The Reflective programmes were developed at the Anna Freud Centre by clinicians in the Family Trauma Department in collaboration with colleagues across the centre. The underlying principle of this group of programmes is that children and young people’s views need to be placed firmly at the centre of parents/carers and professionals’ care for them. Young people who have experienced family trauma have developed chronic mistrust in others because they have not received the secure care they deserve. As a result, it is hard to trust other people and to feel that others understand or can represent their perspective. The Reflective programmes are designed to give a much greater emphasis on understanding the mental health needs of children and young people through the use of a mentalizing stance. That is, through taking the perspective of the young person in order to help them feel better understood. This approach leads to children and young people feeling a stronger sense of connection to the carers and professionals in their lives.
- Reflective care
There are over 80,000 children living in care in England, a number that is increasing year on year. Most of these children do not receive effective support for their mental health needs, often because the distress that the child is experiencing is not known to those caring for them. Over 60% of children in the general population do not receive any support for the difficulties, and these rates are similar or worse for children in care. A fragmented approach to understanding mental health needs across services prevents early and helpful interventions, which over time increases preventable referrals to CAMHS where there are limited resources to meet substantial increase in overall demand. To address this, in 2018, the Department for Education commissioned the Anna Freud Centre to develop and deliver a new approach to improving the identification of mental health needs of children in care.
In response, the Anna Freud Centre developed and piloted the Reflective Care Programme with partner Local Authorities. Based on a mentalization approach, in combination with the use of assessment tools, the RCP provides a new approach to identifying and supporting children in care with their mental health needs. Within the Reflective Care model, a ‘Virtual Mental Health Lead’ embedded within the children’s social care team, provides supervision and support to frontline workers, offering support to reflect during assessments, and helping increase confidence of social workers to use a mentalising approach with CiC, and supporting systemic change in how the mental health needs of CiC are identified and addressed.
The cost of a Reflective Care Programme is based on the specific needs of a local authority site and dependent on there being a designated post for a Virtual Mental Health Lead within each individual site. An estimate of the cost of this workforce development can be given based on the pilot work on this role for the DfE.
For more information on how you might go about embedding a Reflective Care model and access training for the Virtual Mental Health Lead role in your locality, please contact Project Manager Chris Watts on email@example.com
- Reflective fostering
The Reflective Fostering Programme is a mentalization based group intervention for foster carers; an adaptation of a mentalization based programme for parents (Reflective Parenting, Redfern 2016). The programme is being evaluated in a large-scale RCT to find out whether offering the Reflective Fostering programme, alongside the usual care provided by local authorities, is helpful, in terms of; improving children’s emotional well-being and behaviour, helping with carer stress and feelings of burnout and crucially in supporting placement stability. The Reflective Fostering Programme is a 10 session (adapted to run online) psychoeducation programme, each of which lasts for 2-3 hours with 7-10 carers in each group. The programme has been manualised and includes video material, group exercises and discussion. A new adherence scale has been developed (the RFFR) to check on adherence to the model of the group facilitators and this talk will discuss the issue of adherence and self-mentalizing in the facilitators as well as group members. The model has been developed to help foster carers progress from a caring role to an educative one and each group is run by 2 facilitators - a trained social work staff member and a foster carer.
So far, two evaluation studies have been completed and results show that the groups had a positive impact on carer stress levels, carer-child relationships and the child’s emotional well-being.
Independent Fostering Agency employees and Local Authority Fostering Teams can apply for Reflective Fostering Training. This is a two day training at £500 per delegate, (£600 if you would like to bolt on the MBT-CYP Introduction module).
For further information on the Clinical Research Trial for Reflective Fostering, contact Nick Midgely, Principle Investigator at firstname.lastname@example.org or clinical lead, Sheila Redfern at email@example.com or look at the course on our training site here.
You can read more about the Reflective Fostering Study here.
- Reflective parenting
Based on the acclaimed book Reflective Parenting, the Reflective Parenting service offers training on the model to future group facilitators and an intervention to parents who are experiencing difficulties in their relationships with their children.
The Reflective Parenting model introduces an approach to parenting that aims to promote family relationships and reduces parent-child conflicts. Parents can expect to develop a better understanding of their child’s emotions and behaviours, helping the child to feel both understood and of value. The approach also helps to de-escalate difficult situations and reduces behavioural and emotional outbursts. Reflective Parenting is a model of parenting based on theoretical ideas from mentalization – the ability of a parent to understand the thoughts, feelings and intentions behind the behaviour of both themselves and their child.
There is extensive evidence about the importance of understanding the intentions behind a child’s behaviour, and getting a greater sense of your own mind as a parent in relation to them. Research also suggests that understanding the thoughts, feelings and intentions behind your child’s behaviour and your own reaction can act as a buffer against difficult behaviour and can help your child to regulate their emotions better. This can then lead to improved relationships and enhanced understanding of self and others.
Reflective Parenting Group Structure and content
The Reflective Parenting Group is an 8-week closed group (meaning people can’t drop in and out) for a maximum of 12 participants. The group provides both psychoeducation (there are slides and discussion points) and active support (sharing stories and struggles as well as successes with other parents).
The group is facilitated by two highly experienced clinicians.
Reflective Parenting Group Practitioner Training
The progression model enables participants in the training to develop their practice to group facilitator. This comprises attending the short course training in Reflective Parenting and following up with attending consultation sessions with a trained RP consultant who will review video or audio recordings of excerpts from groups and rate adherence to the model of RP. At the end of this process, practitioners are registered as Anna Freud qualified Reflective Parenting Group practitioners.
Training – for training in Reflective Parenting see details on the training page of our website here.
Reflective Parenting Groups – we have groups for the following people:
- Special Guardians
- Adoptive Parents
- Parents of children aged 4-13
- Dads of newborns
We are able to run some groups at low or no cost thanks to the generous support of one of our doners, the Maria Marina Foundation. The majority of groups are charged at £450 for an 8 week (16 hours) course.
For further information on attending a Reflective Parenting Group, please contact the Clinical Lead for Reflective Parenting, Dr Theresa Schwaiger at firstname.lastname@example.org
Clinical Lead for Reflective Parenting
Principle Investigator on the Clinical Research Trial for Reflective Fostering
Clinical Lead on Clinical Research Trial for Reflective Fostering
Project Manager - Family Trauma | Reflective Care