Explain attachment to a foster carer and plan care — CASC communication station

Station brief

Format. Communication station, approximately 7–10 minutes active time after reading. You are the psychiatry registrar in a CAMHS clinic.[2]

Candidate instructions. Meet the foster carer of a 6-year-old boy with early severe neglect. Explain attachment in plain language (secure base / safe haven). Distinguish everyday insecure patterns from Reactive Attachment Disorder and Disinhibited Social Engagement Disorder. Validate that current caring is part of the solution, not the cause. Address an offer of holding therapy. Agree a collaborative plan: stable sensitive care, assessment of comorbidity, school strategies for social boundaries, multi-agency support. Check understanding; avoid jargon piles and blame.[1][2][3]

Candidate scenario

The child lived in neglectful care until 18 months, then two failed placements, now with you (the carer) for 4 months. He sometimes does not come for comfort when hurt, and at the park he walks up to strangers and has tried to leave with them. An online parent group suggested forced holding until he “releases rage.” The carer is exhausted and worries services think she is failing him. No current disclosure of physical abuse in your home; school attendance is good.[2][4][5]

Marking domains

• Empathy, non-blaming stance, jargon control
• Explains secure base and safe haven accurately in plain language
• Distinguishes style/pattern from RAD and DSED with insufficient-care criterion
• Applies both possible phenotypes to the child’s story without overconfident labelling
• Explicitly refuses coercive holding therapy and gives safety rationale
• Collaborative plan: carer support, sensitivity, stability, school boundaries, further assessment (ASD/ADHD/trauma as needed)
• Checks understanding; invites questions; safety/net for carer stress
• Does not invent medication as primary attachment cure [2][3][4]