Tag Archives: attachment

Families and Schools Together

FREE HALF DAY SEMINAR

 

Delivered by Save the Children

Families and Schools Together (FAST)

Introduction to how the FAST programme supports a family therapy, attachment theory approach to improving child/family outcomes through its evidence based community engagement programme.

Aimed at members of the children’s workforce – front line, management or commissioning role in any service which supports children or families.

Voluntary & Community Sector, NHS, Social Care, and Education all welcome.

The seminar will include:   

  • Brain development research
  • Ecological theory
  • Family therapy & attachment theory
  • Building resilience in families & communities
  • Introduction to the FAST programme

 

Date:              Tuesday 31st March, 9.30am-12.30pm

 

Location:      The Elton Room, Armada House, Telephone Avenue, Bristol, BS1 4BQ

 

AIMS AND OBJECTIVES OF THE SEMINAR

  • An opportunity to increase your understanding and knowledge of the impact of parenting approaches on the child’s social, psychological and educational outcomes with a specific focus on brain development.
  • Explore how environmental systems supports building resilience in families, across the wider community and impacts on building social capital leading to increased cohesive communities.
  • Understand how environmental factors and ecological theories builds bridges between home, schools and communities within a community asset based approach to achieve ecological systemic change.

 

If you would like to attend please contact x.dennis@savethechildren.org.uk for a booking form

 

 

Good Enough Parenting

 

There is no such thing as a ‘perfect parent’

Society must be willing to tolerate very diverse standards of parenting, including the eccentric, the barely adequate and the inconsistent. It follows too that children will inevitably have both very different experiences of parenting and very unequal consequences flowing from it. It means that some children will experience disadvantage and harm, whilst others flourish in atmospheres of loving security and emotional stability. These are the consequences of our fallible humanity and it is not the provenance of the State to spare children all the consequences of defective parenting. In any event, it simply could not be done. …It would be unwise to a degree to attempt an all embracing definition of significant harm. One never ceases to be surprised at the extent of complication and difficulty that human beings manage to introduce into family life.

Mr Justice Hedley in Re L (Care: Threshold Criteria) (Family Division 26 October 2006)

The state can only interfere in your parenting if your child is beyond your control, you have caused your child significant harm or there is a serious risk you will cause that harm in the future. 

Being a less than ‘perfect parent’ does not mean that professionals can assume you will cause significant harm to your child. You just have to be ‘good enough’. Its a phrase you will often hear in care proceedings. But what does it mean?

 

Who are parents and why is parenting important?

You don’t have to be a child’s biological mother or father to be involved in ‘parenting’ that child. Anyone in the wider community who is involved in the child’s development could be said to be part of the parenting process – such as grandparents, teachers, friends and neighbours.

A child needs ‘good enough’ parenting to survive and grow into a healthy, functioning adult.  His basic needs for food and shelter have to be met to ensure his physical survival, but meeting such basic needs is not the only obligation of parents. If a child’s emotional needs are neglected or ignored, that is likely to have a serious impact on the child for all his life.  Developing a healthy ‘attachment’ between child and adult carer is an important part of parenting.

 

What do we mean by ‘good enough parenting’?

Donald Winnicott was an English paediatrician and psychoanalyst and probably the first to use the phrase ‘good enough parent’. He recognised that it was unrealistic to demand perfection of parents, and was interested in finding out what made them ‘good enough’.

He believed that the key to healthy development was rooted in a child’s relationships and interactions with others.

With the care that it receives from its mother each infant is able to have a personal existence, and so begins to build up what might be called a continuity of being. On the basis of this continuity of being the inherited potential gradually develops into an individual infant. If maternal care is not good enough then the infant does not really come into existence, since there is no continuity of being; instead the personality becomes built on the basis of reactions to environmental impingement.” (Winnicott, 1960)

Dr Jennifer Kunst describes Winnicott’s ‘good enough mother’ as:

… sincerely preoccupied with being a mother. She pays attention to her baby. She provides a holding environment. She offers both physical and emotional care. She provides security. When she fails, she tries again. She weathers painful feelings. She makes sacrifices. Winnicott’s good enough mother is not so much a goddess; she is a gardener. She tends her baby with love, patience, effort, and care.

 

Components of good enough parenting

Talking, reading, playing, cuddling and communicating

The Joseph Rowntree Foundation report ‘Assessments of Parents and Parenting Support Needed’ showed that professionals who worked with families, together with those in health and education, could agree on  the main components of good enough parenting:

  • meeting children’s health and developmental needs;
  • putting children’s needs first;
  • providing routine and consistent care;
  • parental acknowledgement of any problems and engagement with support services.

‘Risky’ or ‘not good enough parenting’ was basically the reverse of this: not meeting the children’s needs, not putting them first etc. but it would be important to recognise if the risky behaviours identified represented a ‘one off’ or was a more regular part of the parents’ approach.

Part of being a good parent is preparing your child for environments outside your home. See the Social Mobility and Child Poverty Commission report in October 2014, ‘State of the Nation 2014: Social Mobility and Child Poverty in Great Britain’, which looked at what Frank Field highlighted as the essential skills children need by the time they join the reception year at primary school:

  • To sit still and listen;
  • To be aware of other children;
  • To understand the word no and the borders it sets for behaviour;
  • To understand the word stop and that such a phrase might be used to prevent danger;
  • To be potty trained and able to go to the toilet;
  • To recognise their own name;
  • To speak to an adult to ask for needs;
  • To be able to take off their coat and put on shoes;
  • To talk in sentences;
  • To open and enjoy a book.

 

Things which can get in the way of good parenting.

The Department of Education reviewed the literature in this field as part of the Childhood Wellbeing Research Centre programme (see further discussion below).

  • An extensive body of evidence shows how factors such as domestic abuse, substance misuse, mental health problems and learning disability undermine parenting capability and increase the likelihood of significant harm, particularly when they occur in combination. Moreover, parenting does not take place in isolation. Parents are also influenced by stressors within the wider environment and family, such as poor housing, poverty and unemployment that make parenting more challenging and increase the likelihood that difficulties will arise.

Is there a universal definition of ‘good enough’ parenting?

While we can probably all agree about the importance of the basic needs of providing a child with food and clothes, problems may arise in care proceedings when professionals don’t share the same outlook as the parents as to what is important for the children and why.

The participants in the JRF report above were aware that they bought their own personal beliefs about parenting to the process and there could be problems if those doing the assessing came from a very different background to the parents being assessed.

For example, parents from some cultures may have strong views on whether or not it is acceptable to physically punish children. Are they automatically not ‘good enough’ parents because their approach is not universally accepted? The NSPCC and others in 2015 raised serious concerns about a judgment that appeared to ask for ‘allowances’ to be made for those from other cultures who smacked their children.

The DoE commented:

Practitioners reported concerns about making judgements and assumptions or being too accepting of behaviours, assessing whether parental practices were the cultural norm or individual beliefs and behaviours, and fears about damaging parent-practitioner relationships.

This can be a particularly acute problem when dealing with parents with learning disabilities or mental health problems, who may face discrimination and lack of understanding from professionals.

It is important to give every parent an opportunity to show they can be ‘good enough’, with support if necessary and professionals need to be wary of making automatic negative assumptions about certain parenting styles. The key issue of ‘significant harm’ must always be borne in mind.

The case of BR (Proof of Facts) [2015] set out a useful precis of what is commonly identified as ‘positive’ and ‘negative’ factors that might impact on parenting.

However the court stressed that the existence or otherwise of any of these factors proved nothing – children can still be abused in a supportive family environment or thrive in care of physcially/mentally disabled parents. But they offer a useful framework for an assessment, and highlight the areas that professionals will be looking at.

Risk factors

  • Physical or mental disability in children that may increase caregiver burden
    Social isolation of families
    Parents’ lack of understanding of children’s needs and child development
    Parents’ history of domestic abuse
    History of physical or sexual abuse (as a child)
    Past physical or sexual abuse of a child
    Poverty and other socioeconomic disadvantage
    Family disorganization, dissolution, and violence, including intimate partner violence
    Lack of family cohesion
    Substance abuse in family
    Parental immaturity
    Single or non-biological parents
    Poor parent-child relationships and negative interactions
    Parental thoughts and emotions supporting maltreatment behaviours
    Parental stress and distress, including depression or other mental health conditions
    Community violence

Protective factors

  • Supportive family environment
    Nurturing parenting skills
    Stable family relationships
    Household rules and monitoring of the child
    Adequate parental finances
    Adequate housing
    Access to health care and social services
    Caring adults who can serve as role models or mentors
    Community support

Assessing parents’ capacity to change.

How can parents move from ‘not good enough’ to ‘good enough’? In July 2014 the Department of Education published ‘Assessing Parental Capacity to Change when Children are on the Edge of Care’

Executive Summary Introduction

Assessing Parental Capacity to Change when Children are on the Edge of Care is an overview of current research evidence, bringing together some of the key research messages concerning factors which promote or inhibit parental capacity to change in families where there are significant child protection concerns. It is intended to serve as a reference resource for social workers in their work to support families where children’s safety and developmental functioning are at risk. Its purpose is also to assist social workers and children’s guardians in delivering more focused and robust assessments of parenting capability and parental capacity to change, and assist judges and other legal professionals in evaluating the quality of assessment work in court proceedings. The report brings together research findings from a wide range of disciplines, which are not otherwise readily available in one location for social workers, family justice professionals and other practitioners with safeguarding responsibilities.

The research evidence covered in this report confirms that change is both important and necessary when children are suffering abuse and neglect. However it also makes it clear that change is difficult for everyone, but even harder for those parents who are struggling with an interlocking web of problems. It also takes time. Change is a complex process, and although it can be supported and promoted through effective interagency interventions, it cannot be imposed. It will not happen unless parents are proactively engaged. These are the key messages from the review.

The report notes:

  • The assessment of parenting capability and capacity to change needs to reflect the complex reality of child protection cases, including consideration of the individual challenges and wider environmental problems faced by families; how multiple problems interlock; and the potential impact of factors such as coercion or the pressure on parents to present themselves in a positive light.

 

 

What is Attachment Theory? Why is it important?

 

Attachment is a theory about danger and how we organize in the face of it

Crittenden and Clausson 2000

We hear a lot about ‘attachment’ and its important in care proceedings.

Basically ‘attachment’ is a theory developed by psychologists to explain how a child interacts with the adults looking after him or her. If a child has a healthy attachment, this means the child can be confident that the adults will respond to the child’s needs, for example if he is hungry, tired or frightened, the adult caregiver will respond to meet his needs or reassure and comfort him.

This gives the child confidence to explore his environment and develop a good sense of self-esteem. This will help the child grow up to be a happy and functioning adult.

If a child can’t rely on his carers to look after him and respond consistently, this has been noted to have potentially very serious and damaging consequences for the adult that child will become. If adults are seriously inconsistent or unresponsive in their behaviour to the child, he may become very anxious as he is not able to predict how the adults around him will act; the child may even give up trying to get his needs met.

Therefore, identifying how a child responds to the adults trying to look after him, can be very important information when you are trying to work out what is the best thing to do for that child. If the attachment relationship is very poor and there are worries it won’t improve quickly enough for the child then this may have a significant influence on any decision to remove the child from those adult carers.

The National Institute for Health and Care Excellence (NICE) described ‘attachment’ in this way in their November 2015 guidelines regarding children’s attachment:

Children whose caregivers respond sensitively to the child’s needs at times of distress and fear in infancy and early childhood develop secure attachments to their primary caregivers. These children can also use their caregivers as a secure base from which to explore their environment. They have better outcomes than non-securely attached children in social and emotional development, educational achievement and mental health. Early attachment relations are thought to be crucial for later social relationships and for the development of capacities for emotional and stress regulation, self-control and metallisation…

Where did attachment theory come from?

John Bowlby

The psychoanalyst John Bowlby (1907 – 1990) investigated how what happened to us as children could contribute to later problems as adults  – in the way we behave and interact with other people.

He developed the concept of a ‘theory of attachment’, suggesting that we are born pre-programmed to form attachments to others, as without this babies could not survive. This followed on from the work of Lorenz in 1935 where he investigated ‘imprinting’ in ducklings and geese and showed that the birds would attach to the first large moving object they met in the first few hours of life.

Mary Ainsworth

Attachment theory was further developed by Mary Ainsworth (1913 – 1999) and her assessment technique called the Strange Situation Classification (SSC). Babies and toddlers can’t use words to tell us how they feel so Mary Ainsworth needed to find a way to allow them to show her.

Children were observed through a one-way mirror and the researchers noted the children’s reactions in a range of different circumstances.

  • Parent and infant alone.
  • Stranger joins parent and infant.
  • Parent leaves infant and stranger alone.
  • Parent returns and stranger leaves.
  • Parent leaves; infant left completely alone.
  • Stranger returns.
  • Parent returns and stranger leaves.
This allowed four different categories of behaviour to be investigated:
  • Separation anxiety – what does the child do when the caregiver leaves?
  • Willingness to explore – was the child confident to explore his environment?
  • Stranger anxiety – how did the child react to the stranger?
  • Reunion behaviour – how did the child react when the carer/parent came back?
Results of the experiment.

See further this article from Simply Psychology

She identified three main attachment styles

  • Secure
  • Insecure avoidant
  • Insecure ambivalent.

A fourth attachment style has since been identified as ‘disorganized’.

The majority of the children were ‘secure’.

 

  Secure Attachment Ambivalent Attachment Avoidant Attachment
Separation Anxiety Distressed when mother leaves. Infant shows signs of intense distress when mother leaves. Infant shows no sign of distress when mother leaves.
Stranger Anxiety Avoidant of stranger when alone but friendly when mother present. Infant avoids the stranger – shows fear of stranger. Infant is okay with the stranger and plays normally when stranger is present.
Reunion behavior Positive and happy when mother returns. Child approaches mother but resists contact, may even push her away. Infant shows little interest when mother returns.
Other Will use the mother as a safe base to explore their environment. Infant cries more and explores less than the other 2 types. Mother and stranger are able to comfort infant equally well.
% of infants 70 15 15

 

Some concerns about attachment theory

The Sutton Trust have estimated that 40% of the general population do NOT have secure attachments (see ‘Baby bonds: parenting, attachment and a secure base for children’). This claim, and the evidence cited to support it,  has caused some disquiet amongst academics.

There are criticisms of Mary Ainsworth’s experiments, not least the fact that her work is based on the assumption that  brief separations and reunions have the same meaning for all children, which may not give proper consideration to cultures where it is accepted that children will experience everyday  maternal separation.  See further ‘Clinical Implications of Attachment Concepts: Retrospect and Prospect’ Michael Rutter 2005.

Nicola Horsley, the research fellow of the Brain Science and Early Intervention Project at Southampton University comments:

 

Bandying about this figure of forty percent of the population not being securely attached, with the original source so deeply buried, is disingenuous enough. The Brain Science and Early Intervention study, funded by the Faraday Institute and conducted by researchers at the Weeks Centre and the University of Southampton is particularly concerned with how claims like these are being beefed up by ‘evidence’ from neuroscience, as in the Baby Bonds report’s section on ‘neurological pathways’ to developing secure attachment.

You might expect a claim like ‘there is a burst of brain development when attachment bonds are made’ to cite a neuroscientist but the reference supporting this quote is the work of Sue Gerhardt, a psychotherapist who is one of the founders of the OXPIP parenting programme; and her book Why Love Matters: how affection builds a baby’s brain, is core reading for practitioners delivering the programme. The Baby Bonds report features only one neuroscientist in its bibliography and that is Jack Shonkoff, director of the Harvard Center on the Developing Child, which is a partner of the UK’s Early Intervention Foundation. Increasingly, third sector organisations like the Early Intervention Foundation and ‘strategic philanthropists’ like the Sutton Trust, and not rigorous up-to-date studies or neuroscientific thinking, are providing the ‘evidence’ on which policy is based.

In selecting the research that is presented to policy makers, reports like Baby Bonds have the power to privilege certain agendas. It is crucial that their key messages are not based on distortions or misrepresentations of social life. If family policy is to deny the fundamental opposition to attachment theory feminists have articulated for at least twenty years, it should at least be cognisant of critiques of the highly questionable measurements of attachment.

From the conflation of a dyadic relationship with an individual characteristic to the cherry-picking of psychological or biological terms depending on which makes the most compelling case, attempts to measure the quality of human relationships in this way are profoundly flawed.

Through the Brain Science and Early Intervention project, I have witnessed the effects of this discourse on practitioners who work with parents in need of support and these sloppy attributions of good and bad models of parenting have the potential to do real harm with their individualisation of risk factors for a panoply of social ills.

If the UK government is serious about investing in policy and practice that encourages children to flourish, its focus on deprivation should not be narrowed to the prefix of the maternal. When nurses tell us that they are under pressure for their delivery of a parenting programme to be seen to have a direct effect on future prison populations, it is clear that family life has become atomised beyond all recognition. We are left with a science of parenting where family support used to be and this can only serve to further isolate those who are consigned to the 40%.

Why is attachment theory important?

There is clearly room for debate about how attachment should be measured and what implications this has for trying to support families in crisis.

However, attachment theory will remain significant in care proceedings because of the large degree of expert consensus about why it is important. This is primarily because good attachment allows us to develop a well functioning internal working model. This is:

a cognitive framework comprising mental representations for understanding the world, self and others.  A person’s interaction with others is guided by memories and expectations from their internal model which influence and help evaluate their contact with others (Bretherton, & Munholland, 1999).

Having a healthy ‘internal working model’ is thus important for three main reasons

  • Your sense of self
  • Your sense of others
  • Your relationships with yourself and others

Research shows that attachment problems can have a big impact on later life. Attachment difficulties account for a significant percentage of reasons why adoptions break down for e.g.

Children who are securely attached can develop increasing independence, exploring their environment with confidence that they can return to a carer who will respond to their needs. Therefore securely attached children will develop good self esteem and know that they are considered worth looking after.

However, children who don’t get the chance to form good attachments run the risk of developing poor internal working models which can have very negative impacts on their view of themselves and their ability to form relationships with other people. John Bowlby was worried that the long-term impacts included increased aggression and even ‘affectionless psychopathy’ where a person cannot show affection or concern for others.

 

So how this applied in practice?

David Shemmings, Professor of Child Protection Research at the University of Kent sets out seven principles for using attachment – based approaches in child protection work:

  • The main aim of using attachment-based principles is to help and support families stay together, whenever it is feasible to do so.
  • People can usually change and there is, as yet, no firm evidence that there are critical periods of a child’s development after which change is impossible, except in the most extreme forms of maltreatment – although the longer we leave things, the harder it is to overcome abuse and neglect.
  • It is preferable to think of disorganized attachment behaviour, not disorganized attachment per se. (These behaviours are temporary and fleeting, not an attachment ‘style’). The behaviours are not predictive of maltreatment: they indicate that additional questions need to be posed urgently, as the child may already have experienced ‘fear without solution’.
  • Practitioners need to make sure that they are not constrained by ‘confirmation bias’: forming a viewpoint too quickly and then only taking account of information, which confirms it – we need an ‘open mind, but not an empty head’.
  • Where there are concerns, they must be shared in the family (unless doing so might harm a child).
  • Practitioners must be ‘culturally competent’ when using attachment-based principles.
  • Approaches to help families are more likely to succeed if we demonstrate enhanced relationship skills, specifically ‘intelligent kindness’, ‘unsentimental compassion’ and ‘non-directive curiosity’.

 

Further reading.

 

 

 

It’s Not Always Easy

We are grateful for the following contribution from an adoptive parent. We know that adoption can be a hard and difficult option and it is best for everyone to go in with their eyes open and with genuine communication about the potential problems. We hope to increase the information available here about post adoption support and attachment difficulties. 

The Bubble Wrapped Child by Helen Oakwater contains a good discussion about some of the emotional difficulties adopted children can have. Her website is here.

We are adoptive parents. We have birth children who are older than our adopted daughter. We are probably a bit conventional.

We adopted our daughter aged 6. That should have flagged up a lot of signals but we were optimists, believing that love and care would be enough. It wasn’t.

We were not told the truth about our daughter when she arrived, and we gradually found it out over the next 7 years. We were naive, in spite of our professional experiences.  Do not expect to be told the full truth – some of it will be confidential, and even though it would help to know it, you may not be told.

Things got worse with puberty, and our daughter started demonstrating the fight or flight symptoms (we learnt later that she had Reactive Attachment Disorder and this was natural), but it was very stressful and we didn’t understand it.

There were problems, when we adopted her we were told that one day she may “revert to type”. We found this awful at the time, but later it came back to haunt us. Beware though, you may be blamed for the problems, even though it may not be you that have caused them.