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Child and Adolescent Adoption and Fostering Service

How our service can help you

We provide a specialist service for children and young people who are fostered or adopted and who are experiencing difficulties.

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.

These difficulties may relate to issues that are specific to adopted children (attachment, trauma, life story, placement difficulties, degree of contact with siblings or birth family, permanency planning), as well as other aspects of mental health, including neurodevelopmental disorders, mood disorders, behavioural problems. We always consider a child or young person's particular circumstances of being adopted, fostered or under Special Guardianship Orders.

Our services:

  • Individual assessment of attachments and identity in the context of the child's life story
  • Specialist neuropsychological and neurodevelopmental assessments
  • Personalised assessment of any other mental health issues such as trauma, mood, etc
  • Individual psychometric assessment of abilities and emotional profile
  • Educational attainment assessment and current school functioning by talking to teachers
  • Parenting support: Personalised Individual Parent Training (PIPT)
  • Individual Therapy
  • Group work
  • Medication
  • Consultation for local Authorities, private adoption and fostering organizations, Residential Home and Therapeutic Communities.
  • Training for parents and professionals

We accept referrals from:

  • Social Care professionals: Social Workers, Regional Adoption Agencies, private and voluntary agencies.
  • Parentsand Special Guardians via their Social Workers
  • Health professionals:GPs, any CAMHS professionals, Consultant Psychiatrists, Consultant Paediatricians
  • Education professionals:Educational Psychologists, Teachers, SENCOs, etc

  • Service Type: Child and Adolescent Mental Health Services (National and Specialist) Service Borough Covers: National (Child and Adolescent services) Treatment type: Outpatient
  • Contact the service

    Site Location: Maudsley Hospital Email: CAFTservice@slam.nhs.uk Phone Number: 020 3228 2546
  • Disabled Access:
    • Wheelchair accessible building
    • Ground floor therapy rooms
    • Accessible toilets on all levels
    • Lift access to the 1stfloor.
  • Address: The Michael Rutter Centre
    Maudsley Hospital
    De Crespigny Park,
    London,
    SE5 8AZ
  • Business Hours/Visiting Hours: Monday to Friday, 9am to 5pm
  • Other essential information

  • Conditions: Anxiety, Attention deficit hyperactivity disorder (ADHD), Autism, Conduct disorder, Depression, Eating disorders, Learning disabilities, Post-traumatic stress disorder (PTSD), Psychosexual

Interventions

Assessment

The foundation of our interventions is a thorough individualised multidisciplinary assessment. It provides a comprehensive formulation of the child’s strengths, difficulties, needs and protective factors – across the whole range of mental health disorders.

We consider information from different sources and the child's presentation in different settings, such as home, at school, and in our clinic.

We use the formulation to develop a care plan, which may address a range of problems, for example mental health, educational engagement, and home needs. Behavioural problems can be, for example, the expression of a child’s high levels of irritability, or frustration due to problems with learning or inability to focus, or a traumatic experience, a mood disorder, sensory overloading, etc. In addition, it can appear together with “Limited Prosocial Emotions” (for example, with unusually low levels of guilt or remorse) or not. Disentangling the above will guide us into what treatment to recommend (see below).
 

Treatment

Our clinicians are skilled in a range of evidence-based therapeutic interventions that includes one-to-one sessions, individual parent work (PIPT), group sessions, and medication advice. All of these options can be tailored to suit your family's needs.

Parenting support: personalised individual parent training (PIPT)
Also known as the parent-child game (PCG), PIPT is an intensive parenting program designed to promote a positive attachment relationship between a parent (or carer) and a child by reducing children's oppositional and antisocial behaviour and increasing their prosocial behaviour and compliance.

We work collaboratively with families, using our expert knowledge and the parent's understanding of their child. It is based on social learning theory and attachment theory principles, and is evidence-based, which means that it has been shown to be effective in multiple trials and settings. This approach is also recommended by the NICE guidelines for more complex family situations. Its effects can be seen fairly quickly, so it is very popular with parents.
 

Individual therapy

Our clinicians are trained in a range of evidence-based individual therapies and have a wealth of experience working with children and young people that present with behavioural problems. Some of the treatments we offer include:
 

  • Cognitive behaviour therapy (CBT) to assist young people with conditions including depression and anxiety disorders which can co-occur with behavioural problems, or be masked by the disruptive behaviour presentations
  • Trauma-focused CBT for children that are experiencing Post-Traumatic Stress Disorder (PTSD)
  • Psychoeducation: for parents, teacher and the child if we identify triggers that regularly upset the child and present as “meltdowns”
  • Psychoeducation for the parents on the neurodevelopmental basis for irritability and emotional regulation work for the child
  • Psychoeducation for the parents on Limited Prosocial Emotions (LPE), as these children will not respond to standard parenting techniques
  • Social skills work for the child
  • We can also work closely with schools to help generalise the effects of intervention and to provide psychoeducation

 

Medication

We only recommend and use evidence-based interventions. Medication follows diagnosis of a particular condition, so we will only prescribe if it is supported by research and recommended in the NICE guidelines for each specific disorder.

If we decide to do a trial of medication, we provide written information, so the family can read this in their own time and return with any questions. Then we will have a session of psychoeducation with the family to discuss the different options. We understand that this is an important decision and that parents and the child need to understand the rationale behind this.
 

Consultation

In addition to our regular clinical work and training provision, we provide consultation regarding complex cases especially for older children and young people with complex presentations, in which challenging behaviours co-occur with identified or suspected neurodevelopmental problems, issues of mood or anxiety, limited prosocial emotions, or other complicating factors.

Although not a routine part of our work, we can also provide expert assessments for Courts in certain cases, especially those that have a specific issue around parenting capacity for managing challenging behaviours in the light of child factors.
 

Training

We offer professional and bespoke training for professionals from a range of different services, and directly to parents, carers and pre-adopters.

For example members of the team lead the challenging behaviours programs for London and the South-East as part of the Children and Young People’s Mental Health training (formerly CYP-IAPT) for the Postgraduate Diploma in Parent Training; Child Well-being Practitioners (CWP) and Education Mental Health Practitioners (EMHP).

Find out more
 

Research

Our service has strong links with several academic institutions, particularly King's College London, with a strong emphasis on parenting and attachment, and especially the influence of child factors that complicate the delivery of standard, “off-the-shelf” parenting programmes and also the personalisation of parenting training to better address engagement and barriers to access.

Find out more

Eligibility criteria

  • Pre and primary school aged children up to 9 years old
  • We also offer assessment and consultation for children and young people over 9 years old who have complex behavioural presentations and comorbidities


For adopted or fostered children, and young people with a range of emotional and behavioural issues, please see our  Adoption and Fostering service page.

Outcomes

After assessment:

  • A written report will be provided to the family which will include a biological, psychological and social formulation of possible factors that are contributing to challenging behaviour problems. This will also an account of the specific form of those behavioural difficulties.
  • We will include diagnoses as applicable
  • The child and family will be provided with evidence-based personalised recommendations based upon the specific formulation of behaviour problems and associated issues

 

After treatment:

  • Reduction in antisocial and oppositional behaviours in the home and school
  • Improved parent and child relationship
  • Development of more secure attachments and better affect regulation, with fewer tantrums and angry outbursts
  • Increased engagement in education due to reduced hyperactivity, oppositional behaviour and improved emotional regulation

Teaching and Training

The Conduct Problems Team offers a range of teaching and training, including continuing professional development courses from Health Education England. This includes training on Personalised Individual Parent Training (PIPT), guided self-help approaches for practitioners, as well as supervision in these models of working.

We can also offer training on the neurobiological legacy of early maltreatment and neglect which can be helpful in some cases of children with challenging behaviours.

Our team also offers training, advice and consultation to specialist services such as tier 4 inpatient units, and residential placements on ways to assess, formulate and manage complex challenging behaviours.

Our experts

Dr Rafael A González, Senior Clinical Psychologist - Read more

Dr Matt Woolgar, Consultant Clinical Psychologist - Read more

Dr Carmen Pinto, Consultant Child and Adolescent Psychiatrist - Read more

 

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