Framing the Gap: Discussing Analytic Fostering

This is one of the first complete follow-up studies made in Vancouver of the progress of a sample group of foster children, all of whom at the date of the survey had reached the age of twenty-one. The development of each of the cases is traced chronologically from the time the child first entered a foster home, or was known to the Children’s Aid Society. Although the research material is mainly confined to the Children's Aid Society case records the principles of foster home placement which are illuminated may be regarded as applicable to the general field of child welfare. Current enquiries, including some interviews, are incorporated in the study to supplement the material of the case records. The development history for each person (men and women) is analyzed according to family background, health, education, employment, behaviour and personality factors. The Wetzel grid is employed to make more comparable the varied health data. The qualitative material is also converted to more quantitative measurement by ratings assigned to each of the above-mentioned five-fold classifications. The totalled numerical ratings give a composite (1951) evaluation which is compared with a preliminary rating, the result of a previous survey of social adjustment (or maladjustment) in 1948. The results of the study indicate, broadly, that former foster children become part of the lower-middle class in the population strata. The extent of their emotional maturity Influences considerably the level of formal education which they attain, and it, in turn, determines the type of employment they obtain. The outcome of the placement efforts Includes both successes and failures, but the majority of former foster children appear to make a successful adjustment in society. It is evident, however, that the ability of foster children to become successful in life depends upon how well they take root in a foster home and assimilate the principles of satisfactory living. The failures are clearly traceable to the influences of poor living standards at an early age. The failures also reveal the deficiencies of child welfare practice, and the reasons why better results are not being attained for the time and money expended. Pressure of work and lack of adequate resources are among the reasons for the failure to obtain a better yield of successful citizens from children who need foster homes in early life.

This qualitative study explored the perceptions of child welfare workers and foster caregivers regarding stress and crises in foster homes. Interviews of foster caregivers (n = 14) and child welfare staff (n = 11) compare the two perspectives to determine similarities and differences. Findings explored stress and various factors contributing to crises. The ability to compare data between groups allowed important distinctions to emerge. Implications for practice include the need for child welfare systems to support professionals with clinical training and expertise to consult with families or child welfare workers in real time and identify ways to strengthen communication between caseworkers and foster caregivers.

Are children and adolescents in foster care at greater risk of mental health problems than their counterparts? A meta-analysis

This project investigated the subjective perceptions of family reported by people who have experienced long-term foster care. Foster care involves removal from their biological family of children deemed to be in need of care, and their placement in alternative homes. Foster children may spend varying amounts of time in care, and may have multiple caretakers. The research began with three broad questions: Who do people who have experienced long-term foster care think of as their family? How close do they feel to them? How would they like their family to be? Two exploratory studies were conducted. In Study 1, 43 children in long-term family foster care (CFFC participants) aged between 8 and 15, who had been in care for more than one year, and 42 matched controls, completed the Kvebaek Family Sculpture Technique (KFST). They chose figures to represent family members and placed them on a chess board, using the squares to indicate emotional closeness or distance from each figure. A representation of their 'ideal' family was also obtained. Most CFFC participants nominated their foster family as their family, and few changed their ideal representation. In Study 2, 39 adults aged between 19 and 65 (AFCC participants), who had been in either family foster care or cottage homes for at least one year, and a comparison group of 39 matched controls, completed the KFST according to perceptions of family now, as children, and an ideal family. An in-depth, semi structured interview on perceptions of family followed. For the majority of AFCC participants, connections to foster family when they were children had dissipated over time. Nevertheless, about half of the AFCC participants were still strongly and positively attached to one set of foster parents. The major determinant of attachment to foster parents appeared to be a nurturing environment, while a non-nurturing environment was the most prominent feature of failure to attach to foster parents. Visiting by biological parents contributed to continued attachment to them, however, relationships with biological parents were reported as ambivalent, distant, and unsupportive. Foster care participants appeared similar to those in other studies, however, the two samples were small, and may not be representative in terms of ideas about family membership. Caution is necessary in any attempt to generalise from the findings to a wider foster care population. Implications for theory, policy, and clinical applications are discussed, and suggestions made for further research.

The foster care program in Japan started in 1948 under government subsidy and supervision, following the enactment of the Law of Child Welfare. The scale of the program has been small, and, in fact, both the number of foster homes and of foster children show a decreasing trend in recent years (Table 1). The limited development of foster care in modem Japanese society is in sharp contrast to its popular role in traditional Japanese life. The custom originated at least 600 years ago as a way of child upbringing, and even now many adults who grew up in pre-World War II Japan have memories of time spent in foster homes. The foster home custom in Japan evolved primarily from the aristocratic class and was fostered by the hierarchical class and family system of Japanese society. The custom lost its raison d'etre with the changing concept of class and family in post-war Japan, but still exerts its influence upon present foster care practices. This paper deals with the historical background of the foster home custom in Japan, and reports preliminary findings from a field trip to a suburban community of Tokyo, which has been known as a colony of foster homes in the past, and which still plays an active role in the foster care program of today.

The question of how psychoanalysts are affected by their patients is of perennial interest. Edward Glover posed the question in an informal survey in 1940, but little came of his efforts. Now, more than half a century later, Judy Kantrowitz rigorously explores this issue on the basis of a unique research project that obtained data from 399 fully trained analysts. These survey responses included 194 reported clinical examples and 26 extended case commentaries on analyst change. Kantrowitz begins The Patient's Impact on the Analyst by documenting how the process of analysis fosters an interactional process out of which patient and analyst alike experience therapeutic effects. Then, drawing on the clinical examples provided by her survey respondents, she offers a detailed exploration of the ways in which clinically triggered self-reflection represents a continuation of the analyst's own personal understanding and growth. Finally, she incorporates these research findings into theoretical reflections on how analysts obtain and integrate self-knowledge in the course of their ongoing clinical work.This book is a pioneering effort to understand the therapeutic process from the perspective of its impact on the analyst. It provides an enlarged framework of comprehension for recent discussions of self-analysis, countertransference, interaction, and mutuality in the analytic process. Combining a wealth of experiential insight with thoughtful commentary and synthesis, it will sharpen analysts' awareness of how they work and how they are affected by their work.

Compliance and Internalization in Preschool Foster Children

Behavioral and emotional problems have been observed in emotionally vulnerable children in foster care under certain circumstances. A common pattern involves the unpredictable appearance of a previously absent or unavailable natural parent. Such an occurrence precipitates the reawakening of the child's ambivalent feelings toward both natural and foster parents as well as their fears of abandonment. This frequently leads to behavior that is oppositional and difficult to manage. If the foster parents find the child's behavior unmanageable, and if they are not provided with appropriate professional support during this difficult period, a crisis often follows that precipitates the child's removal from the foster home. Individual, familial, and systemic contributions to this dilemma are discussed. This article emphasizes the origins and nature of the intrapsychic dilemma faced by these children. Particular emphasis is placed on the manifestations of a conflict of loyalty, in the child, and its relationship to the oppositional behavior of these children in foster care. Additional considerations include the impact of inconsistent parenting, abuse and neglect by the natural parents, the assumption of a parental role by the child and a concomitant renunciation of the child's dependency needs, as well as an examination of the role of the foster parent's fantasy of what it will be like to parent a traumatized child.

Many children drift into unplanned long-term foster home care, under conditions unsatisfactory for the child, his own family and the foster parents. Current practice in foster care often contributes to foster children growing up without the necessary love, support and guidance from a family that he can call his own. Recent publications in social work journals have suggested that a lack of consistent family relationships may be injurious to the emotional development of children. Social workers have become increasingly dissatisfied with a "helping process" that may, in fact, generate more harm than help. Originating from the social worker's dissatisfaction with the foster care system is an awareness that some method for evaluation of parenting potential is a critically important factor if the goal of responsible planning for foster home placement is to be attained. One possible method for evaluating parenting potential is to analyze the parents' history of adaptation through an examination of case record material. The purpose of our study is to determine the feasibility of the case analysis method as a tool for the development of predictive criteria designed to evaluate "potential for parenting" and thus, aid in more adequate foster care planning.

In this chapter, Musgrove and Michell present a microhistory through the story of John Wood Pledger who died in his foster home at just three years of age. In 1890s Melbourne, John’s 26-year-old single mother was left with few choices but to surrender him to the state. Tragically, a combination of individuals’ actions and systemic failings of the government’s foster care system led to the boy enduring shocking abuse, for which nobody was ultimately held responsible. The chapter considers how foster care systems responded to suspicions of physical and sexual abuse, particularly when ‘problem’ children were the victims, and identifies some disturbing parallels between the cases of John Wood Pledger (d. 1896) and that of another Australian foster child, Luke Anthony Borusiewic (d. 2009).

The prevalence of psychotropic medication use among children and adolescents in foster care has received increasing attention from policymakers and scholars and led to responses from government. Most research has focused on school-age foster children; less is known about psychotropic medication use among foster youth transitioning to adulthood from care. Using data from a longitudinal study of transition-age foster youth (n = 611), this study examines the prevalence of psychotropic medication use over time, evaluates youths’ perceptions of the benefits of medication, and assesses associations between medication use and behavioral health problems. The overall rate of psychotropic medication use dropped from age 17 to age 19. Among youth with at least one behavioral health problem, rates of psychotropic medication use also declined over time. Decreases in psychotropic medication use between age 17 and 19 were found among youth with the following disorders: mania, an alcohol use disorder, and a non-alcohol drug use disorder. Behavioral health status and youths’ living arrangements were associated with the likelihood of psychotropic medication use at age 17, whereas only behavioral health status was associated with the likelihood of psychotropic medication use at age 19. Most youth reported either a positive or neutral view of the relative benefits of using medications. Among youths who had used medications, those in relative foster homes were less likely than those in non-relative foster homes to report negative views of their medications. The findings have implications for child welfare and health care professionals and policymakers.

In this paper the author attempts to describe and illustrate how he talks with his patients. He avoids use of language that invites the patient to engage predominantly in conscious, secondary process thinking, when unconscious dimensions of thinking are what are called for. He values misunderstandings because they tend to invite conjecture, possibility, a sense of humility, in the face of the unknown and unknowable human condition. The author finds that certainty on the part of the analyst undermines the analytic process and patient’s potential for psychic growth. The author discusses the ways describing, as opposed to explaining, in the analytic conversation, better facilitates the analytic process. A clinical example is provided in which the author discusses his own thought processes as he talks with one of his patients.

Bion’s “Notes on Memory and Desire” (1967a) is an impossible paper that this article’s author has struggled with for decades. He views the paper, only two and a half pages in length, as a landmark contribution. Despite its title—and its infamous dictates to resist the impulse to remember past sessions and desire for “results”—the paper is not, most importantly, about memory and desire. It proposes a new analytic methodology that supplants awareness from its central role in the analytic process and, in its place, instates the analyst’s (largely unconscious) work of intuiting the (unconscious) psychic reality of the present moment by becoming at one with it. This article’s clinical examples, provided from the author’s own work, illustrate something of his ways of talking with his patients.

Most discussions of countertransference disclosure have focused on points of impasse. Here, I will discuss countertransference disclosure in which the analyst attempts to make explicit to the patient how the analyst experiences something during an analytic session that differs from the way the patient experiences the same moment. The analyst presents his observation as something for the patient and analyst to work on together, with the aim of arriving at further understanding. In a clinical example, I suggest a way of comparing uses of countertransference that relate to other approaches in analytic technique. Since the analyst's disclosure evokes questions regarding asymmetry and anonymity in the analytic process, I will briefly elaborate these dimensions.

Foster Care: An Update