A qualitative study of foster carers’ experiences of a video-feedback intervention to promote sensitive caregiving

Overview

In this chapter, we present the results of qualitative interviews conducted with foster carers who had received the modified Video-feedback Intervention to promote Positive Parenting and Sensitive Discipline, Foster Care (VIPP-FC), which focused on the practical experience of engaging with the intervention and the foster carers’ perceptions of the key processes that supported change.

Methods

Recruitment

All participants who received the VIPP-FC as part of the case series or feasibility RCT were eligible and were invited to take part in this study. Interviews were completed with 11 foster carers (nine from the RCT and two from the case series). Reasons for not interviewing eligible foster carers were as follows: two foster carers who were randomised to the VIPP-FC did not receive the intervention; in addition, one carer dropped out of the RCT prior to the intervention taking place, one child was moved before the VIPP-FC work started, one carer declined to be interviewed and we were unable to contact one foster carer.

Data collection

Interviews were conducted face to face in foster carers’ homes between January and March 2020. After addressing any questions and obtaining written consent, the interviews were audio-recorded. An interview schedule was developed in consultation with the study team and through discussion with and feedback from the study’s foster carer advisors. The interview focused on all stages of the trial process, from initial contact and screening to receiving the intervention and completing the research assessments.

Data analysis

The audio-recordings were transcribed verbatim and anonymised by a member of the research team. We adopted the same analytic approach as in the previous qualitative study, presented in Chapter 4. Thematic analysis is well suited to implementation research and provides a helpful framework for drawing out both similarities and differences among participants’ perspectives and conceptually organising emergent themes.64 This involved the researcher working systematically through the transcripts, identifying notable features of the narratives and coding/labelling them using NVivo.65 These lower-level codes were then combined to form broader themes and subthemes, and initial drafts of emergent overarching themes were teased out. The overarching themes and subthemes were then reviewed again in relation to their fit with the original narratives and were adjusted when necessary.65

Results

A summary of the key themes and subthemes is presented in Table 7.

Theme 1: motivation for taking part in the study

Participants expressed a range of reasons for taking an interest in the study; indeed, many could not confidently enough to state precisely what had led them to agree in the first place. For some of them, this may have been partly related to the somewhat lengthy process between initial contact at the screening stage to completing the intervention and feedback interviews. Participants’ expectations of the VIPP-FC varied greatly, with some clearly hopeful about the difference it might make, for example to ‘try something new’ [participant (P) 3] and ‘gain knowledge’ (P8), whereas one felt that ‘[given my experience of] things that I had done with the children before, . . . I didn’t really hold out much hope if I’m going to be totally honest’ (P1). Foster carers’ motivation and expectations about receiving the VIPP-FC responses could be divided into three subthemes: to help research, to help the child or to learn new skills.

Helping research

In many of the interviews, participants commented on the significance of this being a research trial. This was emphasised when, for example, they described their experiences of completing the screening questionnaires and research assessments:

. . . the questionnaires are important because you need them to get an idea of where the child is and where the child is going to end up at the end of it, so you need those.

Participants referred to taking part and helping with research as a key part of their motivation and described research as ‘a good way of finding out things’. Many participants seemed to have a clear understanding of the role of research in increasing knowledge and improving care, which underpinned their desire to help:

We agreed to it because I’m a great fan of studies, otherwise you don’t learn to improve and get on.

And also, if it helps other foster carers, or new foster carers in particular, yeah, I think, for young children, then that’s all brilliant.

I just hope it helps, you know if it helps you guys and your research.

One foster carer who was asked to take part after the eligibility criteria had changed owing to low initial recruitment rates explained that this was a factor that persuaded her to take part:

I thought ‘how can anything ever get better if people don’t take part?’, so that kind of swayed me, and I thought ‘you know what, I am going to do it’.

Participants’ knowledge and support for research trials was also evident when they discussed the randomisation process. All of the participants agreed that the randomisation process was not a significant barrier to them; indeed, some carers commented that they were ‘not worried’, ‘not bothered’ and ‘didn’t mind’. The participants seemed to understand that their involvement in the study and the randomisation process was crucial to the research element of the study:

I don’t think it would have worried me whichever group because I knew whichever group, whether you were in the group that was taking part and was going to be used for the study or not, it would benefit.

Overall, the majority of participants described the research assessment process as ‘interesting’. Most participants and carers had positive views of the questionnaires in terms of ease of completion and understanding. A number of participants found the questions straightforward to complete. The only negative comments about the screening process was that the questionnaires were ‘repetitive’ (P9) or, in one case, a carer felt that they were ‘not relevant’ (P7) to their child.

Helping the child in their care

Participants consistently emphasised that a key part of their motivation to take part came from a desire to help the child in their care. Two participants mentioned behaviours of the child in their care that worried them and how they had taken part in the hope that the programme would help them specifically with those concerns:

I just done it for [child’s name] really, I thought that he would get something out of it as well.

I realised that this child really needed some help with his play and getting close with trust and things, so I thought that was really important for him.

When asked what they considered when deciding whether or not to be involved, one carer said:

What benefits could come out of it for [child’s name] because obviously she needs as much help as she can get, it’s very few and far between.

Learn new skills

A number of foster carers mentioned that they had seen their involvement in the study as an opportunity to learn new skills:

Just to learn something new, tactics of what I may and not try, what may or may not work over a length of time . . . Just some insight really, some new tips and to see if any of us together could come up with something that would help in the long-term, not just the short-term.

Is it the right thing? Can we improve, what else can we do to make it better for them, their experiences, that sort of thing.

I thought it was quite a good idea to be honest, em, you know some child . . . some children are sort of struggling a little bit and you could get help from someone and they would give you advice how to do it, I think it’s worth it.

. . . because children who come into foster care, very often they have come from a difficult background, and they can’t attach to you and you end up with a child with difficult behaviour and you don’t know how to cope with it or what you can do to help them and you can be a little bit lost and it can sort of make the situation more volatile, when you are trying to do something with the child and they really don’t want to do it and you can’t think – ‘why don’t they want me to do it?!’.

Well, I just thought it would be interesting, and learning something new is always a good thing.

Theme 2: experience of the VIPP-FC intervention

In general, all participants spoke very positively of their experience of the VIPP-FC. There were three subthemes that articulated how the participants felt about their involvement in the intervention. These themes are practicalities, the relationship with the intervener and being video-recorded.

Practicalities

Foster carers’ working and family lives can present significant challenges for participating in research or indeed in any ‘additional activities’. Foster carers’ busy schedule of meetings, family contacts and paperwork all presented obstacles to be navigated when scheduling the six sessions of the VIPP-FC. However, all of the participants interviewed agreed that setting aside time for the intervener to come to them was manageable, as the intervener was able to be flexible around the child and their timetable:

. . . she came at different times, she would always text me and ask me, say she had to come at lunchtime one day to video us having lunch which wasn’t a problem and we managed that, and we managed the right time.

Not a problem at all. We arranged it around [child’s name]’s nursery.

Even when the child was at school, foster carers and the interveners were generally able to find suitable times to do the work, although this required flexibility on both sides:

We booked it in advance, so we knew, so that was, yeah, it was OK if we booked it with school and with me. We had it all worked out, so it was fine.

It was fine because we done it after school . . . Yeah so it was a lot easier. Taking him out of school ruins his routine. He wouldn’t like it.

Furthermore, the intervention took place at the foster carer and child’s home, a factor about which foster carers were very positive. They emphasised that this was preferable:

Oh no, that was brilliant, I much preferred her coming here than having to go somewhere else to have it done.

Not only did it make the intervention more convenient, some of the foster carers mentioned that they felt that it helped the child as well:

I think [child’s name] felt more at home being at home and then she could just have her lunch and pop to nursery and we could watch the videos, so I think it worked.

Many foster carers mentioned that the interveners were able to arrange sessions at their convenience and that even when there were unusual circumstances, the interveners could be flexible around it:

She fitted in very nicely and, in fact, I had builders here then and she fitted in around that and was really very, you know, great.

One foster carer mentioned a specific difficulty she had when looking after a baby at the same time as caring for the index child. The baby cried in the next-door room, but the intervener reassured the foster carer that this was OK for the intervention and, in fact, it could be important and helpful to have the child in the environment if this was how life tended to be day to day:

And she just fitted in with what we were doing and because that’s part of [child’s name]’s life as well and she said it was important to get all that as well . . . so yeah we managed.

The interview responses emphasised that practicalities were generally not significant challenges, as long as the interveners were willing and able to be flexible and understanding. With that in place, the foster carers reported that they generally found that it was easy to plan the sessions around their timetables and that the interveners were extremely flexible.

Relationship with interveners

The relationship with the intervener was consistently emphasised as a key aspect of foster carers’ experiences of the VIPP-FC. All of the interviewed participants said they had a good relationship with their intervener; they described some of them as ‘perfect’ (P5), ‘brilliant, absolutely brilliant’ (P2) and ‘lovely’ (P6).

Several foster carers described how the intervener would help them to feel at ease during the sessions:

Yeah very good, she was very relaxed, very comfortable to be around. Sort of her mannerisms and the way she spoke, how she interacted with [child’s name]. It just made you very comfortable. So, it was very comfortable to do the sessions because she made you feel comfortable.

She was really friendly, very warm, she came into the home always at a time that’s convenient for us and she never felt intrusive at all, you know she always was very calm and a great tone in the house so that was really good.

I just found her lovely and she just came in and it felt like she was part of the family really, just sat down and . . . yeah natural, natural.

She was amazing, I think she is absolutely lovely. She will try and work with you . . . nothing was a problem.

Linking to the subtheme of flexibility, foster carers also commented on how helpful it was that interveners were able to fit in with whatever the situation happened to be when they arrived, including the presence of other children in the home:

Lovely. She was really friendly, really warm. You know, really accepting of the situation here, of [child’s name], and me and his sister and just giving really good practical tips. Nah, she was fine, [child’s name] really got on well with her and thought she was great.

So, she was always very sweet with them [the other siblings] as well and, in fact, some of the activities, she did include the others, like the sandwich-making – she had them involved.

When asked, all participants said that they felt understood by their intervener and emphasised how important that was:

I think sometimes you wouldn’t understand how much that is important to a foster carer to have somebody to speak to about these kind of things and actually wants to give the time to talk about your child in that kind of level because there is a lot of tick-boxing going on with them, some people, because nobody really wants to discuss in such detail your child’s emotional needs, and that’s really good.

Being video-recorded

A majority of foster carers expressed their initial dislike of being filmed. Several participants said they felt self-conscious or embarrassed, aware of being watched, or possibly judged, or aware of how they sounded or looked:

I don’t like being videoed, I can’t stand it! No one likes it but I can’t bear it. I sound awful on it! . . . I can’t imagine a lot of people would want to be videoed! . . . I hated it, but I done it, [child’s name] wasn’t even deterred by it. He was alright, it didn’t bother him . . .. By the end I did get quite used to it, you know what I think when they video, what I don’t like, they video and you can’t speak to them. That is a bit off-putting.

No not really – just the videos! Yeah, you think ‘oh god, I’m being videoed’. But you get used to it actually, you do get better as it goes along. But you are conscious to start with. It gets better as it goes along . . .. The first one was quite, for me I was thinking ‘oh no, someone is watching me’ and that sort of thing, especially when you’re not used to it, but I think as the more videoing happened, the more you got used to it and just ignored it really once, you got used to it, you forgot, but yeah, it is just that initial getting used to.

I had to forget it was there because otherwise it would just be like ‘oh gosh, we are being watched’ and you’d be more conscious of what you were doing and saying then so just forget it was there.

One foster carer thought the videoing could be something that would put other foster carers off as they might be ‘intimidated’ (P5). However, all of the foster carers we interviewed said that, even if they had found the video-recording, or the prospect of it, difficult initially, by the end they had become used to it or tended to forget it was there, and so ultimately being filmed was not a serious problem and felt worthwhile.

Theme 3: learnings from the VIPP-FC intervention

The theme that occupied the largest portion of the narratives revolved around the positive things that foster carers felt they had learned or gained from the VIPP-FC sessions. This theme could be divided into several subthemes: strategies, techniques and tips, learning about the children in my care, noticing things I would not have noticed before, and confirmation or confidence in what I am already doing.

Learnt new skills: tips, techniques and strategies

An important aspect of the VIPP-FC intervention from the foster carers’ points of view was that they learnt new tips and techniques to help with some of the more challenging behaviours that the foster children they cared for could sometimes display:

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

Yes, because normally I would get wrapped up, got to feed the baby, ‘you play with our toys’ and then he would start throwing his toys, but now if we spend just 5 minutes – not even 5 minutes – playing pat-a-cake or singing a song, he is quite happy then just to let me feed the baby without trying to pull the bottle out of the baby’s mouth. So yeah, that has helped.

Several participants discussed how the VIPP-FC had helped them to realise how important playing with the children is for their development and their relationship, and it encouraged them to set aside time for the child:

I do give them more – even if, like, I said its 5/10 minutes more, doesn’t matter what it is that they want to do, but that’s just their 5/10 minutes . . . the only thing that I can say that has changed in relation to that is the fact they now get their own specific time every day and so they know that they are getting it, so that’s what’s special to them.

I just, I think differently when I am playing with her and it makes me think back when I looked at the videos and saw how she really, really enjoyed it, so I’d probably make a little more time to sit and play a game with her than I did before.

Some participants mentioned how the VIPP-FC changed the way in which they play with their child. One carer realised that she had been leading the play and needing the child to do things in a certain way. By watching the videos, she could see the child’s reaction when she allowed him to play in the way he would like to:

. . . how to let him lead play because that’s one thing that, watching the videos back, I didn’t do, I was always ‘no you put the cup in the saucer and the tea in the cup’, that’s how you play with it, rather than letting him play with it how he wanted, I wanted him to conform to how I thought or how things are done properly. [Laughs.] Whereas [child’s name] was better when I left him to it and let him do what he wanted, and then I praised him for doing what he wanted rather than what I wanted. So, I learnt that, I learnt to step back and not direct his play, but just join in and let him play.

Finally, foster carers also mentioned the potential scope of these skills, as they may be transferable to other children in their care. Some stated that, even if they could not use the techniques for the children they presently care for, they could understand how they would be useful in the future:

So, for me it was really interesting, possibly not in relation to [child’s name] but in relation, I could relate it to children I had in the past and then I can use everything I’ve learnt for any potential children I get in the future . . . how some children, they don’t want you to physically touch them or go near them and how you can get over that if you do have a child like that . . . I can use everything I have learnt for any future placements that we do have difficulties with.

One carer described that they already transfer the skills to another child in their care:

Yeah I think it does, it makes you notice more about how she is and how she is reacting to things from watching the videos of when you are doing things, so yeah, it does.

Reassurance and confirmation

Not only did the foster carers say that they learnt new skills, they also mentioned the benefits of having the videos to confirm and reassure them that what they already do is on the right track:

There are lots of little strategies that I was using before, that have been reinforced now, to the point of doing all of this and how they react to how I would parent.

It was good to know, you know, that the things I’m doing are correct, it’s nice to be reassured that you’re doing the right things and stuff, so yeah it was good.

. . . actually confirms what you are doing is right and how important it is for that child.

I think it would be good to do that with quite a lot of foster carers, just to reinforce what they are doing, and ‘yeah you are doing the right thing’ and even they might not realise.

Two foster carers mentioned that the intervention helped them to look at and appreciate what they had been doing as foster carers:

Yeah I think it has made me sit up and think ‘wow, look what you’ve done!’.

I watched myself do that and I said to [intervener’s name], ‘wow, I didn’t know I could do that!’.

Learning about the child in my care

Carers also expressed that they felt that the VIPP-FC had provided them with insights and helped them learn about the child in their care:

I mean, I knew that [child’s name] was quite ahead of his age and it’s reinforced that, that he is quite advanced for his age, you know he is 2 and he is counting and colours and all of that and he is quite emotionally, quite stable.

. . . how his smile got bigger when I left him to do his own things and praise him for doing his own thing, rather than me wanting to direct his play, that just sticks in my mind.

Yeah, I realised that she really enjoys reading books a lot more than I thought, because we were reading a book together in the videos and looking at her properly concentrating and you don’t see it when you’re doing it.

Another carer said that the videos helped them to notice more about their foster child’s character:

No, it was interesting to see, like the things she did surprised me in a lot of the ways. And like, she’s quite, like you can see in some of the videos she is quite, thinking about things and then deciding how she is going to react. She’s a lot more switched on than perhaps you might think.

One carer mentioned that the videos showed them that their foster child had perhaps missed out on playing. The carer described it as a ‘massive eye opener to see that he couldn’t sing Row, Row, Row Your Boat’ (P11) and they said that, since the intervention, they have ‘brought out some of the younger toys and we’ve seen he’s interacting better’ (P11).

Seeing something that I would not have noticed otherwise

Closely related to the previous theme, the majority of carers described the video feedback as helping them to see things that they would not otherwise have seen and explained that by watching the videos with the intervener they gained new insights into the child in their care:

you can really pick up things that you are doing that you don’t even realise you are doing, so that’s really . . . I thought that was really good.

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

It is quite interesting when you watch back, what you can see that you ordinarily wouldn’t . . . And they are the things that you wouldn’t normally see on a day-to-day basis. Yeah, because, I mean, the difference in size; he’s down here and I’m up there and when he’s looking at you or if he’s behind you, you don’t see the expression on his face, you don’t see the little touches that he does or, you know, the extended arm because he wants to have a cuddle, you don’t see that ordinarily. Sometimes you could miss those things.

Two carers mentioned that they noticed that more was happening for the child when they were playing that they had seen before:

I just thought that I was just playing with him [laughs], so yeah I didn’t take, yeah you don’t take those little things, you don’t take notice of them in the day to day . . . so that was really nice.

When you are playing with a child, doing stuff and then when you go through that and talk about it, afterwards you’re noticing things that you don’t notice when you’re playing. You’re noticing the child’s expression, which you might have noticed all the time, you notice when they are happy and when they are pleased, but there are other expressions in there when you are playing that you don’t notice.

One carer described a moment when the intervener helped them to notice and interpret their child’s behaviour in a very different and important way:

I learnt, to be honest with you, I know when, sometimes I don’t always know when [child’s name] is quite nervous, quite stressed a little bit, but we learnt through the sessions, little signs that he gets that I know now, when he does certain things he is going to get stressed and he is going to get worried, like he shakes his leg and I never noticed that before . . . Yeah, I still think about it now because I never picked up on it before, but I do now.

When discussing seeing the connection between the two of them, one carer was asked whether or not they felt that it was the videos that helped them see that and they responded:

Yeah definitely. Definitely, definitely. Yeah, I would never have seen it otherwise.

Seeing the attachment/bond/connection with my child

A number of carers reported that the intervention helped them to realise or become more aware of the special connection or bond that they had with the child in their care. Two carers in particular felt that, through the VIPP-FC, they came to realise how close their relationship was:

And I just thought oh yeah, I didn’t realise I had that effect on her really. It was really lovely to see that she’s made good secure attachment and yeah it was really lovely to see, really lovely.

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

You know when you sit and see her playing with me, it’s almost like I’m her mum and that she has built such a good relationship and you sort of kind of know it but you don’t really, until you see it . . . but looking back on the videos, every time I thought ‘oh god, she really does like love me’ and I can see that and she loves everything that I do with her and . . . she would look back at me and listen to me differently and she loves me interacting with her and I didn’t realise how much until you saw the videos.

I found them rewarding because I got to see the bond we had rather than, you know, just feel it, so I find it quite rewarding myself.

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.

Probably on the first video, when we watched it back, when she actually looked up into my eyes and smiled, that was quite a warm feeling, yeah.

Theme 4: future improvements

The foster carers who received the VIPP-FC as part of the study had a number of thoughts and suggestions for improvements to the project for a study. A number of the foster carers felt that the intervention should be more targeted to carers and children who need it the most. These reflected suggestions about targeting, timing and the need for local authorities to make training such as this part of routine support for foster carers and their foster children.

Targeting (who should receive the intervention)

For some carers who had looked after their child for a long time, there was sometimes a sense that, although the experience of the VIPP-FC had been very positive, their relationship was already well established and it felt less crucial:

I don’t know if it helped because we have got a good one anyway because he has been with us for 6 months anyway so . . . em . . . but I think it would help with a child that has not been with you very long, you know.

One carer described how they perceived two somewhat distinct ways in which the VIPP-FC can be helpful, reflecting earlier themes: first, even in a relationship that is going well, the carer can learn a lot that they can then apply with other children; and, second, there may be relationships in which there is real difficulty present, and the support may be more urgent and more directly helpful to the child. When asked if they would recommend the VIPP-FC, this foster carer said:

Absolutely! Personally, I think it should be rolled out to all foster carers. Probably more focused on the foster carers you pick up, foster carers that do have attachment issues with the child that they have got in placement. Absolutely brilliant for them! For me and [child’s name] yeah I’ve learnt loads and it’s been really good, but for us personally our attachment is already there and I don’t really have to build on an attachment, but I can use everything I have learnt for any future placements that we do have difficulties with. So that has been great for me, but I think a focused approach and rolling it out and going to foster carers would be a huge benefit. I think it would help a lot of placements not break down because once you understand why a child is doing it, then your whole mindset will change and you will look to manage that child in a totally different way. And I think that would be really helpful . . . I think it should be more focused, so you are not using resources when you don’t need to and I think that would be a better use of everything you’ve got in place.

Another foster carer emphasised that they had enjoyed the VIPP-FC process, but it may have been more helpful for a carer who had not had the child as long as she had:

You know, what I did think to myself, I thought for me and my little foster child, it might have been better when she was here before, when she first came into care or a couple of months in, because then her behaviours and the way she managed things were very difficult, whereas she has settled now so I do think there would have been a real big difference in the beginning, even though there was some things we saw in the videos was lovely.

Time between sessions

According to the manual, the period between the VIPP-FC sessions should be 2 weeks; however, owing to a wide variety of factors, this could sometimes be longer or, rarely, shorter. One carer felt that there had been too long between the sessions and that they would have preferred weekly sessions:

That’s the only thing I would say – I’d do it quicker . . . Yeah I think once a week maybe because it’s only an hour, but I know how children do after-school activities, do you know what I mean. So, once a week might be good or probably would have been fine.

Another carer who had received the sessions a week apart described this as a positive:

. . . for her to know that [intervener’s name] is coming the next week is better than leaving it for 2 weeks. So, no I think it worked well.

The intervention should be training

When asked, all foster carers said that they would recommend the VIPP-FC to other carers. There was a general feeling that it should be rolled out; two carers also added that it should be offered in place of training and one even suggested that it should be mandatory:

I don’t know if they should [be] made to do it to be honest, to be honest. It makes you a better foster carer and the child happier, it should be, I don’t know if it can be compulsory, I don’t know, it probably can’t.

Another carer described the training she already had in place:

It’s a 3-month, nurturing attachment course and you go once a week for 3 months, and it’s a classroom environment, and there are psychologists there, and they go through everything that pertains to attachments about, you know, these children with some of the vital building blocks and how to build attachments, and that’s great and you learn a lot, but when you come down to watching these videos back, seeing that put into practice, it all clicks into place and once that has clicked into place you can then approach that child in a totally different manner and it is . . . it is just that, it clicks in your head and you then, you see that child for what they are doing and what they have been through, rather than they are just misbehaving, so the classroom is great, but this is much, much better because you are physically there and you can see it’s relevant to you, it’s you and your child working together with somebody from the outside and they can pick things up where you can’t.

Conclusion

This qualitative study explored the experiences of foster carers taking part in a feasibility study of a modified video-feedback intervention for foster carers, the VIPP-FC. The interviews explored foster carers’ views and thoughts on all stages of the project from initial contact and screening through to engaging with the intervention itself and completing the research outcome assessments. The feedback in general was very positive. The majority of carers spoke about the importance of research and endorsed its valuable contribution towards promoting best practice in the foster care context. Foster carers were generally motivated to join the study because they wished to help the child in their care, to help research and to learn new skills.

When describing their personal experience of the intervention work, foster carers explained that it had a range of benefits. In particular, many carers felt that they had learnt new strategies that were helpful in the here and now, as well as strategies that could be transferable to other children in the future. They felt that the video feedback helped them notice behaviours and signals in the child that they would not have seen otherwise, as well as raising their awareness of their own behaviour and improving the relationship between the carer and child. They greatly valued their relationship with the interveners and were highly positive about how the intervention focuses on the relationship and on what is going well. One foster carer fed back to the study through their intervener that taking part had led them to decide to move towards permanence for the child in their care, having only taken on comparatively short-term placements in the past. When asked, all carers said that they would recommend the intervention and many took the view that the VIPP-FC could, and perhaps should, be used as universal training in the context of foster care. It is critical to note, of course, that the foster carers whom we were able to interview were a small subset of the larger group of foster carers in the study and the views of those with whom we were not able to engage may be quite different from the views presented here. Throughout the project as a whole, a key challenge was recruitment, and so understanding the barriers to engagement for the wider population of foster carers continues to be an important goal for future research.