This may seem an unusual blog for a Child and Adolescent Therapist to write. However, throughout my working career and extensive training, I have always believed that one of the most vital parts of a child’s healing journey and often the hardest work, is the unconditional care they receive outside the therapy hour. During my training, I remember challenging a psychiatrist who spoke about how difficult the work was, with many in the group agreeing. I found myself saying, “We see the child for one session a week; carers are with them day and night, holding so much more in mind.” Suffice to say, my comment was not met with universal warmth!
When a child enters foster care, they often arrive with more than belongings. They may carry the invisible weight of Adverse Childhood Experiences, or ACEs, such as neglect, abuse, domestic abuse, parental mental health difficulties, addiction, separation, loss, instability, or chronic fear.
These experiences shape how children see themselves, adults, relationships, safety, and the world. Many have learned that adults may not be trustworthy, emotions can feel unsafe, closeness may lead to rejection, and staying constantly alert is necessary for survival.
Therapy, education, specialist support, and professional intervention all matter. But healing does not happen only in a therapy room for one hour a week.
Healing happens in “the other 23 hours.”
It happens in the ordinary, repeated, relational moments of daily life at breakfast, on the school run, during bedtime routines, after an argument, when a child refuses help, when they test boundaries, when they are frightened but cannot say so, and when they slowly begin to believe that this adult may not give up on them.
This is where foster carers become absolutely central to recovery.
What Do We Mean by “The Other 23 Hours”?
The phrase “the other 23 hours” reminds us that while therapy or professional support may offer one focused hour, most healing happens through daily relationships with carers.
For children in foster care, carers provide far more than accommodation, meals, routines, and transport. They create the relational environment where safety, trust, emotional regulation, and recovery can begin.
The other 23 hours include:
- Responding calmly when a child is dysregulated.
- Using a steady tone when setting boundaries.
- Providing predictable routines.
- Showing kindness after difficult behaviour.
- Repairing after conflict.
- Staying emotionally present when the child pushes away.
- Offering daily messages of safety, worth, and reliability.
For children who have experienced ACEs, these moments are the foundations and building blocks of healing.
Children Do Not Heal Through Consequences — They Heal Through Relationships
Children who have experienced trauma often communicate distress through behaviour. They may appear angry, controlling, withdrawn, defiant, clingy, dishonest, impulsive, or shut down. Viewed only through a behavioural lens, these responses can be misunderstood.
Trauma-informed care asks a different question.
Instead of asking, “What is wrong with this child?”
we ask, “What happened to this child, and what do they need now?”
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Refusing instructions may be a way to regain control in a world that has felt unsafe.
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Lying may reflect past experiences where honesty led to punishment or rejection.
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Sabotaging good moments may come from fear of depending on adults.
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Exploding over small changes may signal a nervous system already primed for threat.
Foster carers meet these behaviours in real time. Their responses can reinforce a child’s belief that adults are unsafe, or gently offer a new experience: an adult who stays calm, curious, boundaried, and connected. This does not mean accepting unsafe behaviour; it means holding boundaries within a safe relationship.
Predictability Is Therapeutic
For children with ACEs, life has been unpredictable: who would care for them, whether adults were emotionally available, whether home was safe, or whether their needs would be met. In foster care, predictability will be therapeutic as it instils rhythms and routines.
Regular meals, school routines, bedtime rituals, clear expectations, and reassurance all communicate safety to the child’s brain and body, gradually reducing the need for hypervigilance. A predictable carer says, through action:
- “You do not have to guess what comes next.”
- “Your needs will be noticed.”
- “Adults can be reliable.”
- “You can begin to relax.”
This takes time. Children do not simply abandon survival strategies because they are now safer; they need repeated experiences of safety before they can trust it.
Co-Regulation Comes Before Self-Regulation
Children who have experienced trauma are often expected to “calm down,” “make better choices,” or “think before they act.” Yet many have not had enough early experiences of being soothed by a safe adult, affecting their ability to manage emotions, impulses, and stress.
Before children can consistently self-regulate, they often need co-regulation.
Co-regulation is an adult lending calm to a child who cannot yet find their own. This may mean:
- Lowering your voice rather than raising it.
- Sitting nearby without overwhelming the child.
- Reducing demands when the child is flooded.
- Staying steady during conflict.
- Repairing afterwards rather than withdrawing warmth.
This is emotionally demanding and requires patience, self-awareness, and support. But when children repeatedly experience an adult who does not escalate, shame, reject, or abandon them, their nervous system begins to learn a new pattern. Over time, they internalise the carer’s calm, and this is one of the most powerful ways foster carers support healing.
The Power of Repair
No foster carer will get it right all the time. Caring for children who have experienced trauma can be challenging, exhausting, and emotionally complex. There will be moments of frustration, misunderstanding, and rupture.
What matters most is not perfection. It is repair.
Repair teaches children that relationships can survive difficult moments. For those whose early relationships were shaped by fear, rejection, inconsistency, or loss, this can be transformational.
Repair might sound like:
- “I’m sorry I raised my voice. I was frustrated, but I should have spoken more calmly.”
- “You are not in trouble for big feelings, but we need safer ways to manage them.”
Repair reduces shame, teaches accountability without rejection, and shows that conflict does not have to mean abandonment.
This healing rarely happens in formal sessions alone. It happens around kitchen tables, in car journeys, at bedroom doors, and in quiet moments after the storm has passed.
Foster Carers Help Rewrite a Child’s Internal Story
Children who have experienced ACEs carry painful beliefs about themselves, such as:
- “I am too much.”
- “I am bad.”
- “Adults leave.”
- “I have to cope alone.”
Foster carers challenge these beliefs through hundreds of small, repeated experiences.
Each time a carer stays kind after a difficult day, notices a strength, returns after rejection, or separates the child from the behaviour, “You are not bad; you are having a hard time”, shame softens. Over time, the child can begin to develop a new internal story:
- “Maybe I am worth caring for.”
- “Maybe adults can be safe.”
- “Maybe I do not have to push everyone away.”
- “Maybe I can be loved, even when I struggle.”
This is deep therapeutic work, and foster carers do it every day.
Love Is Not Always Enough — But The Relationship Is Essential
Children who have experienced ACEs need more than love alone. They may also need therapy, education support, life story work, sensory strategies, mental health support, advocacy, and multi-agency planning.
But without the daily trauma-informed foundation foster carers provide, professional interventions can struggle to take root.
- A therapist may help a child understand their story; the foster carer helps them feel safe now.
- A social worker may create the care plan; the foster carer lives it with the child each day.
- A school may support learning; the foster carer helps the child recover from the emotional demands of the day.
- A professional may offer strategies; the foster carer turns them into lived experience.
Foster carers bridge theory and healing.
They make trauma-informed care real.
Supporting the Carer Supports the Child
If foster carers are central to the other 23 hours, supporting them is essential.
Carers need:
- High-quality trauma-informed training.
- Regular supervisions and reflective therapeutic consultations.
- Emotional support after difficult incidents.
- Clear care plans and communication.
- Timely, practical support.
- Recognition of the emotional toll of fostering.
- Kindness, warmth, and care.
When carers feel blamed, isolated, or unsupported, calm, consistent care becomes harder to sustain. When they are held by a supportive professional network, they are better able to hold the child. The system around the child must also wrap around the carer.
The Ordinary Moments Are Not Ordinary
It is easy to underestimate daily care. Breakfast, clean uniform, appointments, lifts, bedtime, homework, limits, listening, and showing up again can seem ordinary. But for a child shaped by fear, neglect, chaos, or loss, these ordinary acts can feel extraordinary.
They say:
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“You are seen.”
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“You are safe.”
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“You are not alone.”
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“Your needs matter.”
The other 23 hours are where trust is built, nervous systems settle, children test whether care is real, and adults gently prove that this relationship is different.
Final Thoughts
Foster carers are not simply looking after children until professionals step in; they are central to the healing system. For children who have experienced ACEs, recovery is rarely straightforward. It is built through repetition, patience, boundaries, nurture, repair, and relationship in everyday moments that seem small but matter deeply.
Therapy, professional networks, care plans, healthcare, and education all matter.
But the other 23 hours are vital.
In those 23 hours, foster carers offer safe, steady, nurturing relationships that help children begin to believe they are worthy of care, connection, and hope.
Thank you to all our amazing foster carers.
If you would like to find out more about fostering and the amazing difference you could make in a young persons life. Give usa call on 0203 757 0070 or click HERE to receive a call back. We’d be happy to answer any questions you may have on fostering and take you through the process.