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Largest ever UK study announced to evaluate support for foster carers and children in their care

Today, the Anna Freud Centre announces the Reflective Fostering Study, the largest ever UK study to evaluate the impact of a foster carer support programme. This study is now recruiting foster carers from across England.

This large scale Randomised Controlled Trial (RCT), running from September 2021 until late 2023, will work with 720 foster carers in over 12 local authorities. It seeks to improve the lives of foster carers and the children in their care by increasing the stability of their relationship and the placement. The Reflective Fostering Study is funded by the National Institute for Health Research (NIHR).

There are over 80,000 children in care in the UK and they are among the most vulnerable in society. Many of these children and young people experience abuse, maltreatment and neglect before going into care, and they have a high risk of poor mental wellbeing throughout life. Research suggests that around 45% of children in care have a diagnosable mental health disorder.

Professor Nick Midgley, Chief Investigator of the Reflective Fostering Study, says: “Foster carers are a key agent of change in the lives of children in care. By supporting foster and kinship carers, we can help them to support the wellbeing of those children in their care, giving them the best chance to overcome adversity and thrive. Finding ways to better support foster carers is vital and this study will make a hugely important contribution.”

The study utilises a model, the Reflective Fostering Programme, which has been developed and tested by the Anna Freud Centre. Local staff, including social workers and experienced foster carers, are trained in the programme. This way of working promotes ‘reflective fostering’, which is being able to think about the thoughts and feelings of themselves and the child in their care, thereby improving the strength of the relationship. Training foster carers allows the programme to be embedded within the local authority in a more sustainable way and strengthens the foster carer role.

Findings from an earlier study of Reflective Fostering are positive, indicating reduced carer stress and improvements in the child-carer relationship, challenging behaviour and the child’s wellbeing. Foster carers have spoken about the importance of making support like this more widely available and of its value in building placement stability for the child.

Dr Sheila Redfern, Co-creator of the Reflective Fostering Programme and Clinical Lead on the study, explains: “At the heart of Reflective Fostering is the focus on relationships, because this is critical if placements are to become stable. The stability of placements for children in care is one of the most significant predictors of their future mental health and wellbeing.”

The UK Government has appealed for effective ways to support the mental health and emotional wellbeing of children in care, following confirmation by the National Institute for Clinical Excellence (NICE) that there is a lack of evidence in this area. The Reflective Fostering Study will make a significant contribution to this appeal.

Professor Nick Midgley adds: “The Reflective Fostering Study provides an exciting opportunity for foster carers in the participating areas to be involved in one of the largest trials of its kind. By getting involved they will help us ensure improved life chances for children in care nationally.”

Foster carers and social workers can find out if your local authority is involved here: and can stay tuned for other opportunities. Study sites to include Bristol, Devon, Hertfordshire, Kent, Lancashire, North Tyneside, and the London boroughs of Barnet, Camden, Enfield, Hackney, Haringey, Islington and Wandsworth. Additional sites may be added.

The study, funded by the National Institute of Health Research (NIHR), is being delivered by a research consortium led by University College London, in partnership with the Anna Freud Centre, University of Hertfordshire, University of East Anglia, Kings College London and Kent County Council. The Reflective Fostering Programme is delivered with the support of KPMG Foundation, The Segelman Trust and Colyer-Fergusson Charitable Trust.