Attachment-based intervention programs to prevent transgenerational trauma: “SAFE - Safe Attachment Formation for

Attachment-based intervention programs
to prevent transgenerational trauma:
“SAFE® - Safe Attachment Formation for
Educators” and
“B.A.S.E.® – Babywatching“
Karl Heinz Brisch
Dr von Hauner Children's Hospital
Department of Pediatric Psychosomatics and Psychotherapy
University of Munich/Germany
Email: [email protected]
www.khbrisch.de
Please, pay attention!
• No fotos, audio- or video-recordings are
permitted due to copyright and data
protection rights.
• Thank you for your understanding!
© Copyright K. H. Brisch Munich/Germany 2013. All rights reserved.
Homepage
www.khbrisch.de/en
• Downloads
– Slides of presentation –
Brisch_SAFE_BASE_Amsterdam_210913
© Copyright K. H. Brisch Munich/Germany 2013. All rights reserved.
SAFE
®
A primary Preventive Parenting Program to
Promote Secure Parent-Child Attachment
Relationships
K. H. Brisch
Dr von Hauner Children's Hospital
Department of Pediatric Psychosomatics and Psychotherapy
University of Munich/Germany
Overview
•
•
•
•
Introduction - attachment theory
Contents, goals and results of SAFE
Preliminary research data
Outlook and further perspectives
Copyright K. H. Brisch Munich/Germany
The development of attachment
according to John Bowlby‘s
attachment theory
• An infant develops a specific emotional
attachment to a primary attachment figure
during the first year of life
• The attachment figure represents a
„secure emotional haven – a secure base“
for the infant
Copyright K. H. Brisch Munich/Germany
Intergenerational transmission of
attachment
• Connection between
attachment of the parents and the child
– Secure parents with secure children
• mother-child approximately 75%
• father-child approximately 65%
– Insecure parents with insecure children
– Traumatized parents with disorganized children
– Children who are maltreated by their traumatized
parents during infancy will develop attachment
disorders
Copyright K. H. Brisch Munich/Germany
Unprocessed parental trauma
• Interactional disorder and disorders of
affective communication with the infant
– prenatal and postnatal
• Fearful behavior by the mother
• Fear-inducing behavior by the mother
• Helpless caregiving by the mother
Copyright K. H. Brisch Munich/Germany
Aims of primary prevention
• Promotion of healthy psychological development of
parents and children
• Development of secure quality of attachment
• Enhancement of parental sensitivity for the emotional
needs of their infants
• Enhancement of emotional availability and sensitivity for
their infant's signals
• Processing and working through of unresolved parental
traumata
• Breaking of vicious circles or re-enactment of trauma
• Stop transmission of violence from generation to
generation
Copyright K. H. Brisch Munich/Germany
The Research Projekt
• Randomized controlled prospective longitudinal
study
• Intervention group (SAFE®) vs. control group
(GUSTA)
• Multi-method measurement
• Five time points of measurement
– Before child birth
– After child birth
– 6, 9 and 12 months of infant‘s age
© Copyright
Copyright
ErhardtErhardt
I & Brisch
I & Dr.
K H,
Brisch
LMUKH,
Munich 2011
LMU Munich
Intervention
• SAFE® = Safe Attachment Formation for Educators
• Attachment based manualized parenting program
• Aim
– improvement of secure attachment and reduction of disorganized
attachment
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Beginning: 20th – 28th week of gestation
End: 12 months of infant‘s age
10 seminar days on Sundays (4 pre, 6 post)
Closed group setting with becoming mothers, fathers and
babies
• Two trained mentors leading the group
© Copyright Erhardt I & Brisch K H, LMU Munich 2011
Participation in SAFE
• Pregnant women and their partners
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First time mothers
Second and more time mothers
Single and adolescent mothers
Motivation for the emotional development of their
infant
– High motivation during pregnancy
– Ideal wishes for a new healthy start with each baby
– Reflection on own childhood and on relationship with
own parents
Copyright K. H. Brisch Munich/Germany
Modules and methods
• Module 1:
– Parent-groups
• Module 2:
– Individual trauma-psychotherapy
• Module 3:
– Video-Feedback sensitivity training
• Module 4:
– Crisis-Hotline
Copyright K. H. Brisch Munich/Germany
Modul 1: Prenatal parent-groups
• Contents (video-based teaching)
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Fantasies and anxieties of parents
Prenatal bonding
Competencies of infants and parents
Role expectancies and models of parents
Parent-infant interaction and general video-based
sensitivity training
– Relaxation, impuls control and stabilisation techniques
Copyright K. H. Brisch Munich/Germany
Modul 1: Postnatal parent-groups
• Contents (video-based teaching)
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Processing of birth experience
Postpartum Depression
Parental competencies
Triangulation mother-father-infant
Interactional problems (crying, feeding, sleep)
Parental bonding, infant attachment and exploration
Copyright K. H. Brisch Munich/Germany
Modul 2: Individual traumapsychotherapy
• Infants and children can trigger parental
unresolved traumatic experiences from their
past ("ghost in the nursery")
• Individual trauma-psychotherapy for
mother/father/partner (unresolved trauma!)
• Prevention of re-enactment of unresolved
trauma with own child
Copyright K. H. Brisch Munich/Germany
Modul 3: Video-feedback sensitivity
training
• Enhancement of sensitivity for infants'
signals
• Before birth: General training with videoclips of unknown parents and infants
(crying, feeding, changing napies, playing)
• After birth: Individual training with videoclips of their own mother/father-child
interaction
Copyright K. H. Brisch Munich/Germany
Modul 4: Crisis-hotline
• Individual guidance and councelling in case of
crisis "emergency" (crying through the night)
• By telephone, mobile phone, e-mail
• Emotional security for parents
• Parents know SAEF-mentor from SAFE-group
• Reinforcement of parental competencies and
parental self-confidence
Copyright K. H. Brisch Munich/Germany
Summary of Research Results
SAFE ®-Program 2011-2012
Attachment Representation of Pregnant
Women and Postnatal Depression - Methods
• Objectives:
– How do attachment representations of pregnant women relate to
postnatal depression?
– How does the intervention SAFE® impact on mothers’ postnatal
depression rate compared to the control group?
• Participants:
– a non-clinical sample
– Randomly assigned
– N = 41 mothers in SAFE® and N = 23 mothers in control group
• Methods:
– 3 months prenatal: Adult Attachment Projective Picture System
(AAP; George et al. 1997)
– Prenatal and 3 months postnatal: Edinburgh Postnatal Depression
Scale (EPDS; Cox et al., 1987) (self-report measure)
Attachment Representation and Postnatal
Depression- Results
1. In this sample 46% (n = 19) have a secure
and 73% (n=30) have resolved attachment
representation prenatal.
no significant
difference between the groups in terms of
attachment representation categories
• their attachment representation is not
related (n.s.) to their depression score at
baseline in pregnancy (EPDS)
2. Preliminary data show, when looking
postnatally only at those with a depression
score of ≥ 10 (cutoff for clinically relevant
depression) that the number of affected
women goes down to 1/6 in the SAFE® group
(fig. 2)
postnatally there is a marginal significant
difference between the groups (p ≤ .10;
Fisher‘s Exact Test).
Attachment Representation of Pregnant
Women and Postnatal Depression Discussion
• Conclusion:
– Women who show higher levels of depressive
symptoms during pregnancy are more likely to report
normal EPDS-scores postnatally if they were part of
the SAFE® group.
• Limitations:
– small sample size.
– preliminary results
• Future prospects:
– To investigate, how these findings interact with
parental sensitivity and infants´ attachment quality
post-intervention
Study
Attachment representation of becoming
mothers and child birth experience
Attachment representation of becoming mothers and
child birth experience - Methods
• Objectives:
– Is there an association between prenatal attachment status
(unresolved vs. resolved) and stressful birth experience?
• Participants:
– N = 120 becoming parents (here: mothers only)
– Non-clinical sample
• Methods:
– Randomized controlled trial
– Longitudinal study (ongoing study)
– 4 measure points in total (in this study: 2 measure points only)
•
•
1) 3 months prenatal (AAP)
2) 3 months postnatal (IES)
Attachment representation of becoming mothers and
child birth experience - Instruments
• Attachment measure:
– Adult Attachment Projective Picture System (AAP;
George et al. 1997)
Attachment Representation (F, Ds, E, U)
– prenatally: start of intervention
• Questionnaire:
– Impact of Event Scale (IES; Horowitz et al. 1979; dt. Hütter &
Fischer 1997)
„Avoidance“ scale, „Intrusion“ scale and total
score
– 3 months after child birth
– Event to rate by participants: „child birth“
Attachment representation of becoming mothers and
child birth experience - RESULTS
• Attachment (AAP) status before childbirth:
• N = 36 (62,1 %) „resolved“ (F, Ds, E)
• N = 22 (37,9 %) „unresolved“ (U)
• Impact of Event Scale (IES) after childbirth:
• Unresolved mothers have higher scores for intrusion (M
= 8.00; SD = 7.40) than resolved mothers (M = 4.25; SD
= 5.39) and
• Unresolved mothers have higher scores for avoidance
(M = 3.23; SD = 7.28) than resolved mothers (M = 0.89;
SD = 1.92).
•
Statistical analyses were controlled for birth
complications
Attachment representation of becoming mothers and
child birth experience - Discussion
• Conclusions:
– Mothers with „unresolved“ attachment representation
experience giving child birth as more stressful and more
intrusive
– Relatively high proportion of mothers in the „unresolved“
category for a non-clinical sample
• Limitations:
– Preliminary data (Study is ongoing)
Study
Attachment, trauma and stress in
pregnant women before childbirth
Attachment, trauma and stress in pregnant
women before childbirth - Hypotheses
1) Attachment measurements are an eligible
stressor of the attachment system and
therefore to measure cortisol levels
1) Unresolved trauma as attachment
representation as well as the experience of
traumatic events are associated with higher
cortisol levels indicating physiological stress
Attachment, trauma and stress in pregnant
women before childbirth- Methods
• Attachment measures:
– Adult Attachment Interview (AAI; Main et al., 1982)
– Adult Attachment Projective (AAP; George et al. 1997)
• Trauma Questionnaires (self-report):
– Trauma Antecendents Questionnaire (TAQ; v.d. Kolk 1997)
– Posttraumatic Stress Diagnostic Scale (PDS; Foa et al. 1995)
• Cortisol levels :
– AAI and AAP as stressors (pre and post)
– Saliva measurements
– 4 times in a sequence
Copyright Erhardt I & Dr. Brisch KH, LMU Munich
Attachment, trauma and stress in pregnant
women before childbirth- Results
1. Frequency of attachment representations
(measured with AAP)
2. Frequency of attachment representations
and experienced traumatic events (AAP
and PDS)
3. Mean differences in unresolved vs.
resolved subjects in cortisol levels to
emotional stressors (AAI and AAP)
Attachment, trauma and stress in pregnant women
before childbirth- Results (3)
• Expectant mothers with an
unresolved attachment
representation (AAP) had
significantly (p ≤ 0.05) higher
cortisol levels before and after
the AAI (1st and 2nd
measurement) than those with
an resolved attachment
representation
Mean
SD
Resolved pre
4.43
1.57
Unresolved
pre
5.06
3.68
Resolved post
3.59
1.31
Unresolved
post
3.85
2.24
F
df
p
pre AAI
8.7
50
.005
post AAI
4.83
50
.032
Copyright Erhardt I & Dr. Brisch KH, LMU Munich
Attachment, trauma and stress in pregnant women
before childbirth - Discussion
• Unresolved trauma states as attachment
representations in pregnant women are
associated with increased cortisol levels but
not in subjects with a resolved representation
(p ≤ 0.05)
• But mothers with unresolved status of
attachment in respect to trauma did not show a
clinical relevant PTSD
Copyright Erhardt I & Dr. Brisch KH, LMU Munich
Attachment, trauma and stress in pregnant
women before childbirth - Conclusions
• Attachment assessment may be more
sensitive for detecting unresolved trauma in
mothers and therefore influence the
attachment development of the infant.
• Self-assessment measure might not be
sensitive enough as denial and resistance to
self-disclosure can easiliy be controlled by
the subjects
Copyright Erhardt I & Dr. Brisch KH, LMU Munich
SAFE
- Mentor
Multiplikatoren
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• Training for health professionals
• "hands on experiences" with parents and babies
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Midwifes
Pregnancy counsellors
Nurses
Obstetricians
Psychologists
Pediatricians
Counsellors
Child- and adolescent psychotherapists/-psychiatrists
And others Copyright K. H. Brisch Munich/Germany
Innovation
• Early start in pregnancy
• Continuation at least till end of first year of
infant's life
• Effects of group coherence
• Combination of advantages of group effects and
individual support
• Crisis-hotline to prevent acut acting-out
• Preventive individual trauma-psychotherapy
• No discrimination of high-risk parents
• Integration of fathers or partners
© Copyright K. H. Brisch Munich/Germany 2013. All rights reserved.
SAFE-Specials
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Parents with multiple risks ("high risk parents")
Adoptive and foster parents
Parents of premature infants
Nurses and parents in daycare centres, kindergarten,
schools
Nurses in mother-infant homes
Parents with psychiatric disorders
Parents with addiction to drugs
Staff and parents in child protective institutions
Immigrant parents with their children after experiences of
torture and extreme violence
© Copyright K. H. Brisch Munich/Germany 2013. All rights reserved.
SAFE-International
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Austria
Switzerland
New Zealand
Australia
Singapore
USA
Latvia
Russia
© Copyright K. H. Brisch Munich/Germany 2013. All rights reserved.
Reference
Brisch, Karl Heinz (2002/2012)
Treating Attachment Disorders.
From Theory to Therapy.
Second Edition 2012
SAFE-Book
Many translations
© Copyright K. H. Brisch Munich/Germany 2013. All rights reserved.
DVD and Homepage
• DVD "Embracing Closeness„ (Eng)
• DVD "BASE – Babywatching" (Eng)
– Kindergarten
– School
• DVD "Strange Situation„ (Eng)
• DVD SAFE (in German only)
www.safe-programm.de
www.base-babywatching.de
© Copyright K. H. Brisch Munich/Germany 2013. All rights reserved.
B.A.S.E.®-Babywatching
A programme to prevent aggressive and anxious
behaviour problems and to promote empathy
Karl Heinz Brisch
Dr. von Hauner Children's Hospital
Department of Paediatric Psychosomatic Medicine and Psychotherapy
Ludwig-Maximilians-University Munich
[email protected]
© Copyright K. H. Brisch Munich/Germany 2013. All rights reserved.
B.A.S.E.
®
Babywatching
Karl Heinz Brisch
Kinderklinik und Kinderpoliklinik
im Dr. von Haunerschen Kinderspital
Abteilung Pädiatrische Psychosomatik und Psychotherapie
Ludwig-Maximilians-Universität München
B
A
S
E
= Babywatching
= Against Aggression and Anxiety
= For Sensitivity
= For Empathy
www.base-babywathing.de
www.base-babywatching-frankfurt.de
© Copyright K. H. Brisch Munich/Germany 2013. All rights reserved.
Babywatching in Kindergarten and
schools
Overview
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Theoretical background
Programme
Training by video and life observation
Results from research to date
Costs
Further perspectives
Roots of Empathy
© Copyright K. H. Brisch Munich/Germany 2013. All rights reserved.
Henri Parens – A Pioneer
• Healing from the Holocaust
• Autobiographie
© Copyright K. H. Brisch Munich/Germany 2013. All rights reserved.
Aggression theory according to
Henri Parens I
• Types of aggression
- Positive healthy aggression as „exploration“
- Negative hostile aggression against others
© Copyright K. H. Brisch Munich/Germany 2013. All rights reserved.
Aggression theory according to
Henri Parens II
• Cause of hostility
- Massive rejection and disregard of basic needs
of the child by caregivers
- Missing empathy in thoughts, feelings and
actions of children
© Copyright K. H. Brisch Munich/Germany 2013. All rights reserved.
Prevention programme
• Goals
- Ability for empathy
- Preventing hostility
• Modules for pupils and teachers
- From Kindergarten to grade 12 or 13
- Significant reduction of aggressive
behaviour in comparison to control groups
© Copyright K. H. Brisch Munich/Germany 2013. All rights reserved.
Kindergarten Programme
Baby-watching I
• Groups of children watching an infant in
interaction with his/her mother/father
• Starting shortly after birth till approx. end of
first year
• Up to autonomous walking and first words
© Copyright K. H. Brisch Munich/Germany 2013. All rights reserved.
Kindergarten Programme
Baby-watching II
• Instruction for baby-watching by educators
• One educator leads the group, while another
leads the watching
• Monitoring of protocol
• Frequency
- 1 x weekly
- Circle of chairs
- Duration approx. 20-30 minutes
© Copyright K. H. Brisch Munich/Germany 2013. All rights reserved.
Training of empathy
• Sensitivity for other people‘s
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Thoughts
Actions
Motivations
Feelings and emotions
• Selfereflective capacity of mentalizing
– „I think that you think that I think…“
– „I feel that you feel that I feel…“
© Copyright K. H. Brisch Munich/Germany 2013. All rights reserved.
Sensitivity (1)
• The caregiver with the highest sensitivity
during interaction will become the infant‘s
major attachment person.
• A high parental sensitivity will enhance the
development of a secure attachment of the
infant.
© Copyright K. H. Brisch Munich/Germany 2013. All rights reserved.
Sensitivity (2)
• The caregiver has to
– perceive the infant’s signals
– interpret correctly the infant’s signals
– react properly
– react promptly
to the infant‘s signals
© Copyright K. H. Brisch Munich/Germany 2013. All rights reserved.
Gaze
• Reciprocal gaze with affect attunement
between infant and caregiver promotes
secure attachment (intersubjectivity)
© Copyright K. H. Brisch Munich/Germany 2013. All rights reserved.
Verbal Interaction
• Support of secure attachment
by verbalization
– of the „inner world“ of affective situations
– of the infant‘s action context
© Copyright K. H. Brisch Munich/Germany 2013. All rights reserved.
Rhythm of interaction
in action and language
• Support of secure attachment by
– reciprocal change in mother-infant-interaction
and communication
– correction of mismatches
• insecure attachment
– via hyper-synchronous interaction and
communication
– absolutely asynchronous interaction
© Copyright K. H. Brisch Munich/Germany 2013. All rights reserved.
Touch
• Sensitive touch/massage between infant and
caregiver promotes secure attachment
• Hormon oxytocin
© Copyright K. H. Brisch Munich/Germany 2013. All rights reserved.
Levels of babywatching
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Behavior
Motivation
Emotion
Identification
Empathy
© Copyright K. H. Brisch Munich/Germany 2013. All rights reserved.
Level of babywatching I
• Level of behavior
– What does the baby do?
– What does the mother/the father do?
© Copyright K. H. Brisch Munich/Germany 2013. All rights reserved.
Level of babywatching II
• Level of motivation
– Why does the baby behave in this way?
– Why does the mother/the father behave in this
way?
© Copyright K. H. Brisch Munich/Germany 2013. All rights reserved.
Level of babywatching III
• Level of emotions
– How does the baby feel in this situation?
– How does the mother/the father feel in this
situation?
© Copyright K. H. Brisch Munich/Germany 2013. All rights reserved.
Level of babywatching IV
• Level of identification with behavior
– What would I do in this situation, if I am the
baby?
– What would I do in this situation, if I am the
mother/the father?
© Copyright K. H. Brisch Munich/Germany 2013. All rights reserved.
Level of babywatching V
• Level of identification with emotions –
level of empathy
– How would I feel in this situation, if I am the
baby?
– How would I feel in this situation, if I am the
mother/the father?
© Copyright K. H. Brisch Munich/Germany 2013. All rights reserved.
Pitfall and failures
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No programme of developmental psychology
No teaching with blackboard
No teacher – caring for baby
No student – touching, holding, cudling the baby
No focus on baby only and developmental steps
BUT always:
Focus is on mother/father-infant-interactions
© Copyright K. H. Brisch Munich/Germany 2013. All rights reserved.
Results Kindergarten I
• RTC-Study
• Behaviour assessment of the children
(N=50, age M=50 months) by
- Educators
- Parents
- Test at start and finish of intervention
- Comparison between control group (without
intervention) and intervention group
© Copyright K. H. Brisch Munich/Germany 2013. All rights reserved.
Results II
• Improvements in the intervention group
- Assessed by educators (CBCL)
• Boys
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Less aggressive behaviour
Less oppositional behaviour
Improved alertness
Less social withdrawal
More emotional reactivity
Less „anxious-depressed“
© Copyright K. H. Brisch Munich/Germany 2013. All rights reserved.
Results III
• Improvements in the intervention group
- Assessed by educators (CBCL)
• Girls
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Fewer physical complaints
Improved alertness
Less social withdrawal
More emotional reactivity
Less „anxious-depressed“
© Copyright K. H. Brisch Munich/Germany 2013. All rights reserved.
Results IV
• Improvements in the intervention group
- Assessed by parents (CBCL)
• Boys
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Less aggressive behaviour
Improved alertness
Less social withdrawal
More emotional reactivity
© Copyright K. H. Brisch Munich/Germany 2013. All rights reserved.
Results V
• Improvements in the intervention group
- Assessed by parents (CBCL)
• Girls
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less sleeping problems
Improved alertness
Less social withdrawal
More emotional reactivity
© Copyright K. H. Brisch Munich/Germany 2013. All rights reserved.
Results VI
• Additional improvements in the
intervention group
• Assessed by educators
- Attachment behaviours
- Looking for comfort from caregiver
- Applying the method of baby watching and
sensitivity of play with one another
© Copyright K. H. Brisch Munich/Germany 2013. All rights reserved.
BASE-School
• RCT Studie (Haneder, 2011)
• N=250 students, Tyrol/Austria primary
schools (N=123 in intervention-groups,
N=127 in control-groups)
• Strengths and Difficulties Questionnaire
• Pre-Post-Intervention
• Duration of intervention: 9 month
© Copyright K. H. Brisch Munich/Germany 2013. All rights reserved.
Results: Parents and Teachers
• Significant improvements in interventiongroups
– Emotional problems
– Prosocial behavior
– Total index of behavior problems
© Copyright K. H. Brisch Munich/Germany 2013. All rights reserved.
Improvement
Emotional behavior problems
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Anxious-depressive
Withdrawal
Somatoforme complaints
Sleep-problems
Anxiety disorders
© Copyright K. H. Brisch Munich/Germany 2013. All rights reserved.
Improvement
Prosocial behavior
• Empathy in behavior
• Social competence
© Copyright K. H. Brisch Munich/Germany 2013. All rights reserved.
Improvement
Externalizing behavior
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Aggression
Attention deficit
Oppositional behavior
Hyperactivity
© Copyright K. H. Brisch Munich/Germany 2013. All rights reserved.
Improvement
Global index of behavior problems
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Aggression
Hyperactivity
Emotional problems
Problems in interactions with peers
© Copyright K. H. Brisch Munich/Germany 2013. All rights reserved.
Summary
• Overall positive effects for both boys and
girls
• Positive changes of externalising and
internalising disturbances
• Similar positive assessments made by
educators and parents
© Copyright K. H. Brisch Munich/Germany 2013. All rights reserved.
Summary II
• For all involved, an emotionally positive
experience
• Noticeable generalisation of the mode of
baby-watching during play with one another
• Preventive intervention at minimal cost
© Copyright K. H. Brisch Munich/Germany 2013. All rights reserved.
Outlook
• More widespread introduction and testing of
programme
• Testing in social areas with high risk
families
• Testing in other age groups
• Follow-up programme
© Copyright K. H. Brisch Munich/Germany 2013. All rights reserved.
Costs of B.A.S.E.® -Training
• BASE-Group-Leader
– One day training of kindergarten or school teacher –
approx. 50 Euros/person
• Supervision by BASE-Mentor
– One day training for Group-Leaders –
approx.120 Euros/person
– Individual prize for supervision
• BASE-Trainer
– In progress: 2 day training - approx 200 Euros/person
© Copyright K. H. Brisch Munich/Germany 2013. All rights reserved.
Costs of running B.A.S.E.® - courses
in kindergarten and schools
• NONE
– For teacher
– For institution
– For parents
• Cost for supervision
– Recommendation: Mentoring/supervision by BASE-Mentor –costs
depending on contract
– Video supervised by mentor
• Mother and baby are not paid
• Number of children in intervention
– As many as one teacher addresses
– Each teacher can run more courses
© Copyright K. H. Brisch Munich/Germany 2013. All rights reserved.
Training-Grades
• BASE-Group-Leader (1day training)
– Running BASE-Groups by her/himself in school and
kindergarten classes
• BASE-Group-Mentor (1-2 day training)
– Hands-on experience with group-leading
– Supervision of group-leaders
• BASE-Group-Trainer (1-2 day training)
– Extended hands-on experiences with groups and
mentoring
– Training of group-leaders
– Supervision of group-leaders and mentors
© Copyright K. H. Brisch Munich/Germany 2013. All rights reserved.
B.A.S.E.® -International
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Germany
Austria
Switzerland
Belgium
Netherlands
Italia
New Zealand
Australia
UK
In progress: Ukraine, Korea, Latvia, Russia
© Copyright K. H. Brisch Munich/Germany 2013. All rights reserved.
Steps towards a BASE-group (1)
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Do a BASE-Group-Leader training
Find an institutional partner and sponsor
Find a kindergarten or school
Inform parents and children
Do advertising
Find a mother/father with a baby
Organize cooperation with local partners e. g. obstetrians, midwifes,
media
• Ask for mentoring/supervision if needed
• Do documentation
• Do research and evaluation pre-post-intervention e. g. with Strength
and Difficulties Questionnaire – SDQ (Goodman)
© Copyright K. H. Brisch Munich/Germany 2013. All rights reserved.
Roots of Empathy
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Canadian Programme – Mary Gordon
Infant Development
Teaching Book
Baby and Mother visit ones a months
Handling the baby, touching, cudling
Results – research papers
– No clear methods, results to doubt
• See critical report in the internet
• Making money
• Benefit not clear from research results
© Copyright K. H. Brisch Munich/Germany 2013. All rights reserved.
DVD
• DVD SAFE "Embracing Closeness"
• DVD "BASE – Babywatching"
• Available for sale after presentation
and after workshop or over the
internet – s. webpages
© Copyright K. H. Brisch Munich/Germany 2013. All rights reserved.
Homepages
• www.safe-programm.de/en
• www.base-babywatching.de/en
• www.khbrisch.de/en
© Copyright K. H. Brisch Munich/Germany 2013. All rights reserved.
John Bowlby (1980)
• Intimate attachments to other human beings are the hub
around which a person's life revolves, not only when he is
an infant or a toddler or a schoolchild but throughout his
adolescence and his years of maturity as well, and on into
old age. From these intimate attachments a person draws
his strength and enjoyment of life, and, through what he
contributes, he gives strength and enjoyment to others.
These are matters about which current science and
traditional wisdom are at one.
• We may therefore hope that, despite all its deficiencies, our
present knowledge may be sound enough to guide us in our
efforts to help those already beset by difficulty and above
all to prevent others becoming so.
• In J. Bowlby (1980) Attachment and loss. Vol. III: Loss: Sadness and
depression (pp. 442). New York: Basic Books.
© Copyright K. H. Brisch Munich/Germany 2013. All rights reserved.
Empathy and Loving Care
Author and lecturer Leo Buscaglia once talked about a contest
he was asked to judge. The purpose of the contest was to find
the most caring child.
The winner was:
A four-year-old child, whose next door neighbour was an
elderly gentleman, who had recently lost his wife. Upon seeing
the man cry, the little boy went into the old gentleman's yard,
climbed onto his lap, and just sat there.
When his mother asked him what he had said to the neighbour,
the little boy just said, 'Nothing, I just helped him cry.'
© Copyright K. H. Brisch
Munich/Germany 2013. All rights
reserved.
Reference
• Brisch, K. H. (2012)
Treating Attachment Disorders
(2nd edition)
Guilford Press, New York, London
© Copyright K. H. Brisch Munich/Germany 2013. All rights reserved.
International Conference
11. - 13. October 2013 in Munich
Attachment and
Psychosomatics
Information and Programme
Email to:
[email protected]
www.khbrisch.de
© Copyright K. H. Brisch
Munich/Germany 2013. All rights
reserved.
Thank you for your
attention!
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