1. Monisha Nayar-Akhtar, Ph.D. Psychoanalyst New Delhi-2018
Standards of care in foster care, group foster care, after care and child care institutions in South Asia
Monisha Nayar-Akhtar, Ph.D.
Psychoanalyst
New Delhi-2018

2. UN Convention of Child Rights (1989)
Human rights treaty
Civil, political, social, economic, health and cultural rights of children
Under 18
Nations that ratify this are bound by international law
Ratified by all countries except United States

3. Does not mention mental health concerns
Promotes models of care based on a model of care defined by main tenets of “attachment theory”
Defines the role of primary attachment especially in fostering secure attachment that ensures healthy social, emotional, and cognitive development
Despite significant insights provided by this theory it has been critiqued especially in the South Asian region where cultural norms for child rearing and parenting are not defined by Western values

4. Psychological Development
The role of the extended family and the function of grandparents, aunts and uncles in the development of a child
Western based notions of individuality do not apply completely to the South Asian region. The notion of a We Self, as a construct is more applicable to this region versus the notion of I self. Thus the family structure is more nuclear and less dependent on extended family for care and nurturing.
This has implications when implement Western based ideas of care for vulnerable children for this region.

5. Vulnerable Children
Orphans and other vulnerable children are now candidates for foster care, group foster care, adoption and institutional care.
Not the purpose of this presentation to advocate for any one model
Examine instead the needs of a vulnerable child and define certain standards of care for the particular model being used.

6. Common elements
Vulnerable child, age, history of trauma, siblings, reason for admission
Transition points
Motivation of the family
Access to mental health care
Psychological mindedness of the family or institution
The vulnerable child and their relationship to the school system

7. Equipping the child with skills for long term adjustment
How do we ensure that families are able to provide the level of care especially mental health when issues arise…behavior, conduct, emotions, trauma related,
What can the family access and are they inclined to do so.

8. Foster Care
In addition to all the rights of a child defined by the UN Convention, important to keep in mind the motivations behind of the family I
Monetary advantage
What does the research show
Siblings
Age of the child
The parents mental health

9. Adoption Age of the child Peer relations that have developed
Separating siblings
Suitability of the family
Motives of the family
The adoptive couple

10. Institutional Care Age at time of admission Developmental concerns
Separating children
Building bonds with caretakers
Equipping caretakers with necessary skills
Administrative concerns
After care
Long term adjustment

11. Group Foster Care The same concerns as for institutionalized care
What is the relationship of the foster mother/father with individual children?
What considerations enter taking ‘in’ a child?
Diversity of foster care children?

12. Outcome Need research on foster care/adoption and group foster care
Also institutionalized children regarding long term adjustment
Are we able to determine certain variables that will make it possible to engage in early intervention?
Can we provide for a good enough fit between family and child?
How do we respond when a child is not adopted or taken into foster care?

13. Long term social adjustment
Once again, need research
At various stages
Early markers
Interventions
Family strengthening for the foster care and adoptive families