Evaluation of an Attachment group for Carers and Parents of Looked After and Adopted Children

Nadzeya Svirydzenka  

Dr Jeanette Bowlay-Williams, Clinical Psychologist, Leicestershire CAMHS

Panos Vostanis


Duration: 2012 - 2013

Funding: Clinical Research Networks


One in ten children and adolescents in the UK has mental health problems.  However, in foster or adoptive children, chances of developing a mental health problem rise to 30%-40%. In providing comprehensive mental health care for this high-risk population, Child and Adolescent Mental Health Services (CAMHS) in Leicester have developed an attachment theory-based training for foster carers and adoptive parents.

Research Objective

The study will evaluate attachment group designed specifically for foster and adoptive carers. Gained insights are likely to improve current services available to a population that is four times as likely to experience mental health problems, as well as (i) inform the design of additional services; (ii) establish an effective model of service evaluation; and (iii) effectively treat mental health problems.

Evaluation will focus on three main questions:

1. Does adopted/foster carer focused training improve the mental health of the child?

2. Does attachment group training reduce adopted/foster carers’ stress and improve their well-being?

3. Can any positive changes in the carer’s management of the child’s mental health difficulties after attachment group training be perceived by the child that received the referral?

Thus, the project will provide a comprehensive account from the points of view of both carers and looked after/adopted children for the benefit of attachment theory knowledge and skills in managing mental health problems of this high-risk population; as well as build an account for patient-led improvements to the training. 


One hundred and twenty adopted or foster carers who attended or will attend group training sessions at Child and Adolescent Mental Health Service (CAMHS) in Leicester will be recruited. They will be asked to complete parenting and mental health measures for their child that received the referral to CAMHS before and after their participation in the training group.

A smaller sample of these adoptive or foster carers and their children that received the referral to CAMHS will be recruited for a follow-up interview. These interviews will provide both the carer’s and child’s perspectives on whether attachment theory-based group training had an effect on how child mental health problems are managed and whether there have been an improvement in placement relationship.

Preliminary Results

Thematic analysis of the carer interview data showed strong support for attachment-based group training for foster carers and adoptive parents as an effective way of supporting mental health needs of a high-risk population of children and adolescents experiencing such problems. Specifically, carers note the value of (i) practical strategies in managing difficult behaviours, (ii) increased understanding of child attachment history, and (iii) shared companionship with other carers on the course. Analysis also revealed that closer integration of carers and children as a part of training and a more rigorous and long-term follow-up on its effects by CAMHS as well as take-home reference material may be good ways to improve training outcomes and facilitate long-term effects.

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