As a 麻豆原创-accredited integrative psychotherapeutic counsellor, my role with children in care is to hold a balance between expectations, systemic complexity and human resilience. Therapy is too often seen as a 'fix' for the deep wounds of developmental trauma, but research shows that children in care face a multitude of difficulties that therapy alone may not be able to untangle.
However, the therapeutic relationship can offer a safe space where the seeds of trust and healing can take root.
The landscape of adversity
According to the NSPCC, around 65% of children are taken into care because of abuse or neglect. They have all experienced adversity, an ingrained part of their lives.
Mental health care is greatly needed: roughly 45% of children in care are thought to have a mental health issue, compared to around 10% of the general child population. Studies show that the rates become higher in residential care settings, with some estimations rising as high as 70% (Mentally Healthy Schools, 2024; Cummings and Shelton, 2024).
These problems worsen when there is instability. DfE data show 10% of children in care in England experience three or more placements in one year; 27% of these vulnerable children had three or more social workers in the same period. Multiple placements and changes in staff teams remind children in care that adults might not stay.
The strength of relationship
Therapy does not fix systemic issues, but it can provide a stable space for children in care to help them live in a world that is forever changing. When placements or schools change and when social workers and carers inevitably rotate, the therapist can be a steady anchor. Children might test, doubt or oppose the therapeutic relationship at first but with time, they often learn to trust it. Each small moment of attunement, where anger is met with steadiness rather than rejection and where silence is held without demand, becomes a significant moment. Over time, therapeutic experience grows and the seeds of safety and trust are planted.
Reframing progress
This work has taught me that progress can be slow and that鈥檚 OK. It鈥檚 Tomas who comes to every session, curls up in the same beanbag but rarely speaks or engages and seems soothed by the routine, suggesting predictability, in itself, feels safer than interaction. It鈥檚 Danni who, after many weeks of solitary play, looks up and quietly invites me to enter their play.
Holding hope in the in-between
Therapists often work in the 鈥榠n-between鈥�: the space between instability and the hope of stability, between mistrust and a longing for care, and between societal expectations of a fix and the slower, more relational work of repair.
If we cannot influence a placement move, we can ensure a child knows they will be remembered. If we cannot prevent changes to social workers, we can model that there is at least one relationship where endings are acknowledged and grief is named.
Therapy isn't a miracle fix but it is a place where children in care can learn how to keep things going, experience safety and take a chance on trust. New roots can grow even in damaged soil.
