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9: Individual psychotherapy for late-adopted children: how one new attachment can facilitate another

Jenny Kenrick Karnac Books ePub

Juliet Hopkins

One of the risks of adopting children in care is that they may perpetuate their deprivation by rejecting the loving care offered them. Clinical experience shows that when this happens, it can sometimes be possible to facilitate children’s attachment to their new parents by involving them in individual therapy.

This chapter aims to describe the difficulties inherent for these deprived and rejected children in making new attachments and to consider how a new relationship to a psychotherapist may help these children to take the risk. Concepts from psychoanalysis and from attachment theory are used to understand the therapeutic process.

In order to explore these issues, I bring examples from the psychotherapy of two children—Max and Pauline—who had each been adopted at the age of 4 years but who had not bonded with their respective adoptive parents.

When they started therapy, Max was 9 years old, and Pauline was 14.

The early histories of these two children were typical of children placed in late adoption and do not need for present purposes to be individually specified. Enough to say that after two or three years in their birth families, where they suffered both abuse and neglect, they experienced several foster home placements before joining their adoptive families. Both sets of adoptive parents were caring, concerned, and thoughtful people who supposed, as many adoptive parents do, that they could undo the adverse effects of their children’s early experiences within a year or two.

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17: Contact with birth families: implications for assessment and integration in new families

Jenny Kenrick Karnac Books ePub

Caroline Lindsey

Working with questions relating to the issue of contact with birth families is an integral part of therapeutic work with children who are fostered, adopted, or in kinship care. The distinctions between the different forms of care are not always the most relevant factors for the child, birth family, and substitute carers, despite the differences in the legal framework that play a part in determining how much and whether contact occurs. The concept of openness is more important here, regarding both open communication and structural openness to actual contact. Therefore, in this chapter, the material relates to contact in all these different contexts. It is self-evident that the meaning and purpose of contact varies depending on the type of care episode, with whom the contact takes place, and its form. Contact is not an all-or-nothing concept. The infinite variations reflect the unique pattern formed by each family constellation. Hence, there are no hard and fast rules for determining what is appropriate in any one situation, and as relationships develop over time, there are changes in the need and abilities of those involved to participate in contact arrangements. Contact can be defined as the symbolic representation of the young person’s relationship with, at least, two sets of families. The type of contact, whether it is face-to-face or letter-box and all the many variations, carries a message about the nature of the relationship. This varies from conveying contact as a step in the process to rehabilitation with the birth family to a loving and lifelong concern and interest in the child who is being brought up by others. It is a socially constructed event in which each in the triad of child, birth family, and substitute carers plays a crucial part, and success depends on the ability of each party to contribute positively to the process. Furthermore, since most of the children and young people with whom a service like ours is involved are placed from care, the ongoing attitude, role, and availability of social work services can be pivotal in ensuring the safety and success of contact arrangements.

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12: Systemic work with families after adoption

Jenny Kenrick Karnac Books ePub

Sara Barratt

Children are often described as “belonging” to their families. We talk about “our” children and like to think that they will become the people we want them to be. Adoptive families struggle to find a way to “belong” to one another within a context of other belongings. This chapter discusses work with families after adoption and the dilemmas they encounter in finding a way to “belong”.

During my professional life I have worked with adoptive families and children through the process of assessment, placement, and breakdown, with adopted adults referred by their GP and, as a family therapist at the Tavistock Clinic, with families after adoption. I draw on these experiences and in particular the work undertaken to help families develop a way of living together that fits well enough for each member of the family.

Much of our work is with families who have adopted children removed from their birth families following concerns about parenting, or with families who have adopted children from overseas. In our multidisciplinary team we work initially with all parts of the system: the family together, the parents on their own, the young person and/ or siblings and involved professionals, such as social workers and teachers, where appropriate. The most common themes in our work are the influence of the past on the present family predicament, of loss and of children’s loyalty to their family of origin, all of which may never previously have been discussed, even with a professional.

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18: The contribution of organizational dynamics to the triple deprivation of looked-after children

Jenny Kenrick Karnac Books ePub

Louise Emanuel

In this chapter I describe how the trauma and disturbance associated with severe deprivation and abuse by children and families can impact on the professionals involved in their care, interfering with their capacity to think about and provide containment for the children and their carers and thereby compounding their deprivation. The chapter title refers to the “double deprivation” as originally described by Henry (1974) together with a third level of deprivation, which can occur within the organizational setting. The first deprivation is inflicted by external circumstances and is out of the child’s control; the second derives from internal sources as the child develops “crippling defences” (Henry, 1974) that prevent him from making use of subsequent offers of support, for example, by foster carers or adoptive parents (or a psychotherapist). The third refers to the ways in which, as Britton (1981) writes, “ the profoundly disturbing primitive mechanisms and defences against anxiety” used by children and families get “re-enacted” in the system by care professionals, who are the recipients of powerful projections. These defences, including unconscious attacks on linking, can interfere with professionals’ capacity to think clearly or make use of outside help with their overwhelming caseloads. A social services department may then replicate these children’s original experience of neglect, allowing them to fall through a hole in the “net”work. This form of “re-enactment” as a substitute for a thoughtful response by professionals within an organization, combined with the “double deprivation” described by Henry, can result in a “triple deprivation” for children within the care system. (The concept of “triple deprivation” was originally described by Sutton, 1991.)

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2: Psychoanalytic framework for therapeutic work with looked-after and adopted children

Jenny Kenrick Karnac Books ePub

Jenny Kenrick

Psychoanalytic child and adolescent psychotherapy as practised at the Tavistock Clinic has two main roots: one is its psychoanalytic theoretical base; the second is its base in the observation of infants and young children. These come together in practice with children and families. This chapter is to show the particular relevance of the theoretical base in our work with looked-after and adopted children and in our participation in the work of a multidisciplinary based team. The same frameworks inform work with both foster carers and parents.

Freud developed a new theory of man and of mind at the end of the nineteenth and early twentieth centuries. His new “science” challenged the prevailing views of mind, motivation, and the innocence of children. A medical, neurological model, it described impulse-driven behaviour in a quantitative way. Later he developed a formulation of mind, in which man is driven by conflict between the life and death instincts, under the influence of ego, id, and superego. He described transference and countertransference. It was left to his followers to elaborate his theories into more finely honed working clinical tools.

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