Background: Children who enter foster care usually do so because of
maltreatment by their birth families. Early adversity such as this is associated
with many negative outcomes, including disturbances of attachment and
mental health in childhood and throughout the lifespan. Young children
(under 5) are particularly at risk due to maltreatment rates being highest in
this age range, and because of the vital brain development that occurs during
this time. Improving the quality of existing relationships for young children is
the most cost effective way to improve mental health outcomes. It is
important that research investigates which relational and psychological
variables that exist within the foster carer-child relationship may be protective
against developing negative mental health outcomes, so as to inform carer
training and future interventions for this vulnerable group.
Aims: The aims of this research project were twofold. The first aim was to
systematically review the existing literature on links between foster carer
psychological variables (such as commitment to their foster child), and/or
child psychological variables (such as their attachment style), and the mental
health outcomes of children in foster care. The second aim was to investigate
whether foster carer acceptance, commitment, awareness of influence and
reflective functioning (RF) predict the mental health outcomes of Scottish preschool
aged children who are looked after in foster care.
Method: A systematic review of the existing literature was undertaken to
address the first aim. The search strategy resulted in 12 quantitative studies
that investigated links between child or carer psychological variables and
child mental health outcomes. An empirical study of 179 pre-school aged
children in foster care in Scotland was carried out to address the second aim.
Participants were taking part in a wider RCT of a novel intervention to
improve outcomes and permanency decisions for children in foster care.
Foster carer acceptance, commitment, and awareness of influence was
assessed using the This Is My Baby Interview, and scores of RF were coded
from the transcripts of this interview using a computer-based algorithm. Child
mental health information was gathered using the Infant Toddler Social
Emotional Assessment. Data was gathered at 2 time points; baseline
assessments occurred around 4 weeks after entry to care, and follow-up
assessments were carried out a year later.
Results: The systematic review found good evidence that foster child
attachment security is linked to more positive mental health outcomes. It also
found some evidence suggesting that foster carer psychological variables
such as commitment and quality of caregiving also relate to child mental
health outcomes, but this research is in its infancy and it is therefore difficult
to draw firm conclusions around this. The results of the empirical study
showed that carer commitment and awareness of influence predict child
competence at baseline, and RF predicts internalising and externalising
problems at follow up. No predictive relationships were found between carer
variables and child mental health over time.
Conclusion: The results from both studies suggest that carer psychological
variables such as commitment to their foster child may relate to child mental
health development. These results have implications in terms of foster carer
training, and for intervention development for this vulnerable population. This
research is however in its infancy, and the results suggest a complex picture
with regard to carer psychological variables and child mental health. Large-scale
high quality longitudinal research is needed to provide a clear
understanding of these relationships