The Internal Representations of Children and Adolescents in Care

• To understand more about attachment and internal representations in children in foster care, and how this may change over time within a new foster family.

• To explore the link between carers’ mentalizing capacity and children’s internal representations.

• To explore the prevalence and manifestation of dissociative behaviours in this population.

• Within the adolescent study, to explore the usefulness of a new video-based measure of the story stems to capture information about their internal world.

First Study

Assessments were carried out with over 30 children aged 4–9 in foster care. These children were administered the Story Stem Assessment Profile, a semi-projective measure of internal and attachment representations, alongside a couple of other tasks. Foster carers were administered a Parent Development Interview adaptation alongside some established questionnaires. To track change in this population, the same assessments are being repeated at 12-monthly intervals.

Second Study

The same design was being used on 30–40 adolescents aged 14–18 in residential care, who were assessed using an adolescent adapted version of the story stems, the Adolescent Story Stem Profile (ASSP). The ASSP is an online and video-based tool developed by Dr Saul Hillman, which focuses on mentalization and attachment. As with the study for younger children, the measures will be repeated at 12-montly intervals.

Both studies had a strong emphasis on feeding back to the participants based on the results from their assessment. In the case of the first study, this would be a way of helping foster carers understand more about their child’s strengths and difficulties.

Findings from the first phase of the study:

• The SSAP assessment revealed that high levels of disorganisation and defensive-avoidance strategies were employed when making sense of different situations. Conversely, levels of ‘secure’ representations were very low. A large proportion of the children in this sample exhibited highly clinical material in relation to their attachment.

• Levels of dissociation were also evidenced, both through the SSAP and the carer report.

• Exploring their internalising and externalising behaviour revealed far more problems (clinically high) in conduct, hyperactivity and peer-related domains.

• Carers’ mentalizing capacity was shown to vary considerably from very low functioning to very high functioning. To date, there did not appear to be any strong links between this capacity and children’s functioning.

Dr Saul Hillman

chaptre@annafreud.org