David Howe

Attachment theory for social work practice

Acknowledgements Social Work and Social Relationships Becoming a Social Being The Development of Social Understanding Attachment Theory and Social Relationships The Organisation of Experience Ainsworths Attachment Classification System Disturbed Social Relationships Relationships With Parents and Family Relationships With Peers Relationships With Self Relationships With Society Relationships With Partners Relationships With Children Resilience and the Development of Protective Mechanisms Assessment Responses Bibliography Name Index Subject Index

Relationship-based thinking and practice in social work

Abstract Relationships with the users of social work are increasingly seen in procedural, legal and administrative terms. However, research studies examining both client satisfaction and intervention effectiveness regularly find that the psychosocial qualities of the worker-client relationship are a major component in the success or otherwise of the service offered. The case is made that the psychological selves of both practitioners and users acquire many of their characteristics, including personality, esteem, efficacy and defensive behaviours, within relationships throughout the lifespan. The level of social understanding and social competence that people develop depends on the quality of their relationship history. If poor relationships are where psychosocial competences go awry, then good relationships are where they are likely to recover. This observation has major implications for the quality, character and skill of the relationship experiences offered to clients by social workers

Disorders of Attachment in Adopted and Fostered Children: Recognition and Treatment:

This article briefly reviews a small number of outcome studies for adopted and fostered children, concentrating particularly on the progress of older-placed children. A transactional model of children’s development is introduced to explain the different pathways taken by children post placement. In this model transactions occur between children and their social environment which co-determine their developmental progress. The model is applied to children placed for adoption and foster care who have had a pre-placement history of abuse, neglect or rejection. Many of these children are also diagnosed as suffering a disorder of attachment. These disorders are the result of early relational trauma experienced in the context of an attachment relationship. The disturbed behaviours of many of these children place great demands on the parenting capacities of adoptive parents and foster carers. The therapeutic work of the Keys Attachment Centre, which specializes in treating children with disorders of attachment, is outlined. A case example is given illustrating the types of behaviour associated with attachment-disordered children and the kinds of intervention developed by therapists specializing in this field.

On being a client : understanding the process of counselling and psychotherapy

INTRODUCTION Love and Work PART ONE: ACCEPT ME Warm and Friendly Acceptance A Secure Base PART TWO: UNDERSTAND ME Understanding People Knowing Other Minds Natural Psychologists Biology and Experience The Development of Social Understanding The Origins of the Empathetic Counsellor PART THREE: TALK WITH ME The Chance to Talk Description Narrative Dialogue PART FOUR: THE FORMATION AND RE-FORMATION OF THE SELF IN SOCIAL RELATIONSHIPS The Formation of the Self in Social Relationships The Nature of the Counselling Relationship

Age at placement, adoption experience and adult adopted people's contact with their adoptive and birth mothers: An attachment perspective

Adoption holds particular interest for attachment researchers. Although children adopted as babies experience almost continuous care by their adoptive parents, older placed children experience at least one major change of caregiver when they join their adoptive family. Moreover, in the majority of cases, older placed children have generally suffered a pre-adoption history of abuse, neglect and/or rejection. It is now being recognized that older placed childrens attachment histories and internal working models (IWMs) established in relationship with their initial carers remain active in relationship with their new carers. Transactional models have helped both researchers and practitioners to understand the dynamics of parent-child relationships in cases where insecure children with histories of neglect,abuse and rejection findthemselves in new caregiving environments. The present study examines the childhood experiences of adult adopted people and their current levels of contact with their adoptive mothers, and in cases where people had searched for and found a birth relative, current levels of contact with their birth mother. Although no information was collected on the adopted adults pre-placement history,age at placementwas used as a proxy measure to examine whether older placed children reported different adoption experiences and what their current levels of contact were with their adoptive and birth mothers. The findings show that age at placement was associated with adopted peoplesreported experiences of being adopted and current rates of contact with their adoptive and birth mothers, with those placed at older ages most likely to report that they (1) did not feel they belonged in their adoptive families while growing up, (2) did not feel loved by their adoptive mother, (3) were least likely to remain in highfrequency contact with their adoptive mother, and (4) were least likely to remain in high-frequency contact with their birth mother. An attachment perspective is used to interpret the findings. Children adopted at older ages appear more likely to have experienced an insecure attachment relationship with their adoptive mother.

Social understanding, attachment security of preschool children and maternal mental health

Studies on childrens social understanding tend to assume that understanding the minds and emotions of others are theoretically and methodologically indistinct. This study, however, aimed to assess differential effects, with particular reference to the quality of the attachment relationship and maternal mental health. The participants were 45, 40-month-old children who were assessed on tasks of social understanding (false belief, Bartsch & Wellman, 1989, and emotion understanding, Denham & Auerbach, 1995); attachment security was assessed by a story completion task (Bretherton, Ridgeway, & Cassidy, 1990), and maternal mental health was assessed by Becks Depression Inventory (BDI) (Beck, Ward, Mendelson, Mock, & Erbaugh, 1961). The hypotheses were (a) that insecure children would have mothers scoring higher on the BDI than secure children and poorer performances on the social understanding tasks; (b) that insecure children need not be any worse than secure children in mind appraisal, rather, it was anticipated that their difficulties would be with emotion appraisal. It was found that, relative to secure children, insecure children had lower verbal mental ages, poorer performances on emotion understanding and had mothers scoring higher in depression. Interestingly, no significant effects were found for mind understanding. A regression analysis showed that verbal mental age and attachment were significant predictors of the childs emotion task performance whilst depression and SES were not. In the light of these results, this paper considers the need for a move towards an integration of theories and methods.

Attachment disorders: Disinhibited attachment behaviours and secure base distortions with special reference to adopted children

It was in the mid 1980s, as a research-oriented academic social worker, that I first became involved with adopters and their adopted children. This was a time of falling baby adoptions and a rapid increase in the placement of older children, many of whom might otherwise have ‘drifted’ in the public care system. A slogan at the time was ‘no child is unadoptable.’ It was against this background that I was asked to describe and evaluate the work of a newly established, and pioneering post-adoption service based in London. During my exploratory interviews with the counsellors and adopted parents, I was struck by the uncanny similarity of the problem behaviours exhibited by most of the adopted children with whom parents were having difficulty. Typically, children in late childhood and early adolescence were behaving very aggressively, particularly towards their adoptive mother. Other behaviours included stealing from home, ‘crazy’ lying, fighting to be in control over most issues, poor eye contact, preoccupation with violent and bloody imagery, and failing to anticipate the consequences of behaviour. The majority of these children had been placed after their first birthday and often much older. Most had suffered abuse and neglect prior to being adopted (Howe 1997, 1998). Many of the adopters had sought help from the child psychiatric and psychological services but had felt disappointed with the response which, in their eyes, seemed to concentrate on the alleged inadequacies of their parenting, ignoring the child’s history and the peculiar features of their problematic behaviour. In desperation, not a few of these parents looked for help from a small number of therapists who were beginning to specialise in treating adopted children using an attachment perspective. At this time, most of these specialists were based in the States, but a steady trickle of British adopters crossed the Atlantic with their children to seek help. Of those who made the journey, most came back not only satisfied but also convinced that there existed a body of knowledge and a group of therapists who understood the nature and etiology of their children’s distinctive problem behaviours. The theoretical background employed by the therapists was attachment oriented, and the label given to the children’s problem behaviour was (reactive) attachment disorder. Thus was the label ‘attachment disorder’ introduced into the British community of adopters and support agencies. Throughout most of their analysis, O’Connor and Zeanah define attachment disorder as the failure to show selective attachment

Disorders of Attachment and Attachment Therapy

Many adopted and looked after children with histories of physical and sexual abuse, and severe loss and neglect, develop highly disturbed and distinctive problem behaviours. Those diagnosed suffering such ‘disorders of attachment’ put great stress on the resources and skills of their post-placement carers. Children with these behaviours have proved very difficult to treat. However, as David Howe and Sheila Fearnley discuss in their paper below, attachment therapies based on ‘cognitive restructuring’ and ‘therapeutic holding’, appear to be having some success with children who have failed to respond to other treatments employed by the child mental health services. The authors describe different patterns of attachment and the behaviours associated with children classified as disorganised and disordered in their attachment behaviours. They outline therapeutic interventions based on developmental attachment theory using a case example.

Adoption and Attachment.

Childrens early attachment experiences can have a dramatic affect on their day-to-day behaviour, as well as on their social development in later life. Drawing from extensive interviews with adoptive parents, all of whose children were in their late adolescence or young adults at the time of research, David Howe asserts the value of understanding the influence of past care on present placements.

Adopted Adults Who Search for Background Information and Contact with Birth Relatives

As part of its work with adopters, adopted people and their birth relatives, the Childrens Society Post-adoption and Care Counselling Research Project is engaged in a number of studies looking at adopted peoples experiences of seeking background information and contact with birth relatives. Between 1988 and 1995, project workers provided advice and counselling beyond initial contact to 366 adopted people seeking information and possible reunion with a birth relative. In the following study, Julia Feast and David Howe analysed the agencys file records to determine the numbers and characteristics of adopted people who sought help from the projects counsellors. Findings are presented about the demographic characteristics of the adopted adults, their reasons for wanting the service, the type of contact established with a birth relative and the quality of relationship with their adoptive parents.