This doctoral dissertation deals with the topic of attachment in foster and adoptive families. It comprises several parts. The theoretical introduction covers the overview of the relevant literature and related research focusing on attachment, adoptions, foster care, therapy for foster and adoptive families, as well as the dynamics of parenting and stress in foster and adoptive families. In the first theoretical part, we emphasized the importance of an open concept of adoption and open conversation about infertility and the importance of focusing on the child, as well as the importance of empathic approach, consistency, adaptability, firmness, sense of humor and ability to think about problems and their origin for successful placement in foster care and adoption. We showed that the contact with biological parents is one of the most important aspects to consider when placing a child in a foster or adoptive family. We then proceeded to investigate the attachment of children in foster and adoptive families, focusing on attachment types and disorders, as well as the influence of developmental trauma in forming attachment, which is reflected in externalization and internalization. We focused on the main factors, which influence the child’s ability to form a secure attachment. These factors are age at placement, length of placement, genetic factors and sex, adoption and foster care, contact with biological parents, appropriate preparation for foster care and the environment, number of children in a foster or adoptive family, and foster and adoptive parents. Establishing a secure attachment is very important, as it reduces the risk of placement interruptions, re-divorces, losses, and the development of further psychosocial problems in foster and adoptive families and involves improved social, emotional and cognitive development. The second part of the theoretical introduction provides a detailed description of therapy for children in foster and adoptive families, presenting family psychotherapy based on attachment. We focused on two therapeutic methods: relational family therapy and dyadic developmental psychotherapy. We researched the roles of security, body, neurobiology, and spirituality in the therapeutic process of foster/adoptive families and studied several other processes applied in attachment-based psychotherapy. The third part of the theoretical introduction presents parenting in foster and adoptive families. We focused on the challenges of parenting in foster and adoptive families highlighting only the crucial ones: maintaining boundaries and integrity as a family unit; communication within the family; coping with insecurity and problematic behavior of the child. All the challenges of foster and adoptive families are largely related to child’s difficult past which results in the lack of trust in others, fear of close relationships and doubts about their own sense of worth and love. We further study the behaviour of children in foster and adoptive families, blocked trust, fear of intersubjectivity, shame and blocked care, and parenting stress. We have shown that adoptive and foster parents face higher stress in parenting than biological parents do, since they have additional stressors associated with the process of preparation for adoption and foster care, the usually sudden arrival of the child in the family, contact with the child and the child's history, coping with the environment and previous losses (infertility). Stress can affect children's ability to perceive and respond to attachment signals and their ability to reflect, so stress resistance is an important quality to consider in future foster or adoptive parents. We concluded the theoretical introduction with a chapter on therapeutic parenting where we presented research results by other authors on the principles of therapeutic parenting and where we focus on relationships, appropriate level of structure, control, compassion and warmth, responsibility for relationships, conscious parenting, parental self-care, and the group support of foster and adoptive parents.
The empirical part comprises three parts. We showed the path of change in the field of attachment in children in foster care and adoption and in the field of stress in foster and adoptive parents. In the first part of our research, we worked with a small sample (9 experts, 30 foster parents and 14 adolescents in foster care) and tried to find out where adolescents, foster parents and experts feel the necessary changes in the field of foster care in Slovenia. The necessary changes were identified in the field of foster parents' preparation for foster care, where parents lacked diversity, as well as in the field of professional support for foster parents during the foster care process (during the process, foster parents usually feel isolated and lack support). The greatest challenge as described by the participants in the research, was the behavior of children in foster care and contacts with biological parents, with which most of the participants had bad experience. In addition, they also had bad experience with the reactions of the environment, long-term foster care and the transition of young people to independence. Professionals, on the other hand, see the necessary changes in reducing norms and increasing professionalism. In the second step, we tried to find out what chenges occur on the field of (1) attachment of children in foster care or adoption, and (2) stress in foster/adoptive parents. With the therapeutic approaches of dyadic developmental psychotherapy and relational family therapy, we monitored six foster families and two adoptive families. The results of the PSI-SF questionnaire that measures stress on the three major domains of the carer–child relationship ((1) parental distress, (2) parent–child dysfunctional interaction, and (3) difficult child) showed that, at the beginning of the process, the level of total stress was high: M = 83.88 and SD = 24.68. The total score at the end of the process was M = 74.25 and SD = 19.38. We observed that the total parental stress decreased at the end of the process; the values of parental distress, parent–child dysfunctional interaction, and difficult child decreased as well, but the difference between the values at beginning and at the end of the process was not statistically significant. In this part of the research, we also measured the attachment to foster/adoptive mothers and to foster/adoptive fathers at the beginning and at the end of the process. The differences between the arithmetic means of the groups were statistically significant on both dimensions for fathers and mothers with p < 0.01. After the process, children had a more secure attachment to both the foster/adoptive fathers and mothers. In the therapeutic process, topics related to biological parents, behavioral problems, and relationship problems with foster/adoptive parents and peers emerged. The therapeutic process discovered that this defensive behaviour that was present in every child, hides shame and fear, but also sorrow. A special place in the therapeutic process was dedicated to playfulness, acceptance, curiosity, and empathy. It is crucial for children to be able to shape and find meaning in their lives with the help of foster and adoptive parents, but the process has shown the complexity and depth of child harm in foster and adoptive families. Foster and adoptive parents did not come to a full acceptance of the child's inner world and to the development of compassion for this child. In the third part of the research, we described the response of twelve foster and adoptive parents to the group psychotherapy program based on the model of Nurturing attachment, and answer the research question how parents respond to the group psychotherapy program. Based on the results of the CQ questionnaire, which was completed by foster and adoptive parents at the beginning and end of the group process, we showed what changes occur in four research domains: (a) parental skills and understanding of their children; (b) relationship between parents and children in foster care/adoption; (c) child’s reactions to care; and (d) stability of placement. The results of this part of the research are statistically significant with p <0.05 in two domains: child’s reactions to care, and parental skills and understanding. Previously, parents’ experience with the child was primarily focused on behavioural difficulties. The behaviour of attachment that parents noticed in their children ranged from fast establishment of contact with strangers, calling the parents by their names, strong care, high potential to be influenced by their peers, strong control, clinginess, and retreating when in distress to extreme difficulties in everyday routines such as feeding and bed-time. The therapeutic programme also emphasizes the importance of foster and adoptive parents’ self-care and their personal growth. Parents claimed to have acquired a lot of useful and interesting knowledge, learned to see the child’s world, adopted nicer and less stressful reactions to difficult situations, learned to be better listeners in the relationship with their child, and became firmer in setting limits and rules. Mutual understanding and the ability to face difficulties also increased. Parents saw the added value of the group work also in the fact that, on the one hand, it opened new perspectives on foster care, children and parenting, and on the other hand, it helped them acquire new parenting skills from one another. The main purpose of this doctoral thesis was to investigate what changes that we introduced into the system of foster care and adoption occur on the field of attachment in children in foster care and adoption and the area of stress in foster and adoptive parents. We have shown that change is difficult to achieve and that the path to a safer attachment is a long process.
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