1. Separation and Reunification: Using Attachment Theory and Research to Inform Decisions Affecting the Placement of Children in Foster Care
David Oppenheim, Ph.D.
University of Haifa, Israel
Douglas Goldsmith, Ph.D.
The Children’s Center, SLC, UT

2. Plan for today Introduction and basic principles of attachment theory
One child’s story of attachment, separation, loss – and attachment
Misapplication of Attachment principles in:
Theory
Assessment
Intervention

3. Attachment Theory
Formulated by John Bowlby and Mary Ainsworth to account for the impact of early separation and trauma on the child
Has revolutionized our views of development, psychopathology, and clinical work
Is the most prominent theory today regarding early socio-emotional development

4. Attachment Theory Is empirically based and supported by research
Is particularly useful in thinking about permanency issues

5. Basic Principles: Forming Attachments
The child is highly motivated from birth to form and maintain attachments to a few caregivers
Attachment has survival value
Children will do whatever is necessary to maintain their attachments and to achieve security
The baby uses the attachment figure as a “secure base”

6. Cooper, Hoffman, Marvin &Powell , 2000

7. More basic principles: Attachment Security
Attachment figures become “psychological parents”.
All babies attach but the security of the attachment depends on the caregivers responses to the child
Sensitivity: Reading the infant’s signals accurately and responding to them appropriately
Insightfulness: Seeing things from the child’s point of view; empathic understanding of the child’s experience

8. Cooper, Hoffman, Marvin &Powell , 2000

9. Cooper, Hoffman, Marvin &Powell , 2000

10. Attachment: Infancy and Beyond
Early attachments lay the groundwork for later development
Children form Internal Working Models of their attachment relationships
The legacy of early attachment is reflected in children’s relationships with others, self-regulation, emotional openness.

11. Separations from attachment figures
Are challenging for young children – and for all of us!
The child experiences separation as a threat to the availability of the secure base.
The degree of challenge will depend on the degree of threat
Often involves separation not only from the parent but from everything familiar

12. Separations
Strong reactions will occur when separating from nurturant parents - but also from abusive parents!
Under certain conditions separations can be traumatic and have devastating consequences.

13. Separation reactions Follow the sequence of Protest (anxiety, anger)
Despair (sadness, withdrawal)
“Detachment” (recovery, renewed interest in the world).

14. The Case of Sara Placed for adoption upon discharge from the hospital
5 months of age legal adoption is not completed
Sara enjoys a loving relationship with her parents
The parent child relationship is marked by reliable, emotionally attuned, and responsive care

15. The Case of Sara Allegations of neglect arise
Sara is removed from the home at the age of 10 months

16. The Case of Sara Shelter home for four days
Second foster home for one week
Third foster home for eight weeks
Adoptive home

17. The Case of Sara
Upon arrival to the adoptive home Sara stares blankly, refuses social interaction, and is oblivious to pain after undergoing a medical procedure
Believing that Sara is available for adoption her name is changed

18. The Case of Sara
At the age of 15 months Sara is responding well to her new environment
First adoptive family hasn’t seen her for 6 months and want her returned to their care

19. The Case of Sara Should she return?
Who are the “psychological” parents?
Does she remember her first adoptive parents?
She’s so young that she won’t remember anything and can be returned without distress
Sara is a “resilient” child

20. The Case of Sara
The internal working model – viewing the world through Sara’s eyes
Assessing “risk”
Could reunion reactivate feelings of loss?
Utilization of second adoptive parents as a secure base
Impact of no contact

21. Common misunderstandings: Theory
There is a critical period in which attachments are formed.
Early childhood is critical, but there is no point when security cannot be damaged
A secure attachment provides “inoculation”
Secure attachments serve as buffers, not inoculations

22. Common misunderstandings: Theory
Secure children are resilient and therefore can be separated
Resilience involves a relationship between the child and the environment; it is not a fixed trait “in” the child
Security or insecurity are personality traits.
Security is a property of a relationship, not a child

23. Common misunderstandings: Theory
We can predict children’s development based on their early attachments
Developmental predictions are probabilistic.
The balance between risk and protective factors is key.

24. Common misunderstandings: Theory
Children do not become attached to maltreating parents (or can easily detach from them)
Children attach to maltreating parents and separation will be experienced as a loss
Removal must always be seen as a last resort; focus on repair of the caregiving relationship
Children’s relationships with their mothers are the most important
Children can develop attachments to several caregivers

25. Common misunderstandings: Theory
Children do not have memories of their early years, and therefore they do not have lasting impact.
Children do not have declarative memories but may have procedural memories encoded in their IWMs

26. Common misunderstandings: Observational Assessment
An observation in the office or at home can be used to assess the child’s attachment
Contexts that are not stressful may reveal very little about the child’s attachment
Casual observations of untrained observers, without the aid of video, and in unstructured situations are of very limited use
Pleasurable play is an expression of a secure attachment
Attachment is most apparent in stressful situations

27. Common misunderstandings: Observational Assessment
Clinging or seeking closeness is an expression of a secure attachment
If desperate, children will cling even to complete strangers, but they will not serve as a secure base
Conflict is an expression of an insecure attachment
Conflicts are integral to healthy relationships; the issue is their negotiation

28. Common misunderstandings: Observational Assessment
Protest during separation is an expression of an insecure attachment (or, conversely, of a secure attachment).
Protest during separation indicates that an attachment bond exists; it tells us little about the child’s security
Ignoring the caregiver, particularly upon reunion, is a sign of non-attachment (conversely, is “normal”)
Avoidant children are attached to their caregivers; the avoidance indicates insecurity, particularly experiences of rejection

29. Common misunderstandings: Assessment
A secure child has secure relationships with everyone
Children can have different attachments to different caregivers
Strong emotional and behavioral reactions before or after a visit with the birth mother are indications of maltreatment by the birth mother or insecure attachment to the foster parents.
These kind of reactions are expected separations reactions and tell us little about the child’s experience

30. Common misunderstandings: Assessment
Separations and reunions are the only contexts in which attachment can be assessed
May be not very stressful for older children; the issue is activation of the attachment system
We know how to perform a “Bonding Assessment”
We don’t! And what does “bonding” have to do with it anyway?

31. Common misunderstandings: Intervention
Children do not develop attachments to foster mothers
Children develop attachments to their foster mothers, and their quality depends on the care the mother provides
The intuitive capacities of foster mothers are sufficient
“Normally” sensitive mothers often need special help when providing care to foster children

32. Common misunderstandings: Intervention
Intervention can help children in periods when placement has not yet been determined
It is extremely difficult to implement psychotherapeutic interventions when the child’s fate is uncertain
Problems in the relationships between foster children and their parents are due to faulty parenting/damaged children.
Problems are products of relationships, and the key involves helping develop a good “fit”

33. Common misunderstandings: Intervention
Reminders of the birth mother are distressing; therefore they should be avoided (context: short separations)
We should think of what promotes the child’s confidence in the continued availability of the “secure base”

34. Common misunderstandings: Intervention
Children who do not speak do not understand language. Therefore, talking with them about the transitions they are experiencing is useless (and changing their name is insignificant).
Expressive language lags behind receptive language; children understand much more than they can express