Child and Adolescent Psychiatry

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Fostering and Adoption 365

the child or adolescent and prevents them from beginning to make
secure and trusting relationships.
2 Frequent contact with a birth parent who makes unrealistic promises
about how wonderful it would be to live with them, or is a sex
offender or seriously abusive, is not advisable and can lead to ongoing
disturbance in the child or adolescent.
3 After disruption of a foster placement, placing the child or adolescent
with another set of foster carers who are of the same level of experience
or skill, rather than specialist foster carers with a good back-up system
is liable to lead to yet further disruptions.
4 Extensive efforts to try to offer parenting treatments with highly abusive
parents who have little prospect of improving sufficiently to meet their
child’s needs will prolong stress and ambiguity for the child and may
lose crucial time periods when they need to experience security and
love consistently in order to develop healthily.
5 When a child or adolescent has to be moved, wherever possible, con-
tinuity of school placement and positive peer relationships should be
encouraged, rather than moving the individual to a different area.
6 Placing the child or adolescent with several disruptive siblings so that
they can be together in a multiple sibling placement is not indicated
if the relationship between siblings is poor or if their behaviour is
markedly aggressive or antisocial; such a placement is highly likely to
lead to further disruption, as it is very difficult for any parents to take
three or four disruptive children at once.
7 Placing a child in a family with two or three children who are around
the same age is likely to lead to jealousies and reduce the attention that
can be given to the newly placed child. In contrast, placing a child in a
family that has a well-adjusted older child can work well, especially if
the older child shows care and interest in the new child and provides a
good role model.
8 Sometimes the birth parents may overcome the acute problems that
that led to their child to come into care, for example, their mental
health problem may improve. Under these circumstances, it is right to
consider reunification. However, studies indicate that a high proportion
of reunifications fail (typically over half), with the child needing to re-
enter the care system and that even when children are deemed well
enough cared for to remain in their birth families, their outcomes are
worse than those who remain looked after.


Identity and contact issues


In addition to whatever treatment is indicated for psychiatric disorders, a
number of issues may need to be addressed. These include: (1) helping
young people to understand why their parents could not keep them,
particularly if there are other siblings who are still living with them.
Giving them a ‘life-story book’ with photos of their relatives can help

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