15. Managing risks and benefits of contact

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Topic 15: Managing risks and benefits of contact

  • The type of contact a child or young person has with their birth family should be determined by what is in the best interests of the child. This may change over time and needs to be reviewed regularly.
  • Social workers need to consider the purpose of contact in the context of each child’s well-being, development and care plan. Contact can be beneficial for children in terms of maintaining links with their family and their sense of identity. It can also be problematic, however, especially when birth families are rejecting or unreliable.
  • Social workers need to manage the complex emotional needs of children, birth families and carers when planning contact. Foster carers have a crucial role to play in supporting contact and they need to be supported to do this by their social worker.
  • Letterbox contact is often used when children have been adopted and where direct contact is not appropriate. This can work well in providing children with information about their birth family and showing they have not been forgotten or rejected.
  • Contact with siblings is important for both looked after and adopted children. Contact with the wider birth family – for example, with grandparents – can be a source of stability and continuity and may help counteract troubled relationships with parents.‘Meaningful permanence must ensure that children are supported to a sense of belonging and identity that addresses the complex and varied meanings of “family” that they have experienced, whilst in care, and going on into adulthood.’ (Boddy 2013)

Legal context

The Children Act 1989 requires that local authorities promote and support contact between children who are looked after and their families unless it is not in the best interests of the child’s welfare. The Children and Families Act 2014, makes changes to the arrangements for contact between looked after children and their families with the aim of reducing disruption caused by inappropriate contact. One change is that local authorities will no longer have a duty to endeavour to promote contact.

Support for family contact is underpinned by theories of attachment and the need for continuity and the negative impact of separation (Sen and Broadhurst, 2011) (see Briefing 2 on Attachment theory and research). However, some argue that contact can be problematic (Moyers et al, 2006; Neil et al, 2011) and in some cases harmful and the likely cause of enduring emotional and psychological damage, even when it appears to be going well (Loxtercamp, 2009).

Between 40 and 50 per cent of looked after children have contact with a family member on a weekly basis (most commonly with their birth mother, often with siblings) (Sinclair, 2005). Children may differentiate between family members and want contact with some, but not others (Sen and Broadhurst, 2011). Contact arrangements, therefore, need to take account of the child’s wishes and need to be reviewed on a regular basis to reflect any changes to the child and family’s circumstances (DfE, 2012; Moyers et al, 2006).

The type of contact with the birth family needs careful consideration and planning, and should be determined by the needs of the child and what is in their best interests. Factors that need to be considered include the age and developmental needs of the child and the reasons why they have been taken into care (Schofield and Stevenson, 2009).
Work with the family beyond contact is also important. Where children have a plan for return home, the focus will be on maintaining relationships to help promote a successful reunification. For children in long-term foster care, the goal will be to support family networks as part of the child’s identity (Boddy et al, 2013). (See Briefing 16 on ‘Working with birth parents’.)

Contact for looked after children

The majority of looked after children have a plan for and want a choice of which birth relatives they have contact with (Morgan, 2009). Contact can be through visits but may also take place on social networking sites, by phone, email or letters. For some children, contact with friends is more important than contact with family.

Contact can help a child maintain their sense of identity and come to terms with what has happened to them. Children often worry about their birth family and contact can help reassure them by letting them see that their parents and siblings are all right. Contact also helps to keep children informed of important changes at home. And for some, contact also plays a role in the assessment of whether return home will be safe (Schofield and Stevenson, 2009; Sen and Broadhurst, 2011).

The age of the child is an important factor in contact arrangements. For older children, the focus is on preserving or developing existing relationships, while for infants the main aim is to develop the attachment relationship with the birth mother, as well as to teach and assess parenting (Schofield and Stevenson, 2009). Contact in infancy is generally for several hours a day and for three to five (or more) days a week. For adolescents, there is an expectation that they should be allowed to start making their own contact arrangements, however, teenagers often need more help than they receive get in managing relationships with their birth family (Schofield and Stevenson, 2009).

Relationships between foster children and their birth family are complex and likely to involve a range of needs and feelings (Schofield and Stevenson, 2009). Contact arrangements must take into account children’s individual needs, as well as the capacity of all those involved to cope emotionally with the arrangements. Social workers need to manage these complex needs and emotions to ensure the child’s welfare is safeguarded and promoted (DfE, 2012).

It is particularly important to assess the benefits to the child of maintaining links with their birth family. Questions that need to be asked include:

  • In what ways are the contact arrangements beneficial to the child?
  • What are the perceived benefits of future contact and/or reunification?
  • What are the emotional costs?
  • Is the current upset to the child manageable in the interests of his or her longer-term well-being? (Schofield and Stevenson, 2009)

Thorough assessment should focus on the purpose of contact in the context of each individual child’s well-being, development and care plan. It should analyse carefully how and why parents, siblings and other family members are involved in children’s lives. This analysis will help determine where and how often contact should take place. Assessment of the risks and benefits of contact is a process and decisions need to be reviewed regularly to take account of changes in circumstances and in children’s needs and wishes.

The Fostering Network has produced a range of tools and resources as part of its Heart of the Matter project around supporting contact for children placed in foster families. These include:

Difficulties associated with contact for looked after children

Although contact with their birth family can be beneficial for children, contact is also associated with placement breakdown and further abuse for some children when it is of poor quality or problematic (Moyers et al, 2006; Selwyn, 2004). In one study, over half of the young people aged between and 11 and 17 experienced contact that was judged to be ‘poor’ and regularly saw relatives who were rejecting, neglectful or unreliable. Many of the young people were unable to cope with these experiences and were unlikely to talk easily about the emotional impact (Moyers et al, 2006).

The study identified a number of difficulties with contact:

  • for more than a third (37%) of young people, contact was unreliable – ie the parent did not turn up or was consistently late
  • some young people experienced inappropriate amounts of contact
  • safety was a concern, particularly where contact was unsupervised
  • replay of negative relationships – many young people had unresolved attachment difficulties that were re-enacted during contact
  • contact could diminish the influence of the foster carer. (Moyers et al, 2006)

Harmful contact is associated with particular people, not with contact in general. Research suggests that when a child has been abused, prohibitions on contact are associated with better outcomes. Where there was no restriction on family contact, children who had previously been abused were found to be more likely to be re-abused during contact or after return home. These findings seemed to hold for all kinds of abuse (Sinclair, 2005).

Foster carers and contact

Foster carers are crucial to supporting contact and helping children to make sense of their history (Sen and Broadhurst, 2011). However, they have mixed views and experiences about contact. Although they accept its importance, they can find it stressful (Austerberry et al, 2013). Difficulties can include

  • birth parents’ aggressive or violent behaviour during contact
  • the negative impact of birth parents behaviour on the child
  • a perception that social workers put the needs of the birth parents first. (Austerberry et al, 2013)

Foster carers, therefore, need practical and emotional support to meet the challenges that often emerge both during and after contact. Proactive social work can help to overcome some of the difficulties associated with contact. Changing venues, negotiating changes to timings and involving other people can also bring about improvements (Moyers et al, 2006; Austerberry et al, 2013).

High-frequency contact for infants

High-frequency contact for infants (eg four to seven times a week) can be particularly problematic and distressing, even when it is carefully supervised and supported (Kenrick, 2009; Humphreys and Kiraly, 2011; Schofield and Simmonds, 2011). A particular concern is the disruption to infants’ daily routines, making it difficult for them to experience settled caregiving. Another concern is that little support may be available for parents during contact with their children. The quality of contact is much more important to a child’s welfare than frequency. ‘Frequent visiting without skilled parenting support will not result in relationship building and enhance the chance of family reunification’ (Humphreys and Kiraly, 2011).

Frequent contact can produce high levels of stress for infants through discontinuity of care and potentially insensitive care during contact, particularly for those who have experienced unreliable or chaotic care in the past. Such infants are likely to be hyper-vigilant or passive and the distress caused by frequent and often unsatisfactory contact can add to the difficulties impeding their recovery (Schofield and Simmonds, 2011). (See the Briefing 4 on Early brain development and maltreatment)

Facilitating contact

The longer a child is in care, the more likely they are to lose contact with their parents and siblings (Morgan, 2009). Therefore social workers have a critical role to play in supporting contact, whether in the context of plans for reunification or for long-term placement (Boddy et al, 2013). (See Briefing 16 on Working with birth parents.)

To help relieve some of the difficulties associated with contact, social workers need to:

  • consider the purpose of contact arrangements for each child
  • influence the frequency, quality and safety of contact
  • establish the wishes and feelings of the child, parents and significant others
  • provide appropriate support for the child, birth family and carers
  • regularly discuss the effects of contact with the foster carer
  • review contact arrangements on a regular basis
  • facilitate contact with other relatives, such as grandparents, as they can be a source of stability and continuity and can help counteract troubled relationships with parents. (Moyers et al, 2006; Sen and Broadhurst, 2011)

Good practice also needs to take into account that birth parents may not maintain contact or that it may become less frequent when children are in long-term placements. Social workers need to consider this in planning and reviews and, where it is in the best interests of the child, explore options for re-establishing contact (Sen and Broadhurst, 2011).

Contact arrangements for infants must focus on their needs. Contact should be arranged around ensuring the day-to-day nurture (including feeding and sleep times) that support early brain development. While maintaining a relationship with birth parent/s it is vital that infants have the chance to establish an appropriate attachment with their primary carer, as this relationship will be the key factor in supporting their healthy development. (See Briefings 3, 4, 5, and 6 on: ‘Child development theory and research’; ‘Early brain development and maltreatment’; ‘Early childhood trauma and therapeutic parenting’; and ‘The impact of and avoidance of delay’.)

Contact environments

‘Children and parents … should be afforded the greatest sense of privacy and homeliness that resources and circumstances can manage.’ (Slade 2002)

Contact may be supervised, facilitated or unsupervised. It may take place in a contact centre, a public place or at the home of the foster carer, birth parents or another member of the birth family.

Professionally supervised contact is a limited resource. A study of supported and supervised contact centres in England and Wales found that:

  • most supervision took the form of observation from a distance
  • less than half the centres had separate exits and entrances to facilitate separate comings and goings of individual birth parents and carers
  • less than half the centres undertook safety or risk assessments
  • varied understanding of the terms ‘supported’ and ‘supervised’ led to confusion and ambiguity among professionals, centre staff and parents. (Harrison, 2006)

Coram’s Model (Slade 2002) suggests that contact centres should have the following key characteristics:

  • a child-friendly and stimulating environment
  • cultural sensitivity (Centres should ask: How can spaces reflect cultural diversity of families? Are staff aware of specific cultural issues for local people?)
  • a commitment to maximum safety (Centres should ask: Can parents and carers be kept apart and safe? What precautions are in place to guard against child abduction?)

Contact and reunification

Contact is a necessary but insufficient condition for reunification. A number of factors will have an impact on successful reunification (see Briefing 14 on ‘Placement stability and permanence’). There is evidence that children who have regular and positive contact are more likely to be reunited with their birth parents. However, while such children are likely to remain in care for shorter periods, this is not a result of the contact per se. Rather it relates to a range of positive factors such as stronger parent-child attachment and good social work support with parents (Biehal, 2006).

Cleaver’s (2000) research found that successful returns may be promoted by ‘purposeful, planned, well-paced, well-resourced and reviewed contact, supported by parental motivation, a positive child response to increased contact and a good attachment between parent and child’ (Sinclair 2005). Often, too little work is done with birth families prior to children returning home; contact offers the opportunity for purposeful work to be done in preparation for return home (Boddy, 2013; DfE, 2012).

Post-adoption contact

Although the purpose of contact changes when a child is adopted, the child’s welfare remains the paramount issue. Many of the issues already noted regarding looked after children’s direct contact with birth relatives apply to adopted children also and individual assessment and regular review remain essential. Contact with birth families can contribute to children dealing with loss and developing a healthy sense of self-esteem and identity. However, it is a complex and emotionally charged experience for all involved. Some argue that contact for adopted children can be a cause of secondary harm (Loxtercamp, 2009) and that children with a history of maltreatment may not be able to deal with the emotions involved (Neil et al, 2011).

Although face-to-face contact can provide a direct means of communication and information exchange between children, adoptive parents and birth relatives, such contact is not appropriate in the majority of cases and may be harmful. One study found that contact was a negative experience for a quarter of children. Problems included feelings of divided loyalty, continued abuse, emotional suffering and progress setbacks (Mackaskill, 2002, cited in Lord and Borthwick, 2009).

Letterbox contact is often used to meet the needs of the child and adults where direct contact is not appropriate. Letterbox contact can work well in providing important information that can answer a child’s questions and show they have not been forgotten or rejected. However, it can bring a number of challenges including:

  • difficulty for birth relatives and adoptive parents in writing to people they don’t know
  • adoptive parents not wanting to write too fully in case it sounds like they are boasting
  • children being excluded from the process
  • delays in receiving letters (or non-response from birth relatives). (Neil et al, 2011; Selwyn et al, 2006)

A meeting between birth parents and prospective adopters (after a match, but before placement) can be very helpful in setting the context for high-quality and meaningful letterbox contact. This is a good opportunity for teamwork between the child’s social worker and the adoption social worker. When children are adopted from foster care, contact may also be beneficial with the carers with whom they developed attachment.

Contact arrangements between adopted children and their birth family rarely remain static. Neil and colleagues continued following up the adopted children and their birth families for 16 years and found that over half of the contact arrangements had reduced or stopped (Neil et al 2013). Reasons for this included dissatisfaction about contact and the difficulty of maintaining contact alongside stressful life events. In some cases, young people themselves had initiated the reduction on the grounds that the contact was not meeting their needs and they did not require it.

Factors that contribute to problematic contact for adopted children include:

  • poor adjustment to adoption by birth relatives
  • a lack of connection between birth relative and child
  • child struggling to cope with emotional/behavioural issues
  • contact with a birth relative who neglected or abused the child
  • high levels of distress in one or more of those involved
  • birth mother contesting the adoption. (Neil et al, 2011)

The follow-up study found that some young people had initiated increases in contact, sometimes through social media. This can be beneficial when it complements existing contact arrangements and where adoptive parents help young people to manage the contact. However, when it is used in an unexpected and unplanned way, it can result in negative and possibly harmful experiences (Neil et al, 2013).

The feelings, behaviours, interactions and attitudes of the adults involved are consistently shown to be key determinates to the success of contact (Neil et al, 2013). These elements are dynamic and will shift over time. Of particular importance is the management of issues such as dual connection, the focus on the child’s needs and the empathy for the other parties involved.

Contact with siblings

Birth siblings are the relatives that children are most likely to have direct contact with after adoption. Selwyn’s study (2004) found that 90 per cent of the children had (mostly face-to-face) contact with siblings, compared to 31 per cent who had contact with a birth parent and 34 per cent with another adult relative. Adopted children are less likely to be in contact with siblings who remain with the birth family, however. Contact may also be limited because of geographical factors (Lord and Borthwick, 2009).

One study found that children and young people’s feelings about contact with siblings vary according to the amount of time the siblings have previously spent together and the nature of their shared experience. Adopted children may worry about their siblings, particularly if they are not settled in a permanent family. In such cases, adoptive parents expressed concerns about contact with some siblings who were still in care in terms of their sexual knowledge and experience, language and rough and excitable behaviour during contact. Although it was not an easy option, most adoptive parents felt that contact was important, particularly for the sibling who remained looked after. (Smith and Logan, 2004, cited in Lord and Borthwick, 2009).

For some children who have experienced abuse within the birth family, negative emotions can resurface during contact meetings with siblings. Some children are also likely to want less contact with siblings as their relationships in the new family become more secure; they want to move on from the past. However, where contact works well, there is good interaction and affection. It also enables siblings to talk about their past trauma together (Mackaskill, 2002, cited in Lord and Borthwick, 2009)

As with contact with birth parents, contact between adopted children and their siblings needs to be based on an assessment of the individual children’s needs. Decisions also need to consider whether this will be arranged by the families on their own or with social work support and the frequency of contact that can realistically be accommodated (Lord an Borthwick, 2009).

Adoptive parents and birth parents

Both adoptive and birth families can gain from well-planned contact. One UK study of children placed before the age of four followed them up two and seven years after placement (Young and Neil, 2004). In most cases, face-to-face contact was ‘very much liked by all parties.’ Adults developed trust and felt better informed. Contact meetings were described as tending to be ‘low key, like seeing a distant relative or friend of the family’ (Young and Neil, 2009: 245).

Contact can allow adoptive parents to ‘engage constructively’ with the reality of birth parents, sometimes reducing fear and insecurity and facilitating empathy for birth parents. It can also help them support their child’s understanding of their history and identity. Adoptive parents need to be fully informed about the birth relatives who will be in contact and the purpose for the arrangements. This may require the family finder remaining involved for some time, providing information about past events and the reasons for direct contact.

Positive contact is facilitated by an ‘openness of attitude’ and the adoptive parent showing the child that they are ‘there with them’ physically and emotionally, whatever arises. Where adoptive parents feel contact is imposed or do not see the purpose they are likely to struggle (Young and Neil, 2009: 251).

For birth parents, contact takes place in the context of grief and loss. Over time and with support to deal with their feelings of bereavement, contact can help them accept reality and be reassured about the adopted child’s situation. Positive contact is facilitated by emotional acceptance of the adoption and the ability to promote the child’s ‘dual connection’ (ibid) and not undermine the placement – for example, being able to speak of adoptive parents as ‘your mum and dad’. Mutual acceptance of each other’s roles and empathy for the other’s experience is key to forming a good relationship. This will take time to build, and can grow through positive experiences.

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Key questions for contact for looked after children

Methods
Suitable for self–directed learning or reflection with a colleague or supervisor. You will need access to a recent contact arrangement.

Learning Outcome
To review whether contact arrangements meet a child’s needs and assess their impact.

Time Required
30 minutes review and 30 minutes reflection with a colleague or supervisor.

Process
Review a recent contact arrangement and assess the extent to which the following areas have been addressed:

  • In what ways are the contact arrangements beneficial to the child?
  • What are the perceived benefits of future contact and/or reunification?
  • What are the emotional costs?
  • Is the current upset to the child manageable in the interests of his or her longer-term well-being?
  • How can this be managed more effectively for the child?

Key questions for facilitating contact

Methods
Suitable for self–directed learning or reflection with a colleague or supervisor. You will need access to a recent contact arrangement.

Learning Outcome
To review how contact arrangements can be facilitated to meet a child’s needs.

Time Required
30 minutes review and 30 minutes reflection with a colleague or supervisor.

Process
Review a recent contact arrangement and assess the extent to which the following areas have been addressed:

  • What was the purpose of the contact arrangement for the child?
  • What factors influenced the frequency, quality and safety of the contact?
  • How were the wishes and feelings of the child, parents and significant others identified and met?
  • To what extent was appropriate support provided for the child, birth family and carers?
    • How could this be improved?

Key questions for supporting and managing contact

Methods
Suitable for self–directed learning or reflection with a colleague or supervisor. You will need access to a recent contact arrangement.

Learning Outcome
To review how contact arrangements can be facilitated to meet a child’s needs.

Time Required
30 minutes review and 30 minutes reflection with a colleague or supervisor.

Process
Review a recent contact arrangement and assess the extent to which the following areas have been addressed:

  • How frequently were the effects of the contact discussed with the foster carer?
  • What additional support did the child, parents, significant others require?
  • What additional support did the foster carer require to support the child?
  • How could you facilitate contact with other relatives, such as grandparents, as they can be a source of stability and continuity and can help counteract troubled relationships with parents?

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Methods
Suitable for self–directed learning or reflection with a colleague or supervisor. You will need access to the contact issues relating to a child you are working with.

Learning Outcome

  • To consider the impact of contact on children, parents and foster carers and identify strategies for supporting them.
  • To identify key areas in the social work role that promote good outcomes for all parties involved in contact.

Time Required
30 minutes review and 30 minutes reflection with a colleague or supervisor.

Process
Read the introduction and use the handout to consider the contact issues relating to a child you are working with.

  1. Record the work that has been done, as well as the work that is required for each of the key areas in the handout.
  2. Review your summary and identify any further work that may be needed.
  3. Are there any barriers to addressing the issues in the hand-out?
    • If so, what are they?
    • what needs to be done to overcome them?

Introduction

Most foster carers accepted the need for contact… Their emotions, however, tended to be more stirred by difficult aspects of contact rather than the positive ones. Fostering Now: Messages from Research (Sinclair 2005: 92)

Children usually looked forward to them [i.e. contact meetings], commonly want more contact than they get, but are nevertheless commonly upset by them (ibid: 91)

Contact between child and birth family raises complex issues… Contact may be beneficial or harmful. Often the same child may have both kinds of contact (ibid: 95)

Patterns of contact are established early in the placement. They probably need to be a focus of work in the first three months. Carers who have undergone training related to contact tend to have better relationships with child and parents and play a role in contact arrangements. Only a minority of children were able to talk about the emotions aroused by contact (ibid: 94)

Policy and practice in foster care actively encourages contact between parents and children who are fostered. The research recognises the complexity of contact and the feelings and issues it raises and the need for support for everyone involved.

Key areas to address Summary of work done and work required
Assessment of attachment between mother, partner and child
The purpose of contact, its frequency, and who should be involved
Assessment of potential benefits and risks of contact
Indirect contact
The appropriateness of venue; the wishes of the child; the role of the carer and social worker
Sharing information with foster carers; have foster carers received training in promoting contact?
Ensuring opportunities for child and foster carers to talk about contact to social workers
The introduction of ‘new’ relatives
Involvement of mothers and fathers in contact arrangements. What are the issues and barriers to contact for mothers and fathers?How will they be overcome?
Ensuring contact is constantly monitored and reviewed

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keymessages_iconReferences

 

 

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  • Biehal N (2006) Reuniting Looked After Children with their Families: A review of the research. London: National Children’s Bureau
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  • Selwyn J, Frazer L and Wrighton P (2006) ‘More than Just a Letter: Service user perspectives on one local authority’s adoption postbox service’ Adoption & Fostering 30 (2) 6-17
  • Sen R and Broadhurst K (2011) ‘Contact between Children in Out-of-home Placements and their Family and Friends Networks: A research review’ Child & Family Social Work 16 (3) 298-309
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  • Young, J. and Neil, E. (2004). The ‘Contact after Adoption’ study: The perspective of Birth Relatives after non-voluntary adoption. In E. Neil and D. Howe (Eds). Contact in Adoption and Permanent Foster Care: Research, Theory and Practice. London: British Association for Adoption and Fostering
  • Young, J. and Neil, E. (2009). ‘Contact after adoption’. In G. Schofield and J. Simmonds (Eds.) The Child Placement Handbook: Research, Policy and Practice. London: British Association for Adoption and Fostering.

 

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