Supporting foster carers to improve mental health outcomes of young children in foster care: a feasibility study

Plain English summary of protocol

Current plain English summary as of 26/03/2019:
Background and study aims
Children in foster care have typically had a very difficult start in life and for these children it is often difficult to trust new adults, such as new carers. Some children in foster care have such severe problems in this area that they may qualify for a diagnosis called Reactive Attachment Disorder (RAD). The difficulties experienced by such children can limit the benefits they might otherwise get from foster care; it also places them at risk of longer-term behavioural and emotional problems. There is currently no evidence-based treatment available for children in foster care with these kinds of difficulties. The aim of this study is to conduct all of the preparatory steps necessary to pave the way for a full–scale trial of a Video feedback Intervention to Promote Positive Parenting (or 'VIPP') for children in foster care with RAD difficulties.

Who can participate?
Families made up of foster carers and fostered children with RAD.

What does the study involve?
Foster families are randomly allocated to either receive the VIPP-FC service (alongside the usual support they receive) or to just receive the usual support in their area (‘usual care’). When foster families are placed in the usual care group, they continue to receive the care they have from their GP, health visitor, or other professionals in the area. When foster families are placed in the VIPP-FC group, they still get the support they would normally, but also receive the VIPP-FC service from their local Child Adolescent Mental Health Service (CAMHS). As part of this service, a CAMHS practitioner who is specially trained to support children in foster care and their carers comes to visit families at home on six occasions, for about an hour and a half each visit. The visits involve both the foster carer and the foster child and start by video-recording both interacting. The carer then looks at this recording with the practitioner, and they discuss it and think together about ways of understanding the foster child’s behaviour and coming up with strategies to try out. Regardless of whether families are placed in the usual care group or the VIPP-FC group, the foster carer and foster child are seen by a researcher twice. During these research visits carers have the opportunity to talk about their foster child’s development and the researcher carries out a number of commonly used assessments of children’s behaviour and wellbeing. These include questionnaires, an interview and an observation to see how the foster child responds to meeting new people and how they respond when you step out of the room for a short period of time.

What are the possible benefits and risks of participating?
It is hoped that the study will be an interesting and enjoyable experience and if allocated to the VIPP-FC group families may also find this helpful. Also, the information obtained from this study will help to improve services to other foster families with young children in the future. Foster families are also given £30 per research visit to thank them for their time. Sometimes the questionnaires and interviews used in this study can be a bit upsetting because they include some questions asking about some social or emotional difficulties the foster child might be experiencing. The assessment of the foster child’s reaction to a new room and an unfamiliar person might also be a little upsetting to either the carer or the child. During all the assessments families are free to stop at any time and do not have to talk about anything that they don’t want to. The assessments do take some time (up to 1 and half hours) and that might be difficult if families are very busy.

Where is the study run from?
1. Dragon Parade Clinic CAMHS centre (UK)
2. Lime Trees CAMHS centre (UK)
3. Brompton House CAMHS centre (UK)
4. Waltham Forest CAMHS centre (UK)
5. Haringey First Step service (UK)

When is the study starting and how long is it expected to run for?
September 2015 to November 2019

Who is funding the study?
National Institute for Health Research, Health Technology Assessment Programme (UK)

Who is the main contact?
Prof. Pasco Fearon
p.fearon@ucl.ac.uk


Previous plain English summary:
Background and study aims
Children in foster care have typically had a very difficult start in life and for these children it is often difficult to trust new adults, such as new carers. Some children in foster care have such severe problems in this area that they may qualify for a diagnosis called Reactive Attachment Disorder (RAD). The difficulties experienced by such children can limit the benefits they might otherwise get from foster care; it also places them at risk of longer-term behavioural and emotional problems. There is currently no evidence-based treatment available for children in foster care with these kinds of difficulties. The aim of this study is to conduct all of the preparatory steps necessary to pave the way for a full–scale trial of a Video feedback Intervention to Promote Positive Parenting (or 'VIPP') for children in foster care with RAD difficulties.

Who can participate?
Families made up of foster carers and fostered children with RAD.

What does the study involve?
Foster families are randomly allocated to either receive the VIPP-FC service (alongside the usual support they receive) or to just receive the usual support in their area (‘usual care’). When foster families are placed in the usual care group, they continue to receive the care they have from their GP, health visitor, or other professionals in the area. When foster families are placed in the VIPP-FC group, they still get the support they would normally, but also receive the VIPP-FC service from their local Child Adolescent Mental Health Service (CAMHS). As part of this service, a CAMHS practitioner who is specially trained to support children in foster care and their carers comes to visit families at home on six occasions, for about an hour and a half each visit. The visits involve both the foster carer and the foster child and start by video-recording both interacting. The carer then looks at this recording with the practitioner, and they discuss it and think together about ways of understanding the foster child’s behaviour and coming up with strategies to try out. Regardless of whether families are placed in the usual care group or the VIPP-FC group, the foster carer and foster child are seen by a researcher twice. During these research visits carers have the opportunity to talk about their foster child’s development and the researcher carries out a number of commonly used assessments of children’s behaviour and wellbeing. These include questionnaires, an interview and an observation to see how the foster child responds to meeting new people and how they respond when you step out of the room for a short period of time.

What are the possible benefits and risks of participating?
It is hoped that the study will be an interesting and enjoyable experience and if allocated to the VIPP-FC group families may also find this helpful. Also, the information obtained from this study will help to improve services to other foster families with young children in the future. Foster families are also given £30 per research visit to thank them for their time. Sometimes the questionnaires and interviews used in this study can be a bit upsetting because they include some questions asking about some social or emotional difficulties the foster child might be experiencing. The assessment of the foster child’s reaction to a new room and an unfamiliar person might also be a little upsetting to either the carer or the child. During all the assessments families are free to stop at any time and do not have to talk about anything that they don’t want to. The assessments do take some time (up to 1 and half hours) and that might be difficult if families are very busy.

Where is the study run from?
1. Dragon Parade Clinic CAMHS centre (UK)
2. Lime Trees CAMHS centre (UK)
3. Brompton House CAMHS centre (UK)
4. Waltham Forest CAMHS centre (UK)
5. Haringey First Step service (UK)

When is the study starting and how long is it expected to run for?
September 2015 to October 2019

Who is funding the study?
National Institute for Health Research, Health Technology Assessment Programme (UK)

Who is the main contact?
Prof. Pasco Fearon
p.fearon@ucl.ac.uk

Contact information

Prof Pasco Fearon
Scientific

University College London
545
Research Department of Clinical, Educational and Health Psychology
1-19 Torrington Place
London
WC1E 7HB.
United Kingdom

ORCID ID	0000-0003-1847-8443
Phone	+44 (0)207 679 1244
Email	p.fearon@ucl.ac.uk

Study information

Eligibility

Locations

Countries of recruitment

• England
• United Kingdom

Study participating centres

Sponsor information

University College London
University/education

University College London
1st Floor, Maple House – Suite B
149 Tottenham Court Road
London
W1T 7DN
England
United Kingdom

Phone	+44 (0)20 3447 5199
Email	david.wilson@ucl.ac.uk
"ROR"	https://ror.org/02jx3x895

Funders

Funder type

Government

Results and Publications

Study outputs

Editorial Notes

15/08/2022: The following changes have been made:
1. Publication reference added.
2. The final enrolment number has been added from the reference.
09/08/2022: The following changes were made to the trial record:
1. Publication reference added.
2. A link to the protocol was added.
06/11/2019: Internal review.
26/03/2019: The following changes were made:
1. The recruitment end date was changed from 28/02/2019 to 30/06/2019.
2. The overall trial end date was changed from 01/10/2019 to 30/11/2019.
3. The plain English summary was updated.
03/09/2018: The following changes have been made:
1. The recruitment start date has been changed from 01/07/2017 to 01/09/2017.
2. The recruitment end date has been changed from 01/03/2019 to 28/02/2019.
3. The ethics approval information has been added.