Introduction.
‘The Mulberry Bush School (MBS) works with some of the most challenging children in the country, and with their families and carers. Our aim is to help the children and their families thrive and achieve fulfilling lives within their communities and as part of society.’ (MBS website, 2021) To enable the school to provide this level of support, there is a dedicated Therapies and Networks Team and within this group I hold the role of Family Link Worker. As an employee of MBS, I have been undergoing a Foundation Degree in Therapeutic Child Care for Children and Young People. As part of the course, we have been asked to complete a piece of Action Research, which is a concept that originated from Kurt Lewin (1948.) ‘Action research is practical, cyclical and problem solving in nature. Research is seen as a fundamental way in which to effect change.’ (Gray, 2004, p374) An area for investigation is identified and an intervention is then put in place. This is later examined, to gauge the impact of what has been implemented. It may be that further changes are needed and this cycle of change and reflection is repeated. (Taylor et al, 2006) Appendix 1, contains a diagram that represents this cycle.
This piece of action research will be based on our work with the parents and carers of children at the school. Each child’s parent or carer will be allocated a Family and Networks Practitioner (FNP) to support them throughout their child’s placement. Some of this work will be co-worked with myself, as the Family Link Worker (FLW.) Our roles involve gaining an understanding of the child’s family relationships, developing a dialogue between home and school and to enable parents and carers to reflect on their experience of parenting their children. The role also includes working in collaboration with the child’s professional network. Working alongside families at the school has enabled me to gain an understanding of the challenges that they face.
The challenges that families of children who have experienced trauma can face.
There is extensive writing that describes in depth about some of the challenges that these families are faced with, which this essay will explore. Parents and Carers of children who have suffered trauma, similar to that of the children at MBS, often experience secondary trauma themselves. Traumatised children often have difficulty in making and maintaining healthy attachments. Their experience leads to additional emotional and behavioural needs that are different to their non-traumatised peers, which can make parenting these children extremely challenging. (Gordon et al, 2015) In 2019, the British Government announced further funding to support adoptive families with some of the challenges that they face and pledged that the Adoption Support Fund would ensure that, ‘Every family that needs it will be able to get therapeutic support until 2021.’ (The Department of Education, 2021) Sadly, in my experience of working alongside adoptive families at The Mulberry Bush, many report feeling as if the professional family support they receive outside of MBS, does not meet their needs. Adoptive Parents can face extensive challenges, including feelings of isolation, stress and inadequate personal and post-adoptive support. (Atkinson et al, 2007; Houston et al, 2008; Miller et al, 2019) The difficulties detailed are not just restricted to Adoptive Parents. It has been well documented that foster carers are also presented with complex issues including; the complicated needs of the children they are looking after, navigating the social care system, the reduction of support services and financial reimbursements, feeling unappreciated for their work and receiving poor communication with professionals. (Bergson et al, 2019; Brown et al, 1999; Brown et al, 2007; Geiger et al, 2013; Hudson et al, 200.) These themes are prevalent within our work with the families at MBS. This identifies a need for additional support or an intervention, for those parenting and looking after some of the most vulnerable children in our society. The identification of a need for an intervention, is the first part of the action research cycle (Lewin, 1948)
The Intervention
In recognising the need for supporting families, one of the interventions that MBS provides are two supportive peer groups for parents and carers. One of the groups is for adoptive parents and special guardians and the other group is for foster carers. This essay will be analysing the impact of the two groups upon those who attend. The groups are already in place. Pre-covid, the MBS groups usually ran once a term, when they were able to be held in person. In the past year, these groups were able to run on average, twice a term. They were held virtually, for up to an hour and a half. They are offered to all of the adoptive parents, special guardians and foster carers of children at the school. When this research began in January 2021, 17% of the child group were adopted, 4% of the children were under a special guardianship order and 66% of the child group were in foster care. 13% of the child group were currently living with their birth family. Parents and carers are able to choose if they attend, making the group self-selecting. The meetings are facilitated by two Family and Network Practitioners (FNP) and provide a space to reflect on what it is like to parent and look after their child. There is no formal agenda and the topic of conversation is led by the groups, with parents and carers raising what they feel is important. The MBS groups are ever changing, as different people may attend each time.
The Value of this Research.
This research will enable my professional development, through gaining a greater understanding into the impact that MBS groups have on the parents and carers who attend them. This has been something that I have been curious about since I started at the school. As a team, we have often received informal verbal feedback about how useful parents and carers have found this space, but there has not been any research into the impact of these groups. The research will therefore provide an internal evaluation for the team. As the intervention is already in place, the ‘planning’ and ‘first action’ steps from an action research cycle are complete. (Lewin, 1948) The research will allow us to evaluate the impact of the intervention and seek ways to develop it further, which is an important part of action research (Lewin, 1948)
Literature Overview
Once an initial idea has been identified, it is important to undergo a literature review. (Lewin, 1948) As this essay will look into the impact of the MBS groups on the parents and carers that attend them, it was crucial to study current writing about support groups for this demographic. The search for information was based on The University of West England’s Library. There was extensive research into parent/carer support groups. ‘Support groups are defined as meetings of people with similar experiences’ (Worrall et al, 2018) Support groups can be useful, as those who attend tend to learn from one another. This can be done through both listening and talking to those who have had a similar experience. (Jacobs et al, 2006) In group therapy, the sessions are led by the group. This allows for group members to raise the topics that they feel are important. (Alle-Corliss et al, 2009) Group members can, ‘Suffer from unexpressed feelings and thoughts and can benefit from expression of these feelings and thoughts or catharsis.’ (Alle-Corliss et al, 2009, p16) This suggests that it can be helpful for those who attend, to hear others verbalise something that they may not feel able to. Group members can sometimes gain a better understanding of their own situation, through attending the sessions. (Alle-Corliss et al, 2009, p21) This observation is reminiscent of Wilfred Bion’s theory of Containment (Bion, 1962) which is,
‘Thought to occur when one person receives and understands the emotional communication of another without being overwhelmed by it and communicates it back to the other person.’ (Douglas, 2007, p14) Parents and carers could receive containment through attending MBS groups, by either having others listen to their experience and relate to it without becoming overwhelmed, naming how it felt for them, or through describing how they felt when explaining a situation that they have experienced, which is similar to others within the group. This could support individuals to gain a better understanding of their own situation, whilst empowering the individual sharing their experience. The support groups for Adoptive Parents, Special Guardians and Foster Carers at MBS are facilitated in a way whereby participants can choose whether or not to contribute and are able to raise what they feel is important for them, within the group.
The power of the shared experience was a common theme that emerged from the literature. ‘Bonding between parents is often attributed to the similarities in their experiences.’ (Ainbinder et al, 1998) The success of these groups have been, ‘Attributed to the reciprocal nature of the relationship, the flexibility of the support and the power of shared experience, which can lend credibility to advice shared between the peers.’ (Dodds et al, 2017) This demonstrates the significance of parents and carers at the MBS, being able to come together and receive support from others who have experienced something similar. These groups involve being able to listen and tolerate what others are expressing. This is reminiscent of Winnicott’s theory of the holding environment, when a mother is attuned with a baby’s emotional needs. (Winnicott, 1965) He describes how a baby can be felt to be held in mind, through the Mothers consistency, empathy and compassion. He applied these relationships to that of a therapist and a patient, whereby the therapist is able to tolerate the feelings of the patient and provide a supportive environment. (Winnicott, 1965) It seems that the compassion and the space that the communities within support groups provide, mirror the theory of being held in mind and could contribute to the positive impact of the groups on those who attend them. The groups at MBS are set up for Adoptive Parents, Special Guardians and Foster Carers, in hope of maximizing the potential for facilitating a space, whereby the individuals are likely to have shared many similar experiences and unique dilemmas.
For some parents, the support from professionals. ‘Is not sufficient to meet their needs (…) and that other parents can provide a unique form of help.’ (Doods et al, 2017) This theme emerged throughout the literature (Galpin et al, 2017; Bray et al, 2017; Singer et al, 1999) demonstrating that there is something unique about receiving support from peers. This highlights the importance of having these groups at MBS, alongside 1:1 family support. Smaller groups of informal peer support have acted as a good source of information sharing for parents and carers. (Dodds et al, 2017) Groups for adoptive parents can provide an important means of receiving effective support and information. (Miller et al, 2021; Bryan et al, 2010) This indicates that alongside the experience of community, the groups can also be a useful platform for more practical help. This is important, as research indicates that parents and carers often feel isolated and can find it difficult to navigate the support systems in place (Miller et al, 2019.)
Although there was significant literature that outlined the benefit of these groups, it became apparent that there was far less information about their effectiveness. ‘Multiple studies have identified the importance of or need for support among adoptive parents, yet there is insufficient research on adoptive parent support groups in terms of effectiveness’ (Miller et al 2021) This emphasised the need for this piece of action research, to analyse the impact of the groups at MBS, to try to determine its effectiveness and evaluate whether the group can be developed further.
The research states the benefits of support groups for foster carers, with those who attend describing feeling more supported by their agency. (Sinclair, 2005 p140) In 2018, Onions writes and reflects on the value of reflective groups for foster carers and how they can provide a way to improve the success of foster care. She states that, ‘A regular reflective group can provide carers with the opportunity to regularly process the emotional impact of their role.’ (Onions, 2018) We know that through providing foster carers with space to reflect, we provide them with containment, which is vital when trying to look after some of the most vulnerable children in our society. This could indicate that through attending groups, the positive impact is not only on those who attend, but can also improve the retention of Foster Carers, which directly impacts the children that they care for.
Due to the covid-19 outbreak, the groups at MBS have been running virtually online. A theme within the literature, in relation to virtual groups, was that it enabled those who may not have been able to attend in person, to join, making them more accessible. ( Barak et al, 2008; Goh et al, 2016; Miller et al, 2021; O’Connor et al, 2014) This action research will hopefully support the team to gain a better understanding of the impact that the virtual groups have had on those who attend the MBS groups, which will be helpful when planning for the support groups going forward.
Data Collection.
Action research is a cycle that aims to improve practice. (Leitch et al, 2006) Data collection is a way that we are able to evaluate something, in order to develop it further. It was vital that the parents and carers were central to this process, to try and capture their reflections about the group, gauge the impact and explore ways to develop them further. The results were gathered via a questionnaire, keeping the parents and carers at the centre of the research. It was important for there to be quantitative questions, which is, ‘Data information about quantities.’ (McLeod, 2019) This number data enables us to group results, allowing us to summarise data and notice patterns. (McLeod, 2019) Qualitative data is descriptive and can be, ‘Observed, rather than measured. Qualitative data is used to try and make sense of an experience. It allows for more in depth answers in the participants’ own words, although this kind of data can be more easily open to interpretation.’ (McLeod, 2019) Although in agreement with McLeod that this data is open to interpretation, it felt paramount to allow parents and carers to provide feedback using their own words.
The Questionnaire
The 2 page questionnaire, compiled with the support of my team, is contained within the appendix. (Appendix 2) It was vital for other members of the team to be involved, as the questionnaire would also be a fundamental part of our internal evaluation into these groups. There were 9 quantitative and 7 qualitative questions, with the addition of an ‘other comments’ section. The questionnaire was sent to all of the 14 current attendees of the group and the parents and carers were given 3 weeks to complete it. To ensure that the research was ethically sound, it was vital that the parents and carers were aware of what the questionnaire was for. Each participant received an email, explaining the nature of the research and how the data would be used. It highlighted that it was not compulsory for them to be part of the research and that if they chose not to, it would not impact on their child’s placement at the school. Their replies to the questionnaires acted as their consent. Consent is vital in ensuring that the research is ethical. (Corti et al, 2019) We needed to ensure that the research followed The Data Protection Act of 2018 (Data Protection Act, 2018) and that the parents and carers were aware of what their data would be used for. This is not only key for ethical and legal reasons, but it was fundamental that relationships with the parents and carers were not damaged, as the two groups are protected and trusted spaces.
The results were analysed by myself in the first instance, in establishing the impact that attending MBS groups has on adoptive parents, special guardians and foster carers. The results were also shared with the wider team, to enable us to internally evaluate the intervention and look at ways that we could potentially develop the groups at MBS. Continuous evaluation and development is a critical part of the action research cycle. (Lewin, 1948)
Findings Summary and Analysis.
There were 8 responses from the 14 questionnaires that we sent out. The results are summarised within appendix 3. When analysing the data, a combination of the quantitative data, in which participants could circle either strongly agree, agree, unsure, disagree or strongly disagree, and the qualitative data, which allowed for participants to use their own words in response to the questions, were used. The questions that best help to evaluate the impact of these groups, have been selected. It is important to state that it is almost impossible to fully understand the impact of these groups, as we do not know how they may or may not, impact these families and children in the future.
The initial findings from the questionnaire results were reflective of the literature overview and seemed to demonstrate that the adoptive parent, special guardian and foster carers groups have an overwhelmingly positive impact on those who attend. All 8 of the participants either agreed or strongly agreed that the group was a place where they felt heard. The impact of feeling heard can be significant, particularly to this population who often feel undervalued and isolated. (Bergson et al 2019; Miller et al 2019) This finding suggests that the format of the group is having a significant positive impact on those who attend, as one of the aims of the two groups at MBS, is to create a space where parents and carers feel heard.
There were two results which surprised me within the findings. Firstly, when asked about the impact of this group, whether positive or negative, only 5 out of the 8 parents and carers answered this question, all describing in their own words, the positive impact that these groups had had on them. The remaining 3 Parents and Carers, did not answer. This could be for a multitude of different reasons, including them not knowing, but we should not rule out that this could be because they feel there is not a significant positive impact. This could suggest that there is space to develop the groups further. 5 out of the 8 participants felt more supported through attending this group, with 3 people answering that they were not sure. This was the second surprising finding from the questionnaire, as although this indicates that for the majority of the group, there is a positive impact, it suggests that for 3 of the participants, there was room for development, to enable the group to feel more supportive. This essay will later explore some suggested developments, which would hope to increase the sense of support for those who attend.
As 3 out of the 8 parents and carers felt unsure about whether or not they felt supported by attending the group, I was curious to explore other reasons as to why they may continue to attend. This led me to wonder whether it could be the sense of community they experience from their peers? The literature indicated that this can be incredibly valuable to parents and carers, (Alle-Corliss et al, 2009; Jacobs et al, 2006) and therefore could play a vital role in creating a positive impact on those who attend MBS groups. This idea correlates with the responses to a later question, with 7 out of the 8 feeling as if there was a sense of community. This felt powerful, as the majority of those attending had attended for less than 6 months and so would not have met one another in person, which could have potentially acted as a barrier. The sense of community experienced by the group, particularly in such a short period of time for the majority of the participants, could indicate that these groups had a significant positive impact, partially due to the sense of community between those who attend. This provides a strong case for the groups to remain in place, with the two groupings continuing as they are.
The research identified that sharing experiences was a key part in why support groups are effective, particularly within a population of parents and carers that can often feel a profound sense of isolation. (Alle-Corliss et al, 2009; Bergson et al, 2009; Gordon et al, 2005; Jacobs et al, 2006) The aim of the MBS groups is to facilitate a space whereby parents and carers can gain support from one another. The findings demonstrated that all 8 of the participants either agreed or strongly agreed that they found it helpful sharing their experiences and hearing those of other parents and carers. When we asked Parents and carers if they felt supported, and if so why, their answers were overly positive, with statements such as, that there had been a, ‘Common understanding of the problems with which the children in our care challenge us.’ (Parent/Carer, 2021) One parent alluded to a sense of feeling less isolated, noting that they were, ‘Relieved that we weren’t the only parents to have had similar experiences.’ (Parent/Carer, 2021) These findings demonstrate that the group has a strong and positive impact on those who attend, particularly in relation to sharing experiences with one another. This mirrors the themes that were prevalent within the literature overview, which discussed how sharing experiences can; reduce isolation, provide containment and empower parents/carers. It therefore feels important to keep the groupings set up in the current way, as all those who attended felt that the sharing of experiences was helpful. However, if the groups were mixed and consisted of adoptive parents and birth parents, for example, some of their experiences may be very different and could lessen the impact that MBS groups have on those who attend.
There were some common themes amongst the participants of each of the two groups. The adoptive parents and special guardians nearly all circled ‘disagree’ when asked if the group helped to increase their understanding of having a child with complex needs, compared with the foster carers who mostly circled ‘agree.’ This could suggest that although the groups are facilitated in the same way, the two groups use the spaces very differently. This could be due to the differing journeys that they have been on with their child. For example, it is quite typical for adoptive parents to struggle significantly in securing support for their children, often undergoing numerous assessments to ensure their child receives the diagnosis that they need for an appropriate educational placement. This could perhaps give parents an increased understanding of their child’s complex needs, therefore requiring less support of this kind from the group. Additionally, nearly all of the adoptive parents and special guardians circled strongly agree,’ for questions 1 and 4, which related to sharing their experiences with other parents and carers, indicating a strong sense of a shared experience through the group. One adoptive parent shared that, ‘I found it really positive. I have felt isolated (…) so to be able to meet other parents/carers, felt inclusive and a good chance to share and learn from them.’ (Parent, 2021) This demonstrates that bringing peers together to share experiences has a significant positive impact. It is interesting that although the sharing of experiences was important to the foster carers, it seemed to be felt more strongly by the adoptive parents and special guardians. The majority of adoptive parents and special guardians had not been part of these groups before, whereas the foster carers had. This could indicate that adoptive parents and special guardians receive less opportunity to attend similar groups and therefore their sense of community provided the greatest impact, whereas for the foster carers, the impact could have been lessened, due to the frequency of their additional support groups.
Next Steps and Development.
It is an important part of the cycle to look at how something can continue to be improved (Lewin, 1948) and in relation to this study, how positive impact can increase. Prior to undergoing the research, the team had explored the potential to reach more parents and carers through continuing to offer virtual sessions, which are deemed more accessible.(Miller et al, 2021) These would be in conjunction with the re-introduction of having the two MBS parent and carers groups held face to face, once the covid pandemic has ended. Although the findings showed that there was a positive impact on parents and carers within these groups whilst held virtually, they also demonstrated that there was room for development of these groups. Many of the parents and carers stated that they would prefer face to face meetings. This could indicate that the groups may have more impact if they were in person. The dilemma we are faced with as a team, is that we know that by holding more virtual support groups, the benefit could reach more people, whilst having an understanding that they will potentially have greater impact if they return to in person meetings. It is important to get the right balance between listening to the parents and carers who have completed this questionnaire and who currently attend, whilst providing increased accessibility for additional parents and carers. This will be an ongoing conversation within the team. It would be interesting to complete a re-evaluation, once the sessions return to in person, to gauge the impact. These discussions and continuous development are a crucial part of the action research cycle. (Lewin 1948)
As action research looks to seek change, it was important to ask the parents and carers if they felt the facilitation of the group could be improved. Their responses were overly positive, but half of the adoptive parent and special guardians group requested for there to be a loose agenda or theme within the group, set by the parents/carers. This was an important finding, particularly as this group does not attend any additional parent support groups. This was taken back to the team, where it was acknowledged that this was something that we could take on board. We decided to take action, by allowing for parents and carers to make suggestions for topics or themes for these groups. The first step will be to email the parents and carers, requesting their suggestions, before their next meeting. The changes that we have made, will hopefully show that we value the group’s feedback. This will hopefully improve the experience of the group and perhaps increase the positive impact. This will be reviewed again at a later point, as we are mindful that through introducing a new format and loose agenda, there is always the risk of lessening the reflection that these groups enable. The development of provision is an important part of the action research cycle and it will be important to re-evaluate this change at some point in the future. (Lewin, 1948)
Within the MBS, there is not a group offered to the birth parents with children at the school. There are complex reasons why this is, including that the parents have very different needs and that for some parents, they have restricted contact with their children, in line with the Children Act 1989 (Children Act, 1989) The findings from this research, highlighting the positive impact on those who attend MBS groups, has reignited conversations within the team about this. We are currently on the ‘evaluate’ and ‘amend plan’ stage of the action research cycle. (Lewin, 1948) We have discussed how these groups could work. For example, there could be criteria that would have to be met for birth parents to join the group, such as, they currently have contact with their child and they are engaging with professionals and with the school. Due to the complexities of beginning this group, we are not yet at the ‘take next step,’ of the action research cycle. (Lewin 1948) These conversations will continue to happen within the team.
This piece of action research has demonstrated that the impact of the groups at MBS on the parents and carers who attend, seems to be overly positive and reflect many of the themes identified from the literature review. The sharing of experiences within these groups, seems to have a more significant impact on the adoptive parents and special guardians, who were more unlikely to have experienced a similar group before, which may indicate that there needs to be more support for adoptive families. This is an important observation and it is vital that this is shared more widely within the charity, including those that work within outreach and the senior charity leads who share the work of the school nationally. This would be in hope of sharing this message with organisations and professionals from outside the school, who support adoptive families. Although this would not directly impact the group itself, it could add weight for there to be more change within our local community and impact future parents and carers of children both at the school and in wider society, which is one of the charity’s aims. (MBS, 2021)
Evaluation of the research process and conclusion.
There have been many strengths to the research, with one being that the data has been gathered directly from those that attend the groups. This allowed us to consider some of the parents’ written suggestions and thoughts, which will hopefully allow us to make positive changes to the groups. Another strength, has been that the data has been collected in a way that has allowed us to notice themes and patterns, to analyse. This acted as a good starting point to find ways to develop the group further.
Reflecting back on the research process, there are many factors that could be changed if the research were to be undertaken again. Firstly, the data has been collected in retrospect, rather than before and after, which may have produced more accurate results of the current impact of the group. Additionally, the respondents were self-selecting, so there are 6 people who did not complete the questionnaire, who may have responded very differently to those who participated. It is worth acknowledging that this information was gathered during an incredibly challenging year due to the covid-19 outbreak. This obviously meant that the groups felt very different and that many of those attending had not met in person, but in addition to this due to the pressures of covid, we were asking the parents and carers to complete the form during a particularly changing time. There are also many other factors that could influence the responses, for example, feelings towards the school and the families current situation. It is important to add that the data is always open to interpretation and was selected to best answer the question, which is another factor to consider. Lastly, it should be noted that it is impossible to fully gauge the impact of an intervention such as the one analysed in this essay. The literature highlighted that support groups, such as the ones at MBS, can provide containment for parents and carers, which can help improve the containment they provide for their own children. (Bion, 1962.) They can help parents and carers to feel heard and understood and the impact can be as far reaching, as helping to retain foster carers. (Sinclair et al, 2004) It is therefore incredibly difficult to ever fully understand the impact of groups such as the ones at MBS.
Re-evaluating changes that have been put in place, are an important part of the action research cycle. (Lewin, 1948) It would therefore be important to complete another questionnaire at some point in the future, once some of the suggestions have been put into action. It would be interesting to gather results, after the groups have returned to face to face sessions to compare the results. These results could be considered during discussions about virtual vs. face to face sessions.
This piece of action research has not only allowed for there to be an evaluation of an intervention that has been in place at the school for many years, it has allowed for my own professional development, in regards to gaining a greater understanding of the impact of the groups and how parents and carers use them. The research has increased my own confidence in being part of these groups, as it is evident that the facilitators make up only a small part of why these groups are useful for those who attend. It is important to end this essay, by sharing thanks to the wider team who have supported this process and most importantly, the parents and carers that kindly completed the questionnaires.
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