Improving the wellbeing of children in care through a group intervention for foster carers

INTERVENTION: There are two study arms. One group (intervention arm) will attend the Reflective Fostering Programme alongside Usual Support and the other (control arm) will receive Usual Support only. Usual support is defined as the support, advice and guidance that all foster carers receive from their allocated social worker, plus any additional support services that they may receive as part of their role as a foster carer Randomisation Foster carers will be randomised individually to the Reflective Fostering Programme arm or the control arm. Randomisation will be managed online (using a tool built by NCTU Data Management) and overseen by the TM. Randomisation will be 1:1, stratified by age of child (4‐9 vs 10‐13), number of previous placements (1 or less, vs 2 or more) and recruiting region. The randomisation sequence will be blocked in random block lengths of two or four. Participants will be informed of group allocation by the local Site Coordinator, who will also contact the relevant social worker(s), so that they are aware that the foster carer is taking part in the study. If they are in the intervention group, the Reflective Fostering Programme Facilitators at each site will be informed. The Reflective Fostering Programme is a group‐based, psychoeducational intervention for foster carers. Reflective Fostering focuses on the practical application of a set of tools that represent the principles of reflective caregiving in a shortened, highly applicable form, for foster carers of children aged 4 to 13. The Reflective Fostering Programme The focus of the intervention is on improving the capability of the foster carer in relation to a nominated child currently in their care. Unlike p CONDITION: Mental health ; Mental and Behavioural Disorders PRIMARY OUTCOME: ; Emotional and behavioural difficulties measured using Strengths and Difficulties Questionnaire (SDQ) at baseline, 4 and 12 months; INCLUSION CRITERIA: 1. The carer is currently fostering a child aged between 4 and 13 years 2. The child has been in this placement for at least 4 weeks 3. The care plan is for the child to remain in this placement for more than 4 months 4. The inclusion criteria are in place to ensure that the intervention targets carers of children in medium to long‐term placements, rather than respite care or emergency placements SECONDARY OUTCOME: ; All measures will be collected at baseline, 4 and 12 months:; 1. Caregiver functioning, the functioning of the child, and the level of stress in the caregiver‐child relationship, measured using the Parenting Stress Index – Short Form (PSI 4‐SF); 2. Carers’ capacity for reflective functioning in their caregiving role, measured using the Parental Reflective Functioning Questionnaire (PRFQ); 3. Compassion fatigue and burnout measured using the Professional Quality of Life Questionnaire; 4. Carer’s view of a child’s emotional self‐regulation and dysregulation, measured using Emotion Regulation Checklist (ERC) – Questionnaire; 5. Achievement of carer's personalized goals in relation to the child, measured using the Carer Defined Problem Scale; 6. Health‐related quality of life measured using the Child Health Utility instrument (CHU9D), completed by the carer for use in cost‐utility analysis; 7. Service use in children in care, measured using Child and Adolescent Service Use Schedule, adapted (CA‐SUS); 8. Changes of social worker, change of school or placement change and reasons for any change, recorded in Placement Stability Log;