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The Solihull Approach Dr Hazel Douglas

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Solihull Approach Parenting Group for universal upto those in moderate difficulty ... able to contain their own children and be in an attuned, reciprocal relationship. ... – PowerPoint PPT presentation

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Title: The Solihull Approach Dr Hazel Douglas


1
The Solihull ApproachDr Hazel Douglas
2
The Solihull ApproachThe power of parentingis
in the relationship!
3
The relationship
  • Video (scenebrain development, The First Years
    Last Forever)

4
Plan for today
  • Solihull Approach and parenting
  • Quick look at the SA model and how concepts
    relate to parenting
  • Underpinning attachment
  • Parenting, anxiety and performance

5
Parenting and the Solihull Approach
  • 11 work with parents
  • Group work with parents the Solihull Approach
    Parenting Group.in Solihull called
    Understanding your childs behaviour

6
Solihull parenting strategy
  • Solihull Approach Parenting Group for universal
    upto those in moderate difficulty
  • Mellow Parenting for those in severe difficulty
  • Solihull population 200,000
  • Aiming for a population effect, increasing SAP
    groups from 12 per year to 120 per year. Mellow
    Parenting from 3 to 9 a year.

7
More parenting support from Solihull Approach
  • Peer support for breastfeeding training (training
    for parents to support other parents, using the
    Solihull Approach model). Completed.
  • Antenatal parenting group (bringing the
    relationship into midwives parentcraft classes).
    In development.
  • Antenatal resource pack for antenatal team
    (supporting parents from conception). Half done.
  • Early Years Foundation Stage training now
    integrated with SA model to support parents
    through good childcare. Completed.

8
Solihull Approach and attachment
  • Solihull Approach is a vehicle for changing
    relationships and attachment.
  • Containment and reciprocity underpin attachment

9
Solihull Approach model
  • Containment psychoanalytic concept (Bion 1959)
  • Reciprocity child development concept
    (Brazelton, 1974)
  • Behaviour management behaviourism (Skinner,
    1938)

10
Containment
  • Containment is where a person receives and
    understands the emotional communication of an
    other without being overwhelmed by it and
    communicates this back to the other person.

11
Containment and the brain
12
Containment and the brain
  • Received/understood

13
Containment and the brain
  • Head full

14
Containment and the brain
  • Parallel process

15
Containment and parenting
  • Helps the parent to think about their child
  • Helps parents and their child to relate
  • Helps the parent to help their child cope with
    anxiety and emotion so that the child is free to
    relate
  • Helps the parent process some old emotions so
    that the parent can relate to the actual child in
    front of them, not a projection of a child

16
Reciprocity
  • Describes the sophisticated interaction between a
    baby and an adult where both the baby and the
    adult are involved in the initiation, regulation
    and termination of the interaction. Reciprocity
    also applies to the interaction between adults.

17
Dance of reciprocity
  • Initiation
  • Orientation
  • State of attention
  • Acceleration
  • Peak of excitement
  • Deceleration
  • Look away

18
Reciprocity and parenting
  • Helps parents and their child to relate
  • Tunes in the parent to think about their baby
  • Increases the parents awareness of their childs
    needs
  • Provides a focus and a language for feeding back
    to the parents about the interaction

19
More on reciprocity
  • Rupture and repair
  • Chase and dodge

20
Attachment
  • Video 2 (scene Bonding and attachment, The First
    Years Last Forever)

21
Attachment and the Solihull Approach
  • Attachment is a descriptive theory
  • Describes the attachment secure, insecure,
    disorganised
  • Doesnt tell you how to change the quality of an
    attachment
  • As recently as 1999 no interventions based on
    attachment theory (Lieberman and Zeanah, 1999)

22
Attachment and the Solihull Approach 2
  • Containment and reciprocity are the building
    blocks underpinning attachment
  • Robert Marvins Circle of Security (Marvin et al,
    2002) explicitly cites reciprocity and object
    relations theory

23
Circle of Security rupture and repair
  • The idea that smooth interactions between
    children and their caregivers are often disrupted
    and need repair.it is this ability to repair a
    disruption that is the essence of a secure
    attachment, not the lack of disruptions. This
    repair requires clear cues from each other, and
    clear understanding of, and responsiveness to,
    each others signals (Marvin et al, 2002 pg 109)

24
Circle of Security containment
  • Each caregiver is guided at her or his own pace
    toward increasing skill in reading the childs
    cues, reflecting on the childs (inferred)
    thoughts and feelings, and reflecting on her or
    his own feelings, plans and behaviour (pg 116).

25
Neurobiological evidence
  • The right hemisphere contributes to the
    development of reciprocal interactions within the
    mother-infant regulatory system and mediates the
    capacity for biological synchronicity, the
    regulatory mechanism of attachment Schore, 2001
    pg 23.

26
Attachment
  • Evidence cited that containment and reciprocity
    underpin attachment .
  • Interventions (e.g. Marvins Circle of Security)
  • Neurobiological (Schore)

27
Parenting, a secure base and containment
  • A secure base is established through parenting
  • via containment and reciprocity (and other
    concepts)

28
Parenting, anxiety and performance
  • It may be thought that the concept of containment
    indicates that parents need to be at a low
    anxiety level to be able to contain their own
    children and be in an attuned, reciprocal
    relationship.
  • But it is probably more complicated than that.

29
Containment and the brain
  • I think, therefore I am (Descartes)
  • The old anxiety/performance curve

containment
performance
anxiety
30
Parenting and anxiety 1
  • Marga Thome, Prof Nursing, Iceland. Research on
    the effect of telephone counselling with parents
    (telephone used because of the distances involved
    and remoteness of some communities). Some parents
    anxiety went down but some went up.

31
Parenting and anxiety 2
  • Solihull Approach Parenting results. Very strong
    correlation with a change in anxiety using BAI.
    But although the trend was down, some parents
    went up.

32
Parenting, anxiety and performance
  • There are many studies now that show that stress
    in the antenatal period can negatively affect
    child development.
  • However, too little stress may also be
    maladaptive. DiPietro et al, 2006 showed that a
    moderate amount of stress is better than too
    little or too much for a childs development.
  • DiPietro JA, Novak MF, Costigan KA, Atella LD,
    Reusing SP. (2006) Maternal psychological
    distress during pregnancy in relation to child
    development at age 2. Child Development, 77,
    573-587.

33
Zone of optimal functioning
  • Research from sport. The zone is different for
    everyone. Some need more anxiety to perform well.
    Some need less.

containment
performance
anxiety
34
Zone of optimal functioning for parents
  • I think this explains Marga Thomes results,
    Solihull Approach Parenting results and DiPietro
    et al.s results.
  • Being in tune with your child may raise your
    anxiety if you werent in tune before

35
Conclusion
  • The Solihull Approach model is used to support
    parenting
  • Containment and reciprocity, concepts within the
    model, can be used to work with the attachment
  • Supporting some parents may mean raising their
    anxiety. For others, it is about lowering their
    anxiety.

36
  • Video (scenebrain development, The First Years
    Last Forever)

37
Research Results effect of training 1
  • Douglas, H. and Ginty, M. (2001) The Solihull
    Approach changes in health visitor practice.
    Community Practitioner, 74, 222-224.
  • Whitehead, R. and Douglas, H. (2005) Health
    visitors' experience of using the Solihull
    Approach. Community Practitioner, 78, 20-23.

38
Research Results effect of
training 2
  • Lintern, J. (2005, unpublished study) A follow-up
    evaluation of the Solihull Approach training,
    Middlesbrough.
  • Lowenhoff, C. (2004) Practice development
    training professionals in primary care to manage
    emotional and behavioural problems in children.
    Work Based Learning in Primary Care, 2, 97-101.

39
Research Results effectiveness
  • Douglas, H. and Brennan, A. (2004) Containment,
    reciprocity and behaviour management preliminary
    evaluation of a brief early intervention (the
    Solihull Approach) for families with infants and
    young children. International Journal of Infant
    Observation, 7 (1), 89-107.
  • Milford, R., Kleve, L., Lea, J. and Greenwood, R.
    (2006) A pilot evaluation study of the Solihull
    Approach. Community Practitioner, 79, 358-362.

40
Ghosts from the nursery
  • From the waters of the womb to the arms of the
    caregivers to the walls of the family home, when
    the shelters in which we harbour our children are
    inadequate or destructive, the final shelter our
    society provides will often be the cement walls
    of a prison cell Karr-Morse and Wiley, 1997

41
Ghosts from the nursery
  • Our challenge is to move this information into
    the mainstream to create a critical mass of
    people who know and who care who will over time
    enable this information to move from
    understanding to practice Karr-Morse and Wiley,
    1997.

42
Risk Factors child
  • Specific learning difficulties
  • Communication difficulties
  • Specific developmental delay
  • Genetic influence
  • Difficult temperament
  • Chronic physical illness
  • Academic failure
  • Low self-esteem

43
Risk Factors from the family
  • Overt parental conflict
  • Family breakdown
  • Inconsistent or unclear discipline
  • Hostile or rejecting relationships
  • Failure to adapt to a childs changing needs
  • Physical, sexual or emotional abuse
  • Parental psychiatric illness
  • Parental criminality, alcoholism or personality
    disorder
  • Death and loss-including loss of friendship
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