space for reflection and transparency on the thought processes which influenced, and were developed from, the data analysis. Results The following (Figure 1) represents what the young people said about their move experiences, which centred around two main themes: Understanding and Survival. The main theme of ‘Understanding’ contains two subthemes of ‘Experience’ and ‘Support’. The ‘Survival’ theme contains three subthemes of ‘Action to Influence’, ‘Self-protection’ and ‘Future Focus’. The two main themes influence each other. However, not all the subthemes directly link to all others but are influential on a meta-level to the other main theme and the subthemes within it. It is emphasised that full saturation of the data was not achieved and therefore these results may lack some additional relevant details. Figure 1: Model of results Understanding of placement moves was constructed from appraisals of past experience and influenced by the presence or absence of support. Experiences used in these appraisals were those from both within care and before care. 'Understanding' shed light on reasons for
Rock, S., Michelson, D., Thomson, S. & Day, C. (2013). Understanding foster placement instability for Looked After Children : A systematic review and narrative synthesis of quantitative and qualitative evidence. British Journal of Social Work, 43, 1-27. Rostill-Brookes, H., Larkin, M., Toms, A. & Churchman, C. (2011). A shared experience of fragmentation: Making of foster placement breakdown. Clinical Child Psychology and Psychiatry, 16, 103-127. Rubin, D., Alessandrini, E., Feudtner, C., Mandell, D., Localio, R. & Hadley, T. (2004). Placement Stability and Mental Health Costs for Children in Foster Care. Paediatrics, 113, 1336-1341. Rubin, D., O’Reilly, A., Luan, X., & Localio, A. (2007). The impact of placement stability on behavioural well being for children in foster care. Paediatrics, 119, 336-344. Rutter, M. (1981). Stress, coping and development: some issues and some questions. Journal of Child Psychology and Psychiatry, 22: 323–356. Rutter M. Psychosocial resilience and protective mechanisms. In (eds): Rolf, J., Masten, A., Cicchetti, D., Nuechterlein, K., & Weintraub, S. (1990). Risk and protective factors in the development of psychopathology. New York: Cambridge. Samuels, G. (2009). Ambiguous loss of home: The experience of familial (im)permanence young adults with foster care backgrounds. Children and Youth Services Review, 31, 1229-39. Samuels, G. & Pryce, J. (2008). What doesn't kill you makes you stronger: Survivalist as resilience and risk among young adults ageing out of foster care. Children and Youth Services Review, 30, 1198-1210.
Appendix D: Participant Demographics Table 1: Participant Demographic Information Participant Age Gender Ethnicity No. of foster placements (not residential) No. of placements (moved into) 12 years of age in Care 1 20 Male White British Multiple 2 No 2 19 Male White British 2 2 No 3 21 Male White British 9 6 No 4 20 Female White British 2 2 No 5 19 Female 2 1 No 6 17 Female White British 3 3 Yes 7 17 Female White British 1 1 No
Sister chose to leave placement without them Bond with brother was important Couldn’t stand being moved away from brother Bad relationship with foster carer impacted on access to see brother Move happened too quickly too handle Found out moving through being told they’d packed her bags Moved on the day she found out me and my brother had that bond and moving away from him was horrible. I couldn’t stand it. . I was depressed as soon as I moved to [town2]. ]. I weren’t allowed to go to his, to go see him ‘cause I’d fell out with my foster carers it all just happened so quick. Too much to handle in my … in a few days They didn’t. They told me they’d packed my bags. On the day No warning they’d obviously been planning it for a few weeks they just didn’t tell me. family when she was sixteen to move in with her mates’ mum who fostered her and me and my brother had that bond and moving away from him was horrible. Absolutely horrible. I couldn’t stand it. I was depressed as soon as I moved to [town2]. I weren’t allowed to go to his, to go see him ‘cause I’d fell out with my foster carers. And it all just happened so quick. Too much to handle in my … in a few days. Interviewer: And how ... and when did you find out the placement was ending, relative to when you were then moved? Participant: They didn’t. They told me they’d packed my bags. Interviewer: Ok. So it was on the day? Participant: Mmhhmm
feelings about moving Glad to leave because of way treated Lost what she viewed as her mum and dad who had been helping her grow up Now back in contact with foster carer Not wanted at foster home anymore Had to contact SS herself to sort where she was going. SS acted immediately to find a new place obviously they didn’t want me staying anymore I had to get hold of my social worker and the fostering agencies to find me a new place they done pretty much straight away. obviously from 18 I had to sort my own place out but from going from erm, one foster family to the other, obviously social services had to be involved, , the fostering agency had to be involved I couldn’t say anything about it. Interviewer: Ok. And how did you feel …. Participant: Erm… I don’t know really. I, like, …. In a way I was glad the way like I found they treated me but obviously unhappy as I counted them as my mum and dad. Like they was there for everything, helped me like grow up and all that lot…… I’m back in contact with them now. We still talk occasionally. Interviewer: Ok. And who moved you? (Rattling in the background). Sorry about that noise. Participant: That’s alright. Erm, well obviously they didn’t want me staying there anymore so obviously I had to get hold of my social worker and the fostering agencies to find me a new place… which they done pretty much straight away.… obviously from 18 I had to sort my own place out but from going from
with siblings, payment of foster carers and a number of other factors that may vary between the US and the UK. These could all be issues of diversity and difference that may impact the appropriateness or effectiveness of psychological interventions. These statistics highlight the breadth and depth of similarities and differences between both the foster care systems themselves and the characteristics of the children fostered in these systems and their difficulties. As discussed, there are also likely to be many more. Given these details, it seems complacent to assume that the evidence for effectiveness of interventions used in the USA is automatically relevant to the UK. It highlights the implementation of such evidence-based practises across the UK as a risky and potentially costly trial, in terms of public money and psychosocial impact on the foster children and their families if it is an ineffective intervention. Though US research dominates the literature databases, one would hope that given the extent that programmes such as MST and MTFC have already been implemented in a number of local authorities, that UK based evidence for effectiveness is now guiding practise in the UK more than US evidence. This literature review will now look at what evidence exists for the effectiveness of interventions for foster children in the UK. Method An electronic systematic literature search was undertaken on Psychinfo, Medline, Ebsco, Web of Knowledge and Cochrane databases. It included peer-reviewed papers published
families. McDaniel et al (2011) conducted a pilot programme in Northern Ireland, implemented by Barnardo's Professional Fostering Service, using a single-group pre-test and post-test design with 13 foster carers. McDaniel et al (2011) focussed on an age range of 8 and 13, providing some (though limited) information on this. Assessments were carried out before and immediately after the group training and included a self-report parent rating scale to measure the degree of conduct and externalising behaviour management problems are exhibited by children. Results from the study suggested a significant decrease in the intensity of social, emotional and behavioural difficulties reported by foster carers following the IYP, and a smaller but not significant decrease in the extent to which foster carers felt their foster child's behaviour was problematic. Bywater et al (2008) also looked at the effectiveness of IYP. They emphasised the potential of IYP to enhance placement stability and help foster carers understand the needs of children. Their study focussed on 46 foster carers of children between 2 and 8 years and employed controlled randomisation to allocate to the intervention (n=29) and control (n=17) groups. Foster carers were approached and requested to participate in the study and received monetary rewards for completing data at baseline and six-month follow-up. The children ranged between 2 and 17 years at the start of the study. Results suggest that the IYP was an effective programme for significantly reducing carer depression and reducing challenging behaviours in the foster children, as rated by the foster carers. Bywater et al (2008) questioned whether their findings had been limited by using a parent-report scale that they felt needed to be more sensitive. They also did not use other measures which reduced the
Practice case report Cognitive behavioural therapy with a middle-aged man presenting with obsessive-compulsive disorder Problem Based Learning – Reflective Account 'Relationship to change' Research – Literature Review UK evidence for interventions to improve the psychological wellbeing of foster children: A systematic review Adult – case report Assessment, cognitive behavioural formulation and therapy with a man in his thirties presenting with severe depression and post-traumatic stress disorder Adult – case report Cognitive behavioural therapy with a woman in her late twenties presenting with anxiety and depression. Research – Qualitative Research Project Trainees’ perceptions and experiences of in a therapeutic Setting Research – Major Research Project Proposal Impact of disrupted placements on the well-being of children who are accommodated Year II Assessments Programme Component title of assessment Research Research methods and statistics test Professional Issues Essay How do we understand the context of mental health, mental illness and mental wellbeing when people are experiencing material poverty? What psychological frameworks do we have to offer such people? Problem Learning – Reflective Account Child protection, domestic abuse, parenting and learning disabilities and kinship care
Older People – Case Report Neuropsychological assessment for a gentleman in his eighties experiencing some mild memory difficulties Personal and Professional Learning Discussion Groups – Process Account Personal and Professional Learning Discussion Groups Process Account Child and Family– Oral Presentation of Clinical Activity Positive risk management with a mid-teenage girl Year III Assessments Programme Component assessment title Research – MRP Portfolio people’s perspectives of foster placement instability: A grounded theory approach Personal and Professional Learning – Final Reflective Account On becoming a clinical psychologist: A retrospective, developmental, reflective account of the experience of training Specialist – Case Report Integrative therapy with a girl with chronic constipation and low self-esteem