Copyright is owned by the Author of the thesis. Permission is given for a copy to be downloaded by an individual for the purpose of research and private study only. The thesis may not be reproduced elsewhere without the permission of the Author. i Context, Identity and Connection: An Examination of Resilience in New Zealand Foster Children A thesis presented in partial fulfilment of the requirements for the degree of Master of Arts In Psychology at Massey University, Albany, New Zealand Gabrielle Marlaina Cornelius 2014 ii Acknowledgments First of all, I would like to thank my supervisor Dr Bev Haarhoff for her support and guidance in this research project, and for supporting my decision to do research in an area I am passionate about. I am very grateful to the various organisations that requested to be kept confidential but supported my research proposal and accommodated me in finding participants. I would also like to thank Dr Clifford Van Ommen for guidance in the focus group planning process and Kaumatua Nephi Skipwith for supporting me in thinking through cultural issues and considering how the aims of my research fit with Māori values. Most of all, I am extremely grateful to my participants, who took time out of their busy lives to participate in this project. Thank you for warmly welcoming me into your homes and support groups and sharing your families and your stories with me. I hope that I have done justice to the stories you have shared and that this research serves our common goal of promoting the great strength and resilience of foster children. Ethics approval was granted by the Massey University Human Ethics Committee under protocol MUHECN14/024, and later reapproved after variation was made to the research design. iii Table of Contents Title page i Acknowledgements ii Table of contents iii List of illustrations and tables vi Abstract 1 Introduction 2 Literature review 4 Resilience as a construct 5 Characteristics of resilience 6 The measurement of resilience 10 Operational definition of resilience 11 Resilience in children 12 Family context 13 Family modelling 15 Factors that impact child resilience 16 Attachment theory 19 Attachment theory framework 20 Importance of attachment 21 Dysfunctional attachment 22 Criticisms 23 Relational resilience 24 Resilience in children in care 30 Resilience in residential care 31 Resilience in foster care 37 Resilience in children leaving care 45 Children in care in the New Zealand context 48 Methodology 52 Aims 52 Research design 52 Participants 53 Data collection methods 57 Data analysis methods 61 iv Results 69 Theme 1: Foster Carer Understandings of Resilience 69 Subtheme 1.1: Resilience as Resistance 72 Subtheme 1.2: Resilience as a Shell 73 Theme 2: Identity 75 Subtheme 2.1: Self-Image 76 2.1.1: Who Am I? 76 2.1.2: Distancing Self from Old Identity 78 Subtheme 2.2: Self-Talk 79 2.2.1: Internal Working Model 81 Subtheme 2.3: Culture 83 2.3.1: Rejection of Cultural Identity 84 Theme 3: Connection 87 Subtheme 3.1: Importance of Trust 87 Subtheme 3.2: Offer and Let Child Respond 90 Subtheme 3.3: Seeking Connection 92 Subtheme 3.4: Place in the Family 94 3.4.1: Sense of Inclusion & Belonging 98 3.4.2: “Home” 101 3.4.3: Use of “Love” 102 Subtheme 3.5: Child-Carer Relationship 103 3.5.1: Title of Carer 103 3.5.2: Role of Carer 105 3.5.3: Commitment 110 Subtheme 3.6: Continuity of Relationship 113 3.6.1: Giving the Child a Positive Life Story 114 3.6.2: Maintaining Not Breaking Connection 115 3.6.3: Foster Child Attempts to Maintain Contact 117 3.6.4: Foster Carer Desire to Maintain Connection 118 3.6.5: Gradual Transition Rather Than Breaking Relationship 119 Subtheme 3.7: Connection with Birth Family 121 3.7.1: Enduring Tie to Whanau 121 3.7.2: Idealised View of Whanau 124 v 3.7.3: Rejection of Whanau 125 Subtheme 3.8: End of Relationship 127 3.8.1: Carer’s Grief 127 3.8.2: Concern for Child’s Future 130 3.8.3: Child’s Response 131 Theme 4. Outcomes 133 Subtheme 4.1: Signs of Progress 133 4.1.1: Slow and Gradual 133 4.1.2: Different Perceptions of Success 134 Subtheme 4.2: Long-term Benefits of Relationship 138 4.2.1: Learning to Trust Adults 138 4.2.2: Short-Term Failure may be Long-Term Success 139 Discussion 142 Foster carer’s definitions of resilience 142 Unique contributions to the field 145 Identity and connection 146 Context model 150 Comparison with existing theory and literature 153 Discussion of participants 159 Researcher’s personal reflections 161 Conclusions 163 Limitations 164 Implications for practice 166 Implications for further research 167 References 168 Appendices vii Appendix 1: Invitation to participate vii Appendix 2: Information sheet viii Appendix 3: Consent form xi Appendix 4: Demographic data collection form xii Appendix 5: Focus group & interview outline xiii vi List of Illustrations and Tables Figure 1: Threshold for resilience 11 Figure 2: Family functioning triangle 14 Figure 3: The relationship between family cohesion and functioning 15 Figure 4: Child protection systems 19 Figure 5: The reinforcing cycle of relationship and resilience 28 Table 1: Key terms in this research 31 Table 2: Overview of experience of sample 56 Table 3: Major themes derived from qualitative data 69 Table 4: Subthemes within theme 1 75 Table 5: Subthemes within theme 2 86 Table 6: Subthemes within theme 3 132 Table 7: Subthemes within theme 4 140 Figure 6: The interrelation of connection and identity 147 Figure 7: Tree model of resilience 148 Figure 8: The context model 151 1 Abstract The purpose of this research is to examine resilience in New Zealand foster children, with a focus on the relationships foster children form with the foster parents who care for them and the ways that resilience is built and displayed within foster care. While there is a range of international research examining resilience in children in state care, research into relational aspects of resilience is rare, particularly in a New Zealand context. This investigation involves one-on-one interviews and small focus groups with foster carers, asking open-ended questions about resilience, attachment and relationships to elicit their opinions and experiences with the children they have fostered. Using the process of thematic analysis, four major themes were developed, entitled (1) Participant understandings of resilience, (2) Identity, (3) Connection, and (4) Outcomes. These themes are compared to existing research, and new theories are proposed relating to the contextuality of resilience and the connection between a sense of identity and the building of supportive relationships with others. Two models are proposed to reconceptualise resilience in foster children, suggesting that behaviours typically seen as problematic may be resilient behaviours that have failed to adapt to a new environment, and that a strong sense of self and the ability to form meaningful connections with others are mutually reinforcing. The limitations of this research are discussed, in addition to implications for further research and suggestions for application in the foster care system. Keywords: Resilience, fostering, children in care, foster children, foster carers, caregivers, relationship, connection, Aotearoa, New Zealand 2 Introduction Foster children as a population are stereotypically perceived in two lights; either as weak and unfortunate victims deserving of pity, or as deeply troubled children with defiant behaviour disorders and delinquent behaviour patterns. The New Zealand foster care system is split into two divisions and includes approximately 3,500 foster parents and almost 4,000 children and young people (MSD, 2014). Children taken into state care have often endured all forms of maltreatment, including sexual abuse, physical abuse, emotional abuse, and neglect (Healey, 2011). While some foster children may fit the stereotyped moulds, many come through the foster care system to reach academic success, develop healthy relationships, and live productive lives. This research seeks to shed light on the positive sides of children in care, recognising that even among those who struggle with behavioural disorders and psychopathology, many foster children possess an innate strength that allows them to fight back in the face of abuse and neglect, find ways to cope as a powerless child within an imperfect government system, and bravely make emotional connections with new caregivers after experiencing broken attachments and abuse from the hands of trusted adults from a young age. Resilience as a research topic has been explored with a number of diverse at-risk populations. While resilience research seeks to increase knowledge and understanding on an academic level, it can also be seen as an intervention, as participation in resilience research aims to empower participants through the process and increase understanding of their own resilience. The University of California-Davis (2009) explains that the strengths focus inherent in resilience research creates a sense of personal accomplishment for participants, while Walsh (1998) claims that focusing on resilience rather than pathology can help at-risk individuals and groups make meaning of adversity, affirm strengths, and maintain hope. 3 There is some suggestion in prior research that foster children who are more resilient are able to build stronger relationships (See Bakermans-Kranenburg et al., 2011), and that building strong relationships has an enhancing effect on resilience (See Emond, 2014). This research endeavour is built on this hypothesis of the relationship between interpersonal connection and resilience in foster children. The purpose of this research is to initiate a conversation with prominent figures in the lives of foster children about their strengths, rather than their weaknesses, and ask in what ways they have seen resilience in foster children and what they believe contributes to this resilience. Psychology as a profession has been criticized for its excessive focus on deficits and pathology; therefore, the goal of this inquiry is to bring stakeholders together to examine the ways that foster children cope despite facing often extreme adversity, and their capabilities to overcome trauma and participate in healthy relationships with their foster families. Based on the links made between attachment and resilience in the literature, a key focus in this research will be the relationships that foster carers have formed with the children in their care, examining the variety of roles foster carers play and the variety of experiences they have had in relationships with foster children. The findings of this research will be used to suggest ways that carers and professionals can recognise and strengthen the pre-existing resilience drive that many foster children appear to possess. 4 Literature Review The structure of this literature review is as follows: The construct of resilience will be examined based on the varying definitions provided in the literature and summarising the many facets of resilience that are relevant in developing a complete understanding of the construct. Both the characteristics of resilience and the measurement of resilience will be discussed, after which a working definition of resilience will be provided to give direction to this research and make clear the theoretical foundation and assumptions on which this research is built. Next, the construct of resilience will be examined in relation to children, who differ from the adult population in their life circumstances and responses to stress. The importance of the family context will be presented, in addition to the influence of adult modelling and other factors that impact upon the resilience of children. Following this, the construct of relational resilience will be considered, forming a connection between the two main topics of consideration in this research: resilience and attachment. Relational resilience will be discussed in the context of the variety of different definitions of the construct used by different researchers. Clarification will be given over how the term relational resilience will be used in theorising this research. Then, attachment theory will be introduced, beginning with a summary of the original framework, followed by an overview of research indicating the importance of attachment, and a discussion of theory based around poor or abnormal attachment. Finally, criticisms of attachment theory and other considerations will be discussed. Once these foundational constructs have been examined, the resilience of children in care will be discussed, including consideration of research in three different areas of care: residential care (in an institutional context), foster care (in a family context), and the transitioning process when children leave care. Subsequently, to place 5 this into the New Zealand context and make it relevant for this research investigation, the New Zealand foster care system will be introduced, with processes within the system and key terms presented. Finally, this literature review will conclude with a summary of the topics of discussion and their relevance to this study. It is hoped that this literature review will provide sufficient background understanding and justify the importance of this research project, which seeks to examine the resilience of children in care in New Zealand in relation to their attachment with carers and relationships with those around them. RESILIENCE AS A CONSTRUCT Research into the concept of resilience has been rapidly expanding, as researchers have been turning away from traditional approaches of deficits and psychopathology, and focusing on positive aspects of coping and strengths in vulnerable populations. Increased examination of resilience can improve understanding, reduce stigma and promote better outcomes. While researchers have struggled to establish a single unitary definition of the construct, there are several themes that reappear in the resilience literature. Resilience is often described in terms of bending but not breaking in the face of adverse life events or traumatic experiences; this definition emphasises the core characteristic of resilience as flexibility (see Tusaie & Dyer, 2004). Another common characteristic of resilience is its accumulative nature; many researchers believe that resilience often increases over time and with life experience (Rutter, 1985, as cited in Harvey & Delfabbro, 2004; Kalil, 2003). The characteristics of resilience identified by various researchers will be discussed in the section below, followed by an examination of the ways in which resilience can be measured. This section will conclude with an operational definition of resilience for the purposes of this research. 6 Characteristics of Resilience Outcome or Process An important consideration when defining resilience is whether it is considered as an outcome or a process. Many researchers see resilience as when an individual achieves good outcomes despite enduring adverse experiences. In this way, focus is centred on the end product, and the amount of resilience can be measured by how many indicators of success an individual displays. Alternatively, other researchers posit that resilience is the process through which individuals overcome difficulties on the path to achieving positive outcomes (Kalil, 2003). Kalil (2003) explains that it is possible to identify patterns of behavioural adaption profiles and use this knowledge to design interventions to increase certain resilient behaviours. For practical purposes, it may be possible to use a combined definition, in which resilience is both the process and the outcome; however, for theoretical purposes, the distinction between these two definitions will be considered below. Internal or External Another point of contention regarding the definition of resilience is whether it is defined as an internal attribute that a person can possess, or whether it is externally determined by the environment and other contextual factors (Kalil, 2003; Lynch, 2011; Emond, 2014). Kalil (2003) explains that if resilience is a personality trait, it is likely to be unchangeable; individuals either possess the trait or they do not. To address this issue, Ryff and Singer (2003) explain that resilience can be seen as interplay of both internal and contextual factors, and that certain combinations of the two can lead to resilience. 7 One way of understanding this is through a diathesis-stress model, where certain genetic and personality predispositions are triggered by life events that occur within the environment (Kalil, 2003). This is often explained as an equation of risk and protective factors, whereby, when the protective factors exceed the risk factors (in number or magnitude), resilient outcomes occur (Harvey & Delfabbro, 2004). This theory has led to research attempts to identify risk factors and protective factors in certain populations and contexts, and efforts to predict resilience based on the balance of these factors. Although identifying risk factors and increasing protective factors can have practical value in applying the construct of resilience to real-life situations, research has shown that resilience is highly contextual (Kalil, 2003). Therefore, it is important to realise that a person may be resilient in some contexts and to some stressors, but not to others. As Kalil (2003) explains, the complexity of resilience makes it extremely difficult to predict. This suggests that research efforts may be better invested in examining how resilience develops retrospectively, rather than attempts to predict outcomes that are likely to be inaccurate. Contextual and Unstable The complexity of the construct is also reflected in the fact that resilience is not a stable attribute; rather, it varies over time, contexts, and cultures. Kalil (2003) explains that resilience changes over the lifespan, and there is no single pattern of development that leads to a resilient individual. McCubbin (2001) elaborates that while a person may be resilient as a child, this does not guarantee they will maintain resilience into adulthood. Indeed, it may be futile to label a person as resilient at all, because a person is likely to be resilient in some situations but not others (McCubbin, 2001). For example, a man may lose his job but cope surprisingly well with the life changes that 8 follow; however, if his mother were to die, the same man may struggle to cope with his grief and experience major psychological difficulties. This reflects the fact that resilience is both contextual and relative to time, place, and situation, and therefore observations of resilience should be tied to specific situations, rather than making broad generalisations. Cultural Variability In addition to varying across situational contexts, the way resilience is displayed can also vary across cultural contexts. Differences in social norms and coping styles can be an example of how a person may be resilient in their own cultural context, but appear to be struggling to cope when compared to other cultural norms. For example, in individualistic cultures where independence is highly valued, a person turning to friends and family for emotional and physical support during difficult times may be seen as a sign of being unable to cope. In contrast, collectivistic cultures are likely to see dependence on family as a socially acceptable way to cope, and recognise an individual who uses this form of support as resilient. This suggests that when assessing the resilience of individuals from different cultures, the traditions and accepted coping styles of the culture concerned should be considered. In the New Zealand context, this should involve examining the resilience of Māori individuals within the context of a holistic Māori worldview, such as the Te Whare Tapa Wha model (See Durie, 1982). Domain Specificity In line with the variation discussed above is the understanding that resilience is domain-specific. This infers that resilience is not a pervasive attribute and a person is unlikely to be resilient in all domains of his or her life. Lynch’s (2011) research refers to the different domains of resilience, listing emotional, relational, educational, and 9 behavioural as examples, although resilience may be divided into many more categories. While an individual may be physically resilient to illness and may be able to maintain high grades in school despite enduring a traumatic event, the same person may be less resilient emotionally and be unable to cope with social situations (See McCubbin, 2001). Lynch (2011) questions whether it is necessary for an individual to be resilient in all domains in order to earn the label ‘resilient.’ However, acknowledging that no one is impervious to the effects of trauma reflects the complexity of resilience and the multitude of factors that influence how people respond to hardship. Response to Adversity The field of resilience research concedes that the prerequisite for resilience is the experience of trauma or adversity. In this way, resilience is seen as a positive psychological or behavioural response to a negative situation. Ryff and Singer (2003) refer to resilience as a persons’ ability to “flourish under fire” (p. 15). This reflects that resilience is only displayed when a person encounters difficulty and is tested. As McCubbin (2001) explains, a person who has not or is not currently encountering obstacles cannot be said to be resilient, because resilience requires adversity. This is reflected in the population samples within which resilience has been examined, such as disaster victims, victims of crime, and marginalised populations. Promotes Empowerment Finally, there is a general consensus among most researchers that resilience by definition promotes empowerment, through its recognition of strengths rather than focusing exclusively on weaknesses (Ungar, 2001; See Shih, 2004 for a discussion of the links between stigma, resilience and empowerment). Resilience as a construct falls in line with the ideals of positive psychology and attempts to balance out the historically 10 biased focus on psychopathology and the deficit-approach that has dominated much of psychology as a field. The very definition of resilience empowers individuals to see themselves as strong and capable, and encourages professionals to take a more balanced view of the people they work with. Given the populations that are typically examined in resilience research, resilience research can be particularly valuable in empowering disempowered individuals and groups in society. The Measurement of Resilience The measurement of resilience is also a research concern. When considering how resilience should be measured, Walsh (1998) explains that resilience is not the absence of problems, but rather the presence of skills to overcome problems successfully. Dichotomy or Continuum While resilience is sometimes understood as a dichotomous attribute that a person either does or does not possess, some researchers portray it as a continuum, whereby most people are seen to be resilient, but to differing extents (Manyena, 2006). Although the concept of a dichotomy is more simplified and easier to measure, the complexity inherent in the characteristics of resilience as a construct, as explained above, is more consistent with the concept of a continuum, which recognises that resilience is relative and not absolute in nature. Threshold Another important consideration when attempting to measure resilience is where the threshold is set (Cornelius, 2013). Some researchers define resilience as merely coping in the face of adversity and maintaining homeostasis, while others set a higher 11 standard of thriving (Tusaie & Dyer, 2004), also referred to as post-traumatic growth (McCubbin, 2001). The more inclusive definition of resilience as a range of responses to diversity, anywhere from coping and maintaining equilibrium to excelling and improving after a difficult experience (See Figure 1 below), allows for a wider range of experiences and fits well with the continuum model discussed above. Figure 1. Threshold for resilience. Different definitions of resilience based on post- stressor level of functioning are depicted. Operational Definition of Resilience Due to the wide variety of definitions of resilience and the lack of consensus on how it is used, it is important to provide succinct definitions in research utilising the construct, in order that comparisons can be made across studies and so that new research can build on existing research towards a common goal (Kalil, 2003). The boundaries around the concept of resilience, as used in this particular piece of research, will be defined as follows: Resilience is coping in the face of adversity, as seen in the achievement of positive outcomes and the strategies that are used to achieve such outcomes. Resilience is highly contextual; an interaction between internal attributes and external 12 circumstances produces resilience at different levels. Resilience is also relative to time, stage of development, domain, particular stressor, and culture. For the purposes of this research, resilience will be defined as maintaining or improving functioning (See Figure X below), as it is recognised that adjusting to life in foster care is no easy feat, and therefore maintaining a stable level of functioning across transitions from family to caregivers and between multiple caregivers requires enormous resilience for a young child. RESILIENCE IN CHILDREN Just as children manifest psychopathology in different ways to adults, special consideration for how children display resilience is necessary. Due to the stage of development a child is in and the high dependency of children on adults, resilient behaviour may appear differently in children, just as it can vary across cultures. Turner (2001) explains that “the premise is that everyone who has survived a trauma, or a neglectful or abusive childhood, has some strength that got her through the experience” (p. 441). A predominant researcher in the area of child resilience is Kalil (2003), who conducted a vast literature review of child resilience in the context of the family system, highlighting the importance of examining resilience as a collective as well as an individual construct. Kalil (2003) explains that the concept of family resilience has been defined as both resilience at a collective family level and as an examination of how the family setting provides a safe environment that promotes resilience in children. Kalil (2003) summarises resilience in children as resulting from an interplay between the child’s dispositions, family characteristics, and the wider environment. These definitions acknowledge that resilience is not just displayed by individuals, but that whole family units can be resilient to challenges they face as a whole. It also recognises 13 the importance of context and how children are greatly influenced by the relationships in their lives, particularly within the family environment. Family Context While research shows that family support plays a role in resilience in adults (Sossou, Craig, Ogren & Schnak, 2008), for children still dependent on their families and living within the context of a family system, family support and relationships with parents and siblings may be even more imperative (Kalil, 2003). Sossou et al. (2008) and Kalil (2003) conclude that family cohesion is an important protective factor for children and promotes wellbeing for all members of the family unit. Cohesion enhances emotional connection and support for all family members, and promotes attachment, sense of safety, and security (Kalil, 2003). According to Kalil (2003), overall family functioning is comprised of three aspects: family cohesion, adaptability, and communication (See Figure 2). Families that score highly in these three aspects can be said to have high levels of family functioning and are more likely to show resilience as a unit. An important consideration in examining the family functioning triangle is that it requires balance. While cohesion is important, it does not ensure healthy family functioning on its own; families that have adaptability in their family structure are more likely to be flexible to the needs of their children and less rigid in patterns of interaction (Kalil, 2003). This is especially important as children enter the adolescent years and being to negotiate their independence (Kalil, 2003). Similarly, flexibility in parenting style is important, as children need a balance of support and autonomy, especially when entering adolescence (Kalil, 2003) 14 Figure 2. Family functioning triangle. Based on the work of Kalil (2003) Kalil (2003) explains that the relationship between level of cohesion and overall family functioning can best be represented using a curvilinear model, as shown below in Figure 3. While this hypothesis needs further testing, it is based on the premise that when family cohesion is either too low or too high, poor family functioning is likely to result. This can be seen when parents are completely uninvolved in their children’s lives, or at the opposite extreme, when a family is enmeshed, parents are overly involved, and children lack any autonomy (Kalil, 2003). It is proposed that family functioning is highest when a family has a moderate level of cohesion, and this is demonstrated in the figure below as an ‘optimal’ zone. 15 Figure 3. The relationship between family cohesion and functioning. The optimal zone is highlighted, based on the explanation provided by Kalil (2003). Family Modelling Like most behaviour, resilient responses to adversity may be a learned behaviour that is passed from parents to children across generations. Coping strategies used by the parents are often adopted by the children through observation and direct instruction (Kalil, 2003). This is commonly observed in terms of children adopting negative parental behaviours, such as the use of substances or violence as a response to stress. However, it is believed that positive coping strategies can also be learned from parents and other adult role models (Healey & Fisher, 2011). For example, parents who observe religious traditions and pray in times of difficulty are likely to teach their children to do the same, and this may lead to the acquisition of coping strategies that children can continue to use as they grow up. Kalil’s (2003) research has identified that holding meaningful belief systems and the presence of religion and spirituality in children’s lives can be valuable in increasing resilience. While spirituality is often seen as non-psychological and non-scientific, some 16 research shows that it is often correlated with better adjustment and higher levels of happiness (Argyle, 2013; Francis & Lester, 1997). People who hold religious belief systems often approach difficulties as setbacks rather than disasters, and take more active problem solving approaches to dealing with such difficulties (Kalil, 2003). In addition, Kalil (2003) explains that religious beliefs often promote responsible parenting, family values, and positive morals such as loving, caring, and altruism. Religious beliefs and worldviews are one example of behaviour and an associated set of attitudes that are commonly modelled from parents to children, and this suggests that parents can have a positive impact on other aspects of their children’s lives and behaviour as well. Factors that Impact Child Resilience As explained above, children are highly dependent on their parents, caregivers, or other adults in their lives to meet their physical and psychological needs, and this gives external figures great influence on their life outcomes. Although research shows that low income and poverty are correlated with many family dysfunctions and negative outcomes for children, young people, and families, Kalil (2003) explains that parents who have limited financial capital can still invest social capital in their children by promoting social relationships and providing support systems for their children through maintaining close relationships with relatives and friends. Research suggests that investing time, social capital, and resources, however limited, into children can increase resilience and compensate for some of the negative effects of poverty (Kalil, 2003). Parents can also shield their children in different ways from external stressors. For example, parents often hide information from their children to protect them, such as if parents decide to wait until after school exams are finished to tell their children they are 17 getting divorced. In this way, parents or other adult figures may have control over the amount of stress that a child is exposed to. Kalil (2003) presents a family resilience hypothesis, explaining that when children grow up in a stress-resistant family, in which the parents try as much as possible to buffer their children from stress and protect them from risks in a high-risk environment (such as poverty or foster care), family resilience is in play (See Figure 4). However, if the family is not resilient as a unit, Kalil (2003) suggests it will be unable to resist pressure and protect the children from the negative effects of an unfavourable environment. While the family resilience theory has received support, questions remain; if the family protects a child too much, will the child be dependent on the family system and have low individual resilience? If the child is removed from the family (as with foster care situations), will they remain resilient? In addition, if children do not have a stable parental figure or permanent family, and are not buffered from stressors, are they able to develop resilience on their own? And can a temporary foster family fulfil the same role as the parents in Kalil’s (2003) model in teaching resilience and buffering children from stress? In some cases, children raised in a context of family resilience may learn resilient processes and coping skills from their family, and this may make them more resilient when they enter foster care. However, it must be considered that if a family displayed high family resilience, would their children be in a situation in which they must be placed into state care? Or does family resilience operate at fairly low levels in the target population of this research project, offering partial explanation for why foster care is necessary and making an examination of family resilience irrelevant? Kalil 18 (2003) explains that poverty, single parenthood, and teenage non-marital parenthood are common barriers to family resilience and child development, factors that are highly correlated with situations from which children enter state care. While family resilience appears to have high theoretical value in the field of child psychology, it may be that other factors are at play in the development of resilience in foster children. Another possible precursor to resilience in children, despite coming from dysfunctional or broken families, is the presence of two parent figures in the child’s life. Kalil (2003) explains that when a child is in maternal custody, maintaining an active relationship with the non-resident father can act as a protective factor. In cases where one parent is absent (often the father), the presence of social fathers, or positive male role models, can often compensate for the loss of the father figure and increase resilience in the child and the mother (Kalil, 2003). Kalil (2003) suggests that this effect occurs both directly and indirectly, as the social father can have a positive impact on the child themselves, and gives the solo mother social support and increases her mental health and overall wellbeing, thereby improving the way she interacts with her children. This idea of substitution parents may be relevant to the field of foster care, as foster parents, like social fathers, may be able to partially compensate for the loss of the parents. 19 Figure 4. Child protection systems. The buffering layers that protect children in a hypothetically ‘normal’ family upbringing. ATTACHMENT THEORY An important consideration when examining resilience in children, particularly children with disrupted home lives and unstable families, is how attachment develops in infancy and affects development and behaviour throughout the lifespan. The prominent early theorist in the field of attachment is Bowlby (1997), who generated a theory of attachment by examining how attachment behaviour develops in normal children and the consequences when attachment processes malfunction. Bowlby (1997) explains that “What is believed to be essential for mental health is that the infant and young child should experience a warm, intimate and continuous relationship with his mother (or permanent mother substitute) in which both find satisfaction and enjoyment” (p. xii). Contexts in which attachment has commonly been researched include orphanages, foster care systems, children in hospitals, infants born to mothers in prison, and children raised by a nanny or substitute mother. 20 Attachment Theory Framework Bakermans-Kranenburg et al. (2011) summarise the basic premise of attachment theory, explaining that healthy attachment develops naturally in response to adequate caregiving. Bowlby (1997) elaborates that the development of attachment is an interactive process, through which the infant shapes and reinforces the mother’s behaviour through actions such as crying and smiling, and the mother shapes the child’s behaviour by picking him or her up and giving the child attention. In this way, the mother and child develop a strong and distinct pattern of interaction very quickly, and learn to predict each other’s behaviour (Bowlby, 1997). Within 12 months of birth, an infant should develop a strong tie to the mother figure or the primary person who meets the child’s physiological needs (Bowlby, 1997). Bowlby (1997) explains that attachment behaviour refers to attempts at “seeking and maintaining proximity to another individual” (p. 195). Attachment is encouraged when adults show sensitivity in response to an infant’s signals, and by the amount and nature of interaction between the adult and child (Bowlby, 1997). Attachment is often understood as being measured by the amount of separation anxiety displayed by a child, but Bowlby (1997) explains that attachment also involves behaviour that initiates interaction, maintains interaction, avoids separation, the reaction on reunion, exploration of the environment, and fear behaviour, such as withdrawing to the mother to seek comfort when frightened. Similar attachment behaviour is seen in many animals, such as when ducklings follow the mother duck very closely, and as displayed in many studies with monkeys and primates (See Bowlby, 1997 for a summary of animal research). 21 According to attachment theory, all patterns of attachment can be classified in four distinct categories. Children are said to be securely attached when they display behaviours seen as typical in development. Bowlby (1997) found that the majority of children actively play, seek their mother when distressed, find comfort from their mother, and then return to play. In contrast, children with an anxious-avoidant attachment are likely to avoid the mother after her absence, and may be unusually friendly towards strangers (Bowlby, 1997). Anxious-resistant children will seek proximity to the mother but resist contact. They are often described as either angry or passive (Bowlby, 1997). Finally, the term disorganised attachment is used to categorise children who display conflicted or fearful behaviour in response to the mother leaving and returning. Examples of this behaviour include huddling on the floor, approaching the parent but remaining hesitant, or entering a “trance-like” state (Lyons-Ruth & Jacobvitz, 1999). In the many years since these categories were developed, much research has been conducted and no additional categories have been supported, with consensus suggesting that these four categories are inclusive of all known types of attachment behaviour. Importance of Attachment As Bowlby (1997) recognised, attachment plays a vital role in adolescent and adult mental health. Since attachment theory was developed, much research has examined the impact of childhood attachment with the caregiver on outcomes later in life. While much of this research is correlational, a strong trend emerges, suggesting that poor attachment leads to poor outcomes in a number of areas, including academic success in childhood (Pianta, Nimetz, & Bennett, 1997; Newland, Coyl & Chen, 2010), personality style and romantic relationships in adulthood (Shaver & Brennan, 1992), 22 empathy and affect regulation (Davidov & Grusec, 2006), and cognitive and social development (Burchinal, 1999). Although it is difficult to directly link problems later in life to poor childhood attachment, evidence suggests that the effects of attachment last well into adolescence and adulthood, and therefore that attachment plays a vital role in human development and may influence the ability to connect with others and levels of resilience in later life. Dysfunctional Attachment Much research has been dedicated to understanding how healthy attachment can be thwarted and the resulting effects of breaking an already formed attachment, as commonly occurs when children are abandoned or removed from parental custody. Bowlby (1997) analysed many observational studies, deducing a common pattern of response to loss of the attachment figure. He observed that typical 15-30 month old children, on first separation from the mother, display a predictable sequence of behaviour: protest, despair, and then detachment. “When removed from the mother by strangers, young children respond usually with great intensity; and after reunion with her, they show commonly either a heightened degree of separation anxiety or else an unusual detachment” (p. 3). He explains these two opposite responses, citing “…great changes in the child’s relation to his mother that are often seen when he returns home after a period away; on the one hand, ‘an intense clinging to the mother which can continue for weeks, months or years’; on the other, ‘a rejection of the mother as a love object, which may be temporary or permanent’” (p. xiii); this is referred to as detachment. According to Bowlby (1997), when at first, the separated child expects his or her mother to return, the child may reject other adults and display pining for his or her 23 mother. However, with time, children often display increasing hopelessness, becoming withdrawn and quiet. Finally, the child reaches a point of detachment. During this stage, the child appears to settle and caregivers may assume all is well, but if the child visits his or her mother, shows a lack of attachment and appears to have completely lost interest in the once yearned for attachment figure. Once the child has detached from the mother, he or she may become attached to a succession of caregivers, but as care placements are often unstable, with each loss of an attachment figure, the child reacts less and less, becoming successively more detached (Bowlby, 1997). Eventually, some children will appear unable to attach to anyone at all. While this behaviour is maladaptive for the child’s emotional and social functioning, it can be understood within the context as a useful adaption to the situation, and in this way it is possible to understand the protective function of such dysfunctional behaviour. However, Bowlby (1997) further examined the phenomenon of detachment, finding that when children have a single mother substitute (stable placement), are fostered with a sibling, or remain in a familiar environment, they often display less distress. In contrast, when children experience a longer separation from their attachment figure, they are likely to have a more extreme reaction. Criticisms Bowlby’s (1997) theory has received criticism, including suggestions that rather than the importance of separation from the mother, being placed in a different environment and having a different parental figure intensifies the negative effects of separation, or alternatively that the noted effects can be attributed to a bad relationship with the mother. However, Bowlby explains that the opposite is true; it appears that having a good relationship with the mother can make separation effects worse. Indeed, 24 Healey and Fisher (2011) suggest that due to loyalty, children who are already attached to their birth parents may be less likely to attach to their foster parents. Bowlby’s (1997) research concludes that the loss of the mother is the key variable effecting change in children’s behaviour after separation (See p. 30-31 for a refutation of these criticisms). Lynch (2011) points out that when an attachment fails to form, this does not necessarily mean the child is unable to attach, as mutual acceptance and willingness is necessary to form a secure attachment. Rather than assuming insecure attachment is due to problems in the child’s ability to connect and trust, it must be understood that attachment is a two-way street. Bakermans-Kranenburg et al. (2011) explain that when caregivers are emotionally unavailable and/or neglect the physical needs of children, the child may suppress his or her needs as an adaptive response to the situation. While this often explains the detachment of children towards their birth parents, this may also occur in fostering situations, when children do not feel safe, secure, and wanted in their placement. Although this may be a maladaptive response in terms of the child’s emotional health, it can also be seen as a method of survival and a form of resilience. RELATIONAL RESILIENCE The field of resilience research is broad and varied, and it has been suggested by some researchers that resilience is not a unified construct, as different types or domains of resilience operate. A particular area of interest, given the influence of adult figures and the importance of relationships in children’s lives, is the concept of relational resilience, which suggests that relationships can be both causative in boosting resilience and a measure of how resilient a child is. Like the construct of resilience in general, differing definitions of relational resilience have been used across different research studies. 25 Hartling (2008) refers to relational resilience as “our capacity to build healthy relationships with others” (p. 53), elaborating on the “ability to connect, reconnect, and resist disconnection in response to hardships, adversities, trauma, and alienating social/cultural practices” (p. 56). Walker and Lee (1998) explain the importance of relationships, as “supportive parent-child relationships have been identified as the single most important protective process operating to produce resilient outcomes across several, diverse populations at risk” (p. 528). This leads to an important premise for this research, that healthy attachment and relationships play a key role in child resilience. Within the specific population of foster children, who by definition have been removed from the care of their parents, the effect of the lack of access to this “important protective process” (Walker & Lee, 1998, p. 528) and the potential for foster carers to compensate for this need, must be considered. Waldegrave et al. (2011) explain that family/relational resilience is an interactional process, whereby the child contributes to the relationship and the resulting resilience, as does the adult. This reflects the influence of the caregiver’s relational style on the dynamics of a foster relationship; a child who is relationally resilient may be placed with a caregiver who is not warm and welcoming, and an attachment may not form. This does not mean that the child lacks relational resilience or has an attachment problem; rather, attachment is a two-way process, and therefore resilience comes from within the child and the context they are placed in. The conclusion is that in order for a child to gain the resilience-building benefits of a healthy attachment, the child must be in an environment that allows for attachment, and be willing to seek and participate in such a relationship. Hartling (2008) explains that “social support is most often described in the research as a one-way, unidirectional form of relating, or something that one gets from 26 others” (p. 63). For this reason, when studying relational resilience, it is preferable to examine relationships, attachment, and connection instead of social support, because these terms imply two-way relationships and offer a more complete view of the benefits of positive social interaction. Calkins et al. (2007) draw connections between early childhood attachment to the parent figure and later resilience, citing research suggesting attachment patterns can be predictive of behaviour problems. Calkins et al. (2007) also implicate the quality of mother-child interactions in developing resilience, across the dimensions of affection, warmth, and positive involvement. They conclude that “less conflict, more synchrony, and greater shared positive affect may be important elements of the child’s relationship with the caregiver that may buffer the child from the negative effects of contextual risk factors” (Calkins et al., 2007, p. 680). This suggests that for the proportion of foster children who do develop healthy attachments in infancy, but are removed from the attachment figure or moved to another placement, resilience may be inhibited or less likely to develop, while those children who have never developed a secure attachment are also likely to be more vulnerable to stressors. While parental relationships are clearly important in building resilience, there is suggestion that other family relationships can also be strengthening for children. Walker and Lee’s (1998) research examined relational resilience in children of alcoholics (COAs), with results suggesting the important role sibling relationships can play in the resilience of at-risk children. Walker and Lee explain that “brothers and sisters can be a potential built-in resource to cope with alcohol-related and other sources of stress” (p. 527), and suggest that facing the difficulty of parental alcohol abuse can lead to stronger sibling bonds than families in which the children have not faced significant difficulty. Additionally, the authors cite empirical evidence that increased emotional connection 27 and the support of a loving family can reduce the likelihood that COAs will develop psychiatric problems such as conduct disorder and depression (Walker & Lee, 1998). Consistent with the discussion of resilience above, this research suggests that encountering negative experiences can lead to increased coping in terms of relational resilience, and that increased strength of relational bonds can act as a buffer for negative outcomes. In the cases of children who do not have supportive relationships with family members, as commonly occurs in dysfunctional or abusive families, research suggests that other adults can act as a substitute. Turner (2001) explains that: Resilient children do not identify with their parents’ maladaptive patterns; they find positive role models elsewhere, such as teachers, parents of friends, coaches, and religious or other community leaders. They learn to disengage emotionally from their families, but still maintain some connection, and they do not feel they are to blame for their family problems. (p. 443) In addition to increasing resilience, Turner (2001) states that the ability to maintain a healthy relationship with an adult role model is an indicator of good resilience in a child or adult, as “the ability to form positive, intimate relationships is an essential component of resilience” (Turner, 2001, p. 443). Hartling (2008) supports this supposition, citing “evidence indicating that children who have at least one supportive relationship (connection) with an adult can achieve good outcomes despite severe hardships” (p. 63). This research suggests that participating in healthy relationships and having resilience forms a reinforcing cycle, as illustrated in Figure 5 below. 28 Figure 5. The reinforcing cycle of relationship and resilience. Relationships enhance resilience, and resilience enhances relationships. Walker and Lee (1998) suggest reconsideration of some taken-for-granted assumptions when considering attachment and relational resilience. The authors urge readers to: Recognize that protective factors are not necessarily positive experiences (Rutter, 1985) and may even deceptively appear to be symptoms of pathology. Behaviors traditionally regarded as dysfunctional (e.g., enmeshment and parentification) may actually be positive ways in which family systems handle the risks associated with familial alcoholism. (Walker & Lee, 1998, p. 529) They further elaborate that “Some parentification may be a healthy adaptation in the face of alcoholism and a sign of relational resiliency. That is, giving capable children appropriate amounts of parental responsibility may benefit the entire family system” (Walker & Lee, 1998, p. 531). Walker and Lee (1998) also explain that the attachment that develops between a child and an adult figure may be seen as unhealthily close, but “it may also be because the pejorative term "enmeshment" has been used to describe a parent-child relationship that is apparently more interdependent than 29 warranted by a child's developmental stage” (p. 530). However, in the particular context, the relationship may be protective for the child. For example, if the child has never had a stable, dependable adult in their life, they may begin to progress through the normal attachment process that develops in infancy (Walker & Lee, 1998). These considerations warn against the traditional assumptions of pathology, recognise the importance of individual variation and acknowledging context, and support the underlying idea of resilience being about survival and adaption. By changing our perspective, pathology can be turned upside down and seen as attempts to survive and adapt to unhealthy life circumstances; once such problems are reconceptualised, creative solutions to readapt in healthier environments can be developed. The term ‘relational resilience’ is often used interchangeably with the term ‘family resilience,’ however in this research a distinction will be made. Foster children are unique to most research populations because often they live their lives in constantly changing contexts; because they do not have consistent families (and have contact with their birth families to varying extents), family resilience may have little impact on their lives and cannot be studied accurately. Instead, this research will examine foster children’s relational resilience, a term that will be used to represent their enduring desire to build relationships and attempts to make connections with those around them and access the positive aspects that relationships with supportive adults can offer, despite experiencing repeated broken relationships and living in an often powerless and constantly changing context. The conclusions drawn from research into relational resilience suggest that relationships play a key role in understanding resilience, and suggest that interventions 30 to increase access to supportive relationships with family members or other adults, and to improve the skills children have to build and maintain relationships, may lead to better outcomes. As Hartling (2008) concludes, researchers are “understanding resilience as a human capacity that can be developed and strengthened in all people through relationships, specifically through growth-fostering relationships” (p. 52). RESILIENCE IN CHILDREN IN CARE While the structure of foster care systems varies across countries, for the purposes of this research, it is helpful to distinguish between two types of state care: children in foster care and children in residential care. However, in reality, most children in residential care have previously been in foster care, and may return to foster care after leaving residence (See Table 1 below for definitions of terms). Leve (2012) state that there is a hierarchy in the quality of different care settings, with children being raised in their own families as preferential, and foster care within a family model setting as preferable over residential care and placement in group homes. There is clearly much overlap between the different types of care, and many children move back and forth between the different care settings within the system. Therefore, many of the observations made based on research in one care setting may be applicable to children in other settings; however, for the purpose of clarity and structure, the literature will be divided into three categories. First, an overview of research examining resilience in the context of residential care will be presented. Secondly, a summary of the key points found in studies examining resilience in foster family situations will be presented. Finally, research conducted with children transitioning out of the foster care system will be summarised. Together, these sections hope to provide an overview of international research into resilience in children who have been removed from their families and placed in the 31 foster care system, forming a foundation from which this independent research project can build upon. Table 1 Key terms in this research Term Definition Children in care General term used to refer to all children and young people who are in the care of Child, Youth and Family, whether long term or temporary, and inclusive of foster care and residential care. Foster care Children who are placed in the care of foster parents or a foster family, constituting the majority of children in care. Whanau care Children who have been removed from the custody of their parents and placed with suitable family or whanau, either long term or temporarily. Residential care Children who are in the care of a group home or state institution, and have usually been in foster care previously, with a history of failed placements leading to residential care. Children in residential care are often at the higher needs end of the care spectrum. Note. This table provides definitions of the key terms that will be used in this research and indicates how they will be used. Resilience in Residential Care For some foster children in New Zealand, a short-term stay in a CYFS residence is necessary to deal with high and complex needs or while appropriate care 32 arrangements are made. Residential care options are often used as a last resort, after foster care arrangements have been unsuccessful, and are often used with older children and adolescents (Emond, 2014). While Bakermans-Kranenburg et al. (2011) explain that for more than 50 years, there has been evidence that institutional care is detrimental to children’s wellbeing, many countries still use long-term residential care facilities, and much international research has examined the differences between outcomes for children in residential care and those in foster care. Emond (2014) explains that children who live in residences often have very different experiences to those in foster care: they lack the ‘normality’ of the family context that their peers grow up in, they must negotiate their lives within two institutions (residence and school), and they often have more educational and psychological difficulties than children in foster placements. As Lynch (2011) explains, temporary placement in a residential facility often means children must live with uncertainty and a lack of stability, not knowing when they will leave and where they will be sent next. Residences commonly consist of high ratios of children to staff, high staff turnover rates, and a lack of opportunities to develop secure attachments to one parental figure (Bakermans-Kranenburg et al., 2011). Despite research suggesting that residential care is in many ways inferior to family- model caregiving (Smyke, Zeanah, Fox, Nelson, & Guthrie, 2010), there is also evidence that children in residential care can develop resilience in other ways and flexibly adapt to their environments. Peer Relationships Research by Emond (2014) suggests that peer relationships are very important for children in residential care, both in terms of relationships with other children at school and with other children in the residence. Due to the lack of a stable parental 33 figure that often characterises residential care, it may be that strong peer relationships can in some way compensate and give such children a sense of family, unity, normality, and belonging (Emond, 2014). In a world of adults who make decisions for the child’s life, such as caregivers, youth workers, social workers, judges, and teachers, the importance of having the freedom to choose peer groups and build friendships appears to be important in children in care (Emond, 2014). The shared experience of children in residential homes also appears to be a unifying factor that helps buffer the shame many foster children experience, and can increase resilience through shared understanding (Emond, 2014). The conclusions drawn from Emond’s (2014) research strengthen the premise of this research endeavour, that relationships play a key role in resilience. Placement Length Another important factor that is believed to influence resilience is the length of placement, as Lynch (2011) explains that it takes time to develop attachment, and that without sufficient time together, the child is unlikely to attach to the caregivers (See also Bakermans-Kranenburg et al., 2011). Lynch’s (2011) research centres on the concept of relational resilience, the ability to form relationships (predominantly with adults such as caregivers and teachers), of which attachment is believed to play a key role. Therefore, Lynch (2011) suggests that if a foster child does not remain in a placement for long enough to develop attachment to his or her carers, the child is likely to have lower relational resilience. Residential Staff Other aspects of the residential care situation that research suggests may inhibit the development of attachment to caregivers include high ratios of children to staff in institutions and high staff turnover rates. Because attachment theory suggests that for 34 healthy attachment to develop, children need to have their needs consistently met by one (or two, in the case of two involved parents) stable attachment figure(s), and an average expectable environment (See Bowlby, 1998, as cited in Bakermans-Kranenburg et al., 2011), residences with low ratios of staff to children often mean a lack of opportunities for one-on-one interaction, and therefore reduce opportunities for normal emotional development. Bakermans-Kranenburg et al. (2011) explain that an ideal ratio of 1:1 and sufficient devotion of time and attention to the child, as well as stability of the caregiver role, promotes healthy attachment and resilience. However, the absence of individualised attention makes it unlikely that children will develop healthy attachment patterns, especially in children who have been institutionalised since infancy. In line with this reasoning, high staff turnover rates also mean inconsistent caregiver roles and lack of sufficient opportunity to develop attachment. Bakermans-Kranenburg et al. (2011) explain that institutionalised children can have up to 50 different caregivers by the age of three; while Lynch (2011) cites research showing that 41% of foster children in the US experienced three or more placement changes within a year. Attachment While attachment studies indicate that abnormal attachment patterns are common in children taken into state care (see Minnis, Everett, Pelosi, Dunn, & Knapp, 2006; Smyke et al., 2010), research suggests that the increased likelihood of multiple carers and unstable placements typical in institutionalised care prevents children from developing healthy attachments. To further strengthen the link between residential care facilities and unhealthy attachment patterns, Bakermans-Kranenburg et al. (2011) cite a study conducted in Greece with infants in residential care since birth, who therefore had 35 no adverse experiences such as family abuse or neglect before entering care. This study found that 66% of these children displayed disorganised attachment styles to their most familiar caregivers, compared to 25% of infants in a two-parent family comparison group (See Vorria et al., 2003). A similar study conducted in Russia by The St. Petersburg-USA Orphanage Research Team (2008) found that 85% of the sample of institutionalised children displayed disorganised attachment, suggesting that, when the effects of pre-care trauma and abuse are eliminated, some aspects of residential care itself appear to cause damage to institutionalised children (Bakermans-Kranenburg et al., 2011). Acceptance Research into the experiences of foster children, particularly those in residential institutions and group homes, has shown that the extent to which a child is aware of his or her own history, and the identity a child forms based around their acceptance of their care status, may influence self-esteem (Emond, 2014), which is believed to play a role in resilience. Often young children may be unaware of the situation that caused them to be removed from the care of their family, but as they grow up and enter adolescence, and begin to develop a distinct identity, develop a need to understand their own journey and the reasons for their position in the foster care system (Emond, 2014). However, Emond (2014) explains that due to a sense of stigma and shame at being institutionalised, some foster children deny their situation to their peers and construct false narratives to explain why they are in care. This may include having idealised views of their birth parents and denial of the wrongs they have committed. Some researchers suggest that with increasing time in the system, hope often diminishes and resilience can decrease as the child or adolescent develops the cognitive maturity to realise that they are unlikely to be reunited with their family or placed in a permanent 36 foster family (Lynch, 2011). However, if the child is able to form a new sense of identity and belonging in the foster context, these negative effects may be avoided. Indiscriminate Friendliness An interesting feature observed in many children raised in institutional care, examined in depth in Bakermans-Kranenburg et al.’s (2011) research with children in institutionalised care in the Netherlands, is that of indiscriminate friendliness, whereby children display overly friendly behaviour to almost all adults they encounter, and appear unable to distinguish between appropriate behaviour towards people they know and strangers. Children who display indiscriminate friendliness often show no preference for the caregiver; when they are upset, they will not run to the caregiver for comfort as expected, but may accept care from wherever it is offered (Bakermans- Kranenburg et al., 2011). This phenomenon has been explained in a number of ways. Rutter et al. (2007) suggest that it may be due to a lack of self-control, while Chisholm (1998) proposes that it is an adaptive response to an environment in early life in which the child’s physical needs have often been unmet. In response, the child learns that when they are friendly, they get more adult attention, and are more likely to get their needs met (Bakermans-Kranenburg et al., 2011). While indiscriminate friendliness is often seen as a result of not developing an attachment to a caregiver, and can therefore be seen as an attachment disorder, Bakermans-Kranenburg et al. (2011) also suggest the behaviour may be caused by problems with attention and behaviour-regulation, and that children who display this behaviour may be unable to inhibit their responses. Bakermans-Kranenburg et al. (2011) also discuss the adaptive value of children who act negatively to get attention, and explain that this can serve the same function. Babies who cry a lot and have a difficult 37 temperament are also more likely to get attention and have their needs met, which can reinforce such attention seeking behaviour later in childhood. Long-Term Effects of Institutionalisation Some studies have examined the effects of adoption or permanent placement on children who have previously been institutionalised, and concluded that in many cases, attachment may not be correctable (See Bakermans-Kranenburg et al., 2011). Bakermans-Kranenburg et al. (2011) suggest that there may be a critical period in which an infant develops the capacity to attach, and if this period is missed, such deficits may not be repairable. However, the authors also suggest that with time and devoted care by the new parents, previously institutionalised children can eventually develop a secure attachment, although the specific factors that influence this have not been identified. Bakermans-Kranenburg et al. (2011) do, however, suggest that if a child developed an attachment to a caregiver in the institution, this existing attachment may inhibit the transition into the new family and make it more difficult for the child to re-attach, again reinforcing the importance of stability in care. Resilience in Foster Care Research into children placed with foster caregivers in a family setting has revealed several themes relating to factors that impact the resilience of foster children and affect outcomes. Some of these key factors, consistent across much of the literature, are placement stability, prior mistreatment, age at first placement, strength of attachment, conditions in care, and whether the child maintains a relationship with his or her birth family. An interesting theme deduced from the literature reviewed is the concept of a redeeming relationship and the possibility that such a positive relationship 38 with an adult can increase resilience in children in foster care. These suggested influencing factors will be examined in the existing foster care literature. Placement Stability A key point highlighted by many researchers is the potential role that placement stability plays in the resilience of children in care. As explained above, foster children are often put through many adjustments and large proportions of foster children move from caregiver to caregiver due to placement breakdown. Stein (2005) explains that when children have a more stable and consistent placement, in terms of home, school, and significant relationships, as measured by fewer placement changes, they are likely to be more resilient and achieve better outcomes. As a strong link has been made between attachment and resilience, Healey and Fisher (2011) explain that when foster children experience placement instability, especially in their early years of life, they experience a lack of continuity that inhibits their ability to development healthy attachment; Jones and Morris (2012) concur that children who experience fewer and longer placements generally develop stronger attachments. Leve (2012) draws a connection between higher number of placements and increasing symptoms of indiscriminate friendliness, while Jones and Morris (2012) explain that foster children who are uprooted often experience higher rates of academic difficulties and are more likely to be diagnosed with attachment disorders. Age Another commonly cited factor in foster child resilience is the age at which a child first enters care. Researchers suggest that children who are younger at the time of placement are likely to have better outcomes and be more resilient (Rees, 2013). This is likely due to children having more opportunities to develop attachment at a younger age 39 (Stein, 2005), which may be explained by the presence of a sensitive period in which attachment patterns develop (See Bowlby, 1997). Jones and Morris (2012) state that children who enter care younger often stay with their foster families longer and experience more stable placements. They further cite the “detrimental effects of late placement” (p. 131) and present correlational evidence that children placed in group homes, who are usually placed at an older age, rate higher on scales for behavioural problems. While this research shows correlation, not causation, it suggests that children who are removed from the parental home at an older age have had more time to assimilate the negative effects of their environment and learn maladaptive behaviour; therefore, removing children at a younger age may be an early intervention to prevent learned problematic behaviour. Pre-care History Many researchers concur that any study of foster children must be based on a foundational understanding that such children are not a clean slate when they enter the system; rather, foster children come into care with pre-existing problems and usually a maltreatment history, which may or may not be fully disclosed (Healey & Fisher, 2011; Kelly & Salmon, 2014). The impact of prior maltreatment on resilience in foster children has been examined by Leve (2012), Healey and Fisher (2011), Osterling and Hines (2006), and Jones and Morris (2012), with Healey and Fisher examining the effects of early maltreatment on the brain and concluding that normal development is often disrupted, leading to emotional regulation difficulties and problems with school adjustment. While Healey and Fisher (2011) explain that early abuse can have significant effects throughout childhood and into adulthood, he suggests that due to brain plasticity, it is not too late to remedy the effects of maltreatment experienced early in life. Children removed from their families and placed into state care need time to 40 stabilize and recover (Healey & Fisher, 2011); it may be that given a safe and stable substitute family environment, even children who have suffered extreme trauma early in life can recover and have high psychological health. Similarly, Leve (2012) examined the effects of prenatal substance exposure in foster children, concluding that such children are more likely to have mental health problems and to have more placement disruptions. Leve (2012) posits that early abuse can disrupt neurological development and impede attachment, requiring much more remedial work and special support than children who have not been abused in infancy and childhood. Osterling and Hines (2006) explain that past maltreatment can lead to difficulties with trust and cause abused children to avoid relationships with foster carers or to have unstable relationships, possibly reflected in high rates of placement breakdown. Finally, Jones and Morris (2012) examined the rates at which foster children reunited with their birth families return into the foster care system. The researchers found that risk factors for returning to care were health problems and the experience of early neglect and abuse (in addition to African American ethnicity, single parent families, non-relative care, and children with siblings also in state care), and that such children re-entered care at a higher rate than average. This suggests that child abuse is rarely a once-off event, but rather an ingrained family pattern that has long- lasting effects on children. Orientation towards Care Status Another factor cited in research as influencing the resilience of foster children is knowledge of their own history and understanding of the need for care. Emond (2014) explains that when children are aware of and accept their care status, they have a stronger sense of identity and cope better with being in foster care. Stein (2005) agrees 41 that when foster children and adolescents are able to work through their abandonment and make sense of their past, it enables them to look to the future and achieve better outcomes. Similarly, Stein (2005) suggests that children who are able to achieve a positive sense of identity, whether it be based around culture or family, are likely to be more resilient. Kinship Care When possible, children removed from parental care are often placed with family members, in line with the philosophy that children should not be removed from their whanau to maintain their identity. Lynch (2011) suggests that children who are placed in kinship care are likely to attach easier to their new caregivers, who usually have a pre-existing relationship with the child. Because the child remains within the whanau, the child is also likely to experience more stability and continuity. In contrast, Jones and Morris (2012) claim that family care does not necessarily mean the child is more likely to develop an attachment, and Leve (2012) states that kinship carers often receive less support and resources than foster carers, making kinship care a less desirable option. In cases where more than one child is removed simultaneously, some research has addressed the question of whether it is beneficial to maintain sibling unity and place siblings together (Jones & Morris, 2012). The authors concluded that due to a multitude of factors, such as the problems that required removal and the relationship dynamics between the siblings, the pros and cons of sibling unity must be determined on a case- by-case basis. Similarly, Rees (2013) suggests that maintaining regular contact with the birth parents can be either beneficial or detrimental to a child’s well-being, depending on the relationship with the parents and the reasons behind the child’s removal. When 42 children have entered care to escape abusive home situations, it may be harmful to place them in an extended family environment that continues contact with an abusive parent. Care Environment Some researchers have examined conditions in care as a variable that impacts resilience in foster children, suggesting that the care environment into which children are placed affects their resilience levels. Jones and Morris (2012) observe that foster care environments that offer children normal life activities, such as school, family time, church, sports, and opportunities to play, lead to higher wellbeing in children. Leve (2012) examined the number of foster children in a home, observing that many foster homes have multiple foster children, often in addition to biological children, and that this can sometimes mean children lack the one-on-one attention necessary for healthy development. However, Jones and Morris (2012) have identified potential resilience building factors, suggesting that school participation, a consistent group of friends, positive relationships with adults, awareness of their own strengths, and participating in extracurricular activities such as sports and cultural groups, can increase positive outcomes for foster children. Interaction Between Child and Caregiver A factor commonly mentioned in the discussion of children in foster care is the difficult child-troubled parenting cycle, as referenced by Leve (2012), Healey and Fisher (2011), Emond (2014), and Bakermans-Kranenburg et al. (2011). Bakermans- Kranenburg et al. (2011) explain that some children are born with a difficult temperament and may be fussy and cry a lot, which can lead to problematic parenting responses, and in the extremes, can result in child abuse, such as shaking a baby who will not stop crying. This can turn into a cycle, where the parent gets increasingly 43 frustrated, causing the baby to become more upset and difficult to console (Leve, 2012). As a result, Healey and Fisher (2011) explain that foster children are often very difficult children when they enter the system, as would be expected by the types of backgrounds that lead to removal from the parental home. However, research by Kelly and Salmon (2014) suggests a framework foster carers can use to understand the child’s internal working model and improve the child’s cognitive and emotional development, despite early abuse. Emond (2014) comment on the cycle in which children with problematic behaviour often end up with few friends due to a lack of social skills. This problematic behaviour may be reinforced by peer rejection, creating a vicious cycle of acting out and rejection. Because foster children often have problematic behaviours, they require caregivers with special parenting skills (Healey & Fisher, 2011). However, even caregivers who have undergone extensive training may struggle with difficult children, which often leads to unstable placements and, as suggested above, can create more damage as children are moved from caregiver to caregiver. Positive Role Models There is significant research to suggest that the presence of mentors and role models contributes to resilience in children in care. For example, Osterling and Hines’ (2006) research examined the use of mentoring programmes in the US, particularly with older adolescents who were aging out of care. Their research showed that the skills learnt during the programme were correlated with better outcomes, and that foster children in the programme appreciated the consistent and dependable encouragement and emotional support they received. The findings of this research are consistent with 44 the theory that building a supportive relationship with one adult figure can enhance resilience in children. Single Redeeming Relationship The theme of the potential of a single redeeming relationship to increase resilience in foster children is alluded to in a range of literature, including Lynch (2011), Stein (2005), Jones and Morris (2012), Kalil (2003), and Osterling and Hines (2006). Stein (2005) refer to the concept of a redeeming close relationship with one stable person, explaining that such a person can be a compensatory secure attachment figure for children who have been neglected or removed their parents. Stein (2005) suggests that this figure may be a mentor outside the foster family, and can fulfil the part of a role model for foster children. Lynch (2011) also refers to such a role as a redeeming close relationship, explaining that children only need one attachment figure and that having such a person is a protective factor for foster children. Lynch (2011) suggests that relational damage caused by mistreatment by parents or the loss of the parents can be repaired by an attentive and loving foster parent. In Osterling and Hines’ (2006) research into a mentoring programme with foster children, they identify the importance of a supportive and caring adult in the lives of children in care, explaining that mentors can fill the role of a consistent relationship outside the family context. Kalil (2003) also refers to the importance of having at least one stable relationship, while Jones and Morris (2012) also identify a positive relationship with an adult as a resilience factor in the foster children they studied. This theory supports the importance of relationships and connection in foster children’s lives, whether it be to a foster carer, a biological child of a foster carer, another foster child, a peer at school, or another figure such as a teacher 45 or coach. While the scope of this research project covers primarily the relationship between foster child and carer, it is important to recognise that a range of significant relationships can have value in bolstering the resilience of a foster child. Resilience in Children Leaving Care An additional area of resilience research in foster children is the area of transitioning out of state care. Researchers such as Osterling and Hines (2006) and Jones (2012) have examined the processes young people go through when leaving foster care, and theories have been proposed about factors that lead to better outcomes after leaving care. For example, Jones (2012) proposes that children who are older at the time of leaving care generally have better outcomes, suggesting that older age is a protective factor. Jones (2012) explains that children in care often leave the ‘parental’ home much earlier than non-foster children, who often live with their parents and receive significant support through their university years and beyond. Most foster children in the US are emancipated at age 18, while the average non-foster child leaves home at approximately 23 years of age (Jones, 2012). Acquired Skills Correlated with increasing age is the acquisition of independent living skills, which researchers have suggested is related to higher levels of resilience (Jones, 2012). Possessing skills such as cooking, cleaning, driving, and knowledge of how to make a CV and open a bank account make the transition out of foster care into independence much easier. Children who age out of foster care often lose both state support and parental support, in addition to lacking job and educational opportunities and having poor financial stability (Jones, 2012). In addition, Jones (2012) explains that foster children have been shown to have higher rates of general health and mental health 46 problems, although it is unclear whether these conditions are a result of being in foster care or part of the causative factors that lead children to initially enter foster care. Due to the connection made between higher age and level of preparedness to enter independence, research suggests that children who leave care later or are gradually prepared to transition are likely to have better outcomes. Social Networks Greater resilience is also associated with developing social networks as a buffer to stress (Jones, 2012). Some foster children may develop friendships at school or in extracurricular activities, and these friendships, if maintained after transitioning out of care, can offer social support and enhance resilience. Lynch (2011) examines the protective qualities of culture, explaining that foster children who maintain relationships with their ethnic communities are likely to have a stronger identity and sense of self, enhancing their resilience and social support resources. Research also suggests that foster children who maintain continuity by remaining in contact with their foster family can receive social support from former foster parents, foster brothers and sisters, social workers, and youth workers (Jones, 2012). Recognising the importance of attachment and continuity, and making comparison with the normal processes non-foster children pass through when leaving the parental home, it is clear that maintaining as many supportive relationships as possible is helpful when all adolescents make the transition to adulthood. Mentoring Research by Osterling and Hines (2006) examined the utility of a mentoring programme for foster children leaving care in the United States. This study found that the presence of a mentor during adolescence can provide multiple benefits for foster 47 children, including the presence of a role model, the availability of emotional support, and the acquisition of important life skills (Osterling & Hines, 2006). Results showed that foster youth who participated in the mentoring programme had better outcomes in general, as seen in their improved self-concept, peer relations and educational achievement, and lower levels of drug and alcohol use and violent behaviour (Osterling & Hines, 2006). The youth who participated also rated the programme as helpful, particularly for the mentors’ willingness to teach valuable practical life skills and spend quality one-on-one time with the youth. Once again, the value of relationships and the associated emotional and practical support that is provided in the context of a supportive relationship is highlighted in this area of research. Reuniting with Family Although increased levels of social support have proven to be beneficial to adolescents transitioning out of care, research suggests that returning to the birth family after aging out of state care often leads to worse outcomes (Jones, 2012). The author suggests this is because the same factors and family dynamics that led to the child being placed into care in the first place often still remain. Research and theory into the effects of environments on individual behaviour support this assertion, suggesting that birth families may be bad influences on newly independent foster children and can cause them to lose progress they have made in care. Despite research strongly suggesting that returning to live with family members after leaving state care often leads to negative outcomes, high numbers of foster youth choose to do so, presumably out of loyalty and a sense of belonging. 48 Children in Care in the NZ Context The foster care system in New Zealand, under the umbrella of the government agency known as Child, Youth and Family services (CYFs), involves almost 3,500 foster parents and almost 4,000 children and young people (MSD, 2014). Statistics reflect that the majority of children under state care are of Māori ethnicity, followed by New Zealand Pākehā and Pacific Island ethnicity (MSD, 2014). Entering Care There are two main pathways through which children can come into CYFs care: Care and Protection, and Youth Justice (MSD, 1989). In many cases, the process that brings children and young people into state care begins with concerns reported by the public, often a neighbour or teacher who has suspicions that the child is unsafe in their home. These concerns can be reported through an anonymous contact centre, and if it is determined that the concerns are valid, the case will be referred to a social worker, who will examine the evidence and complete a safety assessment of the child and his or her family (MSD, n.d. a). If the assessment concludes that the risks to the child’s safety are not severe, the family will likely be referred to community services for support. However, if the child appears to be in serious danger or if there is evidence of abuse, the police may become involved in an investigation and a warrant may be obtained to remove the child or young person temporarily from their parent’s care (MSD, 2014), and a custody order may be granted for longer term removal (MSD, n.d. a). In New Zealand, removing a child from his or her family is only done as a last resort to protect the safety and welfare of the child. In many cases, CYFs will attempt to work with the family to create a whanau agreement which is later re-evaluated to determine whether more intervention is needed. The family model that is utilized in 49 New Zealand often involves the use of Family Group Conferences (FGC), which is a meeting between important figures in the child’s and families’ lives, through which CYFs offers support for the whole family and attempts to facilitate the whanau to make good, collaborative decisions about the children’s welfare. In this way, before children are removed from their families’ care, CYFs tries to empower families to resolve their own problems and make adjustments to ensure the safety and wellbeing of their children. However, if the family does not co-operate or it is otherwise determined that the child is unsafe in the parent’s custody, family court approval will be sought to remove the child and place him or her into CYFs care while decisions are made for the child’s future (MSD, 2014). Due to the principle of the importance of whanau, when assessing options for the care of removed children, CYFs will attempt to make arrangements for the child to be cared for by extended family members or someone with whom the child has an existing relationship, as a first priority. Statistics from 2013 showed that almost half of New Zealand children in out-of-home placements were in family/whanau care (MSD, 2014). In situations where there are no family members able or willing to take responsibility for the care of the child, a trained and approved foster carer will be found and matched to the child. While the child is in state care, CYFs continues to work with the family to make the home environment safe for the child to return as soon as possible. In most cases, the aim of the agency is to reunite children with their whanau, recognising that it is best for children to be safe and cared for in the context of their own families. However, if CYFs determine that the child is unlikely to be able to return to their home, a legal process called ‘home for life’ allows the child to be placed into a permanent caregiving situation, whereby the child is no longer in CYFs custody but becomes the legal 50 responsibility of a permanent caregiver (MSD, n.d. a). This initiative recognises the detrimental effects of instability in children’s lives and the negative consequences of moving from caregiver to caregiver, and instead offers safety and security in an adoption-like context (MSD, 2012). Types of Care Under the CYFs foster care system, six types of caregiving exist and are used in different situations and for different purposes. Short-term fostering occurs when a social worker anticipates that the child will return to his or her family within three months, and is likely to be used for less severe family problems or medical situations in which the parents are unable to provide adequate care for the child (MSD, n.d.). Emergency fostering is for a period of up to three days, and may occur during medical emergencies or when a child is first removed from their family, before long-term plans can be arranged. Respite fostering is often used when families with special needs children need a break, and may be a regularly scheduled occurrence, allowing the child to build a relationship with a stable respite foster carer (MSD, n.d.). Pre-permanent placement or pre-adoption fostering is likely to be short term in duration and usually occurs when arrangements have been made for a young child to be adopted or permanently placed with a new family, but the child is placed in care until this process is finalised. This can be seen as a bridging phase between the original family and the new family, and the pre-permanent placement caregiver may help prepare the child and the new family for their upcoming life changes. Mother and baby fostering may be necessary for school-aged mothers who need support and guidance to look after themselves and their babies. Finally, the focus of this research will be predominantly on long-term fostering, whereby a child is unlikely to return to their 51 family but it is determined that the best interests of the child are to maintain a relationship with his or her parents. In these cases, children are placed into permanent care, providing them with a safe environment and allowing them to maintain contact with their family. Based on an examination of past research into resilience in foster children, this study seeks to examine general resilience as observed by adults who work closely with foster children in New Zealand, in addition to conducting an in-depth examination of the narrower topic of relational resilience in the target population. This topic will be studied by exploring the types of relationships the participants have developed with the children and youth they have worked with. Therefore, the results of this research will be a discussion of the observed resilience of foster children and child-carer relationship dynamics as experienced by the participants and reported during focus group and interview discussions. The data will be analysed for repetitive and unique themes and compared with existing international research into resilience in foster children. 52 Methodology Aims The purpose of this research is to: • Invite members of the foster care community to participate in a collaborative discussion about the positive psychological and relational aspects of the children they have worked with and increase awareness of foster children’s strengths • Develop a theoretical and applied understanding of how internal and external factors contribute to relational resilience and attachment in foster children and the varying dynamics of the relationships foster children develop with the adults in their lives • Build on the existing international literature of resilience in foster children and examine the topic in a New Zealand context from the perspective of influential figures in foster children’s lives • Use the knowledge gathered from the participants to suggest practical ways to increase the recognition of relational resilience and enhance relationships in the New