CareME – An attachment-based intervention for caregivers working in residential care settings

Attachment theory origins can be traced back to the work that Bowlby has conducted in his early career as a volunteer in residential institutions for disturbed children (Eagle, 2013). Since then, attachment theory has made distinctive contributions for child and youth protection policies by addressing the “ill-effects of deprivation” of parental care (e.g., Bowlby & WHO, 1952, contributions for UN programme for the welfare of homeless children). In this report, Bowlby already advocated for the professionalization of careers as a key strategy for understanding and dealing with mental health symptoms such as depression, aggression and regression (Bowlby & WHO, 1952). Nowadays, although it is consensual the need to provide professional care to children and youth under legal protection and promotion measures, namely in out-of-home care, training care practitioners in mental health and human relations is still very residual. In fact, the absence of training and supervision, in line with poor conditions of employment, is an important predictor of high staff turnover in this domain (Colton & Roberts 2004; 2007). Portugal has one of the highest rates of children and young people living in residential care settings in Europe (Delgado & Gersão, 2018), contrasting with the lower rates of foster care placements. Although important changes in legal frameworks concerning both residential and foster care systems have been conducted recently, the vast majority of out of home care is conducted in residential care settings, with institutionalizations that range from less than 1 year and 6 or more years (M = 3.4 years) (ISS, 2020). The main aim of this paper is to present an attachment-based intervention programme developed for caregivers working in residential care settings. This intervention is part of a major action research project, CareME, that includes a multi-informant (directors, caregivers and adolescents) 4 wave longitudinal study. The project also aims to evaluate the effects of the intervention with the caregivers on the psychosocial development of adolescents that live in residential care. This project results from the collaboration of two universities from the North of Portugal, the National Public Social Security Sector - Porto district and includes the participation of caregivers and adolescents living in 21 from a total of 24 residential care facilities operating in the Porto district. We will identify and discuss the major contributions of the intervention programme for improving caregivers’ sensitivity and emotion regulation when working with youth in residential care. We will focus on the caregivers’ attachment representations and the use of reflective functioning to improve mentalization processes in the relationship with youth. The presentation will also discuss the participants’ feedback of the intervention (preferred themes, approaches and practices), and representations of the intervention's applicability/usefulness.