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Internal representations of attachment in Story Stems: changes in the narratives of foster care children

Our Assessment & Therapy Research and Development team keep up-to-date with practical approaches, enabling us to better understand and provide the best outcomes for our children and young people.

In this piece of research, our team explored the use of Story Stem Assessment Profile (SSAP), a narrative-based measure for the assessment of internal representations in children. This study is a follow-up to our first paper Exploring Attachment and Internal Representations in Looked-After Children, published in March 2020.

Representing becoming a sessional worker - a group of young children painting at a table

By Saul Hillman, Carolina Villegas, Katharine Anderson, Asa Kerr-Davis & Richard Cross


It is well-known that children who come into care have often experienced significant adversity, and frequently a discontinuity of care in the form of placement changes and potentially breakdowns. Due to such experiences, such children often develop:

  • Insecure attachments and/or attachments characterised by anxiety or avoidance. Attachment is a clinical term used to describe “a lasting psychological connectedness between human beings” (Bowlby, 1997)
  • Negative internal representations of the self, others, and the world.

The Aim of the Study

The aim of this study was to explore changes in internal representations and attachment-based narratives using the Story Stem Assessment Profile (SSAP). The SSAP is a narrative-based play assessment, which involves the sharing of a story (otherwise known as a ‘stem’) that contains a dilemma. Once the beginning of the story is shared, the child finishes the story, using their words and their actions through play. Their response helps us to understand the representations they hold of themselves, of others, and how they are when in relation to others.

The Results

Nineteen children between the ages of 5-10 years old completed the SSAP at two time points: an initial point, and one year later. Over the two time points it was discovered that:

  • Security representations increased, suggesting a reparative process may be taking place in the children’s relationships with their caregivers – within the children’s stories there was an increase in the following themes – children seeking help, adults providing help, and adults providing comfort, suggesting an increase of trust in their caregivers.
  • Avoidance traits decreased – indicating the beginnings of relational, developmental recovery.
  • However, children with fewer previous placements had lower increases in security representations. It is possible, therefore, that although changes in attachment security are possible when a child is placed in a new environment with responsive caregivers, modifying the existing insecure patterns may be a slower and more laborious process than is wanted or expected. Healing takes time.

What this Means in Practice

“It is important to hold in mind that developmental recovery and healing from adversity can take a long time.”

Positively, representations of security can develop in new placements where caregivers are reliable, consistent, and can model boundaries in their caregiving. However, patience is key here, as insecure and disorganised attachment representations, traits, and styles can be harder and slower to modify. This may be one reason why we see placement instability, as children may be showing carers their representations and experiences through their behaviours, which paint a picture of their inner world and relational experiences. It is important to hold in mind that developmental recovery and healing from adversity can take a long time.

Read the full research paper here – 

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