separation and reunification: using attachment theory and research to inform decisions affecting the...
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Separation and Reunification: Using Attachment Theory and Research to Inform Decisions Affecting the Placement of Children in Foster Care
David Oppenheim, Ph.D. University of Haifa, Israel
Douglas Goldsmith, Ph.D. The Children’s Center, SLC, UT
Plan for today
Introduction and basic principles of attachment theory
One child’s story of attachment, separation, loss – and attachment
Misapplication of Attachment principles in:
TheoryAssessmentIntervention
Attachment Theory
Formulated by John Bowlby and Mary Ainsworth to account for the impact of early separation and trauma on the child
Has revolutionized our views of development, psychopathology, and clinical work
Is the most prominent theory today regarding early socio-emotional development
Attachment Theory
Is empirically based and supported by research
Is particularly useful in thinking about permanency issues
Basic Principles: Forming Attachments
The child is highly motivated from birth to form and maintain attachments to a few caregivers
Attachment has survival value Children will do whatever is necessary
to maintain their attachments and to achieve security
The baby uses the attachment figure as a “secure base”
Cooper, Hoffman, Marvin &Powell , 2000
More basic principles:Attachment Security
Attachment figures become “psychological parents”.
All babies attach but the security of the attachment depends on the caregivers responses to the child
Sensitivity: Reading the infant’s signals accurately and responding to them appropriately
Insightfulness: Seeing things from the child’s point of view; empathic understanding of the child’s experience
Cooper, Hoffman, Marvin &Powell , 2000
Cooper, Hoffman, Marvin &Powell , 2000
Attachment: Infancy and Beyond
Early attachments lay the groundwork for later development
Children form Internal Working Models of their attachment relationships
The legacy of early attachment is reflected in children’s relationships with others, self-regulation, emotional openness.
Separations from attachment figures
Are challenging for young children – and for all of us!
The child experiences separation as a threat to the availability of the secure base.
The degree of challenge will depend on the degree of threat
Often involves separation not only from the parent but from everything familiar
Separations
Strong reactions will occur when separating from nurturant parents - but also from abusive parents!
Under certain conditions separations can be traumatic and have devastating consequences.
Separation reactions
Follow the sequence of Protest (anxiety, anger) Despair (sadness, withdrawal) “Detachment” (recovery, renewed
interest in the world).
The Case of Sara
Placed for adoption upon discharge from the hospital
5 months of age legal adoption is not completed
Sara enjoys a loving relationship with her parents
The parent child relationship is marked by reliable, emotionally attuned, and responsive care
The Case of Sara
Allegations of neglect ariseSara is removed from the home at
the age of 10 months
The Case of Sara
Shelter home for four days
Second foster home for one week
Third foster home for eight weeks
Adoptive home
The Case of Sara
Upon arrival to the adoptive home Sara stares blankly, refuses social interaction, and is oblivious to pain after undergoing a medical procedure
Believing that Sara is available for adoption her name is changed
The Case of Sara
At the age of 15 months Sara is responding well to her new environment
First adoptive family hasn’t seen her for 6 months and want her returned to their care
The Case of Sara
Should she return?Who are the “psychological” parents?Does she remember her first adoptive
parents?She’s so young that she won’t
remember anything and can be returned without distress
Sara is a “resilient” child
The Case of Sara
The internal working model – viewing the world through Sara’s eyes
Assessing “risk”Could reunion reactivate feelings of
loss?Utilization of second adoptive
parents as a secure base Impact of no contact
Common misunderstandings: Theory There is a critical period in which
attachments are formed.Early childhood is critical, but there is no
point when security cannot be damaged
A secure attachment provides “inoculation”
Secure attachments serve as buffers, not inoculations
Common misunderstandings: Theory Secure children are resilient and
therefore can be separatedResilience involves a relationship between
the child and the environment; it is not a fixed trait “in” the child
Security or insecurity are personality traits.
Security is a property of a relationship, not a child
Common misunderstandings: Theory We can predict children’s development
based on their early attachmentsDevelopmental predictions are
probabilistic.The balance between risk and protective
factors is key.
Common misunderstandings: Theory Children do not become attached to maltreating
parents (or can easily detach from them)Children attach to maltreating parents and
separation will be experienced as a lossRemoval must always be seen as a last resort;
focus on repair of the caregiving relationship
Children’s relationships with their mothers are the most important
Children can develop attachments to several caregivers
Common misunderstandings: Theory Children do not have memories of their
early years, and therefore they do not have lasting impact.
Children do not have declarative memories but may have procedural memories encoded in their IWMs
Common misunderstandings: Observational Assessment An observation in the office or at home can be
used to assess the child’s attachmentContexts that are not stressful may reveal very
little about the child’s attachmentCasual observations of untrained observers,
without the aid of video, and in unstructured situations are of very limited use
Pleasurable play is an expression of a secure attachment
Attachment is most apparent in stressful situations
Common misunderstandings: Observational Assessment Clinging or seeking closeness is an
expression of a secure attachmentIf desperate, children will cling even to
complete strangers, but they will not serve as a secure base
Conflict is an expression of an insecure attachment
Conflicts are integral to healthy relationships; the issue is their negotiation
Common misunderstandings: Observational Assessment Protest during separation is an expression of
an insecure attachment (or, conversely, of a secure attachment).
Protest during separation indicates that an attachment bond exists; it tells us little about the child’s security
Ignoring the caregiver, particularly upon reunion, is a sign of non-attachment (conversely, is “normal”)
Avoidant children are attached to their caregivers; the avoidance indicates insecurity, particularly experiences of rejection
Common misunderstandings: Assessment A secure child has secure relationships with
everyoneChildren can have different attachments to
different caregivers Strong emotional and behavioral reactions
before or after a visit with the birth mother are indications of maltreatment by the birth mother or insecure attachment to the foster parents.
These kind of reactions are expected separations reactions and tell us little about the child’s experience
Common misunderstandings: Assessment Separations and reunions are the only
contexts in which attachment can be assessed
May be not very stressful for older children; the issue is activation of the attachment system
We know how to perform a “Bonding Assessment”
We don’t! And what does “bonding” have to do with it anyway?
Common misunderstandings: Intervention Children do not develop attachments to
foster mothersChildren develop attachments to their
foster mothers, and their quality depends on the care the mother provides
The intuitive capacities of foster mothers are sufficient
“Normally” sensitive mothers often need special help when providing care to foster children
Common misunderstandings: Intervention Intervention can help children in periods when
placement has not yet been determined It is extremely difficult to implement
psychotherapeutic interventions when the child’s fate is uncertain
Problems in the relationships between foster children and their parents are due to faulty parenting/damaged children.
Problems are products of relationships, and the key involves helping develop a good “fit”
Common misunderstandings: Intervention Reminders of the birth mother are
distressing; therefore they should be avoided (context: short separations)
We should think of what promotes the child’s confidence in the continued availability of the “secure base”
Common misunderstandings: Intervention Children who do not speak do not
understand language. Therefore, talking with them about the transitions they are experiencing is useless (and changing their name is insignificant).
Expressive language lags behind receptive language; children understand much more than they can express