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Specific Techniques to Increase Family Attachment

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Many foster and adopted children exhibit signs of impaired attachments. It is important for parents to recognize these difficulties and to engage in behaviors, activities, and techniques that repair and establish developmentally appropriate attachments. See Vera Fahlberg (1991) A Child's Journey Through Placement for an excellent discussion of how attachment develops and the signs and symptoms of children with attachment problems.

The following principles guide my work with families to increase attachment:

Based on arousal / relaxation cycle and re-education of parent and child;
Experiential in nature;
Physical-involving all 5 senses;
Reciprocal; mutual in nature; "shared" activities among family members
Permits parents offer child comfort, safety and security;
Helps tie past trauma and lost attachments (for parent and child) to present behaviors and affect; helps parents not take child's behavior personally;
Provides positive experience for family and child;
Frequently based in some form play;
Permits child to regress and replicate early parent/infant relationship in all its aspects;
Many aspects modeled on normal mother/infant interactions-physical, playful, frivolous, fun-filled, and personally engaging,
Involve reassuring, consoling, comfort-providing, stress-and-anxiety reducing behaviors, heightened emotional levels, and mutual pleasure;
Increases parent's self-esteem, capacity to cope, and enjoyment of child
Demonstrates strength of parent and protection that offers
Helps parents identify own attachment style and blocks
Promotes healthy grieving
Offers opportunities encourage and praise when child's defenses are down
All the techniques involve repeated episodes of highly focused attention between adult & child and often involve physical contact.
Techniques divide into 7 major categories:

1. HOLDING / TOUCH

Holding or rage reduction techniques (as described by the Attachment Center at Evergreen, Colorado) are used only with very disturbed children where other treatment modalities have failed
Rocking / play babyholding for pleasure & holding for relaxation, including gentle touching, close eye contact, singing, caressing, feeding, "nursery games"--raspberries on neck & belly, counting fingers & toes, patty cake, "I'm gonna getcha" holding child up on parent's feet, play horsey, bouncing child
Bottle-feeding at least few minutes each day
Parents initiate close physical contact by wearing short sleeves and soft fabrics--avoid buttons and buckles
Take showers, baths, swim together (as is developmentally appropriate)
Carry smaller children in snugglies
Stroke, touch, sit close during feeding times
One Minute Scolding (see G. Nelson's book of same name, 1984)
Wrestling, always include "cool down" close time
Tickling
Massaging / applying lotion
Lap time- have child sit on lap for 3-5 minutes with kitchen timer

2. PLAY

IT IS VERY IMPORTANT THAT THE PLAY IS RECIPROCAL IN NATURE,THAT THE PARENT AND CHILD INTERACT TOGETHER

Doll play-feeding babies, nurturing them; play out child's situation
Ball, rolling back and forth
Swinging
Board games-taking turns
Hide and seek; peek-a-boo
Making faces-link facial expressions with feelings
Imitative play-adult follows child's lead in play
Feeding each other, M & M's for example
Sound--singing rounds, movement, drumming together
Parents use "surprise" behaviors that intrude on child--kisses, blowing in child's face, and unexpected hugs
Staring contests
Screaming matches
The following techniques come from Jernberg's "Theraplay": "Magic button" -adult searches for magic button on child, when he or she finds it, the child sticks out their tongue; "Gingerbread boy"-pretend to turn the child into gingerbread figure by mixing ingredients (rubbing) rolling out dough, cut shape (trace around body) decorate & bake eat up with kisses; "Race track"-pretend child's back is race track and parent's thumbs are cars; "Pass-it-on"- Pass a touch around circle, or handshake, or pat on back
Cradle rocking-wrap child in blanket and swing between two adults, while singing
Trick time-magic trick with partners-child and adult
Puppets-tell stories back and forth, one can begin story and next person pick it up; stress themes which are similar to child's own life story
Doll house figures, as with puppets
Animals, as with puppet play
Mutual storytelling-Parents and children tell stories which include themes of attachment and "teach" children that attachment is safe and desirable
Face painting
Role plays; family charades-change roles and play or mimic another family member
Family drawing-Family portrait; family collage;

3. FEELINGS EDUCATION

Making faces, sounds, music, art projects about specific feelings
Discuss feelings of others in books, magazines, on TV, in videos
Learn to label feelings & validate/ give permission for child to have feelings
Develop ways to assess and discuss feelings of closeness in the family. For example, use the following scale to help family members rate how various activities or behaviors change their feelings of closeness or belonging:

ATTACHMENT SCALE

1=1 DON'T FEEL CLOSE AT ALL
2=1 DON'T FEEL CLOSE
3= I FEEL MEDIUM
4= I FEEL A LITTLE BIT CLOSE
5= I FEEL CLOSE

Keep daily log of closeness-track with any variables want to plug in
Practice moving bodies-come closer, go away, hide-inquire "when do you feel closest?"
Figures-use dolls, figures, puppets, etc. to discuss closeness using scale
Planning together ways to increase feelings of closeness

4. HEIGHTENING OPPORTUNITIES TO NURTURE

Activities which involve soothing, calming, quieting, reassuring
Child sit between parents at dinner, touch child while eating
Attentively nurse sick children; encourage child to cry and accept comfort. Physical complaints are common in the grief process and for child with attachment difficulties parents must respond, respond, respond. This gives increased opportunities for emotional and physical nurturing-band aids, special foods, rocking
Sleeping arrangements-consider child sleeping with or near parents for a time; use bedtime rituals to heighten attachment
Put snacks next to child if he awakens during night to remind child parent is always available
"Pajama days" family stays home, goofs off, and builds relationships

5. CLARIFICATION OF LIFE EVENTS

Children need to understand what has happened to them; that they are blameless, and that they now "belong" in this family

Life Books / Life Maps honoring previous attachments, help child and family visually understand child's history
Visits ( relating to foster care, open adoption, and visits with other significant figures from child's past)-all significant figures should be together if at all possible. This makes it clear to the child that there are no choices or loyalty conflicts necessary
Future planning so that child knows s/he will be with the family in the future, builds hope and trust

6. ACTIVITIES WHICH HIGHLIGHT AND PROMOTE IDENTIFICATION WITH FAMILY

Developmental re-parenting. Adjust parenting style to developmental (not chronological) age or needs of child
Dressing alike-family members wear same 'T" shirts or colors
Family rituals and traditions (bedtime, birthdays, placement day, etc.)

7. DlSCIPLINE--One of primary techniques

Discipline without distance; do not reward misbehavior with parental distance; do not use techniques that involve any form of separation or loss
Use techniques that increase "attachment" "house arrest" chores done together, physical activity, etc.
Must not let child get out of control-must limit behavior BUT not reinforce old maladaptive attachment behaviors; parents must not struggle to get control
Parents must work as team
Set firm consistent boundaries
Make punishments brief, relevant and immediate

Credits: Deborah N. Silverstein

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