Looking after the mental health of looked after and accommodated children in Scotland

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The Importance of Nurturing Relationships
Sarah Williams, Educational Psychologist 26th
October 2009
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Outline of Todays workshop

• What is a nurturing relationship
• Introduction to Attachment Theory
• The development of Secure Attachment
• What can go wrong and why?
• Attachment, Trauma and Loss
• What can schools do to promote nuturing
  relationships

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What do Children and Young People need for
Healthy Development?

• What to we already know?

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What do children and young people need for
healthy development?

• Security Nurturing Trusting Routine
• Permission to express themselves Guidance Rules
• Positive Role Models Good Self Esteem Peers
• Predictability Stimulation Protection Friends
• Fun Interaction Play Empathy Warmth
• Continuity Boundaries Families Continuity

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Maslows Hierarchy of Needs
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The Secure Attachment Process

• Attachment in Practice (DVD)

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Attachment What is it?

• A special kind of bond or tie which is formed
  between a baby and his/ her primary carer(s).
• The person that an infant bonds to in this way is
  known as an Attachment Figure, usually, but not
  always, the biological parent (mother) or
  parents.
•  

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Healthy Attachment Cycle
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Internal Working Model
Children who have warm, satisfying early
relationships are more likely to have a positive
sense of self and more likely to make close and
lasting relationships with others. Main
Cassidy 1988
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Secure Attachment

• Reciprocity
• Containment
• Security
• Effective attunement
• Solid foundation for Learning Development
• Facilitates self-esteem positive relationships
  with others
• Giving receiving empathy
• Resilience in coping with distressing situations

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What can go wrong and why?
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What Can Go Wrong and Why?

• Parent and Child Predisposing Factors
• Overt parental conflict/ domestic violence
• Family Breakdown
• Inconsistent discipline between parents
• Hostile and rejecting relationships
• Abuse physical, sexual or emotional
• Neglect
• Parental criminality, substance misuse (drugs,
  alcohol)
• Mental Illness in the Family
• Post natal depression
• Child with ASN e.g. autism

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Trauma and Loss

• Separation from primary caregiver
• Changes in Primary caregiver
• Frequent Moves or placements
• Traumatic experiences e.g.bereavement
• Maternal depression
• Birth Trauma
• Maternal Addiction
• Divorce, separation
• Lack of attunment between mother/ child
• Young inexperienced mother with poor parenting
  skills

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Trauma

• Psychological trauma leading to mental disorder
  is defined as
• An event which is, or is realistically perceived
  to be, threatening to the life or personal
  integrity of self or others
• And
• the reaction is one of fear, helplessness or
  horror

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Recovery from Traumatic Stress

• Most children, most of the time, recover
  spontaneously from traumatic stress. For them to
  do so 3 conditions must be met
• Safety
• Able to express what has happened to them
• Be part of a secure social network with
  well-formed attachment relationships

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Disturbed Attachment Cycle
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Insecure Attachment in Children/ Young People

• These children may have difficulties with
• Interacting with the environment
• Regulating stress and impulse adequately
• Engaging with others and their environment
• Experiencing empathy
• Expressing emotions
• Establishing trust-based relationships
• Making adjustments about the trustworthiness of
  others
• Distinguishing between types and degrees of
  relationships
• Forming close and intimate relationships.

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• What can we do in school to promote Secure
  Attachment?
• The Qualities of the Skilled Helper
• School as a Safe Base

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Intervention by Teachers

• The teacher perception of the pupil shapes and
  mediates the contact between them and profoundly
  affects the teachers efforts to engage and
  motivate the pupil (Libber 1989)
• Both pupil and teacher bring to the learning
  situation experiences from the past and
  expectations that are both helpful and
  destructive, derived from a history of
  experiences and relationships of which neither
  might be consciously aware
• (Wittenberg et al., 1983)

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Understanding Attachment Offering a Secure Base

• Dependency is the pre-condition for
  independence a measure of relative dependency
  can thus be helpful for learning
• (Greenhalgh, 1994)

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Characteristics of a Key Person Additional
Attachment Figure

• Able to form and maintain a supportive and
  friendly relationship with child/young person
• Continuity of relationship (but not over
  dependence)
• Emotionally and physically available
• Sensitive/ responsive to child/ young persons
  needs
• Empathetic
• Able to provide nurture and structure
• Able to contain and regulate emotional states
  (own and child/young person)
• Robust and resilient
• Calm
• Tenacious
• Resourceful and adaptable

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Teachers and Resilience

• Human relationships are the heart of schooling.
  The interactions that take place between students
  and teachers and among students are more central
  to student success than any method of teaching
  literacy, science or maths. When powerful
  relationships are established between teachers
  and students, these relationships frequently can
  transcend economic and social disadvantages.
• (Cummins 1996)

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TASK

• Think of a person in school who made a positive
  impact on you.
• Share your memory

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Characteristics of School as a Secure Base

• Respect regardless of skills/difficulties
• For young people
• A safe adequately supervised building
• Sensitivity to what is being communicated through
  behaviour
• Routines
• Fast responses to absence
• Consistent rules and expectations
• Familiar long term relationships
• Modelling of good relationships from the adults
• Informed reflection about incidents
• A fair system of disciplinary procedures

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Characteristics of School as a Secure Base

• For staff
• Strong leadership that listens to staff and can
  be relied on for consistent available support
• Respect for the physical comfort of staff
• A capacity to reflect on difficulties rather than
  react
• Mutual support and collaboration
• A common language and framework for understanding
  pupil behaviour
• A regular forum for reviewing difficulties in a
  reliable supportive group

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School as a Secure Base

• Promoting a sense in child/ young person that
  they have relationship(s) with significant people
  available to them and have a supportive
  environment.
• Interventions mirror the functions of a secure
  attachment relationship that acts to reduce
  anxiety and to promote healthy exploration and
  learning in the child/ young person at every
  stage of their development.
• Attachment to a person who values the young
  person for his/ her intrinsic qualities will
  facilitate the development of good self esteem.
• The young person who has a basic sense of
  security is mpore likely to feel that they can
  attempt new tasks and explore the environment in
  the search for mastery and later incorporate
  these positive experiences in to confident self-
  identity

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