Caring for the carers’: a systematic review of the conceptualisation of social support and an empirical investigation into compassion fatigue and associated factors, both in foster and kinship carers

Abstract

RATIONALE: Caring for an accommodated young person, who may have suffered trauma or neglect, is a complex and often emotive 24/7 role. Compassion fatigue has been identified in ‘helping professionals’ such as nurses who care for traumatised others. Research has begun to investigate whether compassion fatigue is present in foster and kinship carers. Factors that have been associated with compassion fatigue in helping professionals are: mentalising, attachment style, self-efficacy, and social support. Whether this will be similar in foster and kinship carers is unknown, however has implications on potential support to this population, as well as for the wellbeing of caregiver and child. There is also limited understanding of how social support itself is conceptualised in carers.

METHODS: The thesis systematically reviewed the available evidence regarding how social support is conceptualised in foster and kinship carers, to ascertain whether previous conceptualisations can be applied to this group. It then assessed levels of compassion fatigue within this population and assessed associations of mentalising, attachment style, self-efficacy, and social support on compassion fatigue.

RESULTS: Previous models of social support apply to foster and kinship carer populations; with perceptions that formal services were not meeting the emotional needs of caregivers, which had wider repercussions on the conception of social support. The time at which social support was given also greatly impacted perception of support. Additionally, foster and kinship carers did not have elevated levels of compassion fatigue compared to the general population of ‘helping’ professionals.

Increased risk of compassion fatigue was associated with lower levels of parenting self-efficacy, greater avoidant attachment styles and greater discrepancies between enacted and perceived social support.

CONCLUSIONS: The thesis highlights the importance of exploring caregivers’ perceptions of supports and evaluating whether a support meets their needs; the mere increase of a support without understanding its function is not acceptable. No elevated levels of caregivers at high-risk for compassion fatigue found within the study are discussed in light of the timing of data collection and sampling strategy during COVID-19 restrictions. Associations between social support and avoidant attachment style, in regards to caregivers accessing entitled supports, have clinical implications for services.