Triple-A Model of Therapeutic Care ( Colby Pearce 2015)

Transcription

1 A back-to-basics, step-by-step model of care promoting children s recovery from abuse and neglect through the promotion of therapeutic care environments Colby Pearce 2015

2 Key Features: 1.Back-to-basics: 2.Step-by-step: 3.Theory-driven: 4.Evidence Informed: 5.Evaluation Component: Addresses core experiences of caregiving necessary for children to thrive As with a child s development, practical steps that build on existing parenting competencies Translates complex theory into accessible, practical information and guidance Drawn from evidence-based theories of child development, learning and neuroscience Facilitates realistic appraisal and reflection on progress Facilitates research and publication in scientific periodicals

3 Key Concepts: 1. Understanding: Children do not act for no reason; responding with understanding is the basis for growth 2. Consistency: Children thrive on consistency, so there is a focus on caregiving behaviours that can be maintained over time 3. Strengths: Carers are more likely to maintain caregiving behaviours that are part of their existing skill set, so there is a focus on existing skills 4. Capacity Build: Agency staff capacity to effectively support carers Carer capacity to effectively support children Prepares staff, carers and children for more specialised/targeted interventions 5. Accountability: Agency accountability to staff, carers and children Staff accountability to agency, carer and children Carer accountability to child and agency 6. Cost-Effectiveness: Strengthens care placements to reduce the incidence of placement breakdowns

4 What is Triple-A? A tripartite model that addresses the impact of abuse and neglect on three key areas of the child s psychological functioning*: Attachment Arousal Accessibility to needs provision *Pearce, C.M. (2010). An Integration of Theory, Science and Reflective Clinical Practice in the Care and Management of Attachment-Disordered Children A Triple A Approach. Educational and Child Psychology (Special Issue on Attachment), 27 (3): 73-86

5 Attachment: Children who experienced abuse and neglect do not do not think the same way as children who were raised in stable and loving homes do. Attachment-Disordered Insecure/Unsure Secure (Manipulative/Controlling) (Expectant) I am: Bad Unlovable Impotent Others (are): Unreliable Unresponsive Uncaring The world is: Unsafe Disordered Attachment Representations I am: Good Deserving Capable Others are: Understandi ng Responsive Accessible The world is: Safe Secure Attachment Representations Attachment security and representations regarding self, other and world (Adapted from Pearce, C (2009), A Short Introduction to Attachment and Attachment Disorder. London: Jessica Kingsley Publishers)

6 Attachment: A Secure attachment develops when the primary attachment figure is experienced by the infant as consistently accessible, understanding and emotionally-connected. An Insecure attachment develops when the primary attachment figure is experienced by the infant as inconsistently accessible, understanding and emotionally-connected Avoidant the primary attachment figure is often unavailable and/or disinterested Ambivalent - the primary attachment figure is often distressed, thereby heightening the infant s own distress A Disorganised attachment develops when the primary attachment figure is experienced by the infant as inconsistently accessible, understanding and emotionally-connected and is a source of fear and distress. The infant appears confused and disorganised when expressing their dependency needs as the person they depend on is also the person who hurts them. Children who experienced abuse and neglect most commonly develop insecure or disorganised attachments. Triple-A targets the promotion of caregiving that supports the development of secure attachments.

7 Arousal: Children who experienced abuse and neglect are hyper-aroused, making them less tolerant to stress and more prone to behaviours associated with the fight-flight-freeze response. (Adapted from Pearce, C (2009), A Short Introduction to Attachment and Attachment Disorder. London: Jessica Kingsley Publishers)

8 Arousal: Refers to level of activation of the child s nervous system High arousal is equated with danger, triggering instinctive, survival responses associated with the Fight-Flight- Freeze Response Corresponding behaviours in children: Controlling, aggressive, destructive (fight) Running, hiding, hyperactivity (flight) Reduced responsiveness to environment, numbing (freeze) Children who experienced abuse and neglect appear to be chronically over-aroused, making them exceptionally prone to behaviours associated with the fight-flight-freeze response. Triple-A offers interventions and caregiving strategies that lower arousal, thereby enhancing adjustment and opportunities for new learning.

9 Accessibility: What they learn is problematic.

10 Accessibility to needs provision: What the child has learnt about the reliability and predictability with which their core human needs are satisfied When a child has experienced complex developmental trauma, core human needs have been met inconsistently or not at all. As a result the traumatised child will: Be preoccupied with accessing needs provision Exhibit behaviour to achieve satisfaction of their needs with high rate & great persistence (a.k.a. demanding & deceitful behaviour) Unlike other Models of Care, Triple-A utilises conventional caregiving practices to facilitate the child s new learning that their needs will be met through reliable and predictable care.

11 The Triple-A Model of Therapeutic Care promotes: Secure attachment for improved relationships Optimal arousal for improved adjustment and learning Acceptance of conventional care for the satisfaction of needs What the programme provides: 1. A comprehensive handbook suitable for carers and professionals who support them 2. Training and ongoing support for carers and professionals from expert trainers/consultants 3. Access to online data recording for individual case review and program evaluation

12 For further information: Visit: securestart.com.au Or contact our consultant in Ireland: John