Youth with Disturbances of Attachment. Attachment Consultation Education Services (ACES)

Behaviour Approaches: For Children/Youth with Disturbances of Attachment Attachment Consultation Education Services (ACES) 1 Behaviour Approaches: ...
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Behaviour Approaches: For Children/Youth with Disturbances of Attachment Attachment Consultation Education Services (ACES)

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Behaviour Approaches: For Children/Youth with Disturbances of Attachment Attachment Consultation and Education Service, CPRI (2015) As you and your child move through life the dance that you share is forever changing. This is why it is imperative for caregivers involved in the child’s life to be aware of his/her attachment needs and to use an attachmentbased, trauma-informed approach to help them to be successful. Attachment is lifelong, and it is human nature to change, so we must realize that the child/youth’s cues/miscues, needs and responses to caregiver interventions will likely change over time too. We should also keep in mind the impact attachment disturbance has on brain development and remember that these children require a kind, supportive and non-reactive approach in to help them learn more adaptive ways to create and maintain healthy relationships. When reflecting on the child’s behaviours, be sure to focus on his/her EMOTIONS and make kind inferences about what they need from you. When a child is feeling unable to cope with their emotions, they often utilise ways that society would deem as unacceptable and respond in a fight, flight, or freeze response. If you can take the time to work thorough the feelings first, the child will learn to establish more appropriate patterns of behaviour with practice.

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In a Nutshell… • • • • • •

A consistent, predictable approach creates feelings of safety. Stay with your child/youth through the situation. Help regulate their feelings. Avoid lengthy verbal counselling/problem solving patterns that focus on behaviour. DELIGHT in your child even when their behaviour is disappointing. Approach any situation with a “WE” attitude, solve the issue together. Providing schedules, structure, rules, and limits help organize feelings too

On the following page are some strategies that may help to promote healthy ways of supporting your child/youth through complicated, emotionally charged situations. These are NOT prescriptions, nor are they “cures”. Rather these suggestions are tools that can be applied to your child/youth’s behaviour to assist you in co-regulating your child/youths emotions.

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Caregiver Response Strategies Behaviour: Stealing Children and Youth with Attachment difficulties may engage in this behaviour in attempts to soothe their internal stress (e.g. Johnny removes items of seemingly little significance to him from his teacher’s desk). Looking outside the attachment/trauma lens, it may appear as though Johnny’s behaviour is designed to intentionally “get back at his teacher”, or to “control” his teacher. Through an attachment/trauma lens, what Johnny may be doing is attempting to self sooth and regulate his feelings of anxiety in response to being in the classroom and/or coping with transitions. For a traumatized child, these experiences can create feelings of helplessness. Equally confusing, is that Johnny may bring items home and make no attempt to hide them from his parents. Johnny is not necessarily stealing to “see what he can get away with”, but rather is using a strategy to help him cope with overwhelming feelings. This could occur at school, at home or in the community. The child already may be aware cognitively that the action of stealing is wrong. What they lack is the ability to regulate their feelings without your help. You truly are the key to success in helping these children manoeuvre through a soup of complex emotions. Focus on the Child’s Emotions – What could they be feeling? • • • • •

Stress Fear Guilt Shame Uncomfortable

• • • •

Sad Anxious Jealous Overwhelmed

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Be Non-judgemental, Supportive, Structured. When your child has stolen please recognize that they need you to… • • • • • • • • • • • • •

• •

Take charge in a kind and nurturing way. Try not to take the behaviour personally! Stay emotionally and physically close to your child in an environment that evokes stress. Limit their space and create containment/structure for them. Explain to your child that you are not blaming them, but that you are helping them to understand social boundaries. Stay with them through the feelings of anxiousness and fear and together work out a plan of what to do when entering the environments that create this kind of a response. Work out a safety plan of who they feel safe accessing when they feel the need to steal. Practice communicating their feelings using visuals or role playing situations that bring on feelings of stealing. Encourage/help your child to put things “back where they belong”. Help them restore social relationships if possible by apologizing. Modeling honesty in all contexts is essential in the growth and development of your child/youth. For some children having a “no lending, trading, or borrowing house rule” Have a concrete routine at home or in school where the child/youth’s back pack and belongings are checked every day as soon as they get home or to school. (For this to feel ok for your child/youth all children in the home should be included.) Higher level of supervision will be required initially which can later be reduced. Ensure that you are keeping your personal belongings in an area that is secure. This will assist in reducing the temptation.

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Caregiver Response Strategies Behaviour: Lying Children with attachment difficulties may exhibit lying behaviours. Not only do they display chronic lying, but they also lie about the most absurd things. What even makes it even more frustrating for adult caregivers is the fact that even when caught in a lie the child will do anything in their power to “get out of it” which often leads to another lie. Please remember that children who present with a history of trauma, lying can be rooted in intense feelings of “FEAR”. These children live in a world where their survival skills (i.e. fight, flight, and/or freeze) are on high alert throughout the day. Because they are over aware (i.e. hyper vigilant) their perceptions of situations become distorted. ”Lies” therefore come from a place of avoiding shame at all costs. They persist with a lie in order to survive. (Survival strategy) Simple life events can cause immediate “fear reactions” in these children. An example is a child picking money up off the floor knowing it belongs to someone else then lying about it. Not only does the act of lying come from a “fear” within the child, but it also evokes a “fear” response from parents. i.e. what’s the matter with you, how could you do such a thing? It’s helpful for parents and caregivers to understand that punitive consequences will likely be ineffective, and may serve to increase the child’s feelings of fear and intense shame. On the following page is a list of strategies that could be implemented to assist the child and caregivers. Focus on the Child’s Emotions – What could they be feeling? • • • • •

Fear Shame Guilt Embarrassment Lonely

• • • •

Sad/Jealous Isolated Desperate Stress

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Be Non-judgemental, Supportive, Structured. When your child has lied please recognize that they need you to understand and follow through with… • • • • • • • • • • • • •

Lying comes from a state of stress and survival Lying can stem from a fear of abandonment. “if I am not perfect then this family won’t keep me” The behaviour may feel like it’s directed at YOU! It likely is not. Responding to the behaviour only will likely increase a power struggle and not address the underlying need. (feeling) You cannot tech the child/youth the moral lessons of lying when they are distressed. (Focus on the feeling attached to the lie) Support the child/youth through the feeling. Later when everyone’s calm address the situation by exploring the feeling and behaviour together.” As an adult you need to model what you want to see in your child/youth. Explore situations that could promote lying behaviour using puppets with younger children and role playing with older youth. Have consistent family rules and consequences that apply equally to everyone in the home Prepare children/youth for the negative consequences at home, school, and the community by supporting their emotional needs ahead of time. Telling the truth needs to be positively attended to consistently by the caregivers. (this could mean natural or tangible responses depending on child and family) If you know that your child is going to lie before asking them, don’t waste your time with questions, just address the lie and move on!

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Caregiver Response Strategies Behaviour: Hoarding/Overeating Children/youth with attachment disturbances can demonstrate this behavior after having been deprived of food or other basic necessities of life. Children who are welcomed into an environment that is inconsistent with this reality (e.g. where food is plentiful and healthy) remained primed to hoard and/or gorge food, especially when they are feeling emotionally vulnerable/unsafe. Parents understandably often feel perplexed by this behaviour, especially when it’s clear that they work diligently to provide for the child’s every need. When exposed to unstructured, chaotic family conditions, children’s normal eat/sleep cycles are disrupted. This also can result in hording/overeating. An exaggerated need for “comfort food” may also occur as a form of self-soothing. Focus on the Child’s Emotions – What could they be feeling? • • • • •

Fear Shame Guilt Unsafe Lonely

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Sad Isolated Desperate Overwhelmed

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Be Non-judgemental, Supportive, Structured. When your child is hoarding please recognize that they need you to understand and follow through with… • • • • • • • • • • •



Viewing the behaviour as a response to stress Try not to personalize the behaviour, rather support the feeling Supporting and organizing the feelings that trigger the behaviour Continue to provide healthy and consistent meal and snack time routines Working together to provide the child/youth with a designated healthy snack container which is easily accessible and visible Work with your child on developing a way of signalling that they are in need of comfort, support, and safety Look for clues that your child is feeling overwhelmed and stressed, even when they state otherwise (i.e. body language, tone of voice, facial expression) As a preventative measure ensure that unhealthy snacks are secured and inaccessible to your child without proper supervision Punitive consequences/approaches such as revisiting the issue, making the issue public, and removing all snacks and treats may increase the level of distress Model healthy food choices and amounts Continue to work with the child/youth on ways to obtain comfort through alternative activities (i.e. music, art, soft blankets, squeeze toys). If experienced by the child as comforting, always make hugs available from Mom or Dad! Schedule meal times together as a family and focus on POSITIVE conversations. (NO electronic devices including cell phones and TV) Daily room checks for ALL family members could be implemented if the issue is creating health concerns in the home.

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Caregiver Response Strategies Behaviour: Aggression/Destruction Children and youth with attachment disturbances may lash out, create chaos, and push loved ones away when they feel threatened. These behaviours occur as a result of the “FIGHT” response, triggered by the child/youth feeling TOTALLY overwhelmed, unheard, and scared. It is important to recognize that, because these children carry with them overwhelming feelings of fear, their tolerance of others, or situations may be compromised. This may result in the child reacting quicker with accompanying escalation of behaviour. Caregivers from the past may have been frightened themselves, and/or frightening to the child thus impacting the child’s ability to feel safe with their attachment figures These troubled relational patterns may be repeated by the child/youth in their current families, in spite of the heroic efforts by their current loving and committed parents. Remember, some of these children have had multiple caregivers come in and out of their lives, and may be in a constant state of fear of losing another attachment figure.

Focus on the Child’s Emotions – What could they be feeling? • • • • •

Terror Shame Hopeless Unsafe Helpless

• • • •

Sad Misunderstood Desperate Abandoned

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Be Non-judgemental, Supportive, Structured. When your child is acting out please recognize that they need you to understand and follow through with… • •

• • •

• • • • •

The parent is responsible for taking charge in a kind and nurturing way. This includes keeping members of the family (pets included) safe from harm. Parents need to become experts at reading their child/youth’s body language, facial expressions, tone of voice etc. These are early indicators that the child is becoming overwhelmed with their feelings. If the child is physically safe the parent may need to recognize the intensity of their own feelings and take a break to recharge. Parents need to defuse the feeling behind the behaviour, making kind inferences NOT participating in problem solving at this time. For some children physically comforting them can have an immediate impact. For others waiting out, verbally offering a hug, and even being a sounding board could help. The goal is to bring down the level of stress of the child! If you need to separate the child from others in the home you may do so for safety but try to maintain a visual and physical presence to reassure the child that they are not alone! Restitution of the environment i.e. fixing damaged property can be an option provided to the child. However, it must be done together without further discussion of the issue. Apologies are also options that can be explored with the child IF it helps regulate their feelings and relationship concerns. Problem solving can be completed only when the emotion of the situation is fully cleared. Society’s rules and boundaries need to be explored so that the child can be educated to understand potential implications of their actions. (relationships, the law)

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Caregiver Response Strategies Behaviour: Non-Compliance/Defiance Defiance like aggression can occur when a child/youth feels like they are backed into a corner. The child/youth experiences feelings of being alone on an island and unheard. Therefore they are forced into a “fight” response and will push away using hurtful language and refuse to co-operate with any request from their caregivers. This “old pattern” of behaviour is the result of their “old dance” which may have included power struggles and violence with their previous caregivers. As well as experiencing power struggles the child/youth may feel unsure/unsafe when current caregivers do not react in the same manner as their previous caregivers. These children require TIME and PRACTICE to “feel” that the new adults are going to take charge in a calm, caring, encouraging, manner. This in turn will allow the child/youth to feel like they are being heard, understood and supported through these overwhelming feelings. Through this new support system the child will eventually be able to “trust” that their new caregivers responses will allow them to feel secure, safe, and valued regardless of their behaviours. Children with attachment disturbances often have difficulty being measured and judged and compared to other children, competition is emotionally hard. Therefore the child/youth may refuse to co-operate to protect themselves from these uncomfortable feelings. Recognition of the child/youth’s feelings is essential when placing a request. If this step is missed the child/youth will more than likely not be able to complete the task to the satisfaction of the adult making it. A child’s cognition decreases when stress increases. Child’s Emotions – What could they be feeling? • • • •

Judged Shame Compared Unsafe

• • • •

Helpless Misunderstood Unheard Abandoned

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Be Non-judgemental, Supportive, Structured. • • • • • • • • • • • • • • • • •

Parent MUST be able to take charge in a kind, nurturing way. Parent MUST NOT personalize the behaviour. Acknowledge the feeling before the behaviour. Children/youth will respond to the request with an immediate “NO” ignore the comment and support the feeling. Always take into account the learning styles and medical needs of the child before placing an expectation. Timing is EVERYTHING. Setup for success by placing expectations or requests when the child is not engaged in a preferred activity. Breaking down the task into easy steps will support the child’s success. Parents need to assume and “scaffold” co-operation not predict a negative response. Use humour appropriately based on the child/youth’s response. (sarcasm and teasing will be interpreted as bullying) Parents should offer to complete the task with the child/youth, make it fun!, it is a great opportunity to connect with your child/youth. Providing the child/youth with occasions to be a “helper” can increase their co-operation, build new skills and self-esteem. Do NOT encourage the child/youth to be a junior parent for other children. Keep routines/chores consistent. There is safety in predictability the child/youth will feel more confident in being able to follow through with the expectations. Do not provide an anxious child with too many choices. This will increase the likely hood of non-compliance. It is the parents RESPONSIBILITY/JOB to ensure safety, health, and organize a predictable environment in the home. Provide positive feedback and praise when the child/youth accomplishes a task. Support the child/youth to take new risks towards in independence. It is the parents RESPONSIBILITY/JOB to help children learn and grow by attending school, participating in community activities and most of all having FUN!!

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