Q: Is the Circle of Security™ a theory or a protocol or both?

A: The COS is a user-friendly, visually based (utilizing extensive use of both graphics and video clips) approach to helping parents better understand the needs of their children. It is based extensively upon attachment theory (from the work of John Bowlby and Mary Ainsworth) and current affective neuroscience.

It is also a basic protocol that can be used in a variety of settings, from group sessions (20 weeks) to family therapy to home visitation. The common denominator is that all of the learning is informed around the following themes:

• Teaching the basics of attachment theory via the Circle of Security™
  
• Increasing parent skills in observing parent/child interactions
  
• Increasing capacity of the caregiver to recognize and sensitively respond to children's needs
  
• Supporting a process of reflective dialogue between clinician and parent to explore both strengths and under developed capacities (i.e. being Bigger Stronger Wiser and Kind, supporting exploration, and supporting attachment)
  
• Introducing parent to a user-friendly way to explore defensive process and how best to work with it

Q: What training is necessary to be able to utilize COS professionally?

A: This is in the process of being established. Currently we encourage people to utilize the Circle of Security™ graphic whenever they find it useful. However, to be able to utilize the key themes mentioned in the question above (attachment theory basics, building observing skills, increasing sensitivity to cues, building reflective dialogue, and exploring defensive process ) requires specific training and ongoing supervision. Please check this website for upcoming introductory workshops.

Q: Who do I contact to find out about current training?

A: This website offers current workshop options on both the East and West Coast of the United States in the coming 12 months. After attending an introductory one-day training, new options will be made available for further learning. We are currently considering two-day trainings and longer “intensives” should the interest arise.

Q: Do I have permission to use the COS graphic and additional handouts?

A: Because psychologists, educators, childcare professionals, counselors, etc. have found these graphics to be useful for parents and professionals in explaining the core themes of attachment behavior in young children we want to make them readily available through this website. Please see the “Download” page and read the detailed description of our request for all of those utilizing these materials.

Q: As I read this material I find myself having many questions and reactions about either my own childhood and/or my own caregiving approach and/or issues concerning certain clients. May I contact you directly to receive advice or perspective on these issues?

A: Although we would very much like to be of assistance, we simply do not have the time available for consultation at such a level. Attachment related material raises many concerns and opens many insights as it is being learned. Please consider contacting a professional in your local area. It is also our hope to publish a book in 2006 that will hopefully address some of the issues that are currently coming into focus for you.

Q: In what way are “Holding and/or Rage Reduction Therapies” different from the COS intervention?

A: This is a very important issue and we are committed to answering it directly. While there are a number of early intervention projects being developed and tested that focus on the security of attachment-caregiving relationships in high-risk parents and their infants there are very few evidence-based programs that are focused on older toddlers and preschool children. Unfortunately, those programs for preschoolers and older children that do exist tend to take one or a few ideas from attachment theory and research, incorporate them in an oversimplified manner into another, usually incompatible, theoretical framework, and apply the resulting programs without adequately testing their effectiveness.

Specifically, these programs, some of which are known as Rebirthing, Rage Reduction, Attachment, or Holding Therapy, and as a group are often referred to as “the holding therapies,” have been published privately, in edited books, and on the Internet. The designers of these programs draw from Bowlby’s theory a focus on the importance during infancy of close bodily contact, security, and trust in the child’s attachment figure. However, these “holding therapies” tend to have taken those constructs and integrated them into intervention models based either: a) on a distorted version of the classical psychoanalytic theory of regression (Rebirthing and Rage Reduction therapies); and/or on behaviorism and principles of behavior modification designed to reduce or eliminate undesirable behaviors (Attachment and Holding therapies). Clearly, these are not really attachment theory-based interventions, and they are not appropriately evidence-based.

Characteristics of the holding therapies have led to the proliferation of interventions that, while they are administered by therapists with the best of intentions, are at worst abusive and potentially life-threatening and at best are neither based on attachment theory, nor empirically tested regarding treatment effectiveness. Unfortunately, many of these programs claim to be based on the Bowlby-Ainsworth theory of attachment, and there are literally thousands of therapists in communities around the U.S., Canada, Europe, and Australia who use them in their daily practice. In defense of these therapists, it should also be noted that until very recently there have been few if any evidence-based interventions for preschool and older children, truly developed from attachment research, available to them.

Interventions that are evidence-based and derived from attachment theory will have many differences from the holding therapies. Three that are especially pertinent to evidence-based practice are:

1. Holding therapies tend to use a diagnostic system that is non-standardized, non-validated, and not able to differentiate among the many psychological disorders found in childhood. In contrast, attachment research-based interventions should utilize a “diagnostic” system that is based specifically on thought and behavior patterns identified through attachment theory and research, and on research in other areas of parent-child interaction and relationships. This system should be scientifically and clinically reliable and validated. It should be sufficiently limited in scope both to identify specific attachment problems, and at the same time to differentiate these problems from other childhood and relationship difficulties as well as from formal diagnostic groups such as ADHD, Oppositional Defiant Disorder, Conduct Disorder, Bi-Polar Disorder, and other disorders so often inappropriately associated in clinical practice with “Attachment Disorders.”
2. Holding therapies tend to direct the intervention to the child him or herself. In contrast, all attachment research-based interventions with which we are familiar, including the Circle of Security™, are designed to impact the child’s attachment pattern indirectly by directly focusing on caregiver patterns of behavior and thinking. This practice follows directly from Ainsworth’s focus on caregiver sensitivity to the child’s cues as perhaps the major variable in predicting security of attachment.
3. Holding therapies tend to view the behavior- and emotion-regulation problems of children with attachment difficulties as unacceptable behaviors, and often make inferences about negative intent on the part of the child. Most holding therapies attempt to eliminate or extinguish these intentions and behaviors through consistent, strong, and often negative, consequences that are based either on aversive behaviors toward the child, or on temporary separation, or interruption of the interaction, between the child and caregiver. In contrast, interventions based on attachment theory are likely to view the behavior- and emotion-regulation problems associated with attachment difficulties as patterns of thinking and behavior that are both an understandable adaptation to the child’s unique developmental and relationship history, and are reflections of the child’s inability, at the moment, adequately to self-regulate his or her affect and behavior. Even if the child is acting in an aggressive, controlling manner, attachment-based interventions will, in most but not all situations, view the child as anxious, vulnerable, “in over his head,” out of control, and needing the parent’s empathy, soothing, and management.