A quick guide for social workers and social care practitioners
The events and experiences that resulted in a child or young person becoming looked after, together with the impact of leaving their family and known way of life, can affect their long-term physical, emotional and mental health.
A focus on their wellbeing can significantly improve outcomes for the child or young person. This can be done through enabling a strong sense of identity, positive relationships and an understanding of their early experiences. Friendships, life story work and meaningful caring relationships with trained, skilful practitioners can all help.
Relationships with people who care for and about children are the golden thread in children's lives
Relationships and wellbeing
The child or young person needs a network of positive relationships around them, with people who are genuinely caring, persistent and understanding, and there when needed.
Their social, emotional and mental wellbeing is best supported through a strong bond with their primary carer. Support this crucial relationship, and work with the primary carer to think through the child or young person’s need for affection. Appropriate physical affection (for example, through play) as part of a healthy relationship with the primary carer could be a major source of emotional stability and wellbeing, particularly for younger looked-after children. Take into account any adverse childhood experiences.
Help the child or young person develop their identity and find peer support and new friendships. Be proactive and encourage them to find and join in with activities, outings and interest groups. These might include:
- Everyday 1 to 1 activities with the primary caregiver that offer opportunities to listen and build positive relationships.
- Funded and facilitated activities that focus on emotional health and wellbeing, such as school clubs.
- Activities or outings that support the development of positive identity, such as community groups, cultural or religious events or festivals.
- Activities intended to bring children or young people, carers and practitioners together informally, such as outdoor group activities.
Consider how contact with friends can best be supported, including those friendships that existed before the child or young person became looked after.
Life story work
Life story work can help the child or young person start to understand and accept their personal history and move forwards. It should capture and embrace all aspects of their identity including ethnicity, culture, religion, sexuality and disability.
Life story work should address:
The present
Start with their identity, strengths and significant relationships.
The past
Then consider why they came into care, the reasons for any moves, important memories and relationships.
The future
Then consider building independence, careers, hopes and dreams.
Life story work should:
- Start as soon as possible after they become looked after.
- Happen at regular, dedicated times and in their preferred setting.
- Be facilitated by someone with whom they have an ongoing and close relationship. This person may change over time.
- Take a flexible approach, tailored to their developmental age and diverse needs.
- Be kept in one place and added to each time. Help the child or young person choose who it is shared with, and how and where it is stored.
Life story work with groups of siblings needs careful planning. Think about:
- How to prepare each child or young person for conversations with siblings, particularly those who are older or not in care.
- Whether sessions should be in a group or individually.
- Whether conversations might include sensitive information.
Practitioners doing life story work need the right skills and experience. You will need support from a social worker if you are not one yourself. Tell the child or young person’s wider network about the work so they can provide any extra support needed. Regularly review how contact arrangements and relationships with the birth family may be affected.
Trauma and disadvantage
All children and young people who are looked after will have experienced trauma in some way. Trauma-informed training for practitioners and sharing expertise across agencies will help ensure there is enough specialist support for those with more complex needs. You should:
Understand
The impact trauma and attachment difficulties can have, and how to respond in a way that helps the child or young person build relationships and communicate well.
Recognise
The additional disadvantage a child or young person may face because of their ethnicity, community, disability, sexuality, religious or socioeconomic background, and avoid marginalising them any further.
Remember
That unaccompanied asylum-seeking children are affected by particular issues that are additional to the disadvantages already listed. These include health needs, safeguarding issue, language, culturally sensitive care needs and the risk of going missing.
Make sure you are sensitive and empathetic in the language you use in care records and the way you describe events, bearing in mind that the people you are writing about may read them.
Further information
- NICE guideline: Looked-after children and young people (NG205)
- NICE quality standard: Looked-after children and young people (QS31)
- NICE video: The health and wellbeing of looked-after children and young people (YouTube)
- Department for Education and Department of Health and Social Care statutory guidance: Promoting the health and wellbeing of looked-after children
- NSPCC Learning resource: Achieving emotional wellbeing for looked-after children
- TED talk: How childhood trauma affects health across a lifetime (YouTube).
Download this guide
We've created a copy of this guide that you can print and share:
NICE's social care quick guide promoting wellbeing and positive identity for a child or young person who is looked after.This content has been co-produced by NICE and the Social Care Institute for Excellence (SCIE). It is based on NICE’s guideline on promoting wellbeing and positive identity for a child or young person who is looked after.