Medium 9781782203018

Surviving and Thriving in Care and Beyond

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This is a book about children who have to grow up apart from their biological parents, the impact of this on their lives and on those who look after them, and how we can respond to the challenges this poses in order that they can grow and develop in healthy directions. It provides a systemic framework to describe working with children and adults who are or have been in care or adopted, as well as working with their adoptive parents and carers, highlighting their own narratives and those of professionals working with them. The authors have tried to make space for multiple voices to speak and describe aspects of the care system and life beyond. There are contributions from those who have been brought up away from their biological parents, their adoptive parents and foster or kinship carers. There are also contributions from researchers and professionals with expertise in working with children in substitute care, who describe their theoretical and clinical approaches, privileging the voices of those with whom they work.This book seeks to highlight the possibilities and opportunities that can be offered and taken by people who were not able to grow up in their biological families. Combining a mixture of insider knowledge, realism, creativity and hope, it is essential reading for all working and living in this field.

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15 Chapters

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Chapter One - Family Placement: Continuity and Discontinuity over Time

ePub

John Simmonds

Ten years ago, I drafted a note to myself.

“My adopted son has just turned eighteen and finished his A-levels. He is currently on a gap year and due to start at university next year studying ‘Product Design’. His plans for this year are to train as a chef. This marks a long-standing ambition of his. His flow in the kitchen is quite remarkable to the benefit of the family that can have a Jamie Oliver meal on a Monday night. His kitchen cleaning skills are not quite so remarkable. On the cooking front, his girlfriend is undoubtedly outclassed—in fact none of his friends can compete with him in this area. He has recently been taken on as an assistant chef at one of our local well-known modern European restaurants in London after a short trial.

“In a fairly academically orientated family, his flair and motivation in the kitchen stand out and as with many families, the question is asked ‘Where does this come from?’ Is it his early life experience of watching Ready, Steady, Cook or indeed being given Jamie Oliver cookbooks as presents? All of this might be true, but can’t explain why he took to actually cooking rather than just passively watching the TV programmes as many of his friends have done. Did he pick it up from us? Well not really—my wife can turn out an excellent meal but like many working families, this tends to be on special occasions rather than Monday nights. And cooking was not something that his school prized or encouraged at all.

 

Chapter Two - Working with Professional Systems

ePub

Wendy Lobatto

Introduction

Children and young people coming into the care of the state are likely to have suffered painful and chronic experiences of deprivation, neglect, abuse, and complex trauma in their birth families which have played a part in shaping their neurophysiological and emotional development, as Graham Music goes on to discuss in the next chapter. Such children have had to adapt to the conditions in which they found themselves, to develop strategies and defences to enable them to survive. These children additionally now find themselves without an adequately functioning birth parental figure and their parenting needs are to be taken over by agencies of the state.

Parenting is a highly complex, multi-faceted, and emotionally involving task which is demanding for parents living in ordinary circumstances. Fostering children who have been hurt and damaged by the adults who should have been caring for and protecting them, and with whom there is no primal “blood” familial connection is an especially demanding task. Social workers are required to make quasi-parenting decisions in the midst of legal disputes, high caseloads, and organisational constraints of various kinds. Creating a good enough parenting team out of a group of paid professional workers requires a particular commitment and approach, especially when this parenting team has to work closely together within contexts of trauma and secondary trauma, profound organisational pressures, and the frequent replaying of trauma-induced organisational dynamics which militate against the provision of good, healthy, and integrated care.

 

Chapter Three - Approaches to Working with Foster Carers and Children

ePub

Sara Barratt, foster carers, and children

Introduction

Foster carers are the backbone of the care system; they provide physical and emotional care for vulnerable and troubled children and support their relationships with members of their biological families, social workers, and a range of other professionals. From a personal perspective, I spent four years in foster care and remember the way my foster families worked hard to support me in coping with all aspects of my life. I now draw on this experience in my work as a systemic psychotherapist in a Child and Adolescent Mental Health (CAMHS) team for children who are looked after, in kinship (connected persons) care, or adopted, as well as for those who are parenting them. The Fostering, Adoption and Kinship Care Team (FAKCT) offers a range of therapeutic interventions, believing that children who have suffered such profound dislocations need a responsive service and professionals on whom they can depend. These therapeutic relationships are important to children and their parents/carers. We are able to offer short and long term interventions to families and are aware that they face different challenges at different stages in their life cycle; therefore, we give careful consideration to the way we respond both at referral and re-referral.

 

Chapter Four - Under our Skins: Developmental Perspectives on Trauma, Abuse, Neglect, and Resilience

ePub

Graham Music

Introduction

These are important times for making sense of the effects of the adverse early experiences so often faced by children not living within their biological families. Disciplines and paradigms that once seemed incommensurable are now in conversation. It is clear that to help children whose lives have been affected by trauma, abuse, and neglect, we need to understand both context and individual psychology, wider systems and internal worlds, biology and culture, and how all these interlink. Neurobiology and epigenetics have shown how not just our minds, but also our brains, bodies, and even our hormonal systems are affected by our contexts and our experiences, and that genetic potentials are turned off or on by what happens in our lives. Recognising the real effects of early experiences and environments can help to change and shift patterns which otherwise can become entrenched and unhelpful.

This chapter examines how the kind of adverse early experiences suffered by children not living within their biological families can affect their psychological, emotional, and physical lives. It examines brain science and developmental psychology research and looks at how the context of the child affects the way their brains are sculpted, the autonomic nervous system develops, hormonal systems are programmed, and how children are, as a result, likely to relate to other people and the social world. I try to make some sense of why so many young people from traumatised backgrounds are at risk if they do not receive appropriate help.

 

Chapter Five - The Journey to Becoming a Family

ePub

Adoptive parents with Sara Barratt

In this chapter, adoptive parents describe their experiences of becoming an adoptive family and of attending our Fostering, Adoption and Kinship Care Service (FAKCT). In my experience, the way foster carers and social workers facilitate and support children’s transition to their adoptive family influences the way the new family is able to establish a sense of belonging together. Wendy Lobatto, in an earlier chapter, describes the importance of professional networks, which need to work together to provide a secure context for new adoptive families. It is important to be aware of what may be “hidden” stories in the transition from foster carers to adoptive families. Sometimes, adoptive parents feel that they have, in some way, “stolen” their children from a foster carer who had, for all sorts of reasons, struggled to support the children in their move to their adoptive family. Some foster carers might have hoped to keep the children, which may lead them to be disapproving or critical of adoptive parents. This initial, and sometimes subtle, message can affect adoptive parents’ feeling of entitlement to parent. Gay and lesbian adoptive parents are particularly attuned to the subtleties of discrimination and often question whether professionals’ or carers’ reticence might also be related to homophobia or ideas about normative families. The placing of siblings together or separately also has a bearing on how children manage the loss of their birth family. In this chapter, William and Mike talk about their attempts to find ways to talk about identity with their son, understanding the complexities of transracial adoption, alongside the impact of the trauma of his early years. Perlita Harris’s chapter (Chapter Ten), which describes the challenges faced by transracially adopted children, confirms William and Mike’s experiences.

 

Chapter Six - Working with Vulnerability and Resilience for Separated Children Seeking Asylum: Towards Stories of Hope

ePub

Gillian Hughes and Neil Rees

We, Gillian and Neil, are both clinical psychologists (Gillian is also a systemic psychotherapist), working with children and young people who have been separated from their families and are seeking asylum. Gillian leads the Child and Family Refugee Service at the Tavistock Centre, and Neil practises at the Newham Child & Family Consultation Service in East London. We first worked together in East London in an adult mental health team where we offered systemic consultations (Hughes et al., 2006) and have remained friends since. We have also maintained a professional relationship through the training of clinical psychologists on the doctoral programme at the University of East London, where Neil is the Programme Director (Clinical) and Gillian an honorary lecturer. We have many shared values and both of us are interested in systemic and narrative approaches, and how our practice can be grounded in communities of support. We draw on community psychology (Nelson & Prilleltensky, 2005) and liberation psychology (Afuape & Hughes, 2016), which are approaches that understand distress within social and political contexts, and relationships of power.

 

Chapter Seven - The Best Thing Is the Lunch! My Friends! Being with Other People in the Same Situation! Oh, and the Slow Walking! The Fostering, Adoption and Kinship Care Team Children’s Group

ePub

Julia Granville

Once or twice a year for a week during the school holidays, our team has run a group for 7–11-year-old children who are fostered, adopted, or living in kinship care. It is named simply after the season in which it takes place: the “summer group”, the “spring” or “autumn” group.

We make films, take photos, play, eat a lot, make and draw things together; we try out new skills, we role-play with puppets, we become mindful and talk. This chapter describes how we developed the group, how it works, and the benefits and, indeed, joys of running it, being in it, and for the parents and carers seeing their children participate in it. I draw on examples from the groups, which are composite and real cases, and names and identifying details have been changed to preserve confidentiality.

The team is a specialist service, the Fostering, Adoption and Kinship Care Team (FAKCT), for children who are fostered, adopted, or living in kinship care and their families that is part of CAMHS at the Tavistock and Portman NHS Foundation Trust. The team offers a range of assessments and therapeutic interventions drawing on systemic, psychoanalytic, developmental, and neurological perspectives. We are a multi-disciplinary team and the complexity of the situations we work with calls for a collaborative approach, working together across disciplines and modalities and engaging with the networks around the children and families who come to the service. Many of the children have been, or could be, given a range of diagnoses and, as is common with many children who have experienced early trauma and substitute care, their needs, presentation, and difficulties are complex (Meltzer et al., 2002). They may show many aspects of a number of diagnosable conditions. Sometimes, these are just below thresholds for diagnosis, but, in combination, mean that the children and those who care for them are struggling—occasionally to breaking point (Tarren-Sweeney, 2008).

 

Chapter Eight - The Strength to Smile behind My Mask

ePub

Chloe Charles

My poems were written as a form of anger management. I was an extremely angry foster child who was torn between the loyalty and love for my biological mother and learning how to accept the love and care from my foster mother. I had to leave a mother who was young, troubled, and struggling and felt forced into a situation I was not happy with. I lived with my younger brother’s aunt, which was difficult for me to accept, especially coming from parents who made it very clear that they were my parents and were not going to be replaced. I acted out and pushed away all forms of kindness, even though deep down all I wanted to be was loved. I did not want to be happy knowing that my mother was all alone and probably unhappy.

In secondary school, I became keen on English, especially poetry. One day when I was having one of my many rage-fuelled strops, my aunt wrote me a poem and I decided to write one back expressing how I felt. This became a way of communication and a big sign of relief for both of us.

 

Chapter Nine - Helping Children through Working with Their Adoptive Parents

ePub

Sara Barratt

In this chapter, the parents in three adoptive families who have used our specialist CAMHS Fostering, Adoption and Kinship Care Team, (referred to as FAKCT) describe their experiences of professional involvement and of work with our team. Their children were referred because of concerns about their emotional problems and, for two of the families, following our initial meeting, we decided together that we would work, at least initially, with the adults. Their children were either in the process of being adopted or recently placed and, as professionals, we are mindful that children who have been in care are very attuned to rejection. As Monica and Rebecca describe in Chapter Five, children feel very anxious about clinic appointments as it signifies that things are going wrong and, therefore, they might be rejected again. Thus, some parents find it helpful to work separately to unpack their difficulties in understanding and responding to their children, alongside describing the challenges from working with different agencies. We initially met Simon and James with their adopted daughter, now aged seventeen; her brother aged fourteen did not want to attend. Following a family crisis, their daughter stopped attending; we offered to meet her individually but she did not take this up. Simon continued to welcome individual appointments; he writes about his experience as an adoptive parent below. Other contributions are from Caitlin and Brian, who adopted Elizabeth and Rosa, now aged eleven and four, and Beatrice and Martin, who adopted Lorcus, now aged three and a half.

 

Extracts from Two Poems by Jackie Kay

ePub

Jackie Kay’s poems describe her adoption by a white Scottish couple and her search for her birth parents. In two poems she offers the mother’s and the daughter’s feelings about belonging to one another and the struggle with identity.

The poem “Black Bottom” opens with the mother’s voice:

Maybe that’s why I don’t like

all this talk about her being black,

I brought her up as my own

as I would any other child

colour matters to the nutters;

but she says my daughter says

it matters to her.

(Kay, 1991a)

In the poem “Generations”, the daughter writes,

I have my parents who are not of the same tree

and you keep trying to make it matter,

the blood, the tie, the passing down

generations.

We all have our contradictions,

the ones with the mother’s nose and the father’s eyes

have them;

the blood does not bind confusion,

yet I confess to my contradiction

I want to know my blood.

 

Chapter Ten - The Lived Experience of Transracial Adoption

ePub

Perlita Harris

“Adoption is dislocating and confusing. Loss is distressing and disorientating. Racism is devastating; it claims lives…”

(Dewan, 2003, p. 125)

Introduction

This chapter centralises the experiences of adopted adults who have been placed domestically and transracially in the UK, in order to examine the lifelong effect of transracial adoption. I begin with the historical and socio-political context that gave rise to the practice of transracial adoption, followed by the current socio-political context which ensures that transracial adoption continues as a permanency placement option for looked-after children in England. Following an overview of UK and USA research on the experience of transracially adopted children and adults, I draw upon service user knowledge to explore the lifelong impact of transracial adoption.

Historical context

No figures exist regarding the number of domestic transracial adoptions that have taken place in England (Selwyn et al., 2010). Over the past sixty-five years, there has been a shift from UK adoption practice viewing black children as “unadoptable” or “hard to place” (Rowe, 1991; Small, 1982), to adoption agencies demonstrating that black children are adoptable. Historically, there has been a correlation between social factors and an increase in domestic transracial adoption. With the decline in white babies available for adoption from the late 1960s onwards (from 14,000 in 1968 to 1,400 in 1988) (Prevatt Goldstein & Spencer, 2000), transracial adoption became an established practice. Further, targeted recruitment initiatives in the 1970s and 1980s showed unequivocally that black adoptive families can be found for black children (Brunton & Welch, 1983; James, 1986; Small, 1986; Soul Kids, 1977) and agency failure and institutional racism became viewed as the reasons for the shortfall in black adoptive families (Kirton, 2000).

 

Chapter Eleven - Positioning and Respectful Professional Interventions for Working with the Legacy of Irish Institutional Care

ePub

Valerie O’Brien

Introduction

Since the late 1990s, there has been an outpouring of stories of abuse and maltreatment of residents in Irish institutional settings. The use of institutional care for children and adults in need crosses many cultural and geographical boundaries. Two major differences exist between institutional care in Ireland and that provided elsewhere. First is the extent of the practice and, second, the delay in change and the slow pace of commencement of family-based care. Paradoxically, Ireland now has one of the highest rates of family-based care in the world (O’Brien & Cregan, 2015).

A significant part of this chapter is given to an analysis of the context in which the institutional care of children occurred in Ireland to enable professionals to have a better understanding of:

This chapter is drawn from four major bodies of work which include:

The work also draws from the author’s clinical work and supervision of those working with this population. It is this context that inspires me to review the legacy of the past in order to try shape better futures through reflection.

 

Chapter Twelve - Never Too Late

ePub

Janet, Mark Brownfield, and Sara Barratt

Introduction (Sara Barratt)

I work as a systemic psychotherapist in general practice. Mark Brownfield, her GP, referred Janet to me in 2011. This chapter is written by Janet, Mark, and me, with a contribution from the agency. We describe the work we have undertaken to help Janet to find some recovery from her childhood in a residential school and in care. It has been a privilege to work with Janet, for whom it took so much courage to talk about events that had been locked inside her for so many years, and brings to light the contested notion of memory. Her account can be difficult and painful to read and the passage of years has not diluted her feelings about the past. As part of our therapy we used EMDR, which is helpful in the treatment of post-traumatic stress (Shapiro & Maxfield, 2002). Essentially, the importance of our work was the creation of a system working together to create a safe enough environment to support Janet in talking about her early traumatic experiences and their effect on her adult life. While this chapter is primarily about systemic work with an older adult whose childhood experiences blighted her adult life and that of her children, it is important to note that the context of care in the 1940s was harsh, professionals did not consider that children might be suffering sexual abuse and, if they did, there were no structures in place to protect them. It was not until the 1948 Children Act that things started to change, although, as we know, in some ways nothing has changed and there are adults who still feel entitled to abuse children without fear of being held accountable.

 

Chapter Thirteen - Co-creating a Coherent Story with Adults who Have Been Fostered or Adopted

ePub

Val Molloy

Adults who have grown up separated from their birth family through adoption, or by being brought up in care, might experience a number of difficulties when trying to make sense of their lives. Connections have been broken, information might be missing or withheld, and memory might have become subject to loss, suppression, selectivity, and revision. The importance of keeping an open dialogue with children about the circumstances of their lives was not recognised in the past, so children lacked the opportunity for an ongoing discussion which could take account of their growing need for information and developing capacity to understand complexity (Brodzinsky et al., 1992). Instead, many felt they were left alone to cope as best they could with the task of making sense of their circumstances. Adults who grew up in institutional or foster care, or who were adopted in the days when anonymity prevailed, can find themselves in great difficulty when it comes to piecing together their personal histories to create a sense of personal continuity and connectedness. I have worked for many years in an organisation which has been involved in caring for children in alternative care and this chapter describes the work I have undertaken in co-creating life stories with adults who were placed in foster or adoptive families by our organisation.

 

Chapter Fourteen - “It Turns Your Whole World Upside Down … but still it Brings Immense Pleasure”: Perspectives on Kinship Care

ePub

Julia Granville

In this chapter, I think about work in the area of kinship care. I start with some thoughts about the portrayal of kinship care and the language used to describe it and go on to explore some of the issues that arise in work with this client group. I draw on my experience of facilitating a support group for kinship carers over a number of years and include interviews with four members of that group. I also offer a clinical example from my therapeutic work to illustrate ways of working with the themes that emerged in the group. My work in this area has been as a member of the specialist Fostering, Adoption and Kinship Care Team (FAKCT), based in the Child and Family Department at the Tavistock and Portman NHS Foundation Trust.

All the interviewees have agreed to participate and chosen their pseudonyms. The clinical examples I have used are amalgams of clients I have worked with as a systemic family therapist and I hope represent faithfully the dilemmas and concerns of the many people in this situation that I have worked with over the years, while preserving their anonymity and confidentiality.

 

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