1. AN INTRODUCTION TO THE SECURE BASE MODEL Gillian Schofield and Mary Beek

2. Why use theories of attachment and resilience in developing a caregiving model?  Children are significantly harmed by abuse, neglect, separation and loss. Many will suffer to some degree all their lives as a result.  But many children from troubled backgrounds will benefit from therapeutic caregiving experiences in foster care, adoption and residential care and go on to lead successful stable lives as adults, partners and parents.  The goal is to promote security and resilience.

3. The caregiving cycle Child’s needs and behaviour Caregiver’s thinking and feeling Caregiving behaviour Child’s thinking and feeling Child’s development

4. Caregiving dimensions that promote security and resilience  AVAILABILITY - helping the child to trust  SENSITIVITY - helping the child to manage feelings and behaviour  ACCEPTANCE - building the child’s self esteem  CO-OPERATION - helping the child to feel effective -and be co-operative  FAMILY MEMBERSHIP - helping the child to belong

5. The secure base model

6. Availability Child’s needs and behaviour What does this child expect from adults? How can I show this child that I will not let him down? Alert to child’s needs/signals Verbal and non- verbal messages of availability I matter, I am safe I can explore and return for help Other people can be trusted Helping the child to trust Child thinking/ feeling Caregiving behaviour Caregiving thinking/ feeling

7. Children who lack trust  Troubled children have often lacked consistent care and protection from reliable caregivers  Caregivers unavailable through drugs, mental health, learning disabilities, own childhoods  Caregivers may have rejected the child’s emotional demands responded unpredictably been frightening or frightened  Children will have developed defensive strategies to cope with this lack of trust Children who lack trust

8. Availability- helping the child to trust Caregivers need to  be available physically, psychologically and emotionally  signal availability in age appropriate ways  time the relationship ‘dance’ at the pace of the child  help the child to know that they are thinking of him or her when apart

9. When tiny babies have switched off  When Jennie came to me at 12 weeks old, she was completely unresponsive, not waking for feeds, not responding to me, not showing any emotion. She had just switched off. I had to stay close to her and respond to even the slightest sound or facial movement and keep talking to her and touching her. It took time to replace those first weeks, but gradually she started to show different feelings and become more responsive.

10. Having the patience to let the child approach  Sam (5) found it impossible to trust me and watched my face warily all the time. I found that if I sat with a drink for him on the settee with children’s television on, he would circle the house for a long time dragging his favourite blanket and eventually end up sitting on my lap wrapped in the blanket, drinking his drink. I needed just to be there and he needed to have the confidence that I would wait for him to come to me.

11. When children are anxious and away from their secure base  When Aiden (4) had contact with his father he was always very anxious about what might happen and whether he would come back to me and I would be here for him. On one occasion I gave him a small cushion to take with him so that he had something to hold onto, but also so that he would know he would be coming home.

12. Sensitivity Child’s needs and behaviour What might this child be thinking and feeling? How does this child make me feel? Helping the child to understand, express and manage feelings appropriately My feelings make sense and can be managed Other people have thoughts and feelings Helping the child to manage feelings and behaviour Child thinking/ feeling Caregiving behaviour Caregiving thinking/ feeling

13. Children who find it difficult to manage their feelings and behaviour  Feelings have often not been acknowledged or understood in their birth families  From infancy, overwhelmed by feelings that can’t be managed  Feelings often mislabelled/distorted –what is the truth?  Cannot appropriately express feelings – so excessively expressed or denied and repressed or dysregulated and chaotic or dissociated.  Feelings expressed through their bodies in confused ways

14. Sensitivity - helping the child to manage feelings and behaviour Caregivers need to  read the child’s signals, think flexibly, contain anxiety  name thoughts and feelings– provide a ‘commentary’  give a predictable shape to events e.g. feeds, nappy change, school  model the expression and management of their own thoughts and feelings  promote empathy – how do you/how might other people think and feel?

15. Promoting mind-mindedness, perspective taking and empathy  I think Jenna (9) spent so long in self defence and looking after herself that she never learned to look at things from any one else’s point of view. She missed that out when she was little. And even things like stories.. When you say, what do you think is going to happen next? or why is that person thinking that? she hasn’t got a clue, she doesn’t follow the motives of what people are doing, or how they are feeling. So we do a lot of story reading together and I talk it through.

16. Using an experiences book : making it safe to think and remember  Paula (8) couldn’t remember or didn’t want to remember what happened this morning or yesterday or last week and couldn’t anticipate ‘next week’. So we started to do an Experiences Book together - each day writing down what had happened and her feelings about it. This helped her to reflect on the shape of each day and the immediate past and build her capacity to remember.

17. Acceptance Child’s needs and behaviour This child needs me to value and accept him/her. I need to value and accept myself Helping child to feel good about him/herself and manage setbacks I am accepted and valued for who I am I do not have to be perfect Building the child’s self-esteem Child thinking/ feeling Caregiving behaviour Caregiving thinking/ feeling

18. Children with low self-esteem  Many troubled children feel profoundly worthless  They have often experienced parenting that was negative and lacked warmth/sensitivity  Tend to see the world /other people in extremes - all good or all bad  Multiple separations within the birth family/once in care may also move  Defend against feelings of worthlessness –boastful/ or won’t compete  Often won’t take risks /try new things

19. Acceptance - building the child’s self-esteem Caregivers need to  promote the idea in the foster family- ‘Nobody’s good at everything but everybody’s good at something.’  find activities to do and to share - orchestrate achievements, but allow failures and setbacks to happen and be managed.  model and teach the child to accept and celebrate difference – ethnicity, personality, talents.

20. Showing pride - promoting resilience  Rob (11) loves his fish pond. Now he’s in charge of his own and he’s totally reliable in that department. We encourage him all we can. We say ‘Rob’s the top pond man’. He gave his talk at school on goldfish and got top marks.

21. Helping a disabled child to be accepted by others  For Ben (10) to be accepted some of his behaviour had to be modified and he will get the benefits of that. We go to a nice hotel and he’ll walk into the dining room on his walker and everyone thinks he’s so wonderful and it’s so great for him. They say ‘Ben, you’re so clever, you’re marvellous, you’re such a beautiful boy’. I think, that’s part of what’s building him up, not me, but the response of all these other people. And he’d never have got that, not how he was before.

22. Co-operation Child’s needs and behaviour This child needs to feel effective and competent How can we work together? Promoting choice Making co-operation enjoyable Negotiating within firm boundaries I can make things happen within safe limits I can compromise and co-operate Helping the child to feel effective – and be co-operative Child thinking/ feeling Caregiving behaviour Caregiving thinking/ feeling

23. Children who do not feel effective- can’t compromise/co-operate  Lack confidence in getting their needs met  Have rarely experienced co-operative parenting – parents were often either too controlling and intrusive or too passive and ineffective  Children have often felt powerless or too powerful  Feelings of powerlessness or powerfulness can occur for children in the care system

24. Co-operation- helping children to feel effective: examples Caregivers need to  offer choice - even in small things  help the child to achieve results - both on their own and with help  help the child to see the benefits of negotiation and compromise  model co-operative behaviour with other family members

25. The therapeutic effect of supporting a child to take the lead  George (3) would only relax in the garden, so although it was winter we wrapped up warm and everyday we spent time outside. He would potter about, looking at stuff and I would follow him sometimes and talk occasionally and he would stop and he’d look at an insect, or whatever it was he’d found. I pretty much let George lead, but sometimes I’d draw his attention to things. Yes, he pulled out all the plants and I just decided that I wasn’t going to have a garden that year and I just thought – yeah, I can have a garden next year.

26. Promoting co-operation- avoiding a battle  We try, actually, never to tell Salim (7) to do anything. It’s a matter of phrasing it differently, so that you are not triggering his feelings of threat. So, instead of saying, ‘Please wash your hands before you have a sandwich’ we might just say ‘Would you like to come and have a sandwich after you’ve washed your hands?’ or ‘We’ll have a nice long story time if you brush your teeth quickly’.

27. Family membership Child’s needs and behaviour This child is part of my family and also part of another family Verbal and non-verbal messages of inclusion in both families I can belong comfortably to more than one family Helping the child to belong Child thinking/ feeling Caregiving behaviour Caregiving thinking/ feeling

28. Children who do not feel they fully belong - in any family  Children may have been rejected in their birth family – singled out for rejection or became excluded when parents separated  Their identity may have been confused and uncertain – but still feel ‘loyal’ to their original family /parents  In a new family they find it hard to ‘join in’ – to accept the patterns/rituals of a new family  Make carers feel that they don’t want to belong

29. Family membership – Helping the child to belong  Ensure the child understands how this family does things; include the child in foster family life/photos  Have special places for the child in the family home - for their clothes, at table, in the garden  Enable the child to talk about and value their birth family identity  Manage contact in ways that promote the child’s well- being and comfortable sense of belonging in both families.

30. Belonging to a family: Can you describe your relationship with your foster mother?  Mother and son. She looked at me as her son and I looked at her as my mum sort of thing. Even though when you’re 18 you officially leave care, but we kept in touch. We go round there for dinner, she comes round here. She classes my children as her grandchildren. (Christopher age 29 placed at 5)

31. Part and parcel of our family  We always say – from the moment you walk through the door, you are part of us. No matter how long you’re staying or how many other families you relate to, you are part and parcel of our family, the same as everyone else who lives here. We say it and we show it to them as well.

32. Leroy ( 18 – placed at 8) talking about his foster mother  My mum’s helped me a lot because she was determined for me to do well. That’s a really important thing, other people believing that you can do well... It was my home - whereas before it was just somewhere I was staying.

33. Family relationships transforming lives  ‘I wasn’t a good child because my birth family never showed me any love...I was always angry, all the time. And then my foster mother saw what was going on and she knew. So she gave me love and she gave me what every mother should give their daughter and I changed my ways and now I don’t do drugs or anything bad like that.’ (Sally, 16)

34. Social work practice using the secure base (www. uea.ac.uk/providingasecurebase)  Assessment and working with children in child protection, fostering, kinship, adoption and residential care  Assessing, preparing and supporting carers  Matching  Carers /social workers setting goals for each dimension and monitoring progress – new and existing placements  Assessing and providing help to placements in difficulties

35. The secure base model