Interventions to Enhance Attachment in Vulnerable Groups

Module titleInterventions to Enhance Attachment in Vulnerable Groups
Module codePYCM035
Academic year2019/0
Credits20
Module staff

Dr Catherine Gallop (Convenor)

Duration: Term123
Duration: Weeks

10

8

5

Number students taking module (anticipated)

15

Description - summary of the module content

Module description

Applying evidence-based psychological therapies to children, young people and their families requires fundamental academic knowledge and clinical skills together with a reflective approach to practice. This module delivers the Department of Health’s Improving Access to Psychological Therapies national curriculum of specific knowledge and skills you will need in order to practice effectively as a 0-5s Therapist. You will explore how session-by-session measurement and routine outcome monitoring are fundamental components of effective practice.

This module will build on learning acquired in PYCM034 and will introduce you to evidence-based methods of working that specifically enhance parental sensitivity and infant attachment, in vulnerable parents and babies. The module will extend learning from PYCM034 about attachment problems, and provide you with the skills to begin to deliver interaction guidance using video feedback.

Workshops in the module will include teaching using a range of techniques that are focused on addressing the key ways in which parental mentalisation of the infant/child and the sensitivity of their interactions enhances parental sensitivity and promotes secure infant/child attachment, and how these support the long-term development of children between the ages of 0 to 5 years.

Workshops will explore the ways in which problems in these domains may manifest themselves, and the impact on the child’s development. It will address the key factors that contribute to optimal parental sensitivity and child attachment, and the factors that can limit development in these domains, including the attachment style of parents and deficits and failures that occur in parents’ mentalising of self and of the infant/child.

You will be trained to adopt a mentalising stance alongside an empathic, emotionally validating, attuned and supportive relationship.

You will develop competencies in the use of video feedback techniques to promote parental sensitivity and mentalisation, and secure attachment in children aged 0- 5 years, and in assessment of parent-child communication, interaction and child attachment.

Module aims - intentions of the module

The module aims for you to:

  • Obtain foundational knowledge regarding the importance of parental sensitivity, and infant/child attachment problems.
  • Develop critical knowledge of the theoretical and research literature relating to interventions to promote parental sensitivity and infant attachment including parental mentalising of the infant/child, using video feedback techniques.
  • Develop practical competencies in the engagement of parent-infant/child dyads and families in assessment, and the delivery of a video-feedback intervention, to promote sensitivity and parental mentalisation of the infant/child, and promote attachment in children from birth to age 5 years.
  • Differentiate the phenomenology, diagnostic classifications and epidemiological characteristics of attachment problems in young children ensure you develop practical competencies in evidence-based interventions to enhance attachment in vulnerable groups.
  • Understand the development of security of attachment in children and factors that influence such attachment including parental attachment style and history, mentalising capacity in parent (self, other and infant/child).
  • Understand the principles of attuned communication/interactions and guidance (e.g. being attentive; encouraging initiatives; receiving initiatives; developing attuned interactions and then ‘carefully scaffolded guidance and advice’).

The module further aims for you to:

  • Develop a critical understanding of the phenomenology, diagnostic classifications and epidemiological characteristics of attachment problems in young children.          
  • Develop a critical understanding of the development of security of attachment in children and factors that influence such attachment including parental attachment style and history, mentalising capacity in parent (self, other and infant/child).
  • Develop a critical understanding of the use of video feedback techniques to promote attachment, with specific reference to use of video feedback.
  • Acquire knowledge about the style and structure of video feedback, including the number, length and frequency of sessions; requirements in terms of parental involvement; and expectations of the young child.
  • Acquire an overview of a typical video feedback session structure should be provided (e.g. Review of areas of progress and concerns since last meeting; feedback of selected video-clips with the aim of supporting the parent to see what they are doing to enhance interactions with their child) and key stylistic features of video feedback (e.g. Identification of goals; reframing these goals to focus on enhancing parent-child interaction, clips selected to show attuned interaction and to match parent's goals, professional modelling of attuned interaction with the parent, helping them become active in their own change while supporting them with new ideas).
  • Use competently principles of attuned communication/interactions and guidance (e.g. being attentive; encouraging initiatives; receiving initiatives; developing attuned interactions and then 'carefully scaffolded guidance and advice'.
  • Assess competently attachment problems in young children.
  • Assess competently the suitability of the dyad for video feedback intervention.
  • Develop skills in adopting an overall mentalising stance with parents/guardians that holds caregiver and infant/child in mind and embeds assessment and therapeutic interventions in an empathic, emotionally validating, supportive relationship.
  • Be able to explain the principles of engagement of a caregiver and infant/child in a therapeutic assessment and/or treatment.
  • Be able to explain the principles and general procedures of video feedback to parents/guardians responsible for informed consent to treatment including.
  • Develop shared goals with the parents.
  • Enable you to set up filming sessions in a way which maximises the likelihood of attuned interaction between infant/young child and caregiver in accordance with the families helping question, and microanalyse videoclips in order to edit and select clips that demonstrate the principles of attunement and/or the families goal/helping question; delivery of a shared review session (7-step model) to attuned interaction) including skills related to the feedback process (e.g. Stopping the film for the purpose of discussion); development of an attuned dialogue between guider and family (e.g. Guider modelling attuned interactions); and co-creation of new meanings, solutions and change (e.g. The use of naming; exploring; reflecting; appraising and challenging on the part of the guider).
  • Enable you to deal with ending therapy and planning for long-term maintenance of gains with evidence of relapse prevention plan.
  • Enable you to use supervision to support the learning and delivery of video feedback.
  • Enable you to sensitively use video feedback for different case scenarios (e.g. Couples, the use of an interpreter, twins).
  • Enable you to use clinical measurement to monitor video feedback process and outcome.
  • Enable you to recognise difficulties that require referral for specialist intervention instead of, in addition to or following cyp-iapt intervention (e.g. Adult psychiatric/individual psychological therapies input alongside dyadic/family based cyp-iapt work).

Intended Learning Outcomes (ILOs)

ILO: Module-specific skills

On successfully completing the module you will be able to...

  • 1. Synthesise theory and practice in planning, delivering and reflecting attachment based work for 0-5s for children, young people and families
  • 2. Apply the core competencies in attachment-based work for 0-5s, for children, young people and families
  • 3. Identify how you meet the relevant specific competency standards in PST for children, young people and families
  • 4. Evaluate the use of routine outcome monitoring in PST practice

ILO: Discipline-specific skills

On successfully completing the module you will be able to...

  • 5. Address systematically complex therapy practice problems that may be framed within unpredictable contexts, thinking critically, creatively, and independently
  • 6. Critique the wider ethical and professional issues encountered within psychological therapy practice

ILO: Personal and key skills

On successfully completing the module you will be able to...

  • 7. Appraise your personal strengths and weaknesses in training and experience, and reflect upon the implications for your further training needs
  • 8. Function independently and reflectively as a learner and practitioner

Syllabus plan

Syllabus plan

This module is taught through weekly whole day workshops and half-day small group tutorials in terms two and three. Topics derived from the Incredible Years Parent Training Programme will form the core content of the workshops. There will be plenty of opportunities for skills practice and discussion of clinical issues through simulation and problem-based learning.

Learning and teaching will be through lectures, role-plays, and small group discussions. These will last from 09:30 to 16:30. In addition, they will be supplemented by e-learning material and experience of assessment and treatment of patients within the workplace.

Teaching will be provided by module tutors, with some experts where appropriate. The reflective personal and professional portfolio encourages you to use reflective practice. Reflected practice will be integrated as part of training throughout the module.

In addition video supervision will enable you to learn to fine tune new techniques and develop a reflective style to your therapy. Feedback and outcome measures from the therapy session will guide discussion in therapy.

Research for case reports, essays and reading will provide you with further academic knowledge and critical appraisal skills.

Furthermore, you will receive written feedback from supervisors each term regarding your strengths and areas for further development.

Learning and teaching

Learning activities and teaching methods (given in hours of study time)

Scheduled Learning and Teaching ActivitiesGuided independent studyPlacement / study abroad
1133750

Details of learning activities and teaching methods

CategoryHours of study timeDescription
Scheduled Learning and Teaching57Lectures and workshops
Scheduled Learning and Teaching28Clinical supervision at UoE
Scheduled Learning and Teaching28Clinical skills tutorials
Guided Independent Study37Guided independent study and clinical preparation
Placement50Clinical practice

Assessment

Formative assessment

Form of assessmentSize of the assessment (eg length / duration)ILOs assessedFeedback method
Self-rating of baseline specific therapy competencies20 minute discussion in supervision 1-3, 5-6Oral
Therapy practice competency Video clips presented in supervision minute session recording1-3, 5-6Written

Summative assessment (% of credit)

CourseworkWritten examsPractical exams
25075

Details of summative assessment

Form of assessment% of creditSize of the assessment (eg length / duration)ILOs assessedFeedback method
Therapy practice competency tape B and reflective log of individual work (this assessment must be passed; failure in this assessment will lead to failure in the module and the programme)2560 minute session recording1-3, 5-7Written
Therapy practice competency tape C and reflective log (this assessment must be passed; failure in this assessment will lead to failure in the module and the programme)2560 minute session recording1-3, 5-7Written
Case report B (individual Video Interaction Guidance case) (this assessment must be passed; failure in this assessment will lead to failure in the module and the programme)253000 words1, 4, 6, 8Written
Extended case report C (this assessment must be passed; failure in this assessment will lead to failure in the module and the programme)255000 words1, 4, 6, 8Written
Practice portfolio – this is an assessment of competency and is pass/fail only (this assessment must be passed; failure in this assessment will lead to failure in the module and the programme)06000 words1-3, 5, 7Written

Re-assessment

Details of re-assessment (where required by referral or deferral)

Original form of assessmentForm of re-assessmentILOs re-assessedTimescale for re-assessment
Therapy practice competency tape B and reflective logTherapy practice competency tape B and reflective log1-3, 5-712 weeks after written feedback
Therapy practice competency tape C and reflective logTherapy practice competency tape C and reflective log1-3, 5-712 weeks after written feedback
Case report BCase report B1, 4, 6, 8Four weeks after written feedback
Extended case report CExtended case report C1, 4, 6, 8Four weeks after written feedback
Practice portfolioPractice portfolio1-3, 5-7Nine weeks after written feedback

Re-assessment notes

Five assessments are required for this module. In all cases re-assessment will be the same as the original assessment. Where you have been referred/deferred for any form of assessment detailed above you will have the opportunity to resubmit within the period specified above from the date that feedback was provided.

If you pass re-assessments taken as a result of deferral, your re-assessment will be treated as it would be if it were your first attempt at the assessment and the overall module mark will not be capped.

If you pass re-assessments taken as a result of referral (i.e. following initial failure in the assessment), the overall module mark will be capped at 50%.

If you fail re-assessments taken as a result of referral (i.e. following initial failure in the assessment), you will be failed in the module and as a consequence you will be failed in the programme and your registration as a student of the University will be terminated.

Resources

Indicative learning resources - Basic reading

  • Child IAPT National curriculum (2012). London: Department of Health
  • Scott, S and Dadds, M (2009) When parent training doesn’t work: Theory-driven clinical strategies. Journal of Child Psychology and Psychiatry 50, 1441-1450
  • Webster-Stratton, C. (2008). Collaborating with Parents to Reduce Children's Behavior Problems: A book for Therapists Using the Incredible Years Programs. Seattle: IY Press.

Indicative learning resources - Web based and electronic resources

  • ELE page: http://vle.exeter.ac.uk/course/view.php?id=7173 (All resources will be made available on ELE. This includes additional material covered in the tutorials, the required readings, information about assessment and additional material (e.g., videos).)

Module has an active ELE page

Indicative learning resources - Other resources

  • DVD/audio competency clips from IAPT and University of Exeter teaching team.

Key words search

Supervision, young people, children, improving access to psychological therapies, IAPT, cognitive behaviour therapy, parenting, competency assessment, 0-5s

Credit value20
Module ECTS

10

Module pre-requisites

None

Module co-requisites

None

NQF level (module)

7

Available as distance learning?

No

Origin date

01/12/2016

Last revision date

17/01/2018