An illuminative evaluation of foster carers' experiences of attending an attachment theory and practice training programme offered by a Child and Adolescent Mental Health Service for Looked After Children

摘要

Background: In 2006, a review of the research and literature in relation to the mental health needs of children in care, led to the rationale for providing training to foster carers and the network of professionals surrounding the child, offered as an integral part of the service provided by a Child and Adolescent Mental Health Service for Looked After Children (CAMHS/LAC) in the South of England. Individuals who are prepared to become foster carers need solid mental health training to successfully parent children who have experienced severe trauma and present with a range of emotional and behavioural difficulties (Dorsey et al 2008). Foster carers expressed the need for more information and support to improve their understanding of mental health issues when caring for their looked after child. In order to meet this need and given the dearth of evaluation within the literature regarding foster carers’ experience of attending mental health training, this research study provides an evaluation of the process and outcome of attending training. Understanding the experience of the training from a foster carer’s perspective was paramount in order to target support to carers to both prevent placement breakdown, deterioration in childrens’ health and emotional wellbeing and for service development. The overall objectives of this research study were to explore the experience of professional foster carers before, during and after receiving training; to evaluate the knowledge gained from the training and explore their perception of how this affected their practice and identify areas of strengths and weaknesses of the training. Methodology: An in-depth illuminative evaluation for two cohorts of foster carers used a mixed methods approach (quantitative and qualitative) to explore process and outcomes; with the main emphasis upon the comprehensive collection of qualitative data. Quantitative data were collected in the form of two validated questionnaires, the Strengths and Difficulties Questionnaire (SDQ) (Goodman, 1999) and the Family Impact Questionnaire (FIQ) (Donenberg & Baker, 1993), a knowledge questionnaire which was piloted and devised by the researcher and a satisfaction questionnaire devised by the local City Council. Qualitative data took the form of a series of semi structured interviews pre training, immediately post training and twelve weeks follow up training. A diary interview method was also used to complement the data gathered within the follow up interviews (Zimmerman & Weider, 1977). Results: Results from the quantitative questionnaires suggest that foster carers provide care for foster children in the South of England with a high level of need in relation to their mental health. Overall the SDQ results did not reach statistical significance but suggest a trend towards reduced perceived emotional and behavioural difficulties presented by children in their care. The FIQ identified that both foster children and birth children have a high impact on several areas of family functioning which continued over the twelve week period of the study. Increased knowledge was measured and showed statistically significant differences from baseline, which were retained over time and led to the reported positive change in foster carers’ levels of confidence, ability to advocate for their child in a school setting and a sense of empowerment for foster carers. An interpretive approach to analyzing data was used through the aid of thematic content analysis using the Framework Approach. Findings from the qualitative data revealed ten themes and suggested that foster carers experience training as a journey of awareness in relation to understanding the mental health needs of the children in their care. Conclusion: Illuminative evaluation has provided description and interpretation to unravel the experience of group training, whereby foster carers negotiate, choose and create their own learning in relation to individual needs. There appears to be a move away from foster carers being passive recipients of knowledge towards the proactive creation and sharing of knowledge within which carers from all levels of experience contribute. Recommendations include a review of the existing package of training, involving the aid of foster carers input, to co-develop appropriate training programmes.