BOOK
Attachment-Based Milieus for Healing Child and Adolescent Developmental Trauma
(2017)
Additional Information
Book Details
Abstract
This book presents an innovative relational and community based therapeutic model to ensure children's essential attachment needs are catered for in intensive mental health care.
The text combines an overview of theory relating to attachment and trauma before laying out a model for working with children and adolescents in an attachment-informed way. The approach applies to a diverse range of settings - from in-patient psychiatric settings, through to schools-based programs, and provides the reader with the knowledge and guidance they need to introduce the approach in their own service. It also addresses the complexities of working with specific clinical populations, including children with ADHD, ASD, RAD and psychosis.
Accessible for entry level clinical caretakers, yet sophisticated enough for clinical supervisors, this book is essential reading for professionals looking to improve the effectiveness of child and adolescent treatment programs.
John Stewart is a psychologist with 35 years' experience. He is Assistant Clinical Professor, Department of Psychiatry, Tufts School of Medicine, Boston MA.
John Stewart has given us a gift. This book expands our use of attachment theory and provides a road map for institutions to travel on towards more secure base milieu care.
Guy Diamond, Director, Center for Family Intervention Science, Drexel University, Professor Emeritus, University of Pennsylvania
John Stewart's new work is an excellent endeavor to describe the complex qualities that are central in developing and maintaining a milieu that provides young people with the relationships that they need to begin to trust.
From the foreword by Dan Hughes, psychologist and founder of Dyadic Developmental Psychotherapy
In Attachment-Based Milieus, John Stewart shares his original and practical approach to utilize relationship based approaches to healing. In a clear and well-written way, he provides us with the tools to leverage our Paleolithic tribal instincts in the service of plasticity and positive change
Louis Cozolino PhD, Professor of Psychology, Pepperdine University
Table of Contents
| Section Title | Page | Action | Price |
|---|---|---|---|
| Foreword by Dan Hughes | 11 | ||
| Preface | 16 | ||
| Introduction | 23 | ||
| Section I: Introduction to Attachment Theory | 31 | ||
| 1. Treatment within a Theoretical Model | 33 | ||
| 2. What Attachment Theory tells us Is Wrong with these Kids and What They Need | 36 | ||
| 3. Introduction to Attachment Theory | 38 | ||
| What is attachment? | 38 | ||
| Why are attachments important? | 40 | ||
| 4. Attachment Needs within a Three-Stage Developmental Framework | 44 | ||
| Safety and security vs. insecurity and shame | 46 | ||
| Emotional regulation vs. emotional dysregulation | 48 | ||
| Meaning and purpose vs. meaninglessness | 50 | ||
| Conclusion | 52 | ||
| Section II: Supporting Healing Attachments in the Treatment Milieu | 55 | ||
| 5. How Are Attachments Formed and How Is this Applied in the Treatment Milieu? | 57 | ||
| Intersubjectivity | 59 | ||
| PACE | 61 | ||
| Optimal frustration—supporting secure attachment, sense of self and evolving competency | 82 | ||
| Connect–tear–repair | 90 | ||
| 6. Understanding and Using \nCo-regulation of Emotion as a Precursor to Self-Regulation | 93 | ||
| Emotional co-regulation | 94 | ||
| Unreasonable attributions and accepting responses | 97 | ||
| 7. Executive Functioning Weaknesses, Attachment and Organization of the Treatment Milieu | 100 | ||
| Making sense of the environment | 101 | ||
| Factors affecting a child’s capacity to organize | 102 | ||
| Program challenges in work with children with weak organizational capacity | 105 | ||
| Analogy to support empathic understanding of a life with limited executive functioning skills | 107 | ||
| 8. Attachment-Informed Limit Setting within the Treatment Milieu | 111 | ||
| Use and misuse of behavioral limits | 112 | ||
| The what and how of structure within an attachment-informed treatment milieu | 117 | ||
| Connect, and only then direct | 124 | ||
| Use as few words as possible and don’t offer too many warnings | 125 | ||
| Express respect for the child and avoid threats | 126 | ||
| Managing overtly oppositional behavior | 128 | ||
| 9. Rewriting (Healing) Shame‑Based Self-Narratives within the Treatment Milieu | 142 | ||
| An introduction to the neurosciences | 142 | ||
| Creating a positive self-narrative | 144 | ||
| Planting the seeds of self-work with children with limited identity development | 146 | ||
| 10. What Gets in the Way of the Attachment-Informed Stance for Clinical Caretakers? | 153 | ||
| Limited understanding of the importance of connection | 153 | ||
| Competing objectives and values | 155 | ||
| Environmental stress | 156 | ||
| Conclusion | 157 | ||
| 11. Institutional Support to Attachment-Informed Work | 158 | ||
| Institutional core values and philosophy | 158 | ||
| Criteria for hiring | 160 | ||
| The nature and focus of staff training and supervision | 161 | ||
| Effective Clinical Administration Management of Frightening Episodes of Aggression and/or Assault within the Milieu | 164 | ||
| 12. Attachment-Informed Work within the Treatment Milieu with Special Populations | 165 | ||
| Autistic spectrum disorders | 165 | ||
| Reactive attachment disorder and developmental trauma | 169 | ||
| Psychotic disorders | 170 | ||
| Narcissistically defended children and adolescents | 172 | ||
| 13. Special Strategies and Considerations for Milieu‑Based Attachment‑Focused Treatment | 189 | ||
| Touch | 189 | ||
| Food | 190 | ||
| Unexpected positive reactions | 194 | ||
| Transitional objects | 197 | ||
| Peer-centric milieus | 199 | ||
| 14. The Role of Kindness in Treatment | 204 | ||
| Conclusion | 206 | ||
| References | 208 | ||
| Subject Index | 210 | ||
| Author index | 214 | ||
| Blank Page |