Separation and Reunification: Using Attachment Theory and Research to Inform Decisions Affecting the Placement of Children in Foster Care

David Oppenheim, Ph.D. University of Haifa, Israel

Douglas Goldsmith, Ph.D. The Children’s Center, SLC, UT

Plan for today

Introduction and basic principles of attachment theory

One child’s story of attachment, separation, loss – and attachment

Misapplication of Attachment principles in:

TheoryAssessmentIntervention

Attachment Theory

Formulated by John Bowlby and Mary Ainsworth to account for the impact of early separation and trauma on the child

Has revolutionized our views of development, psychopathology, and clinical work

Is the most prominent theory today regarding early socio-emotional development

Attachment Theory

Is empirically based and supported by research

Is particularly useful in thinking about permanency issues

Basic Principles: Forming Attachments

The child is highly motivated from birth to form and maintain attachments to a few caregivers

Attachment has survival value Children will do whatever is necessary

to maintain their attachments and to achieve security

The baby uses the attachment figure as a “secure base”

Cooper, Hoffman, Marvin &Powell , 2000

More basic principles:Attachment Security

Attachment figures become “psychological parents”.

All babies attach but the security of the attachment depends on the caregivers responses to the child

Sensitivity: Reading the infant’s signals accurately and responding to them appropriately

Insightfulness: Seeing things from the child’s point of view; empathic understanding of the child’s experience

Cooper, Hoffman, Marvin &Powell , 2000

Cooper, Hoffman, Marvin &Powell , 2000

Attachment: Infancy and Beyond

Early attachments lay the groundwork for later development

Children form Internal Working Models of their attachment relationships

The legacy of early attachment is reflected in children’s relationships with others, self-regulation, emotional openness.

Separations from attachment figures

Are challenging for young children – and for all of us!

The child experiences separation as a threat to the availability of the secure base.

The degree of challenge will depend on the degree of threat

Often involves separation not only from the parent but from everything familiar

Separations

Strong reactions will occur when separating from nurturant parents - but also from abusive parents!

Under certain conditions separations can be traumatic and have devastating consequences.

Separation reactions

Follow the sequence of Protest (anxiety, anger) Despair (sadness, withdrawal) “Detachment” (recovery, renewed

interest in the world).

The Case of Sara

Placed for adoption upon discharge from the hospital

5 months of age legal adoption is not completed

Sara enjoys a loving relationship with her parents

The parent child relationship is marked by reliable, emotionally attuned, and responsive care

The Case of Sara

Allegations of neglect ariseSara is removed from the home at

the age of 10 months

The Case of Sara

Shelter home for four days

Second foster home for one week

Third foster home for eight weeks

Adoptive home

The Case of Sara

Upon arrival to the adoptive home Sara stares blankly, refuses social interaction, and is oblivious to pain after undergoing a medical procedure

Believing that Sara is available for adoption her name is changed

The Case of Sara

At the age of 15 months Sara is responding well to her new environment

First adoptive family hasn’t seen her for 6 months and want her returned to their care

The Case of Sara

Should she return?Who are the “psychological” parents?Does she remember her first adoptive

parents?She’s so young that she won’t

remember anything and can be returned without distress

Sara is a “resilient” child

The Case of Sara

The internal working model – viewing the world through Sara’s eyes

Assessing “risk”Could reunion reactivate feelings of

loss?Utilization of second adoptive

parents as a secure base Impact of no contact

Common misunderstandings: Theory There is a critical period in which

attachments are formed.Early childhood is critical, but there is no

point when security cannot be damaged

A secure attachment provides “inoculation”

Secure attachments serve as buffers, not inoculations

Common misunderstandings: Theory Secure children are resilient and

therefore can be separatedResilience involves a relationship between

the child and the environment; it is not a fixed trait “in” the child

Security or insecurity are personality traits.

Security is a property of a relationship, not a child

Common misunderstandings: Theory We can predict children’s development

based on their early attachmentsDevelopmental predictions are

probabilistic.The balance between risk and protective

factors is key.

Common misunderstandings: Theory Children do not become attached to maltreating

parents (or can easily detach from them)Children attach to maltreating parents and

separation will be experienced as a lossRemoval must always be seen as a last resort;

focus on repair of the caregiving relationship

Children’s relationships with their mothers are the most important

Children can develop attachments to several caregivers

Common misunderstandings: Theory Children do not have memories of their

early years, and therefore they do not have lasting impact.

Children do not have declarative memories but may have procedural memories encoded in their IWMs

Common misunderstandings: Observational Assessment An observation in the office or at home can be

used to assess the child’s attachmentContexts that are not stressful may reveal very

little about the child’s attachmentCasual observations of untrained observers,

without the aid of video, and in unstructured situations are of very limited use

Pleasurable play is an expression of a secure attachment

Attachment is most apparent in stressful situations

Common misunderstandings: Observational Assessment Clinging or seeking closeness is an

expression of a secure attachmentIf desperate, children will cling even to

complete strangers, but they will not serve as a secure base

Conflict is an expression of an insecure attachment

Conflicts are integral to healthy relationships; the issue is their negotiation

Common misunderstandings: Observational Assessment Protest during separation is an expression of

an insecure attachment (or, conversely, of a secure attachment).

Protest during separation indicates that an attachment bond exists; it tells us little about the child’s security

Ignoring the caregiver, particularly upon reunion, is a sign of non-attachment (conversely, is “normal”)

Avoidant children are attached to their caregivers; the avoidance indicates insecurity, particularly experiences of rejection

Common misunderstandings: Assessment A secure child has secure relationships with

everyoneChildren can have different attachments to

different caregivers Strong emotional and behavioral reactions

before or after a visit with the birth mother are indications of maltreatment by the birth mother or insecure attachment to the foster parents.

These kind of reactions are expected separations reactions and tell us little about the child’s experience

Common misunderstandings: Assessment Separations and reunions are the only

contexts in which attachment can be assessed

May be not very stressful for older children; the issue is activation of the attachment system

We know how to perform a “Bonding Assessment”

We don’t! And what does “bonding” have to do with it anyway?

Common misunderstandings: Intervention Children do not develop attachments to

foster mothersChildren develop attachments to their

foster mothers, and their quality depends on the care the mother provides

The intuitive capacities of foster mothers are sufficient

“Normally” sensitive mothers often need special help when providing care to foster children

Common misunderstandings: Intervention Intervention can help children in periods when

placement has not yet been determined It is extremely difficult to implement

psychotherapeutic interventions when the child’s fate is uncertain

Problems in the relationships between foster children and their parents are due to faulty parenting/damaged children.

Problems are products of relationships, and the key involves helping develop a good “fit”

Common misunderstandings: Intervention Reminders of the birth mother are

distressing; therefore they should be avoided (context: short separations)

We should think of what promotes the child’s confidence in the continued availability of the “secure base”

Common misunderstandings: Intervention Children who do not speak do not

understand language. Therefore, talking with them about the transitions they are experiencing is useless (and changing their name is insignificant).

Expressive language lags behind receptive language; children understand much more than they can express