Family Attachment Narrative Therapy Renewing the mind of a child

Denise Lacher, MA, LPTodd Nichols, MA, MPAff Maren Harris, MA, LMFTJan Norman, PsyD, LP

ATTACh 2002 Preconference Institute October 16, 2002 Costa Mesa, California

2002

Model and Meaning

Attachment Relationships Meaning

2002

Attachment Patterns of Behavior

Organized Secure Insecure-avoidant Insecure-resistant or

ambivalent

Disorganized/Disoriented

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Model and Meaning

Life EventsTrauma

Attachment Relationships

Meaning

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Trauma Effects

Affect regulationAttention-

ImpulsivityAggressionDissociation

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Model and Meaning

Development

Life EventsTrauma

Attachment Relationships

Meaning

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Developmental Issues

EmotionalCognitiveSocialNeurological disorders

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Discovering the Model

Gathering informationStandardized testingObservational methods

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Attachment-Promoting Interactions

StructuringChallengingEngagingNurturing

From The Theraplay Model, Jernberg & Booth

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Other Essential Interactions

EmpathyStress ReductionPlayfulness

From The Theraplay Model, Jernberg & Booth

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Discovering the Model

Gathering informationStandardized testingObservational methodsWhat parents knowPutting the pieces together

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Parental Attunement

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Attunement

Enhances emotional Supports healthy development of

representation of self and othersSupports language developmentBecomes cooperative partnershipSupports development of coherent

narrative

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Lack of Attunement

Easily overwhelmed with emotionNegative mental representation of

self and othersImpaired language developmentInsecure relationship with

caregiverIncoherent narrative

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Role of Professional

SupportNew way of looking at childNew toolsAssess parentsRelationship with child

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Constructing Stories

SettingPropsPerspectiveHeroMessage

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Shifting Inner Working

Model with Narratives

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Claiming Narratives

Strengthens emotional bondFacilitates trustEstablishes birth orderExtended familyPasses on traditions, history,

rituals

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Trauma Narratives

Heals pain of traumaCreates empathyFosters understanding

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Developmental Narratives

Facilitates cognitive development

Enhances emotional regulationBuilds relationshipsRemedial skill building

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Successful Child Narratives

Teaches valuesReinforces cause and effect thinkingPresents alternative behaviorsExplains basics of “How To Do” life

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Narrative Themes

From the first, you were a child that deserved to be loved and cared for by parents you could

trust.

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Narrative Themes

Even though you experienced abuse,

abandonment, neglect, you deserved to be loved

and cared for by responsible parents.

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Narrative Themes

Your problem behavior does not define your value and we will be there to love

and support you as you make changes.

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Program Outcomes

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Data Collection Plan

Prior toStart ofProgram

30 DaysAfter

Starting

90 DaysAfter

Starting

6 MonthsAfter

Starting

12 MonthsAfter

Starting

Child Behavior Rating Scale

Achenbach Child BehaviorChecklist

Vineland

Parent Stress Index

Satisfaction Survey

2002

Child Behavior Rating Scale

Examines four diagnoses Conduct Disorder Oppositional Defiant Disorder Attachment Disorder Attention Deficit Hyperactivity Disorder

Compares parent report of child behavior to diagnostic criteria from DSM IV

2002

Pre Treatment and 30 Days After

0.0%

20.0%

40.0%

60.0%

80.0%

100.0%

CD ODD RAD ADHD

Diagnosis

Pe

rce

nt

Pre Treatment 30 Days After

Pre Post CBRS

Pre Treatment and 12 Months After

0.0%

10.0%

20.0%

30.0%

40.0%

50.0%

60.0%

70.0%

80.0%

90.0%

100.0%

CD ODD RAD ADHD

Diagnosis

Per

cen

t Q

ual

ifyi

ng

Pre Treatment 12 Months After

2002

Achenbach CBCL

Total Score2 Broadband Measures-

Internalizing and Externalizing

8 Syndromes-Withdrawn, Somatic, Anxious/Depressed, Social, Thought, Attention, Delinquent, Aggressive

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Significant Change CBCL

Pre-Post CBCL Scores

67.3

72.974.4

58.3

64.2 65.3

50.0

60.0

70.0

80.0

Internal External Total

Scale

CB

CL

T s

co

re

Pre

Post

N=69All differences significant at 99% level.

2002

Client Satisfaction

98% Believe program helped parent child better

98% Would recommend program to others

94% Believe program helped them parent child better

N=60

2002

Additional Resources

Parenting with Stories: Creating a foundation of attachment for parenting your child available at conference bookstore and website

Forthcoming book for professionals and parents

Speaking and trainingWebsite: www.familyattachment.com

2002

Family Attachment Center18322C Minnetonka BlvdDeephaven, MN 55391

952-475-2818

www.familyattachment.com