A thematic synthesis of foster carer experiences when engaging in attachment-informed interventions for children in care

Research indicates that children and young people in foster care frequently experience attachment-related difficulties that are associated with social, emotional, and behavioural challenges and later psychopathology. Accordingly, attachment-informed interventions are often considered an appropriate way to help care-experienced young people and their carers. Here, a thematic synthesis approach is employed to explore the experiences of foster carers who engaged in attachment-informed interventions. Thirteen intervention studies containing qualitative data, at least partly informed by attachment theory, were identified from six electronic databases in March 2024. The studies included in this review were published between 2008 and 2023. The included studies were evaluated for their limitations using the Critical Appraisal Skills Programme (CASP) checklist. Adhering to the guidelines for thematic synthesis provided by Thomas and Harden (2008), four overarching themes were identified: ‘carers’ perceptions of the salient aspects of the intervention’, ‘a process of change’, ‘relating with others’, and ‘barriers to change’. Confidence in the findings of this review was evaluated using the GRADE-CERQual approach. The synthesis of these articles highlights the impact of attachment-informed interventions in providing psychoeducation, facilitating reflective processes, and fostering connections to support foster carers in meeting the complex needs of the children in their care. The review also identifies foster carers' systemic challenges and the need for longer-term intervention and follow-up to fully implement and measure the impact of interventions informed by attachment theory.