Like other children and young people who have additional needs, those who are looked after foster-care, or residential homes, often miss out on receiving the psychological help they need. There are many reasons for this additional deprivation.
Sometimes it may be because their complex behaviours are difficult to understand and they struggle to ask for help. Sometimes, they resist help. Sometimes it’s because their circumstances are unstable and they may move frequently between different care arrangements. Sometimes it’s because there is not one adult over-seeing their needs for long enough to clearly assess them. For these, and many other reasons, children who are fostered often do not receive specialist help for their emotional and psychological well-being when it is needed.
Why are foster children different?
Children who can’t be looked-after by their birth families suffer trauma and loss. Many face many severe adversities and are much more vulnerable than their peers. They are highly-sensitive, often hyper-vigilant and experience troubling bio-chemical conditions with excess stress hormones. Ironically, what is happening ‘inside’ for these children is not always shown on the outside. They are often misunderstood as ‘having no feelings’ or of being deliberately destructive.
Many children and young people who are removed from their natural families, have suffered extreme levels of neglect for a very long time. Many have suffered abuse; physical, sexual or both. Most then continue to suffer from complex difficulties which, if not helped, worsen.
What is ‘wrong’ with the child?
Looked-after-children often behave in troubling ways. Often their carers, or social workers, or teachers, may ask what is ‘wrong’ with them. Often caring adults seek a diagnosis, such as autism or ADHD or PDA.
However, one diagnosis, or even multiple diagnosis, is/are unlikely to fully represent the complex difficulties of a looked-after child. Behaviours which are troubling need to be understood in the light of their experiences. Many looked-after-children have suffered inadequate primary care, developmental adversity and multiple trauma as a result of chronic exposure to neglect, abuse, risk and social adversity.
Many children who have become separated from their birth families find relationships very hard to manage. They do not always communicate in conventional ways. The impact of trauma, and toxic stress, upon their emotional well-being and mental health can have life-long repercussions including neuro-developmental difficulties which affect global functioning. Looked after children have far higher incidences of physiological difficulties, bodily confusions and learning difficulties.
What are the signs of emotional distress or psychological difficulties?
Looked-after children often struggle with :-
- attachment difficulties
- relationship insecurity
- sexualised behaviour
- trauma-related anxiety
- conduct problems
- sensory difficulties
- Risk-taking behaviours
- Suicidal ideation and self-harm
Why do children in foster care have so many difficulties?
Many looked-after-children have suffered from emotional and physical neglect, sometimes physical or sexual abuse within birth families. Often, there have been inter-generational mental health difficulties, learning disabilities and past histories of local authority care are common. They have experienced, and may still be exposed to, domestic violence, drug and alcohol misuse, physical, sexual and emotional abuse. In addition, some have childhood illnesses to contend with and suffer repeated bereavement and loss.
What about asylum seeking children?
Increasingly we are caring for children who have become dislocated from their countries and families of origin. These children and young people may have experienced shocking violence and multiple trauma. The mental health needs of such children and young people are further complicated by cultural, social and language differences.
Can therapy help children-in-care?
Therapy for traumatised children, whose early experiences of neglectful parenting have left their emotional worlds in damaged and fragile states, requires a very specialist approach. Behaviours which would ordinarily be cause for concern, might be signs of misdirected resilience. I have worked extensively in specialist services for looked-after and adopted children and am passionate about their entitlement to comprehensive treatment that can support their ongoing recovery from childhood trauma.
My approach to this work will therefore be different. I will ensure that all of their families are thought about. I will consider past and present experiences. Assessment of current stability of family or residential care will all be carefully taken. Further information can be found in my information for professionals