The costs of doing nothing

Why do people choose to foster?

The State of the Nation Report 2019 undertaken by Fostering Network, having asked foster carers directly, found that there are three main reasons why families foster.

  • The desire to make a difference to the lives of children in care
  • The desire to offer children the opportunity to be part of their family
  • Really enjoy working with the children.

What we know about foster carers

At To the Moon and Back Foster Care, we know that our own fostering families foster for the same reasons noted above, so we agree with the outcomes that the biggest reasons to foster are altruistic.

What we hear and what appears to be reflected in the most recent research (State of the Nation 2019) is that foster carers want to be seen as equals and part of the perceived professional team and feel valued for the work they do. The Fostering Network states that “foster carers are supervised, trained, skilled and experienced – and ought to be well respected, sufficiently remunerated, offered ongoing training and properly supported.

Sadly, I have recently had to reassure families when they have felt insulted as a result of comments, made by external professionals, about not being part of the professional team and we wonder why every year we have to replace the existing workforce of foster carers at a rate of 10-12% every year, all before we actually start addressing the shortfall of around 8000 families. But it’s not just the external professional team that influences the foster carer’s feelings of being valued. Recent research showed that up to one in ten foster carers have considered transfering to another fostering service because they were unhappy with their agency. However they had not transferred because they were concerned about the transfer process. This reflects what we have experienced. We have been approached by amazing foster families considering a transfer but very nervous and subsequently wary of making the move to a different service. Amongst the reasons for not transferring were concerns about having to go through the assessment process all over again, and concerns that foster children may be taken off them. Seemingly their lack of trust in the system sees them resorting to “better the devil you know” and staying where they are, accepting they are unlikely to resolve issues and never have the improved service they would prefer and deserve.

What is the reality of fostering?

We acknowledge and appreciate that some views of fostering can be idealistic. For some who enquire about fostering, their willingness to care for a child who cannot live with their own family is overwhelmingly heart felt. At To The Moon and Back Foster Care, our extensive expertise, tells us that the children who need to be looked after, have, by the very nature of their reasons for not being able to live with their family, experienced adverse childhood experiences (ACEs). There is a wealth of knowledge, research and evidence to show that this has a profound impact on children of all ages and there is no child that comes in to the care system without having experienced or been touched by an element of trauma. We are clear with everyone we come in to contact with, that every foster carer and member of staff should be trained from the very start, to understand the impact of toxic stress, loss, separation, abuse and neglect. Why? Because we know we cannot expect families to provide care to traumatised children without the tools to do this well. We work using some key principles of therapeutic parenting and as such all of our social workers have a high level of skill and knowledge in this area.

“The fostering task requires carers who can become ‘therapeutic parents’ to looked-after children in a way that promotes the child’s developmental recovery, often after abuse, neglect and trauma”. 

Bristol University Compassion Fatigue Research

We should be surprised and shocked, but sadly we are not, when we hear and see families who have not been prepared for fostering in this way.  My co-founder Angela Hunt and I have worked in other organisations that have not been trauma informed and whilst the staff and foster carers have done the best they can, the team had not had the necessary training, development or expertise to prepare or support families for the care they needed to provide. It was for this reason we set up To The Moon and Back Foster Care, with a clear ethos of a trauma informed approach built on a foundation of a skilled and equal team, focused on enabling our foster carers to succeed well.

Our past experience is further echoed in the findings of Bristol University’s research “Almost without exception, the foster carers in the focus groups felt that they had not been adequately prepared during the three-day preparation programme and their home study. As one carer said, ‘fostering is about normalising the most extreme behaviours and pretending it’s a normal life, and it just isn’t a normal life at all really’.

The rewards of fostering – what families tell us

We work with some very inspirational foster families. Their perceived rewards of fostering are humbling and encouraging.

“The moments when you can see happiness in a child’s face and know you have helped to create an environment for them to flourish”.

(Foster carer at To The Moon and Back)

“You’ve got to look for the little things. One little child was probably with us six months before they smiled, and it was just like the sun came out. Because sometimes it’s hard, very hard, and you’ve got to look for the little things that make you think it’s worth carrying on”.

(Compassion fatigue research Bristol University)

“Amongst a mountain of despair comes a bright light of hope and an incredible need for love from a child”.

(Foster carer from To The Moon and Back)

“The one person I keep going for is her … I love her and that’s what makes it worthwhile. Looking after her is 95% hard work and 5% reward, but that 5% reward makes every day that’s hard worthwhile.”“When a child confides in you with an experience or opens up about their emotions, it is so rewarding to gain a child’s trust”.

(Foster carer at To The Moon and Back)

So what can we do to help, when it is not feeling great?

None of us should be surprised by how fostering can leave families feeling. Young people who have experienced trauma, abuse or neglect, have strong feelings that they struggle to regulate. Many have grown up in families where they have not been shown how to respond to strong emotions in safe ways. Our foster children show us how they have been cared for in the past, by the way they express their hurt, trauma and neglect. They are not able to regulate their complex emotions and therefore express their feelings through behaviour that we expect carers to try and understand, contain and live with.

Having been a social worker involved in fostering for nearly thirty years, I have been inspired that despite the level of trauma children and young people bring in to family homes our foster carers live with and many remain committed to doing their best no matter what children present. What I have found sad and appears to be shown through research on foster carers and compassion fatigue, is how little as a professional, some social workers think or talk about the impact of fostering on families without an element of blaming the families for lacking in something, (resilience, skills support network, understanding… the list goes on).

At To The Moon and Back we truly see ourselves as trauma informed and we share our thoughts about the expectations of a trauma informed foster carer from the moment a family considers fostering with us. Only last month we hosted a conference on secondary trauma with Dr Karen Treisman and invited not only our foster families but every prospective family who had applied to us to foster. We feel strongly that they should know what they are signing up for and what they can expect from our support and ongoing development.

Foster carers we feel, cannot be supported effectively unless we are talking safely about trauma and what it does to young people, but equally to them and their family. By “talking safely” we mean, in a safe trusting relationship where foster carers can be honest about their feelings and fears, without feeling judged. We say of this basic need that, “this is not rocket science” but common sense. We are delighted that in our first Ofsted inspection report, our inspector was able to see that our trauma informed culture, values and ethos are central to everything we do.

Foster carers looking to transfer to us, have given permission for us to share their stories of their agency.

“There were issues surrounding support, my first agency was focused on “heads on beds” and it wasn’t’ at all child centred. We never wanted to be in a position where we felt we had nowhere to turn to for day to day support, we became involved, through our own research and study, with an external  support service, funded by ourselves”

“I think it is hard in fostering, you are generally on your own and support groups never really happened ….which made it more isolating”

The research undertaken by Bristol University reflects these thoughts, with further sad and shocking quotes from foster carers.

“I’ve been there with children when you’re just meeting the basic needs, and you’re doing what you think they need, but you’ve taken on their trauma, and actually you can’t cope with that as well as looking after this person, so we’ve put a lid on it. We can’t take any more in that glass, so you literally are protecting yourself. Most foster carers felt that the social work professionals supporting them did not generally have the appropriate knowledge and understanding of issues of attachment and trauma, its effects on children and the challenges of caring. As a result, the support provided did not meet their needs.”

So why don’t families just move to a more supportive and trauma informed service?

In the most recent research undertaken by Fostering Network in 2019 only 53% of foster carers rated their service provider as good or excellent. One in ten families had considered transferring but didn’t. The biggest reasons given for not moving included feeling that the transfer process took too much time and effort and that their long-term placed child would have to leave them if they moved.  One family apparently stated “I am redoing the assessment, but it has taken eight months just to get references!” Also mentioned as part of the report were delays to transfer caused by spurious concerns raised by the foster carers agency, alongside threats of deregistration, resulting in their new agency often halting or delaying the process. All of which we believe is unacceptable and a sad indictment of how we see the value of foster carers within the sector. Foster carers have a right to change agency, so much so that protocols are in place to support the process, ensuring that foster carers are treated with respect and the children in their care are put at the centre of the decision making. It is important that the transfer process is undertaken swiftly once a foster carer has formally indicated their decision to leave their agency, so that the carers can remain focused on the care of the child.    

We have seen much of this for ourselves in previous roles with other organisations as well as more recently, in conversations with other colleagues and families who have discussed their intention to transfer. We hear the reluctance to move to another service and go through a full assessment only to find nothing is different. The carers invest in sharing intimate details about their lives and have their families and friends participate in another assessment. In The State of the Nation Report one family stated “We had to redo everything! References from family and friends, they met with them and interviewed them, they looked at our bank accounts, they asked intimate questions about our marriage and family relationships, they went through the whole invasive process again, from scratch.” It is acknowledged that the transfer process has to be thorough, but there is so much that can be done better. We work hard to make the process of transfer, meaningful and valued by the foster carer, using the time to reflect and be developmental, alongside the legislative processes which are purposefully rigorous and therefore unavoidable.

We are concerned that there are foster carers who, despite feeling so unappreciated, decide to remain where they are. Where a trauma informed approach or trusting relationship does not exist or has broken down we believe there is a cost to a foster carer’s wellbeing and therefore to the children they support.

One of our favourite trainers, Dr Karen Treisman, states “relational trauma requires relational repair”. This relies on there being a positive relationship with all parties and can only happen when there are safe relationships modelled throughout the organisation. We support our foster carers to care for children with relational trauma through relationship repair. Our foster carers are the secure base for the child to explore the world safely. Our supervising social workers are themselves, supervised using a relational approach, so that they too then become the secure base for the foster carer. This ensures that, in our case, the culture of the organisation remains true to the statement of purpose.

We firmly believe that having a supervision process that takes in to account working with trauma, enables issues, like the sharing of honest feelings raised as a result of caring for children, to be openly discussed. We know that sharing these can feel risky in an agency that does not consider this part of clinical supervision as important and can leave families feeling vulnerable, judged and open to being seen as unable to cope as a foster carer.  Just imagine, how would it be if you felt safe as a foster carer or a social worker in your supervision to explore these feelings which arise as part of the day to day work. We are told by foster carers who experience this type of supervision that they feel “topped up”, “heard” and “truly supported”, sometimes also relieved that what they are feeling is a normal part of fostering. We truly believe that this is what every foster carer should be getting as part of their support package.

We know the feelings that children raised in foster carers can give insight into a young person’s needs. We have children for example, who engender despair and pain in our foster carers and children who leave our foster carers feeling unusually sad and tearful. This bears no reflection on the carer’s shortfalls, rather, evidences what is going on for young people that they are projecting onto the foster carers and the family. It gives us all clues as to how we might need to support children and therefore is an essential conversation we should be having. By having this conversation regularly it potentially reduces compassion fatigue in foster carers.

“Compassion fatigue can be described as the emotional residue, or strain of exposure to working with those suffering from the consequences of traumatic events. It differs from burn-out but can co-exist. Compassion Fatigue can occur due to exposure on one case or can be due to a “cumulative” level of trauma”

(Figley, 1995)

I love the description used by Figley, he states “We have not been directly exposed to the trauma scene, but we hear the story told with such intensity, or we hear similar stories so often, or we have the gift and curse of extreme empathy and we suffer. We feel the feelings of our clients (children). We experience their fears. We dream their dreams. Eventually, we lose a certain spark of optimism, humour and hope. We tire. We aren’t sick, but we aren’t ourselves.”

This we hold true in our foster families and social workers who are empathic and sensitive to traumatised children. It should be spoken about and to not do so is damaging to foster carers health and wellbeing and ultimately the children they foster.

What we know, is that families who are not being supported by other professionals to recognise the impact of fostering on carers, is that the carers can feel judged, and criticised. We hear families saying that they were offered solutions to issues that were basically behaviour management tools which they knew would be unlikely to have a long-term impact on their child. We have seen foster carers throughout our careers, who have become isolated, perceived as challenging and difficult simply because they respond to criticism, solutions and guidance from professionals, in what are sometimes deemed as negative ways. I loved hearing from a foster carer who when described as being challenging, thanked the professional for the feedback. They knew that in their challenge of professionals they were acting as true advocates for a child whose needs were not being understood.

In the research carried out for a fostering service by Bristol University, the following quotes highlighted the findings from the research

“Foster carers also attributed lack of support to individual social workers’ lack of respect and empathy, which resulted in the carers not being trusted, their expertise being ignored and a lack of partnership working. Many foster carers also talked about social workers wanting to ‘solve’ problems rather than simply listening and being empathic, and this is not what they needed”

What we know about our social workers is that they too need empathic listening and supervision that supports them with the trauma that they work with. We end up otherwise in a cycle of all the professionals replicating the chaos of the families from where the children may have come, this manifests as blame, criticism and harsh judgements being made on other professionals.

 “Some foster carers felt judged and blamed by social workers for the difficulties they experienced in caring for traumatised children. Feeling judged led to a reluctance to ask for help and concerns from carers that if they were honest about the way they were feeling they might get deregistered. Lack of support is likely to have contributed to the moderate to high levels of burnout and secondary traumatic stress, and moderate to low levels of compassion satisfaction which many foster carers reported”.

As foster agencies we have a responsibility:

To provide the right leadership and agency culture which encourages the building of trusting relationships with everyone in the team but especially the relationship with our foster carers, enabling everyone to feel safe about being honest and open about their feelings.

To emphasise the priority of providing meaningful and individualised support of foster carers that they themselves value, recognising that we are all different and sometimes processes and approaches need to be reviewed to fit the needs of individuals.

To actively listen for signs of tension in a non-judgemental way, so that it can be discussed and the tensions relieved.

To advocate for foster carers to be treated with respect and recognised as part of the professional team around the child, challenging on the carers behalf when the need arises.

To promote best practice, ensuring that our foster carers are informed about the impact of childhood trauma not only on the child but also on themselves.

The transfer process can be a positive experience. One foster carer said of us “All Form F assessments can feel invasive, but Alison was very sensitive and understanding in her approach.” 

Another transferring family said that they had found the process with us “much more straightforward” than their previous assessment, and said “clearly the assessor had been able to get a lot from our files in advance, it had been surprisingly much more plain sailing than the initial assessment”. Furthermore they felt that because they were already foster carers they knew more than the first time and therefore everything was more understandable and therefore more enjoyable. 

We are particularly sensitive to the transferring foster carer. We recognise that the decision to change agency is one that isn’t taken lightly. We treat any transfer to us, as an opportunity to reflect on the care being provided and offer a new space to reconsider support, development and training that may enhance that care.  It doesn’t have to be an assessment that repeats the earlier process, but it needs to be rigorous and evidence based to show what has already been achieved and what more could be done with the right tools, resources and support. Often attributed to Einstein, “continuing to do what you have always done, hoping things will get better, is a form of insanity” or as I have already said, “comes at a cost” and having a good relationship with those supporting you really matters when trying to support a child who has experienced trauma.

Related article

Back to school

Back to school

Our challenging times Many parents saw this, at least initially, as very challenging. Yes, some schools remained open for some pupils, but the majority were out of school, out of their familiar routine and no longer able to be with their friends. For these reasons,...

Helping children deal with domestic violence

Helping children deal with domestic violence

The NSPCC believes 1 in 5 children live with domestic violence.  At To the Moon and Back Foster Care we are often asked to find a foster family who can support a child who has repeatedly witnessed domestic violence. This is recognised as a significant adverse...

Life story

Life story

For children who are adopted or fostered there can be a disconnect with their past and for a variety of reasons, the anecdotes and life moments referred to above, are not known to the child. We may think that somehow discussing the past with a child who has...