Are children in care offered effective therapeutic support?

Abstract

Aim - This thesis aims to answer the question as to whether or not the therapeutic support offered to children in care in the U.K. is effective. There are two parts to the question: ascertaining what the actual offer of therapy consists of; the quality of that offer in terms of therapeutic effectiveness. Background - children in care are significantly more likely than their peers to be involved in offending behaviour, substance misuse, and to be unemployed DfE (2019). There is evidence to suggest that unresolved developmental trauma can contribute to these outcomes (National Audit Office, 2015). It is unclear how focused the government is on supporting effective therapeutic recovery from developmental trauma. Method - Questionnaires were distributed to every local authority in the country, with approval from the Directors’ of Children’s Services. Interviews were attempted. A Foucaultian Discourse Analysis of key pieces of legislation in the field was then completed, and a Thematic Analysis of 28 studies into therapeutic recovery from complex developmental trauma was achieved. Key Findings- The study found that children in care are not systematically offered effective therapeutic support. In fact, there are multiple issues according to the quality of therapies on offer: there is a legal/political/organisational system that is dysfunctional: the offer of therapy is impossible to ascertain across the country; the way in which therapists research their own provision is laden with methodological, political, and ethical issues. However, the evidence supports the idea that we are aware of some key factors that help therapeutic recovery. Implications for Practice - The evidence provided a range of factors to support future development of therapeutic support to children in care, and supported a mapping out of the way in which therapies could usefully be developed in the future. The evidence led to the development of a model of best practice. Conclusion - The thesis ends with some recommendations as to how the profession of psychotherapy and counselling could begin to develop both their knowledge base and way of working with children care to support more effective therapeutic recovery.