Looked after and adopted children are among the most vulnerable in our society and it is well established that they present with a higher prevalence of mental health problems than children who live with their birth family. In their histories, they frequently have birth parents who have lived chaotic lives, some with mental health problems and substance misuse, and have experienced disruptions of care as well as exposure to neglect and/or abuse. However, often when they try to access mental health services, all their problems are formulated as ‘trauma and attachment issues’ with lack of data to support these. This article presents a case study of a 15-year-old boy whose severe difficulties were understood and formulated in terms of ‘attachment problems’ for many years. Neuro-developmental issues, unrelated to his being removed from his birth parents and adopted, had not been considered as the biological factors of the formulation (e.g. genetics and intra-uterus events) were ignored. Because there are no evidence-based interventions for a vaguely defined presentation such as ‘attachment problems’, he was given non-evidenced therapies for years and the parents felt blamed. Understandably, there was then little progress with his difficulties and this in turn had a very detrimental impact on his family, academic and social life. It is recommended that looked after and adopted children have their presentations formulated using a biopsychosocial model that takes into account their complexities to personalise future interventions, just like children who live with their birth parents. It is imperative they stop receiving mental health services where ‘one size fits all’ and that the training of staff working with this group ensures that children’s whole life experiences are understood.

中文翻译：

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照顾和收养儿童：将最新科学应用于复杂的生物心理社会公式

被照顾和领养的儿童是我们社会中最脆弱的群体之一，众所周知，与与出生家庭生活在一起的儿童相比，他们的心理健康问题发生率更高。在他们的历史中，他们的亲生父母经常过着混乱的生活，有些人有心理健康问题和药物滥用，经历过护理中断以及被忽视和/或虐待。然而，通常当他们尝试获得心理健康服务时，他们的所有问题都被表述为“创伤和依恋问题”，缺乏支持这些的数据。本文介绍了一个 15 岁男孩的案例研究，多年来，他的严重困难被理解为“依恋问题”。神经发育问题，由于忽略了配方的生物学因素（例如遗传学和子宫内事件），与他被从亲生父母带走并被收养无关，没有被考虑。由于没有针对诸如“依恋问题”之类的模糊定义的表现的循证干预措施，他多年来一直接受无证据的治疗，父母感到受到指责。可以理解的是，当时他的困难几乎没有进展，这反过来对他的家庭、学业和社交生活产生了非常不利的影响。建议照顾和收养的儿童使用生物心理社会模型制定他们的陈述，该模型考虑到他们的复杂性，以个性化未来的干预措施，就像与亲生父母住在一起的儿童一样。