Researching the Effectiveness of TA in Fostering
by Mica Douglas
Billy was an absconder. He was 10 and he would run away from his foster home late at night and be out all night. His various foster parents worried sick about him and many gave up on him because they could not bear the stress of waiting up night after night, police visits and waiting for him to do it again.
He moved to his eleventh placement in three years and his latest foster parent began to notice that he would always run away after he had been in trouble in the home. She was frantic with worry when he absconded because he would often stay out all night. She began to think about the part that she played in Billy’s behaviour and realised that he always absconded after she had shouted at him “get upstairs to your room and I will deal with you later”.
She then reflected on what those words might mean to him and when he returned one night, she asked him. He said that his parents always used to tell him to go to his room and what that meant was that one of them would come up some time later and physically abuse him. Naturally she was horrified and has never shouted at him again; similarly he has never absconded.
This is one example of how foster parents and social workers are looking differently at the behaviour displayed by children who have been significantly harmed: looking at what the meaning of that behaviour may have for the child rather than just reacting to the behaviour. The approach is part of a TA-based training course for foster parents and social workers, which has resulted in fewer breakdowns (the foster parents giving notice to end the placement on the child) and provided better outcomes for children.
The year-long course called the Certificate in Therapeutic Fostering focuses on enhancing a therapeutic approach to fostering using TA as the main theoretical approach. The course was commissioned by an independent fostering provider, By the Bridge, and is credit-rated by Greenwich University. A study has taken place through action research for qualitative measures and questionnaires for quantitative measures. The course has been running for four years and four cohorts of between 12 and 15 people have engaged with the study aims and both kinds of methodology. The objective was to discover:
- What skills and knowledge did foster parents need to have to reduce the incidence of placement breakdown (measured through Action Research)
- How could use of the self impact on the work with children if foster parents had greater self-awareness (measured through Action Research and Questionaire)
- How far the course helped or hindered foster parents to deal with difficult behaviours and children with complex needs (measured through Action Research and Questionaire)
An initial hypothesis was that foster parents could become more effective in their work with children if they had the opportunity to become more self-aware, reflective practitioners and if they had some underpinning theories that help them to be more consciously competent. TA is an effective tool for personal change and lends itself to practical application in communicating with others.
Fostering is a daunting task that has high expectation of the people who are deemed very good as parents but often have no experience of working with children who have been significantly harmed. As Jane Keenan, Training manager at By the Bridge, said:
“The nature of working closely with children who have experienced trauma and disturbance is to be in a constant process of making informed decisions and calculating risk. In fostering the work is a very particular combination of familial environment combined with professional task and the vehicle, the conduit, for change is the relationship between child and invested adult.
The foster child cannot leave their unconscious on the doorstep of the foster home. Nor can the foster parent. Powerful projections and transferences are inevitable, the only question is whether we realise what’s going on, and seek to engage productively, or not.”
The setting of a family environment for working with traumatised children, children with attachment difficulties and children suffering the loss of their birth families, means the skills and knowledge needed goes beyond ordinary parenting. As Jane Keenan states:
“Finding people who have the basic capacity to stay alongside the child in the midst of their turmoil is essential. If someone else can sit alongside them, can survive the consequences of their trauma and continue to live healthily the child learns that they can do the same … the unbearable slowly becomes bearable, the child begins to live rather than simply survive.
To advocate a raised self-awareness in foster parents is not to advocate ‘therapy at home’. It is simply an acknowledgment of the professional, skilled and sophisticated task, its associated responsibilities and the radical potential of authentic human attachment. Ongoing professional and personal development means that children gain ever more sophisticated tools for change – in the shape of foster parents.”
The problem of unacceptable breakdown rates is recognised by social workers, local authorities and the Government, but the responses so far have been to provide therapeutic fostering in the form of teams of professionals that can support the foster parent in their time of need. The problem with that approach is that it keeps foster parents infantilised, disempowered and the client of a service rather than the provider of a service. In this country we have seen a rash of groups to support foster carers (Golding and Picken 2004), an indirect model of placement support (Sargent and O’Brien 2004) and Treatment Foster Care based on the USA model of foster parents receiving 20 hours training and support from a long-arm team of professionals (Chamberlain 1998). I would contend that none of the above offers a lengthy enough form of training to provide foster parents with the skills and knowledge they need to help them grow personally and professionally through a process of self-awareness and reflection. The Certificate in Therapeutic Fostering was designed to see if any difference could be made to outcomes for children through a longer-term training that offered foster parents the internal and external resources to provide a therapeutic environment for children with complex needs. The training does not make foster parents into therapists; it is the equivalent of a foundation year in TA training with a specialist focus.
Quantitative Methods
A comparative questionaire was devised by myself and a research analyst, Carin Augustyn, using a scale to ask before and after questions about the training on the following topics:
- Self-awareness
- Behaviours common to foster children such as lying, stealing, soiling, defiance, aggression Transitions – beginnings, endings and changes Attachment
- Emotional Resilience
- Incidence of breakdown
Qualitative Methods
Action research (Heron and Reason 2001) was used as the main method for qualitative research because it was important to explore the personal meaning, beliefs and learning of the participants. This was gathered through self reports, questionaires on the development of new strategies, evidence of integration of theory and anecdotal evidence offered in structured Action Research group discussions. Validation of what was reported was available through self, peer and tutor assessment, essay work and end of year presentations.
Findings
In embarking on this project I was interested to see if the study may help to show that using such methods as a basis for training foster parents, will have a direct influence on the outcomes for the child in terms of:
- Longevity of the placement
- Dealing with difficult behaviour
Foster parents use of self in the relationship with foster children and professionals
Responses to TA
Every participant in the certificate course had to attend a TA101 as a pre-requisite. This gave group members a common language and shared experience that could then be built upon whilst going more deeply into theories about child development, trauma, living with a child who has been significantly harmed, parenting and unconscious processes. TA models that foster parents and social workers used over and over again to understand themselves and others were:
- Ego States
- Drama Triangle
- Script
- Strokes
- Racket feelings
TA was also reported to be hugely influential in developing the self-awareness of participants. Self-awareness proved to be the single most popular development of use to foster parents and social workers: it meant that they could stop reacting and look at their own behaviour first and then address the child’s behaviour.
One foster parent had described how she regularly had a strong urge to hit her five-year-old foster child when she could not dress on her own in the morning for school. What she realised in the module on unconscious communication was that the child was expecting to be hit because she came from a violent home and that was familiar to her. The counter-transference evoked in the foster parent was to want to hit the child when she felt frustrated because that is what her father used to do to her when she was small.
Knowledge of unconscious processes helped this foster parent’s self-awareness to grow and she was then free to think differently about the situation. She could also apply other theory that helped her to recognise that the five-year-old was not able to operate as a five-year-old because her emotional development had been delayed due to abuse. She was functioning as a two-year-old would and nobody would expect a two-year-old to dress herself and be able to tie shoelaces.
Findings
As shown by the diagram some 59% of participants felt that they had fewer placement breakdowns because of the course and described how the learning from the course helped them to not give up on children.
Other key findings are:
- The ability to deal with sexualised behaviour had grown on average by 43%
- The ability to recognise and deal with different kinds of attachment behaviours had risen by an average of over 43%
- The ability to deal with lying had risen by 40%
- Areas of physical and verbal violence, which were not dealt with intensively on the course, had lower scores in terms of people’s perception of their increased abilities. Ability to deal with verbal violence had risen by 32%
- Ability to deal with physical violence had risen by 27%
Interestingly, none of the behavioural questions had a neutral or negative value ascribed to them; everyone believed that their abilities had increased in each area of behaviour common to foster children.
Bibliography
CM 5860 (2003) Every Child Matters HMSO, London CM 5730 (2003) The Victoria Climbie Inquiry. Report of an inquiry by Lord Laming, HMSO, London Chamberlain, P. (1998) Treatment Foster Care Oregon Social Learning Centre
Golding, K., and Picken, W. (2004) Group Work for Foster Carers Caring for Children with Complex Problems Adoption and Fostering Vol. 28:1 BAAF Heron, J. and Reason, P. (2001) The Practice of Cooperative Inquiry in P. Reason and H. Bradbury (eds) Handbook of Action Research: Participative Inquiry and Practice Sage, London
Hutchinson, B., Asquith, J. and Simmonds, J. (2003) “Skills Protect”: Towards a Professional Foster Care Service, Adoption and Fostering 27:3 pp 8-13 BAAF
Sargent, K. and O’Brien, K. (2004) The Emotional and Behavioural Difficulties of Looked After Children Adoption and Fostering Vol 28:2 pp 31-37 BAAF Department of Health (2001) Planning and Providing Good Quality Placments for Children in Care Department of Health National Minimum Standards for Fostering and Adoption on Counselling Children and Young People: a Systemic Scoping Review
Laming (2003) The Victoria Climbie Inquiry www.victoria-climbie-inquiry.org.uk
Mica Douglas (MSc in TA Psychotherapy, CTA, PTSTA, MASW, AASW) is consultant psychotherapist to By the Bridge and has a private therapy and supervision practice in Kent, UK. For more information contact Mica Douglas mica.douglas@btinternet.com or Jane Keenan jane@bythebridge.co.uk
