Monisha Nayar-Akhtar, Ph.D. Psychoanalyst New Delhi-2018 Standards of care in foster care, group foster care, after care and child care institutions in South Asia Monisha Nayar-Akhtar, Ph.D. Psychoanalyst New Delhi-2018

UN Convention of Child Rights (1989) Human rights treaty Civil, political, social, economic, health and cultural rights of children Under 18 Nations that ratify this are bound by international law Ratified by all countries except United States

Does not mention mental health concerns Promotes models of care based on a model of care defined by main tenets of “attachment theory” Defines the role of primary attachment especially in fostering secure attachment that ensures healthy social, emotional, and cognitive development Despite significant insights provided by this theory it has been critiqued especially in the South Asian region where cultural norms for child rearing and parenting are not defined by Western values

Psychological Development The role of the extended family and the function of grandparents, aunts and uncles in the development of a child Western based notions of individuality do not apply completely to the South Asian region. The notion of a We Self, as a construct is more applicable to this region versus the notion of I self. Thus the family structure is more nuclear and less dependent on extended family for care and nurturing. This has implications when implement Western based ideas of care for vulnerable children for this region.

Vulnerable Children Orphans and other vulnerable children are now candidates for foster care, group foster care, adoption and institutional care. Not the purpose of this presentation to advocate for any one model Examine instead the needs of a vulnerable child and define certain standards of care for the particular model being used.

Common elements Vulnerable child, age, history of trauma, siblings, reason for admission Transition points Motivation of the family Access to mental health care Psychological mindedness of the family or institution The vulnerable child and their relationship to the school system

Equipping the child with skills for long term adjustment How do we ensure that families are able to provide the level of care especially mental health when issues arise…behavior, conduct, emotions, trauma related, What can the family access and are they inclined to do so.

Foster Care In addition to all the rights of a child defined by the UN Convention, important to keep in mind the motivations behind of the family I Monetary advantage What does the research show Siblings Age of the child The parents mental health

Adoption Age of the child Peer relations that have developed Separating siblings Suitability of the family Motives of the family The adoptive couple

Institutional Care Age at time of admission Developmental concerns Separating children Building bonds with caretakers Equipping caretakers with necessary skills Administrative concerns After care Long term adjustment

Group Foster Care The same concerns as for institutionalized care What is the relationship of the foster mother/father with individual children? What considerations enter taking ‘in’ a child? Diversity of foster care children?

Outcome Need research on foster care/adoption and group foster care Also institutionalized children regarding long term adjustment Are we able to determine certain variables that will make it possible to engage in early intervention? Can we provide for a good enough fit between family and child? How do we respond when a child is not adopted or taken into foster care?

Long term social adjustment Once again, need research At various stages Early markers Interventions Family strengthening for the foster care and adoptive families