Four Essential Enrichment Activities to Promote Recovery at School from Interpersonal Trauma

  1. Greet the child before they do anything to initiate engagement with you.

Greeting children in this way offers them the experience that they are in your thoughts, that they are worthy and that you are accessible. This is necessary as children who have experienced interpersonal trauma have learnt that they cannot rely on others to attend to them and their needs. They also have a low opinion of their worth. Promoting their sense of self-worth and the worth of relationships with others underpins all endeavours to promote recovery from interpersonal trauma. Check in with them proactively throughout the day.

  1. Tune into the child’s emotions and restore calm.

When the child is happy, allow yourself to feel and project happiness in your interactions with them. When the child is sad or frustrated, show a little of those emotions as well. In doing so you and the child will be connected at an emotional level. Then restore calm. They will remain connected and return to calm themselves. These experiences of emotional connection offer the child experiences that their feelings matter; that they matter; that they are worthy. It also promotes tolerance of, and a return to calm from, a range of emotions.

  1. Say what is in their head and in their heart.

Observe the child and the situation/activity. Say what you think is their experience of the situation/activity. Make it a statement. Say it with congruent feeling. Speak their mind. Communicating in this way offers the child an enriched experience that they are understood, that their experience matters, and that they matter. Do not ask questions, as questions communicate that you do not know them.

  1. Develop a ritual involving one-to-one time.

Plan to spend five minutes per day of one-to-one time with the child. Do it in a routine and predictable way, such as at a certain time of the day. This satisfies a number of important needs the child has, including their needs for attention and order. Help them with a task or play a simple card game with them. Tune into their emotions and say what is in their head and in their heart (enrichment activities 2 and 3). If you play a game of Uno, play their hand. Match your emotions and your words to their experience of the game.

For more information about the thinking behind these enrichment activities visit securestart.com.au or email Colby at colby@securestart.com.au.

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Therapeutic Foster Care in Ireland – From Adelaide with Kindness

Recently, the Irish Foster Care Association (IFCA) called for tenders to review current pre-approval foster carer training in Ireland, develop a new package of training, and train trainers. At the end of the competitive international tendering process I was successful in receiving the tender for the project. In this collaboration with IFCA I will be partnered by John Gibson of Secure Attachment Matters, Ireland. We are grateful to Lynne Peyton, who provided valuable assistance and support during the tendering process.

The nominated working title for the tender submitted was Entering CARE. This is meant to reference the beginning of a journey as an alternate care provider but also picks up the the four, evidence-based components of therapeutic care that anchored the Second Edition of A Short Introduction to Attachment and Attachment Disorder (Pearce, 2016), these being:

  • Consistency
  • Accessibility
  • Responsiveness
  • Emotional Connectedness.

This does not mean that the new package will simply be an extension of what appears in my most recent book. Rather, it is envisaged that that new package will draw on the views of stakeholders in Ireland and the most up-to-date ideas and evidence that appears in the relevant international literature; including my own contributions to that thinking and literature.

In tendering to develop this package there was a strong emphasis on bringing together the at-times disparate elements of child protection and social care endeavours under the following maxims:

  • Common Knowledge – that is, a knowledge framework that is shared between foster and kinship carers and professionals who work with children recovering from abuse and neglect;
  • Common Language – that is, a language framework that facilitates effective communication between foster and kinship carers and professionals who work with children recovering from abuse and neglect;
  • Common Purpose – that is, a set of goals that facilitate strong outcomes for children that are easily shared by foster and kinship carers and professionals who work with children recovering from abuse and neglect.

Those who are familiar with my work, including those who have participated in the Donegal implementation of the Triple-A Model of Therapeutic Care, will know that I strongly emphasise the care of those who care for children recovering from abuse and neglect. I believe that, alongside the care and protection of children, the care of foster and kinship carers must also be a priority. Any child protection endeavour that does not also care for foster and kinship carers will struggle to achieve its core business – the therapeutic care and protection of children that facilitates them achieving their developmental potential.

Finally, I believe that kindness should be at the heart of all of our endeavours in this space. It is my great hope that that the pre-approval foster care training package developed as part of this project will extend on the efforts of those who developed the existing package and promote kindness to others.

About me: I am a practising clinical psychologist who lives in Adelaide, South Australia. I am known beyond Adelaide as a consultant, trainer and author of periodical articles, the Triple-A Model of Therapeutic Care, and two books; including A Short Introduction to Attachment and Attachment Disorder, which now runs to two editions (2009, 2016). I am  known in Ireland as the author of the Triple-A Model of Therapeutic Care. Triple-A is a back-to-basics, step-by-step approach to therapeutic care designed to facilitate children’s recovery from early adverse childhood experiences and promote self-efficacy and wellbeing for foster and kinship carers. Triple-A incorporates modules for the training of foster and kinship carers and for professionals who work with and support these carers. Triple-A carer training modules address the therapeutic care of children in out-of-home care, as well as carer wellbeing. Triple-A is currently part-way through an initial three-year implementation programme with TUSLA staff and foster carers in Donegal[1].

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

 

 

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Therapeutic caregiving – why conventional is vital

We know that . . .

We do that . . .

These are all-too-familiar responses to endeavours to promote conventional aspects of caregiving and relating as part of a therapeutic approach to the care of children who are experiencing, or who have experienced, adverse life events and adversity.

 

So why recommend conventional approaches to caregiving and relating as part of a therapeutic approach to care?

In my opinion, recommending conventional approaches to caregiving and relating represents our best chance of promoting a common language and understanding among adults in a care and management role across environments (eg home and school) and consistency in their implementation across time.

Consistency is vital to the care of children recovering from adverse life events and adversity*. Consistency of care experiences represents the optimal condition for new learning; including learning that they are good, capable and deserving, that adults are reliable and dependable, and that the world is predictable and safe place. Inconsistency mimics the circumstances under which adverse life events and adversity occurs, thus perpetuating their negative impacts on the developing child.

Recommending conventional approaches to caregiving and relating that are therapeutic reassures caregivers that they are a person of worth and that their efforts on behalf of the child are worthwhile. Not only is it intended to be validating, but a process is facilitated whereby the caregiver becomes more aware of those occasions when they exhibit the therapeutic caregiving or relational behaviour and, in turn the response of the child. Therapeutic caregiving and relational behaviours are anticipated to promote a positive response in the child, which is rewarding and reinforcing of the behaviour. Rewarded behaviour remains in the caregivers repertoire, thus promoting consistency in the child’s experience of care, and facilitating conscious adherence to a therapeutic care approach.

Recommending conventional approaches to caregiving and relating that are therapeutic for children promotes feelings of self-efficacy and wellbeing for caregivers, which are vital to the longevity of their endeavours. As these therapeutic aspects of caregiving and relating are rewarded both intrinsically (the caregivers experience) and extrinsically (the child’s reaction), they become consistent and predictable aspects of the child’s experience of care.

Recommending conventional approaches to caregiving and relating that are therapeutic for children enriches their lives, and those of their caregivers.

 

*Pearce, C. (2016), A Short Introduction to Attachment and Attachment Disorder (Second Edition), London & New York: Jessica Kingsley Publishers

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Parental CARE: Implications for Attachment Security and Disorders

Parental CARE: Implications for Attachment Security and Disorders

A webinar with Colby Pearce

Saturday 20 May 2017, 10.00am – 1.00pm, London, UK time

 In the same way that an infant’s attachments develop in association with their experience of who cares for them, the type of attachment relationship or attachment style is dependent on the type of care they receive.  At this practical and engaging webinar, we carefully examine the inextricable linkages between quality of caregiving and developmental pathways for both attachment security and attachment disorders. Colby Pearce helps us conceptualize these linkages by using a descriptive model that refers to the consistency, accessibility, responsiveness and emotional connectedness (CARE) of caregiving experiences and explains how each of these aspects impact not just developmental pathways, self-conceptualization, social relatedness and adversity resilience; but also aid our understanding of the two main forms of attachment disorders according to DSM-5: Reactive Attachment Disorder (RAD) and Disinhibited Social Engagement Disorder (DSED).

Through case vignettes and interactive discussions, the webinar helps us comprehend:

  • how deficits in the CARE model can explain the development of attachment disorders
  • why we observe compulsive re-enactment of maladaptive interactions when care arrangements change
  • in therapeutic settings, how we can interpret the exhibition of controlling, manipulative and / or deceptive and deceitful behaviours
  • the situations where caregivers can experience feelings of revulsion and loathing towards the attachment-disordered careseeker
  • when grossly deficient CARE may be the best explanation for disturbed presentations (RAD and DSED)
  • how the tenets of CARE can be built into our therapeutic engagements

The webinar will be especially useful for psychotherapists, psychologists and counsellors who are interested in learning how to integrate specific attachment-related interventions in their work with clients.

Colby Pearce is an Australian Clinical Psychologist, author and consultant. Across a career spanning more than twenty-five years he has made important contributions to professional endeavours in the fields of child and adolescent mental health research, child protection and therapeutic child care. He is the author of two books and a number of periodical articles, though he considers that the recently-released second edition of A Short Introduction to Attachment and Attachment Disorder (Jessica Kingsley Publishers) should count as a third book; such is the extent to which the first edition has been revised and updated. He consults in Australia and in Ireland and has extensive experience in teaching and training professional audiences. He is the author of the Triple-A Model of Therapeutic Care, which is currently being implemented in Donegal, Ireland, as part of a three-year programme of support for foster carers.

 Webinar Schedule:

9.45am: Online Registration

10.00am: Session 1: Parental CARE, Attachment Security and Attachment Disorders

  • The basic tenets of the CARE model
    • Developmental pathway implications
  • What do Attachment Disorders look like?
    • CARE and Attachment
    • CARE and Arousal
    • CARE and Learning

 11:30am: Break

 11:45am: Session 2: Enriched CARE for better outcomes

  • Maladjustment and the role of promoting Attachment Security
  • Holding appropriate developmental expectations
  • Proactive needs provision
  • The prerequisites for Attachment Oriented Therapy
  • Illustrative case examples and discussion

 1:00pm: Close

To register, visit: http://www.nscience.co.uk/20-may-2017-webinar.html

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CARERS must CARE – Lessons on attachment from Colby Pearce

Lynne PeytonIt was such a privilege to be asked recently to write a review for Colby Pearce’s second edition of a ‘Short Introduction to Attachment and Attachment Disorder’.

Colby Pearce is one of the leading experts in attachment and as a clinical psychologist, he has interacted with hundreds of children over his long career. His writing is informed by his considerable experience and he has a huge amount of empathy with children who have experienced early childhood trauma.

I want to summarise just a few of the core insights on attachment from this latest guide.

  • Attachment is the term used to describe the dependency relationship children develop towards their primary caregivers.
  • An attachment figure is someone who provides physical and emotional care, has continuity and consistency in the child’s life, and is emotionally invested in the child.
  • Human infants are not born with attachments already in place with their primary caregivers. This special relationship emerges over time.
  • Attachment theory was developed by John Bowlby and colleagues to describe the relational variables in the development of the mother infant relationship and the importance of the relationship itself on the successful adaptation of the young child to life more generally.
  • Children can form multiple attachment relationships.
  • Infants form attachment to the person or persons who they experience to care for them physically and emotionally on a continuous period.
  • Pearce Identified that carers must be experienced by the child as Consistent, Accessible Responsive and Emotionally connected. Hence his C.A.R.E. model:

              C – Consistent -consistent care is where an action is consistently followed by a                           desired outcome.

              A – Accessible care means the parent is present and available physically and                               emotionally to the growing child.

              R – Responsive carers accurately interpret the child’s signals and directly address                     their needs

              E – Emotionally connected carers “tune in” to the infant and reflect a similar                               emotion back.

(Tronick’s ‘still face’ experiments vividly demonstrate the distress experienced by youngsters when a previously playful parent adopts a ‘dead pan’ expression and stops engaging with the child)

  • Early attachment experiences contribute to a child’s sense of self and self-worth. It also forms the basis for future relationships as, if children experience parents to be consistent, accessible, responsive and emotionally connected, they will develop emotional resilience in their engagement with the rest of their world.

Having established the basis for healthy attachment, Pearce goes on to consider how attachment  can be disrupted through early childhood experiences of abuse, neglect and other trauma. He offers effective forms of treatment for attachment disorders.

This is an essential read for Social Workers, teachers, foster carers and residential care staff. It is available from Jessica Kingsley Publishers: http://www.jkp.com/uk/a-short-introduction-to-attachment-and-attachment-disorder-second-edition-34523.html

Lynne Peyton

Tackling Childhood Neglect(Lynne is a childcare expert, leadership coach and consultant to social welfare organisations. Lynne consults internationally. and is the author of Tackling Childhood Neglect: http://www.lynnepeyton.com/audiobook)

Originally published herehttp://www.lynnepeyton.com/single-post/2017/04/19/CARERS-must-CARE-%E2%80%93-Lessons-on-attachment-from-Colby-Pearse

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Foster Carers report Model of Care Interesting and Helpful

AAA-Model-of-Therapeutic-CareThe Health Information and Quality Authority (HIQA) is an independent authority established to drive high-quality and safe care for people using health and social care services in Ireland. HIQA monitors foster care services against the National Standards for Foster Care, published by the Department of Health and Children in 2003.

In September and October 2016 HIQA conducted an assessment of foster care services in Donegal, Ireland. This is what HIQA said about the implementation of the Triple-A Model of Therapeutic Care to foster carers in Donegal:

The area had also recently piloted training in a particular therapeutic model of care with 22 of their foster carers. This model focused on helping foster carers create a care environment where they were emotionally available to children in care in order to help them create healthy attachments based on trust. Foster carers who had completed the course told inspectors they found it interesting and helpful in their role as foster carers. Social workers received training in the model of care during the course of the inspection and there were plans to extend this training to all foster carers.

For the full report follow this link: https://www.hiqa.ie/system/files?file=inspectionreports/4393-foster%20care-donegal-23-September-2016.pdf

 

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Further information about Colby

Source: Further information about Colby

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Therapeutic Childcare – The CARE Approach

Colby Pearce Attachment National Psychology Exam

Earlier this year I set about revising and updating A Short Introduction to Attachment and Attachment Disorder. The second edition is available from December 2016. As part of the revision process I considered what we might mean when talking about therapeutic care of children. This is the CARE Model I came up with:

Be Consistent – Children develop and learn (including new ways of relating) best in a stable care environment where there is consistency in caregiver approach to the child’s care and management across caregivers and across time.

Be Accessible – Children benefit from an enriched experience that their carers are available to them. They learn this best when carers attend to them before the child has done anything to draw attention to themselves.

Be Responsive – Children benefit from an enriched experience that their inner world is understood and their needs will be responded to without them having to go to great lengths to make it so; either through behaviour that communicates internal states or inordinately demanding or deceptive behaviour to secure a response to basic needs (such as the need for attention, acceptance and physical sustenance). Communicating understanding of their inner world in words used by their caregiver and through proactive needs provision is vital for enriching the child’s experience and new learning about caregiver responsiveness.

Be Emotionally-Connected – Children benefit from the experience that their emotions are felt by their caregivers. Their experience of connection is enhanced and the foundations for empathy and self-regulation are promoted. Through their caregivers making an emotional connection with the child’s emotions and restoring calm themselves, the child will themselves be calmed, with the result that the child will to explore a range of emotions (thereby promoting emotional growth) and develop their own capacity for self-regulation of emotion.

13754277_10207024040505557_6258179799568697908_nFor more information about the CARE model and the CARE approach, secure the revised and updated second edition of A Short Introduction to Attachment and Attachment Disorder, available December 2016.

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Therapeutic CARE and the Triple-A method

As a practising Clinical Psychologist and as a father to three boys I often think of child-rearing as akin to being a farmer who grows crops.

The farmer expends significant effort preparing the soil and sowing seeds. Then the farmer waits and hopes. The success of his endeavours is dependent on his preparation of the soil and climatic conditions through the growing period. Until his crop is reaped, the farmer is never completely certain of the outcome of his endeavours.

Good CARE

 

 

Similarly, in order to grow up happy, healthy, well-developed and well-adjusted, children require a range of experiences and responses to their needs that, in combination, constitutes child-rearing. The colours on the picture opposite represent important experiences and responses to needs that constitute good CARE.

 

 

 

Black Page

 

 

 

The results of our endeavours in child-rearing are not always obvious, and there may be dark times where we doubt the effectiveness of our endeavours on behalf of our children.

 

 

 

 

 

Whole Child

 

 

 

However, little-by-little, where there is good CARE, the whole child will shine through.

 

 

 

 

 

 

 

Neglectful CARE

 

 

 

Unfortunately, not every child is offered the important experiences and responses to needs that constitute good quality CARE with a consistency that promotes their development, wellbeing and adjustment.

 

 

 

 

Neglected Child

 

Where CARE is neglected, the whole child in all of their potential cannot shine through.

In order to be whole, these children require adults in a caregiving role to enrich their experience of CARE and fill in the gaps.

This is the primary task (Kahn, 2005) of therapeutic care; getting back-to-basics and offering enriched experiences of CARE that promotes the child’s development, wellbeing and adjustment.

 

 

 

13754277_10207024040505557_6258179799568697908_n

 

 

In the forthcoming revised and updated Second Edition of A Short Introduction to Attachment and Attachment Disorder (available December 2016) I describe in detail what is good quality CARE, how it benefits outcomes for the developing child, and how to enrich CARE to promote attachment security and associated positive developmental, behavioural and mental health outcomes for children.

 

 

 

 

 

AAA-Model-of-Therapeutic-CareIn the Triple-A Model of Therapeutic Care I provide a therapeutic CARE framework and a step-by-step approach to the implementation of a therapeutic care approach to children recovering from abuse, neglect and insecurity.

 

To register your interest in purchasing the revised and updated Second Edition of A Short Introduction to Attachment and Attachment Disorder, please email me at colby@securestart.com.au.

For more information about the Triple-A Model of Therapeutic Care, currently implemented as a therapeutic care approach among TUSLA foster carers in Donegal Ireland, please click here.

To cite this article, please use the following:

Pearce, C (2016). Therapeutic Care and the Triple-A Method. Attachment and Resilience: https://colbypearce.wordpress.com/2016/07/30/therapeutic-care-and-the-triple-a-method/

Reference:

Kahn, W. A. (2005) Holding Fast: The Struggle to Create Resilient                         Caregiving Organisations, Hove and New York: Brunner-Routledge.

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Strengths-based therapeutic foster care

Triple-A is an approach to the therapeutic care of children that emphasises human connection. It is relational, practical and rooted in conventional caregiving practices. As such, it is an enrichment programme, as opposed to a wholesale alternative to conventional caregiving and relating. It is also strengths-based. A core premise is that people already do and know about the importance of the approaches recommended; albeit on an implicit (that is, semi-conscious) level. In Triple-A, we make therapeutic aspects of caregiving and relating conscious and organise them so that they are implemented mindfully and predictably with children.

Triple-A is not just a set of strategies. It incorporates a way of thinking about, caring about and relating with children. It also incorporates self-care strategies to support the caregivers.

Triple-A is represents a fusion of Attachment Theory, Neurobiology and Learning Theory. It’s broad applicability is represented in the author’s published works concerning attachment and trauma and the promotion of resilience in all children.

There is a five-module training package – spanning 2.5 days of training. Triple-A is available as a group training and implementation programme.

For more information visit here: http://securestart.com.au/triple-a-model-of-therapeutic-care/

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