1. INTRODUCTION TO THE SECURE BASE MODEL An attachment and resilience based model of caregiving Gillian Schofield and Mary Beek

2.  Abuse, neglect or rejection have implications for the child’s internal working model (their beliefs and expectations of self and others).  Separation and loss raise anxiety and intensify a child’s defensive strategies.  There is a risk that children will recreate their previous experiences of caregiving in new families /new relationships – the child may think good care is just a trick (Crittenden 1995) What attachment theory helps us to understand about troubled children in care and adoption

3.  Providing a secure base reduces a child’s anxiety and enables the child to explore, to think, to enjoy play and learning and to fulfil their potential.  Key to promoting security and resilience is mind-mindedness  Attachment focuses attention on the quality of the child’s experience in the relationship with the caregiver as an active source of therapeutic care.  Security and resilience comes not just from relationships with specific attachment figures but from a secure base provided by the whole environment (family, friends, school, activities) Use of attachment theory and research in developing a model of caregiving

4.  Availability – helping the child to trust  Sensitivity – helping the child to manage feelings  Acceptance - building the child’s self-esteem  Co-operation– helping the child to feel effective  Family membership – helping the child to belong Caregiving dimensions from attachment theory and child placement research

6.  Assessment and working with children in their birth / foster / adoptive families and in residential care  Assessing, preparing and supporting foster carers / adopters / residential workers  Matching children and caregivers  Working with caregivers - setting goals for each dimension and monitoring children’s progress (new and existing placements)  Assessing and providing help to placements in difficulties Working with children and carers : the Secure Base Model in practice

9. Caregiving approaches:  Be available physically and emotionally– and signal availability in age appropriate ways  Provide predictable routines  Time the relationship ‘dance’ at the pace of the child  Make sure the child feels special/cared for when unwell or troubled  Help the child know that you are thinking of him or her when apart Availability – helping the child to trust

10.  ‘When Jennie came to me at 12 weeks old, she was completely unresponsive, not waking for feeds, not responding to me, not showing any emotion. She had just switched off. I had to stay close to her and respond to even the slightest sound or facial movement and keep talking to her and touching her. It took time to replace those first weeks, but gradually she started to show different feelings and become more responsive.’ When tiny babies have switched off

11.  ‘Sam (6) found it impossible to trust me and watched my face warily all the time. I found that if I sat with a drink for him on the settee with children’s television on, he would circle the house for a long time dragging his favourite blanket and eventually end up sitting on my lap wrapped in the blanket, drinking his drink. I needed just to be there and he needed to have the confidence that I would wait for him to come to me.’ Having the patience to let the child approach

12.  ‘When Aiden (4) had contact with his father he was always very anxious about what might happen and whether he would come back to me and I would be here for him. On one occasion I gave him a small cushion to take with him so that he had something to hold onto, but also so that he would know he would be coming home.’ When children are anxious and away from their secure base

14. Caregiving approaches:  Tuning in – reading signals, anticipating distress, containing anxiety  Naming thoughts and feelings– providing a ‘commentary’.  Scaffolding experience- giving a predictable shape to events e.g. feeds, nappy change, school  Modelling expression and management of carers’ own thoughts and feelings  Promoting empathy – how do you/how might other people think and feel? Sensitivity - helping the child to manage feelings

15.  ‘I think Jenna (9) spent so long in self defence and looking after herself that she never learned to look at things from any one else’s point of view. She missed that out when she was little. And even things like stories.. When you say, what do you think is going to happen next? or why is that person thinking that? she hasn’t got a clue, she doesn’t follow the motives of what people are doing, or how they are feeling. So we do a lot of story reading together and I talk it through.’ Promoting mind-mindedness, perspective taking and empathy

16.  ‘Paula (8) couldn’t remember or didn’t want to remember what happened this morning or yesterday or last week and couldn’t anticipate ‘next week’. So we started to do an Experiences Book together - each day writing down what had happened and her feelings about it. This helped her to reflect on the shape of each day and the immediate past and build her capacity to remember.’ Using an experiences book: making it safe to think and remember

18. Caregiving approaches:  Promote the idea in the family - ‘Nobody’s good at everything but everybody’s good at something.’  Look for special strengths / talents in the child  Find activities to do and to share – ‘orchestrate’ achievements  But allow failures and setbacks to happen and be managed.  Model and teach the child to accept and celebrate difference in self and others – ethnicity, personality, talents. Acceptance: building the child’s self-esteem

19.  ‘Rob (11) loves his fish pond. Now he’s in charge of his own and he’s totally reliable in that department. We encourage him all we can. We say ‘Rob’s the top pond man’. He gave his talk at school on goldfish and got top marks.’ Promoting positives - showing pride

21. Caregiving approaches:  Offer choices- even in small things  Help children follow through/achieve results-both on their own and with help e.g. plan a trip, take photos and see them developed and framed.  Involve child in family tasks that all can see the benefit of.  Model co-operative behaviour with other family members as well as showing it with the child. Co-operation - helping the child to feel effective

22.  ‘George (3) would only relax in the garden, so although it was winter we wrapped up warm and everyday we spent time outside. He would potter about, looking at stuff and I would follow him sometimes and talk occasionally and he would stop and he’d look at an insect, or whatever it was he’d found. I pretty much let George lead, but sometimes I’d draw his attention to things. Yes, he pulled out all the plants and I just decided that I wasn’t going to have a garden that year and I just thought – yeah, I can have a garden next year.’ The therapeutic effect of supporting a child to take the lead

24. Caregiving approaches:  Have special places for the child in the family /residential home - for their clothes, at table, in the garden  Ensure the child understands how this family does things - include the child in foster family life/photos  Enable the child to talk about and value their birth family identity  Manage contact in ways that promote the child’s well-being and comfortable sense of belonging in both families. Family membership - helping the child to belong

25.  ‘We always say – from the moment you walk through the door, you are part of us. No matter how long you’re staying or how many other families you relate to, you are part and parcel of our family, the same as everyone else who lives here. We say it and we show it to them as well.’ Part and parcel of our family

26. Leroy (18 – placed at 8) talking about his foster mother  ‘My mum’s helped me a lot because she was determined for me to do well. That’s a really important thing, other people believing that you can do well... It was my home - whereas before it was just somewhere I was staying.’

27.  ‘ I think if you can just catch children in time, they really can start to heal and recover well enough to go on and just enjoy their childhoods and become reasonably adjusted adults - and that’s a great result, really.’ Final thoughts from George’s foster mother

29.  Schofield G and Beek M (2014) The Secure Base Model: promoting attachment and resilience in foster care and adoption London: BAAF  Schofield G and Beek M (2006) Attachment Handbook for Foster Care and Adoption London: BAAF http://www.uea.ac.uk/providingasecurebase Main sources