Therapists recognise the importance of endings; preparing a client for the ending of therapy or ensuring they are properly prepared for a significant break, such as a vacation. Sometimes, events overtake the process and an ending occurs without preparation. Maybe illness or a sudden change of circumstances means that therapy cannot continue. In some cases, the client may simply stop coming without explanation, providing the therapist with food-for-thought and soul searching.
For children who live with foster carers the significance of their placement coming to an end is no less significant, requiring just as much thought and preparation. When a placement is disrupted by events or ends without due planning, there are consequences to be considered for the foster carer, for the child and across the wider professional network.
The nature of foster care:
Removing a child from their home to live with a foster family is in itself a dramatic event. Such an intervention usually signifies the final stage in a series of actions by children’s services departments and other agencies. In some instances, there may be a sense of underlying relief on the part of the child; relief coming from being removed from a place of abuse, neglect or trauma, often experienced over many years. Nevertheless, this transition still represents a forced separation from known family and carers with an accompanying sense of loss. Sometimes the move will incur a change of school, with friends left behind. There will also be disruption to familiar, even if unreliable, daily routines and the sense of security that they hold for the child.
The ideal for foster carers and for the children whom they look after is that the placement will continue in a planned way, perhaps with a phased moved back to family and a more settled and safer home or to some kind of permanent care arrangement such as adoption or long-term fostering, sometimes with the child staying with their first foster carers.
Experience and research suggests that traumatised children respond best in a stable and consistent environment with daily routines delivered by adults who are able to provide appropriate and caring boundaries and who interested in their welfare and happiness. These boundaries must be sufficient to contain the children’s inevitably high levels of anxiety and the associated acting out. A loving home, in the context of a secure relationship with adult foster carers, challenges a child’s earlier experiences with adults on whom they should have been able to rely and trust but who for various reasons were unable to provide the necessary stability.
For most children the experience of being placed with foster carers involves a number of transitions, hopefully planned and prepared for, resulting in a permanent living arrangement with loving and caring adults.
But, this process does not always work smoothly and some children and young people will experience what is known as ‘placement breakdown’, where the transition is unplanned and sudden. Before going on to explore the consequences of this it is interesting to note some of the reasons that may lead to an abrupt end to a foster care placement:
Reasons for Placement Breakdown:
Research from the Social Care Institute for Excellence, ‘’Fostering Placement Stability” suggests five factors that appear to cause frequent placement moves:
- a change of social worker, i.e. a break in the continuity of adult support. This can also bring about changes to a previous plan as a result of differing perceptions and understanding of the child’s needs. The relationship between a social worker and foster carers is a critical factor in placement stability and a change of social worker may lead to friction and even conflict in the professional network; a conflict that may get acted out in a dispute ostensibly about the child’s ‘best interest’.
- over-optimistic expectations, i.e. initial hopes of a ‘home for ever’ are expressed by the adults without a thought out understanding of the child’s longer-term needs or readiness for the extreme acting out that may emerge from the child’s reactions to earlier life experiences
- any policy or practice which generally discourages children from remaining fostered after the age of 17, e. the failure to plan for the transition to adulthood or a premature move into ‘independence,’ which is still the lot of too many looked-after young people.
- the child’s level of emotional disturbance and motivation to remain in the placement, e. the extent to which the child or young person can be engaged in the process by the adults involved in their care, especially their foster carers, with the provision of the right kind and proper intensity of support required.
- The management of key life stages, e.g. the onset of adolescence, e. the extent to which foster carers, who may have accepted the child at a young age, are prepared to adapt and face the different challenges presented by a teenager. This is often made more complicated by the re-emergence of what might have been thought to be extinct behaviours from the child who is re-working in adolescence earlier trauma.
Whilst one or more of the above factors may play a part in an unplanned placement ending research findings only provide a meta-view of disrupted placement outcomes. Every foster family has their own particular history and culture (their way of doing things) amongst which a child must live and with which they must engage. The emerging dynamics, as the placement evolves, provide unique patterns of behaviours and responses that have to be thought about and contained if the stability of the placement is to be maintained and the foster family and the looked-after child enabled to grow and develop in mutually beneficial ways.
Understanding these dynamics is key in trying to disentangle the complexities around placement breakdowns and for making sense of the effect this can have on individual children, foster carers and other professionals.
The following case study illustrates some of the dynamics involved in an unplanned placement ending.
At the time when the placement came to an end Alan was just 17 years old. He had been with his foster carers, Ron and Shirley, for nearly five years. They gave notice on the placement following an allegation made by Alan, in which he claimed that Ron had physically and aggressively pushed him whilst trying to prevent him from leaving the house.
Ron disputed the claim, stating that although he had pushed Alan, it was not aggressive and was done to prevent Alan from hitting him, i.e. in self-defence.
Although Alan withdrew the allegation, Ron and Shirley did not feel able to similarly withdraw the notice that they had submitted, feeling that things had come to a head and that it was in all their interests to say goodbye to Alan, although they did agree to keep in touch once he had moved on.
The incident that triggered the decision to give notice on the placement came as a culmination to a series of events, including a serious disagreement between the foster carers and Alan’s social worker about the longer-term plan for Alan’s education and living arrangements. During Alan’s time of being with Ron and Shirley he had five social workers, each of whom were able to work with the carers and the fostering agency to greater or lesser degrees.
Background to the placement:
Before the referral to the fostering agency and placement with Ron and Shirley at the age of 12 years, Alan had experienced five foster care placements since being removed from his birth family at the age of seven. The frequency of moves was a result of a number of different reasons including rather drawn out and contested legal proceedings, during which time he was placed with three sets of respite and short -term local authority foster carers. Another foster carer decided to retire whilst Alan was with her and the immediate placement prior to his move to Ron and Shirley ended when the carer gave notice, saying that she felt Alan needed more specialist help and she was unable to meet his needs.
The context to the final move before placement with Ron and Shirley was increasing anxiety on the part of the single female carer who was looking after Alan. She was reporting growing concerns over his behaviour, which was becoming more challenging and confrontational and in her words, ‘bizarre’. This meant that she was concerned by Alan’s fascination with the world of super-heroes and his particular inclination to dress as Batman and try to emulate his hero in word and deed! Alan was placed in a children’s home as a temporary move whilst a long-term fostering placement was found.
Matching Alan with Ron and Shirley:
Throughout his early years Alan suffered profound neglect, with some suspicion of physical and possibly sexually abusive behaviour on the part of his father. Both parents had severe problems with alcohol addiction and use of substances and were not able to provide the kind of consistent, loving parenting needed to promote Alan’s healthy growth and development. A combination of support from social services and his wider family, specifically his maternal grandmother, had somehow managed to keep the family intact until Alan was seven years old. Growing concerns about his welfare and his deteriorating behaviour at school resulted in the local authority seeking an interim care order with Alan moving into foster care.
The referral to the fostering agency and the identification of Ron and Shirley as potential carers came when Alan was 13 years old in the circumstances described above.
His transition to secondary school had been difficult, exacerbated by the accompanying insecurity about where he was to be living. The acting-out of the super-hero fantasy seemed to be escalating at times of anxiety and uncertainty along with increasing signs of obsessing behaviours, difficulties in communicating with peers and adults and outbursts of what his teachers expressed as Alan taking opportunities for seeking confrontation.
Placing Alan with Ron and Shirley was not without its risks, but they were positive about the referral and seemed to think that they could offer Alan stability and boundaries within a warm and caring home environment.
The Lived Experience:
The word ‘turbulent’ might be best to describe the overall experience of Alan being fostered by Ron and Shirley. During the course of the four and a half years’ placement there were several times when it seemed that things could not go on and that alternative arrangements would need to be made for Alan. However, situations were managed and issues resolved.
Moreover, the placement continued for an extended period of time and gave Alan some of the security and continuity he needed. During the course of the placement the Annual Reviews reflected the difficulties but noted the basic stability provided for Alan. The comments in the reports from Ron, Shirley and Alan regularly indicated an overall level of satisfaction with the arrangement and were often written in warm and positive tones.
Over time a number of key issues emerged, which revealed elements of both Alan’s and the foster carers’ personalities but were also manifestations of the vagaries of the wider networks within which their relationship was grounded.
Throughout his early teenage years Alan was prone to being bullied at school and to some extent within the local community. He presented as younger than his actual age and with a slightly odd appearance drew comments and remarks from his peers. On the other side, Alan would also bully other younger children, who were obviously weaker than he was and could also be intimidating and challenging to adults in authority, notably teachers. Ron was a strong advocate for Alan with regard to school and to his entitlements in education. He often made his representations in a forthright, blunt manner and would challenge the school if he thought Alan was being unfairly treated or blamed for an incident.
Bullying was also a feature of the home situation and increasingly focused on Alan’s behaviour towards Ron and Shirley’s own son, who continued to visit and whom Alan found difficult to be with. Shirley also was an occasional object of Alan’s anger, and towards the end of the placement he became particularly abusive and intimidating towards her. At one stage Shirley had spent a period of time away from the home, staying with relatives, in order to give her a break from the worry of looking after Alan. Ron found this aspect of Alan’s behaviour really challenging and it had fueled a number of serious confrontations between him and Alan.
As Alan grew older the issue of boundaries came increasingly to the fore. Alan continued to show interest in the world of super-heroes, spending long, lonely hours in his bedroom using computer games to explore this. Even at sixteen years old he would insist on dressing up as batman and playing with younger children in the park. Inevitably this agitated other youths of his age and was a contributing factor to the bullying to which Alan was victim in the local community.
This behaviour became a focus for disagreement between Ron, the support social worker from the fostering agency and also the local authority social workers. Over the course of the placement any changes in social worker always added to Alan’s anxiety; some he liked, some he loathed, but there was never any opportunity to forge and maintain a longer- term relationship. For Ron, the frequency of these changes were a source of irritation, leading him to become dismissive of the local authority’s role and to take an entrenched attitude that he alone was acting in Alan’s interests and as he knew him best, was most competent to judge his needs.
The support social worker, who remained the same person throughout, tried to act as mediator but was often drawn into taking sides, weakening his influence with both parties.
The frequent changes in social worker inevitably resulted in different opinions and plans for Alan’s future and became the trigger for the final breakdown of the placement.
Alan’s ‘leaving care’ pathway plan had included the possibility of him transferring to a residential provision providing further education. Contact would remain with Ron and Shirley with whom Alan would spend weekends and holidays.
This plan, was never formally agreed, with the standard stumbling block of funding continually presenting itself and its progress hampered by successive social workers not following up meetings with sufficient urgency or sense of purpose.
The last social worker appointed for Alan had very strong opinions that Ron and Shirley were not allowing Alan sufficient opportunities to prepare for independence and were infantilising him with their imposition of rules and restrictions around such matters as staying out late or going to see friends. Ron and Shirley were equally adamant they understood Alan’s vulnerability and were not willing to allow him to put himself in what they perceived to be high risk situations.
Alan, caught up in this dynamic, acted out the conflict, upping the level of his confrontations with Ron and Shirley, insisting on his ‘near-adult rights’ and defiant of their attempts to set boundaries. Interestingly, he still maintained the batman persona and in fact appeared increasingly anxious, paradoxically showing more dependent and child-like behaviours right up until the ending of the placement.
Ron and Shirley’s experience with Alan exhibits a number of the aspects previously identified from research as contributory factors in placement breakdown. But the specific circumstances and the dynamics of their relationship recount an essentially human story leaving all those involved bearing residual feelings of doubt and sadness.
For Ron and Shirley, it led to real questions about whether they wanted to continue as foster carers as well as carrying huge amounts of guilt about whether they had done enough. They were also angry with social services, who they felt had let Alan down and failed to provide them with the support they were looking for in trying to care for him. They also had ambivalent feelings about the agency for which they were foster carers, asking if they had offered sufficient support?
For the agency, there was an equal amount of wondering; the usual have we done enough, but also should we have seen this coming and acted in advance of the final crisis? And if so, what would have been the right course of action?
Whilst these questions are difficult to answer it did lead to some useful reflection and thinking on the part of the agency about their role in managing placement endings and taking responsibility and making decisions proactively, rather than reactively.
And what of Alan? Following the notice on the placement the local authority finally agreed to the residential college placement, due to start in a couple of months, and Alan went to live on a temporary basis back in the children’s home where he had been before coming to live with Ron and Shirley. What feelings was he left with?
Outwardly, he expressed satisfaction that he was going to college and that he was pleased to be away from Ron and Shirley. Inwardly and for the long-term, it is much more difficult to know. Ron and Shirley provided him with several years of stable care, held on during times of upset, argued his corner when he was in trouble at school and gave him experiences that otherwise he would have been deprived of. The placement ended abruptly and badly, but the question as to whether what went before will be enough to provide sustenance and hope for the future, remains unanswered.
It is of critical importance to provide stable and loving placements for children presenting with extreme emotional and behavioural needs who cannot live with their birth family. Sustaining such placements is often challenging and stressful for foster carers and their supporting social workers. These challenges are not only to do with meeting the children’s daily needs, often exhausting and demanding work, but are compounded by the systemic difficulties of financial constraints and competing organisational hassles. In Alan’s case what seems so evident is the lack of any consistent, organising authority able to provide an overview of his situation providing an understanding of his emerging difficulties, whilst formulating some thoughtful responses to the complexities of his behavioural presentations.
In all work with troubled or traumatised children and young people, including counselling or psychotherapy, planning for the unexpected is just one of the impossible tasks! Judging when an intervention should reach its natural ending requires experience and insight grounded in the particular relationship. The false comfort offered by manual based techniques, i.e. a fixed number of sessions and the job is done, seems attractive when faced with the competing demands of knowing the value of stability and the importance of resilience and perseverance. In preventing what we have described as placement breakdown there is no single answer, and seeing into the future is not a gift afforded to many!
The presence of resilient and thoughtful adults, able to build and sustain relationships in complex and testing circumstances would seem to offer the best hope for working through difficult times and providing the essential continuity and stability to come through crises. Embedding those relationships into the network of professional agencies and integrating them into wider systems remains a continuing challenge.
Social Care Institute for Excellence. Fostering Placement Stability: