Family Minds:  An Attachment-based Mentalizing Psycho-Educational Intervention for Foster and Adoptive Parents

Introductionfamily-minds-logo for Family Minds

David Howe, a world-renowned researcher in attachment and foster children, has stated (2006) that the most effective and impactful way to help foster children is to “work with and through” the foster parents themselves (p.129).  One of the ways to significantly impact the mental health and development of foster children is to give them caregivers who have the traits that generate secure attachment in children.  Mentalization-based interventions show promise in improving mental health outcomes for children and parents through increasing a family’s ability to mentalize.  Mentalization, or reflective functioning, develops within the context of a secure attachment relationship and involves the ability to understand behavior in relation to mental states such as thoughts and feelings.  It is the skill of being able to see yourself from the outside and your children from the inside, and is an essential component of being a sensitive, therapeutic foster or adoptive parent. Research shows that parents who are skilled at mentalizing have high rates of secure attachments with their children.  By supporting foster parents’ ability for reflective functioning and mentalization, they are also gaining the ability to not only regulate themselves, but also regulate the arousal of their foster children.  Foster children, in particular, can significantly benefit from learning to recognize and reflect on their feelings in a more conscious and regulated way (Howe, 2006). Teaching foster parents about this helps them understand their foster children and their behaviors better, and helps them interact with them in a more sensitive and reflective manner (Golding, 2003; Marvin, Cooper, Hoffman, & Powell, 2002; Schofield & Beek, 2006).

Why the Family Minds Intervention is Important for Foster and Adoptive Parents

One factor not given much consideration when recruiting or training foster parents in the U.S., is their state of mind regarding attachment or their mentalizing skills.  Those parents with insecure or even unresolved states of mind are poor mentalizers, and are more likely to be triggered negatively by their foster children’s attachment needs and behaviors (Howe, 2006).  As a result, this will likely activate childhood anxieties, traumas and defenses of these foster parents.  Unfortunately, this prevents them from being able to successfully attune to their foster child and challenges their sensitivity.  Maltreated children who are placed with such foster parents have an increased risk of placement breakdown (Dozier, Stovall, Albus, & Bates, 2001; M. Steele, Hodges, Kaniuk, Hillman, & Henderson, 2003).  Ensuring foster parents have such skills is especially relevant given that maltreated children who have been removed from their homes display higher rates of insecure attachment, emotional and behavioral challenges, relationship problems and poor social skills.  Having a parent who is good at mentalizing helps prevent such issues in children and is thought to be a protective factor.

Benefits of the Family Minds Intervention

Improving mentalizing skills can be very beneficial for foster parents, as they frequently deal with children who come into their home with challenging behaviors, attachment issues and negative internal working models of relationships.  This intervention can result in:

  • Parents that are less likely to jump to conclusions about their foster children’s negative behaviors
  • Parents that can see the deeper meaning behind their child’s behavior, which enables them to problem solve those issues more successfully which leads to more meaningful and successful relationships with their foster children
  • Parents that are more likely to interact with their children in a more sensitive and therapeutic manner; increasing secure attachment
  • Less parental stress, reduced placement breakdowns and improved mental health of foster children
The Intervention

This Family Minds psycho-educational training intervention was developed specifically for foster and adoptive parents and was designed to be short-term and practical.  It was evaluated as part of this author’s dissertation project at University College London and the Anna Freud Center.

Key Features:

  • Psycho-educational; can be taught to and given by social workers
  • Cost effective and short-term
  • Designed to increase parent’s knowledge and ability to mentalize and be reflective
  • Helps parents go deeper in understanding the thoughts, feelings and behaviors of their children, as well as themselves
  • 3 separate trainings of about 3 hours each spread out over 6 weeks (can be adapted)
  • Content is cumulative and includes info on trauma, attachment and mentalization
  • Includes slides, handouts, videos, discussions, classroom activities and at-home activities

Fifty-four foster and adoptive parents in Austin, Texas, received the intervention.  Data were collected both before and after the intervention, measuring reflective functioning/mentalization capacities and parenting stress.  The same data were collected with a comparison group of 48 foster parents who received a typical foster parent training.  Results: Intervention parents’ significantly increased their reflective capacities and lowered their parenting stress, while the parents who received a typical training did not show any such improvements.  Additionally, parents who went through the intervention reported feeling more connected and attuned to their children, that there was a lowering of behavioral issues and that they felt it improved their relationship to their children. 

Next Steps

We are hoping to replicate these results with other populations of foster and adoptive parents and look at other measures as well, such as placement stability and other long-term outcomes.  Presently, this intervention is being manualized, as the results of the study lend credence towards this being an evidenced-based intervention.  Results are presently in press for publication:

Bammens, A., Adkins, T., & Badger, J. (2015).  Psycho-educational intervention increases reflective functioning in foster and adoptive parents.  Adoption & Fostering 39(1).

Visit the Family Minds website

Contact if you are interested:
Tina Adkins