Understanding Trauma Effects On Children Session I and II Lois A. Pessolano Ehrmann PhD, LPC, NCC...
88
Understanding Trauma Effects On Children Session I and II Lois A. Pessolano Ehrmann PhD, LPC, NCC ATTACh Registered Clinician; Certified Attachment Focused Family Therapist EMDR Certified Clinician and Approved Consultant & Certified IFS Therapist ATTACh Board of Director Founder and Executive Director of the Individual and Family CHOICES Program State College, PA Most Important Credential: Mom of a previously attachment challenged and traumatized child Northeast Adoption Summit
-
Upload
julie-lane -
Category
Documents
-
view
214 -
download
1
Transcript of Understanding Trauma Effects On Children Session I and II Lois A. Pessolano Ehrmann PhD, LPC, NCC...
Understanding Trauma Effects On Children Session I and II
Lois A. Pessolano Ehrmann PhD, LPC, NCCATTACh Registered Clinician; Certified Attachment Focused Family TherapistEMDR Certified Clinician and Approved Consultant & Certified IFS Therapist
ATTACh Board of DirectorFounder and Executive Director of the Individual and Family CHOICES Program
State College, PAMost Important Credential: Mom of a previously attachment challenged and traumatized child
Northeast Adoption Summit
WELCOME!!!!
Who are you?
Clinicians?
Parents?
Educators?
Advocates?
Double Duty?
Learning Objectives
As a result of finishing this training participants will be able to:
1. Describe theoretical foundations and core concepts related to childhood traumatic stress.
2. Discuss the impact of simple and complex trauma on the developing brain.
3. Describe the impact of traumatic stress on a child’s daily functioning.
The Tentative ScheduleBefore the Break: Part I
• What is Trauma ? • Simple versus complex?• Hey what is your ACE number?• Child traumatic stress: Core Concepts and theoretical foundations
After the Break: Part II
• Trauma and the Brain: A sad and terrible mix• Trauma and daily functioning: Really NO Fun• Treatments that show promise!
What is Trauma?
Definitions- Trauma
Traumatic event- one in which a person experiences, witnesses or is confronted with threatened death, or serious injury, or threat to the physical integrity of oneself or others.
Person’s response- intense fear, helplessness or horror
Private versus Personal From DSM-IV , Fourth Edition; American Psychiatric Association
The Expansion of the DefinitionExperiences of threatened deathWitnesses of threatened deathSerious injuryThreat to the physical integrity of oneself or othersACE Study (Felitti et. Al., 1998)
Two Categories of TraumaOne-Episode Trauma (Type I post-traumatic stress disorder PTSD)
– Retain detailed memories– Intrusive recollections– Nightmares– Startle and vigilance– Why me?
Repeated Trauma (Type II post-traumatic stress disorder PTSD)– All of the above plus– repeated trauma occurs in children who have been abused often and for a long time.
common in children who have been reared in violent neighborhoods or war zones – witness violence in the home or in their communities– sickening anticipation and dread of another episode. After being repeatedly confusing
combination of feelings, at times angry and sad, at others fearful– appear detached and seem to have no feelings (emotional numbness)
Let’s Make it even MORE Complex!
What is Complex Trauma?
• Also called developmental trauma• Involves multiple traumatic experiences
• Defining factor is chronic early maltreatment within a caregiving relationship
Complex Trauma:Where Trauma and Attachment Collide
Trauma is perpetrated by the child’s caregiver so
Maltreatment itself +
Loss of caregiver as safe base+
Overwhelming distress with which the child must cope and navigate developmental challenges mostly
alone
Maltreatment by Primary Caregiver
• Results in amplified damage that is pervasive• Erosion and damage of the child’s normal
developmental pathways• Places individual at risk for chronic and
recurrent anxiety• Breaks down fundamental psychobiological
development in the body, healthy identity, coherent personality secure attachment
• Disturbed relationships
Complex Trauma Impairs 7 Domains
AttachmentBiology
Emotional regulationBehavioral regulation
DefensesCognition
Self concept
And Let Us NOT Forget SIT…..
Children and Trauma Often Misdiagnosed
Child’s Age Internalizing Behaviors Externalizing Behaviors
Five years and younger
Fear of separation from mother or primary caretaker; excessive clinging; crying, whimpering, trembling; frightened facial expression; immobility;Regressive behaviors such as thumb sucking, bedwetting and fear of the dark
Screaming; aimless motion
6-11 years old Extreme withdrawal; emotional numbing or flat affect; somatic complaints; symptoms of depression and anxiety; guilt; inability to pay attention; other regressive behaviors including sleep problems and nightmares
Irritability; outbursts of anger and fighting; school refusal
12-17 years old Emotional numbing; avoidance of stimuli; flashbacks and nightmares; confusion; depression; withdrawal and isolation; somatic complaints; sleep disturbances; withdrawal and isolation; somatic complaints; sleep disturbances, academic or vocational decline; suicidal thoughts; guilt; revenge fantasies
Interpersonal conflicts; aggressive responses; school refusal or avoidance; substance abuse; antisocial behavior
From: Responding to Childhood Trauma: The Promise and Practice of Trauma Informed CareGordon R. Hodas MD (2006)
The Misdiagnosis of Trauma in Children
ADHD/ADDBipolar Disorder
SchizophreniaGeneralized anxiety disorder
DepressionElective Mutism
Intermittent explosive disorderODDRAD
Enuresis/encopresisEating Disorders
Stereotypic movement disorder
Still Expanding the Definition…
ACE Study (Felitti et. Al., 1998)http://www.cdc.gov/ace/outcomes.htm
What is Your ACE Score???
Family Centered Practice, June 8, 2007Regional Child Abuse Prevention Councils 2011
The ACE ScoreIn your family of origin have you experienced
any of the following? If so give yourself 1 point for each one.
•Recurrent physical abuse•Recurrent emotional abuse •Contact sexual abuse •An alcohol and/or drug abuser in the household •An incarcerated household member •Someone who is chronically depressed, mentally ill,
institutionalized, or suicidal •Mother is treated violently •One or no parents •Emotional or physical neglect
The Important Implications of The ACE Study
http://www.azpbs.org/strongkids/
Adverse Childhood Experiences vs. Smoking as an Adult
0
2
4
6
8
10
12
14
16
18
20
0 1 2 3 4-5 6 or moreACE Score
Regional Child Abuse Prevention Councils 2011
Adverse Childhood Experiences vs. Adult Alcoholism
0
2
4
6
8
10
12
14
16
18
% A
lco
ho
lic
ACE Score
0 1 2 3 >=4
Regional Child Abuse Prevention Councils 2011
ACE Score vs. Intravenous Drug Use
0
0.5
1
1.5
2
2.5
3
3.5
% H
ave
Inje
cted
Dru
gs
0 1 2 3 4 or more
ACE Score
Regional Child Abuse Prevention Councils 2011
Adverse Childhood Experiences vs. Likelihood of > 50 Sexual
Partners
0
1
2
3
4
Ad
jus
ted
Od
ds
Ra
tio
0 1 2 3 4 or more
ACE Score
Regional Child Abuse Prevention Councils 2011
ACE Score vs. Unintended Pregnancy or Elective Abortion
0
10
20
30
40
50
60
70
80
%
ha
ve
Un
inte
nd
ed
PG
, or
AB
0 1 2 3 4 or more
ACE Score
Unintended Pregnancy
Elective Abortion
Regional Child Abuse Prevention Councils 2011
Childhood Experiences Underlie Chronic Depression
0
10
20
30
40
50
60
70
80
% W
ith
a L
ife
tim
e H
isto
ry o
f D
ep
res
sio
n
0 1 2 3 >=4
ACE Score
Women
Men
Regional Child Abuse Prevention Councils 2011
Childhood Experiences Underlie Later Suicide
0
5
10
15
20
25
% A
ttem
pti
ng
Su
icid
e
ACE Score
0 1 2 3 >=4
Regional Child Abuse Prevention Councils 2011
ACE Score vs. Serious Job Problems
0
2
4
6
8
10
12
14
16
18
% w
ith
Jo
b P
rob
lem
s
0 1 2 3 4 or more
ACE Score
Regional Child Abuse Prevention Councils 2011
Again Expanding the Definition of Trauma
Untreated Trauma linked to negative outcomes (Mueser et. al., 2002)
Trauma survivors are at risk (Felitti et. al., 1998)
Between 51% and 98% of public mental health clients diagnosed with severe mental illness have trauma histories. (Mueser et. al.,
1998)
Trauma linked to social, emotional, economic costs and cognitive impairments, disease, disability, serious social problems and
premature death (Center for Substance Abuse Treatment, 2000).
In children trauma may be incorrectly diagnosed (Shonkoff, 2000; Cook, Blaustein, & van der Kolk, 2003).
Common Observations by Adults of Children who have Experienced Maltreatment
(Hodas, 2006) page 26
“A casual adult observer, unfamiliar with maltreatment and its potential effects, might obtain a highly skewed impression of a child so affected.”
Many of the following characteristics apply to both males and females, but tend to be more extreme in males:
Guarded, defensive, and angry behavior; Difficult to redirect, and dismisses support.
High degree of reactivity.
Behaviors may be extremely inappropriate and offensive.
Slow recovery and holds onto grievances
Common Observations by Adults of Children who have Experienced Maltreatment
(Hodas, 2006) page 26 Continued
Blames others or minimizing the event
Oppositional and disruptive “on purpose”.
Overly sexualized behaviors and a lack of interpersonal and physical boundaries.
Social withdrawal and lack of response to adult efforts at engagement.
Common Cognitions & Beliefs of Children (and Adults) Who have Experienced Trauma – Page 27
“The world is threatening and bewildering.”
“The World is punitive, judgmental, humiliating and blaming.”
“Control is external, not internal and therefore I don’t have control over my life.”
“People are unpredictable. Very few are to be trusted.”
“When challenged, I must defend myself- my honor and my self-respect. Above all else I must defend my honor-at any price.”
“If I admit a mistake, things will be worse than if I don’t.”
32
Overview of Attachment Theory
33
Common Language
Attachment
“the deep and enduring connection established between a child and caregiver in the first several years of life. This connection profoundly influences every component of the human condition- mind, body, emotions, relationships and values.”
From: Attachment Trauma and Healing: Understanding and Treating
Attachment Disorder in Children and Their Families by Terry Levy and Michael Orlans
Founders of Attachment TheoryFirst Wave
John BowlbyMary Ainsworth
Second Wave
Mary MainSroufe
TrevarthenTronickOthers
34
Recent Influences in Attachment Theory and Therapy Kicked it up a Notch or Two
Trauma researchers and cliniciansSchorePerry
Van der Kolk
Neurobiological FocusSiegel
Emotion Focused Therapy out of CanadaLeslie Greenberg & Susan Johnson
35
36
Bonding
• Focuses on caregiver rather then the child.
• child attaches to a parent but a caregiver bonds to the infant.
• Related to choices a caregiver makes in order to bring the caregiver/ child relationship into
attunement.
37
Conscience
• Development of an internally modulated sense of caring about what happens to
others, the world and the self.
• This sense of caring helps the individual to decipher right from wrong.
Internal Working Model
The template or blue print that a person develops internally about him or her self, other
people, and the world in general.
38
39
Why is Attachment so Important to the Development of a Healthy Individual ?
1. Basic Trust and Relationship Reciprocity
2. A Secure Base
3. Formation of an Identity
4. Self Regulation Ability
5. Pro-social Moral Framework
6. Positive Internal Working Model
7. Defense against Stress and Trauma
40
The Context in Which Attachment and Bonding Occurs
• Touch
• Eye Contact
• Smile and Positive Affect
• Need Fulfillment
41
The Healthy Attachment/ Bonding Cycle
Attachment occurs between the infant and caregiver within the context of the baby’s needs. When they are met most of the time, trust in relationships and attachment occurs.
4th TRUST- Baby develops trust from having needs met
1st-NEED- The Baby is hungry/wet/scared and needs touch, food, comfort etc.
3rd-GRATIFICATIONBaby’s needs are met through being fed held comforted
2nd-AROUSAL- Baby is angry, crying or upset
42
43
What Happens when the Healthy Attachment Bonding Cycle is Broken
Intersubjectivity
• Refers to those moments when the parent and child are in synch with each other.
• Both child and parent or caregiver are affectively (emotionally) and cognitively (thoughts) present to each other.
• Vitality of their affective states are matched and their cognitive focus is on the same event or object.
• Affect is being co-regulated and within the dyad parent and child are co-creating meaning.
Attachment Focused Family Therapy by Dan Hughes
44
The Brain….What is Happening in there?
47
What is Happening in the Brain
The Harlow Monkey Studies
Neglect as far worse then abuse
Van der Kolk and Perry: Trauma is stored/ stuck in the right hemisphere
Amygdala issues
The reason for the stuckness is underdevelopment/ Trauma and Learning Disabilities
Overstimulated Stress Response
Cortex Damage
On Line 3-D Images of the Brain
http://www.g2conline.org/2022
49
The Harlow Monkey Studies
Experiments in the 1960s with Rhesus MonkeysCloth mothers or wire mothers with foodRole of the mother as a secure baseThe babies had behavior problemsClinging desperately/trauma bondedFreeze flight fightMotherless monkeysLove at Goon Park: Harry Harlow and the Science of Affection (2002) by Deborah Blum
50
Effects of Abuse and Neglect on the Brain
Neglect has been found to be far more a factor for attachment disorder then abuse.
Bessel Van Der Kolk and Bruce Perry did Pet Scans on the brains of various children and adults. The
following findings were documented:
The Brains of Two Three Year old Children
Regional Child Abuse Prevention Councils 2011
54
Trauma Storage in Integration
55
Amygdala Issues
56
Trauma and Learning Disabilities
57
Is it Neurological Immaturity &/or Neurological Impairment
• attachment disorders who have neurological immaturity
• neurologically impaired children who look attachment disordered but….are they really???
• neurologically impaired children that do also have a legitimate attachment disorder too!!
• Neurologically impaired children– have primary process thinking and cognitive
distortions. – don’t move to preoperational thinking
58
Overstimulated Stress Response Systems
• Excess Cortisol• Results in abnormal brain development
• Impairs the immune system and sets up circuitry for psychosomatic disorders
• Kills neurons in the Limbic System of the Brain• Reduces post-natal growth and produces functional
impairments of the process of directing emotions into adaptive channels
59
Cortex Damage
Underlying Neurobiological Processes related to Trauma Exposure
• Acute Trauma shocks a person’s neurological system and creates a fear response
• Complex physiological systems and multiple brain structures are affected via chemical activations and feedback loops
• Active Response: Fight or Flight
• Passive Response: Surrender or Freeze Response
Underlying Neurobiological Processes related to Trauma Exposure-Continued
HPA Axis
Brain stem; amygdala (limbic system); hippocampus; prefrontal cortex; vermis of the
cerebellum, corpus collosum and cerebral cortex
Cortisol
Traumatic Stress and Daily Functioning of a Child
Infancy
Still Face http://www.youtube.com/watch?v=apzXGEbZht0
Toddlerhood
Possible effects of maltreatment overlap through the developmental stages and can be seen well into adulthood such as:• Chronic malnutrition: growth retardation, brain
damage, possibly mental retardation• Head injury and shaking: skull fracture, mental
retardation, cerebral palsy, paralysis, coma, death, blindness, deafness
• Internal organ injuries• Chronic illness from medical neglect
Preschool• Speech delays: May not use language to communicate• Insecure or disorganized attachment: overly clingy, lack of discrimination
of significant people, can’t use parent as source of comfort• Passive, withdrawn, apathetic, unresponsive to others• Frozen watchfulness, fearful, anxious, depressed• Feel they are “bad”• Poor muscle tone, motor coordination• Poor pronunciation, incomplete sentences• Cognitive delays; inability to concentrate• Cannot play cooperatively; lack curiosity, absent imaginative and fantasy
play• Social immaturity: unable to share or negotiate with peers; overly bossy,
aggressive, competitive• Underweight from malnourishment; small stature• Excessively fearful, anxious, night terrors• Reminders of traumatic experiences may trigger severe anxiety,
aggression, preoccupation
Early Childhood (Ages 5-7)• Lack of impulse control, little ability to delay gratification• Exaggerated response (trantrums, aggression) to even mild stressors• Poor self-esteem, confidence: absence of initiative• Blame self for abuse or placement• Physical injuries, sickly, untreated illnesses• Enuresis, encopresis, self-stimulating behavior-rocking, head-banging• Poor social/academic adjustment in school: preoccupied, easily frustrated,
emotional outbursts, difficulty concentrating, can be overly reliant on teachers; academic challenges are threatening, cause anxiety.
• Extremes of emotions, emotional numbing• Act out frustration, anger anxiety with hitting, biting, fighting, lying, stealing,
breaking objects, verbal outbursts, swearing• Extreme reactions to perceived danger (fight, flight or freeze)• May be mistrustful of adults, or overly solicitous, manipulative• May speak in unrealistically glowing terms about his parents• Difficulties in peer relationships, feel inadequate around peers, over-controlling• Unable to initiate, participate in, or complete activities, gives up quickly• Role reversal to please parents, and take care of parent and/or younger siblings.
Elementary/Middle Childhood (Ages 8-10)
• Brief and usually limited denial and emotional numbness. • Try to stop thinking of the traumatic experience• In repeated trauma a type of self-hypnosis (dissociation) that enables them to
deaden, at least in their minds, the pain • Emotional distancing as a frequent coping mechanism • Rage as anger festers, occasionally exploding as tantrums and violent behavior• Rage turned within, engaging in self-mutilating and self-endangering behavior, or
by making physically damaging suicidal gestures• Anger outward through aggressive or delinquent behavior• Identification with the aggressor by turning the rage toward other children,
victimizing and humiliating them• Children may also experience aggression as dangerous so behavior may become
extremely passive resulting in victimization. • Holding tenaciously to the specific memory of the trauma may be an effort to
master the experience• Developing a belief in omens – attaching meanings to unrelated occurrences• Unresolved mourning, and continuing grief interferes with the ability to move on
with life.• Feelings guilt, shame, self-revulsion, or rage
Late Childhood/Pre-adolescense (Ages 10-11)
• Lag behind peers in all developmental areas• Cognitively looks like ADHD symptoms such
as lack of concentration and disorganization• Can especially be seen in emotional and
psychosocial functioning
• View clips of B. showing:– Regression to where trauma occurred– Evidence of unhealthy internal working model
Middle School (Ages 11-13)• A sense of responsibility or guilt for the bad things
that have happened • Feelings of shame or embarrassment • Feelings of helplessness • changes in how they think about the world • Loss of faith • Problems in relationships including peers, family, and
teachers • Obsessive retelling of the single episode trauma• Sleep disturbances• Difficulty concentrating or focusing in the classroom• Conduct problems
Adolescence (Ages 14-21)• Anxiety, depression, and/or anger • Cognitive distortions • Posttraumatic stress • Dissociation • Identity disturbance • Affect dysregulation • Interpersonal problems • Substance abuse • Self-mutilation • Bingeing and purging (bulimia) • Unsafe or dysfunctional sexual behavior • Somatization • Aggression • Suicidality • Personality disorder
From: Integrative Treatment of Complex Trauma for Adolescents (ITCT-A): A Guide for the Treatment of Multiply-Traumatized Youth by John Briere, Ph.D. and Cheryl Lanktree, Ph.D; MCAVIC-USC Child and Adolescent Trauma Program;National Child Traumatic Stress Network;Final draft, August 2008
Best Practices of Trauma Informed Treatment
Trauma, Brain and Relationship: Helping Children Heal, You Make the Difference
http://youtu.be/RYj7YYHmbQs
Prenatal Development
• Providing a safe haven of a “good womb” experience can be done through monitoring your stress, using sensation-focused mindfulness to alleviate the accumulation of stress, giving you and your baby an opportunity for deep relaxation and rest.
• Eating a healthy diet, sleeping well and light exercise daily
• Reading, talking, singing to your baby
Child Birth
Birth as nature intended-good health, emotional support and a tranquil environment with privacy from strangers
Infancy
• Healthy infant development is all about attunement or the careful “tuning in” to the baby’s needs.
• Talk to your infant directly and wait for their response. • Babies need quiet, softness, appropriate stimulation,
gentle rocking, cuddling, eye contact, calmness, soothing voices, and music, tranquility, swaddling, and firm support (especially for the neck.)
• They also need warmth, skin contact, snuggling, molding into their caregiver’s body. They need an easy pace and the environment to be arranged to help them repair any traumatic experiences.
• Biodynamic cranial sacral therapy
Toddlerhood
• Play therapy-helping children express their concerns in their native language=play.
• Providing the opportunity to try things out and master skills need to overcome traumatic situations
• EMDR• Attachment-focused family therapy
Preschool
• PCIT- Parent Child Interaction Therapy• Dyadic Developmental Psychotherapy (DDP)
and other safe Attachment Focused Therapy• Prescriptive Play Therapy • Trauma Narratives• EMDR• Begin a basic IFS (Internal Family Systems)
understanding
Early Childhood (Ages 5-7)
• Prescriptive Play Therapy• PCIT• Dyadic Developmental Psychotherapy (DDP) and
other Attachment Focused Family Therapy• Trauma Narratives with more of a focus on Art
therapy • Sand Trays• EMDR• IFS using toys & symbols to physically represent
parts.
Children Ages 8-10 (Middle and Late Childhood)
Play Therapy
Art Therapy
Internal Family Systems
DDP and Attachment FocusedFamily Therapy
EMDR
Neurofeedback
Cranial Sacral Therapy
Excellent FREE Resource for Trauma Work with Adolescents
Integrative Treatment of Complex Trauma for Adolescents (ITCT-A): A Guide for the Treatment
of Multiply-Traumatized Youth John Briere, Ph.D. and Cheryl Lanktree, Ph.D; MCAVIC-USC
Child and Adolescent Trauma Program;National Child Traumatic Stress Network; August 2008
www.JohnBriere.com
Middle School & Adolescence(Ages 11-21)Individual Psychotherapy DDP & Attachment Focused Family TherapyInternal Family Systems
– Video clip of B. and his family reworking a traumatic memory
Trauma-Focused CBT (TF-CBT)Psychological first aid/crisis managementMindfulness/Meditation StrategiesEye movement desensitization and reprocessing (EMDR)
– Video clip of B’s mother in the Resource Development phase of EMDR Processing
Play therapyNeurofeedback
Required Qualities of the Therapist in Individual Psychotherapy with Traumatized Youths
NonintrusivenessVisible positive regardReliability and stabilityTransparencyDemarking the limits of confidentialityVisible willingness to understand and accept
– Attunement– Empathy– Acceptance; – Understanding– Curiosity about the client’s perspective and internal experience
Active relatedness (including emotional connection) Patience
From: Integrative Treatment of Complex Trauma for Adolescents (ITCT-A): A Guide for the Treatment of Multiply-Traumatized Youth by John Briere, Ph.D. and Cheryl Lanktree, Ph.D; MCAVIC-USC Child and Adolescent Trauma Program;National Child Traumatic Stress Network;Final draft, August 2008
Preventing Vicarious Trauma in the Helper
• Self-care cannot be over emphasized when working with trauma. We hear, witness and feel many of our child clients’ painful and traumatic memories.
• Developing a wellness plan• How do you let go?• How do you transition from work?• What to do with those emotionally intense
cases?
References and Websites
In addition to the references and websites already identified in the slides the following informed this presentation:
The National Child Traumatic Stress Network http://www.nctsnet.org/
Bradenoch, B. (2008). Being a brain-wise therapist: A practical guide to interpersonal neurobiology. New York: W.W. Norton & Company.
Chaffin, M., Silovsky, J., Funderburk, B., Valle, L., Brestan, E., Balachova, T., Jackson, S., Lensgraf, J., &Bonner, B. (2004). Parent-child interaction therapy with physically abusive parents: Efficacy for reducing future abuse reports. Journal of Consulting and Clinical Psychology, 72(3), 500-510.
De Bellis, M.D. (2005). The psychobiology of neglect. Child Maltreatment, 10(2), 150-172.
De Wolff, M., & van IJzendoorn, M. (1997). Sensitivity and attachment: A meta-analysis on parental antecedents of infant attachment. Child Development, 68(4), 571-591.
Dozier, M., Stovall, K.C., Albus, K., & Bates, B. (2001). Attachment for infants in foster care: The role of caregiver state of mind. Child Development, 72(5), 1467-1477.
Dunber, A., Motta, R. (1999). Sexually and physically abused foster care children and posttraumatic stress disorder. Journal of Consulting and Clinical Psychology,67(3), 367-373.
Hodas, Gordon, R. (2006). Responding to childhood trauma: The promise and practice of trauma informed care. Harrisburg, PA: Pennsylvania Office of Mental Health and Substance Abuse Services.
Jennings, A. (2004). Models for developing trauma-informed behavioral health systems and trauma-specific services. National Association of State Mental Health Program Directors (NASMHPD). Washington DC: National Technical Assistance Center.
Shapiro, R. (2010). The Trauma treatment handbook: Protocols across the spectrum. New York: W. W. Norton and Company.
Seigal, D. (1999). The developing mind. NY: Guildford Press.
Siegal, D. (2007). The mindful brain: Reflection and attunement in the cultivation of well-being. NY: W.W. Norton & Co.
Sroufe, L., Egeland, B., Carlson, E., Collins, A. (2005). The Development of the Person: The Minnesota study of risk and adaptation from birth to adulthood. New York: Guilford Press.
Witness Justice (from Internet May 2009) Trauma: The “common denominator”. Frederick, MD.
85
Attachment BibliographyAinsworth, M. (1969). Object relations, dependency, and attachment: A theoretical review of the infant-mother relationship. Child
Development, 40(4), 969-1025.Ainsworth, M., Blehar, M., Waters, E., & Wall, S. (1978). Patterns of attachment. Hillsdale, N.J.: Earlbaum.Barnett, D., & Vondra, J. (1999). I. Atypical patterns of early attachment: Theory, research and current directions. Monographs of the
Society for Research in Child Development, 64(3), 1-25.Bird, G., Peterson, R., & Miller, S. (2002). Factors associated with distress among support-seeking adoptive parents. Family Relations,
51(3), 215-220.Bowlby, J. (1969). Attachment and loss volume 1: Attachment (2nd Edition). New York: Basic Books.Chaffin, M., Silovsky, J., Funderburk, B., Valle, L., Brestan, E., Balachova, T., Jackson, S., Lensgraf, J., & Bonner, B. (2004). Parent-child
interaction therapy with physically abusive parents: Efficacy for reducing future abuse reports. Journal of Consulting and Clinical Psychology, 72(3), 500-510.
De Bellis, M.D. (2005). The psychobiology of neglect. Child Maltreatment, 10(2), 150-172.De Wolff, M., & van IJzendoorn, M. (1997). Sensitivity and attachment: A meta-analysis on parental antecedents of infant attachment.
Child Development, 68(4), 571-591.Dozier, M., Stovall, K.C., Albus, K., & Bates, B. (2001). Attachment for infants in foster care: The role of caregiver state of mind. Child
Development, 72(5), 1467-1477.Dunber, A., Motta, R. (1999). Sexually and physically abused foster care children and posttraumatic stress disorder. Journal of Consulting
and Clinical Psychology,67(3), 367-373.Eley, T.C., Deater-Deckard, K., Fombonne, E., Fulker, D.W., & Plomin, R. (1998). An adoption study of depressive symptoms in middle
childhood. Journal of Child Psychology and Psychiatry, 39(3), 337-345.Erich, S., & Leung, P. (1998). Factors contributing to family functioning of adoptive children with special needs: A long term outcome
analysis. Children and Youth Services Review, 20(1/2), 135-150.Erich, S., & Leung, P. (2002). The impact of previous type of abuse and sibling adoption upon adoptive families. Child Abuse and Neglect,
26, 1045-1058.Festinger, T. (2002). After adoption: Dissolution or permanence. Child Welfare, 81(3), 515-533.Finley, G., & Aguiar, L. (2002). The effects of children on parents: adoptee genetic dispositions and adoptive parent psychopathology. The
Journal of Genetic Psychology, 163(4), 503-506.Fisher, P.A., Burraston, B., & Pears, K. (2005). The early intervention foster care program: Permanent placement outcomes from a
randomized trial. Child Maltreatment, 10(1), 67-71.
86
Attachment Bibliography Continued
Groza, V., & Ryan, S.D. (2002). Pre-adoption stress and its association with child behavior in domestic special needs and international adoptions. Psychoneuroendocrinology, 27, 181-197.
Groze, V. (1994). Clinical and non-clinical adoptive families of special needs children. Families in Society, 75(2), 90-97.Gunnar, M.R., Morison, S.J., Chisholm, K., & Schuder, M. (2001). Salivary cortisol levels in children adopted from Romanian orphanages.
Development and Psychopathology, 13, 611-628.Haugaard, J.J., & Hazan, C. (2003). Adoption as a natural experiment. Development and Psychopathology, 15, 909-926.Juffer, F., Bakermans-Kranenburg, M., & van IJzendoorn, M. (2005). The importance of parenting in the development of disorganized
attachment: Evidence from a prevention study in adoptive families. Journal of Child Psychology and Psychiatry, 46, 263-274Kemp, S.P., & Bodony, J.M. (2000). Infants who stay in foster care: Child characteristics and permanency outcomes of legally free children
first placed as infants. Child and Family Social Work, 5, 99-106.Kochanska, G., Aksan, N., Knaack, A., & Rhines, H.M. (2004). Maternal parenting and children’s conscience: Early security as moderator.
Child Development, 75(4), 1229-1242.Kochanska, G., Forman, D.R., Aksan, N., & Dunbar, S. (2005). Pathways to conscience: Early mother-child mutually responsive orientation
and children’s moral emotion, conduct and cognition. Journal of Child Psychology and Psychiatry, 46(1), 19-34.Livingston-Smith, S., Howard, J., & Monroe, A. (2000). Issues underlying behavior problems in at risk adopted children. Children and Youth
Services Review, 22, 539-562.McDonald, T., Propp, J., & Murphy, K. (2001). The post-adoption experience: Child, parent, and family predictors of family adjustment to
adoption. Child Welfare League of America, 80(1), 71-94. McGlone, K., Santos, L., Kazama, L., Fong, R., & Mueller, C. (2002). Psychological stress in adoptive parents of special-needs children. Child
Welfare League of America, 81(2), 151-170.Meins, E., Fernyhough, C., Fradley, E., & Tuckey, M. (2001). Rethinking maternal sensitivity: Mothers’ comments on infants’ mental
processes predict security of attachment at 12 months. Journal of Child Psychology and Psychiatry, 42(5), 637-648.Meins, E., Fernyhough, C., Wainwright, R., Gupta, M., Fradley, E., Tuckey, M. (2002).Maternal mind-mindedness and attachment security
as predictors of theory of mind understanding. Child Development, 73(6), 1715-1726.NICHD Early Child Care, Research Network, (2004). Affect dysregulation in mother-child relationships in the toddler years: Antecedents
and consequences. Development and Psychopathology, 16(1), 43-68.O’Conner, T. G., Rutter, M., & the English and Romanian Adoptees Study Team. (2000).Attachment disorder behavior following early
severe deprivation: Extension and longitudinal follow-up. Journal of the American Academy of Child and Adolescent Psychiatry, 39(6), 703-712.
Priel, B., Melamed-Hass, S., Besser, A., & Kantor, B. (2000). Adjustment among adopted children: The role of maternal self-reflectiveness. Family Relations, 49(4), 389- 396.
87
Attachment Bibliography Continued
Simmel, C., Brooks, D., Barth, R., & Hinshaw, S. (2001). Externalizing symptomatology among adoptive youth: Prevalence and pre-adoption risk factors. Journal of Abnormal Child Psychology, 29(1), 57-69.
Singer, E., Doorenbal, J., & Okma, K. (2004). Why do children resist or obey their foster parents? The inner logic of children’s behavior during discipline. Child Welfare, LXXXIII(6), 581-610.
Stams, G.J., Juffer, F., & van Ijzendoorn, M. H. (2002). Maternal sensitivity, infant attachment, and temperament in early childhood predict adjustment in middle childhood: The case of adopted children and their biologically unrelated parents.Developmental Psychology, 38(5), 806-821.
Sullivan, A., & Freundlich, M. (1999). Achieving excellence in special needs adoption. Child Welfare, 78(5), 507-517.U.S. Department of Health and Human Services, Administration for Youth and Families. (2004) Trends in foster care
and adoption. Retrieved October 13, 2006 from the US Department of Health Website: http://www.acf.hhs.gov/programs/cb/dis/afcars/publications/afcars_stats.htm. van der Valk, J.C., Verhulst, F.C., Neale, M.C., & Boomsma, D.I. (1998). Longitudinal genetic analysis of problem
behaviors in biologically related and unrelated adoptees. Behavior Genetics, 38(5), 365-380.van IJzendoorn, M., Juffer, F., & Duyvesteyn, M. (1995). Breaking the intergeneration cycle of insecure attachment: A
review of the effects of attachment- based interventions on maternal sensitivity and infant security. Journal of Child Psychology and Psychiatry, 36(2), 225-248.
van Ijzendoorn, M.H., Juffer, F., Poelhuis, C.W. (2005). Adoption and cognitive development: A meta analytic comparison of adopted and nonadopted children’s IQ and school performance. Psychological Bulletin, 131(2), 301-316.
Webster, D., Barth, R.P., Needell, B. (2000). Placement stability for children in out-of-home care: A longitudinal analysis. Child Welfare, LXXIX(5), 614-632.
Weinfield, N., Sroufe, L., Egeland, B. (2000). Attachment from infancy to early attachment in a high risk sample: Continuity, discontinuity, and their correlates. Child Development, 71(3), 695-702.
Zeanah, C. (2000). Disturbances of attachment in young children adopted from institutions. Journal of Developmental and Behavioral Pediatrics, 21(3), 230-236.
88
Books for Clinicians on Attachment Therapy
The ATTACh books: • Hope for Healing: A Parent’s Guide to Trauma and
Attachment;• The Attachment Therapy Companion: Key Practices for
Treating Children and FamiliesAll books written by Dan Hughes
All books written by Art Becker Weidman
All books written by Greg Keck and Regina Kupecky
All books written by Daniel Siegel and Alan Schore
Bonnie Bradenoch’s book: Being a Brain-Wise Therapist
