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  • About CairnsMoir
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for those living or working with the impact of trauma

Book of the Month March 2021 - A Tiny Spark of Hope: Healing Childhood Trauma

29/3/2021

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Tiny Spark of Hope: Healing Childhood Trauma in Adulthood by Kim Golding and Alexia Jones  

This is a very beautiful, vulnerable and brave story of healing.  Kim and Alexia together weave this story and the stories Kim writes through the therapy form the story within the story, bringing the process alive with imagery and narrative.

Alexia brings the ‘spark of hope’ with her as she seeks out Kim, a figure from her childhood who really saw her when others could not.  Kim holds this spark so carefully with her acceptance and her empathy and this part of their journey begins.

Alexia’s courage, openness and determination to do this journey flows through the pages.  She brings to life the ups and downs of the therapy journey and the realisation and eventual acceptance that we will not be ‘fixed’ by this journey.  I am so grateful to you, Alexia, for sharing your path with us and I have no doubt that this book will bring healing and connection for many who also walk a path that is similar to your own.

I recently heard Irving Yalom speak about his career and how important writing has always been to him.  He spoke about it being part of what helped him with his work and his desire to understand.  Kim’s art of narrative and desire to share what she has learnt feels to me that it resonates with my understanding of Yalom’s words about his writing.

Kim openly explores her hesitation with starting individual work with Alexia not having received a formal training in an individual psychotherapeutic approach.  She is encouraged to call on the DDP model to help inform her work, a model she is so very familiar with.  When I started to learn about DDP I was struck by how the work of Carl Rogers seemed to weave through all aspects of the model.  Dr. Dan Hughes had created a way of facilitating an environment where safety could be created between the therapist, the parent and the child.  An environment that could be gradually taken by the parent and the child back onto their own home.   Much like a blanket of empathy, unconditional positive regard and congruence for Carl Rogers or, in the language of DDP, Playfulness, Acceptance, Curiosity and Empathy  (PACE).

Kim allows herself to become the kind person, guided by DDP, to come alongside Alexia to walk with her on her journey.  Kim helps us to see how the dyadic aspect of DDP means that there is a structure within which another very significant other can join the journey Alexia and Kim are on.  It allows the environment in which Alexia’s day to day life continues to be very much a part of the therapy.  This  ability to bring significant others into the work feels so very important for the adult who experienced early neglect and developmental trauma.  I am not aware enough of whether other approaches are able to incorporate the significant others into someones therapy, it was not recommended during my own integrative Counselling Training and for good reason.  But in finishing this book it struck me that Kim used DDP to help guide her into a beautiful piece of interpersonal and integrative therapy and introduces us to how DDP could help guide individual psychotherapists into working with a clients wider network.

This is a gift of a book for me as it brings two of my worlds together, that of DDP Practitioner and Psychotherapeutic Counsellor.  I will be recommending it to the professionals in both sides of my working life as well as some of my clients at the right time.

Thank you.

Anna Binnie-Dawson
Occupational Therapist (RCOT), Psychotherapeutic Counsellor (UKCP) and DDP Practitioner, Consultant and Trainer (DDPi)

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Book of the Month February 2021 - Working with Relational Trauma in Schools: An Educator's Guide to Using Dyadic Developmental Practice

26/2/2021

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Working with Relational Trauma in Schools: An Educator's Guide to Using Dyadic Developmental Practice 
(Guides to Working with Relational Trauma Using DDP) by Louise Michelle Bombèr (Author), Kim Golding (Author), Sian Phillips (Author), Dan Hughes (Foreword)

A collaboration between practitioners of such esteem as Kim Golding, Sian Phillips and Louise Bomber cannot fail to grab the attention of anyone who seeks to learn more about developmental trauma. 



​The first of a planned series examining how DDP (Dyadic Developmental Psychotherapy) principles can be applied in different settings, this book is a welcome addition to the growing literature on how schools and educators address the needs of vulnerable pupils.  The focus on the theory and practices associated with DDP and how these may be applied by school staff is timely and informative. 

The authors very much focus on educators rather than just teachers as they are keen proponents of the team pupil approach, something which is crucial if trauma-informed approaches are to become embedded in whole school practice and ethos.  The premise of the book is that educators are not therapists, nor should they be expected to be, but that using the principles of DDP and accepting them as a ‘way of being’ is essential if we are to address the needs of our vulnerable pupils.  It is enlightening, then, that the educator remains at the heart of the theory explored in the book.

Chapters 1 to 3 introduce some key concepts providing theory in typically easy-to-access manner.  We learn about blocked trust, the reasons behind it but, most importantly here, how it can impact on a daily basis within the classroom.  Intersubjectivity and the powerful, though often overlooked, consequences of shame are discussed in chapter 2 and, again, they are skilfully related to what happens between educator and pupil.  Where the writing is interspersed with specific examples it is most impactful as we find ourselves recognising behaviours we may have encountered in our own experience. Moving on to how we may address these behaviours, chapter 3 looks at building connections encouraging educators to be ‘trust builders’ and ‘emotional detectives’.  The analogy of the river of integration in which we are tasked with remaining open, engaged and flexible is a useful one while the section on mind-mindedness reminds us of the skills we can all develop. 
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Many readers of this book will be familiar with the need for PACE (playfulness, acceptance, curiosity and empathy) in our interactions with young people but chapter 4 goes beyond simple information-giving and prompts us to consider how we demonstrate and live PACE as a philosophy rather than label it as a set of strategies.  Like driving a car, the authors write, each of the skills involved are crucial parts of an even more significant ‘whole’.  Similarly, it is not something that can be learned overnight.  Chapter 5 provides a very useful set of frequently asked questions which heads of service might find helpful for training purposes.  Chapter 6 looks on the surface like a collection of ideas but here we consider, amongst other areas, the use of praise and rewards with vulnerable children.  The language used throughout is about ‘supporting’ behaviour rather than ‘managing’ it and practices are critiqued constructively with very clear and thoughtful advice provided. 

Chapters 7 to 10 offer further practical advice but steer clear of doomed-to-fail ‘tips for teachers’ instead asking us to consider how we may adapt our mindsets and predominant modus operandi in order to build relationships, create safe learning environments and become authoritative educators.   That said, the consistent message remains that this is no easy or simple task and that the challenges faced when trying to do this can be immense.  The authors accept that all of this is often easier said than done and they are clear that educators need time, self-compassion and support from colleagues.  Far from being a supplementary thought, as is often the case, this point is reiterated in particular with chapters 11 and 12 where we are asked to consider our own attachment patterns and how we may look after ourselves.  

It is here where this book excels.  That is, the authors have managed to steer clear of the sometimes idealistic-sounding advice that educators get and produce a work that acknowledges the challenges, places the educator at the centre and offers sensitive, practical and realistic guidance. The interlacing of examples illustrates both how common and understandable it is to ‘get it wrong’ as well as how scenarios may be approached differently.  Ideas are presented concisely and a number of broad strategies, like ‘follow-lead-follow’ and ‘rupture-repair’, are clear and difficult to contest.  Practitioners with some knowledge of DDP and PACE as well as those who are beginning this particular journey will both benefit from this work.  A highly recommended read!

Dr Christine Hadfield
Lecturer in Teacher Education at the University of Glasgow.  

I worked as a secondary school teacher in England for 10 years before becoming an adoptive mum, moving home to Glasgow and educating myself in all things attachment and trauma.  I now work at the School of Education, University of Glasgow where I teach Modern Languages and Health and Wellbeing. 

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Book of the Month October 2020 - The Little Book of Attachment

1/10/2020

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The Little Book of Attachment: 
Theory to Practice in Child Mental Health With Dyadic Developmental Psychotherapy 
​by Daniel Hughes and Ben Gurney-Smith


In ‘The little book of attachment’, Dan Hughes and Ben Gurney-Smith carefully consider the relevance of attachment theory and research for practitioners working in child mental health. 

They notice how understanding attachment theory and the importance of relationships can bring an extra dimension to formulation, diagnosis, and treatment of mental health difficulties within children. They emphasise that this goes beyond recognising children with difficulties of attachment and finding interventions that can reduce these difficulties. It is a recognition that children who do not experience security of attachment can be left with core difficulties in trusting and feeling safe in relationships, regulating emotions and reflecting on experience. These developmental areas, associated with attachment, are critical for emotional well-being and development and therefore can usefully inform how we intervene to help children who present with mental health difficulties. 

Much research, described in this book, has highlighted therapist variables as a more accurate predictor of outcome than mode of intervention. Here Dan and Ben present a powerful discussion of why this might be so. Therapist qualities such as building a therapeutic alliance, empathy, recognising and repairing ruptures, affirmation and holding clients with positive regard are the very same relational qualities that parents bring to parenting a child with a secure attachment. Dan and Ben propose that ‘if we utilize the qualities of human relationships, found in secure attachment, we might begin to enhance the developmental outcomes attachment theory would predict as being important to mental health; named here as the developmental triad of safety and trust, regulation and reflection.’

Dan and Ben are clinicians and they bring all their clinical experience into helping us to translate these ideas into practice. They draw upon Dyadic Developmental Psychotherapy as one example of a therapy that has a relational approach central to the intervention and which actively uses principles derived from Attachment Theory in the therapy. This approach helps families to work towards developing their child’s trust in reciprocal relationships which in turn can help them to develop the emotional and reflective skills needed to both experience attachment security and to move towards improved mental health and emotional well-being. The book is illustrated with many examples of DDP interventions, providing a very practical focus to understanding the ideas being discussed.

This book is called ‘The little book of attachment’. I think it is misnamed. Although the book is little, the ideas within it are huge and have profound implications for the practice of child mental health. All clinicians working with children and families will recognise the importance of understanding the attachment relationship. As one clinician once told me: ‘it always comes down to the attachment stories in the end.’ Our early attachment relationships impact on us in many ways developing both our resilience and our vulnerabilities. By attending to these relational qualities in the therapy room, and within the families, we can only enhance the interventions we use, from whichever model we are comfortable working within. As a DDP practitioner myself, I am persuaded of the benefits of DDP as a relational model of therapy which is helpful for children who have experienced developmental trauma in their lives. Within this book we are invited to broaden our thinking to consider how this, or similar approaches to therapy, can enhance our interventions for all children and families who have been touched by poor mental health and reduced emotional well-being. In doing this there is no ‘throwing the baby out with the bath water’, such an approach to intervention can add an extra dimension to the therapies currently on offer.

I recommend this book to all practitioners interested in improving children’s mental health. It will not necessarily change your practice, but it will enhance it. In bringing relationship to the fore, our interventions will be more successful. We are relational beings, living in a relational world. Attending to relationships within our therapy has to make sense.
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As I ‘tweeted’ when I first read this book: ‘Thanks to Dan and Ben for this gem of a ‘little’ book. Like a Tardis it is bigger on the inside!’

Kim Golding, Clinical Psychologist, DDP trainer and author
August 2020

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Book of the Month September 2019 - By Your Side Foster Carer and Adopter Guide

1/9/2019

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​By Your Side Foster Carer and Adopter Guide: support for children moving families
by Vivien Norris (The Family Place 2019),
reviewed by Sheila Lavery

 
Transitions are understandably difficult for care-experienced children, not least because of the huge losses they involve or rekindle. Chief among these are the transitions from birth family to temporary foster care and from foster care to permanency.  

We expect a lot from children when we leave them to manage these moves without respecting their relational history and their ability to make sense of the conflicting and potentially overwhelming feelings such transitions involve.
 
So I was thrilled to read and review By Your Side, by Vivien Norris, Clinical Director of the Family Place. This genuinely trauma-informed guide for supporting both children and adults involved in the move to permanency joins the ranks of Norris’s other publications including Parenting with Theraplay (with Helen Rodwell) and Not Again Little Owl. This review is in respect of the foster carer and adopter guide, which forms part of a wider resource package including a practitioner guide and training programmes.
 
By Your Side acknowledges that starting well is crucial in adoption. It aims to do this by establishing a model of collaboration and containment. It employs DDP and Theraplay to provide consistency, playful connection, a coherent narrative, routines and rituals and a level of caring engagement so a child remains seen, heard and valued at a time when practicalities and planning often take precedence over emotional connection. The book aims to help the adults develop greater insight and empathy when moving a child. That means the adults must cooperate, manage their own feelings and model mind-mindedness and containment for the child.
 
It’s interesting that even though we know how attachments are built through rupture and repair we fail to use the huge rupture of transition as a critical attachment building opportunity and indeed, a key responsibility. Likewise, we may fail to recognise that the liminal space of transition between what was and what is yet to come is not a void but an opportunity for growth. Norris’s guide is hugely valuable in addressing this area.
 
 The manual begins by listing the seven core principles of the approach (see above) and defines the terms attachment and trauma, which helps to clarify the content that follows. The principles give a framework, goals and everyday examples of the By Your Side approach while providing the flexibility needed for every child and family’s unique experience.
 
By Your Side recognizes that the practical tasks of permanent placements and the excitement of a “forever” family means that adults often minimize or ignore the very real feelings of anxiety, grief, frustration, sadness, confusion etc., that a child may struggle to manage. In doing so we begin or continue a culture of, “if we don’t look at the tough stuff, it will go away” or we wait until a child is settled before addressing challenges. Norris addresses the reality of dealing with what comes up, as it comes up, in the here and now because that’s what being present for a child really means. She also asks us to consider our use of language and a child’s understanding of terms like “forever family”. It’s important to be curious about how those words fit with the child’s experience of family and the concept of forever, given the child’s current feeling state and developmental stage. For example, might we not distinguish between “first family”, “helping family” and “keeping family” rather than the usual fostering, adoption and care-order terminology.
 
What I liked most about this guide is that it puts attachment into action in this minute and every minute that we engage with a child, not somewhere down the line. It makes attachment the responsibility of each one of us involved in the child’s journey, not just the job of the “forever family”. Despite the abundance of attachment and trauma language on everyone’s lips, attachment is still not alive in the detail of care planning. There is still an expectation that a child will transfer attachment from one set of parents to another because it’s in their best interests. The system struggles to hold simultaneously the view of what is needed in the here and now with a long view of permanency. In reality minimising the pain of the transition undermines the chances of “permanency” or ‘forever” from the outset. When placements are not managed well subsequent transitions often become problematic and the adolescent transitions can become so difficult as to challenge the stability of everyone’s place in a “forever family”.
 
The sensitivity of the transfer of care from foster carer to permanent parent in the By Your Side approach means the adults can hold the child and the practitioners can hold the adult carers throughout the transitional process. For anyone familiar with DDP and Theraplay the detail of this approach will seem very familiar. I guess what is new is the packaging of those principles into a practical resource with a refreshing view of the space between temporary care and permanency as a bridge rather than a void.
 
As an adopter I questioned how some of the approach would work in practice. I was reassured that the midway review in the process could pick up on the fragility of some situations and the professionals could bolster any support needed for the child. Practitioners using the approach would need to be very skilled, hence the accompanying training, and the support system would need to be very robust. I’m also curious about what other supports might be available to help the adults in this vulnerable period. Still, it’s a great resource. Thinking as I often do these days about adoption disruption, the content of this guide is not only relevant to getting off to a good start in permanent placements, but together with the practitioner guide and training it would be a hugely valuable resource for repairing the hurt in families when the “forever” bubble is fit to burst and it provides a model of collaboration and support that gives adoption placements their best chance of success throughout the lifespan.

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Book of the Month April 2019 - Healing Relational Trauma with Attachment-Focused Interventions. Dyadic Developmental Psychotherapy with Children and Families

2/4/2019

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Healing Relational Trauma with Attachment-Focused Interventions. Dyadic Developmental Psychotherapy with Children and Families
Daniel A. Hughes, Kim S. Golding & Julie Hudson (2019)

I work as a Consultant Clinical Psychologist with fostered and adopted children.  This book landed into my hands as I approached the end of the Practicum to become a Certified Practitioner in Dyadic Developmental Psychotherapy (DDP).  And, wow, what a wonderful resource to have.  Its like having a DDP Consultant on hand!
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This is a ‘must have’ resource for anyone who wants to learn about DDP and develop their practice of it.  It begins logically with chapters that explain the guiding principles, theory and what is known about the neurobiology of attachment and developmental trauma.  It explains PACE (which stands for Playfulness, Acceptance, Curiosity and Empathy) as the attitude which helps to provide children with a foundation for safe and healthy relationships.  The experience of DDP is described.  One chapter addresses the ‘nuts and bolts’ of DDP; wisdom that I wish I’d had when I first began practising with this model.  Basically, you are told everything that you need to know to get started with DDP in a practical way. 

There is a chapter on working with parents therapeutically and helping them to develop parenting that conveys PACE.  The book then explains how Dyadic Developmental Practice can be used to create safe settings.  There is an emphasis on thinking about a child’s wider system and network, such as education, social work teams and mental services.  This chapter shows how DDP is more than a psychotherapy.  DDP is a framework for professional practice.  It is a framework for creating strong unified and connected teams around a child in which a shared understanding of the child can be explored and created.  This networking approach is essential for helping children to feel safe, understood and regulated, and it can provide the foundation for successful psychotherapy.  The book explores DDP in residential care, fostering and adoption, individual therapy.  Specific populations are focused upon such as children with learning disabilities, children who show violence to parents and adolescents.  The combining of Theraplay and DDP is described.  The experience of having supervision for developing one’s own DDP practice is described.  To conclude, the book finishes with a chapter on the evidence base.   

This book packs a lot of information into its 335 pages.  It is aimed at professionals although it has little jargon in it so would be accessible to a wider audience.  It is very easy to read and the inclusion of many powerful case examples bring the concepts and ideas to life. 

As I finished reading this book, I was delighted to successfully complete the DDP Practicum and become a Certified Practitioner.  I’m confident that this book had helped me in those final stages by giving me knowledge, support and motivation.  It’ll certainly be a book that I keep accessible, especially when I need reminding of how to maintain a PACEful approach in my work. 
 
Review by:
Dr Helen Rodwell, Consultant Clinical Psychologist,
Co-author of: Parenting with Theraplay; An Introduction to Autism for Adoptive and Foster Families; CoramBaaf Good Practice Guide on Supporting the Mental Health of Looked After and Adopted Children. 

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Book of the Month February 2018 - Parenting Strategies to Help Adopted and Fostered Children with Their Behaviour

1/3/2018

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Parenting Strategies to Help Adopted and Fostered Children with Their Behaviour by Christine Gordon

​The wonderful wisdom in this book is a most welcome addition for any parent, professional or educator supporting children with difficult to understand behaviour. Although the focus of the book is on children affected by early trauma, (especially children who are fostered or adopted) the strategies and
underpinning knowledge is universally valuable. I found the book to be full of insights which have deepened my understanding of parenting and working with children who have had a difficult start in life.

The book offers a unique contribution to the literature on parenting children with early life trauma due to the inclusion of the invaluable behaviour charts which make up the second half of the book. The charts explain the underlying causes of many common behaviours children affected by trauma display, with useful insights and strategies for interpreting and supporting behaviour when it arises.

It is very understanding of the struggles many adults have in caring for traumatised children and helps you feel understood and validated.
It is not easy caring for children with trauma histories and when a book like this come along it provides light at the end of an often very long tunnel. 

This book helps carers make the shift from seeing behaviour as:
Challenging to distressed
What is wrong with you? to What has happened to you?
What are you doing? to What is your behaviour trying to tell me?
and from focusing only on behaviour to wondering about the meaning and the deeper communication.

The uniqueness and value in this book lies not only in the author's obvious knowledge and expertise, but the clear and applicable charts which really do help decipher and translate behaviour into communication. I have my copy beside my bed and refer to it often. This not only helps me, but ensures my adopted children get a more understanding and supportive parent.

 Kevin Denvir
​(Adoptive parent, foster carer and ASN teacher)

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Book of the Month February 2018 - Everyday Parenting with Security and Love

1/2/2018

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Everyday Parenting with Security and Love: Using PACE to Provide Foundations for Attachment. by Kim S . Golding
 
Everyday parenting with Security and Love is written primarily for parents of children and young people who have experienced developmental trauma and also for the practitioners working with them. The book uses Kim Golding’s Foundations of Attachment Model as a structure to strengthen our understanding of the impact that these experiences can have on children’s development as well as how, through the power of our relationships, we can begin to build an emotional connection with them.
 
Everyday parenting with Security and Love offers the reader an incredibly rich and comprehensive explanation of concepts and theories including: attachment theory; the theory of inter-subjectivity; the impact of trauma on development; Dyadic Developmental Practice (DDP) - informed therapeutic parenting; blocked care and blocked trust.  This fusion of current thinking is combined with practical examples and illustrations which are skilfully woven together to create an engaging read.  Each chapter provides a summary of the concepts covered and the glossary of key concepts covered. This ensures that the content is not overwhelming.
 
Very early on in the book, we are introduced to some fictional children and their parents. These families reappear at various points throughout the book in order to provide illustrative examples of some of the concepts discussed. This approach served to intensify the reader’s understanding of and empathy for the lived-experience of the families. Although the families are fictional, they are completely relatable and brought a pragmatism and texture to the book.

​As we journey with them through the book, we find our connection with them growing stronger as our understanding of the complexity of the inner world of both children and their parents deepens. In this way we come to, not only gain an understanding of the concepts contained within the foundations of attachment model, but we also come to experience the impact that PACE can have on relationships.  

Everyday Parenting with Security and Love is interlaced with a tone of acceptance and understanding. The importance of self care is a valuable feature of the book.  It is this sense of acceptance and realism that gives the reader the security to begin to reflect on their own relationships.
 
Throughout Everyday parenting with Security and Love, the author’s knowledge, skill, experience and warmth is evident. This book ultimately offers the reader a message of hope: “Marian knows that there will be plenty of difficult times ahead, but she dares to think that maybe she can do this after all.” 

Elisa Mitchell
Educational Psychologist
Clackmannanshire Educational Psychology Service

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Book of the Month January 2018 - Building the Bonds of Attachment

1/1/2018

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Building the Bonds of Attachment: Awakening Love in Deeply Traumatised Children
(3rd Edition), Daniel A. Hughes PhD

This highly engaging and insightful book uses the story of Katie, a child at risk and then in foster care to explore the theory and application of Developmental Dyadic Psychotherapy (DDP), both in therapy in in therapeutic care.  Although the characters Hughes introduces us to (especially Katie) are an amalgam of real carers, children and Social Worker that Hughes and other practitioners have known over the years, they are believable.  The Inner World of “Katie” is well described, as is the seemingly endless patience of Jackie, Katie’s fourth foster mum.
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Through the narrative (novelistic) style, Hughes adopts, we get a revealing outline of blocked trust, blocked care, PACE in action and the process of PACEFUL parenting & therapeutic intervention.  Use of the Social Worker’s own developing relationship & parenting of his first child provides an opportunity for the reader to compare normal developmental pathways of relational styles, with the disordered reactions and thinking of Katie.

Each chapter is full of detailed descriptions of significant incidents followed by a reflective “commentary” section.  This allows the reader to refresh and summarise what has occurred, whilst checking their understanding of the trickier concepts and reviewing their own learning and development of ideas.

The introduction can be read alone as a helpful outline of attachment, why it is important and the role of therapy.  It also provides a helpful overview of the main aspects of attachment, and the important concepts that develop through early care, especially the role of attachment, empathy and intersubjectivity.  It provides a useful definition of trauma and the distinction between PTSD and developmental trauma.

At times the reader feels exhausted alongside the foster carers, especially Jackie, who are struggling to get it right for Katie and this is one of the books strengths – the ability to illustrate how difficult it can be to care for, and keep caring for highly traumatised children.  Although the outcome for Katie might be seen, by some, as too easy, for others it will be seen as an inevitable outcome of the hard work of therapeutic parenting where the aim is to build the bonds of attachment.  The reader never loses sight of wanting things to be better for Katie no matter how challenging she seems, because Hughes has drawn her character and the motivations for her behaviours so well.

Hughes skilfully outlines, through the examples he describes, the need for constant self-reflection on the part of therapeutic carers, including support to explore their own attachment history and the necessity of having access to the support of a therapist who is focused on the development of the relationship between carer and child.  By accompanying Jackie and Katie through their therapy sessions, the focus of the problem is shifted from a “within child” model (and the reader is given an example of this type of therapy in Katie’s first therapist) to a “within relationship” model.  By making the mind shift to seeing the problem located within relationship and knowing how they work, the message of this insightful, highly readable book is one of hope.  Things can change.  Children can be helped and healed.

Lesley Craig
Educational Psychologist
Clackmannanshire Educational Psychology Service.


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Book of the Month - The Neurobiology of Attachment-Focused Therapy

1/1/2017

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The Neurobiology of Attachment-Focused Therapy - Enhancing connection & trust in the treatment of children and adolescent
by Jonathan Baylin and Daniel A Hughes 
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The Neurobiology of Attachment-Focused Therapy - Enhancing connection & trust in the treatment of children and adolescent by Jonathan Baylin and Daniel A Hughes 

The focus of this book is set with a quote from Colwyn Trevarthan Emeritus Professor of Child Psychology and Psychobiology, University of Edinburgh.
“If we are to protect young children from harm …we will have to value more and give response to what children bring to human life-the eager spirit of their joyful projects beyond their seeking to survive.” 

How can therapists and caregivers help maltreated children recover what they were born with: the potential to experience the safety, comfort, and joy of having trustworthy, loving adults in their lives? 

In order to address this question this book shares the work of Dan Hughes and Jon Baylin in their development of a science based model of attachment focused therapy that links clinical interventions that are informed by an understanding of brain functioning on attachment and relationships. Thus Dyadic Developmental Psychotherapy (DDP) is linked to neurobiological processes.

Neuroscience shows that negative experiences lead to the development of a neural “alarm system” called the mid brain defence system linked to chronic defensiveness- the core of blocked trust.

The treatment is to target the mid brain alarm system – the part of the brain sensitised by pain suppression and chronic defensiveness evident in children who have developed blocked trust –the suppression of inherent relational needs due to poor care. 

The prefrontal cortex is activated in order to support new learning and move from mistrust to trust. This is done through techniques of reversal learning, fear extinction, memory reconsolidation, reflection, and reappraisal. The therapy ensure adults send messages of approachability and trustworthiness into child’s brain. i.e. not being defensive adults in order to ensure provision of comforting enjoyable experiences with adults. Safety is key in developing this trustworthy environment. 

Underpinning this approach are the key DDP elements of PACE – playfulness, acceptance, curiosity, empathy which are utilised by the therapist in work with children, parents and families. 

The content of the book is laid out in such a way that the reader is informed by the new science of attachment and the bio behavioural processes of trust, mistrust and trust building. This is rich and informative. The focus then leads on to the means of change in the brain functioning in order to bring about therapeutic intervention. There are summaries for some chapters (those providing theoretical background) which are an excellent learning aid. The chapters on intervention are very well illustrated with clinical examples which bring alive the approach as well as reminding the reader of the pain for the children and families involved. 

In drawing the book to a close the focus is directed to the future and the possible expansion of the DDP model looking at more processes to decrease chronic stress and defensiveness. 

The linking of the constantly developing information on brain functioning with attachment focused therapy is very successfully achieved in this book which will provide those working with children and families with potentially both an increased body of knowledge and an improved skill base.

​Ann Rooney
Consultant / Trainer
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Book of the Month September 2016 - Parenting a child who has Experienced Trauma.

1/9/2016

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Parenting a child who has Experienced Trauma.
​By Dan Hughes with Matthew Blythe
Published by CoramBAAF
​
Dan Hughes defines simple and complex trauma; explains the effects of both and the aims of supportive treatment programmes. This part of the book is tightly packed with vital information to educate parents and advice on how to begin to understand and support their children; particularly those who have experienced complex trauma. Hughes suggests that parents and therapists need to “mentally search for the child under the problems and help that child emerge”. 

By being Playful, Accepting, Curious and Empathetic (PACE) parents can communicate that they love their children “for better or for worse”.  Being and relating in this way helps parents give their children the experience of greater safety, even though their children are wired to distrust them. PACE also enables parents to be “emotionally strong, present, confident and comforting” and able to protect their ability to care. Hughes deals with the differing relational needs that traumatised children are likely to have at different developmental stages of their lives. He also provides a very useful introduction to the educational and social issues traumatised children contend with. Hughes theoretical introduction is complimented by the final section of the book in which Matthew Blythe describes his life as the father of his adopted twin boys. Here we hear how early trauma impacts on the development of each of the boys and how Matthew struggles to understand and support them. Their roller coaster journey together will be familiar to adopters and adoptees as well as full of insight.      

My 21 year old son has also reviewed the book. He says: “As a young adult who has experienced complex trauma, I found the section about the effects of childhood trauma very useful.  It helps explain why I feel the way I do sometimes and why I behave in the way I do sometimes. This information has given me ideas about how to help myself”.

“The chapter on symptoms, prognosis and treatment describes how my early life felt to a point of scary accuracy! The treatment suggestions, based on Playfulness, Acceptance, Curiosity and Empathy (PACE) make sense and, if put into practice consistently, work well. However I would say I struggle with the empathetic response that Hughes suggests. I don’t want somebody walking in my shoes with me. I want them beside me, but pushing me on with reassurance. Some people may gain a sense of greater safety from empathy but I do not. That said, the section on helping your child develop internal safety is helpful. It explains that telling someone to ‘forget about it’ or ‘get over it’, is very likely to fail. This is because even as little as a smell or sound can make you feel unsafe/angry/irritated.”

“Some parts of the book seemed obvious to me, however not many people have been through interpersonal trauma. I think the people who will benefit most from this book are teachers, mental health professionals, the police and anyone else working with young people. They all need this knowledge and understanding to get beyond reacting to how young people behave.”

Roberta Manners and HH

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Book of the Month - May 2015 [8 Keys to Building Your Best Relationships by Daniel Hughes]

1/5/2015

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8 Keys to Building Your Best Relationships by Daniel A. Hughes

As a relationship counsellor, this book has impressed in the way it distils the roots and processes that so often lead to difficulties and conflict in relationships. It also offers insight and hope for relationships that can be very secure and fulfilling. 

Dan Hughes has translated theoretical concepts making them accessible to a wide audience, including the latest science behind relationships, making it a tool for husbands, wives, friends, lovers, professionals, business people, and parents. It would also add greatly to personal and social development curriculum within schools.

Personally I love models that break things down into smaller steps which build cohesive, integrated meaning. Dan does this really well and has combined his experience and understanding with lots of short case study examples and scenarios to make it easy to appreciate the relevance and importance of 
what he contributes here. As a reader already familiar with attachment theory I found the description of attachment styles much more easily understood and applicable to everyday life. 

Chapter and Key no 1 – Learn Why Attachment Matters lays out clearly the authority and standing of attachment theory, it’s usefulness and ultimately links the patterns of relating found in both children and adults to the behaviour that, when explained so insightfully, makes so much sense.

Key No 2 is - Know your Autobiography and be willing to rewrite it. In this chapter he leads the reader through 10 themes that help establish a stronger sense of who we are and the life factors that have contributed to it. Dan explains how re-experiencing the past can give new meaning and alter the influence these have on our present lives. A conclusion drawn is “….if you’ve been able to make sense of the events in your life – and the nature of your most influential relationships – and then develop a story that is organised and interwoven with different elements, you tend to be in the best position to develop healthy relationships.”

In Key no 3 the important areas of Brain and Biology are explored with reference to prominent researchers. Dan manages to craft explanations which make understanding concepts such as interpersonal neurobiology and social engagement remarkably easy. He gives everyday, credible examples to highlight his ideas which allow the reader to get a felt sense of what he attempts to explain.  It is becoming more and more accepted that neuroscience underpins attachment, and therefore relationships are a part of brain function. A key part of this chapter has to be a summary explanation of Dan’s signature PACE approach using Playfulness, Acceptance, Curiosity and Empathy, with poignant examples to support and lay a foundation for how this can and does work in supporting anyone experiencing relationship difficulties.

Key no 4 looks at Building your Reflective Capacity. Here you are invited to consider a range of questions designed to cultivate a conscious presence within relationships. What do relationships mean to me? What am I like in relationships? How do I reflect on others? These questions drill down into more specific questions which tease out what we might be looking for and expecting from our relationships. These questions are designed to increase our awareness of both what we might look for and what we ourselves bring to our relationships.

Key number 5 starts with an example of a young female professional who had difficulties managing her emotions within friendship. This introduces the reader to an interesting chapter called – Build Your Emotional Competence. Here again we get a chance to consider “the mind” and how neuroscience has brought greater understanding of emotions and the complexities of brain function. Dan goes on to explain the wider body systems including the links between our heart and gut which all play a part in felt experience. I found the differentiation between Shame and Guilt useful with great insights into how and why these emotions become established within our emotional self through our early experiences. Looking at how relationships develop provides a helpful way of considering the tensions which ebb and flow in relationships around conflicting emotions and the common causes that lie beneath. Practical exercises support the building of the three characteristics of emotional competence – Knowing what you feel, communicating your feelings and managing your feelings. 

To Master Effective Communication is Key number 6 which looks at reciprocity within the context of taking turns in communication. I like the way Dan describes the pre-requisites of effective communication as an ability to listen and more importantly the ability to stay open and engaged, avoiding defensiveness. This is again well illustrated by examples that help the reader appreciate the different patterns of communication that emerge as relationships grow and change. Developing capacities like saying what you mean and asking for what you want are considered to highlight some subtleties of more effective communication. I love the way the reader is invited to consider the influence of non verbal communication which so often leads to misunderstanding and conflict. Our voice and our physiology often let us down and the examples offered help to understand how this can lead to conflict but also be a very effective part on the solution.

In addressing the reparative work Key No 7 is aptly titled – Tinker and Repair. Accepting that even the healthiest of relationships have problems, and as human beings we will all make mistakes at some point, this chapter looks at what we do, and indeed how we might deal better, when problems arise. The reassurance given around mistakes helps the reader feel OK about personal challenges and experiences.  “People in relationships need to be able to repair whatever conflicts emerge if the relationships are to become truly meaningful and lasting.” Dan goes onto to point out that “Avoiding conflicts leads to a more polite but superficial relationship,” going on to explain what he feels are the fundamental points about relationship tinkering and repair. These are headlined as – Decide if the relationships is more important than the conflict, Remember the importance of the relationship, Remember that assigning blame is counterproductive, Don’t deny or avoid: Address the conflict, Don’t endlessly replay conflict, Remember that behaviour has more than one meaning, Address one conflict at a time and finally Mistakes happen: Say your sorry. Period. In summary our ability to tinker and repair is enhanced when our focus moves towards the opportunity to strengthen our relationships rather than to any risk to its durability when we experience conflicts.

The final Key and Chapter is titled Balance Autonomy with Intimacy. An autonomous attachment, as explained in previous chapters, provides both the safety and satisfaction that promotes balance in relationships. However, to feel fulfilled across your life, that wider awareness needs to reflect that “You are not a passive recipient of your life; you are active in creating it.” All of the work from the previous Keys comes together here to illustrate how knowing yourself and the impact of your story provides the platform for meaning and understanding which grows awareness. The example given in this chapter highlights how relationship difficulties develop. The autonomy which was a factor in the partner’s attraction is readily given up changing the rhythm and dynamics of the relationship beginning a cycle of dependency pushing the other away. The moral of this is that no person can be the source of another’s happiness. It is in the sharing of the uniqueness of two autonomous individuals that rich and fulfilling relationships thrive. This does not mean other relationships can’t last or don’t work but it highlights clearly that they will not be deep and fulfilling. 

In pulling the collection of 8 Keys together Dan has provided a valuable tool for building and maintaining balance in autonomy and intimacy within relationships. In claiming that “Your past relationships do not have to dictate your future relationships”, strategies are offered to increase the meaning of relationships in your life and exercises to help you establish how you may have contributed to past relationships and where you have made relationships difficult. A framework is offered for starting a journal, recording important features of yourself which can be used to promote and preserve your autonomy while allowing space for important relationships to develop and grow. This is further developed with a longer term use of a journal being used to compare and guide us towards sustainable healthy relationships. In the final paragraph Dan reminds us of the importance of being Playful, Accepting, Curious and Empathic to keep us on track with both our relationship with our self and our relationships with others. I thoroughly recommend this book.

Kevin Denvir
Relationship Counsellor

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Book of the month - January 2015 [Holding on and hanging in by Lorna Miles] 

1/1/2015

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 Review

 ‘Holding on and hanging in’ (2010) by Lorna Miles 

I have just discovered this wonderful book by Lorna Miles, therapeutic foster carer. Interlaced with both the understanding and therapeutic PACE parenting (Dan Hughes model) of Wayne – a severely traumatised nine year old – it is wise, practical, poignant and playful.  

Lorna Miles takes the reader with her on her family’s  journey to support Wayne to start to grow and heal, and in telling the story she gives an honest account of the many challenges, frustrations, trials and tribulations.  

The book packs a punch with respect to the importance of the team around the family (social work, health and education) working together with a shared understand and a high level of support available.   

This is a great book for parents, carers and professionals.  As Dan Hughes says: 
‘This one story brings the theories, research, professional conferences and training to life.  And makes all the effort worthwhile’ 

Edwina Grant
Scottish Attachment in Action Committee Member
DDP Practitioner, Trainer & Consultant


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