1. HU-500 Presentation David Beans Family Counseling for Children With Attachment Disorders

2. Introduction. Experience: Three years as Qualified Mental Health Specialist in PHP. Children's classroom with clients ranging in age from 6-10. Development and Facilitator for Therapy Groups Social Skills Mood Management Self-Esteem Emotional Education Creative Expression Currently have minimal interaction with caregivers.

3. Everyday brings new excitement.

4. Attachment. Population in Program Currently, 4 out of 6 clients have Attachment Disorders. Criteria of Attachment Disorder (American Psychiatric Association [DSM-IV-TR], 2000) Persistent failure to initiate or respond in a developmentally appropriate fashion to most social interactions, as manifest by excessively inhibited, hyper vigilant or highly ambivalent and contradictory responses. Diffuse attachments as manifest by indiscriminate sociability with marked in-ability to exhibit appropriate selective attachment. (I.E. Lack of selectivity in attachment figures, easily comfortable with strangers.) Behaviors Poor social responsiveness, destructiveness, lying/stealing, inappropriate sexual behavior, poor relationships.

5. Attachment. Assumptions of Attachment Theory. (Cornell & Hamrin, 2008; Lopez, F.G. 1995) Humans are programmed to seek and form attachments with others for survival. Individual who is confident in availability of support from caregiver is less prone to apprehension, more likely to engage in exploratory behavior. ‘Internal Working Models of Self and Others’ Activated during periods of stress. Attachment Theory provides theoretical framework to provide an understanding in the importance of early relationships.

6. …Importance of Early Relationships.

7. Attachment. Negative Outcomes of Early Attachment.(Cornell & Hamrin, 2008; Szewcyk-Sokolowski, et. al, 2005) Peer Relational Problems Poor Self-Esteem Delinquent and Aggressive Behavior Conduct Disorders Anti-Social Behavior Can lead to Adult Psychopathology. A youth’s ability to establish and maintain healthy relationships with their peers is critical to the development of their own well being by feeling socially connected and enhancing their ability of adjustment (Szewcyk-Sokolowksi, Bost & Wainwright, 2005).

8. Family Counseling and Treatment. Masters in Community Counseling Acquire appropriate licensure and specialize in Family Therapy for children featuring Attachment Disorders and their families. Aspire to work in community agency setting and/or private practice in correlation with other outpatient services. I.E. Working with children in PHP. Communication and consistency is vital. Broaden skill-set to work with caregivers, as well as children. Develop trusting and therapeutic alliance. Correlate with case managers and teachers.

9. Family Counseling and Treatment. Psychoeducation for Caregivers (Cornell & Hamrin, 2008; Hardy, 2007) Counselor takes role of coach to parent, teaching practical information while providing support for in-home implementation. Increase knowledge of disorders development, child and self-care and building of relationships. Educate responses to social cues and reciprocity. Parenting techniques for situations. Interaction guidance Importance of modeling. Encourage self assessment for personal health.

10. …Coaching.

11. Family Counseling and Treatment Interventions for Children (Cornell & Hamrin, 2008; Hardy, 2007) Enhancing current attachment relationships Remediate relationship between child and caregiver to provide stable support base. Creating new attachment relationships. Encouraging development of healthy attachment relationship to the therapist and processing events through play therapy. Reducing problematic symptoms and behaviors. Mood and Anger Management Social Skills Feeling Education Relationship Building

12. Conclusion There is a much larger scale of work in treatment when working with the family and child, as opposed to being restricted to just the child in a closed setting. Aspirations: Explore further treatment techniques for maladaptive behaviors in children with attachment disorder, including group methods. Encourage improved therapy model within agency settings (I.E. PHP) with consistent communication and interventions. Involvement in discovery and development of universal understanding of diagnosis and treatment of attachment disorder.

13. Thanks. Thanks for watching my presentation. It was fun. Go Cavs.

14. References. References American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders (Revised 4th ed.). Washington, DC: Author. Cornell, T. & Hamrin, V. (2008). Clinical Interventions for Children With Attachment Problems. Journal of Child and Adolescent Psychiatric Nursing. 21(1), 35-47. Hardy, L. T. (2007). Attachment Theory and Reactive Attachment Disorder: Theoretical Perspectives and Treatment Implications. Journal of Child and Adolescent Psychiatric Nursing, 20(1), 27-39. Lopez, F.G. (1995). Attachment Theory as an Integrative Framework for Family Counseling. The Family Journal: Counseling and Therapy for Couples and Families. 3(1), 11-17. Szewczyk-Sokolowski, M., Bost, K. & Wainwright, A. B. (2005). Attachment, Temperament, and Preschool Children’s Peer Acceptance. Social Development, 14(3), 379-393