I think my child and I are attached, how can your program help us?
Almost all children entering our program are attached! Often, however, their relationship with their parent(s) is problematic, based on difficulties in the child's early life history. One way to say this is that the attachment pattern they are demonstrating in relationship to the caregiver is not secure, or is disordered. The resulting behavioral problems make parts of every day life a challenge. A main goal of treatment is to increase the security of the child's relationship with the caregiver.
What is an example of a "disordered" attachment relationship?
By age 2 most children begin to use their parent as a "secure base" from which to explore the world around them. This means that they will increasingly venture out from their parent, but routinely check back to make sure their parent is watching over them. It may be helpful to think of this process as a need which has evolved in humans-the child needs to have the parent provide security for them, to protect them from harm. As the child grows older and gains confidence, they venture further from their parent and check back less frequently, but are secure in the knowledge that their parent is available for them should they need help.
Many children with attachment difficulties did not have a parent they could rely on as a "secure base." Their parent may have been unavailable or inconsistent. The child loved their parent and was attached to them, but the child's need to have the parent provide consistent, reliable security was not fulfilled by the parent. Consequently, the child may be anxious and demanding or be very distant and independent. These patterns of behavior served to help them overcome the lack of parent-provided security, but can be unhealthy in other contexts and may result in seemingly bizarre behavior. The root of this child's problems, then, lies in the disordered attachment relationship.
My child fits much of the descriptions I see on your website, but I adopted my child as a newborn, so will your program help?
A child's challenging behaviors may be caused by a variety of underlying issues. The key to Family Attachment Narrative Therapy is discovering the meaning of behavior. Narratives can be helpful to children and their families even when behaviors are not related to attachment or adoption issues.
My child had a diagnosis of reactive attachment disorder but he also has other diagnoses, is this still a good approach?
Family Attachment Narrative Therapy may be effective in children with multiple mental health diagnoses. The narratives are not only designed to improve the attachment relationship, but to help children heal from past trauma and to learn new skills to help them in their family, school and community environments.
Many childhood diagnoses are rooted in a child's inability to adequately self regulate, or to control their emotional states. One important role of a secure attachment relationship in early life is to enhance the ability of the brain to regulate social and emotional processes. Narratives provide a channel to transfer social and emotional regulation from the parent to the child. The narrative process provides organization and coherence, and can serve as a blueprint for new behavior in older children.
Do you do holding therapy?
No. The primary techniques we use are Family Attachment Narrative Therapy, EMDR, and play therapy. Other techniques we may use include individual therapy, family therapy, assessment, audio-visual entrainment, etc.
Do you force, or coerce, children to participate?
Family Attachment Narrative Therapy does not use force or coercion. During the telling of the narrative, we might encourage the child to sit in the parents lap or beside the parent. This process is like a parent reading a child a storybook while the child sits in their lap. However, if the child chooses not to sit near the parent, we do not force the child to do so. Sometimes children chose to sit in the opposite corner of the room-we even had one child that chose to lie on the back of the couch like a cat!
What is important in the telling of the narrative is that the child can hear and absorb the lesson of the story. Sitting in the parents' lap or making eye contact is not essential to this process. Using force or coercion would cause the child to become dysregulated and would defeat the purpose of the intervention.
Will this therapy help a child with a diagnosis of fetal alcohol syndrome/effects and other developmental disorders?
Yes it can. Narratives not only help families build stronger connections, they may be used to help children master specific skills. For example, repetition of a successful child narrative about behavior on the bus may help the child memorize "how to do life." Visual aides (props) are often used to help children understand and remember verbal information.
Why does intensive treatment have to be every day?
Inner working models are formed early in life and are not easy to change. Daily treatment builds upon progress before clients return to previous patterns of behavior. In traditionally therapy sessions, which take place weekly or every other week, a great session may challenge beliefs and cause the child to begin to consider other possibilities. But that night or the next day, events may happen which cause the child to return to his negative beliefs. For example, his brother may get to play with a friend or the teacher may call on someone else to read in class, which reinforces his negative thinking patterns and results in behavioral outbursts. Our experience tells us that therapeutically challenging the mistaken beliefs in daily sessions is more successful to provide an initial therapeutic foundation to build upon.
Does my child need an evaluation before entering your intensive program?
Your child does not need an evaluation outside the clinic, but if one has already been completed, that information will be useful to the therapeutic team working with your child. Treatment here will start with a thorough diagnostic assessment. Intensive therapy combines assessment concurrently with treatment. Rather than another diagnosis, however, we use assessment to determine the child's internal working model. Narratives are then tailored to fit the unique needs of each child.
Do we need a referral for your program? How do we get one?
In general, no referral is necessary. You may call the center and self-refer. There are some insurance plans that may require a referral from a current provider in order to receive services from an out of network provider.
What kind of assessment will be done during the intensive? Will I get a report or summary?
Prior to entering the program parents are asked to complete some initial behavioral assessments that are useful in developing initial treatment goals. In addition, parents complete a brief family assessment to help us to determine the impact that parenting the child has had on the family as a whole. The goal of any assessment is to determine a child's inner working model in order to facilitate treatment planning. If therapeutically necessary we may administer additional testing instruments during the intensive to better understand the meaning of the child's behavior.
After the intensive has concluded, a treatment summary will be completed. This report summarizes the child's background, pretreatment functioning, assessment results, response to treatment and makes recommendations for possible school accommodations and future therapy needs.
What kind of results can I expect from your treatment program?
Upon completion of the program, most parents report improved behavior, enhanced parenting skills and satisfaction with their experience at the Family Attachment Center. However, expectations for an individual child will depend on the specifics regarding that child's history, functioning, genetics, functioning ability, etc. While no therapeutic treatment outcome can be guaranteed, you should talk with a therapist about likely expectations regarding individual children. Please see the outcome research page on this website.
What if my child/teen won't cooperate with the therapy?
Minimal cooperation is required from the child. We tell children and adolescents at the beginning of the intensive that we will be making their parent(s) do all the work. The children may talk or not talk, listen or not listen, they just have to be in the same room during the narratives. Most children and adolescents will cooperate at this minimal level. If the child or adolescent refuses to attend therapy with the parent, then it may be necessary to look at other resources for that family.
I see therapists at your agency are Christians. How will your program work with me if I am not a Christian, or from an alternative lifestyle?
We welcome all individuals, regardless of religious beliefs, sexual orientation, lifestyle choices, etc. We do not use the therapeutic session to preach or proselytize, and we will address issues of faith, religion and/or lifestyle only at the client's request. Then, we will address such issues in a nonjudgmental fashion. Our Family Attachment Narrative Therapy process is an excellent tool for families to incorporate their own values and beliefs into the therapy via the narratives, and as such is respectful of all backgrounds.
I am so angry with my child, I can't do it. Why do parents have to be involved?
We believe that parent's are the best people to help their child heal from attachment difficulties. Many children are able to form relationships with adults other than their parents. It is in the context of the attachment relationship that avoidance or ambivalence (and difficult behavior) is observed. Strengthening the connection between the parent and child is vital for their future emotional and psychological well being.
Most parents entering our intensive program are exhausted, frustrated and burnt out. Our supportive, understanding therapists can help. As the meaning of the child's behavior is understood, parents often rediscover the empathy and love they felt when they initially met the child and discover the motivation to help their child.
I'm not very creative, and I'm not a good story teller. Why do I have to tell stories?
Our therapists may know about attachment, adoption, and many therapy techniques, but they do not know the child as well as the parent. Parental expertise about the meaning of behavior, the child's developmental level, cognitive and emotional abilities is key in constructing effective narratives. We have heard thousands of stories over the years and we are here to help create the narratives. However, our experience has proven that narratives, spoken by the parent, are most effective at reaching and connecting with the child.