Clinical application of attachment theory in permanency planning for children in foster care:: The importance of continuity of care

Permanency planning is a critical issue facing all children in foster care. Foster children frequently suffer from developmental delays and severe behavior problems, often leading to repeated displacements that in turn increase the risk for attachment disorders. To prevent the emergence of such disturbances, an Attachment Clinic was developed in Montreal to offer consultation to Youth Protection workers. A specific problem has frequently been identified in this Clinic: Should a child who has developed a significant attachment to his or her foster parents return to the biological parents or stay in the foster family? The choice between the two families is even more difficult when the parenting competencies of the biological parents seem to have progressed while the child has developed secure attachments in the foster family. Clinical cases will be presented to illustrate such dilemmas. Concepts rooted in attachment theory have been very useful to understand such problems, and have led us to believe that children's best interests lie in the preservation of their attachment ties and that repeated ruptures of such ties constitute a severe trauma. Resistances of the milieu to our position will be discussed as well as the Court's decisions in light of Canadian jurisprudence.