‘No-one told us it was going to be like this’ is the first national study of compassion fatigue in foster carers in England and calls for greater support and understanding of the debilitating effects of caring for some of the most vulnerable children in society. The findings will be submitted to the Government’s Fostering Inquiry, led by the Education Committee, which is expected to examine all evidence in January 2017.
The study, conducted by the University of Bristol’s Hadley Centre for Adoption and Foster Care Studies, investigated the presence and experience of compassion fatigue through measuring levels of burnout and secondary traumatic stress, as well as mental well-being in a survey of 546 foster carers. The survey also looked at what elements of the foster caring role give pleasure and reward, or compassion satisfaction, which is widely seen to reduce the effects of burnout and secondary traumatic stress. Focus groups were also held with 23 foster carers to explore the impact of compassion fatigue and their support needs in greater depth.
Compassion fatigue is experienced as a physical and emotional response to the stress of caring for those who have experienced trauma. It involves a decrease in empathy and a decline in feelings of pleasure, alongside an increase in stress, anxiety, sleeplessness and negativity. Unlike other people working in helping professions who can go home to rest and escape from a stressful day, a foster carer’s home is also their place of work. The study found that without appropriate support to regularly have some ‘time-out’, foster carers are likely to have increased symptoms of compassion fatigue.
Study participants described shutting down their own emotions so that they could simply get through each day, and only being able to meet the child’s basic needs. Others said that many social workers had little knowledge of the effects of trauma on children and the demanding reality of caring for them. Some carers described feeling as though they were judged or blamed and did not feel safely supported.
“Carers need a safe and non-judgemental space to talk through concerns, where their expertise is recognised,” said lead researcher Dr Heather Ottaway. “To reduce symptoms of compassion fatigue they also need access to respite which is creative and flexible, and takes account of children’s needs resulting from trauma.”
In the study, carers viewed support from fellow foster carers as vital because of their mutual understanding of the task, the lack of judgement present, and in reducing feelings of isolation. However, carers perceived that this type of support was viewed with suspicion by social workers and insufficiently utilised by agencies.
The type of agency also influenced levels of foster carers’ compassion satisfaction. Those who worked for Independent Fostering Agencies had significantly higher levels of compassion satisfaction than those working for Local Authorities. This suggests that the agency has a key role in enabling carers to remain committed to fostering and enjoying their work.
Sarah Naish, Managing Director of Fostering Attachments Ltd, which funded the study, said: “Over the years I have become aware what a dramatic impact compassion fatigue had, firstly on a personal level, then on the foster carers and adopters I worked with. This kind of research is imperative for us to establish how widespread the problem is and the implications for the whole sector.”
Dr John Simmonds OBE, Director of Policy, Research and Development at CoramBAAF, said the study provides an opportunity, which should not be missed, to drive a re-exploration of the current state of foster care and the key part that foster carers play:
“This research uniquely demonstrates the serious cost to foster carers of the role they take on. That should not be surprising but it has played little part in what we have come to see as central to the support they need as their commitment to care for a child is confronted by the impact of various forms of abuse and neglect on the child’s thoughts, feelings and behaviour. The role of the foster carer could not be more important. They are the lifeblood for the child 24/7.”
As a result of the study, the researchers, along with Fostering Attachments Ltd, are urging statutory and voluntary fostering agencies to: ensure that all staff have a good knowledge of compassion fatigue, and can identify and support (without judgement) foster carers who are suffering; improve the preparation of prospective foster carers; commission locally-based and independently run support groups that promote a safe space for carers to talk with each other and with professionals about the difficulties they face; actively promote peer support for foster carers within and across fostering agencies to provide local informal support that addresses issues of isolation; consider reviewing the remuneration of foster carers and their conditions of service; and commit to investing in respite provision which is creative, relationship-focused and responsive to need, to reduce the effects of compassion fatigue.