Led by Dr Matt Woolgar & Tom Cawthorne, who are leading experts in the mental health of adopted and fostered young people, the session explored:

· How mental health support services for adopted and fostered children were structured in the UK

· The benefits and challenges of the current system

· Key factors that drove the difficulties families faced in accessing and navigating services

· Practical strategies families could use to work with CAMHS and other professionals to maximise positive outcomes for their child and themselves

Ideal for:

• Adoptive parents and foster carers

• Special guardians and kinship carers

• Social workers, educators, and mental health professionals

Anyone supporting adopted or fostered young people who had unmet neurodevelopmental needs

Talking to CAMHS was especially complex for adoptive families because the way services were organised, understood, and delivered varied enormously across the UK. Adoption added further layers of complexity, with families, social care, education, and CAMHS often working from different frameworks about children’s needs and what support should look like. Our survey of adoptive parents highlighted how this lack of shared understanding could lead to frustration and dissatisfaction when trying to access mental health support. This webinar mattered because it explored the different narratives at play, why they could make collaboration harder, and—most importantly—what practical strategies families could use to improve communication and maximise the chances of getting the right support for their child.

Dr Matt Woolgar is a Consultant Clinical Psychologist in the National Adoption & Fostering Clinic, based at the Maudsley Hospital, London. He is also an academic at King’s College London, focusing on attachment, parenting, and developmental psychopathology. Matt has a particular interest in the assessment and treatment of complex presentations in adopted children or children from the care system, especially with regard to disentangling the effects of biological and neurodevelopmental factors from attachment, trauma, and behavioural issues.

Dr Tom Cawthorne was the Senior Clinical Psychologist in the National Adoption & Fostering Clinic and is currently undertaking a research fellowship focused on improving mental health care for adopted and fostered young people. He has a specialist interest in supporting children and adolescents with neurodevelopmental differences, including autism and ADHD. Tom brings extensive experience in conducting neurodevelopmental assessments to inform diagnosis and in delivering tailored psychological interventions for the co-occurring mental health challenges often faced by this group. This includes supporting young people with neurodevelopmental conditions who have experienced significant trauma and attachment disruptions.

A reasonable question might be why is this even a topic for a podcast? But in over 20 years of working with adopted; special guardianship and foster parents across the UK it has always been very clear that there is a huge variation in the ways in which services are organised and how they conceptualise care experienced children. This variability goes beyond a simple post code lottery of whether or not people in one geographical location get access to the standard healthcare offer while people in a different geographical location do not.

What happens with adoption in particular is that there exist different conceptual frameworks amongst families, social care and education which adds several layers of variability on top of the fact that the mental health services you are trying to engage with will also have variability in how they conceptualise problems in adopted children and young people, and also what are the appropriate service responses to them. So it rapidly gets very complicated, unless your understanding of what your child needs aligns with what the social worker believes you need which then further aligns with what CAMHS services think you need and are able to offer.

You can’t easily take a one size fits all approach to asking for help, but rather you may often have to work out what it is that you think that the service you’re trying to engage with believes and has services available for and then see if you can achieve some collaborative understanding, aligned with what you believe and what you want to get out of the referral. Unfortunately, sometimes even if you do all that then collaborative understanding required to move forward does involve compromises, some of which might be fairly significant compared with what you want to believe.

We have evidence of this from survey we did with adopted parents and their experiences with CAMHS services. And part of the message from that was families felt there was quite a low level of shared understanding about children’s problems between families and CAMHS, and this seemed to be one of the big factors driving what was very high rates of dissatisfaction with CAMHS services, at a rate that was much higher than general satisfaction with CAMHS services and with the NHS more generally.

In this webinar we will consider some of the various narratives that exist in adoption and how these different narratives, even if some are more true than others, have almost inevitably led to a much more challenging environment for families to achieve a shared understanding about what their child needs and what a service can offer compared to children and birth families. It does involve acknowledging that there are these differences. But then we want to talk about things you can do to maximise your chances of getting the kind of service that you want, or at least strategies to help facilitate the communication about what you believe is important for your child and what services might have to offer. And one most reliably helpful ways is to be prepared to talk less about theory, and top-down explanations of behaviour, and more about behaviours and observations.