When carers end foster placements: exploring foster carers’ experience of adolescent foster placement breakdown

Abstract

While foster carers experience the rewards and challenges of parenting vulnerable and complex adolescents, some of these placements break down. Compared to research into the impact of placement breakdown on looked after children, there are relatively limited reports on how foster carers are affected. The aim of the present study was to provide an exploratory account of foster carers’ lived experience of ending adolescent foster placements. Nine participants from seven foster families in the UK were recruited. Semi-structured interviews were conducted and analysed within an Interpretative Phenomenological Analysis (IPA) framework. Exploration of the foster carers’ experience identified four superordinate themes, two of which are relevant here: ‘emotional aftermath’ and ‘we’re only human’. Following a placement ending, foster carers identified different emotions including joy, relief and sadness. A grieving process was also identified, which involved coming to terms with loss and accepting the termination of the relationship. It is further suggested that foster carers are likely to experience shame and guilt as a consequence of placement breakdown.

Keywords

Foster placement foster breakdown fostering challenges disenfranchised grief IPA

Introduction

Background: caring for challenging young people

Foster carers have a significant responsibility in looking after vulnerable adolescents (The Fostering Network, 2016). Foster care placements can offer stability, a sense of belonging and connectedness (Schofield, Beek and Ward, 2012). While they can end for a number of reasons, such as reunification with birth family, a significant number of them break down, leading to the child moving to another care arrangement (Leathers, 2006; Ofsted, 2016).

Many looked after children have experienced inconsistent nurture and caregiving. Within the literature this is often defined as complex trauma – developmental experiences wherein the child is traumatised by their caregiver (Hughes, 2004). Developmentally traumatised children are at higher risk of difficulties within the areas of attachment, affect regulation, dissociation, cognition, self-concept and behavioural control (Golding, 2007; van der Kolk, 2017). As a result, it is not surprising that those in care are four times more likely than their counterparts to experience mental health problems (Bazalgette, Rahilly and Trevelyan, 2015); they are also at risk of behavioural, social and academic difficulties (Munro and Hardy, 2007) and poorer general health outcomes (Rock, et al., 2015).

The specific challenges of caring for adolescent looked after children

Adolescence is a crucial developmental period and can account significantly for a successful transition into adulthood (Cicchetti and Rogosch, 2002). In the year ending March 2012, the 13- to 17-year-old age range of young people looked after in the UK had the highest annual proportion of three to five placement moves (Department for Education, 2013). Farmer, Moyers and Lipscombe (2004) reported that factors linked to the foster carers’ capacity to parent adolescents, as well as difficulties such as the impact on other children in the family, make fostering adolescents particularly challenging. Further, low self-esteem and a fractured understanding of their earlier life experiences might be key for teenage looked after children (Schofield and Beek, 2009). Given their early encounters with adversity and reports that adolescents experience the highest frequency of placement breakdown, understanding the impact of caring for this complex cohort is paramount.

Foster carers’ experience of ending a placement

While there are several studies reporting the negative impact of foster placement breakdown on looked after children, there is limited research on the lived experience of foster carers during these difficult times. It has been noted that increased challenging behaviour presented by this population of young people is significantly associated with a rise in the stress, anxiety and depression among foster carers (Morgan and Baron, 2011). Research has also extended to include factors such as hope, resilience and persistence, which foster carers consider important to placement success (Oke, Rostill-Brookes and Larkin, 2011). There is also limited research reporting on the experiences of foster carers after placement breakdown. One such study found that some foster carers experience grief when a placement ends and that this influences the choice to stay in the profession (Hebert, Kulkin and McLean, 2013). Other findings indicate that foster carers can become distressed when their expectations of foster placements are invalidated (Broady, et al., 2010).

It is perhaps simplistic to suggest that foster carers’ experience of placement breakdown is solely influenced by the complex needs of the young people in their care. In commentary discussing the movement of foster carers to independent fostering agencies (IFAs), Bawden (2018) reported that systemic factors, such as feeling disillusioned or undervalued within the role, together with a lack of financial and emotional support, contribute towards problems with local authority foster carer retention. This provides some indication of the pertinence of systemic factors. In addition, foster carers experience personal circumstances related to areas such as health and close relationships that may deteriorate or improve. Research into the influence of systemic factors suggests that foster carer support is imperative in managing the difficult emotions that can arise when a foster child moves out of the home (Samrai, Beinart and Harper, 2011).

Rationale for the current study

In a review of the literature, Rock and colleagues (2015) recommended further research exploring experiences within the foster home environment by differentiating factors such as the child’s age and gender. Studies have used surveys (Hendrix and Ford, 2003), focus groups following a novel task (MacGregor, et al., 2006), postal questionnaires (Hudson and Levasseur, 2002) and telephone interviews (Brown and Campbell, 2007). However, few of these report on an in-depth exploration into foster carer experience.

Although fostering is referred to as the gold standard of care for looked after children and young people (Ofsted, 2016), The Fostering Network (2016) reported that in 2015, 12% of foster carers retired or left fostering whereas the number of children in need of such placements increased. Consequently, there is growing pressure to provide an adequate volume of carers, especially for adolescents where the availability of carers is particularly low. It is well established that early life adversity and subsequent foster placement breakdowns saddle looked after children with a double disadvantage (Silver, Golding and Roberts, 2015); it is less recognised that placement stability also benefits foster carers. The loss and grief they can go through when a foster child leaves the foster home have been well documented (Hebert, Kulkin and McLean, 2013; Lynes and Sitoe, 2019). However, there has been little focus on exploring carers’ experiences in order to understand and to intervene to support them to continue fostering.

This article addresses some of these methodological and research gaps by exploring one central question: What are foster carers’ experiences of terminating foster placements involving looked after children placed in later childhood (11–18 years)?

Methods

Research design

Interpretative Phenomenological Analysis (IPA) posits that humans are ‘sense-making creatures’ and that this requires researching the individual’s representation of their experience (Smith, Flowers and Larkin, 2009: 33). Since the aim of the present study is to understand the meaning that foster carers give to placement breakdown, IPA is applicable as it has been demonstrated as an appropriate method for exploring a specific context, focused on a sample of people who have significant lived experiences (Brocki and Wearden, 2006; Reid, Flowers and Larkin, 2005).

Once the research design had been fashioned, the approach was piloted through interviewing a married couple with a shared experience of placement breakdown. In addition, in a later feedback session six local authority foster carers all reported that the initial superordinate themes to be identified connected with their experiences of foster placement challenges and breakdown.

Recruitment and selection of participants¹

Three fostering organisations (two independent fostering agencies (IFAs) and one local authority) were gatekeepers to participants with the inclusion criteria outlined below. Participants were emailed the information sheet and offered a telephone conversation to discuss any questions about participation with the principal researcher, after which a suitable interview date and time was arranged.

IPA challenges the notion that the quality of research is directly related to the number of participants recruited (Reid, Flowers and Larkin, 2005) and in a review of the literature, Smith (2004) noted that studies typically report sample sizes between five and 10. Hence, given the need to balance time-specific constraints and the requirement for richness in data, a sample size of seven was recruited. The inclusion and exclusion criteria are outlined in Table 1.

Table 1.

Participant inclusion and exclusion criteria.

Criteria	Inclusion criteria	Exclusion criteria
Population	Registered foster carers who hold approved foster carer status	Kinship carers Special guardiansOther care arrangements
Placement breakdown	Foster carer terminated foster placement	Experience of foster placement breakdown outside of foster carers’ controlCare plan meant placement was intended to be short-term
Time frame	Foster carers with experience of foster placement breakdown within approximately six months and three years ago Considered on an individual basis	Short-term placementsPlacement breakdowns that occurred historicallyCarers with limited memory of their experience of foster placement breakdown
Gender	Male and female foster carers with experience of male or female placement breakdowns	N/A
Age	Foster child aged 11 or above at the time of the placement breakdown	Experience of placement breakdown involved primary school-age children (<11 years)

The characteristics of the participants can be seen in Table 2. They were invited to engage on their own or with their partner/spouse. Participants 6 and 7 both took part as a couple, with both partners identified under the same heading given that they shared their experiences of the same child, foster home and placement breakdown. Consideration was given to the length of time that had passed since the placement broke down, with particular attention paid to the ‘rawness’ of the breakdown and ability to recall relevant details. The pilot study indicated the unhelpfulness of rigid inclusion criteria in relation to time elapsed since the disruption, so this was discussed with participants and gatekeepers on a case-by-case basis.

Table 2.

Participant characteristics.

Participant number	Pseudonym	Foster carer age range	Family composition	Years as approved foster carer	Fostering agency type	Child age at time of breakdown
1	Joan	45–64	Couple	8	IFA	12
2	Christine	45–64	Couple	7	IFA	14
3	Simon	35–44	Couple	6	IFA	14
4	David	45–64	Couple	7	IFA	13
5	Jane	65+	Couple	13	Local authority	15
6	Amanda & John	45–64	Couple	18	Local authority	14
7	Sally & Peter	45–64	Couple	20+	Local authority	14–18

Procedure

The existential nature of IPA, whereby participants are asked to reflect on and vocalise what happened, may in itself be distressing (Pietkiewicz and Smith, 2014). When developing and administering the research materials, the risk of harm was duly considered in keeping with the British Psychological Society Code of Human Research Ethics (2014) and ethical approval was sought from the relevant University Ethics Committee and the fostering agencies’ respective research committees/board of directors. All participants were provided with an information sheet beforehand, to duly consider what engaging with the research would entail. They were also given a debriefing sheet including information about support services and the opportunity to make further comments. After the interview, they had time with the researcher to discuss their experience of taking part.

At the start of the interview, participants were reminded about the purpose and nature of the research, anonymity, confidentiality and withdrawing consent and had opportunities to ask questions. Once underway, the interviews were recorded and transcribed.

Materials and analysis

In keeping with IPA methodology, a semi-structured interview schedule was designed to afford a space for participants to share their experience and collaboratively provide a rich and reflective account (Reid, Flowers and Larkin, 2005). The research aims were explored through an interview guide structured around themes delineated from the literature review: expectations of the foster carer (Broady, et al., 2010); foster carer experience of forming an attachment to the foster child (Golding, 2007); foster carer views on parenting looked after children and their experience of challenges within the placement (Morgan and Baron, 2011); and foster carer emotional well-being following the placement breakdown (Edelstein, Burge and Waterman, 2001; Hebert, Kulkin and McLean, 2013). The analysis followed the procedure for IPA outlined by Smith and colleagues (2009).

Results

The data analysis identified four superordinate themes, but two of these related more generally to foster placement challenges. Thus, the present article focuses on the two themes that were most relevant to placement breakdown: emotional aftermath and ‘we are only human’. These tend to indicate a journey from starting fostering to placement breakdown, but given that participants reported a number of factors, such as ‘sticking it out’, self-doubt and attempted reunification, the journey is clearly not a linear one.

The themes selected for discussion are listed in Table 3.

Table 3.

Superordinate and subordinate themes.

Superordinate themes	Subordinate themes
Emotional aftermath	Holding mixed emotionsRipples of loss
‘We are only human’	‘You’ve developed, it’s different’Meaning makingMoving on

Emotional aftermath

In accounts of their experiences of foster placement breakdown, carers described a range of immediate difficult feelings and longer-term emotional consequences.

Holding mixed emotions

Most participants described feeling relieved, accompanied by other difficult emotions. David felt that being sad and relieved at the same time represented an ‘emotional rollercoaster’. Joan described relief in not ‘having all the trauma every day’. Similarly, Simon described it as grounded in the absence of ongoing worry and stress ‘on me’. Most expressed this sense of relief following placement breakdown as a ‘cruel’ and ‘horrible’ thing to say, indicating a sense of shame around positive feelings, as Jane highlights:

I was overjoyed. I don’t mind admitting that.

Interviewer: Mmm.

Jane: I am absolutely honest about that. I probably felt the biggest weight had left off and took off my shoulders, that I had never been so relieved to see the back of a child.

Jane’s language of ‘honesty’ indicates uncertainty about the acceptability of her feelings. It implies that she perceived the potential to be criticised but also suggests an internal view of herself as ‘wrong’ or ‘bad’ for admitting those feelings. Christine noted an overall sense of herself as ‘bad’, with increasing reassuring thoughts to herself that she is a ‘good foster carer’ in spite of her decision to end the placement. Simon, too, noticed that by ‘admitting defeat’ there was an element of questioning his capacity as a carer, particularly as he felt judged by others. Similarly, David attempted to reassure himself by saying: ‘No one in their right mind would put up with this.’ He indicated that he was creating commonality with others as a means to alleviate shame and offered this as a statement, suggesting some finality in his reflections, perhaps indicating a long process of circular thinking between blame and reassurance. But, in spite of feeling relieved, participants also noted sadness: ‘It … it broke my heart it really did [pause]. I don’t cry often but I did that day.’

David’s description of his heart being broken appears to symbolise the experience of placement breakdown as distressing. He further illuminates this by describing that immediately after the breakdown he was ‘in a slump’, feeling ‘awful, really awful’.

Ripples of loss

Most participants cited grief as a consequence of the placement ending, either through the labelling of their immediate emotional experience or identifying ‘ripples of loss’ that continued longer term. David identified that his family continue to miss the young person. Joan and Simon said the same but with the caveat that they coped by focusing primarily on the positive memories that served to remind them that they had not failed. Most carers talked about how grieving the placement breakdown had led to, or at least involved, acceptance. It seemed to resonate with everyone that the ending of a close relationship is likely to lead to loss regardless of the circumstances, further indicating the longer-term emotional impact of the events.

‘We’re only human’

This theme helps develop understanding of a complex mixture of reflections from across the interviews; the self and the family are changed in light of the placement breakdown.

‘You’ve developed, it’s different’

In explaining the personal impact of the placement ending, some participants contrasted a current view of themselves to the one they had before fostering. Given that many likened the period up to the placement ending as fraught with battles – whether this was within the placement or with the wider system – often the personal impact had been in bolstering the participant’s voice and opening up. For example, David described his transition from shy and reserved to being increasingly opinionated and vocal about his beliefs. Like others, he also reflected that the process had ‘brought a lot out of him’, implying that those qualities were always present but had become more prominent following the placement ending. For Jane, it was her husband’s reflections that encouraged her to consider how she had changed:

Years and years back when you first started, fostering was so important that … it was everything but now … you’ve developed, it’s different.

Jane’s extract emphasises the development of self as a journey ‒ experiencing the ending of a placement and surviving it, leading to a reduction in fear. Simon described increasing his capacity to share his emotions and receive support. This indicates an acknowledgement of himself as potentially fragile, only recognised as part of ending the placement. This development was highly important to Simon, as he described the opening of opportunities to seek psychological support when the placement ultimately broke down.

Meaning making

This theme draws on participants’ experiences of making sense of the placement breakdown. Most discussed having tried to sustain the placement, reinforcing to themselves that they could not have done any more and that as Joan said, they had made ‘the right decision’:

I’m so proud of ourselves because it could have gone the other way, but we made sure it was positive for her, which meant that we didn’t feel as guilty.

Joan’s identification that she acted in the best interests of the young person contrasts with a sense of concurrent guilt. This is characteristic of most of the interpretations of what happened, supporting the notion of accepting that it had not worked despite a lot of effort. However, Jane’s narrative about the placement breakdown is characterised more positively. She referred to the potential long-term benefit of the disrupted placement: ‘I think there will always be later on in that kid’s life, something that you might have done.’

This suggests a view that amid the distress and difficulties, the placement was still worthwhile. This might have served as an important protective factor for Jane; perhaps it is particularly damaging to feel that one’s hard work and investment is worthless or rubbished. David reflected on his experience of being ‘blamed’ and feeling ‘really small’. His responses in the aftermath seemed to have bolstered his fragile self through accepting that he was not to blame. Jane added to this interpretation by reflecting that the young person had been so deeply affected by trauma that his ‘walls had gone up and were never coming down’. This seemed to further protect Jane, by identifying the problem as not being with her but located within an unchangeable past. This is strengthened in other extracts, including Christine’s comment that ‘We are only human you know. I learned not to beat myself up so much about it.’

By identifying herself as ‘human’, Christine emphasised that it was important that she came to understand that she was not to blame. Further, it seemed that she had wondered whether she could have done more, and that making meaning involved disentangling herself from unreasonable expectations to be ‘superhuman’. Simon reflected that he could not have done any more, but that things could have been different in an ‘ideal world’; this also links to the notion of readjusting expectations as part of understanding what happened. Overall, making meaning appeared to appease the idea of placement breakdown as their fault, so reducing their sense of guilt and lowering their expectations of what could have been achieved.

Most participants reflected on the strength they had relied upon in their marriages in order to ‘survive’ placement breakdowns. Amanda, John, Joan and Simon echoed sentiments of their spouses as being their ‘rock’; this seemed to offer recognition of the positive among the negatives.

Moving on

This theme encapsulates coping with grief and moving forward following placement breakdown. David noted this as ‘a breath of fresh air’ and identified a restored normality wherein he could reconnect with his home as an enjoyable space. Joan reflected that the emotional journey ended with acceptance:

The initial feeling of abandoning someone did change because we had to realise we had done and took it as far as we could.

For most participants, acceptance represented a genuine belief that the placement ending was ‘for the best’ and this was an important element in moving on. For others, this involved processing and remembering that the young person was a child:

I mean after her, you would have thought we would never have had teenagers but as I say, you get to the stage where you think they are still a child.

John’s account indicates that remembering the young person as a child diluted the strength of feeling about the placement breakdown. Overall, the period of coping with the emotional experience associated with placement breakdown, but also in reclaiming the family home, involved reconnection to loved ones, the home environment or the fostering profession. Acceptance may mark the end of or a latter part of grieving, and this seemed to provide participants with an ability to acknowledge what had happened in a non-judgmental way.

Discussion

A selection of the identified themes pertinent to recent research are discussed in context below.

Emotional aftermath

Grief is a complicated phenomenon of which many people have personal experience (Hebert, Kulkin and McLean, 2013). A broad view focuses not only on the experiences of the death of a loved one but also on feelings that occur when people experience a separation from someone or something important to them (Walsh-Burke, 2012; Worden, 2009). Foster carers felt sadness and sometimes distress about the end of the placements. Although they acknowledged that the placement ending had been their choice, they often felt ‘stuck’ without an alternative. Consequently, they questioned what might have been needed in order to prevent the breakdown and indicated a sense of guilt. These emotions are consistent with grief conceptualised as natural, and encompassing many reactions, from sadness, anxiety and guilt, to physical symptoms and fatigue (Lynes and Sitoe, 2019; Walsh-Burke, 2012).

The methodology also allowed further exploration of previous findings offered by Hebert and colleagues (2013). They did not specifically explore foster placement breakdown but found that grief can occur regardless of the ways in which placements end. While the present study did not compare types of placement endings, the findings suggest that there are specific emotional experiences linked to the process of placements breaking down as opposed to simply ending. This is consistent with bereavement literature that recognises grief as unique and emotionally complex (Stroebe, Schut and Boerner, 2017).

Our study also supports broader literature reporting that symbolic or psychological losses are significant, and so recognises that psychological loss involves a grieving process that is vital (Doka, 2008). Anecdotally, it has been reported that ‘separation from an infant or very young child is obviously more likely to elicit a stronger grief reaction’ (Hebert, Kulkin and McLean, 2013: 255) but the present study has identified distress as a common grief reaction to placement breakdowns involving adolescents. The literature identifies this as ‘disenfranchised grief’, a concept defining the experience of grief when it is perceived to be unrecognised or defined by others as illegitimate (Doka, 2008) and Lynes and Sitoe (2019) highlight its detrimental impact. This is particularly important in the light of the finding from this study that foster carers can grieve adolescents within the context of a suggested narrative about a lack of acceptability of grieving older children. It is a requirement of foster carers to commit to young people in a way that is loving, warm and compassionate yet maintains professionalism. Grieving an adolescent following placement breakdown may be complicated by thoughts about the professionalism of one’s own feelings and this could introduce an additional and unique layer for grieving foster carers about the acceptability of their emotional experience.

These findings are supported by literature from the area of developmental disabilities reporting social support as vital to managing challenges presented by children (Dunst, Trivette and Jodry, 1997) and specifically that parents of children with disabilities experienced increased marital strain (Risdal and Singer, 2004). It is noted in this study that parenting young people with a complex trauma presentation places unique and specific demands on carers that may differ from those of parents with children with developmental disabilities. However, within the present study, the carers strongly identified their partners as significant in terms of providing support throughout the emotional experience associated with the placement breakdown.

‘We’re only human’

Following placement breakdown, foster carers identified the development of a narrative of what had happened, acknowledging the self as changed, resuming normality through reconnecting with the home and family and ‘moving on’. Most noted acceptance as key to those processes. Within the context of loss, acceptance has been defined as ‘a sense of inner peace and tranquility that comes with the letting go of a struggle to regain what is lost or being taken away’ (Prigerson and Maciejewski, 2008: 435). There is debate within the literature regarding the limited empirical support for a stage model of grief, with some authors reporting findings that suggest that disbelief, yearning, anger and sadness may represent aspects of a single underlying psychological construct of grief (Prigerson and Maciejewski, 2008). While the present study cannot clarify this debate, findings do support the suggestion that as grief decreases so acceptance grows. It is also possible that acceptance is part of the grieving process but is more accessible once the raw and sometimes overwhelming emotions of placement breakdown have begun to be processed.

In line with other recent research, this study highlighted that foster carers can experience a variety of emotions following a placement ending (Lynes and Sitoe, 2019). Some noticed that as relief dissipated, other emotions and thoughts emerged: foster carers doubted decisions they had made, wondered whether they had ‘failed’ the young person and questioned the positive feelings they had felt (such as joy) as a result of the placement breaking down. This implies that processing joy, relief and elation can lead to shame. This has been described as a negative, exposing and sometimes psychologically painful emotion (Tangney, Stuewig and Mashek, 2007). It suggests the experience of feeling defective, with either a real or imaginary sense of how one’s shortcomings would appear to others; in this sense shame can also encompass feelings of being worthless or powerless (Tangney, 1995). Overall, it refers not only to one part of self but also to an overall view of the self through a negative lens (Tangney, 1995). This suggests that the circumstances of the placement ending do have a significant impact on the foster carers’ sense of self. Furthermore, in relation to mental health difficulties, a number of studies (Jagdeo, et al., 2009; Schomerus, Matschinger and Angermeyer, 2009) have highlighted shame as one emotion that can present as a barrier to people seeking help. At various points, foster carers perceived themselves to be judged rather than believed. Seeking help is likely to be limited by fear of ‘public stigma’ ‒ the experience of being or perceiving to be discriminated against by others (Evans-Lacko, et al., 2012). Guilt related to perception of self as a failure, or shame related to the experience of positive emotions, are also proposed from the present study. This indicates the pervasive nature of shame for foster carers at individual and systemic levels.

Implications for policy and practice

Containing systems: a secure base

If, as noted, shame can act as a barrier to caring for oneself, it is suggested that foster carers would benefit from an enhanced ethos of self-care, with awareness and encouragement to replenish their own well-being. In caring for vulnerable children, there is an inherent demand of fostering professionals to provide a contribution from the self. This indicates that fostering organisations need to review where and what support or permission there is for carers to process and make sense of their experiences when they end placements so that they can integrate this into their development and then use it as a point of reference and stability. As in psychological models of a ‘secure base’, it is from this reference point that individuals can remain open, engaged, curious and explorative (Biggart, et al., 2017). Interestingly, this may fit with foster carer reports that a ‘positive’ aspect of the placement ending related to their personal development through these difficult experiences.

This ethos of self-care is also relevant to fostering professionals such as social workers and team managers (Biggart, et al., 2017). Developmental trauma is pervasive and it is well reported that it can influence foster carers, professionals and systems (Emanuel, 2002). If carers need self-care, it is pertinent to ask where they might get it from. Professional systems might offer the space to contain emotional experiences by having mechanisms to slow down, reflect and be thoughtful. There are examples of teams that prioritise the implementation of these types of ideas such as Building Attachments, Security and Emotional Wellbeing (BASE) in South Wales (Cooper, 2018). BASE strives to provide a secure base to social care professionals in order that they can transfer this to the carers and children they support. This highlights the important preventive role of psychological and therapeutic practitioners to notice, contain and sustain work with the complexities of human relationships and developmental trauma. Similarly, the Gwent Attachment Service highlights in its information leaflet, the importance of supporting agencies to embed attachment principles into their service planning and delivery (Gwent Attachment Service, n.d.).

Formal training, supervision and consultation

This study also draws a tentative link between foster carer experience of loss when a placement breaks down and the concept of ‘disenfranchised grief’. It is essential to validate grief through recognising foster carer experience as ‘legitimate’. The findings presented here are consistent with the conclusion offered by Lynes and Sitoe (2019) which includes the recommendation that foster carers be supported not only individually but also by the professional environment. Professionals interacting with foster carers might benefit from developing a grief framework and skills in initiating conversations about this complex emotional reaction. However, it is also important that the professional system around foster carers has the capacity to deliver this support. For example, this might include social workers having supervision or consultation to remain open and attuned to foster carers’ emotions.

Reflective practice

Findings indicate that foster carers can experience shame as a result of positive emotions when a placement breaks down. Thus, they may benefit from the opportunity to share their genuine emotional experiences within a non-judgmental professional context. This could include normalisation of grief as natural and encompassing many emotional reactions. Anecdotally, foster carers reported that they had valued taking part in the present research, not least because it provided a space to openly and honestly discuss their emotional experience. Therefore, as highlighted by Lynes and Sitoe (2019), it cannot be assumed that these narratives are consistently articulated to foster carers in their usual professional conversations – the power of this should not be underestimated. BASE has clinical psychologists within the team to facilitate reflective practice groups (Cooper, 2018). Reflective practice is recommended as a process to explore conflicting views, repeated patterns of breakdown, uncertainty and poor communication (NICE, 2016). In this way, psychology practitioners can play a valuable and crucial role in services.

Psychological formulation

Psychological formulation is described as ‘a hypothesis about a person’s difficulties, which links theory with practice and guides the intervention’ (British Psychological Society, 2011: 2). This study highlights the role of professionals in developing a shared psychological understanding of the difficulties experienced by adolescents and consideration of support to the placement in meeting the young people’s human needs (e.g. to socialise, connect, be safe). A psychological formulation of each young person’s presentation could help to inform, or be co-constructed, with carers’ narratives if a placement is ended by a foster carer. Psychology therapists can offer a valuable role in supporting the professional network to develop this shared understanding (Gwent Attachment Service, n.d.), in thinking creatively about responding to difficulties (Cooper, 2018) and perhaps, in making sense of placements ending.

Limitations

Although this study has explored a little researched area, it has several limitations. Firstly, self-report methods inherently introduce a risk of attribution. It would be pertinent to explore placement breakdown from the perspective of social care practitioners, particularly given the findings that foster carers have felt blamed and even vilified. In addition, consideration was given to the methodological implications as well as the relative merits of interviewing individuals and couples. Impressions regarding the interview process and analysis of the content indicated that couples expressed their experiences relatively openly and offered alternative and at times contrasting views. However, research utilising IPA to explore couples’ experiences emphasises the dyad due to the significance of events for the couple rather than only for the individual (Antoine, et al., 2013). This study provided depth of exploration of lived experience at an individual level that limited its exploration at a dyadic one. Finally, findings were identified through the interpretive and reflexive focus of IPA using a relatively small sample. It is important to note, however, that many of the children referred to by foster carers had experienced multiple placement breakdowns which might have been an additional influence on their views.

Recommendations for future research

This area would benefit from further investigation into foster carer reports of guilt and shame and their experience of being able to share their emotional world, given their concerns about being ‘bad’ and ‘to blame’. This could be further supported by quantitative research looking at indicators of shame. Observing the human use of language through discourse analysis can also offer further opportunity to examine relevant discourses.

Foster carers regularly reported the significance of the marital relationship in supporting recovery from difficult emotional experiences following placement breakdown. Recruiting single carers to explore their experience of placement breakdown would be pertinent towards considering how far the themes can be generalised.

A number of foster carers discussed the impact of family contact on placement stability. Navigating social media, mobile phones and online gaming can place significant strain on placements, particularly as young people may utilise these means to have unsupervised contact with family. Although such contact might offer significant positives, some placements may come under strain; for example, despite having a positive experience of foster care, some young people may feel a sense of division of loyalty between foster carers and their birth family. Anecdotally, professionals working in this area highlighted that some young people have stated a preference for residential placements, noting the difficulty in residing in a foster family when they remain loyal to their birth parent/s. Understandably, this too can affect foster carers’ experiences of investing in a relationship. Thus it would be pertinent to understanding difficulties specific to adolescent placement endings to explore the views of looked after children and adults with experience of being in care.

Conclusion

This UK-based study explored foster carers’ experience of ending foster placements involving older children, and specifically where the placement ending was in the carers’ control. Grief was identified as a primary emotional experience to process as part of the placement ending. Foster carers made sense of and accepted this termination, although ripples of loss remained. Grief was situated amid a more varied emotional experience, including joy, elation and relief, all of which were suggested to contribute towards a sense of shame. Shame may have been exacerbated given that the social care system was perceived to blame and belittle foster carers, and is most likely to be helped by those from whom we have experienced a warm and non-judgmental approach.

Footnotes

Acknowledgements

The authors kindly thank the foster carers who contributed to this research project. They further thank the individuals within the fostering agencies who championed the benefits of taking part and helped this research come to fruition. Additional thanks to Dr Jodi Pennington (Consultant Clinical Psychologist), Dr Sarah Hobson (Clinical Psychologist), Dr Helen Kirkaldie (Consultant Clinical Psychologist) and Dr Lynn Burns (Consultant Clinical Psychologist) for their support in refining the presentation of findings.

Funding

The author(s) received no financial support for the research, authorship, and/or publication of this article.

Daniella Valentine was a trainee clinical psychologist at the Universities of Coventry and Warwick when conducting this research. She now works as a clinical psychologist in South East Wales.

Fiona MacCallum is an associate professor at the University of Warwick, West Midlands.

Jacky Knibbs is a consultant clinical psychologist and clinical tutor at Coventry University, West Midlands.

Note

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When carers end foster placements: exploring foster carers’ experience of adolescent foster placement breakdown

Abstract

Keywords

Introduction

Background: caring for challenging young people

The specific challenges of caring for adolescent looked after children

Foster carers’ experience of ending a placement

Rationale for the current study

Methods

Research design

Recruitment and selection of participants 1

Procedure

Materials and analysis

Results

Emotional aftermath

Holding mixed emotions

Ripples of loss

‘We’re only human’

‘You’ve developed, it’s different’

Meaning making

Moving on

Discussion

Emotional aftermath

‘We’re only human’

Implications for policy and practice

Containing systems: a secure base

Formal training, supervision and consultation

Reflective practice

Psychological formulation

Limitations

Recommendations for future research

Conclusion

Footnotes

Acknowledgements

Funding

Note

References

Recruitment and selection of participants¹