Group dynamics in the delivery of the Reflective Fostering Programme: managing ‘face-threat’ risks in a mentalization-based intervention for foster carers

Abstract

Interventions aimed at enhancing the reflective capacity of parents and carers (their ability to think about their own and their child's mental states, and how these underpin behaviour) aim to improve the quality of the carer-child relationship and child wellbeing. Evaluating how implementation of such interventions for foster carers interacts with the wider context of social care is vital for understanding how intervention mechanisms function. The Reflective Fostering Programme (RFP) is a mentalization-based, psycho-educational intervention delivered across 10 sessions to groups of 5–10 foster carers. Video-recordings of sessions were collected between April 2020 and December 2023 in three sites taking part in a randomised controlled trial in the United Kingdom. Group size in our sample ranged from 5 to 8 people (18 in total). Most participants were foster carers (n = 16), with the remaining (n = 2) kinship or connected carers. In close alignment with the demographic characteristics of carers in the UK, the majority (n = 15) were female, and White British (n = 17). Drawing on Goffman's concept of ‘face threat’, we used conversation analysis to examine the enactment of reflective fostering mechanisms within sessions to explore how the wider children's social care system shaped implementation and mechanisms of change. The development of supportive and trusting group dynamics was critical for facilitating engagement and participation with RFP. However, a supportive dynamic was contingent on carers navigating ‘interactional dilemmas’ to manage face-threatening risks to their personal and professional reputations. Active engagement with RFP relied on successful mitigation of these face-threats. In doing so, an interactional space was afforded for carers to practise and develop their reflective capacity. These findings highlight how implementation of RFP and other group-based foster care interventions need to carefully consider pre-existing relationships, the distribution of power, and strategies for creating a space for carers to overcome potential face-threatening risks and share difficult experiences. Social care services can facilitate implementation by creating a supportive environment which acknowledges and validates carer stress and vulnerability.