CONNECTING THE TOTS:
HELPING PARENTS WITH
UNDEVELOPED ATTACHMENT
CONNECT WITH THEIR
CHILDREN
Jennifer Tabor, LCSW
2013 STATEWIDE CONFERENCE
Tweet us at #NASWIL
CONTACT INFORMATION
JENNIFER TABOR, LCSW
OFFICE ADDRESS:
5206 W ELM ST, STE 103-105
MCHENRY, IL 60050
PHONE:
FAX:
(815) 363-6080, (815) 529-5933
(815) 363-6080
EMAIL:
jennifer_tabor@ymail.com
Tweet us at #NASWIL
WORKSHOP OBJECTIVES
1. PARTICIPANTS WILL DEVELOP AN UNDERSTANDING
OF ATTACHMENT THEORY AS IT APPLIES TO PARENTS
(BOTH ADULT AND ADOLESCENT).
1. PARTICIPANTS WILL LEARN WHAT CONSTITUTES A
HEALTHY ATTACHMENT RELATIONSHIP.
1. PARTICIPANTS WILL LEARN 5 SPECIFIC ACTIVITIES
AND TOOLS THAT THEY CAN USE WITH THEIR CLIENTS
(PARENTS WITH UNDEVELOPED ATTACHMENT) TO
IMPROVE THEIR CLIENTS’ ATTACHMENT
RELATIONSHIPS WITH THEIR CHILD(REN).
OUTLINE OF WORKSHOP
- INTRODUCTION
- HOW ATTACHMENT DEVELOPS
- HOW TO TREAT UNDEVELOPED ATTACHMENT IN
THE PARENT-CHILD RELATIONSHIP
- INTERVENTIONS THAT PROMOTE ATTACHMENT
HOW ATTACHMENT DEVELOPS
HOW ATTACHMENT DEVELOPS
• Attachment is a learned relationship of trust that is built
little by little over time.
• Attachment is not an inborn instinct.
– We are born NEEDING attachment for our survival,
not knowing HOW to form an attachment
relationship.
– We learn HOW to form an attachment relationship
from our primary caregivers.
• Attachment patterns can be multigenerational.
HOW ATTACHMENT DEVELOPS
• Attachment has been identified as playing a vital role in
all of the following:
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maintaining the bonds of trust
attaining full intellectual potential
acquiring a conscience
developing relationships with others
identity and self-esteem
learning to regulate feelings
language development
development of brain structures
organization of the nervous system
PARENTS WITH
“UNDEVELOPED ATTACHMENTS”
- Parents who experienced insecure attachment patterns
with their own parents/caregivers as children.
- These parents are capable of forming secure
attachment relationships with their children, they just do
not posses the knowledge and skills to be able to do so
at this time.
- These parents CAN “break the cycle” by:
PARENTS WITH
“UNDEVELOPED ATTACHMENTS”
1. Facing the things that were painful.
2. Acknowledging that those things still influence them,
especially at times of stress.
3. Intentionally choosing the things they want to pass on
to their child(ren) and the things they want to leave
behind – and talking about those things with someone
who can help them monitor how it is going between the
parent and the child.
4. Finding resources to help them live out their choices,
including good information about child development
and positive parenting, as well as a good social
support system.
TREATMENT PROCESS
-
RECEIVE REFERRAL – USUALLY THROUGH DCFS
-
GATHER AND REVIEW BACKGROUND INFORMATION,
SOCIAL HISTORY, ETC. FROM REFERRAL SOURCE
-
MEET INDIVIDUALLY WITH PARENTS FOR AN INTAKE
SESSION
-
ASSESSMENT OF THE ATTACHMENT RELATIONSHIP
-
DEVELOP GOALS AND A TREATMENT PLAN
-
INTERVENTIONS THAT PROMOTE ATTACHMENT
-
REVISIT INDIVIDUAL SESSIONS WITH PARENTS
THROUGHOUT TREATMENT PROCESS
TREATMENT PROCESS
- RECEIVE REFERRAL – USUALLY THROUGH DCFS
- GATHER AND REVIEW BACKGROUND
INFORMATION, SOCIAL HISTORY, ETC. FROM
CASEWORKER OR REFERRAL SOURCE
* You will want to triangulate information as some
parents may minimize their own history of
relational trauma.
TREATMENT PROCESS
- MEET INDIVIDUALLY WITH PARENT(S) FOR AN
INTAKE SESSION
• This session is part of the assessment and part of
the individual therapy with the parent.
• It is important to establish a good working
relationship with the parent.
• We will use the “therapeutic relationship” to help
heal the parent’s childhood wounds and empower
them.
• Use “Questions for Parental Self-Reflection” from Dr.
Daniel Siegel’s book Parenting from the Inside Out .
INTAKE SESSION WITH PARENT
TREATMENT PROCESS
- ASSESSMENT OF THE ATTACHMENT
RELATIONSHIP (ESTABLISH A BASELINE)
Observe the parent and child interaction and make note of
the parent’s strengths and needs (opportunities).
I use the following assessment tools:
- Keys to Interactive Parenting (KIPS)
- Marschak Interaction Method (MIM)
- Informal checklists
ASSESSMENT
• KIPS – A structured observation technique with a rating
scale; measure 12 key facets of parenting; training
available and required; certification required.
http://comfortconsults.com
• MIM (Theraplay) – A structured observation technique;
uses 9 Theraplay activities; videotaped; training
available but not required.
• Informal Checklists – FREE!
http://ocfs.ny.gov/ohrd/toolkits/cfv/16c.pdf
ASSESSMENT
ASSESSMENT
ASSESSMENT
TREATMENT PROCESS
- DEVELOP GOALS AND A TREATMENT PLAN
Start by asking the parent what his/her goals are.
Base goals off of the areas of need that you observed.
- The KIPS and the MIM assessments provide
guidance in developing goals.
- KIPS: 12 parenting behaviors
- MIM: 4 dimensions
Select interventions that will address those needs.
TREATMENT PROCESS
- INTERVENTIONS THAT PROMOTE ATTACHMENT
INTERVENTIONS THAT PROMOTE ATTACHMENT
1. Teach parent about non-verbal behaviors that promote
secure attachment and demonstrate.
2. Teach parent about the importance of physical touch
and give them ideas for how to increase physical
contact with their child.
3. Assist the parent to “know about” their child (helps the
child to experience being understood, noticed, special).
4. Guide the parent to develop a “coherent narrative” and
“earned secure attachment.”
5. Help parents with setting limits and creating
boundaries.
1. NON-VERBAL CUES THAT PROMOTE
ATTACHMENT
Dan Siegel’s 4 “S”s of Attachment (The Whole Brain Child)
Children Need to Be:
•Seen: perceiving them deeply and empathically, “getting” them.
•Safe: avoiding actions and responses that frighten or hurt them.
•Soothed: helping them deal with difficult emotions and situations.
•Secure: helping them develop an internalized sense of well-being.
Parents can meet these needs through their non-verbal
behaviors.
Often, we are not aware of our non-verbals. But, children
pick up on EVERYTHING.
NON-VERBAL CUES THAT PROMOTE
ATTACHMENT
- Eye contact – eye-to-eye (not avoiding their gaze)
- Facial expression – calm and attentive (not distressed, angry,
worried, sad, fearful, or distracted)
- Tone of voice – tender, interested, calm (not harsh, indifferent
or preoccupied)
- Body language - sit with a relaxed, open posture, leaning
towards your child (not with your arms crossed and your head
back)
- Pace, timing and intensity - need to be aware of their child’s
preferences for pacing and intensity, which are often slower and
less forceful than the parent’s.
2. PHYSICAL TOUCH
Increasing physical touch helps parents become the
source of comfort and calm for their child.
“Touch” will look different at each developmental
stage/age of child.
Examples of activities you can teach parents to do with
their children at each developmental stage:
Infants/Toddlers: massaging lotion on child
Preschoolers: beep-honk
Children: create a hand shake
Teens: manicures, doing hair
PHYSICAL TOUCH
Some parents are uncomfortable with physical touch. This
intervention can become therapeutic for them as well.
Gradually expose them to physical touch to increase their
comfort.
Examples:
•stickers on hurts  lotion on hurts  lotion on arm
•therapist makes physical contact with parent during
sessions (placing hand on parent’s shoulder)
3. KNOWING THEIR CHILD
This is done in conversation with the parent.
Ask questions about their child during the intake session
and in an ongoing manner as you work with the family.
Some question ideas are available at the following
website:
http://www.radkid.org/know_your_kid.html
These questions also make good conversation starters
when working with both the child and parent.
The therapist can also ask the parent similar questions
about themselves during all interactions.
KNOWING THEIR CHILD
KNOWING THEIR CHILD
4. COHERENT NARRATIVE
All parents can have a secure attachment with their
child(ren), regardless of what their childhood experiences
were like.
The key is to have developed a “coherent narrative.”
“life narrative” the way we put our story into words to
convey it to another person
“internal narrative”  the story we tell ourselves
“coherent narrative”  telling our story in a balanced way
(Dr. Daniel Siegel, Parenting from the Inside Out, 2003)
COHERENT NARRATIVE
Acknowledging both the positive and negative aspects of
their family experiences.
Connecting their early family experiences to their later
development.
Giving a coherent account of their past and how they
came to be who they are as adults.
For our clients, this requires processing in a relationship
with someone who is genuinely attuned to them – a
relative, a neighbor, a teacher, a counselor…YOU?
COHERENT NARRATIVE
Example of a coherent narrative:
“My mother was always angry. She loved us, there was never any doubt
about that. But her parents had really done a number on her. Her dad
worked all the time, and her mother was a closet alcoholic. Mom was
the oldest of six kids, so she always felt like she had to be perfect. So
she bottled everything up, and her emotions just boiled over anytime
something went wrong. My sisters and I usually took the brunt of it,
sometimes even physically. I worry that sometimes I let my kids get
away with too much, and I think part of that is because I don’t want them
to feel that pressure to be perfect.”
The result of developing a coherent narrative is called
“earned secure attachment.”
5. SETTING LIMITS AND CREATING BOUNDARIES
Limit setting and creating boundaries are an important
part of a parent developing a secure attachment with their
child.
The focus of attachment during the second year of life (or,
once the child becomes mobile).
This is where they learn to trust that adults can and do
keep them safe. They also learn to trust those boundaries.
SETTING LIMITS AND CREATING BOUNDARIES
“Structure” activities in Theraplay These activities help
to regulate and organize the child’s experience.
In them, the parent sets limits, defines body boundaries,
keeps the child safe, and helps to complete sequences of
activities.
Examples: bean bag game, pop the bubble, mirroring,
peanut butter and jelly, stack of hands, eye signals
Booth, Phyllis B. and Jernberg, Ann M. (2010). Theraplay: Helping Parents and Children Build Better
Relationships Through Attachment-Based Play (Third Edition). Jossey-Bass Publishers.
SETTING LIMITS AND CREATING BOUNDARIES
A.C.T. (Child-Parent Relationship Therapy) limit-setting
model:
1. Acknowledge the feeling:
“I know you would really
like to….” or
“I can see you are feeling very….”
2. Communicate the limit:
“….but you may
not_______... (because…)” or
“but your sister is not for
hitting” or
“but the answer is no.”
3. Target an alternative:
“You can _______ if you
would like” or
“What you can do is________.”
SETTING LIMITS AND CREATING BOUNDARIES
Examples of A.C.T.
•“I know you would really like to go outside to play, but you may not because it
is raining. You can choose to either complete a puzzle or we can play a
game together.”
•“I can see you felt very angry / hurt when your sister was making fun of you,
but your sister is not for hitting. When you feel angry you can choose to either
hit a pillow or bang on your toy drum.”
•“I know you do not like to take your medicine, but whether or not you take
medicine is not a choice because it’s something your body needs to get
better. However, you can choose to either take it [with juice or with yogurt] or
[through a syringe or a cup].”
Landreth, Garry (2012). Play Therapy: The Art of the Relationship (Third Edition). New York: Taylor
and Francis Group.
TREATMENT PROCESS
- REVISIT INDIVIDUAL SESSIONS WITH PARENTS
THROUGHOUT TREATMENT PROCESS
Remember, you are working with the parent to help them
develop a coherent narrative so that they can form a
secure attachment with their child(ren).
We want to empower them with knowledge and skills.
Our relationship with them should model a healthy secure
attachment.
CONTACT INFORMATION
JENNIFER TABOR, LCSW
OFFICE ADDRESS:
5206 W ELM ST, STE 103-105
MCHENRY, IL 60050
PHONE:
FAX:
(815) 363-6080, (815) 529-5933
(815) 363-6080
EMAIL:
jennifer_tabor@ymail.com
Tweet us at #NASWIL
References
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Bailey, Becky A. (2000). I Love You Rituals. New York, NY: Harper Collins Publishers, Inc.
Booth, Phyllis B. & Jernberg, Ann M. (2010). Theraplay: Helping Parents and Children Build
Better Relationships Through Attachment-Based Play (Third Edition). San Francisco, CA: John
Wiley & Sons, Inc.
Landreth, Garry (2005). Child Parent Relationship Therapy (CPRT) Treatment Manual: A 10Session Filial Therapy Model for Training Parents. New York, NY: Taylor and Francis Group.
Landreth, Garry (2012). Play Therapy: The Art of the Relationship (Third Edition). New York:
Taylor and Francis Group.
Nicholson, Barbara & Parker, Lysa (2009). Attached at the Heart: Eight Proven Parenting
Principles for Raising Connected and Compassionate Children. Bloomington, IN:iUniverse, Inc.
Siegel, D.J., & Bryson, T.P. (2011). The Whole-Brain Child: 12 Revolutionary Strategies to
Nurture Your Child’s Developing Mind, Survive Everyday Parenting Struggles, and Help Your
Family Thrive. New York, NY: Delacorte.
Siegel, D.J., & Hartzell, M. (2003). Parenting from the Inside Out: How a Deeper SelfUnderstanding Can Help You Raise Children Who Thrive. New York, NY: Tarcher.