Supporting Strong Developmental Outcomes: The case for CARE and Attachment Security

Raising children who have the best chance of achieving their potential involves connection with our task. It involves parenting with intention; thinking about what we are doing, and why. It involves holding the child in our mind; especially their experiences and their needs. It involves responding to their experiences and needs.

When children experience others to be connected with their experience and needs, they feel a sense of worthiness that profoundly supports their emerging identity and sense of worth. They feel that they can trust and rely on the adults who are connecting with their experience and needs. They develop a reciprocal connection to these adults. This reciprocal connection goes by various names, but the one I will use in this post is Attachment.

Attachment refers to the dependency relationships a child forms to the adults in their life who look after them, beginning in the first year of life (noticeable from 6-8 months), and developing progressively over the first four years of life. Central to the concept of attachment is the idea of secure base. The dependency relationship the child develops towards the adult who cares for the child (referred to as the attachment relationship and the attachment figure) becomes the secure base from which the child launches out into the world, and to whom the child returns for comfort and reassurance before launching out again. Having an attachment figure that can be trusted and depended upon forms a necessary condition for the child to explore their world without anxiety and, in doing so, supports all aspects of their developmental progress.

Not all children have the same type of attachment relationship with the adults who care for them. Attachment varies depending on the child’s experience of care. Extensive research has identified four predominant attachment styles. When thinking about the child’s development, the optimal attachment style is a secure attachment. Children who form a secure attachment to the adults who care for them use these adults as a source of comfort and reassurance so that they can launch into the world without being restricted by unnecessary worry or fear. This attachment style is optimal because development unfolds through exploration, and a secure attachment style is optimal for exploration.

Other children have an insecure attachment to the adult or adults who care for them. Some of these children orient to their attachment figures for relief from distress but are not easily reassured so that they might launch back into the world. They might be viewed as unnecessarily clingy and temperamental and, relative to securely attached children, their exploration restricted. In Attachment Theory, these children are typically referred to as having an Insecure-Ambivalent attachment style.

Other children have what is known as an Insecure-Avoidant attachment style. These children do not use their attachment figures enough for comfort and reassurance. Though they appear to be self-reliant, they are actually overly anxious which, in turn, restricts their exploration (and development).

A fourth group of children show a more concerning pattern of behaviour. They orient to their attachment figure, only to experience uncertainty when doing so. These children are referred to as having a Disorganised attachment style. They are observed to need and avoid their attachment figures. Their priority is not exploring their world (and growing and developing from doing so). Rather, the most important driver of their approach to life and relationships is achieving feelings of safety.

A fifth group of children have no attachment to anyone. These children have lacked opportunity to form an attachment to someone who provides care on a consistent basis. As with insecure and disorganised attachment styles, the development of these children is restricted by unrelieved anxiety and an intense focus on coercively controlling their environment in order to achieve needs provision. These children struggle to form mutually-satisfying dependency relationships with the adults who care for them.

Attachment styles are profoundly influenced by the child’s experience of care. A child whose parents are connected with what they are doing as a parent and with the child’s experience is more likely to develop a secure attachment style. A secure attachment style represents the optimal condition for the child to fulfil their potential and enter adulthood with the knowledge and capabilities to be successful (including in parenting their own children).

For the sake of the child’s development (and wellbeing), attachment security is the goal.

Parenting intentionally stands the best chance of supporting attachment security. Intentional parenting that supports attachment security involves the following:

  • Being a consistent presence in the child’s life
  • Being accessible to the child
  • Being responsive to the child’s experience, and
  • Being emotionally-connected to the child.

These aspects of intentional parenting can be summarised in the acronym CARE:

  • Consistency
  • Accessibility
  • Responsiveness
  • Emotional Connectedness

Hereafter, I will present each of these concepts and why they are important to attachment security and development.

Consistency

Children form attachments to adults who are familiar and continuous aspects of their life, as well as being responsive to their dependency needs. In order to for a secure attachment to develop, these adults must be involved with the child and respond to their dependency needs in a consistent way. They also need to be recognisable to the child, and so must present in a consistent way. Knowing that their recognisable adult caregivers are consistent aspects of their life and will respond to them in a consistent way supports confident exploration unhindered by anxiety about who is their caregiver.

Where there has not been a consistent adult or adults who cares for them, the child is unlikely to have formed a selective attachment to anyone. They can be excessively self-reliant, and/or indiscriminate in who they will seek a caregiving response from. They lack trust in caregiving adults, and in their own deservedness of care. They may resist care and may also be coercively controlling towards adults.

Accessibility

Children form attachments to the most available adults during the early developmental period. Children form secure attachments to adults who are accessible to them for comfort and needs provision on a continuous and consistent basis. Further, they form a secure attachment to adults who attend to them whether they are crying or quiet. These forms of accessibility support and reinforce a child’s understanding that they have a person who is responsible for their care, how to recognise them, and that their caregiving adult continues to exist during temporary separations. Knowing that they have a recognisable caregiver who is accessible to them even when temporarily separated supports a profound sense of comfort and reassurance for the child that allows them to get on with exploring their world without anxiety about the accessibility of their caregiver.

In contrast, when a child has not experienced their main caregivers to be consistently accessible to them, they struggle to accept separations and are commonly excessively demanding and preoccupied with their caregiver. During temporary separations, they are excessively anxious about where their caregiver is and who will respond to their needs. Both scenarios detract from the child’s capacity to explore and learn about their world and develop the capacities that support their success in life.

Responsiveness

Responsiveness refers to the actions of the caregiving adults perform in response to the needs and experience of the child. Responsiveness extends from consideration of what is going on for baby/child? What is happening for them and what is their need, including the need or experience that is responsible for the behaviour you see? We do this naturally during the child’s preverbal years. (Incidentally, we also do this with our pets). When the child is verbal we tend to encourage them to use their words more and more, which can be problematic, as I will explain in a bit. However, the child’s first experiences of the responsiveness of caregiving adults occur during a time when they cannot tell us in words about their needs and experiences that they require a caregiving response to. This spans much of the first three years of their life, before gradually reducing as the child becomes increasingly verbal.

When we come up with the answer to the experience or need the child has, and which may be evident in their behaviour or gestures, and respond to it, the child has their experience that their needs and experiences are understood, that they are withy, and that they can rely on the caregiving adult to respond to them. Children who form a secure attachment experience their adult caregivers as consistently responsiveness to their needs and experience. That is, their caregivers regularly and accurately ask and answer in their head the question what is going on for baby/child (?), and then perform an action that responds to the need or experience of the child. The reflection on the need and experience of the child, and the associated response, is often accompanied by words, which is significant.

Children learn language in at-least three ways:

  • Firstly, they learn language as a result of their caregivers expressing pleasure when, during their babbly, the infant says something recognisable as a word, such as the response of mum when the infant babbles Ma.
  • Secondly, they experience their attachment figures speaking to them about their experience; that is, speaking the words the child would use if they had them. I am not trying to be funny, but we tend to do the same with our much-loved pets. When we do this the child gradually learns what words go with what experience or need. That is, they learn that the word happy is what goes with feeling happy.
  • Thirdly, they watch and learn from others how they use language.

We are particularly interested in the first two. When a child’s caregivers are not consistent in these actions, the child will be relatively slower to learn language. Being slower to learn language and develop their vocabulary, the child will rely on behaviour and gesture to communicate about their experience and needs, long after the time when we would usually expect them to say what they need or what is going on for them. This can result in a punitive response, leaving the child feeling unheard and unsure of their worthiness. If this happens often up, there can be long-term impacts to their self-esteem.

The second aspect of responsiveness is the action performed to satisfy the child’s need or experience. Sometimes, it is simply the words we say that communicate understanding of the child’s experience. Other times, it is what we do in response to the child’s need or experience; such as when we feed the baby at four-hourly intervals, burp them after a feed, and change their nappy regularly and when soiled. Responsiveness to the child’s needs and experiences supports the development of cause and effect thinking; that is, the understanding that when you do this that happens. This is important as it supports the child’s knowledge of how to access a caregiving response, thereby allowing them to explore and learn about other things.

Children form secure attachments to the adults who consistently respond to their needs and experiences through actions taken, as well as the words used. Securely attached children trust that their caregivers will respond to them when needed which allows them to explore their world, learn, and develop without anxiety about responsiveness to their needs.

Where responsiveness has been inconsistent and/or inadequate, these children approach life and relationships preoccupied with their needs. They can be excessively demanding or self-reliant; often both. They have learnt that they cannot always rely on adults in a caregiving role. This limits or impairs their exploration, with associated developmental impacts.

Emotional Connectedness

Emotional connectedness refers to those times when the emotions of the child and caregiver are in synchrony with each other. Emotional connectedness extends from the adult observing the child and allowing themselves to feel what the child is feeling.  Often referred to as attunement, it is typically a natural experience to the emotion of another. Emotional connectedness typically flows from interaction and paying attention. In this sense, it can be intentional.

Emotional connectedness supports diverse aspects of emotional development. By tuning in and allowing emotional connectedness to occur, the child begins to develop an understanding of the experience of others, which is an early building block for the development of empathy. The infant connects back with the experience of the adult and follows them where they go. This allows the adult to regulate the infant’s emotions before they are overwhelmed by them. This is commonly referred to as co-regulation, and it provides a safe space for the child to explore a range of emotions without fear of being overwhelmed by them, thereby developing a broad emotional repertoire. Through repeated experiences of being regulated by the adult, the child learns to regulate themselves. Through emotional connection with their adult caregivers, the child begins to regulate their emotions and behaviour in consideration of others in order to maintain connection, thereby providing the foundations for social competence and satisfying relationships.

Most important, emotional connectedness represents another opportunity for the child to feel heard and acknowledged in their experience, thereby supporting their sense of worth and trust in others.

Children form secure attachments to adults who are consistently attuned to their experience. Again, these children feel free to explore their world, learn, and develop free of unnecessary anxiety. In contrast, those children for whom emotional connectedness has been inadequate tend to show a restricted range of affect, restricted empathy, and restricted regulation of their emotions and behaviours in consideration of others. Too often, this serves to further distance them from others as they encounter disinterest and punitive responses to their so-called inappropriate behaviour.

If you would like to read more about CARE and Attachment, the best overall coverage is in my book (Click the image for more):

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More than a spare room: What kids really need from foster carers

I have been thinking about what children and young people who cannot be safely cared for at home need from their foster carers. I want readers to adopt a broad definition of foster for the purposes of this post, including all carers and care arrangements that the child or young person might enter into during the period of time that they cannot be safely cared for at home. I choose to use the term foster as foster carers remain the main focus of child welfare agencies to provide care for these children and young people, and the greatest challenge to recruit and maintain. I hope, nonetheless, that this post is informative to all carers of children and young people who are recovering from a tough start to life, and those who are considering taking on the role.

I started to make a list and have found it has grown quite long. I do not want to over-complicate the matter, so have chosen to include what I think are the key characteristics and considerations. Others may wish to add to this list or develop their own list. That’s ok. I guess I just wanted to make a list based on my experience interacting with children and young people in out-of-home care across the past 26 years.

Children and young people in out-of-home care need carers who understand that they are hurt rather than broken, and that they need patience and time to heal.

Children and young people in out-of-home care need carers who understand that they are hurt rather than broken, and that they need patience and time to heal. They need carers who will make and maintain connection with them, at their pace. They need carers who are warm, playful, kind, and caring. They need carers who are resilient, who can hang in there during inevitable tough times. They need carers who are prepared to take the time to understand them.

Children and young people in out-of-home care need carers who are open and receptive to learning and adapting their caregiving practices. They need carers who believe in them and advocate for them. They need carers who support connection to birth family and birth culture. They need carers who acknowledge their strengths, and who support opportunities to them to succeed. They need carers who support their interests.

Mostly, children and young people in out-of-home care need carers who support a sense of belongingness, to place, family, and community.

Finally, children and young people in out-of-home care need child welfare authorities and fostering agencies to insist on these qualities in foster carers. They also need for their foster carers to be meaningfully supported.

What would you add to the list?

The CARE Curriculum

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A Short Introduction to Attachment and Resilience

I have maintained this blog site or more than ten years. This will be the 250th post published to it. Given the sheer volume of content I have decided to make a post with links to the posts that I think best reflect my work. It is not an exhaustive list, as the list would become too long. Rather, I simply wanted to assist visitors to this site to be able to quickly and easily access what I think are some of the central posts. I may even do a separate post containing links to the significant posts that did not make this list . . .. In any event, I hope this is useful to you.

It is too hard to rank the posts in order of what I consider to be their importance, or by topic. Rather, I will do them by year, starting with the earliest posts that probably no longer get the attention they once did.

2011

Four good reasons for using play during therapy with children and adolescents.

My first post, and still relevant. A printout of this post still appears in the waiting room of my practice and was re-published on the blog site of Jessica Kingsley Publishers following publication of the first edition of A Short Introduction to Attachment and Attachment Disorder – my first book.

2012

Attachment therapy for children who have experienced family trauma.

Another post about my approach to psychotherapy. This resulted in an approach by the editor of a periodical of the British Association for Counselling and Psychotherapy to write an article for them. That article, titled Repairing Attachments, can be accessed here.

Taming Tantrums; Managing Meltdowns: Part One.

One of my earlier posts on this topic of much attention. Subsequent posts include:

The Hawthorne effect in schools.

One of my earlier posts about therapeutic care and management of children and young people at school, it is also one of the most read posts on this site. There are a number of other posts about trauma-informed practice in schools, but in addition to reading the ‘Hawthorne Effect’ post I would direct readers to my article titled Attached to the Unattached, published in SEN Magazine in the UK in 2010.

A simple method for getting children off to sleep.

Drawn from my book, A Short Introduction to Attachment and Attachment Disorder, this is my most read post. Part 2 (2019) is also worth looking at.

2014

Adopting a Balanced View.

This short article first appeared in the Blog for The Adoption Social on 21/1/14. I have subsequently revised it, somewhat, for inclusion in the handbook for The CARE Curriculum.

2015

Lessons about Learning: Some Truths about Behaviour Management.

A reflection piece about why traditional behaviour management is problematic for addressing challenging behaviour among children and young people recovering from a tough start to life. It reflects my deep consideration of the operant conditioning paradigm and how that can inform the care of deeply hurt and troubled children, an exemplar of which is the prologue of the first edition of A Short Introduction to Attachment and Attachment DisorderA Tale of Three Mice: An Attachment Story.

2018

It is, perhaps, not surprising that my more recent blogs best reflect my contemporary views and work. They also reflect some changes in the way I communicated about my work, including in this first post.

Your child’s CARE Requirements through the years.

In this post I was experimenting in developing infographics to give a quick and easy snapshot of the information I wished to convey.

2019

When Punishment if Problematic.

This was an update to an earlier post from 2015, and provides a succinct exemplar about my views and approach to the care and management of children and young people, and challenging behaviour.

Use your words: Supporting expressive language development and use

An article about the importance of communicating the thoughts and feelings of children and young people, which has significant developmental implications, especially for children and young people who are recovering from a tough start to life.

Raising kids who have high and complex needs: The importance of self care

Not my first foray on the issue of self-care for parents and carers, but the one that best reflects my contemporary views and approach; including that which is represented in The CARE Curriculum.

2020

Preserving placements during a pandemic: Video series with handbook.

One of a number of posts that appeared during the early stages of the COVID 19 pandemic, this content was developed for foster, kinship and adoptive parents of children recovering from relational trauma, and was included on the COVID 19 resource page of the South Australian Department for Child Protection. A related post of interest to a more general audience is Practical Parenting During a Pandemic.

Child Psychotherapy: An update about my approach

A recent update about my approach to psychotherapy with children and young people, this should be read in conjunction with Relationships Regulate and Repair (2021).

Five strategies for addressing issues with compliance in children

One of the more recent of a series of posts that appear on this site in which I attempt to distil my thoughts into a short list of practical strategies for addressing parenting challenges. If you enter ‘four things’ or ‘five things’ into the search bar on this site you will be able to access similar posts about other care and management challenges in the home and school.

2021

All relationships are important for attachment security

Perhaps, the most important post on this site, and one that I will soon expand into a periodical article for publication, this article challenges conventional privileging of singular relationships in attachment outcomes for children and young people, and makes the point that all significant relationships contribute to the attachment style and attachment security of children and young people.

This brings us to the end of this post. I hope you find it useful. For the best overview of my work, why not access one or both of my books; A Short Introduction to Attachment and Attachment Disorder (2 Editions), and A Short Introduction to Promoting Resilience in Children? Best wishes. Colby

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Is your service trauma-aware, trauma-responsive, or trauma-informed?

Borrowing from ideas underpinning culturally safety in service provision, where a distinction exists between being culturally aware, culturally responsive, and culturally safe, there is worth in distinguishing what is trauma-informed practice, as opposed to trauma aware and responsive.

Culturally safe practice involves being culturally aware and culturally responsive, But it is more than this. Being culturally safe includes being sensitive to, and reflective upon, the experience of a cultural group, and developing relationships with that group and individuals within it that acknowledge their experience. It also involves taking action that responds to the experience of the group and individuals within it. Culturally safe practice is distinguished by the emphasis on relationship and acting in consideration of the experience of cultural groups.

Safe practice is relational.

It is worth noting that it is possible to be culturally aware and/or culturally responsive, but not be culturally safe.

Similarly, when working in the area of trauma, it is possible to be trauma aware (this is what you know about trauma), trauma responsive (this is, what you do based on what you know about trauma), and/or trauma-informed. Trauma-informed practice might be thought of as intentional practice where we draw on what we know about trauma and practices that help, but use that to meaningfully connect with the individual or group with whom we are delivering a service and to respond to their experience.

Fundamentally, trauma-informed practice is relational.

As with working with cultural groups, it is possible to be trauma aware and trauma responsive, without being trauma-informed. The necessary additional ingredients are relationships and relational responsiveness.

This represents the cornerstone of success in trauma work; providing a safe and containing relationship for therapeutic work to occur in.

In the absence of relationship, a service cannot rightly refer to itself as trauma-informed.

I have been considering these ideas for a little while and am happy to receive and consider your thoughts. Best wishes. Colby

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Trauma-informed training for foster, adoptive, and kinship carers

This morning I read an interesting narrative review of fifteen evaluation studies of trauma-informed care training for foster and adoptive parents (and kinship carers):

Lotty, M, Bantry-White, E, & Dunn-Galvin, A, (2021) Trauma-informed care psychoeducational group-based interventions for foster carers and adoptive parents: A narrative review. Adoption and Fostering, 45(2), 191-214

The review drew the following conclusions:

  • that there is evidence for the effectiveness of trauma-informed training for those who care for children and young people who are recovering from a tough start to life (albeit, the evidence in the studies they reviewed was mixed);
  • that effective trauma-informed training incorporates psychoeducation, reflective engagement, and skills building;
  • that the success of trauma-informed training for carers is likely to be enhanced by parallel practitioner training (eg child welfare staff, schools);
  • that kinship carers have different (training) support needs; and
  • that there is a need for more evaluation of training initiatives in this area.

While reading the review I felt both validated and frustrated. Validated, that my own training programs (The (Kinship) CARE Curriculum and The Triple-A Model of Therapeutic Care) are consistent with the conclusions drawn by these authors about what makes for effective and valued training initiatives in this space. Frustrated by difficulties that exist in conducting formal evaluation studies in this area, including for my own programs, including:

  • The Triple-A Model of Therapeutic Care Implementation in the TUSLA Fostering Service, Donegal, Ireland (ongoing);
  • The Kinship CARE Project, a two-year project delivered to statutory kinship carers in South Australia (2018-2020); and
  • Martinthi, an ongoing project to deliver trauma-informed training in an Aboriginal Kinship Care support program in South Australia.

My frustration arises as in all of my training endeavours I do have a parallel evaluation methodology, but lack the time and resources to collate the data we have into articles for publication. I am a sole practitioner with significant psychotherapy commitments and I often joke that I am more a therapist than a trainer when delivering my programs. I have also had the experience that evaluation data demonstrating the effectiveness and worth of training endeavours not being sufficient to ensure its continued support.

In any event, I am pleased to say that I am about to embark on a two-year implementation project in an independent school supporting trauma-informed practice, and that there are plans to conduct a formal evaluation of the intervention. The project will involve the delivery of trauma informed training and support, following a methodology recommended in the article above, reflecting my existing program for schools (Connected Classrooms), which has has been implemented in South Australia and by my trained trainers in Ireland.

It is the case that I have been fortunate to able to develop and implement content and programs consistent with the conclusions above. Both the Triple-A Model of Therapeutic Care and the (Kinship) CARE Curriculum incorporate psychoeducation, reflective engagement, and skills building, parallel training and mentoring for support professionals, and a complementary training program for educators/schools. There are separate curricula for foster and kinship carers, recognising their similarities and their different needs. There is a new curricula that recognises the particular needs of Australian Aboriginal children and their kinship carers.

I look forward to contributing more in this vital area of endeavour. If you would like to read more about my work, I would recommend A Short Introduction to Attachment and Attachment Disorder (Second Edition). Best wishes.

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Relationships Regulate and Repair

Relational trauma, such as that which occurs as a result of abuse and neglect, impacts three key areas of relational connection:

  1. The relational connection a child has with others, including those who care for them;
  2. The relational connection the child has with their own self; and
  3. The relational connection the child has with their community.

Where relational trauma has occurred, relational connection with others tend to be weak or superficial, easily replaced, and characterised by mistrust and/or uncertainty about safety and dependability. Similarly, relational connection with self tends to be weak, unstable, and characterised by mistrust and/or uncertainty about worthiness and competency. Further, relational connection with community tends to be characterised by an absence of identification and sense of belongingness with.

These impacts have a range of lasting, further impacts for the development and wellbeing of the child, and their approach to life and relationships. Among these, it leaves them vulnerable to poorly regulated behaviour, wherein such behaviour reflects a lack of concern for the impact of their behaviour on themselves, others, and their community. In time, such behaviours extend to antisocial, self-sabotaging, and self-destructive behaviours.

They act with an apparent lack of concern for themselves, for their relationships, and for the community in which they live.

When we sanction children and young people who are recovering from relational trauma for their behaviour and do little to address the reason for it, we compound their feelings of unworthiness and isolation. We leave them vulnerable to orienting to similar others for relational connection, whereupon their antisocial, self-sabotaging, and self-destructive behaviours become normalised and justified.

Therapeutic work with children and young people who have experienced relational trauma necessarily involves the promotion of strong, functional relational connections with those who care for them, with their own self, and with their community. This is best achieved by approaching their care, management, and psychotherapeutic endeavours in such a way:

  • that they experience others as sensitive and interested in what is happening for them and why they approach life and relationships in the way that they do;
  • that they experience themselves as worthy and competent; and
  • that they experience their community as welcoming and accepting.

Put another way, all therapeutic endeavour with children and young people recovering from relational trauma must facilitate experiences of the following:

  • My experience is real!
  • You get it!
  • I am a person of worth!
  • I can trust and depend on you!
  • What a relief!
  • The world just became a little less overwhelming!

In the passage of time, these experiences support regulating relational connections, where one of the primary drivers for their behaviour is their concern for their own self, their relationship with the important people in their life, and their relationship with the community from whom they experience belongingness.

Relationships regulate! They also support a functional approach to life and relationships. In this sense, regulating relational connections, as described herein, are also reparative relationships.

In order for these relationships to occur, children and young people recovering from relational trauma need opportunity to develop regulating relational connections. This means that they need stability of care in arrangements and communities that support experiences of their worth, competency, and belongingness. Their carers and communities need support to better understand these young people and provide care that strengthens regulating relational connection. This is the primary consideration for those involved in the care and management of children and young people who are recovering from relational trauma, and the primary area of endeavour upon which the success of all other endeavours rest.

Further Reading

For an extended commentary about the use of behaviour management among children and young people recovering from relational trauma, written by international consultant in therapeutic residential childcare and therapeutic services for traumatized children, Patrick Tomlinson, click here.

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Connected Classrooms – A school-based programme for addressing the impacts of early adversity on the developing child

Schools play a vital role in helping children and young people to recover from a tough start to life, and thrive. My Connected Classrooms programme has been successfully delivered in South Australia, with more than 99% of participant ratings reflecting that the content was informative, practical, and useful, and that they would recommend the programme to other schools.

Connected Classrooms is also delivered in Donegal, Ireland, by my trained trainers in the TUSLA (Child and Family Agency) Fostering Service.

Here is a sneak peak of the content.

To find out more, and to discuss an implementation, contact me at:

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Intentional parenting benefits you and your kids

With lots of things that command our attention these days, it is natural to approach aspects of our life and roles in the easiest manner possible. In Psychology, automaticity is concept used to describe times in which we perform a task almost unthinkingly, as if on auto-pilot, freeing up space to respond to other matters. An example most people identify with is the experience of arriving by car at your destination and having little conscious memory of the journey. It can be troubling, though it is natural. Aspects of parenting can become “automatic” too. Children benefit from their parents approaching the role consciously and intentionally. The challenge is to do so without adding to the sensation of overwhelm that is an ever-present risk in modern life. In the CARE Curriculum I put forward simple (and conventional) ways of parenting intentionally that have maximum impact on children, without being overwhelming (for parent or child). I have included some examples in the graphic below.

In the Kinship CARE Project, our outcome data revealed that carers felt more confident in the role and observed improved relationships in the home after completing training in the CARE Curriculum.

For more information about the CARE Model and Curriculum, see:

http://securestart.com.au/the-care-curriculum/

or:

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A common knowledge, language, and approach for parents, professionals, and organisations: The CARE Curriculum

The CARE Model (Pearce, 2016) offers an evidence-informed conceptual framework for understanding the impact of relationships on the developing person. CARE stands for:

  • Consistency
  • Accessibility
  • Responsiveness
  • Emotional Connectedness

The CARE Curriculum offers a comprehensive approach to the delivery of culturally-sensitive, trauma-informed and -responsive services among families recovering from adverse life and family circumstances, via the delivery of enriched CARE.

Developmental growth is a central feature of the CARE Curriculum. Key outcomes include:

  • Growing a consistent, strengths-based and relationship-focused organisational approach to service delivery;
  • Growing confident and knowledgeable professionals who exhibit key competencies in their practice that support growth in their clients; and
  • Growth in parental growth capacity to provide consistent, enriched, and reparative care to their young ones.

Personal growth is mediated by individual factors that influence approach to life, relationships, and roles. Key individual factors include:

  • The beliefs one holds about ourselves, others, and the world (also known as Attachment Representations, Internal Working Models, and Schema);
  • Central Nervous System activation (also known as Arousal, and implicated in performance and wellbeing); and
  • Life learning, especially about access to needs provision.

This is the Triple-A Model (Pearce, 2016; 2011, 2010), and represents a  framework for understanding how CARE influences individual outcomes. An optimal approach to life, relationships and roles is enhanced through strengthening the influence of:

  • Secure Attachment Representations;
  • Optimal Arousal for performance and wellbeing; and
  • Trust in Accessibility to needs provision.

CARE directly influences Attachment, Arousal, and Accessibility (Pearce, 2016). CARE develops people, thereby addressing the factors that underly common manifestations of psychological impairment, including substance abuse issues, mental health issues, and maladaptive relationships. The CARE curriculum offers an approach to developing optimal functioning and growth via a comprehensive approach to service delivery.

The CARE Curriculum recognises that not all circumstances are the same. As such, there is a particular focus on reflective capacity and practice. Participant organisations, practitioners and parents are supported to develop their knowledge and understanding of the importance of CARE, but they are also supported to reflect on how they can offer enriched care in their work and roles.

A common statement in feedback from practitioners about the CARE Curriculum is that it not only helped them to be better at their work roles, it helped them to be better in their personal roles and relationships. The CARE Curriculum offers the opportunity for people to be the best version of themselves.

Recent and ongoing projects utilising the CARE Curriculum include:

  • The implementation of the Triple-A Model of Therapeutic Care (a programme of the CARE Curriculum) in the TUSLA (Child and Family Agency) Fostering service in Donegal, Ireland – ongoing since 2016. (Nb. Ongoing implementation maintained by twelve trained local trainers in Ireland).
  • Martinthi – Aboriginal Kinship CARE Program (A collaboration of InComPro, Bookyana, UCWB, and Secure Start®) – ongoing
  • Trauma-Informed Psychotherapy – A Programme delivered to Connecting Families with grant support from the DHS Trauma Responsiveness Grant, 2020
  • The Kinship CARE Project (A Collaboration of The Department for Child Protection and Secure Start®, 2018-2020)
  • Supporting Trauma Informed Practice in Schools – Programme delivered in DECD regional school and purchased for roll-out in schools in Donegal, Ireland.

The CARE Model, as described in A Short Introduction to Attachment and Attachment Disorder  – Second Edition (Pearce, 2016) remains recommended reading for all prospective psychology registrants in Australia who must sit the National Psychology Examination. The Triple-A Model of Therapeutic Care (a programme of the CARE Curriculum) has been favourably referenced in Inspection reports of the TUSLA Fostering Service in Donegal, Ireland, in 2016 and 2018 by the independent inspection authority for health and social care services in Ireland (HIQA).

Some Stats:

A two-year joint-initiative of Secure Start® and the Department for Child Protection (DCP) in South Australia, the CARE Curriculum was delivered to 250 kinship carers across 7 regional and 17 metropolitan locations. Twelve percent (12%) of participants identified as being of Australian Aboriginal descent. Eighty-four percent (84%) of participant kinship carers who completed the training and a three-month follow up survey reported that they were experiencing improved relationships with the children in their care, eighty-nine percent (89%) reported that they felt more confident in the role, ninety-eight percent (98%) reported that they had learnt strategies that had helped them in the kinship role, and one-hundred percent (100%) reported that they had received helpful information. Session by session evaluations showed that more than 98% of participant kinship carers indicated that the training was informative, practical and useful, that they were satisfied with the training, and that they would recommend it to other kinship carers. Analysis of pre-post questionnaires for the first twelve implementation groups identified that kinship carers were more than twice as likely to refer to behaviour being an expression of needs, as opposed to naughtiness, after four training sessions.

References:

Pearce, C.M. (2016) A Short Introduction to Attachment and Attachment Disorder (Second Edition).London, Jessica Kingsley Publishers

Pearce, C & Gibson, J (2016), A Preliminary Evaluation of the Triple-A Model of Therapeutic Care, Foster, 2, 95-104

Pearce, C.M. (2011). A Short Introduction to Promoting Resilience in Children. London, Jessica Kingsley Publishers

Pearce, C.M. (2010). An Integration of Theory, Science and Reflective Clinical Practice in the Care and Management of Attachment-Disordered Children – A Triple A Approach. Educational   and Child Psychology (Special Issue on Attachment), 27 (3): 73-86

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All relationships are important for attachment security

Our approach to life, roles, and relatedness (engagement) is influenced by many factors. Chief among these is the relationships we have with significant others, especially during our developing years. It sounds trite to observe, but our relationships play a key role in our engagement.

The relationships we form toward significant people in our life, and upon whom we depend for care and protection, are our attachments. Our most active period of developing attachments is during childhood, when we form attachments to our parents/caregivers, and also to relatives, siblings, and other significant adults who have continuity and consistency in our life and provide some level of care and protection.

Our attachments to significant others vary, depending on our experience of care and protection from them. Some attachments are secure, meaning that we can confidently explore our world and take on challenges, secure in the knowledge that we have someone we can turn to when we need them; someone who will help us to feel better quickly so we can brave the world again. Other attachments are insecure, leaving us unsure about our access to the support we need to take on the world with confidence after it challenges us in some way. Other attachments are particularly problematic (disordered), as the person we rely on for care and protection is also a source of fear and distress. This type of attachment (also known as Disorganised) is rare and typically only occurs where there has been abuse and/or neglect.

Although some of these attachments are more influential than others (typically referred to a primary attachments), it is widely considered that our overall attachment style is influenced by our experience of relationships with all of the people towards whom we have developed an attachment. That is, if we think of attachment as a spectrum that ranges from disorder to security (see below), where each of us sits on the the spectrum is influenced to a greater or lesser degree by our collective attachment relationships.

In consideration of this, we see the positive influence of secure primary attachments and the disruptive (and, at times, destructive) influence of disordered ones. This is brought into further focus when we consider the relationship between where we sit on this spectrum and the the beliefs that form about ourselves, others and our world that develop from our experiences of attachment and influence our approach to life, roles, and relatedness:

Adapted from: Pearce, C (2016) A Short Introduction to Attachment and Attachment Disorder (Second Edition). London: Jessica Kingsley Publishers

All attachments are significant. All influence our approach to life, roles and relatedness. This is particularly important in child welfare and related endeavours where the focus is facilitating recovery from a tough start to life and traumatic relationships, including through the promotion of attachment security. Where the opportunity exists to do so, we need to support repair in disordered attachments and strengthen new attachments through high quality family contact and therapeutic child care. It is in the child’s best interests that all attachments are strengthened when attachment security is the goal.

Food for thought:

No matter that you consider the child in your care already has a secure attachment to you, where that child has had disruptive attachment experiences you will need to do more to compensate for the impact of those disordered attachments.

Where possible, our focus must be on repairing attachments that have gone awry. Where this is not possible, all other significant adults in the life of the child will need to do more to support attachment security.

For more information about attachment see:

http://securestart.com.au/a-short-introduction-to-attachment-and-attachment-disorder/
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