As part of our ongoing series on Therapeutic Foster care, we are looking at areas that anyone considering therapeutic foster care will be likely to encounter. Therapeutic foster care has gained in prominence largely in response to the rapidly changing needs of children entering the care system. Children with complex emotional and behavioural needs often require therapy in order to come to terms with their experiences and begin to make progress. Carers who are trained in therapeutic foster care, will be expected to support any clinical interventions judged necessary within the home environment. An understanding of the main issues is essential to successful therapeutic parenting.

Therapeutic foster care: attachment theory

Attachment refers to the general ability to form emotional bonds and empathic relationships with people. This is a process which starts early in life and begins with close family members. John Bowlby was the developmental psychologist who first described the concept of Attachment. This focused on the bond between the infant and its mother. Bowlby regarded attachment as a process, not a single event. This begins at birth and then extends into the early years of a child’s life. The nature of a child’s relationship with its primary caregiver – usually the mother – could have important consequences for the child’s attachment style for life. Insecure attachments, it was determined, could interfere negatively with the ability to form sustainable romantic relationships later in life.

In general children develop secure and healthy attachments to mothers who both regularly and competently respond to their child’s needs. The classic example is feeding the child when it cries. Less research has been carried out in relation to attachment between a father and child. Studies of a preliminary nature suggest the process is similar but with a greater emphasis on play.

It is possible to measure attachment using the ‘Strange Situation Test’. This was first developed by the developmental psychologist Mary Ainsworth. This involves researchers observing a child’s reactions when it is left with them by the mother. The mother then departs – children with secure attachments exhibited a strong attachment to the mother. By contrast, a range of unhealthy reactions was demonstrated by children with insecure attachments. This would often include demonstrating anger toward the mother on her return.

Therapeutic foster care: attachment issues

A weak attachment bond can lead to problems in creating healthy social and emotional ties. Typically, attachment issues arise because of an early separation from parents, a lengthy period of hospitalisation, trauma, neglect or exposure to other indicators of a troubled childhood. Issues around attachment are more prevalent in maltreated infants – usually due to neglect or the child being passed from one caregiver to another. Inconsistent behaviour from caregivers can also lead to the development of attachment issues.

Signs of insecure attachment can include the following:

• avoiding physical contact;
• avoiding eye contact;
• frequent bouts of crying;
• a habit of self comforting;
• little interest in toys  or social play;
• rejection of touch;
• rejection of attempts at emotional connection.

There are four main types of attachment.

1. Secure: a child is able to interact with others  in the presence of its mother and then become upset when she leaves. the child will then avoid contact with strangers. Such behaviour is characteristic of a healthy attachment.
2. Anxious-Resistant Insecure: here a child will exhibit anxiety in the presence of strangers and will not interact with them. The child will become very upset when the mother disappears and then be unreceptive to her attempts to interact when she returns. This can indicate the mother does not meet the needs of the child consistently.
3. Anxious-Avoidant Insecure: here a child will demonstrate ambivalence to the mother as well as to strangers. The child shows no interest in being held and no preference toward caregivers. This particular attachment style means that a child has learned their efforts to have their needs met will be ignored.
4. Disorganized/Disoriented: with this issue, a child may become upset when its mother leaves and then appear relieved on her return, it may refuse to be held and show aggression to the mother. Past research indicated half of the mothers of children with this form of attachment issue had experienced trauma-induced depression prior to giving birth.

Therapeutic foster care: Reactive Attachment Disorder (RAD)

This is a serious  condition that can develop between the age of six months and three years. It arises from a failure to form normal attachments to primary caregivers. This failure can be the result of early experiences of a severe nature. These can include frequent changes of caregivers, abuse or neglect. Children with RAD often establish a pattern of consistently withdrawn behaviour. They may also fail to respond socially as well as emotionally. Such children may be sad, anxious, irritable as well as having irrational fears. They may show an aversion to physical affection, or have anger and control issues as well as experiencing difficulty showing affection. past research has shown that RAD occurs at a higher rate amongst maltreated children.

Therapeutic foster care in a Rainbow setting

Interest, passion and dedication are the qualities needed if you are interested in therapeutic foster care as a career. Could you provide a supportive and stable home for children with a range of emotional and behavioural needs? The training we provide is stimulating – working in therapeutic foster care means no two days will be alike. Make sure you keep up to date with our ongoing series of blogs on the issues that relate to therapeutic foster care.

More information is available on 020 8427 3355 or our National line 0330 311 2845.

Latest fostering news stories:

British Columbia boosts support for children leaving foster care

26th, February 2018

The issues affecting foster care can be the same wherever you are in the world. The government in British Columbia has announced a $7.7-million funding boost for young adults leaving foster care (more) http://bit.ly/2e8PrIK

Good news at the end of our Rainbow…celebrating the last of our Rainbow birthdays for the month – Happy Birthday to all concerned! 

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