Evidence-based practice is integral to social work, as it often informs best practices. Competent social workers understand this connection in general and the ways it benefits clients in particular.
ORIGINAL PAPER Maltreated Children’s Social Understanding and Empathy: A Preliminary Exploration of Foster Carers’ Perspectives Nikki Luke •Robin Banerjee Published online: 11 February 2011 Springer Science+Business Media, LLC 2011 AbstractPrevious research suggests that parental abuse and neglect can have adverse effects on children’s peer relationships and self-perceptions. Emerging theoretical and empirical work suggests that children’s social under- standing and empathy could play a key role as mediators of these effects, but we have little knowledge about the via- bility of such a model in explaining the everyday experi- ences of children in care. Thus, in order to gain an in-depth insight into the potentiality of this conceptual model, a focus group and detailed semi-structured individual inter- views were conducted with a total of 10 foster carers. First, a thematic analysis revealed that problematic self-percep- tions and peer relationships were indeed commonplace. Crucially, in line with our theoretical model, carers readily identi ed children’s dif culties with social understanding and empathy as relevant explanations for their socio-emo- tional problems. Carers reported using a variety of strate- gies to help children, but expressed a need for a clearer training package of practical strategies that could be used to encourage social understanding and empathy in children, with the aim of improving their social relationships. KeywordsFoster care Physical abuse Neglect Child development Qualitative researchIntroduction Foster carers are regularly faced with the challenge of looking after children with social and emotional dif cul- ties. Research has shown that physically abused or neglected children are at greater risk of problematic peer relationships and negative self-perceptions than their nonmaltreated peers (e.g., Anthonysamy and Zimmer- Gembeck2007; Toth et al.1997). Understanding the mechanisms by which such socio-emotional problems may arise is crucial for informing the design of intervention strategies and support for foster carers. Two inter-related constructs likely to play a role in the developmental trajectory of maltreated children are social understanding and empathy. Social understanding, incor- porating what has been termed ‘theory of mind’, involves an appreciation of mental and affective states, including beliefs and desires, and the role that they play in social behaviour and interactions (Carpendale and Lewis2006). Empathy is de ned in terms of emotional responses to another person’s affective state, speci cally those in which the recognition of the other’s state produces a similar emotion in the observer (Eisenberg et al.1996). Problems with social understanding and empathy may serve as mediators of maltreatment effects on socio-emotional functioning, because existing research suggests that they can in uence the way children behave with their peers (Dekovic and Gerris1994), which in turn relates to peer status outcomes (Anthonysamy and Zimmer-Gembeck 2007) and self-perceptions (Bolger et al.1998). Emerging research provides tentative support for the link between maltreatment and problems with social understanding and empathy. This is a relatively recent area of research, and the variables have not yet been fully explored; for instance, there exists little research on N. Luke (&) R. Banerjee School of Psychology, University of Sussex, Falmer, Brighton BN1 9QH, England, UK e-mail: [email protected] 123 J Child Fam Stud (2012) 21:237–246 DOI 10.1007/s10826-011-9468-x maltreated children’s empathic reactions, and none on more advanced social understanding (e.g., knowing that one person can misunderstand a second person’s beliefs). However, the small number of studies that have been conducted so far are consistent with the proposal that social understanding and empathy may act as mediating in u- ences on maltreated children’s socio-emotional well-being. Maltreated children perform worse than their peers on tasks measuring false belief understanding (Cicchetti et al. 2003), and are more likely to attribute hostile intent to others in ambiguous situations (Price and Glad2003). Maltreated children also underachieve relative to peers on tests of emotion recognition (Fishbein et al.2009), and their understanding of the causes and consequences of emotions is poor (Sullivan et al.2008). Furthermore, this lack of understanding may affect children’s behavioural responses: Main and George (1985) found that maltreated children were less likely to show an empathic response to another’s distress than their peers. Notwithstanding the research described above, we know little about the role played by social understanding and empathy in maltreated children’s socio-emotional out- comes. However, this hypothesis ts comfortably with the propositions of attachment theory, which represents a dominant theoretical perspective in practitioners’ work with children (Kelly2000). The maltreated child’s internal working model (IWM) of the self in relation to others is based on the quality of the relationship with the primary carer, and acts as a template shaping the child’s expecta- tions and interpretations of subsequent relationships. Mal- treated children have often received poor or inconsistent information from caregivers about their thoughts, beliefs and feelings, impeding their ability to interpret these in other people (Pears and Fisher2005). Attachment theory can help us appreciate the role of social understanding and empathy as part of the insecurely attached child’s gener- alised representations of social relationships. Moving beyond a simplistic view of negative attach- ment, social understanding and empathic awareness can be seen as skills which emerge in the context of social rela- tionships, and whose development may be impaired in atypical rearing environments such as those provided by maltreating parents. In line with social learning theory (e.g., Bandura1973), children may view the high levels of narcissism and limited empathy seen in maltreating parents (Wiehe2003) as a model of acceptable behaviour. However, children’s interactions with their parents may provide a more powerful learning device than passive observations of behaviour. From a Vygotskian perspective, parent–child communications provide the context in which children are taught the tools for successful social exchan- ges, which are then internalised to become part of the child’s intrapersonal repertoire of skills (Vygotsky1978).Viewed in this way, impoverished or distorted interactions with caregivers may jeopardise children’s chances of developing a full complement of socio-emotional skills. As an example, maltreating mothers engage in less discussion about the internal states (IS) of self and others than non- maltreating mothers (Edwards et al.2005), and maltreated toddlers’ IS lexicons are consequently delayed and impoverished (Beeghly and Cicchetti1995). Moreover, abusive mothers’ production of less recognisable facial expressions (in comparison with nonabusive mothers; Camras et al.1988) may account for children’s poor emotion recognition skills (Fishbein et al.2009). Although repeated exposure to the displays of anger preceding harmful interactions may account for the superior recog- nition of this emotion in physically abused children (Pollak et al.2009), inconsistent information about the antecedents of emotional displays may explain why these children nd it dif cult to recognise the situations that provoke anger (Pollak et al.2000). The present study builds on these theoretical consider- ations and emerging research ndings to explore a pro- posed mediational model. Our review of the literature gives us reason to expect that interactions with parents in a maltreating context may compromise the development of children’s skills of social understanding and empathy, and that this might impact negatively on their peer relationships and self-perceptions. We therefore propose that the rela- tionship between negative parenting experiences and chil- dren’s peer relationships and self-perceptions is likely to be mediated by children’s social understanding and empathy. However, we know little about whether such a conceptual model provides a viable and plausible account of the everyday experiences of maltreated children in care. In order to make an initial evaluation of the viability of this theoretical formulation, we used focus groups and individual interviews to explore foster carers’ accounts of maltreated children’s dif culties with social understanding and empathy, and how these related to peer relationships and self-perceptions. As an exploratory study, the choice of our methodology was based on two considerations. Firstly, we wanted to draw on the experience of those who had the most frequent and prolonged contact with children in the care system. We felt that foster carers could offer a unique perspective on the details of children’s interpersonal skills and their impact on socio-emotional outcomes: it is only by listening to them that practitioners can discover how best to support them in looking after children. Secondly, we also wished to ascertain carers’ current conceptualisation of the potential mediating role of social understanding and empathy. Gathering carers’ current understanding of the importance of these skills would also enable us to assess the need for training on ways to support children in developing social understanding and empathy. 238J Child Fam Stud (2012) 21:237–246 123 We approached the current study with two research questions in mind: (1) Do carers’ experiences with mal- treated children support a model in which dif culties in social understanding and empathy mediate the relationship between maltreatment and problematic self-perceptions and peer relations? And (2) What is the current status of carers’ knowledge about—and attitudes towards—ways of supporting the children who have dif culties with these skills in order to improve their socio-emotional well- being? Methods Participants The study consisted of two parts. In the rst part, foster carers from the Local Authority’s Intensive Placement Team (IPT) attending a regular meeting were asked to participate in a focus group discussion on the subject of social and emotional problems in the children they had fostered. The focus group sample consisted of six foster carers who were members of the IPT and two social workers. Five of the carers were female, as was one of the social workers. The age of participants was not requested. The focus group was recruited as a whole via their lead social worker. Group members gave written consent for the audio recording of the discussion. For the second part of the study, we recruited four of the carers from the focus group and a further four carers from outside of the IPT. Two of these were approached by their social workers following an appeal to the social work team by the researcher. One carer was a student at the authors’ university; she recruited a friend who was also a carer as the nal interviewee. All of the carers participating in individual interviews were female and lived in urban or suburban areas in the South East of England. As in the focus group, carers’ ages were not requested. One carer had been fostering for 2 years, ve had been carers for 6 to 10 years, while two had been carers for 19 years. Of those able to calculate the number of place- ments they had experienced, two had looked after one or two children, three had cared for seven to ten, and two counted between 30 and 45 children. The ages of the children and young people in these placements ranged from birth to young adulthood. Five of the carers discussed the length of their current placement: one was in its third year, three were currently at 5 to 7 years, and one carer had been looking after the same young person for 18 years. Only one of the carers did not have a current placement; her most recent placement lasted over 5 years, and ended several weeks before the interview.Procedure A provisional interview schedule was developed to explore the topics of socio-emotional well-being in maltreated children and the potential role of social understanding and empathy in in uencing these outcomes (seeAppendix A for the nal version). The focus group was used as both a testing ground for our provisional interview questions, and as a source of data in its own right (Morgan1996). The discussion took around 75 min of a 2-h session, and was recorded using a digital voice recorder. At the beginning of the session, carers were asked to share their experiences of children who had dif culties getting on with their peers; this discussion accounted for most of the session. As par- ticipants warmed to the discussion they began questioning each other and less input was required from the researcher. However, when carers spontaneously mentioned children’s dif culties with social understanding and empathy as potential contributors to problematic peer relations they were questioned about this further. The interview schedule was largely unchanged following this session, although following an interesting avenue of discussion during the session a question was added about children’s ability to practise their social understanding in emotionally over- whelming social situations. Volunteers for individual interviews were contacted by telephone or email to arrange a convenient appointment. Interviews took place in private in participants’ homes and were also audio recorded. The interview followed a semi- structured design, which permitted exibility in the use of questions and probing of participants’ responses (Burman 1995). Interview length was determined by participants’ responses, lasting from 45 to 74 min. All interviewees were made fully aware of the purposes of the interviews prior to commencement and gave written consent for their participation. The interviews began with questions about the carers’ length of experience and number of placements. Carers were then asked to provide examples of Looked After Children who had dif culties getting on with peers (‘‘Does this child have dif culty getting on with other children?’’), or who displayed a negative perception of themselves (‘‘Do they feel very bad about themselves?’’). Carers were also asked to speculate what might have led to these dif culties (‘‘Why do you think they might have had these dif culties?’’). Next, a range of questions cov- ered speci c cognitive, emotional, and behavioural prob- lems which might lead to dif culties in peer relationships; for example, ‘‘Have any of the children you mentioned had dif culties seeing things from someone else’s point of view?’’; ‘‘Have any of them had dif culties responding appropriately to someone else’s emotions?’’ Our intention in asking these questions was not simply to establish if J Child Fam Stud (2012) 21:237–246239 123 carers could recognise these dif culties, but to understand the extent to which carers could clearly identify speci c and detailed examples of children tting the descriptions. Finally, carers were asked about the sort of strategies they might use to support children’s social understanding and empathy (‘‘How did you try to support them/work to improve their skills?’’), and whether they felt they would bene t from training in these strategies (‘‘Would you nd this useful—for you?—for the foster child?’’). See the Appendix Afor a copy of the full interview schedule. Analytic Strategy A thematic analysis (Braun and Clarke2006) was con- ducted to identify patterns in carers’ experiences with the children they had looked after. Transcripts of the focus group and individual interviews were examined and re- examined for recurring themes as data were collected. Coding of the data was performed using NVivo, a quali- tative analysis software package which allows for the organisation of themes in a hierarchical structure. In the present study, we started with a number of theoretically- derived a priori categories corresponding to our research questions. These categories are listed below: a. Self-perceptions—direct references to children’s neg- ative self-perceptions or behaviour implying negative self-perceptions. b. Peer relations—references to dif culties in establish- ing or maintaining peer relationships, or behaviours that might lead to such dif culties. c. Carers’ explanations for outcomes—references to aspects of children’s backgrounds or individualdifferences presumed to have led to dif culties with self-perceptions or peer relations. d. Social understanding and empathy—references to children’s speci c dif culties with social understand- ing or empathic responding. e. Foster carers’ strategies to support children—refer- ences to speci c or general support provided by carers or others, which might aid the development of children’s social understanding and empathy. Within these broad categories, initial coding of the data from the focus group suggested a number of potential themes where a particular idea seemed to recur across participants’ accounts. The themes were revised and re ned as data collection and analysis progressed to ensure that the nal list of themes incorporated the full range of experiences and beliefs referred to in participants’ accounts. The full set of themes is shown in Fig.1. Results Results are presented here under the headings of the ve major categories. In the interests of brevity, we provide a narrative summary of the themes relating to self-perceptions, peer relations, and carers’ explanations for these outcomes. Then we turn to our core interest in themes pertaining to social understanding and empathy, with illustrative excerpts to help us to address our key research questions. Labels following the quotes indicate the contributions of foster carers (C1–C10). As an overall summary of the data set, Table1shows the number of individual interviews in which each theme was clearly identi ed as a relevant issue. SELF-PERCEPTIONS Direct reference to negative self- perceptions Behaviour implying negative self- perceptions PEER RELATIONS REJECTED BY PEERS DUE TO: Inappropriate learned behaviours Age-inappropriate behaviour Out of control Need to control situations Needy/desperate behaviour BUT: Wish to belong CARERS’ EXPLANATIONS FOR OUTCOMES Parenting Parents’ general behaviour Child’s role in the birth family Individual differences SOCIAL UNDERSTANDING AND EMPATHY PROBLEMS WITH: Seeing others’ perspectives Lack of empathy Understanding others’ emotions Recognising motivations/desires influencing behaviour Negative/hostile interpretations of others’ behaviour Understanding consequences of own behaviour Social understanding present but overwhelmed by emotional need FOSTER CARERS’ STRATEGIES TO SUPPORT CHILDREN Specific strategies to aid social understanding and empathy General carer support Involvement in groups and clubs Access to support network Training needs Fig. 1Hierarchical representation of categories and themes arising from foster carer focus group and interviews 240J Child Fam Stud (2012) 21:237–246 123 Self-perceptions When asked whether they had looked after children who felt badly about themselves, almost all of the carers could provide examples of children who had expressed negative self-perceptions. However, children’s low opinions of themselves were not always explicitly stated, and all carers spoke of some children whose general behaviour led them to draw inferences of negative self-perceptions. Peer Relations The common view amongst carers was that most of the children they had looked after had had dif culty getting on with their peers. Carers talked about children who had been actively rejected by peers, as demonstrated when no-one turned up to their birthday parties. The foster carers’ responses clearly indicated a number of different behav- iours which proved challenging for the formation and maintenance of friendships. Often children would displayinappropriate learned behaviours, such as stealing food; these behaviours had helped them cope with a dif cult home life, but now created problems in peer interactions. Most carers also had experience of children displaying age- inappropriate behaviour. This was seen as more of a problem with increasing age, when former friends would begin to grow up and grow away from them. All carers had looked after children whose behaviour or emotions were out of control, making it dif cult for peers to feel com- fortable around them. In contrast, some children’s reaction to their background expressed itself in a need to control situations, which was not viewed kindly by peers. Other children were so desperate to have friends that they frightened peers off with their needy behaviour. Yet, importantly, in discussing the range of social dif culties for Looked After Children, carers expressed the belief that these children were not socially isolated by choice. There was a clear consensus that the children were motivated to seek out social relationships with peers and families, revealing a fundamental wish to belong. Table 1Number of interviews in which each theme was mentioned Category Theme Number of interviews (max. 8)Mentioned in focus group (y/n) Self-perceptions Direct reference to negative self-perceptions 7 n Behaviour implying negative self-perceptions 8 y Peer relationships Rejected by peers 7 y Inappropriate learned behaviours 6 y Age-inappropriate behaviour 6 y Out of control 8 y Need to control situations 7 y Needy/desperate behaviour 5 y Wish to belong 8 y Carers’ explanations Parenting 8 y Parents’ general behaviour 3 y Child’s role in the birth family 4 y Individual differences 4 y Social understanding and empathy Seeing others’ perspectives 7 y Lack of empathy 5 y Understanding others’ emotions 8 y Recognising motivations and desires in uencing behaviour 6 n Negative and hostile interpretations of behaviour 6 y Understanding consequences of own behaviour 7 y Social understanding overwhelmed by emotional need 6 y Foster carers’ strategies Speci c strategies to aid social understanding and empathy 8 y General carer support 7 y Involvement in groups and clubs 4 y Access to support network 6 y Training needs 7 n J Child Fam Stud (2012) 21:237–246241 123 Carers’ Explanations for Outcomes When asked for their thoughts on why children expressed particular dif culties, carers referred to a range of possible in uences. Perhaps unsurprisingly, much was made of the effects of good or bad parenting. However, carers also appreciated the in uence of children’s observation of par- ents’ social behaviour. In half of the interviews carers also discussed how the child’s role in the birth family might affect their self-perceptions or peer relationships. For example, one carer traced a child’s attempts to dominate peer relationships back to the reversal of caring roles she had experienced with her suicidal mother. In addition, half of the interviewees expressed the belief that individual differences in children’s temperaments and coping strate- gies might moderate the effect of parenting experiences. Social Understanding and Empathy Our key interests in the role played by social understanding and empathy were re ected in several questions to ascer- tain carers’ experiences of children who had dif culties in this area, and to determine whether this might help to explain the relationship between children’s backgrounds and their social and emotional problems. Overall, this seemed to be a widespread issue: all carers were able to provide several examples from current or previous place- ments. All but one had encountered general problems with seeing others’ perspectives: What he did wrong in that school is, he came home to me the second day and he said to me, ‘I’ve told everybody that you’re my Nan’, and I said…‘I don’t mind what you call me, but all the children from your primary school, only six went to a different school, all the others went to your school and some of them were in your class, so they know I’m not your Nan, and I think you’ve dug a little bit of a hole for yourself’. And that’s why they tease him, and he just can’t handle it at school (C5). More speci c dif culties were also described. Examples where children showed a lack of empathy towards another person’s emotional situation were given by over half of the interviewees. Carers explained this in terms of an inability to understand the other’s emotions: I lost my horse that I’d had for 20 years just before Christmas, and I can’t tell you how devastated I was…And [girl] couldn’t say anything comforting at all, she just kept really quiet, but couldn’t wait to tell anyone that she knew that the horse had died [laughs] and how sad it was, but she didn’t actually understandreally. Although she got extremely upset when one of her chickens died, because that was more personal to her. So even though she’d felt those feelings herself, she couldn’t give me any comfort at all (C8). The lack of empathic awareness was seen as playing a critical role in the children’s social interactions: [Boy] has got no compassion at all. That’s why we bought him the cat, to look after, so that he could see that other things hurt. If he can’t feel it, it doesn’t hurt. He’ll say things to people that are really unkind, but he can’t see it…(C5). As well as problems with understanding and responding to emotions, carers also cited cases where children strug- gled to recognise the underlying motivations and desires in uencing others’ behaviour. One girl failed to understand that a boy was only sending her text messages to persuade her to pass on the telephone numbers of her good-looking friends. For some children, however, the problem was not lack of understanding but misunderstanding. These were the children who displayed a negative or hostile bias in their interpretations of others’ behaviour, which foster carers perceived to have emerged as a result of their maltreatment: Well, she’s got this thing of feeling that she’s under attack, even when she isn’t. It’s a lot better than it used to be now, she used to hit out straight away if she thought that somebody said something that she felt was an attack on her. Or if somebody touched her when she wasn’t expecting it and she thought she was being attacked, she’d hit out or kick. That’s a lot better, but she still does the verbal reaction to stuff. I know it’s a protective thing that she’s learned, but she says really unkind things (C2). Many children discussed by carers also had problems understanding the consequences of their own behaviour, in terms of other people’s reactions to what they had done: Although they all want friends, they don’t understand that if you shout and scream at someone they won’t want to be your friend. But they don’t want people to do it to them. I mean [boy] used to be terri ed if anyone was aggressive towards him, although he could be aggressive really easy, be very very aggressive towards people (C8). There were plenty of examples, then, of children dis- playing dif culties with various dimensions of social understanding. However, foster carers also described some children who showed this understanding when interacting with their carers, but were unable to access it when socialising with peers. This was seen as a case of social 242J Child Fam Stud (2012) 21:237–246 123 understanding being present, but being overwhelmed by emotional need in stressful social situations: You’d talk to her about personal space, and you’d ask her to explain it back to you and all that sort of thing she’d get it, but…I think again it’s just that despera- tion of friendships and the thought processes going out, not even there when it’s happening…I think she gets herself into such a state concentrating on them being her friend that any, those rules and regulations don’t even come to the forefront sort of thing, they’re just at the back of the mind rather than the front, so I think it doesn’t even occur to her. But if you then spoke to her afterwards she would be able to tell you (C10). Foster Carers’ Strategies to Support Children Questions about the ways in which carers might tackle children’s dif culties revealed a number of speci c strat- egies used by carers to aid children’s social understanding and empathy. For most, the principal strategy was to talk through social situations with the children, encouraging them to draw on their own experiences in order to under- stand others’ points of view. This technique had been expanded by one carer to include everyday discussions about the possible thoughts and feelings of characters in television shows. Another carer had encouraged a child involved in a bullying incident to think about how their victim might be feeling and write them a letter of apology. Carers also made use of resources provided by practitio- ners, including cartoon strips and story books to encourage emotion understanding and consequences of behaviour, pictures of faces to develop emotion recognition, and specialist board games to stimulate discussion of social cues. The strategies described had met with mixed success. To close the interviews, carers were asked to identify any training needs around the areas discussed. Most were able to name courses they had attended which had touched on some aspects of social understanding or self-percep- tions, but none could recall a course that had speci cally covered strategies to encourage social understanding and empathy with the aim of improving peer relationships and self-perceptions. All but one agreed that such a course would be welcomed. Discussion Our interviews with foster carers allowed us to draw on their unique perspective on the day-to-day behaviour of Looked After Children, in order to address our research questions. A thematic analysis revealed that problematic self-perceptions and peer relationships were commonplaceamong the children discussed by these carers. The carers frequently attempted to interpret socio-emotional dif cul- ties in the light of information about experiences within the birth family. Moreover, in line with our theoretical model, carers readily identi ed features of children’s social understanding and empathy as relevant explanations for their socio-emotional dif culties. While some children were perceived to lack the understanding that might help them negotiate peer relationships, others had acquired this understanding but were unable to access it during stressful social interactions. There were also important differences in individual children’s empathic responses to others’ dis- tress. Interestingly, carers reported using a variety of strategies to help children in these problem areas. This work was seen as a long, slow process, and success was not guaranteed. Carers said they would welcome a training package of practical strategies that could be used to encourage social understanding and empathy in children, with the aim of improving their social relationships. Our primary purpose in conducting this study was to determine whether carers’ experiences with maltreated children would provide preliminary support for a model in which dif culties in social understanding and empathy mediate the relationship between maltreatment and prob- lematic self-perceptions and peer relations. In fact, carers often supplied spontaneous examples of children’s dif – culties with these skills when asked about their socio- emotional well-being. Similarly, when speci c questions were posed about social understanding and empathy, carers’ accounts of children who had trouble with these skills also made reference to the socio-emotional effects of such problems. This gives added strength to our proposed mediational model as a framework for understanding the psychosocial adjustment of maltreated children in care. First, carers had little trouble in providing examples of children displaying dif culties with what might be termed ‘mind-reading’ or ‘mentalization’: the ability to take another’s perspective and to recognise their motivations and desires. While developmental progress in these skills was not a focus of our investigation, age differences might be expected; however, carers’ accounts included examples of dif culties with mentalization skills across the full range of age groups looked after, from infants to young adults. These dif culties may develop in the context of the mal- treating family where identifying with the caregiver’s mental state can undermine the child’s own mental state by making them feel worthless (Fonagy et al.2002). This lack of understanding extended to affective as well as mental states. In line with previous research (Quinton et al.1998), carers also gave accounts of children who had dif culties in understanding and responding to emotions in others. For some of the children discussed, the problem was a misinterpretation of others’ behaviour. Speci cally, these J Child Fam Stud (2012) 21:237–246243 123 children were perceived to display a hostile bias in the way they processed their interactions with others. Pollak et al. (1998) suggest that this may be because the traumatic experiences associated with particular emotional displays in maltreating families can guide children’s interpretation of events and their choice of behavioural responses to produce a hostile bias. That foster carers’ accounts suggested that many mal- treated children showed dif culties with social understand- ing and empathy was in line with our proposed model. However, while some children lacked the understanding that might help them negotiate peer relationships, others had acquired this understanding but were unable to access it during stressful social interactions. Even for children mak- ing good progress in foster care placements, stressful situ- ations can prompt a return to the defensive strategies they developed to survive in times of maltreatment (Scho eld and Beek2005b). It has been suggested that affect regulation is a precursor of mentalization (Fonagy et al.2002); our ndings would suggest that even when mentalizing abilities have developed, the regulation of affect and behaviour is a necessary requirement for children to put this ability into practice. This may prove more dif cult for children in foster care, as maltreatment has been linked to inferior affect regulation (Robinson et al.2009). A key part of the foster carer role is to support children with such dif culties in the move towards more adaptive cognitions and behaviours (Stovall and Dozier1998). The results of our analysis indicate that one avenue for carers and practitioners to target in tackling maltreated children’s socio-emotional problems is through enhancing their skills of social understanding and empathy. Our interviewees expressed a desire to improve their knowledge of methods of support for children who have dif culty with developing or expressing these skills. The majority of our interviewees felt that they would bene t from speci c training on ways to enhance children’s skills, and that this could have a positive impact on social relationships and self-percep- tions. Offering carers the training they need to support children can combat feelings of inadequacy, which can have a greater effect on carers’ satisfaction and intention to continue fostering than even the perceived emotional and behavioural dif culties of children (Whenan et al.2009). The carers’ positive attitude to training in this area is therefore extremely encouraging. Helping a socially isolated child to learn the skills necessary for successful social interactions may have a signi cant impact on their quality of life (Daniel et al. 1999). Children who lack these skills are not a lost cause, and the foster placement should be viewed as a key context in which change is possible (Wilson2006). Indeed, Scho- eld and Beek (2005a) identi ed that the promotion of children’s capacity tore ecton self and others—preciselywhat may be lacking in many of the illustrative dif culties cited in the present investigation—is a key parenting dimension for foster carers, and one which predicted good progress in children’s behaviour and relationships. More- over, a review of the evidence has shown that in order for interventions for emotional and behavioural dif culties in Looked After Children to be effective, they must be administered directly by or in close liaison with foster carers (Rushton and Minnis2002). Given that attention to social and emotional well-being is part of the UK Gov- ernment’s statutory guidance for Looked After Children (Department for Children, Schools and Families2009), designing training to address the antecedents of children’s dif culties with peer relations and self-perceptions is vital. Conclusions Our interviews with foster carers have provided support for the proposed model, in which dif culties with social understanding and empathy mediate the relationship between maltreatment and children’s problematic peer relations and self-perceptions. Additional work is now required to explore the model further as a potential developmental explanation for maltreated children’s socio- emotional dif culties. Clearly, we must recognise that the experiences related here are associated with a particular group of individuals and may not re ect the reality for all carers. Accordingly, it is crucial for further research to evaluate the model presented here with larger and more varied samples, and with full attention to the perspectives of the Looked After Children themselves. In addition, we propose a longitudinal test of the proposed model, in which the role of social understanding and empathy as predictors of maltreated children’s self-perceptions and social rela- tions is assessed over the course of Looked After Chil- dren’s changing experiences. Such work will bene t from the use of a battery of measures to produce a more detailed assessment of chil- dren’s social understanding and empathy than is currently offered. The experiences related here by carers support the idea that maltreated children are not a homogenous group, as it was apparent that individual children displayed varying strengths and dif culties in social understanding and empathy. This is only to be expected; for example, physically abused children might be hyper-sensitive to displays of anger and more likely to show a hostile bias (Keil and Price2009), while neglected children are likely to have had an impoverished education in all types of emotion (Pollak et al.2000). Knowledge of these differ- ences will help in the design of individualised support plans that can be delivered by foster carers to improve children’s socio-emotional well-being. 244J Child Fam Stud (2012) 21:237–246 123 AcknowledgmentsWe are indebted to the foster carers and social workers who took part in the focus group and individual interviews, and to all those who helped in the recruitment of participants. Special thanks also go to the staff at the Local Authority’s Fostering and Adoption Team for their advice and support in conducting this study. Appendix A: Interview Schedule Background How long have you been a foster carer? How many children have you looked after? What age range do you foster? Tell me a bit about your current placement. Self-Perceptions and Peer Relationships Thinking about this child/these children, do they…. …have dif culty getting on with other children? …feel very bad about themselves? What kind of reputation do they have?—How do other children respond to them? Teachers? Other adults? Have you also seen this with any children you’ve fostered previously? In your experience, how common are these dif culties in foster children? Why do you think they might have had these dif culties? What is it that makes you think that? Social Understanding and Empathy Have any of the children you mentioned had dif – culties…. …seeing things from someone else’s point of view? …understanding someone else’s emotions? …understanding why someone else has done something? …responding appropriately to someone else’s behaviour? …responding appropriately to someone else’s emotions (e.g., when you are sad they become happy/angry/ frustrated)? …controlling their own behaviour? [If yes:] Do you think that’s because they don’t understand what is appropriate behaviour, or do they understand but can’t control it? Support and Training How did you try to support them/work to improve their skills? 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