Reflective programmes

The Reflective Programmes ensure that the views of children and young people are placed at the centre of their care.

Overview

The Reflective programmes were developed at Anna Freud by clinicians in the Family Trauma Department in collaboration with colleagues across the organisation. The underlying principle of the programmes is that parents/carers and professionals who look after children and young people place the child’s views at the centre of their care.

Young people who have experienced family trauma have developed chronic mistrust in others because they have not received the secure care they deserve. As a result, it is hard to trust other people and to feel that others understand or can represent their perspective. The Reflective programmes are designed to give a much greater emphasis on understanding the mental health needs of children and young people through the use of a mentalizing stance. That is, through taking the perspective of the young person in order to help them feel better understood. This approach leads to children and young people feeling a stronger sense of connection to the carers and professionals in their lives.

Overview
There are over 80,000 children living in care in England, a number that is increasing year on year. Most of these children do not receive effective support for their mental health needs, often because the distress that the child is experiencing is not known to those caring for them. Over 60% of children in the general population do not receive any support for the difficulties, and these rates are similar or worse for children in care. A fragmented approach to understanding mental health needs across services prevents early and helpful interventions, which over time increases preventable referrals to CAMHS where there are limited resources to meet substantial increase in overall demand. To address this, in 2018, the Department for Education commissioned Anna Freud to develop and deliver a new approach to improving the identification of mental health needs of children in care.
In response, Anna Freud developed and piloted the Reflective Care Programme with partner Local Authorities. Based on a mentalization approach, in combination with the use of assessment tools, the RCP provides a new approach to identifying and supporting children in care with their mental health needs. Within the Reflective Care model, a ‘Virtual Mental Health Lead’ embedded within the children’s social care team, provides supervision and support to frontline workers, offering support to reflect during assessments, and helping increase confidence of social workers to use a mentalising approach with CiC, and supporting systemic change in how the mental health needs of CiC are identified and addressed.
Costs
The cost of a Reflective Care Programme is based on the specific needs of a local authority site and dependent on there being a designated post for a Virtual Mental Health Lead within each individual site. An estimate of the cost of this workforce development can be given based on the pilot work on this role for the DfE.
Contact us
For more information on how you might go about embedding a Reflective Care model and access training for the Virtual Mental Health Lead role in your locality, please contact Project Manager Chris Watts on emily.rayfield@annafreud.org
Overview
The Reflective Fostering Programme is a mentalization-based group intervention for foster carers; an adaptation of a mentalization-based programme for parents (Reflective Parenting, Redfern 2016). The programme is being evaluated in a large-scale RCT to find out whether offering the Reflective Fostering programme, alongside the usual care provided by local authorities, is helpful, in terms of; improving children’s emotional well-being and behaviour, helping with carer stress and feelings of burnout and crucially in supporting placement stability.
The Reflective Fostering Programme is a 10-session (adapted to run online) psychoeducation programme, each of which lasts for 2-3 hours with 7-10 carers in each group. The programme has been manualised and includes video material, group exercises and discussion. A new adherence scale has been developed (the RFFR) to check on adherence to the model of the group facilitators and this talk will discuss the issue of adherence and self-mentalizing in the facilitators as well as group members. The model has been developed to help foster carers progress from a caring role to an educative one and each group is run by two facilitators - a trained social work staff member and a foster carer.
So far, two evaluation studies have been completed and results show that the groups had a positive impact on carer stress levels, carer-child relationships and the child’s emotional well-being.
Costs
Independent Fostering Agency employees and Local Authority Fostering Teams can apply for Reflective Fostering Training. This is a two-day training at £500 per delegate, (£600 if you would like to bolt on the MBT-CYP Introduction module).
Contact us
For further information on the Clinical Research Trial for Reflective Fostering, contact Nick Midgley, Chief Investigator at nick.midgley@annafreud.org or clinical lead, Sheila Redfern at sheila.redfern@annafreud.org or look at the course on our training site.
You can also read more about the Reflective Fostering Study.
Overview
Based on the acclaimed book Reflective Parenting, the Reflective Parenting service offers training on the model to future group facilitators and an intervention to parents who are experiencing difficulties in their relationships with their children.
The Reflective Parenting model introduces an approach to parenting that aims to promote family relationships and reduces parent-child conflicts. Parents can expect to develop a better understanding of their child’s emotions and behaviours, helping the child to feel both understood and of value. The approach also helps to de-escalate difficult situations and reduces behavioural and emotional outbursts. Reflective Parenting is a model of parenting based on theoretical ideas from mentalization – the ability of a parent to understand the thoughts, feelings and intentions behind the behaviour of both themselves and their child.
There is extensive evidence about the importance of understanding the intentions behind a child’s behaviour, and getting a greater sense of your own mind as a parent in relation to them. Research also suggests that understanding the thoughts, feelings and intentions behind your child’s behaviour and your own reaction can act as a buffer against difficult behaviour and can help your child to regulate their emotions better. This can then lead to improved relationships and enhanced understanding of self and others.
Reflective Parenting Group Structure and content
The Reflective Parenting Group is an 8-week closed group (meaning people can’t drop in and out) for a maximum of 12 participants. The group provides both psychoeducation (there are slides and discussion points) and active support (sharing stories and struggles as well as successes with other parents). To learn more about the Group, please check our service leaflet.
Who this group is for
We are currently running this group for Special Guardians, facilitated by two highly experienced clinicians.
Costs
We are able to run most groups at no cost thanks to the generous support of one of our donors, the Maria Marina Foundation. A minority of the groups are self-funded.
Please contact referrals@annafreud.org for further information and to find out when the next group will be on offer.
For professionals - we also offer training in Reflective Parenting.
Contact us
For further information on attending a Reflective Parenting Group, please contact the Clinical Lead for Reflective Parenting, Dr. Sheila Redfern at sheila.redfern@annafreud.org.