Table 4

 Helping attachment

Helping children to attach to parents Closeness
Offering closeness when tired, hurt, ill, and after tantrums, even if not sought
Discouraging closeness with others than immediate family
Opportunities to communicate—shared one-to-one activities
Teaching “language” (verbal and non-verbal) of closeness
Safety (emotional and physical)
Reducing the likelihood of failure
 Reducing competition for attention—allowing one-to-one time
 Preparation, explanation, routine, etc to reduce anxiety
 Avoiding circumstances likely to result in difficult behaviour
Behaviour management: establishing control; clear boundaries; allowing success
Calming strategies—touch, massage, music, etc; anxiety management techniques
Helping parents to attach to children Attunement
Helping parents to “see through the child’s eyes” and understand behaviour
Reducing fear/stress/fatigue
Ensuring that expectations for attachment are realistic
 Normality of adoptive parents attaching at different rates
 Normality of attaching more rapidly to one child than another
Ensuring adequate support in the early stages of placement
 Acknowledgement of the difficulty of parenting without attachment
 Addressing guilt, fear, self-doubt; identifying signs of progress
Support for post-placement depression
Respite—informal or formal; encouraging self-care
Secondary consequences/vicious circlesUnderstanding body signals—talking re body sensations—hunger, satiety, etc
Understanding emotions
Parental attunement to the child’s feelings and mood, not behaviour
Clear/exaggerated verbal and non-verbal responses to the child’s feelings—through touch, facial expression, gesture, tone of voice, etc
Teaching words for feelings; discussion of feelings; use of role play, etc
Teaching reading of body language, behaviour, facial expression, etc
Peer relationships—active support of friendships; teaching cooperation, social skills, etc
Stranger safety—education through discussion, books, play, etc
Identification and development of strengths; ensuring success; focusing on positives
Life story work to reduce guilt, shame, sense of responsibility for circumstances, etc
Temper control problems—multiprofessional approach addressing causes and symptoms
ADHD—low threshold for treatment, especially if interfering with mutual attachment
Detailed assessment
Low threshold for intervention because of risk of vicious circles
Ensuring teachers’ understanding of the implications of attachment problems
Specialised psychological servicesTask definition—purpose, choice of resource, mode of delivery and timing of services focused on the priority of securing attachment
Service structure—allowing rapidity of response, to address crises
Specific mental health problems
Identification and treatment of depression, obsessional-compulsive disorder, anxiety, post-traumatic stress disorder, etc
“Attachment therapy”—e.g. for avoidance of or ambivalence to closeness, difficulties with trust and control, etc, when simple strategies are insufficiently effective