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

Introductionfamily-minds-logo for Family Minds

Supporting the mental health and development of foster children starts with giving them caregivers who have the traits that generate secure attachment in children. Dr. Tina Adkins developed the Family Minds intervention to provide attachment-based mentalizing psycho-education to foster and adoptive caregivers.

Mentalization-based interventions show promise in improving mental health outcomes for children and parents by increasing a family’s ability to mentalize. Mentalization, or reflective functioning, develops within the context of a secure attachment relationship. This involves the ability to understand behavior in relation to mental states such as thoughts and feelings. The skill entails seeing yourself from the outside and your children from the inside. Mentalizing is an essential component of being a sensitive, therapeutic foster or adoptive parent.

Research shows that parents with mentalizing skills have high rates of secure attachments with their children. Increasing foster parents’ reflective functioning and mentalization helps them to not only regulate themselves, but also regulate the emotions of their foster children.

Foster children can significantly benefit from learning to recognize and reflect on their feelings in a more conscious and regulated way (Howe, 2006). Teaching foster caregivers about this helps them understand their foster children and their behaviors better. In turn, this helps caregivers interact with children 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 Caregivers

One factor not given much consideration when recruiting or training foster caregivers in the United States is their thoughts regarding attachment or their mentalizing skills. Caregivers with insecure or even unresolved states of mind are poor mentalizers. This makes them more likely to be triggered negatively by their foster children’s attachment needs and behaviors (Howe, 2006). As a result, this will likely activate the childhood anxieties, traumas, and defenses of these foster parents. Unfortunately, this prevents them from being able to successfully attune to their foster child.

Maltreated children placed with such foster parents face an increased risk of placement breakdown (Dozier, Stovall, Albus, & Bates, 2001; M. Steele, Hodges, Kaniuk, Hillman, & Henderson, 2003). 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. Placing these children with caregivers who have mentalizing skills serves as a protective factor for these issues in children.

Benefits of the Family Minds Intervention

Improving mentalizing skills can prove beneficial for foster caregivers who frequently deal with children exhibiting challenging behaviors, attachment issues, and negative internal working models of relationships. This intervention can result in:

  • Caregivers being less likely to jump to conclusions about their foster children’s negative behaviors.
  • Caregivers who can see the deeper meaning behind their child’s behavior. This enables them to problem solve those issues more successfully, which leads to more successful relationships.
  • Parents who 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

Dr. Tina Adkins developed the Family Minds psycho-educational training intervention specifically for foster and adoptive caregivers. The intervention was designed to be short-term and practical. Evaluation of the intervention took place as part of Dr. Adkin’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
  • 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)
  • Cumulative content including 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, TX, received the intervention. Researchers collected data 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. In contrast, 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. This group also reported a lowering of behavioral issues and that they felt it improved their relationship to their children. 

Next Steps

Results from the randomized controlled trial of this intervention were very positive, showing that parents who went through the intervention significantly increased their ability to mentalize and reported less dysfunctional interactions between themselves and their foster children. This intervention has been manualized and is now considered evidenced-based. Next steps include training others on how to deliver this intervention to fidelity, which will include measuring outcomes to ensure other trainers can get the same positive results.

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

Contact if you are interested:
Tina Adkins