Not exact matches
And, indeed, the most effective
attachment -
focused home - visiting
interventions offer parents not just parenting tips but psychological and emotional support: The home visitors, through empathy and encouragement, literally make them feel better about their relationship with their infant and more secure in their identity as parents.
The most effective
intervention we have is a
focus on parental
attachment, through a public policy of home visit programs, starting in the first days of a child's life.
Children who have experienced trauma, abuse, neglect, loss, grief and multiple placements often need extraordinary care, understanding and «
attachment -
focused» therapeutic
interventions.
Focusing on the latest research dealing with environmental factors and non-cognitive skills (perseverance,
attachment, relationships, etc.), this quick read provides insights on possible strategies and
interventions which lead to greater academic and personal success.
Summary: (To include comparison groups, outcomes, measures, notable limitations) Children and foster parents were randomly assigned to receive the
Attachment and Biobehavioral Catch - up (ABC)
intervention or to a comparison group which received the Developmental Education for Families (DEF) program which
focuses on cognitive and language development.
The Externship provides an overview of Emotionally
Focused Therapy including the stages and steps of the model, adult
attachment theory, and EFT
interventions.
Summary: (To include comparison groups, outcomes, measures, notable limitations) Children and foster parents were randomly assigned to receive with the
Attachment and Biobehavioral Catch - up (ABC)
intervention or to a comparison group which received the Developmental Education for Families (DEF) program which
focuses on cognitive and language development.
These are opportunities for delegates to engage with a selection of key note speakers in an extended training session
focusing on a cutting edge topic in the field of neurobiology, trauma,
attachment and therapeutic
intervention.
Pediatricians must advocate for workforce development for professionals who care for very young children and for promotion of evidence - based
interventions focused on healthy
attachment and parent - child relationships.
Although this might be true for other
intervention goals, such as helping high - risk mothers to cope with adversity or the daily hassles surrounding the birth of a child, the recent meta - analysis shows that for sensitivity and
attachment, the most effective way is to provide
attachment - based
interventions in a modest number of sensitivity -
focused sessions.
Recently, 88
interventions on maternal sensitivity and infant security in 70 studies were included in a thoroughly extended and updated quantitative meta - analysis.6 This meta - analysis showed that
interventions that specifically
focused on promoting sensitive parental behaviour appeared to be rather effective in changing insensitive parenting as well as infant
attachment insecurity.
Related topics include: developmental considerations, social and cultural factors of interpersonal issues of adolescents, gender specific and LGBT issues, multicultural family systems, use of diagnostic criteria, treatment planning issues, counseling
interventions, relational and career issues, chemical and process addictions, technology, trauma
focus and
attachment, justice involved adolescents, sexually maladaptive behaviors and legal and ethical considerations.
Future studies should also
focus on evaluating
interventions that are explicitly directed at parental frightening or frightened behaviour as the empirically derived determinant of infant disorganized
attachment.
As an example, a preventive
intervention in families with internationally adopted infants significantly enhanced maternal sensitivity and also significantly reduced disorganized
attachment: in the
intervention group there were only 6 % disorganized - attached children compared with 22 % in the control group.11 This study used a brief
intervention of three home - based sessions of video feedback
focusing on parental sensitivity, with the
intervention starting when the child was six months old.
Because of the negative impact of, in particular, disorganized
attachment on child outcomes,
attachment - based
interventions should not, or not only,
focus on the empirically derived determinants of organized (A, B, and C)
attachment, such as parental (in) secure mental
attachment representations and sensitive behaviour (see Dozier), but also on the determinants of disorganized (D)
attachment.
Based on the findings of the Dutch studies, it appears that
attachment - based
interventions that
focus on enhancing sensitivity are likely to be successful with parents who are motivated to learn ways of responding with their difficult infants.
Therefore, Benoit concludes that
attachment - based
interventions should
focus both on improving parental sensitivity (to promote secure
attachment) and on reducing or eliminating atypical parental behaviours (to prevent or reduce disorganized
attachment).
Nevertheless, a meta - analysis showed that
interventions with a
focus on sensitivity were successful in reducing or preventing
attachment disorganization9 (see below), and we noted that the explanation for this finding might be that parents become more
focused in the interaction with their child, and thereby less prone to dissociative processes in the presence of the child.
My primary therapeutic
interventions are drawn from Mindfulness Psychology, Internal Family Systems Therapy (IFS), and
attachment -
focused psychotherapy.
Attachment and trauma
focused interventions based on a relational model of change.
Citing research literature neurobiology, developmental psychology, trauma, and psychodynamic therapy, she insists that the body has been left out of the «talking cure,» and argues that integrating body -
focused interventions into our work provides a more holistic — and effective — approach to the treatment of trauma,
attachment, and relational issues.
A strengths - and relationship - based family
intervention that
focuses on the HOWs of parenting — the ways in which parents «parent» — to improve parent - child interactions that strengthen
attachment, family functioning, and parents» capacity to nurture the well - being and healthy development of their children in every domain.
With an emphasis on
attachment, self - regulation, and competency (ARC), this course
focuses on how to plan and organize individualized
interventions that promote resilience, strengthen child - caregiver relationships, and restore developmental competencies undermined and weakened by chronic, multiple stressors and traumas.
Rather than punitive and restrictive
interventions, I
focus on healing by establishing a stronger connection /
attachment between children and caregivers.
A number of therapeutic
interventions have evolved from
attachment theory, although the majority of these
focus on families with younger children or on marital relationships (71).
Parental
interventions that
focus on
attachment and the development of sensitivity, attunement and conflict negotiation can be particularly beneficial (74).
Yet few of these writings
focus on specific
intervention strategies to help the traumatized individual experiencing
attachment avoidance.
Parent - Child Interaction Therapy (PCIT) is a dyadic behavioral
intervention for children (ages 2.0 — 7.0 years) and their parents or caregivers that
focuses on decreasing externalizing child behavior problems (e.g., defiance, aggression), increasing child social skills and cooperation, and improving the parent - child
attachment relationship.
Thus, consistent with the theoretical underpinnings of many evidence - based,
attachment -
focused parenting
interventions, reflective functioning may be an important port of entry for reducing negative parenting behaviors in mothers who were exposed to ACEs.
Emotionally
Focused Family Therapy (EFFT) is an
attachment - based approach that combines both systemic and experiential
interventions to mend broken bonds and heal fractured families.
My approach is person centered,
focused on creating a caring and empathetic therapeutic relationship, while utilizing varied
interventions, including psychodynamic, behavioral and cognitive based techniques, family systems theories, and
attachment based strategies.
Funded by the National Institutes of Health since 1995, her research has
focused on developing and evaluating
attachment - based parenting
interventions for mothers with substance use and psychiatric disorders.
Although some literature exists on long - term and intensive
interventions for altering
attachment styles (Cicchetti, Rogosch, & Toth, 2006; Levy et al., 2006; Travis, Bliwise, Binder, & Horne - Moyer, 2001), the preponderance of research on modifying
attachment has
focused on short - term outcomes.
Certificate Course in Emotionally
Focused Therapy with Sue Johnson:
Attachment - based
interventions for couples in crisis
In summary,
attachment - based
interventions to date have
focused mainly on precursors of organized types of
attachment rather than on precursors of disorganized
attachment, reflecting the fact that the extent of negative sequelae of disorganized child - caregiver
attachment has only recently been identified, as have precursors of disorganized
attachment.
The sensitivity -
focused attachment interventions that changed disorganized
attachment started after infant age six months (rather than during pregnancy and before infant age six months),
focused on children at risk (rather than parents at risk), and were conducted by professionals rather than non-professionals.
It is important to appreciate that when dealing with problems in the child - caregiver
attachment relationship, recent meta - analyses5, 8 show that the best
interventions to date are brief, use video feedback, start after infant age six months, and have a clear and exclusive
focus on behavioural training of the parent rather than a
focus on sensitivity plus support, or a
focus on sensitivity plus support plus internal representations.
However, a few sensitivity -
focused interventions seemed to have some impact, suggesting that disorganized
attachment might change as a side effect of some sensitivity -
focused attachment interventions.
In other words, from a health - promotion perspective (promoting secure
attachments), shorter and more
focused interventions may be preferable, but from a risk - reduction perspective (reducing disorganized
attachment), longer and more intensive
interventions may be necessary.
Attempts at improving caregiver sensitivity have been largely through targeting caregiver representations and / or caregiver behaviour during interactions with their children.5 However, while caregiver sensitivity is linked to the organized types of
attachment (secure, avoidant, resistant), it may not be as robustly linked to disorganized
attachment.6 Thus,
attachment - based
interventions that target child - caregiver interactions to date may not have
focused on the most clinically significant caregiver behaviours to prevent or reduce disorganized
attachment.
Children who have disorganized
attachment with their primary
attachment figure have been shown to be vulnerable to stress, have problems with regulation and control of negative emotions, and display oppositional, hostile - aggressive behaviours, and coercive styles of interaction.2, 3 They may exhibit low self - esteem, internalizing and externalizing problems in the early school years, poor peer interactions, unusual or bizarre behaviour in the classroom, high teacher ratings of dissociative behaviour and internalizing symptoms in middle childhood, high levels of teacher - rated social and behavioural difficulties in class, low mathematics attainment, and impaired formal operational skills.3 They may show high levels of overall psychopathology at 17 years.3 Disorganized
attachment with a primary
attachment figure is over-represented in groups of children with clinical problems and those who are victims of maltreatment.1, 2,3 A majority of children with early disorganized
attachment with their primary
attachment figure during infancy go on to develop significant social and emotional maladjustment and psychopathology.3, 4 Thus, an
attachment - based
intervention should
focus on preventing and / or reducing disorganized
attachment.
Thus, given current knowledge, one could argue that an
attachment - based
intervention that targets caregiver behaviour should
focus both on improving caregiver sensitivity (to promote secure
attachment and the associated positive socio - emotional outcomes) and on reducing and / or eliminating atypical caregiver behaviours, a known precursor of disorganized
attachment7 (to prevent or reduce disorganized
attachment and associated negative outcomes).
Overall,
attachment - based
interventions that
focus on improving caregiver sensitivity have limited effectiveness (d = 0.05, not significant) in preventing or reducing disorganized
attachment.
Benoit discusses the fact that, in an analysis of 15 studies from their 2003 meta - analysis, Bakermans - Kranenburg and colleagues concluded that
attachment interventions that
focus on preventing or reducing disorganized
attachment may need to target the reduction of atypical caregiver behaviours.8 Specifically, frightened or frightening caregiver behaviour has been implicated in the etiology of disorganized
attachment.
Maltreated infants randomized to the community standard condition continued to evidence extremely high rates of insecure
attachment consistent with that present at baseline.9 Interestingly, in the latter preventive
intervention, a didactic and more behaviourally
focused intervention was just as effective as one dealing with maternal representations in promoting secure
attachment.
One shortcoming of the Bakermans - Kranenburg et al. 8 meta - analysis is that it did not address the question of whether
attachment - based
interventions focusing on caregiver sensitivity have a significant impact on preventing disorganized
attachment.
Historically, most
attachment - based
interventions have
focused on improving caregiver sensitivity (which could be defined as the capacity to read cues and signals accurately and respond promptly and appropriately), with the assumption that this would promote secure child - caregiver
attachment, which in turn would be linked to positive social and emotional outcomes.
1995 — Building Relationships: Families and Professionals as Partners 1996 — A Promising Future 1997 — Fostering the Well Being of Families 1998 — Trauma: A Multi-Dimensional View 1999 — Coming Together for Children and Families: Developing Comprehensive Systems of Care 2000 — The Neurobiology of Child Development: Bridging the Gap Between Theory Research and Practice 2001 — Processing Trauma and Terrorism 2002 — The Road Less Traveled: Adoptive Families in the New Millennium 2003 — A Better Beginning: Parents with Mental Illness and their Young Children 2004 — Approaches That Work: Multi-Stressed Families and their Young Children 2005 — The Screening and Assessing of the Social Emotional Concerns 2006 — Supporting Young Children through Separation and Loss 2007 — Social Emotional Development: Promising Practices, Research and Policy 2008 —
Attachment: Connecting for Life 2009 — Evidenced - based Practices for Working with Young Children and Families 2010 - Eat Sleep and Be Merry: Regulation Concerns in Young Children 2011 - Climbing the Ladder Toward Competency in Young Children's Mental Health 2012 -
Focusing on Fatherhood 2013 - Trauma in Early Childhood: Assessment,
Intervention and Supporting Families
2007 - 2008: Program in Spiritual Counseling at the Center for Intuitive Listening with Kim Chernin, Ph.D 2009 - 2010: Pierce Street Integral Counseling Center 2010 - 2012: Community Healing Center, Internship with Dr. Ellen Hammerle 2012 - 2013: UCSF Positive Women's Health Program of Rita da Cascia (HIV + women and children) 2013: Collaborative Couples Therapy workshop with Dan Wile 2014: The Developmental Model of Couples Therapy: Integrating
Attachment, Differentiation, and Neuroscience in Couples Therapy, with Ellyn Bader of the Couples Institute 2014: Sue Johnson, author of «Hold Me Tight» training in Emotionally
Focused Therapy: On Target Couples
Interventions in the Age of
Attachment 2013 - 2016: PPTP program, San Francisco Psychoanalytic Center
A recent meta - analysis of early childhood
interventions asserted that brief
interventions (< 5 sessions)
focusing on increasing maternal sensitivity and enhancing infant
attachment security were more effective than long - term
intervention.23 In contrast, Hennighausen and Lyons - Ruth cited evidence that disorganized
attachment responds best to home - based, intensive and long - term
interventions.