The secure base star: an attachment based model of caregiving that promotes security and resilience

1
The secure base star an attachment based model
of caregiving that promotes security and
resilience

• Professor Gillian Schofield
• Co-Director of the Centre for Research on
• the Child and Family

2
Balance of concern and hope for troubled children

• Children are significantly harmed by abuse,
  neglect, separation and loss.
• Many children will suffer to some extent all
  their lives as a result.
• But many children can benefit from therapeutic
  caregiving experiences and go on to lead
  successful stable lives as adults, partners and
  parents
• The goal is to promote security and resilience

3
What does attachment theory help us understand
about troubled children?

• Abuse, neglect or rejection have implications for
  the childs internal working model (beliefs and
  expectations of self and others).
• Separation and loss raise anxiety and intensify a
  childs defensive strategies.
• There is a risk that children will recreate their
  previous experiences of caregiving in new
  families /new relationships the child may think
  good care is just a trick (Crittenden 1995)

4
Use of attachment theory and research in
developing a parenting / caregiving model

• Key to promoting security and resilience is
  mind-mindedness - in carers and children
• Attachment focuses attention on the quality of
  the childs experience in the relationship with
  the caregiver as an active source of therapeutic
  care.
• Security and resilience comes not just from
  relationships with specific attachment figures
  but from the whole environment (family, friends,
  school, activities)

5
The cycle of caregiving
Childs needs / behaviour

Carer thinking and feeling
Child thinking and feeling
Effect on childs development
Parenting behaviour
6
Parenting dimensions from attachment and foster
care research that promote security and resilience

• Being available helping children to trust
• Responding sensitively helping children to
  manage feelings and behaviour
• Accepting the child - building self esteem
• Co-operative caregiving helping children to
  feel effective (and be co-operative)
• Promoting family membership helping children to
  belong

7
Dimensions of parenting interact secure base
star
8
Working with children and carers the secure
base star in practice

• Assessment and working with children in their
  birth /foster/adoptive families, residential care
  and schools
• Life story work
• Assessing, preparing and supporting foster
  carers/adopters /residential workers
• Matching children and carers
• Foster carers - setting goals for each dimension
  and monitoring progress (new and existing
  placements)
• Assessing and providing help to placements in
  difficulties

9
Main sources

• Schofield G and Beek M (2006) Attachment Handbook
  for Foster Care and Adoption London BAAF
• Schofield G and Beek M (2006) Achieving
  Permanence in Foster Care A good practice guide
  London BAAF
• http//www.uea.ac.uk/providingasecurebase
• Also research books Growing up in Foster Care
  (2000), Part of the Family (2003) and Providing a
  Secure Base in Long-term Foster Care (2004) (all
  BAAF)

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Being available
Childs needs/ behaviour
Carer thinking/ feeling
Child thinking/feeling
What does this child expect from adults? How can
I show this child that I will not let him down?
I matter, I am safe I can explore and return for
help Other people can be trusted
Helping children to trust

Alert to childs needs/signals Verbal and
non-verbal messages of availability
Parenting behaviour
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Children who lack trust

• Troubled children have often lacked consistent
  care and protection from reliable caregivers
• Caregivers unavailable through drugs, mental
  health, learning disabilities, own childhoods
• Caregivers may have
• rejected the childs emotional demands
• responded unpredictably
• been frightening or frightened
• Children will have developed defensive strategies
  to cope with this lack of trust

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Being available helping children to trust
examples

• Be available physically and emotionally and
  signal availability in age appropriate ways
• Provide predictable routines
• Time the relationship dance at the pace of the
  child
• Make sure child feels special/cared for when
  unwell or troubled
• Help the child know that you are thinking of him
  or her when apart

13
When tiny babies have switched off

• When Jennie came to me at 12 weeks old, she was
  completely unresponsive, not waking for feeds,
  not responding to me, not showing any emotion.
  She had just switched off. I had to stay close
  to her and respond to even the slightest sound or
  facial movement and keep talking to her and
  touching her. It took time to replace those
  first weeks, but gradually she started to show
  different feelings and become more responsive.
  (Carer)

14
Having the patience to let the child approach

• Sam (6) found it impossible to trust me and
  watched my face warily all the time. I found that
  if I sat with a drink for him on the settee with
  childrens television on, he would circle the
  house for a long time dragging his favourite
  blanket and eventually end up sitting on my lap
  wrapped in the blanket, drinking his drink. I
  needed just to be there and he needed to have the
  confidence that I would wait for him to come to
  me. (Carer)

15
When children are anxious and away from their
secure base

• When Aiden (4) had contact with his father he was
  always very anxious about what might happen and
  whether he would come back to me and I would be
  here for him. On one occasion I gave him a small
  cushion to take with him so that he had something
  to hold onto, but also so that he would know he
  would be coming home. (Carer)

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Difficulties for some carers in being available

• Overwhelmed by the childs demands
• Feel marginalised
• Distance themselves- emotionally or physically
• AND / OR
• Dont believe a child should need that much
  attention
• Do not have enough time for the child
• Lack commitment to this child
• CARERS need help to understand a) childs needs
  and signals b) own feelings/ideas /parenting

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Responding sensitively
Childs needs/ behaviour
Carer thinking/feeling
Child thinking /feeling
My feelings make sense -and can be managed Other
people have feelings and thoughts
What might this child be thinking and
feeling? How does this child make me feel?
Helping children to manage feelings and behaviour

Tuning in to the child. Helping child to
understand /express feelings appropriately
Parenting behaviour
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Children who find it difficult to manage their
feelings and behaviour

• Feelings have often not been acknowledged or
  understood in their birth families
• From infancy, overwhelmed by feelings that cant
  be managed
• Feelings often mislabelled/distorted what is the
  truth?
• Cannot appropriately express feelings so
  excessively expressed or denied and repressed or
  dysregulated and chaotic or dissociated.
• Feelings expressed through their bodies in
  confused ways

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Responding sensitively-helping children to manage
thoughts and feelings examples

• Tuning in reading signals, anticipating
  distress, containing anxiety
• Naming thoughts and feelings providing a
  commentary.
• Scaffolding experience- giving a predictable
  shape to events e.g. feeds, nappy change, school
• Modelling expression and management of carers
  own thoughts and feelings
• Promoting empathy how do you/how might other
  people think and feel?

20
Promoting mind-mindedness, perspective taking and
empathy

• I think Jenna (9) spent so long in self defence
  and looking after herself that she never learned
  to look at things from any one elses point of
  view. She missed that out when she was little.
  And even things like stories.. When you say, what
  do you think is going to happen next? or why is
  that person thinking that? she hasnt got a clue,
  she doesnt follow the motives of what people are
  doing, or how they are feeling. So we do a lot of
  story reading together and I talk it through.
  (carer)

21
Using an experiences book making it safe to
think and remember

• Paula (8) couldnt remember or didnt want to
  remember what happened this morning or yesterday
  or last week and couldnt anticipate next week.
  So we started to do an Experiences Book together
  - each day writing down what had happened and her
  feelings about it. This helped her to reflect on
  the shape of each day and the immediate past and
  build her capacity to remember. (carer)

22
Difficulties for some carers in responding
sensitively

• Lack mind-mindedness-about self/others
• Difficulty in thinking about the childs past-
  too painful/want to give the child a fresh
  start
• Difficulty in thinking flexibly having flexible
  theories about the childs thinking/behaviour
• Tend to be negative -so children withdraw /act
  out so react negatively...
• CARERS need help to think about the mind of the
  child/reflect on their own minds

23
Accepting the child

Childs needs/ behaviour
Carer thinking/feeling
Child thinking/feeling
I need to value and accept myself. I can value
and accept this child.
Building self-esteem
I am accepted and valued for who I am
Helping child to fulfil potential, feel good
about himself- and accept setbacks
Parenting behaviour
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Children with low self-esteem

• Many troubled children feel profoundly worthless
• They have often experienced parenting that was
  negative and lacked warmth/sensitivity
• Tend to see the world /other people in extremes -
  all good or all bad
• Multiple separations within the birth family/once
  in care may also move
• Defend against feelings of worthlessness
  boastful/ or wont compete
• Often wont take risks /try new things

25
Accepting the child-building self-esteem
examples

• Promote the idea in the (foster) family-
  Nobodys good at everything but everybodys good
  at something.
• Look for special strengths/talents in the child
• Find activities to do and to share
  orchestrate achievements
• But allow failures and setbacks to happen and be
  managed.
• Model and teach the child to accept and celebrate
  difference in self and others ethnicity,
  personality, talents.

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Accepting the child for better or worse

• Just look at her. Shes got such a twinkle.
  Shes an absolute rogue. And you would never
  want that squashed. Its lovely. Its just got
  to be channelled the right way. (Carer)

27
Children often blame themselves

• Salina (4), had repeatedly been disappointed by
  her mother failing to come to visit her at her
  foster home. Shortly after such a disappointment,
  her foster mother overheard Salina saying to
  herself, If I good girl, Mummy come. She
  believed she was not good enough to be loved.
  (Social worker)

28
Promoting positives - showing pride

• Rob (11) loves his fish pond. Now hes in charge
  of his own and hes totally reliable in that
  department. We encourage him all we can. We say
  Robs the top pond man. He gave his talk at
  school on goldfish and got top marks. (foster
  carer)

29
Helping children to be accepted by others
-including disabled children

• For Ben (10) to be accepted some of his behaviour
  had to be modified and he will get the benefits
  of that. We go to a nice hotel and hell walk
  into the dining room on his walker and everyone
  thinks hes so wonderful and its so great for
  him. They say Ben, youre so clever, youre
  marvellous, youre such a beautiful boy. I
  think, thats part of whats building him up, not
  me, but the response of all these other people.
  And hed never have got that, not how he was
  before. (Carer)

30
Difficulties for some carers in accepting the
child-building self-esteem

• Focus on negative to avoid child being
  big-headed
• Find it hard to accept the child being different
  from the foster family
• Low-self-esteem as carers- child seen as a burden
• Less likely to take time to help child do
  activities
• Again- children feel different and rejected-
  withdraw (sometimes attack/break placement)
• CARERS need help to accept/empathise/enjoy the
  child

31
Co-operative caregiving
Child needs/ behaviour
Carer thinking/feeling
Child thinking /feeling
The child needs to feel effective and
competent How can we work together?
I can make things happen within safe limits I can
compromise and co-operate
Helping children to feel effective

Promoting autonomy and choice Co-operating/
negotiating within firm boundaries
Parenting behaviour
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Children who do not feel effective- cant
compromise/co-operate

• Lack confidence in getting their needs met
• Have rarely experienced co-operative parenting
  parents were often either too controlling and
  intrusive or too passive and ineffective
• Children have often felt powerless or too
  powerful
• NB Feelings like this can be made worse in poor
  communities and in the care system

33
Co-operative caregiving- helping children to
feel effective examples

• Offer choices- even in small things
• Help children follow through/achieve results-both
  on their own and with help e.g. plan a trip,
  take photos and see them developed and framed.
• Involve child in family tasks that all can see
  the benefit of.
• Model co-operative behaviour with other family
  members as well as showing it with the child.

34
The therapeutic effect of supporting a child to
take the lead

• George (3) would only relax in the garden, so
  although it was winter we wrapped up warm and
  everyday we spent time outside. He would potter
  about, looking at stuff and I would follow him
  sometimes and talk occasionally and he would stop
  and hed look at an insect, or whatever it was
  hed found. I pretty much let George lead, but
  sometimes Id draw his attention to things. Yes,
  he pulled out all the plants and I just decided
  that I wasnt going to have a garden that year
  and I just thought yeah, I can have a garden
  next year. (carer)

35
Promoting co-operation-avoiding a battle

• We try, actually, never to tell Salim (7) to do
  anything. Its a matter of phrasing it
  differently, so that you are not triggering his
  feelings of threat. So, instead of saying,
  Please wash your hands before you have a
  sandwich we might just say Would you like to
  come and have a sandwich after youve washed
  your hands? or Well have a nice long story
  time if you brush your teeth quickly. (carer)

36
Difficulties for some carers in being co-operative

• Foster carers emphasise control a battle with
  the child that they must win
• Cant accept /enjoy childs need for autonomy
• Cant take risks
• SO child feels powerless- OR becomes defiant
  /oppositional
• CARERS need help to see the value and benefits
  for the child of feeling effective and for the
  family of co-operation being on the same side.

37
Promoting family membership
Childs needs/ behaviour
Carer thinking/feeling
Child thinking/feeling
This child is part of my family as well as part
of his/her birth family
I can belong comfortably to both of my families

Helping children to belong
Verbal and non-verbal messages of inclusion in
both families
Parenting behaviour
38
Children who do not feel they belong- in any
family

• Children may have been rejected in their birth
  family singled out for rejection or became
  excluded when parents separated and remarried
• Their identity may have been confused and
  uncertain but still feel loyal to their
  original family /parents
• In a foster family they find it hard to join in
  to accept the patterns/rituals of a new family
• Make carers feel that they dont want to belong

39
Promoting family membership-helping children to
belong examples

• Have special places for the child in the family
  /residential home - for their clothes, at table,
  in the garden
• Ensure the child understands how this family does
  things - include the child in foster family
  life/photos
• Enable the child to talk about and value their
  birth family identity
• Manage contact in ways that promote the childs
  well-being and comfortable sense of belonging in
  both families.

40
Belonging to a real family Can you describe
your relationship with your foster mother?

• Mother and son. She looked at me as her son and
  I looked at her as my mum sort of thing. Even
  though when youre 18 you officially leave care
  but we kept in touch. We go round there for
  dinner, she comes round here. She classes my
  children as her grandchildren. (Christopher -
  age 29 placed at 5)

41
Leroy (age 18 placed at 8) talking about his
foster mother

• My mums helped me a lot because she was
  determined for me to do well. Thats a really
  important thing, other people believing that you
  can do well... It was my home - whereas before it
  was just somewhere I was staying.

42
Part and parcel of our family

• We always say from the moment you walk
  through the door, you are part of us. No matter
  how long youre staying or how many other
  families you relate to, you are part and parcel
  of our family, the same as everyone else who
  lives here. We say it and we show it to them as
  well. (carer)

43
On learning that two boys (9 and 11) would be
staying in the foster family

• I was absolutely over the moon. When they came we
  just fell in love with them and everyone in the
  family said, Wouldnt it be great if we got them
  for good?.... Then when they asked us if we
  wanted to keep them I couldnt believe my luck.
  (Carer current study)

44
Difficulties for some carers in promoting family
membership

• Treat child differently to own /other foster
  children
• Dont include the child fully in family occasions
• Have extended family that excludes the child
• Dismiss importance of the birth family to the
  child
• Talk negatively about birth family
• Make contact difficult for child and birth
  relatives
• CARERS (and other family members) need to reflect
  on the childs experience, their own responses -
  and their commitment to the child

45
Social work practice

• Work with carers birth/ foster / adoptive /
  residential- so that they can identify their
  sticking points /difficulties
• Alert at the time of a foster care match to gaps
  in carers capacity few foster carers are
  equally good at all dimensions
• Have some practical suggestions for carers to try
  appeal to their empathy and creativity
• Goal of the model is for parents / carers to
  enjoy as well as help the child.

46
Final thoughts from Georges foster mother

• I think if you can just catch children in time,
  they really can start to heal and recover well
  enough to go on and just enjoy their childhoods
  and become reasonably adjusted adults - and
  thats a great result, really.

47
Working with children and foster carers the
secure base star in practice

• Assessment and working with children
• Life story work
• Assessing, preparing and supporting foster carers
  
• Foster carers setting goals for each dimension
  and monitoring progress new and existing
  placements
• Assessing and providing help to placements in
  difficulties
• NB Use in other environments - birth families,
  residential care, adoption, schools