Attachment Relational Approach to Working with Carers and Young Adults

Within my practice I use a relational attachment approach, I am informed  by the work of Dan Hughes, and the therapeutic models of Dyadic Developmental Therapy, Theraplay, The Ambit Model (Adolescent Mentalisation Based Integrative Therapy)  and NVR (None Violent Resistant Approach to Parenting).

Through the process of a phased relational attachment approach taking place, a scaffolding of all respective narratives within the system is addressed to identify the particular attachment rupture for both the young person and the respective family system. Using a phased approach of separate relational sessions prior to joined therapy taking place is key to addressing the “attachment rupture” within the system. It is subsequently through the process of joined therapy where therapeutically “intersubjectivity” is used to emotionally mentalise the young person; (affording new connected conversations to take place) that therapeutic opportunity for change away from entrenched problem saturated dialogue can start to take place.

It is through this therapeutic process of modelling emotional attunement that themes around attachment, bonding and loss can be explored safely (through separate sessions prior to joining). The therapeutic process considers the absent voices such as that of the birth mother where consideration of the young person’s entrenched feelings can start to be explored. Concurrently consideration of the carers own respective historical and  current narratives of loss in relation to fertility issues, and their sense of disappointment and hopelessness  is addressed within the context of the relationship breakdown with their respective young person.

Structure:

The model is structured in five phases to afford the opportunity for a balanced relational alliance between all parts of the system to be established prior to joined therapeutic work taking place.

Phase 1: Systemic Assessment Identifying Relational Rupture for all respective family members.

Phase 2: Joined Session contracting relational task to be worked on prior to family therapy taking place.

Phase 3:  Relational Alliance Sessions with young person /individual sessions:

Themes to be explored:

*Relationship building is the first stage of the therapeutic process for the young person    where flexible engagement listening and emotionally attuning to the young person’s voice and feelings is privileged and starts to take place.

*Supporting the young person to verbalise the primary emotional responses around frustration, loss and confusion regarding relational trauma is addressed. This will include exploration of the concept of “splitting” within the context of conflicted responses regarding themes of abandonment experienced by the young person in relation to the birth parent and the subsequent projected behavioural response towards the adoptive parent.

*Exploring themes of identity, narratives around the meaning and relationship of their adoptive experience and the impact on their sense of “self”.   Within this context themes of guilt, hopelessness and narratives around perfectionism will be explored.

*Addressing the potential for re storying themes of resilience and support in developing a coherent narrative linked to future hopes and dreams and exploring the relational network to provide ongoing support with this.

*Emotionally preparing and supporting young person for joined family session where the scope for improved understanding and communication can start to take place. Key to this will be for the young person to have their lived experienced expressed and listened to.

Phase 4: Relational Alliances with adopter/carer:

Themes to be explored:

*To provide  a safe therapeutic space for the adopter/carer to explore independently ( or as  a couple) the impact of communication difficulties with their young person is having on their emotional well being and to identify what resources they need  to be able to engage in a sustained change process towards reconciliation.

*To understand the triggering response that the relational rupture has had in reopening attachment wounds regarding themes of loss, and infertility issue in conjunction with the themes of shame and inadequacy which for the respective adopters/carers

*To provide therapeutic support in understanding the impact that “splitting” can have on the adoptive relationship with the young person. The underlying triggers around abandonment and the subsequent impact of the projected behaviour for carers is addressed and processed.

*To provide psycho educational and therapeutic reflective intervention regarding emotion focused parenting addressing the principles of emotional attunement and intersubjectivity referring to the framework of PACE (Playfulness, Acceptance, Curiosity and Empathy). This will provide the scaffolding for preparing for joined work with the young person.

Phase 5:  Joined Family Work:

Themes to be explored:

*The family is supported therapeutically through joining relationally where the therapeutic modelling of emotionally attuned communication is modelled between the therapist and the young person. Key to this process will be addressing everyone’s wishes and needs with a view to considering the relational and communication changes which need to take place.

*Key to this process will be the priority placed in supporting the young person having agency to express their wishes and feelings openly.  In joining with his respective parents/carers therapeutically and feeling heard and held emotionally through the process of inter subjectivity will be the start of the change process.

*As the communication system is experienced as more contained, transparent and safe for all the family joined conversations around re storying previously problem saturated narratives for the young person can start to take place. Accessing stories and meaning around subjugated narratives of resilience are encouraged with a view to supporting the young person to start developing a coherent narrative of strength for the future.