Attachment-based practice with adults : understanding strategies and promoting positive change : a new practice model and interactive resource for assessment, intervention and supervision

338 Pages·2011·103.33 MB·English

by  Baim, Clark, Hathaway, Jo, Morrison, Tony

Clark Baim and Tony Morrison
‘But what should I do?!!’ This is what clinicians ask me after
every talk I give. Baim and Morrison have filled a crucial need
in Dynamic-Maturational attachment theory: the translation of
theory into practice. After two decades of theory development,
accomplishing this is my personal goal for the next decade. This
book marks a strong beginning – and it is aimed exactly where
it is needed most: toward ‘feet on the street’ professionals who
must resolve the problems of troubled families every day. The
ideas are fresh and integrative; the language is clear. Bravo!
Patricia M. Crittenden, PhD, Developmental
Psychopathologist and Founding President of IASA
(The International Association for the Study of Attachment)
This interactive practice guide offers a new approach to attachment-based practice with adults. By integrating
audio, visual and written information around five characters and their stories, the guide brings attachment theory
to life in a conceptually clear but dynamic, engaging and hands-on way.
This guide offers:
„ an introduction to contemporary attachment theory and its links with neuro-biology
„ a practical, user-friendly interactive workbook for frontline practitioners to help them understand adult
attachment theory and its relevance to their work
„ a specific but flexible interviewing strategy (the LEARN Model), which helps practitioners to work with for aA ne
confidence in an attachment-informed way ssew p
„ frameworks, tools and other resources to assist practitioners who want to use a relationship-based, ssmrac
attachment-informed approach entice
„ a work-based resource that can be used by individuals, teams, co-workers, supervisors or teachers/trainers t, inte mod
to reflect on and improve the preparation, use and support of attachment thinking in practice rveel a
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„ an approach that speaks to diverse professions and modalities, and that can be used in a tiond in
multidisciplinary environment by both adult and children’s services practitioners andtera
„ ways to increase the confidence of practitioners to act as change agents with their clients supctive
with five detailed case studies and attachment-based interviews (in written and audio format), step-by-step ervisio resou
commentary, illustrations and practical exercises to apply the learning throughout. nrc
e

Who is this book for? This book is aimed primarily at frontline practitioners and teams within the social care,
mental health, criminal justice and education professions. People in professions such as social work, nursing,
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psychology, psychotherapy, counselling, family therapy, psycho-sexual counselling, education, probation, ndla
forensic mental health, adoption and fostering, residential care, leaving care services and related professions will Tork B
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find the book helpful, as will students, teachers and trainers in any of these fields. y Maim
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Pavilion Publishing and Media Ltd Telephone: [phone] o
n
Rayford House Facsimile: 01273 227308
School Road Email: [email protected]
Hove BN3 5HX Web: www.pavpub.com
UK
Clark Baim and Tony Morrison
ISBN: 978-1-908066-17-6
E-245-3-11

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Attachment-based Practice with Adults:
Understanding strategies and promoting
positive change
A new practice model and interactive resource for assessment,
intervention and supervision
© Clark Baim and Tony Morrison 2011
Published by:
Pavilion Publishing and Media Ltd
Rayford House
School Road
Hove BN3 5HX
UK
Tel: [phone]
Fax: [phone]
Email: [email protected]
Web: www.pavpub.com
First published 2011. Reprinted 2012, 2013.
The authors have asserted their rights in accordance with the Copyright, Designs
and Patents Act 1988, to be identified as the authors of this work. All rights reserved.
With the exception of the permission given below, no part of this publication may be
reproduced, stored in a retrieval system, or transmitted in any form or by any means,
electronic, mechanical, photocopying, recording or otherwise, without the prior
permission in writing of the publisher and the copyright owners.
Photocopying/printing permission
The discourse marking sheets in Chapter 2 on pages 76-87, the Interviewing Guide on
pages 89-132 and the client-related pages in Chapter 9 (pages 264, 283) in this guide
may be printed or copied without fee or prior permission by the purchaser subject to
both of the following conditions: that the item is reproduced in its entirety, including
the copyright acknowledgement; that the copies are used solely by the person or
organisation who purchased the original publication.
A catalogue record for this book is available from the British Library.
IISSBBNN:: 997788--11--990098801606--8137--96
Pavilion is the leading publisher and provider of professional development products
and services for workers in the health, social care, education and community safety
sectors. We believe that everyone has the right to fulfil their potential and we strive
to supply products and services that help raise standards, promote best practices and
support continuing professional development.
Editor: Jo Hathaway
Illustrations by Jo Hathaway
Cover design and page layout: Emma Garbutt, Pavilion
Layout design: Tony Pitt
Printed by: CMP Digital Print Solutions
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Contents
About the Authors ..........................................................................................................v
Acknowledgements ......................................................................................................vii
Foreword by David Howe ..............................................................................................ix
Introduction and How to Use this Guide ......................................................................1
Welcome to this interactive practice guide ........................................................................1
Origins of this practice guide .............................................................................................2
Who is this guide for? .........................................................................................................3
What are the aims of this guide? ........................................................................................3
What this guide cannot provide .........................................................................................4
Guiding beliefs ....................................................................................................................5
How to use this guide: a roadmap .....................................................................................7
Tips for different readers ....................................................................................................9
Now you are ready to start ...............................................................................................12
PART ONE
Attachment Theory, Memory Systems, Discourse and the LEARN Model ..............13
Chapter 1: Introducing Attachment Theory .......................................................13
The origins and importance of attachment theory: who will survive? ...................13
Attachment and how we learn to self-regulate .....................................................15
The identification of attachment patterns .............................................................15
Interpersonal neurobiology and mentalisation – the basis for emotional
and social intelligence ...........................................................................................16
Key benefits of attachment theory ........................................................................17
The ecological-transactional model of development: our lives in context ...........19
How information processing underlies attachment strategies ..............................20
The A, B and C patterns ........................................................................................22
The balanced attachment strategy (‘B’) and the goal-directed partnership .........24
The distancing (‘A’) attachment strategy ...............................................................28
The preoccupied (‘C’) attachment strategy ...........................................................34
Summary and comparison of the three strategies ................................................39
The dynamic-maturational model ..........................................................................40
Disorganisation ......................................................................................................43
Conclusion .............................................................................................................45
Chapter 2: Memory Systems, Integration and Discourse .................................47
Introduction ...........................................................................................................47
How the brain, the mind and relationships interact to shape who we are ...........48
A brief tour of the brain .........................................................................................51
The impact of unresolved trauma on memory and coherence .............................57
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Contents
Development and function of different memory systems .....................................59
Implicit memory .....................................................................................................61
Explicit memory .....................................................................................................63
Integration .............................................................................................................68
Discourse and discourse markers ..........................................................................72
The discourse marking sheets ...............................................................................76
The Interviewing Guide .........................................................................................89
Chapter 3: The LEARN Model for Promoting Narrative Integration .............133
Introduction .........................................................................................................133
The importance of our personal stories ..............................................................135
How the Model works ..........................................................................................136
Safety first: the foundation stage ........................................................................138
The five steps of the LEARN Model explained ...................................................139
Consolidating your learning about the Model ....................................................150
PART TWO
Putting Attachment Theory to Work: Five case studies, with guided
practice exercises
Introduction ........................................................................................................151
Background information about the five characters .........................................152
Chapter 4: Beth and the Reorganising ‘B’ Strategy ........................................153
Chapter 5: Anne and the Concerning ‘A’ Strategy .........................................171
Chapter 6: Adam and the Endangering ‘A’ Strategy ......................................191
Chapter 7: Calum and the Concerning ‘C’ Strategy .......................................209
Chapter 8: Christy and the Endangering ‘C’ Strategy ....................................233
PART THREE
Integrating Attachment-informed Practice
Introduction ........................................................................................................249
Chapter 9: Tools and Exercises for Practice ....................................................251
Introduction .........................................................................................................251
Essential preparation, context and considerations ..............................................251
Common aims and considerations of all psychological treatment .....................254
Being responsive to each client or service user: finding the ‘shoe that fits’ .......256
Purposeful adaptation for clients with ‘A’ and ‘C’ strategies ..............................258
Exercises: ............................................................................................................262
Exercise 1: My strengths .............................................................................263
Exercise 2: My family tree and its hidden legacies .....................................266
Exercise 3: Timeline of my life ....................................................................271
Exercise 4: ‘My world’ diagram ...................................................................276
Exercise 5: Recognising, expressing and talking about feelings ................279
Exercise 6: Ten conversations about unfinished business ..........................286
Exercise 7: My attachment relationships, then and now ............................295
Exercise 8: My mind, brain and relationships – bringing them
all together ................................................................................299
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Contents
Exercise 9: Conducting my internal orchestra ............................................307
Exercise 10: S TOP-MAP – an attachment-based approach
to problem-solving .....................................................................309
Chapter 10: Supporting, Supervising and Sustaining Practitioners
(written with Bridget Rothwell) .........................................................................313
Introduction .........................................................................................................313
The importance of good supervision ..................................................................314
What do we mean by supervision?......................................................................314
What is attachment-informed supervision? .........................................................315
Supervision in action, part one: Christy’s social worker in supervision ...............319
Workers who get hooked into using an ‘A’ or ‘C’ strategy with their clients......327
Supervision in action, part two: Adam’s interviewer – issues for supervision .....327
Supervision in action, part three: Christy’s interviewer – issues for supervision .331
Applying attachment-informed supervision in your own practice: applying
the LEARN Model to supervision ........................................................................335
Key messages for supervisors ..............................................................................336
Questions to consider ..........................................................................................336
References ...................................................................................................................338
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About the authors
Clark Baim, M.Ed., Dip. Psych., is a Psychodrama Psychotherapist (UK Council
for Psychotherapy) and a registered senior trainer with the British Psychodrama
Association. He is the Co-Director of the Birmingham Institute for Psychodrama, a
psychotherapy training organisation, and Change Point Ltd., a training provider in
criminal justice, mental health and social care settings (www.changepointlearning.
com). Clark has 20 years of experience as a group facilitator and trainer in the UK,
Ireland, Greece, South Africa, Latvia, Sweden, Australia and the USA. A native of
Chicago and graduate of Williams College, Massachusetts, he moved to the UK in
1987 to establish and serve as the first Director of Geese Theatre UK, a company
using applied drama in prisons and probation.
In the late 1990s, Clark worked as a group psychotherapist for five years at HM Prison
Grendon, near Aylesbury, Bucks. Since 1999, he has been contracted as co-lead
national trainer for the Probation Service’s groupwork programmes for men who have
committed sexual offences, and in this role he has trained several thousand criminal
justice practitioners in group treatment methods. He has also co-trained more than
100 criminal justice trainers and delivered training in residential children’s homes, to
child and adolescent mental health service practitioners, to social work managers and
to frontline social workers.
In recent years, Clark has focused on the study of attachment theory and its links with
trauma, loss, maltreatment and the development of offending behaviour. Clark is the
co-editor of several books and author of numerous chapters and articles on various
aspects of psychotherapy, offender treatment, supervision and groupwork methods.
In 2008, he was presented with the Scholar’s Award by the American Society for
Group Psychotherapy and Psychodrama. He is a founding member of the International
Association for the Study of Attachment.
Tony Morrison was a leading figure in the field of social care, particularly respected
for his work on supervision, staff development and promoting interdisciplinary
collaboration. After completing his training in 1977, he worked as a probation officer
with Greater Manchester Probation Service before joining the NSPCC Special Unit
in Rochdale, Lancashire, where he and colleagues were instrumental in developing
an assessment framework used in child protection. He became an independent
trainer and consultant in 1989. At a time when treatment for sexual offenders was
only just developing in the UK, he was the co-founder and first chair of the National
Organisation for the Treatment of Abusers. He was made an MBE in 1998 in
recognition of his efforts in creating a network to support and develop professionals
undertaking this challenging work.
Tony was perhaps best known for his work on improving the quality of supervision. His
book Staff Supervision in Social Care (1993/2005) – also published by Pavilion – has
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About the authors
become the standard text on the subject and is now in its third revised edition. He
wrote and co-authored many other chapters, manuals, articles and books on social
care practice. In 2009, he developed a national training programme for the Children’s
Workforce Development Council for England, aimed at improving the quality of
supervision received by newly qualified social workers.
Tony was awarded an MA in management, learning and leadership from Lancaster
University in 2007 and, shortly before his death, had been awarded a PhD from
Huddersfield University. He died suddenly in 2010, when this book was at an
advanced stage of preparation.
Bridget Rothwell, who is the co-author of Chapter 10 of this guide, is an independent
social care trainer based in Scotland. Bridget’s roots are in childrens’ and families’
social work as both practitioner and manager. As a consultant and trainer, she is a
passionate advocate of emotionally intelligent and relationship-focused management
in general, and supervision in particular. She has a strong belief in the tasks of social
work and seeks in her work to honour and support the commitment and resilience
of the workforce. Bridget worked with Tony Morrison on a number of projects and
collaborated with him in the development of training for social work supervisors.
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Acknowledgments
Many readers of this book, particularly those who have followed the writings and
training offered by Tony Morrison over the past 20 years, will be aware of Tony’s
tragic and untimely death in an accident in early 2010. Thousands of people who knew
Tony, who had been trained by him, and whose lives he had touched and inspired,
were shocked and saddened by this terrible loss. He was a man of unique gifts and
enormous energy, drive and zest for life, combined with a penetrating intellect that
brought together many domains of knowledge. He was also a very dear friend.
This book was at an advanced stage of writing when Tony died, and after 12 months
of pausing to reflect, and much encouragement from colleagues, course participants,
friends and loved ones, I have ‘seen it through’ to its conclusion. This project is the
result of 10 years of collaboration, development, testing and refinement with Tony,
and it is entirely fitting that the book resulting from our close work together should
have both our names on it; his ideas, his words and his inspirational approach are
interwoven in every paragraph. It has been my pleasure and honour to complete the
work, and I know that Tony would have been so pleased to see this important way of
working continue to develop.
Many people have helped us to develop the course and to write this book. First
and foremost, thanks are due to Bridget Rothwell, who co-wrote Chapter 10 (on
supervision) and whose steady hand of encouragement helped to keep the ship
steering in the right direction. Bridget is an independent social care trainer and
long-time colleague of Tony’s, and it was a privilege to collaborate with her on that
chapter. Thanks also to the many people on three continents who played a key role
in the development of the course and who also provided vital feedback during the
writing process. This includes Cathy Appleby, Eden Baim, Julie Bolger and the staff at
Braymoor Road Children’s Home, Ann Marie Bradley, Kathryn Bundesen, Ann Butler,
Julet Butler, Jo Butterworth, Geraldine Campbell, Morag Campbell, Joan Cherry
and colleagues, Alyson Coupe, Sandra Cummings, the staff of Dalton-Ellis college in
Manchester, Marcus Erooga, Ane Freed-Kernis, Geese Theatre UK, Jeremy Gunson,
Clare Harrington, Marie Hatton, Jan Hext, Jan Horwath, David Howe, Valerie Hyde,
Annette Jackson and the Take Two Team at Berry Street, Eve Jones, Rosemary Kelly,
Roger Kennington, Becky Kidman, Karen Lerpiniere, Clive Leyland, Mary Leyland,
Clare Lowe, Ezra Loh, Olivia Lynch, Anna Mason, Helen Masson, Judith McBrien, Pat
Mckeever, Pam Miranda and colleagues at Berry Street; Patricia Mosher, Siobhan
O’Brien, Fran O’Grady and colleagues, Amanda O’Shea, Ian Pringle, Damian Price,
Catherine Quigley, Val Ready, Lynda Regan, Catriona Rioch, Jill Sheehan, Valerie
Sheehan, Heidi Southall, Joe Sullivan, Richard Swann, Tess Tackett, Julie Wachowski,
Sally Wassell, Jon Watson, Janet Westhorpe, Maureen Whittle, Amelia Wilson, and
Jane Wonnacott at In-Trac. We are also deeply grateful to many service users, course
participants, practitioners, supervisors and managers who have contributed ideas that
have influenced this book.
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