Circle-of-Security-An-Attachment-Based-Intervention英语教学课件

Circle

of

Security:An

Attachment

Based

InterventionCircle

of

SecurityRelationship

based

intervention

designed

to

changechild’s

behavior

through

changes

in

parent’s

behaviorDeveloped

by

Bert

Powell,

Kent

Hoffman,

Glen

Cooper,and

Bob

MarvinDerived

from

attachment

and

object

relations

theoriesShares

features

ofInteraction

guidanceChild

parent

psychotherapyCBTCOS:

An

InterventionConsistent

with

attachment

theory

andresearchCaregiver

has

greater

degrees

of

freedomfor

initiating

dyadic

changeFocuses

on

both

the

caregiver’s

InternalWorking

Models

of

self

and

child

and

onhis/her

caregiving

behaviorUses

either

group

or

individual

therapymodelsComponents

of

Infant-ParentRelationshipIBBabyIBParentRBabyRParentAdapted

from

Bruschweiler–Stern

and

Stern,

1989Basics

of

COS

ProtocolPre-intervention

videotaped,

structuredassessment

to

inform

treatment

goalsGroup-based

parent

education

andpsychotherapy

lasting

~20-weeks

usingvideotaped

interventionGoals

of

video

review

are

to:increase

sensitivity

to

the

child’s

cuesincrease

self-other

reflective

capacityexplore

new

representations

and

interactionpatternsCircle

of

Security

GraphicA

guide

for

the

therapist

to

negotiate

becoming

asecure

base

and

safe

haven

for

the

caregiver.Learning

tool

for

caregivers

to

see,

understandand

support

their

children’s

attachment

andexploratory

needs.Allows

the

clinician

to

assess

caregiver/childdyad.Treatment

plan

is

tailored

to

address

particulardyad’s

strengths

and

struggles

on

the

Circle

ofSecurity.••••

Circle

of

SecurityParent

Attending

to

the

Child’s

Needs

I

need

you

toSupport

My

ExplorationWelcome

MyComing

To

YouI

needyou

to••••Watch

over

meHelp

meEnjoy

with

meDelight

in

meI

needyou

to

I

need

you

toProtect

meComfort

meDelight

in

meOrganize

my

feelings••Whenever

necessary:

take

charge.

(Almost)

Everything

I

Need

to

Know

About

Being

a

Parent

in

25

Words

or

lessAlways:

be

BIGGER,

STRONGER,

WISER,

and

KIND.

•

Whenever

possible:

follow

your

child’s

need.AssessmentResearchSSP

plus

read

a

book

(5

min)

and

clean

up

toys

(3

min)Coded

using

Ainsworth

or

MacArthur

systemCaregiver

behavior

coding

systemCOSI5

questions

about

SSP20

questions

about

perceptions

of

child6

questions

about

family

of

originsClinicalChild’s

attachment

and

exploratory

behaviorsParent’s

behaviors

responding

to

child’s

needsParent’s

perceptions,

meaning

of

child

and

parent

behaviorCircle

of

Security:

Handsability

to

maintain

a

position

of

bigger,

stronger,

wiser

and

kind

Comfort

SupportNurturance

ProtectionTop

of

the

Circle:Facilitating

ExplorationWatch

over

meHelp

meEnjoy

with

meDelight

in

meBottom

of

the

Circle:Facilitating

Contact/Proximity

SeekingProtect

meComfort

meDelight

in

meOrganize

my

feelings••••

Circle

of

SecurityParent

Attending

to

the

Child’s

Needs

I

need

you

toSupport

My

ExplorationWelcome

MyComing

To

YouI

needyou

tome•

Help

me•

Enjoy

with

me•

Delight

in

me

I

need

you

to•

Watch

over

I

need

you

toProtect

meComfort

meDelight

in

meOrganize

my

feelingsStrange

Situation

ProcedureStandardized,

laboratory

(playroom)

procedureinvolving

series

of

episodesInfant,

caregiver

and

an

unfamiliar

adult(Stranger)Designed

to

examine

balance

between

infant’sattachment

(proximity

seeking)

and

exploration.Lasts

between

20-25

minutesOrganization

of

infant’s

attachment

behaviortowards

caregiver--may

differ

with

differentcaregiversAttachment

ClassificationsInfancySecureAvoidantResistant/AmbivalentDisorganizedPreschoolSecureAvoidantResistant/DependentDisorganized/ControllingInsecure-OtherSecure

AttachmentDistressed

by

separationDirect

expression

of

negative

affectClear

approach

and

expectation

of

comfortSettled

by

caregiver’s

attempts

to

soothe55-65%

in

low

risk

samplesAvoidant

AttachmentMinimal

response

to

separationEither

minimal

reaction

during

reunionor

active

avoidance

of

caregiver

duringreunion;

attention

focused

on

toysImplicit

claim

of

strength,

independence,normalcyhypoactivation

of

attachment

systemPhysiologic

arousal15-20%

in

low

risk

samplesCircle

of

Limited

SecurityChild

Anxious

about

the

Parent’s

NeedsI

NEED

YOU

TOWELCOME

MYCOMING

TO

YOUBUT…Resistant/Ambivalent

AttachmentDistressed

by

separationUnable

to

be

soothed

by

caregiverEither

passively

overwhelmed

or

angrilypreoccupiedHyperactivation

of

attachment

system5-10%

in

low

risk

samplesI

NEED

SUPPORT

FOR

EXPLORATION

BUT…Circle

of

Limited

Security

Child

Anxious

about

the

Parent’s

NeedsDisorganized

AttachmentDerived

from

aberrant

organization

of

child’sattachment

behavior

in

presence

of

caregivercontradictory

attachment

behaviorsbehaviors

lacking

goal

orientationdirect

indices

of

fear/apprehensionUnderlying

pattern

(secure,

avoidant,

orresistant)

usually

evidentCircle

of

Disorganization

I

need

you

but

you

are

so

frightened

or

frighteningthat

I

have

no

one

to

turn

to

and

I

don’t

know

what

to

do.ProtocolWeek

1,

2

Introduce

Circle,

power

ofrelationship,

cues

and

miscuesWeeks

3-10

Tape

review

#1Week

11

Introduce

Shark

musicWeek

12-19

Tape

review

#2Week

20

Graduation

celebrationPort

of

EntryCore

fear

is

abandonment.Therapist

conducts

a

“differential

diagnosis

ofeach

parent’s

specific

relational

paradigm.”Based

on

belief

that

each

parent

approachesattachment

relationships

with

a

particular

lensregarding

sense

of

self

and

sense

of

other.Three

core

sensitivities

that

range

from

adaptiveto

personality

disorders.Three

Types

of

SensitivitiesAdaptiveSeparationEsteemSafetyDisorderedBorderlineNarcissisticSchizoidSeparation

SensitivityTo

avoid

perceived

abandonment,

they

must

comply

withwhat

others

–

including

their

children

-

want,

need,

andfeel,

while

disavowing

their

own

wants,

needs

andfeelings.Feel

incapable

of

living

without

feeling

the

continualavailability

of

significant

others.Their

job

is

to

focus

on

another’s

needs

and

appear

tobe

helpless

regarding

their

own.Struggle

to

allow

their

children

an

experience

ofautonomy

while

exploring

but

are

unable

to

genuinelyprovide

comfort.Esteem

SensitivityWho

they

are,

just

as

they

are

(imperfect,

flawed,average)

is

not

enough

to

be

valued.Must

prove

that

they

and

their

children

are

worthy(unique,

special,

exceptional,

anything

but

average,

etc.)through

performance

and

achievement.Vigilant

about

any

implication

of

having

failed

or

beinginadequate

as

parents

or

having

others

see

their

child

asinadequate.Pressure

their

children

for

achievement

and

performanceand

struggle

to

provide

comfort

and

organization

offeelings.Safety

SensitivityCost

of

being

connected

and

emotionally

closeto

their

children

is

the

loss

of

self-determination.Perceptions

of

being

controlled

and/or

intrudedupon

by

their

children.Must

maintain

a

position

of

self-sufficiency,

andto

expect

self-sufficiency

from

their

children.Child’s

lack

of

fulfillment

leads

to

demands

thatreconfirm

the

parent’s

view

of

significant

othersas

demanding

and

controlling.Linchpin

IssueLinchpin

struggle--the

key

defensive

pattern

ofattachment-caregiving

interaction

and

caregiverinternal

working

model

that

most

maintains

thepattern

of

insecurity

in

the

dyad.QuestionsIs

the

parent

in

charge—providing

safety

andstructure?

[Hands]Can

the

parent

reliably

provide

comfort

to

child?[Bottom

of

circle]Can

parent

allow

exploration

for

child?

[Top

of

circle]Tape

Review

#1Apply

learning

about

circle

to

child.Highlight

underutilized

strength.Talk

about

child’s

struggle

on

circle.Name

that

need.Learn

about

cues

vs.

miscues.Tape

Review

#2Welcome

to

the

ClubEveryone

strugglesShark

MusicNeed-Shark-MovieAlternativeKey

FeaturesActively

engages

parents

wish

to

be

a

better

parentBeautiful

tapeVideo

richVisual

aidsMagnetsHandoutsPhotographsBlending

of

psychoeducation

with

psychotherapyCaseVirginia

38

years

oldDavid

15

months4

oldest

in

custody

of

state

because

motherabused

drugsLater

quite

depressedEnrolled

in

SA

Residential

treatment

withyoungestBaby

avoids

mom—she

feels

pressure

to

createCPS

proof

bond

with

him.Confident

and

WorthyI

can

readhis

signals

and

respond

He

needs

me

andwill

signal

meOld

Working

Model

NewWorking

ModelReflective

Dialogue

SelfProtection

Hurt,

Ashamedand

Empty

I

am

afailure

asa

motherVirginia’s

Representational

World

“He

doesn’tneed

me”Interactive

BehaviorVirginia

will

need

to

see

how

her

wish

tohave

her

son

“fill

her

void”

is

influencingher

behaviorShe

is

very

intrusiveHe

is

very

avoidantShe

experiences

his

avoidance

as

not“needing

her”

and,

with

the

wei