The Fostering surgery: therapeutic support for foster carers in Leeds

Leeds hosts one of the few therapeutic social work teams. And the lessons learned from the experience have informed a trailblazing surgery that provides therapeutic support to the city’s foster carers.

The idea of the Fostering Surgery came out of a consultation project in children’s homes and family resource centres.

Therapeutic services co-ordinator Jan Hext says: “We were looking for ways to promote stability and avoid vulnerable children bouncing around the system. It was clear that many foster carers would benefit from having a place to go where they could get the advice of therapeutic social workers experienced in behavioural issues.”

Set up in 2004, the Fostering Surgery has three therapeutic social workers, all of whom have a background in residential childcare and children and families social work, plus a mixture of child and adolescent mental health services (Camhs) experience and additional therapeutic qualifications.

Funded jointly by Leeds Council’s Children and Young People’s Social Care Service and the local Camhs, the services the therapeutic team offers include direct work with children and families, and training and consultation for other professionals.

Therapeutic support for foster carers was initially piloted for those on specialist fostering schemes, such as the remand and assessment scheme. However, this was soon extended to the family placement scheme and mainstream foster carers.

Hext says: “Supporting the emotional and psychological health of children in foster care is a key part of our local children and young people’s plan, so everyone welcomed the idea. Also, it sits very well with the Every Child Matters agenda targets.”

The service operates like a doctor’s surgery with foster carers booking an appointment by phone to discuss concerns they have about a child they are looking after.

“Having direct access to this kind of specialised support can help to prevent problems escalating into crises, and can even mean the difference between a placement continuing or breaking down,” Hext says.

Many of the issues brought to the surgery involve behavioural problems that stem from a child’s previous experiences. These range from aggression towards their foster carers, other family members or pets, through to self-harm and sexualised behaviour, often as a result of trauma and abuse.

Andy Friis, a therapeutic social worker at the surgery, says: “Most commonly, we see foster carers who are generally worn down by the challenging behaviour of the children they are caring for. It’s a 24-hour job with lots of peaks and troughs, and sometimes they have simply run out of steam.”

Hext adds: “Foster carers who come here are desperate for answers. What we try to do is show them that one of the best ways of managing a child’s behaviour is by changing their responses. So we offer coping strategies and practical tips that may be as simple as suggesting that the foster father and mother swap roles for a bit and see how the child responds.”

Foster carers can attend up to three hour-long appointments at the Foster Surgery to discuss a specific issue relating to a child they care for. Further help can be sought from a formal referral to the service for a longer-term intervention. However, Hext says that, for two-thirds of foster carers, one appointment is usually enough.

For foster carer Angela*, the surgery has helped her to understand the troubled background of the seven-year-old boy she looks after.

“I went to the surgery because he seemed to have an unnaturally high pain threshold, which I noticed when he developed a bad ear infection,” Angela says. “He would never show any emotion other than just smile. I felt that he was scared to be himself because of things that had happened in his past.”

After a couple of appointments, Angela says she was able to play a more active role in the child’s development. “It really turned things around. The therapeutic social worker gave me lots of practical suggestions about how I can get him to open up, and even gave me some stickers of smiley faces and sad faces to gradually help him understand that it’s OK to show his emotions.”

Liz*, another Leeds-based foster carer, says the service stands out because it is specifically for foster carers.

“Sometimes you just need the reassurance from a professional that you’re on the right track and that, with a bit of tweaking, your strategies will work.

“I feel more able to say I’m finding things difficult to a therapeutic social worker than to a link worker, and I also know that I’ll get expert advice.”

*Names have been changed

For further information on the Fostering Surgery, e-mail Jan Hext

This article appeared in the 29 November issue under the headline “Pain-free surgery”