Attachment presentation


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  • This presentation is used for introducing foster parents to the basic tennants of 'attachment' as an important element in fostering children. it is used in small group discussions as part of a foster care orientation process. Useful as an early intervention strategy or as seperate session in a foser care training programme.
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Attachment presentation

  1. 1. Attachment Developing and repairing the bond between parent and child
  2. 2. Attachment: where does it begin? <ul><li>Attachment is always a two way street </li></ul><ul><li>Before birth in the womb </li></ul><ul><li>After birth: attachment chemicals (oxitocin) in the brain of child and mother </li></ul><ul><li>Taking care of the baby- responding to his basic needs </li></ul><ul><li>Pattern of care in early years set an expectation of relationships within the individual for life </li></ul>
  3. 3. What is attachment? <ul><li>Special enduring emotional relationship (bond) with a special person </li></ul><ul><li>Involves familiarity, comfort, soothing and pleasure </li></ul><ul><li>Threat of losing that specific person is distressing </li></ul><ul><li>Security and safety within the context of the relationship </li></ul><ul><li>Emotional glue between people </li></ul>
  4. 4. Phases of attachment <ul><li>Birth to six weeks: neutral </li></ul><ul><li>Six weeks to six months: developing attachment with primary care giver </li></ul><ul><li>Six months to 15 months: discriminate between carers, preferred attachment </li></ul><ul><li>16 months and three years: established-start to experiment and expanding to others </li></ul><ul><li>Three years and onwards: repeating attachment patterns in all relationships </li></ul>
  5. 5. Discuss <ul><li>What age were the children placed in your care, removed from their birth parents? OR </li></ul><ul><li>At what age was your child separated from you? </li></ul><ul><li>In what phase of attachment were they? </li></ul><ul><li>What implications do you think this had in the children? [10 min] </li></ul>
  6. 6. Attachment patterns <ul><li>Secure: safe well balanced emotional connection between parent and child </li></ul><ul><li>Parent is attuned and responsive to the child's needs </li></ul><ul><li>Child respond to the carer with affection respect and accepts guidance from adult </li></ul><ul><li>Trust is established </li></ul>
  7. 7. Attachment patterns continued <ul><li>Insecure attachment: </li></ul><ul><li>Avoidant: parent not giving attention to the child- child gives up-avoid making contact. </li></ul><ul><li>Ambivalent: parent sometimes gives attention sometimes not. Child becomes hyper demanding to ensure parents attention </li></ul>
  8. 8. Attachment patterns continued <ul><li>Disorganised: could be avoidant or ambivalent but with element of fear or abuse-child disconnects </li></ul><ul><li>Indiscriminate: multiple placements multiple carers- child will attach to anyone- superficial attachments </li></ul>
  9. 9. Case study <ul><li>Peter was removed at 18 months </li></ul><ul><li>Chronic neglect- hospitalised for infected nappy rash for third time </li></ul><ul><li>Did not talk sit crawled or walked and did not eat solids </li></ul><ul><li>Hospitalised for 8 weeks where he caught up most of milestones </li></ul><ul><li>Was in three places of safety before entering long term foster care </li></ul><ul><li>At age 15 he does not interact with peers and has been reprimanded for setting the dog on fire and watching while the dog burned </li></ul>
  10. 10. Discuss <ul><li>Does he have a secure / insecure attachment? </li></ul><ul><li>What possible attachment pattern does he have? </li></ul><ul><li>Can you recognise any possible attachment patterns of your child/foster child? </li></ul><ul><li>How does this make you feel? [10 min] </li></ul>
  11. 11. Internal working model <ul><li>From birth to 3 years a child form an opinion about themselves and the world based on the interactions with their primary care givers-engrained in implicit memory </li></ul><ul><li>If the child has been abused / neglected they would view the world as a hostile environment without any warm place for himself </li></ul><ul><li>If that inner working model goes unchallenged they would use this as their point of departure in all their interactions </li></ul>
  12. 12. How do you change this inner working model? <ul><li>Healing takes place through positive repetitive ,specific, predictable, experiences in a cognitively stimulating and attachment rich environment </li></ul>
  13. 13. What is the effect of insecure attachment of children <ul><li>Problems accepting adult control </li></ul><ul><li>Child: “I must take charge of things or no one will”- internal message </li></ul><ul><li>Refuses to co-operate not accepting leadership of parent </li></ul><ul><li>Parents: Threatens parents belief that they have the right to parent the child </li></ul><ul><li>Feels frustrated or like failure </li></ul><ul><li>+Response: safety, understanding, structure, completing tasks –lead by doing not saying story telling. </li></ul>
  14. 14. DISCUSS <ul><li>What is your child’s inner message about accepting adult control? </li></ul><ul><li>How have you been affected by his/ her refusal to accept your leadership? </li></ul>
  15. 15. What is the effect of insecure attachment of children <ul><li>Engagement and relationship problems </li></ul><ul><li>Child: “I must stay away to avoid getting hurt” internal message </li></ul><ul><li>No eye/ physical contact, superficial relationships, unpredictable, not there </li></ul><ul><li>Parent: difficult to claim child as own or develop mutual feeling of belonging </li></ul><ul><li>Feels rejected by child </li></ul><ul><li>+Response check up list, wonderment, eye contact, repetition story telling </li></ul>
  16. 16. DISCUSS <ul><li>What is your child’s doing to avoid engaging with you? </li></ul><ul><li>How have you been affected by this? </li></ul>
  17. 17. What is the effect of insecure attachment of children <ul><li>Problems in accepting care. </li></ul><ul><li>Child: “ I can take care of myself-don’t need anyone” internal message </li></ul><ul><li>Don’t ask for help. Don't allow assistance with care- wear dirty clothes wont let you wash hair. </li></ul><ul><li>Parents: feel rejected and frustrated </li></ul><ul><li>Not easy or pleasurable to sooth comfort these children </li></ul><ul><li>Caretaking becomes devoid of emotion foster family vs. board & lodging </li></ul><ul><li>+ Response: soothing, singing, rocking, lotioning feeding, tucking in at night. Repetition story telling </li></ul>
  18. 18. DISCUSS <ul><li>How is your child avoiding your attempts to care for him/ her? </li></ul><ul><li>How have you been affected by this? </li></ul>
  19. 19. What is the effect of insecure attachment of children <ul><li>Problems with competence and self- worth </li></ul><ul><li>Child: “ I deserved the bad treatment- its my fault” ” I'm worth nothing” internal message. </li></ul><ul><li>Cognitive and developmental delays </li></ul><ul><li>Poor school performance, child feels like a failure </li></ul><ul><li>Parent: Too high expectations, disappointment with child's performance </li></ul><ul><li>Extra expenses of occupational therapy or remedial classes </li></ul><ul><li>Enrol child for activities they are not ready for </li></ul><ul><li>+ Response: more nurturing and warmth than challenge </li></ul><ul><li>Lower expectations so that the child can achieve success </li></ul>
  20. 20. DISCUSS <ul><li>What is your child’s inner message about their self –worth? </li></ul><ul><li>have you been expecting too much or have you been disappointed by their lack of performance? </li></ul>
  21. 21. What is the effect of insecure attachment of children <ul><li>Problems with regulation and expressing of emotions </li></ul><ul><li>Child: “emotions are bad and scary” internal message </li></ul><ul><li>Cant control emotions- “loose it” and has low frustration threshold. </li></ul><ul><li>Emotional age is much younger than actual age. </li></ul><ul><li>Hurt others tantrums, no remorse, or cut off from their feelings </li></ul><ul><li>Parent: sometimes panic in fear or become out of control themselves. </li></ul><ul><li>Parents own emotions become a barrier between them and the child. </li></ul><ul><li>+ Response: acknowledge and validate their emotions </li></ul><ul><li>Don’t react but parent from safety- provide emotional safety for child to feel and express their emotions. </li></ul>
  22. 22. DISCUSS <ul><li>Can your child express his/her emotions? </li></ul><ul><li>How have you been affected by their emotional state? </li></ul>
  23. 23. Intervention dimensions <ul><li>Structure: routine, guidance, consistency </li></ul><ul><li>Engagement: catching them off guard, new interesting experiences. </li></ul><ul><li>Nurture: physical and emotional care, involvement </li></ul><ul><li>Challenge: challenging old ways, stretching, moving out of the comfort zone </li></ul>
  24. 24. References <ul><li>Jenberg, A.M. & Booth, P.B. 2005. Theraplay: Helping parents and children build better attachments through attachment based play.2 nd ed. San Francisco: Josey Boss Publishers </li></ul><ul><li>May, J.C. 2005. Family Attachment Narrative Therapy: healing the experience of early childhood maltreatment. Journal of Marital and Family Therapy , 81-99, Jul. </li></ul><ul><li>Peluso, J. P. Peluso, P. R. Kern, R. M. & White, J. F. 2004. A comparison of Attachment Theory and Individual Psychology: A review of literature. Journal of Counselling and Development , Vol. 82:139+ </li></ul><ul><li>Single, T. 2005. Long term foster care for abused and neglected children: how foster parents can help healing the trauma. Unpublished training manual for John Hunter Children's Hospital . </li></ul>