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Best outcomes project
In conjunction with the Royal Borough of Kensington and Chelsea Social Services, the Anna Freud Centre has been conducting an evaluation study of a specialist service for Looked After Children. This study is a phase 1 trial which will assess the efficacy of a mentalization−based intervention for children living in foster placements. More specifically, we hope to determine how effective the therapy is in improving the stability of foster and kinship placements, in reducing the behavioural problems of children in care, and in improving their mental health. We will measure these changes by assessing children before and after their therapeutic engagement. We will also conduct a long-term follow up assessment to determine whether changes are maintained over a longer-term period (12 months post-referral). Once we know more about the effectiveness of this approach, we will be able to develop a theory-driven protocol to be used by other voluntary and statutory services addressing the needs of this vulnerable population.
Research Questions
- Is a multi-modal approach to the support of foster care placements effective in improving placement stability?
- Is this approach effective in enhancing foster carers’ and other professionals’ capacity to better understand the child?
- Is this approach effective in improving the child’s behavioural problems (at home and at school)?
- Is this approach effective in improving the child’s mental health?
The intervention
Unlike children raised at home, foster children are looked after by a whole number of professionals sometimes referred to as the ‘corporate parent’, and the parenting role is therefore far less integrated. The hypothesis on which this intervention is based is that if the professional network can be encouraged to reflect on the child’s needs in a more integrated way, the child will feel more contained and stable in his/her placement. The intervention is therefore based on enhancing the reflective capacity of the system around the child, centrally involving the foster carer, but including social workers, teachers and mental health professionals.
The intervention is targeted at children of 8 – 15 years in long-term foster or kinship placements where there is some concern about the stability of the placement. Once a referral is made by the child’s Social Worker, members of our multi-disciplinary team work variously with the foster carer, social worker, teacher and birth family to think about the child’s behaviour in the context of his/her emotional state. The aim is to enable the ‘team around the child’ to reach a common understanding and to communicate about the child’s needs. The team also makes recommendations for further work where necessary.
Progress
We received NRES ethical approval for this study in December 2008 and recruitment began in January 2009. Progress has been slower than expected because of a lack of referrals to the project but we have now recruited 13 families who will be followed up until July 2011.
The Team
- Minna Daum – Project manager and Systemic Therapist
- Lesley Bennett – Educational Psychologist
- Emma Keaveny – Clinical Psychologist
- Ruth Jennings-Hobbs – Assistant Psychologist
