Adopted children and children who are in, or have been in, the care system can have a wide range of mental health problem as well as difficulties in school, at home and with peers. We offer a highly specialist assessment of a child or young person’s mental health and well-being across all these aspects of functioning, and then make recommendations. But why are we a different and unique service in the UK?

  We offer personalised assessments 

We are proud that we offer personalised assessment rather than ‘one-size-fits-all’ solutions for adopted and looked after children [see Assessment for more information].

We are a multidisciplinary team of clinical psychologist and child & adolescent psychiatrists with high levels of clinical expertise across a range of problems, including Post Traumatic Stress Disorder (PTSD), Attachment pathologies, and any issues around life story or related to the adoption journey. At the same time, we specialise in the identification and differential diagnosis of neurodevelopmental disorders (e.g. autism spectrum disorder, attention deficit hyperactivity disorder, tic disorder), mental health problems (e.g. anxiety, depression), behavioural problems, including a special interest in temperamental irritability and limited prosocial emotions. We routinely assess and make recommendations about risk-taking behaviours including self-harm, aggression and the child being at risk from others.

 In addition to our clinical expertise, we have a been at the cutting edge of research into the mental health needs of adopted and looked after children, and how to support their families. This means we are in a unique position to disentangle complex differential diagnosis between presentations that are purely related to the adoption status of the child, or others that may have other factors involved, and how these two interact. Differential diagnosis refers to the process of differentiating between two or more conditions which share similar signs or symptoms, and this can happen sometimes with attachment disorders, PTSD and some neurodevelopmental disorders [like autism spectrum disorder, attention deficit hyperactivity disorder] and mental health conditions [like depression, anxiety, OCD and so on]. We have found that services without this background knowledge -that as above combines clinical expertise and the research base-, can sometimes struggle to make these differential diagnoses and we find that many of the children that come to our clinic have been understood, often for many years, as if all of their problems were simply related to their adoption or care history. Sometimes they have been labelled with attachment or trauma or some other over general description when a wider bio-psycho-social formulation could have helped the understanding and also considered a range of other common disorders, the benefit of the latter being that there are clear evidence-based treatment options for them.

 This does not mean that we do not recognise the importance of forming new attachment relationships and the various possible legacies of early traumatic or adverse experiences in adopted and foster children's development, we just do not seek to lump all their issues under the same “attachment & trauma” umbrella without consideration of other potential factors in  the formulation and if applicable, disorders. And because we can conduct the whole assessment under one team, we can take a holistic view of the child, their family and their needs instead of one that is arbitrarily fragmented according to care pathways or particular treatment offers.

 We use the evidence-based interventions adapted to adoption & fostering.

In the same way that, as above, we use the latest research knowledge to ‘unpick’ and make sense of complex presentations, we also only recommend treatments that are personalised for the specific child and their family and that have been proved in research to work. Please refer to Treatment for more information, but a few examples of what we offer:

1.     Narrative exposure therapy, which combines life story work with an evidence based Trauma-focused CBT approach (Tf-CBT).

2.     Personalised Intensive Parent Training (PIPT). You can read more here.

3.     Cognitive Behavioural Therapy (CBT) for mood or anxiety disorders, adapted to adopted children.

4.     Mentalization-based therapy (MBT)

5.     Emotional regulation work.

6.     Emotional literacy work.

7.     Video-feedback intervention to promote positive parenting and sensitive discipline (VIPP-SD)

8.     Specialized parent work

 We offer personalised recommendations.

We use the latest research knowledge to ‘unpick’ and make sense of complex presentations to create treatment recommendations that are personalised for the specific child and their family. 

 We use the evidence-base and routinely measure outcomes.

As part of our commitment to evidence-based practice, in our work we always use outcome measures to see if what we are proposing is actually working. That way we can be sure that what we are doing is meeting your needs as a family, and if not, then we can review it, and try something different.

 We keep a dynamic approach and review regularly.

The needs of adopted children and their families can be very complex and it is important to keep an open mind throughout assessment and treatment to try to capture what the specific issues are for any one family. We welcome feedback from families to ensure that we are concentrating on the issues that are more important for them.

 We are flexible about timing.

We will see children and their families or carers, at any point in their journey into and out of the care system, including pre-adoption and even earlier within Care Proceedings, because we do not believe that arbitrary distinctions such as legal status should be barriers to children accessing appropriate and effective services.

 We work as part of a wider service of experts at The Maudsley National & Specialist Services.

We are fortunate to be situated within the National NHS CAMHS Services at the South London & Maudsley Hospital, amongst the National services for inpatient and outpatient (community) services and are able to draw upon expertise of our colleagues there for especially complex presentations or cross-referrals as necessary.

 We are committed to partnership working.

Although we offer a range of evidence-based treatments ourselves [see Treatment], we also regularly work in partnerships with services across the NHS, local authorities, education and the voluntary sector to devise a package of care tailored to the child and family. We believe this is a particular strength of our approach because we do not assess any child with a particular treatment package in mind and can keep options open.

 We are research experts in this area.

Our team has always had a strong research presence nationally and internationally [see Research] especially around attachment, parenting, children in care, trauma, neuropsychology and the effects of maltreatment. We continuously strive to translate research, our own and others, into clinical practice and recommendations. We are committed to using the latest evidence from research to inform our clinical work and we prioritise evidence-based treatments.