Results

We received 60% of screening questionnaire packs that were mailed out to foster carers. However, this required a great deal of follow-up contacts from the research team and social workers. This was an early indicator for the RCT as recruitment was one of the most difficult challenges. Our learnings from this stage included the limited resources and capacity of local authority staff and the long delays in obtaining data from them, and the importance of having a “link” member of staff.

Social workers (including service managers), clinical psychologists (including service leads), CAMHS practitioners and a local authority commissioner were interviewed to understand the impact, acceptability and feasibility of implementing a trial of VIPP-FC in a CAMHS and local authority context. These interviews were helpful in anticipating challenges that may come about due to structural factors in this context. Suggestions included taking time to build relationships with staff in the local authorities and to involve foster carers as study champions.

We had aimed for 40 foster carers and children to be included in the randomised controlled trial (RCT). However, due to many challenges in recruitment we had to revise our target. Through the hard work of the research team and the help of enthusiastic individuals in the local authorities we were able to recruit 30 families and, in total, 13 were offered VIPP-FC.

As can be seen from the diagram on the right, our main difficulty was to establish an initial contact with carers (which was possible with the return of screening questionnaires packs). But once the research team was in contact with carers, they tended to be willing to take part in the next stage. As expected, only a proportion of these was able to take part in the actual trial. Reasons for not taking part in the RCT included:

• child moving placement
• their sibling already recruited into the study
• foster carer too busy
• no VIPP-FC intervenor available     

We interviewed 11 participants who received VIPP-FC as part of the Nurturing Change study, and we have included some extracts below. Of all of the foster carers who received VIPP-FC all completed 100% of the sessions, which is a good indicator of the acceptability of the program. Carers were positive about their experiences of VIPP and all said that they would recommend it to another carer.

“I knew we had a strong bond because I could feel it but I hadn’t seen it and seeing the videos back I could actually see the bond being there.”

 “It’s definitely helped me to look at how I manage my child and how we’ve grown to love each other and have a really good connection and as I said I didn’t see that until I saw the videos so it was worth it for that.”

“There were things that were pointed out to me that I would never, ever have noticed.”

“Yeah I think it has made me sit up and think “Wow, look what you’ve done!”

“…As we got further into doing the sessions there was some useful advice on how to manage [child’s name] and their behaviours when I’m trying to do something else. So yeah some good advice and good strategies came out of it.”