Informing and Evaluating Foster Carer Peer Support Groups

1. Informing and evaluating foster carer peer support groups Nikki Luke Rees Centre for Research in Fostering and Education nikki.luke@education.ox.ac.uk http://reescentre.education.ox.ac.uk/wordpress/wp-content/uploads/2013/07/ReesCentre_PeerContact2013_web.pdf

2. Peer support project • Key messages from the literature review • Translating evidence-based recommendations into practice • The involvement of peer researchers • Preliminary results from the evaluation • Research and practice: an iterative process

3. Stages of the project

4. Stage 1: literature review • Role of foster carer: satisfaction and fulfilment but also stress • Types of support: • informal (family and friends) • formal (practitioners, schemes for meeting other carers) • Review questions: • What is the nature of peer contact between foster carers and what does it provide? • How far does peer contact improve outcomes for carers, children and placements? • What are the interventions that increase contact between carers and could thereby potentially improve outcomes? • 33 studies from UK, USA, Australia, Canada, New Zealand and Ireland

5. Stage 1: literature review Key findings: • Providers offer a range of forms of peer contact • e.g. local support and advocacy groups, social contact, training sessions, mentoring • Peer contact can fulfil a number of important support needs • emotional, instrumental, informational and appraisal (Hinson Langford et al., 1997) • counters sense of isolation (Blythe et al., 2011) • Less positive experience when group meetings become ‘gossip sessions’ or a forum for putting down social workers (Murray, 2007) • important role of group facilitator (Fostering Network, 2009) • Key factors: chance to meet with other carers, learn from each other, offload about problems, reduce potential social isolation, talk to those with a shared understanding of the issues

6. Stage 1: literature review Key findings: • Only four studies examined links between peer contact and benefits for carers, children and placements – they showed: • a greater likelihood of continuing a career as a foster carer (Rhodes et al., 2001; Sinclair et al., 2004) • a more positive attitude to fostering (Sinclair et al., 2004) • a lower likelihood of depression (Cole & Eamon, 2007) • increased availability of respite care might help to avoid placement disruptions (Northwest Institute for Children and Families, 2007) • Intervention designs which directly relate pre- and post-test outcome measures to the experience of peer contact could increase the validity of the findings

7. Stage 2: menu of recommendations • Working with three local authority/state providers • We produced a detailed menu on peer support groups, based on the research in the review • The menu contains: • practical questions on how the provider will operate the scheme • specific evidence-based recommendations • Providers used the menu to design their new/revised schemes • Examples of menu items… Stage 2: menu of recommendations

8. Stage 2: menu of recommendations

9. Eight-month pre- and post-test design to evaluate impact • Semi-structured interviews (conducted by carer-researchers): • carers’ perceptions of peer support • perceived impact of the group on relationships with others, attitudes to fostering and intention to continue in the role • what they liked/didn’t like about the group • why some carers might not attend • Questionnaires: • stress levels (Parenting Stress Index; Abidin, 1995) • parenting attitudes (Child-Parent Relationship Scale; Pianta, 1992) Stage 3: evaluation of support groups

10. Carer-researchers provided feedback on: • draft review • choice of questionnaires • interview schedules (before and during data collection) • experiences of conducting research • emergent findings • Carer-researchers invited to contribute to: • trade magazine articles • conference presentations • journal articles (at end of project) Stage 3: evaluation of support groups

11. 50 interviews completed at baseline across 7 support groups • 26 follow-ups completed so far across 5 groups • Preliminary findings from 2 groups Stage 3: evaluation of support groups

12. Group 1 • Authority runs separate groups for carers of children in three different age groups; Asian carers; and male carers • Preliminary findings are from one of the age groups • Group discussed review findings and recommendations in Sept 13 • Carers were asked what they wanted to see change and what they liked about the group • Group is organised and run by two link workers • Fairly unstructured – lots of social time, occasional speakers Stage 3: evaluation of support groups

13. Group 2 • Authority had previously run support groups but these had ‘fizzled out’ some time ago • Wanted to relaunch groups but with best chance of ‘success’ • Carers were asked what they wanted to get out of a group • Group is organised and run by foster carers • Fairly structured – agenda, information posters, meeting with service providers Stage 3: evaluation of support groups

14. Shared experience “It has been a great support because the people are going through the same things that you are.” “Just listening – just being able to talk things through with somebody that understands.” “It’s nice to hear that there are other foster carers who have similar problems to you, and they might be able to give you ideas on how to make things better at home.” Stage 3: evaluation of support groups

15. Advice and support “It’s not so much advice, it’s more saying how they do things, and it’s not saying, ‘If you did this it would be better.’” “You think, ‘I don’t know if that will work but maybe I’ll try it.’” Other carers tell you about “things you can do, places you can go if you’ve got a problem.” “You don’t feel like you’re having a finger pointed at you.” “It can save you money.” Stage 3: evaluation of support groups

16. Reducing sense of isolation “Things you’re going through, you find out somebody else is as well so it’s, ‘Maybe it’s not just me’.” “I do think it’s a good thing because you do feel isolated, and it is nice to meet people who are doing the same thing as you’re doing.” “It’s put my faith in people. You’re not on your own.” “It shows that you’re not on your own – there’s always someone that you can turn to… I could have given up a couple of times, but the support’s been there.” Stage 3: evaluation of support groups

17. Confidentiality “I’ve got lots of friends and family, but everything is on a need-to-know basis. You wouldn’t divulge a person’s background or perhaps some of the things they’re doing. You just wouldn’t talk about it, but you can in the group because it’s confidential.” “I’ve got friends who have seen what’s going on, but I try not to go into an in-depth conversation about it, I just try and gloss over it really. Because I don’t think it’s fair on the child to divulge everything to everybody. Young people in care are in the spotlight. Your own kids won’t have as much going on in their lives that will be told to everybody – they’ve got such a lot of people knowing such a lot about them.” Stage 3: evaluation of support groups

18. Letting off steam “It’s quite informal, quite mixed, sometimes you can just talk and have a laugh, which is useful because it lightens the atmosphere – because sometimes you can feel very stressed and very negative, but you come in and listen to everybody else and you just end up laughing about it sometimes! Because sometimes it’s not a nice feeling when you’ve got a young person and everything feels so negative and you can’t think of any positives – that makes you feel upset. But to come in and you can talk about it, and you just think, ‘It’s not as bad as that!’ Maybe it is, but other people are doing it as well.” Stage 3: evaluation of support groups

19. Group 1: What had changed? • Moved from 6-weekly to 4-weekly • some felt this had made it more difficult as it was one more thing to fit in with school runs, meetings etc. • others were happy to attend more often • More informal atmosphere • carers liked the fact that meetings were no longer minuted as they felt more relaxed in nature Stage 3: evaluation of support groups

20. Group 2: What had worked? • Had tried different formats, including training and guest speakers • “The speakers are really useful.” • “There’s more training than support.” • Supervisors were present for part of session if appropriate • carers found this very helpful • problems get heard and passed up the chain, but carers felt they didn’t always hear the outcome • Some carers organised their own groups outside the sessions, meeting for lunch and a chat • they enjoyed the informality of these groups • there wasn’t always time to exchange names and phone numbers in the group • Room space and parking were seen as problematic Stage 3: evaluation of support groups

21. Both groups felt they needed to attract more carers • Carers were concerned that it was “still always the same faces” turning up • Thought the group was important, especially for new carers: “I had worked with children before and I thought I could do it – but it’s different 24 hours a day!” “I thought I knew what I was letting myself in for, and it was nothing like I thought. It’s 24 hours a day, it’s very difficult. But being able to come and share that with other people makes a difference.” “I’m glad I did because I burst into tears! You think – maybe not that it’s easy – but the stuff that you have to put up with, you don’t expect.” • Unsure how to attract new faces to the group • Felt that taking ‘support’ out of the title might help: “They’ll say, ‘I’m alright, I can cope.’” Stage 3: evaluation of support groups

22. Research and practice: an iterative process Practitioners and foster carers: • Helping to ensure practice is evidence-based • Getting practitioners’ and carers’ priorities onto researchers’ agendas • Partnering up with researchers to contribute complementary skills (e.g. data analysis, practical interpretation of results)? Researchers: • Helping to ensure we’re asking the right questions • Getting practitioners and carers to ‘buy into’ research • Working with practitioners and carers to get more ‘authentic’ data Research Practice

23. Peer support project Thanks to: Colin, Theresa, Gwen, Alex, Jane, Sue, Mike, and all of the foster carers, social workers and link workers who have welcomed us into their groups Tusindtak

24. References • Abidin, R. R. (1995). Parenting Stress Index (3rd ed.). Odessa, FL: Psychological Assessment Resources. • Blythe, S.L., Jackson, D., Halcomb, E.J., & Wilkes, L. (2011). The stigma of being a long-term foster carer. Journal of Family Nursing, 18(2), 234-260. • Cole, S. A., & Eamon, M. K. (2007). Predictors of depressive symptoms among foster caregivers. Child Abuse & Neglect, 31(3), 295-310. • Fostering Network (2009). Learning together: Learning from each other. London: The Fostering Network. • Hinson Langford, C. P., Bowsher, J., Maloney, J. P., & Lillis, P. P. (1997). Social support: A conceptual analysis. Journal of Advanced Nursing, 25(1), 95-100. • Murray, L. (2007). Foster and kinship caregiver perceptions of support and training in Canterbury, New Zealand. M. Ed. University of Canterbury, New Zealand. Available at: http://ir.canterbury.ac.nz/bitstream/10092/1061/2/thesis_fulltext.pdf.txt [Accessed 12 November 2012]. • Northwest Institute for Children and Families (2007). Mockingbird Family Model project evaluation [pdf] Available at: http://www.mockingbirdsociety.org/images/stories/docs/MFM/nwicf_2007-5_report.pdf[Accessed 18 January 2013]. • Pianta, R. C. (1992). Child-Parent Relationship Scale. University of Virginia. Retrieved from http://curry.virginia.edu/academics/directory/robert-c.-pianta/measures • Rhodes, K. W., Orme, J. G., & Buehler, C. (2001). A comparison of family foster parents who quit, consider quitting, and plan to continue fostering. Social Service Review, 75(1), 84-114. • Sinclair, I., Gibbs, I., & Wilson, K. (2004). Foster carers: Why they stay and why they leave. London: Jessica Kingsley.