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Fostering Attachment With Families in the Foster Care System

Dyadic Treatment, Reflective Functioning, and Videofeedback: Fostering Attachment with Families in the Foster Care System

Pages 104-119 | Published online: 31 May 2016
 

ABSTRACT

The Building Blocks Program encourages parent-child bonding, attachment, and reflective functioning based on theories of nonverbal communication and mentalization. In the Building Blocks Program, young children who are in foster care or at risk of being in foster care are seen in dyadic sessions with their birth parents in a clinical setting. The parents come in with traumatic histories, including adverse childhood experiences, disrupted connections, mental illness, ongoing exposure to poverty and violence, and have little social support. The children have significant medical, emotional, and/or cognitive challenges. In this article, all aspects of the Building Blocks Program are described, including training for therapists, treatment for parents and children in supervised play/visitation sessions, Reflective Supervision with therapists in group and individual sessions, and the model of Nested Mentalization. Using video and videofeedback as a vehicle for positive change, therapists promote emotional healing and parent-child attachment. In Reflective Supervision, supervisors make every effort to understand the thoughts and feelings of the therapists. A holding environment is provided for the therapists who, in turn, hold the parent, who can then hold the child. Two cases are described that demonstrate the many layers of complexity in the Building Blocks model, and how the multifaceted levels of complicated systems are addressed.

Notes

1. Names and details of cases have been disguised to protect confidentiality.

2. NAC is a child welfare agency serving families with children who have complex, chronic medical conditions and co-occurring mental health challenges. NAC includes a health care center and an Article 28 and Article 31 mental health clinic, located at 37 West 26 Street in New York City. Executive Director Dr. Arlene Goldsmith has consistently supported this project since its inception.

3. The Building Blocks Program was initially supported by the FAR Fund. Currently, the Building Blocks Program is mainly supported by the Child Welfare Fund, with a grant from the Kenworthy-Swift Foundation.

4. Initially, there were four trainer/supervisors from NYIPT (Dr. Roanne Barnett, Dr. Jill Bellinson, Dr. Phyllis Cohen, and Dr. Andrea Remez), but since the second year of the program we have been a team of three (Bellinson, Cohen, and Remez).

5. NYIPT supervisors would like to thank all the therapists and clients who have participated in the Building Blocks Program.

6. A discussion of this case has been published: Golub, Ashley (2015). Holding each other in mind: A mentalization-based approach to dyadic therapy. Journal of Infant, Child and Adolescent Psychotherapy, 14, 253–257.

Additional information

Notes on contributors

Phyllis Cohen

Dr. Phyllis Cohen is the director of the New York Institute for Psychotherapy Training in Infancy, Childhood and Adolescence. She has a private practice in Brooklyn, teaches child and family therapy, and since 2013 has been the Building Blocks/NYIPT Program Coordinator at the New Alternatives for Children.

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