Every Child Journal
Families
Moving into the
comfort zone
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Every Child Journal
Relationships are everything to young children, helping them to build confidence, resilience and security. So what do you do when parents struggle to form attachments with their children? Brenda McLackland looks at practice that helps create a comfort zone for relationships to thrive.
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n 2013, at a conference run by the charity What about the Children, the keynote speaker, Sir Denis Pereira Gray, delivered a presidential lecture entitled: ‘It’s the relationship, stupid!’ He remarked that the source of his blunt but succinct title owes its origin to James Carvill, a Clinton advisor. His statement: ‘It’s the economy, stupid’ helped the Democrats focus on their priority and win the US election. As Sir Denis stated, ‘the essence of any society, at any time, is how people relate to each other, in short: It’s the relationship, stupid!’ The evidence for the importance of early relationships to children is overwhelming.1 Developing a secure attachment with a primary caregiver is essential for children’s future emotional health. But how many children enter school without a secure attachment? What are the consequences of this for teachers? And is there anything we can do to help? Approximately 55-65 per cent of children have secure attachment.2 These children will come to school happy, emotionally regulated and ready to learn. It is the rest of the children that should concern us. Children with insecure attachment patterns may already be experiencing difficulties. These children may be clingy and whingey, or may hide their distress. Either way, they are not ideally placed for learning. Indeed we know that insecurely attached children: n n n
are less socially competent3 are more likely to be rejected or cosseted by teachers are more likely to be victims or to victimise others.4
The consequences for teachers may be that these emotional difficulties hinder a child’s ability to learn effectively. Clearly this is not a desirable state of affairs. What then if there was a tool to help parents to form a secure attachment with their child in the first place? This article is about the progress to date of ‘Comfort Zone’ an intervention to help parents with their emotional attunement with their child.5 Attunement with their child is a step on the path to forming a secure attachment promoting children’s emotional regulation and readiness to learn. The rationale for the development of Comfort Zone was that despite the current acknowledgement of the importance of attunement, there is a lack of intervention tools available to help with it. There are several interventions that focus primarily on children’s behaviour such as Triple P6 and the Incredible Years7. However, it is also acknowledged and highlighted in other approaches such as Solihull8, that if children are securely attached they are more likely to be calm and able to emotionally regulate themselves. When children have this ability, the incidence of behavioural problems is likely to be lower. In other words, getting it right emotionally with children from the start is likely to lead to reduced problems later on in life. This idea is now acknowledged by the government, academics and practitioners.
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Attachment patterns
Figure 1: Hypothesised link between attachment patterns and Comfort Zone
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Attachment patterns develop according to the type of responses a child gets from their parent or carer when they are distressed. If parents are consistently responsive and loving and available, the child feels safe and develops trust and a secure attachment. If parents are inconsistently available and responsive to their child, he/she may develop an insecure, ambivalent attachment pattern. These children tend to be demanding, ‘clingy and whingey’, this being their adaptive behaviour to cope with their lack of confidence that their needs will be met. Where parental responses to a child’s distress are consistently unresponsive, say irritable and controlling, these children tend to develop an avoidant attachment. They can become over self-reliant and maskers of their own distress. If the parents in these latter two insecure categories could modify their responses so that they become better attuned to their child and able to meet his/her needs, the outcome for the child could improve. The new perspective brought by Comfort Zone is the application of colour and temperature to the ABC+D model of attachment.9 (See Figure 1, below). The reason for the colour and temperature imagery is that it simplifies and pictorially represents attunement. This makes it easy to understand and less threatening to engage with.
It is hypothesised that the Comfort Zone for children is attained when parents are sensitively attuned and respond warmly to the child. This response is represented as warm in temperature and yellow in colour. Parental responses that are intrusive and controlling are characterised as hot in temperature and red in colour. Parents who are unavailable or withdrawn from their child are described as cold in temperature and blue in colour. Parental responses that are hot could cool down to be more beneficial to the child and
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conversely if responses are too cold they could warm up a little for the child’s benefit. If parents rated their responses as blue/cold, strategies were offered to help them to ‘warm up’. If parents rated their responses as red/hot, strategies were offered to help them to ‘cool down’. The Comfort Zone programme was commissioned by Barnardo’s in 2009. The rationale behind Comfort Zone was to develop an intervention that empowered parents and enabled them to provide sensitive and responsive relationships with their child. It was hypothesised that if attunement was improved, then secure attachments would also increase. In practical terms, Comfort Zone aims to help parents to understand the importance of attunement and attachment, to rate their own responses to their child and to change their responses if necessary.
Pilot study A pilot study was undertaken to see if the intervention was feasible, acceptable and useful to staff and parents. Initially, family support staff from a Children’s Centre were trained to implement Comfort Zone. Staff were asked to record parents’ ratings of their response to their child before and after the intervention. This allowed for an examination of pre and post intervention ratings. In order to quantify the changes made following the intervention, numerical values were given to all the colours (see figure 2). Staff received supervision of their work through monthly group supervision sessions with the author in addition to their individual supervision with their team manager. The use of the intervention was monitored throughout this process and amended as necessary during the pilot year. Figure 2: The numerical values assigned to the colours
Figure 3 is a summary of the parents’ scores before and after the intervention. Full data sets were available for 26 parents, all mothers. In the pre-intervention data, 13 parents rated themselves toward the blue/cold zone and 13 toward the red/hot zone, with no parents rating themselves in the comfort zone. Post-intervention, more parents rated themselves closer to the comfort zone with ten parents’ ratings in the central comfort zone and 11 rating themselves just one point away (B1=6 and R1=5) at the end of the intervention.
Figure 3: Summary of pilot data. Number of parents rating their response to their child at each colour pre and post-intervention (N=26)
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Figure 4: Points change postintervention N=26
Figure 4 below shows the direction and magnitude of change in more detail. It can be seen that seven (three in red zone and four in blue zone) out of 26 parents did not change. A total of 12 parents managed a one point change in the direction of the comfort zone (seven from the red and five from the blue zones). Five parents felt they had made a more substantial change of two points, (two from the red zone and three from the blue zone). One parent felt they had moved three points from the blue zone and one other rated themselves as having moved from the extreme red four points to the comfort zone.
Initial findings from the study were encouraging as 19 parents appeared to change their responses to be more attuned to their child after the Comfort Zone intervention. Parents reported that Comfort Zone was simple, visual and easy to understand. The focus on colours functioned really well in conveying an idea without getting caught up in language which can be difficult and threatening. They found the intervention strategies helpful and seemed to have understood how to ‘warm-up or ‘cool-down’ in order to tunein to their child. The family support team manager was positive about the intervention and the staff team valued it as an easy-to-understand universal tool.
Feedback Given these positive early findings, the intervention has been rolled out to many more children’s centres and to health visitors and nursery nurses. When staff had been trained, the author returned to conduct reflective practice sessions with the staff in order to help embed it in their practice. At one such session, the following feedback was received from a health visitor:
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‘I received a referral for a pre-school child with behavioural problems. When I met the parents, the Dad told me that he had ADHD and anger management issues. Both parents reported massive amounts of conflict between themselves. I decided to use Comfort Zone to
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see if it could help the Dad to cool down. The change was remarkable – it was as if the penny dropped. Seeing the colours helped the Dad to understand how much time he spent in the red zone and he understood that he needed to cool down. He made good use of the strategies and has managed to stay calmer longer. The couple are now able to compromise even if they don’t agree! The child’s behaviour has improved as he is in a much more stable environment.’ And secondly: ‘I was referred a mum with low mood and low self-esteem. Her life was disorganised and she found it very difficult to manage her three children. They were aged five, three and a baby under one year. She had separated from her husband but he remained supportive and involved. I was asked to help her manage her children’s behaviour. I decided to start with the mother’s mood as this seemed the biggest problem. I showed her Comfort Zone and she identified straight away that she was in the blue zone. We discussed how her mood affected her children’s behaviour as she admitted she often did not have enough energy and motivation to give them attention. They would then try harder to get her attention, which was often in the form of crying and shouting. She said that this made it even more difficult for her to give them positive attention. She realised she was now quite defensive. However, Comfort Zone offered her some strategies to ‘warm-up’ her mood and responses to the children. She seemed to be empowered as finally there was something she could use to help herself. It worked really well – she used Comfort Zone to manage her mood and before long, the children’s behaviour improved too’.
Group work A three-session, Comfort Zone, group work course has been developed for parents with young children. Instead of individual work with parents in their own home, some parents prefer the option of Comfort Zone delivered in a children’s centre to parents in small groups of approximately six. The advantage for some parents is that they are better able to concentrate when their children are in the centre’s crèche. Some of the feedback from parents who have attended the groups has been as follows: ‘I know I go into the red, I need to be able to calm myself down or do something before I get to red.’ (after the first of three sessions). ‘This has made me think more. Listening to other people’s experiences has made it more meaningful.’ (after second session). ‘This has made me more aware of my moods and I now have things I can try when either I am getting angry or feeling low.’ (after third session). ‘It has helped me recognise my feelings and given me techniques I can use.’ (after third session).
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The Comfort Zone intervention has also been delivered extensively to foster carers. Although it could be argued that foster carers are selected, trained and supported to remain in the yellow zone, what they find is that some of the children placed with them are very challenging. Foster carers report having feelings toward children in their care right across the Comfort Zone spectrum. What they are able to do is use the Comfort Zone strategies to modify their feelings so that their responses to the child are in or close to yellow. Furthermore foster carers have reported that Comfort Zone is easily understood by children. Some children coming into care, as well as struggling emotionally also have no ‘map’ for emotions. Some foster carers have used Comfort Zone to explain, contain and help children to self-regulate their emotions. They report that this is a relief for everyone.
Conclusions Since its development, Comfort Zone has been piloted and subsequently rolled out across local authority children’s centres, with health visitors, nursery nurses and foster carers. Comfort Zone groups have also been delivered for parents in various children’s centres. So far, both qualitative and quantitative data are positive, although further data are required on the hypothesised correlation between the concepts of attunement, attachment and the Comfort Zone intervention. Areas for future development include antenatal classes. Some preliminary work has already been undertaken with teenagers which has been well received. The advantages of antenatal work are twofold, Comfort Zone can be used as a preventative/early intervention so parents are informed about attunement and attachment before their baby is born thereby providing optimal conditions for a secure bond to form. In addition, as this work is antenatal, there is no even implied criticism regarding people’s ability to be parents. A further new area for potential use of Comfort Zone is in schools. The colour spectrum could be placed on a wall and children could be informed that they are likely to learn best when they are in the yellow zone. Staff trained to use Comfort Zone could then support students to use the strategies to emotionally self-regulate. One of the health visitors remarked that if schools did use it, this would simplify communication between families and agencies as all would be using the same language. Brenda McLackland is Consultant Clinical Psychologist at Barnardo’s. She can be contacted on: ComfortZone@barnardos.org.uk.
References 1. Allen, G., Early intervention, Smart Investment, Massive Savings. London: HM Government.: 2-4. 2. Van Ijzendoorn, M. et al(1992) The relative effects of maternal and child problems on the quality of the attachment: a meta-analysis of attachment in clinical samples. Child Development, 63: 840-58 3. Moss, E., Parent, S., Gosselin, C., Rousseau, D., and St Laurent, D. (1996) Attachment and teacher reported behaviour problems during the pre-school and early school age period. Development and Psychpathology, 8, 511-525. 4. Greenberg, M.T., Kursch, C.A.. Cook, E.T.,& Quamma, J.P. (1995) Promoting emotional competence in school age children: The effects of the PATHS curriculum. Development and Psychopathology, 7, 117-136. 5. see also McLackland, B., Channon, S., Fowles, K., and Jones, L., (2013) An intervention aimed at helping parents with their emotional attunement to their child. Community Practitioner 86(4); 24-27 6. Saunders, M.R. (1999) Triple P – Positive Parenting Program: Towards an empirically validated Multilevel Parent and Family Support Strategy for the prevention of behavioural and emotional problems in children. Clinical Child and Family Psychology Review 2 (2):79-90 8. Douglas, H. and Ginty, M. (2001) Solihull Approach: changes in Health Visiting Practice. Community Practitioner 74 (6) 9. Main, M., and Hesse, E., (1990) Parents’ unresolved traumatic experiences are related to infants’ disorganised attachment status: Is frightened and/or frightening parental
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behaviour the linking mechanism? In: Greenberg, M., Cicchetti, D., and Cummings, E., (eds) Attachment in the pre-school years, Chicago: Universiyt of Chicago Press: 161-182.
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