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The Dance of Attachment - Child Centred Practice

The Dance of AttachmentThe Dance of AttachmentThe parenting challenge for carers fostering or adopting children with Attachment difficultiesKim S. GoldingSensitive parenting: parent meets the Attachment needs of the Child Secure AttachmentChild signals Attachment needs clearlyDancing the Same StepsDancing the Same StepsSecure AttachmentSecure Attachment Secure Base The world ExplorationNeed for comfort and protection Dancing Different StepsDancing Different StepsFoster/Adopted Child signals Attachment needs in a distorted wayCarer tries to meet the needs sensitivelyChild resists sensitive parentingChild re-enacts early experience & resists changeDeveloping a Complex DanceDeveloping a Complex DancezResponding to expressed to hidden Child into a new Dance within which they can express their needs openly and respond to sensitive Attachment Ambivalent

Case Study zJane’s foster carers offer her a close and loving relationship. zThe foster mother wants to give Jane the experience of a loving mother that she didn’t have herself, because her mother left them when she was 3 years old.

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Transcription of The Dance of Attachment - Child Centred Practice

1 The Dance of AttachmentThe Dance of AttachmentThe parenting challenge for carers fostering or adopting children with Attachment difficultiesKim S. GoldingSensitive parenting: parent meets the Attachment needs of the Child Secure AttachmentChild signals Attachment needs clearlyDancing the Same StepsDancing the Same StepsSecure AttachmentSecure Attachment Secure Base The world ExplorationNeed for comfort and protection Dancing Different StepsDancing Different StepsFoster/Adopted Child signals Attachment needs in a distorted wayCarer tries to meet the needs sensitivelyChild resists sensitive parentingChild re-enacts early experience & resists changeDeveloping a Complex DanceDeveloping a Complex DancezResponding to expressed to hidden Child into a new Dance within which they can express their needs openly and respond to sensitive Attachment Ambivalent

2 Attachment PatternPattern Secure BaseThe world Need for comfort and protection You will attend to me, I fear abandonment Parenting the Child With an Parenting the Child With an Ambivalent Attachment Ambivalent Attachment PatternPatternExpressed need :zReassurance of availability when Child needs and and emotion that is need:zSupport to be apart from you need help to be apart and to feel secure that you will be there when Attachment PatternAvoidant Attachment Pattern Secure BaseThe world Exploration I will do it by myself, I fear closeness Parenting a Child With an Parenting a Child With an Avoidant Attachment PatternAvoidant Attachment PatternExpressed need:zI don t need need:zHelp to feel comfort and safety with to accept emotion that is Disorganized/Controlling PatternPattern Secure BaseFrightening The world I am powerful, I am scared, I fearParenting the Traumatized Parenting the Traumatized need:zI need to be in need:zNeed help to feel low stress a Dysfunctional DanceDancing a Dysfunctional DanceFostering a Child with Attachment difficulties can lead to complex feelings within the : the Child projects feelings that the carer picks up and experiences as his/her for unresolved issues: the Child evokes feelings in the carer that trigger a reaction to a past relationship.

3 The carer responds automatically and stops being able to respond a Dysfunctional DanceDancing a Dysfunctional DancezThe carer is left feeling angry, sad or feelings are communicated to the Dance becomes even less StudyCase StudyzJane was removed from her mother when she was 30 months old because of her mother s mental health is placed into a short term foster behaviour becomes increasingly difficult and she moves into a new short term initially settles in very easily and appears to get on well with all family review it is decided to pursue adoption for Jane, but the foster carers are willing to offer long term foster StudyCase StudyzJane s foster carers offer her a close and loving relationship.

4 ZThe foster mother wants to give Jane the experience of a loving mother that she didn t have herself, because her mother left them when she was 3 years resists this. She becomes very rejecting and self pushes her carers into a distant and frustrated relationship to StudyCase StudyzJane becomes very aggressive towards the foster carers own can no longer baby sit because of Jane s adoptive family has yet been carers wait to hear whether she will be staying with them or moving. They are uncertain about what is best for Task Parenting Task zProvide a home where emotional, behavioural and developmental needs are and , contingent & responsive nurturing and appropriate need for dependence and independence at different developmental Challenge of This The Challenge of This Parenting TaskParenting TaskzPrior experience which influences how Child can be presented in a distorted or hidden to be available & responsive andgently beliefs This family will be lost as well.

5 Parents can t keep you safe/parents are dangerous. I am so bad nothing you can do or say will change s disturbance can trigger own past, unresolved parenting history. The Challenge of This The Challenge of This Parenting Task Parenting Task zChildren need nurturance but present difficult/alienating need support for independence but present a need for continuing attention and involvement of the need to feel safe but behave in ways that increase their need to trust and rely on parents but maintain a rigidly controlling and rejecting Challenge of This The Challenge of This Parenting TaskParenting TaskzSuccess can lead to increased defensive behaviour in of close relationship and of its future loss leads to: rejecting, controlling or challenging behaviour.

6 Overwhelming need of carers time and is left feeling StudyCase StudyzCarers are helped to understand Jane s behaviour in relation to her past mother relates her own feelings and frustrations to her own early are taught to provide empathy for Jane s fear of close relationships and gently challenge her need for control and are taught to meet the need for nurture that she does not StudyCase StudyzGradually Jane learns to trust in their availability and develop some dependence upon more secure relationships help Jane, but she remains a very controlling little decision is made that Jane will remain with them in a long term foster are exploring special guardianship or adoption to help Jane to feel more Training InterventionsParent Training InterventionszTraditional or need expanded curriculum that goes beyond social learning impact of early adverse experience on impact of early adverse experience on Attachment needs of the Child .

7 Child development Brain development Trauma Loss Transactional theory Attachment TheoryExamples of InterventionsExamples of InterventionszAdapted Webster-Stratton Incredible Years (Pallett et al).zCircles of Attachment (Marvin et al).zAttachment & Biobehavioural Catch-up Intervention (Dozier).zAttachment based multi-dimensional model of parenting (Schofield & Beek).zThe Attachment , Self-regulation and Competency (ARC) model (van der Kolk).zPACE & PLACE (Hughes).Fostering Attachments GroupFostering Attachments Group Interactive repair Let the Child know that they are still loved and valuedAttunement Help the Child to experience emotional connection and understandingR e-attunement Re-establish attunem ent following episodes of mis-attunementSecure Base Provide security and a solid foundation for the relationship.

8 Everything else builds upon this foundation. M aintain empathy Be Curious Understand Child s feeling,thoughts and beliefs Be Playful Be Accepting Accept the Child and what Child feels Claiming, Help Child to belong Looking after yourself Support, rest, relaxation Family atmosphere Maintain positive emotional rhythm Family R ituals H elp Child to experience mutual enjoyment. A home for containing anxiety and building trust and security Step aside from confrontation. Discipline with em pathy, avoid battles, rem ain calm Choices & Logical Consequences Supervision Provide supervision m atched to need of Child regardless of age Structure Provide fam iliar routines and clear boundaries Security Help the Child to feel safe Rew ards & Sanctions H elp Child to m anage behaviour Module 1: Attachment TheoryModule 1: Attachment TheorySession Introduction to Attachment TheorySession Caregiving and the Attachment SystemSession The Internal Working Model and Patterns of AttachmentSession The Organized Attachment PatternsSession The Disorganized Attachment PatternsSession Parenting Children with Attachment DifficultiesModule 2.

9 A Model for Parenting the Module 2: A Model for Parenting the Child with Attachment Difficulties. Child with Attachment Difficulties. Part a Secure BaseProviding a Secure BaseSession Introduction to the Model and Creating a Secure BaseSession Empathy and Support from the Secure BaseSession Attunement and EmpathySession Protecting the Family AtmosphereSession Creating a Feeling of Belonging for the ChildSession Looking After YourselfModule 3: A Model for Parenting the Child with Module 3: A Model for Parenting the Child with Attachment 2: Building Relationships and Managing Part 2: Building Relationships and Managing BehaviourBehaviourSession Helping the Child to Enjoy Being Part of the FamilySession Learning to Parent with PACES ession Providing Structure and SupervisionSession Managing Confrontation and Coercive InteractionsSession Thinking, Feeling and Behavioural ChoicesSession Managing Behaviour whilst Maintaining a Secure BaseEvaluationEvaluationzCarers report increased understanding, confidence, and ability to relate to report difficulties of Child as report high self report changes were greater cf W/S (N=7)Evaluation (N=7)zSDQ (carer rated) hyperactivity, peer problems, total difficulties improved (stat sig)

10 , conduct problems and emotional problems improved (not stat. sig.). Effect sizes greater cf changes in conduct problems in W/S problems Q. Small improvement (not stat. sig.).zCF 10 children, routine service, no group training. SDQ small improvements in prosocial and peer dif. (no stat. Sig.). Total dif unchanged. Conduct problems worsened. Sometimes when I go on training things I think the time would have been better spent with the children, but I haven t felt that once on this course. This session tonight has helped me to restore some faith in myself and what I am doing. In a word relevant! Gives confidence in what we are doing and strength to carry on. Brilliant discussion.


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