (Clinical Psychology)
Liz is a chartered clinical psychologist who has been working with children for the past 16 years. She has worked in both residential adolescent units and outpatient CAMHS before taking up specific posts to work with looked after children and their carers. She is interested in systemic and psychodynamic approaches to consultation and uses these ideas to inform practice when working with larger organizations such as Social Services, smaller organizations such as children’s homes and also in consultation with carers. She is currently employed by Partnership Trust in Gloucestershire.
Contact details: The Child and Adolescent Mental Health Service, Delancey Hospital, Charlton Lane, Cheltenham, Glos GL53 9DU.
Email: liz@patnliz.eclipse.co.uk

This innovative collection makes thinking psychologically about looked after and adopted children accessible and, in doing so, provides an insight into the world of these children. Informed by research, practice and psychological theory, this volume provides an overview of the area and considers the context for helping children change and develop. It goes on to describe in detail the techniques and approaches used by clinicians, and explains how interventions can be developed and adapted for children and young people living in residential, foster and adoptive care. Careful consideration is also given to carers and families living with these children.

With its multi-disciplinary approach, Thinking Psychologically About Children Who Are Looked After and Adopted will appeal to all professionals involved in the care and education of placed children. It will also be of interest to policy makers and lecturers and students of social work.

This innovative collection makes thinking psychologically about looked after and adopted children accessible and, in doing so, provides an insight into the world of these children. Informed by research, practice and psychological theory, this volume provides an overview of the area and considers the context for helping children change and develop. It goes on to describe in detail the techniques and approaches used by clinicians, and explains how interventions can be developed and adapted for children and young people living in residential, foster and adoptive care. Careful consideration is also given to carers and families living with these children.

With its multi-disciplinary approach, Thinking Psychologically About Children Who Are Looked After and Adopted will appeal to all professionals involved in the care and education of placed children. It will also be of interest to policy makers and lecturers and students of social work.

Excerpt. © Reprinted by permission. All rights reserved.

Thinking Psychologically about Children Who Are Looked After and Adopted

Space for ReflectionBy Helen Dent

John Wiley & Sons

Copyright © 2006 Helen Dent
All right reserved.
ISBN: 9780470092019

Chapter One

BEING HEARD: LISTENING TO THE VOICES OF YOUNG PEOPLE, AND THEIR FAMILIES

Kim S. Golding, Helen R. Dent, Ruth Nissim and Liz Stott

Upon rereading my old diaries I realized how hard foster care was and what a detrimental effect it had on me at that time. Before my first foster placement broke down I thought foster care was a relatively positive experience, apart from the usual problem of occasionally feeling a bit awkward around the family, but when my foster care placement did break down literally overnight I realized why some young people in care do have the problems they do. I became very defensive and was determined to never let anyone ever hurt me ever again. I developed a very hard exterior to protect me at that time. (Caroline Cuckston, 2004, p. 24)

Historically the voice of the person receiving services has been overlooked. The welfare tradition in the UK has its roots in the Victorian moral imperative to help the disadvantaged and those less fortunate. This moral stance did not expect or actively elicit a voice from the 'grateful poor'. This was further reinforced by the strong role the Christian Church took in rescuing lost souls and guiding the sinners back onto paths of righteousness. The guidance of a wise God who knew best did not leave a lot of room for alternative perspectives.

It is only very recently that procedural or legal frameworks have been set up to ensure that there is user involvement in the development and delivery of services. This has extended into the provision of services for children. Within child protection services, for example, there is now considerable focus on involving the child and parent. This policy development has in turn become enshrined in law. Thus the Children Act 1989 (DOH, 1989) identified the need for collective responsibility in the care and protection of children. This act, for the first time, placed emphasis on a partnership between local authorities and families. It placed the wishes of parents and children as central within decision making, only to be over-ridden in exceptional circumstances through a court process (Hill, 1999). This same focus is present within a number of acts, for example, in proceedings for adoption via the Adoption Act (DOH, 1976) and in divorce involving children via the Family Law Act (DOH, 1996). More recently Every Child Matters, Change for Children (DFES, 2004a) clearly sets out the need to ensure that children and young people are listened to and that they are involved in the design and delivery of services. This is followed through in the Children Act 2004 (DFES, 2004b), which sets out the establishment of a children's commissioner, part of whose duty is to involve children in the provision of services and to promote the awareness of the views of children. In particular, the children's commissioner is tasked with involving children who do not otherwise have adequate means by which they can make their needs known. Guidance to support the programme of change outlined in Every Child Matters includes advice about commissioning placements and services for looked after children. This sets out as a key principle that 'mechanisms should be in place to enable the views of children in placements and using services to be taken into account' (DFES, 2005, p. 9).

Within the United Nations Convention on the rights of the child, Article 12 states the right of capable children to express their views freely in all matters affecting them (United Nations, 1989). Foster children have not been overlooked in this process. The 10th article of the Bill of Rights of Foster Children 1973 states that the foster child should receive high-quality child welfare services, including involvement in major decisions that affect his or her life. This article also highlights the need to involve the natural parents in decision making (see Martin, 2000), while the UK joint working party on foster care (NFCA, 1999) set out as a central principle a partnership approach to foster care - embracing parents, carers, social work services and the children themselves. Similarly, Promoting the Health of Looked After Children (DOH, 2002) emphasizes consultation and involvement with children and young people and the front-line staff delivering services to them.

The National Service Framework for children, young people and maternity services (DOH, 2004) has been developed to improve health and social care services, organized around the needs of the children and their families. These standards require services to involve children, young people and their parents in planning. Again there is particular emphasis on listening to the views of users both in relation to individual care that is being provided and in the development of local services. Particular attention is given to hearing from those who are often excluded.

Thus it is clear that there is increasing awareness of the principle of hearing the voice of the recipient of services. Having a principle, even one that is enshrined in law, however does not ensure good practice. A study by the Joseph Rowntree Foundation concludes that, at an individual level, children and young people are still not being properly consulted about decisions that affect their lives (Stuart & Baines, 2004). Thomas (2005) has compared the responses of local authority childcare managers to a postal survey carried out during 1997/8 and repeated in 2004. He concludes that there have been significant changes in the engagement of children and young people in the provision of services. This, however, only represents a changed culture in some areas. There is still some way to go in the development of a process for taking a child's view into account.

Moving from principle to practice, especially in the complex area of looked after and adopted children, is not likely to be straightforward. For example, what is the relative importance of the child's and the parent's views when these are not in accord? How do you best listen to the voice of the child without compromising the needs of the carer? There are also tensions between the child's right to participate in decisions and the right to have his or her welfare protected (Schofield, 2005). At what point do you over-ride the requests of the child because it is deemed unsafe or clearly against his or her interests, when a child's wish is to return to what is considered an unsafe home, for example. What is the process whereby the child is listened to, heard and also protected? The fact that these questions are being asked and actively considered indicates the progress that has been made in this area. However, there is some considerable way to go if services are truly to be developed around the expressed wishes of child, carer and parent.

WHAT DO WE KNOW ABOUT THE VIEWS OF CHILDREN, YOUNG PEOPLE AND THEIR CARERS?

There is a growing literature on user views within adult services (e.g. Campbell, 1999; Pilgrim & Hitchman, 1999; Chambers et al., 2003). This, in turn, has led to attention being focused on child services. Thus children have been asked for their perceptions of services provided by child guidance clinics (Ross & Egan, 2004), of mental health services (Laws, 1998; Leon, 1999), of services for young people (Franklin & Madge, 2000) and of play therapy services (Carroll, 2002). Similarly, children's perceptions of therapeutic change have been sought (De La Cruz, 2002; Jessie, 1999).

Seeking children's views about the process of adoption, fostering or residential care is an important part of understanding the needs and wishes of children, but until recently research has been scarce.

An exception to this is the Who Cares? Trust. In 1992 it commissioned a survey of 626 looked after children and followed this up with a larger survey of the views of 2,000 looked after children in the UK (Shaw, 1998). This wide-ranging questionnaire survey obtained views on many aspects of being in care, including lifestyle, education, health, emotional well-being and leaving care. Some of the key findings were that:

entry into care can be traumatic and needs to be better thought out and resourced;

only 57% could state with certainty that they had a care plan;

education was improved by being in care except that many of those regularly attending school reported never receiving homework or not having a quiet place and resources to do it;

the health education needs of under 11s (e.g. body changes, sex) were not generally being met; despite receiving helpful advice on health, many were still putting their health at risk;

many reported loneliness, isolation and lack of support;

foster care generally appeared to be more successful in all respects than residential units, with the important exception that children in foster care were less protected by knowledge of their rights, e.g. complaints procedures, awareness of the need/right to have a care plan;

there was a much higher incidence of risk taking in residential care - smoking, drugs, alcohol - and poorer educational attainments.

Thomas et al. (1999) reported on a study of adopted children that provides invaluable guidance for helping children with the process of being adopted and the continuing difficulties of contact, stigmatization and bullying. While this study is rich in providing a window on the voice of the child, the children interviewed were all successfully integrated into their families. The voice of the child troubled within an adoptive family, or who has suffered adoption breakdown, is missing.

More recently there has been increased interest in nationally relevant studies that seek to ascertain the views of children about the care system. For example, Skuse and Ward (2003) conducted a study of children's views when they were living within the looked after system, and after they had left. Dance and Rushton (2005) report on the Maudsley follow-up study of children joining foster or adoptive families in middle childhood. These studies reveal that children can be settled and positive about their experience although Dance and Rushton (2005) point out that it can take a considerable length of time to feel settled. The small sample size and difficulties in recruiting children, especially those experiencing placement disruption, make it difficult to generalize these findings.

The Commission of Social Care Inspection has produced a series of reports following consultation with children (see www.csci.org.uk). At the time of writing, the CSCI is reporting on findings from the children's audit of inspections. These are visits made to children's homes and boarding schools to talk to the children shortly after inspections have been conducted (Morgan, 2005). The CSCI has also surveyed foster children alongside foster carers and birth parents (in Collier, 2005). Children like having a sense of belonging, being cared about, stability and feeling safe. They are equally clear in wanting improved monitoring of residential units and foster placements, better communication between professionals, and keeping the same social worker. Children want action to be taken, not just talking and listening.

Research that explored children's views in the UK is mirrored by similar research in America. The National Survey of Child and Adolescent Well-Being included 316 children living in foster, residential or kinship care. These children report satisfaction with their placement and feel close to their carers, with children living in residential care being least satisfied. The ambivalence the children experience, however, is expressed through their desire for more family contact and their wish to live with their biological mothers (Chapman et al., 2004).

There is therefore a range of research studies that provide the child with a voice (Box 1.1). These will help to guide the future development of services for children who are looked after or adopted.

When carrying out such studies special efforts are needed to hear the voices of children living within minority groups. These children can be especially affected by problems of exclusion, discrimination and stereotyping. They need opportunities to express their views separate from, as well as being part of, studies talking to children.

The Worcestershire Children's Fund commissioned a research study exploring the impact of a range of projects on the children, their families and communities. This contained a separate report concerning the impact on minority groups, including children from minority ethnic groups, children with learning disabilities and young carers. Through talking to the children and their families, the differing needs and experiences stemming from social, cultural or practical issues were apparent (Cooper & Cooper, 2004). Children from such minority groups, living within the looked after system, can be doubly disadvantaged. Studies will need to make special efforts to include these children and to provide them with a separate voice.

While there is a small but growing literature reporting on the perceptions of children, there is little research or guidance about how to best use the views once they are expressed (Maguire et al., 2001). The studies are seen as providing powerful messages for practitioners and decision makers, but more research studies are needed on how these messages can be successfully listened to and whether the services that develop as a consequence are then perceived more positively.

There is also less information about how to listen and use the voices of multiple families and the children and young people. Guidance, especially about how to develop services around the differing views of children, their carers and their families of origin, is lacking.

No matter how much support you get in foster care, be it from social workers, foster carers or psychologists, you still feel alone as there is no one definite to turn to. Other young people would have their parents. From my experience this sense of lack of belonging was reinforced by statements such as 'do you still want to live here?', and examples of normal teenage behaviour, e.g. 'if the untidy room doesn't stop then you'll have to go'. (Caroline Cuckston, 2004, p. 24)

PROVIDING SERVICES THAT LISTEN TO THE VOICES OF CARERS AND PARENTS

Services can be set up in a way that either gives a voice to those who are at the receiving end or prescribes the service for them. Traditionally the NHS/medical model of intervention is one of experts treating patients. Patients place their trust in the professional and until relatively recently did not expect to be asked for their views.

Often psychological services for children and families have moved away from this expert model, preferring to adopt more collaborative approaches to intervention. This approach places more emphasis on working in partnership and thus provides a greater scope for eliciting and listening to the views of those receiving the service.

Collaborative practice is not, however, without its difficulties. Psychologists and other professionals providing a service are often invited to take charge and be in control rather than working collaboratively. Expectations and limited resources can reduce the time made available for really listening to the child and family and fully involving them in planning assessment and interventions. Allowing the child, young person or carer to have a clear voice means that sufficient time needs to be made available for them to talk and be listened to and that careful attention is given to how the individual or family can be empowered to be full partners within the design and delivery of interventions.

Continues...

Excerpted from Thinking Psychologically about Children Who Are Looked After and Adoptedby Helen Dent Copyright © 2006 by Helen Dent. Excerpted by permission.
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Edition details

• Publisher: Wiley
• Publication date: 2006
• ISBN 10: 0470092017
• ISBN 13: 9780470092019
• Binding: Paperback
• Language: English
• Edition number: 1
• Number of pages: 400
• Editor: Golding Kim S.