Reducing Separation Trauma:

A Resource Manual for Foster Parents, Social Workers, and Community Members who Care for Children and Youth

Kathleen I. W. Brundage, PhD. student

Deborah Gerrity, Ph.D., Assistant Professor,

StateUniversity of New York at Buffalo

Counseling, School and Educational Psychology

Meg Brin, Child Welfare Administrative Director

Tom Needell, Child Welfare Trainer

Mary Jane Irwin, Child Welfare Trainer

CC02 Child Welfare / Child Protection Services Common Core Training for Caseworkers

Funding for this research project was provided by NYS Office of Children and Family Services, Contract year 2004: Project 1037122, Award: 31183; Contract year 2005: Project 1044698, Award 34851, through the Center for Development of Human Services, College Relations Group, Research Foundation of SUNY, Buffalo State College.

Contents

Chapter 1: Introduction

Chapter 2: Attachment

The Importance of Attachment

Attachment Development

Styles of Attachment

Attachment and Developmental Problems

Attachment Disorder

Attachment and Foster Children

Effects of Neglect and Maltreatment

Promoting Trust and Attachment

Chapter 3: Normal Child Development and Implications for Separation and Placement

Chapter 4: Children’s Reactions to Separation and Placement

Factors that Influence Reactions to Separation

The Traumatic Impact of Multiple Separations

Emotional Responses to Separation

Behavioral Responses to Separation

Chapter 5: Grief as a Reaction to Separation and Placement

Chapter 6: Fostering Attachment and Resiliency: Supporting Children and Youth through Transition and Minimizing the Trauma of Separation

Creating Successful Transitions

Supporting Children throughout the Placement Process

Building a Relationship with the Child

Other Factors that Reduce Separation Trauma

Creating a Lifebook

Handling a Child’s Departure from the Caregiving Home

Caregiver Self-Care

Chapter 7: Resources

Internet Resources

Books for Adults

Book for Children

Games to Promote Communication

Therapists and Mental Health Resources

References

Appendix: Attachment Disorder Checklist

Chapter 1: Introduction

At some point in our lives, we will all experience a loss or separation from someone or something dear to us. Significant losses are always painful and are sometimes frightening and even life-changing. Whether due to death, relocation, the breakup of a close friendship or partnership, or a child leaving home, many people react to losses in predictable ways. Sadness, depression or despair, accompanied by anger, anxiety, fear, and loneliness, and sometimes, loss of self-esteem or direction in life, are typical reactions to loss and separation (Bloom, 1980; Bowlby, 1961, 1973; Fahlberg, 1979; Kubler-Ross, 1972; Parkes, 1972; Rycus and Hughes, 1998).

Children who are removed from their homes and placed in substitute care are all too familiar with the pain and uncertainty of losing important people, places, and things in their lives. They often experience many, repeated, and often sudden, losses, which can make their adjustment very difficult. They lose their parents, siblings, grandparents and extended family members, friends, neighbors, teachers…the list of important people goes on. In addition, they lose their familiar surroundings, their toys, clothes, pets, and other meaningful objects. Their losses are often compounded by damaging home lives that have left them emotionally scarred and behaviorally troubled.

In 2002, Child Welfare investigated nearly 3 million of claims of child abuse and neglect. Of those, 926,259 were substantiated (Child Welfare League of America, 2002b). Many of these children found their way into the foster care system. Foster children with backgrounds of neglect and abuse suffer three to seven times as many acute and chronic emotional problems as other children (Rosenfeld et al., 1997) and often experience compromised development that leads to disproportionately high involvement in the mental health, juvenile justice, and adult criminal justice systems (Briere, 1992; Cahill, Kaminer, & Johnson, 1999; Finzi et al., 2001). This increased risk is partly due to difficulties in attachment created by the abusive and/or neglectful situations that characterize their developmental years, as well as trauma caused by repeated separations from caregivers as they move from home to home (Kates, Johnson, Rader, & Strieder, 1991).

But do not despair! Not all separations are equally distressing, and there is hope even for children who have experienced repeated separation traumas. Research studies, clinical case studies, and reports from foster children themselves echo the sentiment of hope for foster children who receive appropriate care from alternative caregivers (e.g., Dozier, Stovall, Albus, & Bates, 2001; Festinger, 1983; Holmes, 1993, Hopkins, 2000; Kenrick, 2002; Lopez & Dworkin, 1996;Parkes, Stevenson-Hinde, & Maris, 1991). Although problems associated with traumatic separation from attachment figures can contribute to emotional and behavioral troubles and difficulty in future relationships, children who experience a caring relationship with an adult who is knowledgeable of the special needs of these children can form healthy relationships and expect to go on to lead healthy and fulfilling lives (ex., Lopez & Dworkin, 1996; Kenrick, 2002)If care givers are aware of the factors that lead to traumatic separation, they can better understand the impact on a child of separation from his or her family and be better equipped to limit the damage done by the separation and repair some of the damage caused by early abuse.

This manual will present theory and research on issues of attachment, separation, grief, and development for children in foster care and ideas and resources to help care givers ease their children’s transition into placement. Attachment theory (see Ainsworth, 1967; Ainsworth & Witting, 1969, Bowlby, 1969, and Bretheron, 1992) is presented as a framework to help care givers understand the emotional and psychological world of the children they look after, helping them recognize typical reactions to removal from the home and behaviors that may indicate a more serious problem.

The goal of this manual is to illuminate the experience of children in care so that foster parents, social workers, and other people involved with the children can understand the reasons for their behavior and the emotional turmoil behind them. This manual also includes specific steps that can be taken to minimize the impact of separation and placement and reduce separation trauma. This information is intended to ensure that caregivers are equipped with the knowledge to understand and effectively deal with a child who is transitioning to a different home.

It will take knowledge, patience, and dedication to care for a child with a background of abuse and the difficult task of moving to a new home. But with patience, care, training, and support, caregivers can make a life-long difference in the quality of a child’s life.

Notes about Language in this Manual

This resource contains much discussion of the relationships between children and the adults who provide care for them. Research reflects cultural biases, such as considering the mother to be the primary source of nurturance and support for an infant. With fathers, grandparents, and many others filling this role in current times, this book attempts to demonstrate sensitivity to the many possible relationships and family configurations by using language that is more inclusive. Particularly in the chapter on attachment, terms such as “primary caregiver” or “primary attachment figure” are used in place of “mother” of “father”.

Certain other terms are used to describe persons involved with children in the child welfare system. The term “caregiver” is used here to describe parents, foster parents, family foster caregivers, adoptive parents, intimately involved clergy or other community members, and others who take on the role of providing for a child’s needs.

Finally, an attempt to remove gender bias has been made by including both the masculine and feminine pronouns when referring to a child in care (for example, his/hers; (s)he). It is acknowledged that this can at times reduce clarity and readability, but this is a necessary compromise in balancing the language in this manual to reflect the fact that foster placements, attachment disorders, and other problems described in this manual effect both genders equally (Thomas, 1997).

Chapter 2: Attachment

Intimate attachments to other human beings are the hub around which a person’s life revolves, not only when he [or she] is an infant or a toddler or a schoolchild but throughout his [or her] adolescence and in his [or her] years of maturity as well, and on into old age. Form these intimate attachments a person draws his [or her] strength and enjoyment of life and, through what he [or she] contributes, he [or she] gives strength and enjoyment to others. These are matters about which current science and traditional wisdom are one.

-John Bowlby (1980, p. 441)

Attachment is a complex process. The ways in which humans form relationships and how those relationships influence all aspects of development, are highly studied subjects; the base of knowledge about the complexities of how people’s attachments form and function continues to grow. It is imperative that people involved in making major life decisions for children have a basic understanding of attachment theory and what is currently known about how human relationships work. This knowledge is especially important for people who look after children in the child welfare system, for “attachment and separation are the heart of child welfare work” (Fahlberg, 1991. p. 19).

The bond between an infant and his or her primary caregiver serves several important purposes. Attachment figures are a source of safety, and they satisfy an infant’s physical needs for nourishment and protection. In addition, the attachment bond provides socialization and promotes connection with others, stimulates intellectual development, and is essential for the development of a sense of one’s self. Research on the effects of inadequate interpersonal relationships reveals a variety of emotional, behavioral, social, and even neurological and physical problems for children who do not have stable ties with supportive parent figures (e.g., Greenberg, 1999). Many of these problems can be long term. A child’s style of attachment can also give insights into the functioning of his or her family and the environment into which he or she was born. In light of the far-reaching implications of attachment, “the significance of intimate interpersonal relationships and the importance of early caretaking in learning how to make such attachments have become the canons of the child welfare and mental health professions.” (Watson, 1997, p. 160). An understanding of how attachment normally develops is critical for social workers and caregivers.

The Importance of Attachment

Foster children have often come from homes in which circumstances have severely limited the formation of healthy, nurturing, parent-child relationships. The emotional and physical bond that forms between an infant or young child and his or her primary caregiver through their relationship is known as attachment. Infants and young children who have been abused and neglected are at high risk for developing problems with attachment, as are children who have survived early, prolonged, or traumatic separations from their primary caregiver (Levy & Orlans 1998; Bowlby 1973).

Attachment is important for all aspects of a child’s development. The emotional bond that forms between a child and his or her first primary caregiver* (see note in Introduction) sets the stage for all of the child’s future relationships and the ways in which the child interacts with the world (Bowlby, 1988). This first, and most important, relationship teaches the child how to view the world and how to respond to it. A child’s relationship with his or her first attachment figure creates a template for future relationships, a sort of lens through which all people are viewed. The attachment lens colors people and situations in a way that is similar to the child’s experiences with his or her primary caregiver, such that the child behaves, at an almost instinctual level, in the same way that he or she did with the first primary caregiver.

If a child’s first attachment figure responds to the child in a sensitive, consistent, and effective way, the child learns to trust the primary caregiver and seek her out in times of need, creating the building blocks for healthy relationships. At the same time, the child learns to be autonomous, exploring the environment with a sense of confidence that his or her caregiver will not allow anything bad to happen to the child (Ainsworth et al., 1978). This confidence will become a part of the child’s template, and (s)he will encounter new people and new situations with the capacity to interact in a way that is flexible and appropriate. These children are more able to cope with stress, form relationships, and experience the positive aspects of life (Fahlberg, 1991). Children who develop secure attachments are more able to:

Attain full intellectual potential

Sort out perceptions

Think logically

Develop social emotions

Develop a conscience

Trust others

Be resilient

Become self-reliant

Cope better with stress and frustration

Reduce feelings of jealousy

Overcome common fears and worries

Have increased feelings of self-worth

If the child does not experience a healthy attachment relationship with the primary caregiver, or if the attachment with the caregiver is disrupted, the child will not develop the same flexibility, and healthy development of social, psychological, behavioral, and even physical health are compromise. Children who do not maintain a healthy attachment will not learn to trust other people, themselves, or their environment. They will develop behaviors that protect them as well as possible in these undesirable circumstances. As these children grow and develop, these protective behaviors will no longer be sufficient to get their needs met; they will not learn how to interact with the world and people in it in an effective way.

Children who have problems with attachment may develop behaviors that seem extreme in order to cope with the inadequate conditions in their relationships with primary caregivers (see Lyons-Ruth for review of aggressive behavior problems associated with attachment). Many of the “problem behaviors” expressed by children in care are in fact survival skills they have learned in order to make their way in their troubled lives. Poor attachment and the behavior problems associated with it can seriously interfere with adjustment in foster placements, for the child and for the family, and can increase the risk of placement disruption (Fahlberg 1991; Levy & Orlans 1998;Pinderhughes & Rosenberg, 1990). It is important for caregivers to put these sometimes outrageous and incomprehensible behaviors into context, so that they can maintain their empathy and understanding for a troubled child and prevent further disruptions to the child’s attachment system through repeated moves. Later in this chapter, behaviors associated with attachment problems will be discussed, as well as the reasons for some undesirable behaviors and the purposes they have served for children.

Despite the many problems associated with attachment problems, some children who grow up in relatively deprived environments retain the capacity to overcome their beginnings and learn to trust and love (Cline 1992; Cournos, 2002; Egeland & Sroufe, 1981; Fahlberg 1991; Hughes, 1997; Kagan, 2004; Kenrick, 2000; Levy & Orlans 1995; Toth & Cicchetti, 1996). Researchers agree that a major factor in promoting this resiliency is the presence of a caring, committed, adult who can provide a stimulating and supportive environment. Even children with severe attachment disorders can be helped to develop trusting, intimate, meaningful relationships given the caring, dedicated, and patient support of caregivers who serve as attachment figures.

Attachment is an important concept in the development of children’s identities and their relationships with others, and it is among the most influential theories informing child welfare practice today (Rycus & Hughes, 1998). Knowledge of attachment issues is essential for people who care for foster children because this group is at increased risk for problems with attachment (Main, 1996), which can lead to serious disruptions in a child’s emotional and behavioral development and can cause problems that last a lifetime if not appropriately addressed. Caregivers who are aware of issues concerning attachment will be better equipped to understand the experiences of children involved with the child welfare system and to handle transitions in a way that inflict as little harm as possible on vulnerable children. This chapter attempts to provide the necessary information about attachment. It will 1) define attachment and describe the ways in which attachment normally develops; 2) identify the effects of weak attachment, including attachment disorder, and the ways in which weak attachment form; 3) describe the circumstances which often surround a foster child’s attachment development and the effects of unstable home environments; and 4) provide suggestions for strengthening weak attachments and promoting new ones for children in care.