Development of a Psychoeducational Foster Carer Program Using the Medical Research Council (MRC) Framework for Complex Interventions

Figures & data

Figure 1. Study's alignment with the medical research council framework. Adapted from “Developing and evaluating complex interventions: the new Medical Research Council guidance,” by Craig et al., 2008, BMJ, 337, p. 6. Copyright 2008 by the BMJ Publishing Group Ltd.

Table 1. The principles of fostering connections.

Name of Principle	Description of Principle
Overarching Principle: Child in Mind	The children's needs are at the heart of this program. Trauma-informed foster carers are equipped with a foster caring approach to care for children who have experienced trauma. This foster caring approach promotes placement stability which in turn supports better outcomes for children.
Principle 1: Trauma in Mind	Trauma-informed foster care requires foster carers to develop an understanding and awareness (a mindset) of the impact of trauma on children and also of the impact of caring for children who have experienced trauma on themselves as caregivers.
Principle 2: Safety in Mind	The foundational skill of the foster carer in trauma-informed foster care is supporting children in foster care to develop a feeling of safety.
Principle 3: Relationships in Mind	The second trauma-informed foster care skills area for foster carers is developing safe relationships with children in foster care.
Principle 4: Coping in Mind	The third trauma-informed foster care skills area for foster carers in supporting children in foster care to develop coping skills.
Principle 5: Resilience in Mind	The fourth trauma-informed foster care skills area for foster carers is developing fostering resilience. Fostering resilience is rooted in the foster carer’s empathetic capacity and capacity to remain hopeful about the child’s future.
Principle 6: Teamwork in Mind	Trauma-informed foster care requires foster carers to be effective members of the team that supports the child in order to promote positive outcomes for the child.

Figure 2. Program hypothesised causal pathway.

Table 2. Description of program content.

Session	Learning Objectives	Content
Trauma in Mind	Understand the impact of trauma	Program rationale/structure
	Recognise the child's trauma history, trauma responses, and the child's strengths	Developmental trauma Resilience
	Understand the importance of connections when children come into care	Separation and loss
	Understand the concept of the “Invisible Suitcase”	Trauma impact on core beliefs
Safety in Mind	Understand and recognise trauma triggers	Neurobiology of stress
	Understand and promote the feeling of safety in the child	De-escalation strategies
	Understand the dangers of burn-out	“Felt safety” through caregiving Vicarious trauma
	Strategies for self-care	Self- care
Relationships in Mind	Understand trauma impact on child development	Child development
	Understand basic concepts of attachment	Attachment theory Developmental trauma
	Develop skills that promote child emotional and social development	Trauma-informed fostering
Coping in Mind	Understand how to help children develop coping skills	Developmental trauma recovery
	Develop connecting skills with children through play	Stages of play in child development/ Non-directive play
	Develop skills in helping the child to manage behaviours	Trauma-informed approaches to behaviour
Resilience in Mind	Understand and develop Reflective Fostering skills/ Fostering Resilience	Reflective fostering
	Understand and develop resilience in children in foster care	Foster carer resilience
	Understand the importance of Fostering relationships with birth families	Child resilience
	Develop strategies that support safe and positive access for the child	Impact of having a “dual identity”
		Foster carers’ role in contact with birth families
		Safe access
Teamwork in Mind	Understand the foster carers’ role in the team around the child	Collaborative practice
	Identify learnings from the training	Program review
	Understand the importance of hope	Hope in fostering
	Introduction to the PACE	PACE model

Craig, P., Dieppe, P., Macintyre, S., Michie, S., Nazareth, I., & Petticrew, M. (2008). Developing and evaluating complex interventions: The new medical research council guidance. BMJ, a1655. https://doi.org/10.1136/bmj.a1655

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