This guideline covers the identification, assessment and treatment of attachment difficulties in children and young people up to age 18 who are adopted from care, in special guardianship, looked after by local authorities in foster homes (including kinship foster care), residential settings and other accommodation, or on the edge of care. It aims to address the many emotional and psychological needs of children and young people in these situations, including those resulting from maltreatment.
This guideline included recommendations on:
- principles of care
- supporting children and young people with attachment difficulties
- assessing attachment difficulties
- interventions for attachment difficulties in children and young people on the edge of care
- interventions for attachment difficulties in children and young people in the care system, subject to special guardianship orders and adopted from care
- interventions for attachment difficulties in children and young people in residential care
Who is it for?
- commissioners and providers of health and social care services
- schools and other education providers
- all health and social care professionals working in a range of community (including fostering, residential and kinship care settings), primary care, secondary care and secure settings who have contact with children and young people who are adopted from care, in special guardianship, looked after by local authorities or on the edge of care
- all educational staff working in schools and other education settings (including early years) who have contact with children and young people who are adopted from care, in special guardianship, looked after by local authorities or on the edge of care
- children and young people with attachment difficulties and their families and carers
Guideline development process
The recommendations in this guideline represent the view of NICE, arrived at after careful consideration of the evidence available. When exercising their judgement, professionals are expected to take this guideline fully into account, alongside the individual needs, preferences and values of their patients or service users. The application of the recommendations in this guideline is not mandatory and the guideline does not override the responsibility of healthcare professionals to make decisions appropriate to the circumstances of the individual patient, in consultation with the patient and/or their carer or guardian.
Local commissioners and/or providers have a responsibility to enable the guideline to be applied when individual health professionals and their patients or service users wish to use it. They should do so in the context of local and national priorities for funding and developing services, and in light of their duties to have due regard to the need to eliminate unlawful discrimination, to advance equality of opportunity and to reduce health inequalities. Nothing in this guideline should be interpreted in a way that would be inconsistent with compliance with those duties.
Commissioners and providers have a responsibility to promote an environmentally sustainable health and care system and should assess and reduce the environmental impact of implementing NICE recommendations wherever possible.