Using the secure base star: working with children

1. Using the secure base star: working with children Assessment, planning and support

2. What do children need? Assessment and planning work with attachment in mind • Family support – multi-agency (including social work, education, health) • Child protection • Court proceedings • Matching children and placements • Supporting placements • Helping young people into adulthood

3. Assessment tasks • Attachment related history • Well-being across all areas of functioning • Listening to children • Observation • Remember- a transactional model - children shape their environment as well as being shaped by it.

4. Secure base star: focus on child development and progress

5. Assessment: 1. Trust in availability - what happens when a child is anxious? • Evidence of the child’s capacity to use a caregiver as a haven of safety when they are anxious, upset or fearful • Evidence of the child’s capacity to use the caregiver as a secure base for exploration, play and learning • Reducing anxiety is a means to achieve the goal of freedom –because it makes thinking possible

6. Managing anxiety: need to understand the child’s internal working model • Mental representations • Self, others and relationships • Expectations/beliefs about • the lovability, worthiness and acceptability of the self- ‘I am…..’ • the emotional availability and interest of caregivers ‘ My mum is…..’ • the ability of caregivers to provide protection‘When I’m upset I can….’

7. Strategies for managing anxiety: attachment patterns • Strategies based on previous experiences of caregiving • Secure • Insecure avoidant • Insecure ambivalent • Insecure disorganised

8. Secure patterns /strategies-Infancy to adolescence • Parenting has been available, sensitive, accepting and co-operative • Child has learned to trust in a secure base - capacity to learn/enjoy • Capacity to think flexibly – pause for thought • Flexible use of self and others • Positive peer relationships Evidence at different ages? Implications for planning/moving the child?

9. Insecure avoidant patterns /strategies:Infancy to adolescence • Parenting has not been available or responsive – rejecting the child’s emotional demands • Child then lacks trust in parent’s availability so • reduces displays of emotional need • denies the importance of feelings in self and others • tries to be self-reliant Evidence at different ages? Implications for working with the child?

10. Insecure ambivalent patterns /strategies:Infancy to adolescence • Parenting has been unpredictably available • So lacking trust, the child remains preoccupied with getting the attention of the parent, shows emotions excessively to force their availability Evidence at different ages? Implications for working with the child?

11. Insecure disorganised patterns /strategies:Infancy to adolescence • Frightening or frightened parenting –majority of children who have been abused and /or neglected • Dilemma- approach/avoidance. Child instinctively approaches parent when anxious, but parent is also the source of the anxiety • Options- fight, flight, freeze. • Role reversal Evidence at different ages? Implications for working with the child?

12. Child behaviour Inactive, after being neglected physically and emotionally Physically malnourished/ no muscle tone Unresponsive to mother Not reacting to sound, colourful toys, touch. Frozen Carer response Sadie was given more food, but initially became more fretful and resistant of comfort. Foster mother though something was ‘wrong’ with the baby. Foster mother’s structured daily rhythms eventually calmed her. Contact issues? Lack of trust/disorganisation Case example: Sadie (10 months)

13. Child behaviour Very confused / frightened Very aggressive, very destructive, screamed constantly. Three placements had broken down. Contact with mentally ill mother made her difficulties worse Carer response Caregiver gave her special time / full attention Opportunities to learn to trust/ feel effective Exploration of senses. Mind-minded commentary. - the world makes sense. Contact needed to be less frequent and in the presence of the long-term carer Lack of trust trust/disorganisation Case example:Chantelle (3)

14. Child behaviour Anxious as a result of loss/neglect/abuse Wary, monitoring the carer’s face Highly anxious and verbally aggressive Soiling, harmed animals Carer response Need to be open to the mind of a child who is now frightened and frightening Made herself available –steady consistent responses Needed therapeutic support Lack of trust trust/disorganisation Case example: Craig (7)

15. Child behaviour Frightened of other people and himself Drew picture of cutting up his foster carer with chain saw. Clumsy, awkward, disruptive at school -attended special school Carer response Foster mother had faith in Leroy / found something to love Helped him to manage his feelings and behaviour at school Supported his enthusiasm for making models Treated him as a permanent part of the family Lack of trust trust/disorganisation Case example: Leroy (12)

16. Assessment 2. Child’s capacity to manage feelings and behaviour • ‘Salina (3) will shout. She will lose it completely , bite, hit, scratch, hit. If I can’t defuse the situation, then the tears and screaming will start.’ (Carer) • In their play or at school, as well as in their relationships with family and friends, being overwhelmed by feelings such as anxiety or anger make it impossible for children to become competent and confident, relaxed and happy.

17. Assessment –managing feelings and behaviour • Can children appropriately express and manage feelings OR do they suppress or become overwhelmed by feelings • Mind mindedness – can they reflect on their own feelings and the feelings of others • Assessment includes verbal and non-verbal communication of feelings- e.g. headaches and stomach aches Capacity to change? Implications for planning the caregiving environment? Work with child?

18. Assessment3. Child’s self–esteem • ‘Hannah’s got very low self-esteem-always asking “Have I been a good girl?” She has a great fear of failure’. (Carer) • Early experiences as young children in stressed, preoccupied or frightening families can lead children to question their lovability and worth long before they reach nursery or school.

19. Assessment-self-esteem • Gathering evidence of the child’s pleasure in the self /capacity to manage setbacks / failure • Defences against fear of failure: for example, boasting /denial • Self-concept - ethnicity, religion • Different areas of esteem/different environments e.g. home/school. Capacity to change? Implications for planning the caregiving environment? Work with child?

20. Assessment 4. Child’s capacity to feel effective –be co-operative • ‘Ashley wouldn’t answer for himself. He just sort of sat there. He didn’t have a lot of confidence at all.’ (Carer) • How effective does this child feel? This is not an easy question • Some children who feel powerless become withdrawn /others become domineering /bossy

21. Assessment and effectiveness /co-operation • Evidence of the child’s ability to make choices or complete a task – alongside evidence of the child’s ability to compromise/co-operate • The more appropriately effective and assertive a child is able to be, the more likely it is that the child can also compromise and co-operate. Capacity to change? Implications for planning the caregiving environment? Work with child?

22. Assessment 5. Family membership • Important for all children in all types of family • Multiple family memberships –Hierarchy? Different families for different needs? • Contact?

23. Assessment – the range described by carers • Maala calls my mum and dad ‘granny and granddad’. She wants to belong. • Jamil doesn’t want to do family things - he has no interest in being part of our family unit. • Kay is totally aware that she has another family. She loves her mum to bits ...she doesn’t know who to love most. Capacity to change? Implications for planning the caregiving environment? Work with child?

24. Working with children who need a secure base: relationship with the child • Available – worker as secure base for the child • Sensitive – helping children to be mind-minded / to make sense of themselves and other people • Accepting- building the child’s self esteem –working with and on behalf of the child • Co-operation-helping child be effective/participate in decisions • Family membership- helping the child to feel they belong, often to more than one family