Attachment and the Stages of a Placement

Children come to RCC with life experiences that are beyond those of most of the people caring for them.

They arrive considerably unsettled, often with challenges to regulate their thoughts or emotions and requiring close care from informed people who can provide boundaries and thinking when they are overwhelmed by their past, which might be often.

An environment of care is established that, if it meets the needs of the child, allows them to feel contained then begin to be able to accept being cared for, not a small thing when for so long you have had to be self-reliant in environments that were actively destabilising you.

There are developmental stages to a placement. After bewilderment, often described as a honeymoon period and which sometimes social workers describe as stabilisation, comes a degree of settling. It isn’t.

Commonly based on this misunderstanding comes a mistaken call to arrange a change of placement because the child has stabilised, a ‘step down’ to a foster placement. When there is a move at this stage the child loses the ground that they have gained and is again in emotional turmoil which is frequently manifested through their behaviour, going missing or being what is described as ‘uncooperative’ or ‘challenging.’

If the placement continues, as it should, comes a stage of ‘testing out’ boundaries and relationships. This is ‘normal’ and to be expected. It is a sign of hope, this spark is a sign the child is trying to return to the moments where all was going well and to  continue their development. There can be no telling when this stage will come, all children have had a unique set of experiences before coming into care and before we have known them. This communication through behaviour has meaning and needs to be understood. What is important is that the staff are ready for it whenever it comes. There will be no surprise, there will be calm, supportive care and regard. There are any number of internal scenarios that might be in the forefront of the child’s mind.

This followed by fleeting glimpses of reciprocity in relationships.

The key is for there to be a primary care relationship with one grown up. The ‘keyworker’ is given. Previous events and experiences are played out and these require understanding and exploring. To be successful both the child and keyworker need to be ‘held in mind’ by the person managing the care. They do so by reflecting on what is going on for the care to be given and received as well as can be. Sometimes children will choose another particular grown up. This too has to be understood as a memory from previous relationships. It is important to recognise if this is a positive memory and a helpful recreation, or one that is a reminder of a person who, through no fault of the child, failed him or her. It is a question worth thinking through whether parents are given or chosen.

The test comes when the primary care giver is not around and the effect on the child when they come back.

As this relationship grows and strengthens so does self-regulation and the transferability of that primary relationship to others.

There is a diamond shape to this exploration of the lifeworld. It grows then tapers as the primary carer is less present. This is still a fragile achievement, perhaps diamond shaped but with the vulnerability of a fine crystal.

Once again at this stage sometimes there a move to make a move, to step down now they have ‘really’ stabilised, for them to be cared for by a family.’ When there is a move at this stage the child loses whatever they have gained and communicates this through their behaviour, going missing or being what is described as ‘uncooperative’ or ‘challenging.’ Often the placement will be said to be a ‘failure.’ In reality the responsibility rests with the external decision makers. Reasoning by the care givers might be seen as ‘wanting to hang on to the child.’ This would be true, for the good reason the necessary experiences are only halfway through, they have not been internalised. They have formed a relationship the child is beginning to be loved and to love in return. The crystal is shattered.

Assuming that the interests of the child are followed, and the placement is allowed to continue, there is then the need for a second diamond with the primary carer in support. Lessons are learned from a different perspective by all.

This is the moment for transition.

It needs to be understood that the child is still in recovery, as they have been throughout the previous stages. Getting ‘better’ is something that takes time. It is the reason the concepts of Continuing Care and Through Care are considered relevant where Leaving Care is not. Terminology matters as it determines practice. The idea of ‘leaving care’ needs interrogation. For example, what is support if it does not have care? Few people ‘leave care’ in their life. Care changes, but continues, the need for it does not diminish.

If the active stages of containment and nurture are complex and frequently misunderstood so the recovery continuing is now a forgotten aspect of care. There is a rush to normalisation of children whose previous life has not been normal. There are still many gaps and spaces to be filled in positively in a manner that removes them as risks for the child to fall into. There are islands of functioning and for as long a time as the child, or young person needs assistance in recognising that they are getting close to the edge then trusted adults with whom they have chosen to form relationships need to be there to guide them gently back explaining what was happening and why and how to avoid in the future

Other references

Howe, D (2005) Child Abuse and Neglect, Attachment, Development and Intervention.

Bowlby, J (1988) A Secure Base

Pearce, C (2009) A Short Introduction to Attachment and attachment Disorder

http://www.uea.ac.uk/providingasecurebase

Schofield, G. & Beek, M. (2011) Attachment Handbook for Foster Care and Adoption

Sunderland, M.  (2006) What Every Parent Needs to Know: The incredible effects of love, nurture and play on your child’s development.

Gerdhart, S.  Why Love Matters: How Affection Shapes a Baby’s Brain

Golding, K. & Hughes, D. Creating Loving Attachments: Parenting with PACE to Nurture Confidence and Security in the Troubled Child

Cairns, K. Attachment, Trauma and Resilience: Therapeutic Caring for Children