Tag Archives: family counseling

The lingering influence of attachment

By Laurie Meyers June 25, 2018

A few years ago, American Counseling Association member Lisa Bennett took a trip to Southeast Asia. While there, she thought it would be fun to visit an elephant sanctuary where sick and injured animals had been sent to heal. What she saw fascinated her. The elephants engaged in attachment behavior.

Among herds, young elephants are raised not just by their mothers but by an older female who has already had babies and “retired,” moving on to another tribe. These older females return to their original herd, however, to serve as nannies to the young elephants. Bennett noticed that the nanny elephants seemed to be teaching the mother elephants how to connect with their calves.

“Nannies will literally push the mother toward the calf when the calf is in need and will model to the mother the actions to take to secure the calf’s safety and security,” Bennett says. The calves still viewed the mothers as their primary attachment figures but also displayed an attachment to the nanny elephants.

Of course, as a professor and director of clinical mental health counseling at Gonzaga University in Washington state, Bennett knows that attachment theory has even bigger ramifications for counselors and the clients they serve. All humans are born with the need for engagement with and responsiveness from other humans, says Bennett, who studies and gives presentations on attachment theory. People need to be touched, to be stimulated, to feel safe and to believe that someone — usually their primary caregiver or caregivers — will provide things for them. In other words, people need to be “attached.” If children don’t feel as if they have reliable attachment figures — a source for stability and safety — they are more likely to experience anxiety and have difficulties trusting others and forming relationships, Bennett says.

Bennett recently took a group of students from various programs, including clinical mental health, marriage and family therapy, and school counseling, to a wildlife park containing elephants. She wanted them to observe attachment in action in the animal kingdom and apply what they saw to human behavior.

Interestingly, Bennett’s group also observed that elephants can transfer their attachments to humans. In the park, there was no way for retired females to return to their old herds. As a result, there were no elephant nanny figures. However, whenever the human trainer appeared, the calves responded to him as if he were a nanny. Bennett believes that because human attachment is analogous to that of other animals, the elephants’ consistent attachment to a nanny figure showed that secondary attachment figures play an essential role in well-being.

Attachment theory is derived from the combined work of John Bowlby, a British child psychologist and psychiatrist, and Mary Ainsworth, a Canadian psychologist. The theory posits that infants have an instinctual survival-based need to form an emotional bond with a primary caregiver. This attachment provides a sense of safety and security. If children receive consistent attention and support from a caregiver, they are more likely to develop a “secure” attachment style. Children who do not receive consistent attention and support develop insecure — avoidant or anxious — attachment styles. Attachment style affects a person’s sense of self and shapes his or her ability to regulate emotions and form relationships.

Bennett notes that neurological research shows that humans are wired to make attachments, but these connections need to be reinforced, optimally between birth and age 2. However, children can become attached at an older age if they receive the right care and connection, she says. In addition, if a primary caregiver does not cultivate attachment in a child, another caregiver can provide that crucial link by responding to the child’s emotional and physical needs with “connection and delight,” Bennett says.

As children develop, they form a working model of the world and themselves, Bennett says. Children who have secure attachments tend to believe that they are lovable and likable and that other people are safe and kind and will meet their needs, she explains. Children whose needs are not being met generally develop one of two beliefs about themselves and the world. Those who have formed an avoidant style of attachment often believe that they are OK but that the world and the people in it are bad. Children who have developed an anxious style of attachment usually think that other people are generally benign but that they themselves are bad or unlovable, Bennett explains.

ACA member Joel Lane previously worked with children, adolescents and young adults and now supervises counseling trainees who work with this same population. He says that attachment issues often play a significant role in clients’ presenting concerns, either as the primary difficulty or as a complicating factor. With children and adolescents, much of Lane’s work consisted of helping these clients and their parents or caregivers understand one another’s needs better.

Attachment styles — and the interpersonal behaviors they engender — can form a lifelong emotional template. People with secure attachments know they can depend on those to whom they are attached to be available for support and vice versa, says Christina Schnyders, an assistant professor of counseling and human development at Malone University in Ohio and a frequent researcher and presenter on attachment issues. In contrast, anxious attachment creates fear that an attachment figure will not be dependable, she explains. In response to this fear, people with the anxious attachment style can become co-dependent and may also become frustrated or angry because their relational needs are not being met. People with avoidant attachment create distance from others to prevent having to depend on anyone or having anyone depend on them.

Each of these attachment behaviors affects how people function in crucial life areas such as family, peer and romantic relationships, Schnyders says. Attachment style can even influence a person’s career choice and interactions in the workplace.

Leaving the nest

Lane, an assistant professor in the counselor educator department and coordinator of the clinical mental health counseling program at Portland State University, studies attachment, particularly as it relates to the population known as “emerging adults” (those in their late teens to late 20s). Emerging adulthood is a time of tremendous interpersonal transition that usually involves an individual leaving the parental household, forming new friendship groups and getting more attachment needs met by peers — and particularly by romantic partners — rather than by family members or caregivers, he says.

Transferring attachment needs from parents or caregivers to peers is a process that typically begins in a person’s teens, says Schnyders, an ACA member and part-time college counselor at Malone. Parental attachment doesn’t become any less vital at this time; it’s just that peers are placed higher on the attachment hierarchy, she explains. In fact, having a secure attachment to parents or caregivers is critical to adolescents’ ability to make connections with their peers, says Schnyders, a licensed professional clinical counselor formerly in private practice.

“Attachment beliefs inform our sense of self and others, particularly during times of distress,” Lane says. For example, in stressful situations, people with attachment insecurity may believe they are incapable of dealing with the problem, he says. Stress may push those with anxious attachment to rely solely on other people rather than deploying their own problem-solving skills, whereas people with avoidant attachment may believe they cannot count on others to provide emotional support, causing them to withdraw from the support system and creating greater isolation, Lane explains.

In contrast, emerging adults who have formed secure attachments to peers and parents are more resilient and better able to handle changes, both good and bad, Schnyders says.

“Put simply,” Lane says, “attachment plays a major role in understanding our emotional needs and getting those needs met. And in emerging adulthood, it can be especially important since our emotional needs evolve, as do the groups of people whom we hope or expect to meet those needs.”

The question becomes, how can counselors help “fix” an attachment style that may be having a negative impact on multiple aspects of a client’s life?

Lane doesn’t believe it’s a matter of changing clients’ attachment styles. Rather, he says, counselors can help clients better understand and anticipate their attachment needs, which can lead to increased attachment security over time.

“I believe that the counseling relationship provides clients with corrective attachment experiences,” he says. “When we feel heard, seen and understood, insecure attachment beliefs are challenged, and secure attachment beliefs are reinforced. Over time, this can have a powerful impact on how we view ourselves and how we view others. We can also help our clients learn to better understand their attachment needs and communicate those needs to others.”

Schnyders uses psychoeducation to teach clients the differences between secure and insecure attachment. She then uses cognitive behavior therapy to help clients understand how their insecure attachment has created core, irrational beliefs. Schnyders and the client then work together to reframe and restructure these beliefs. This allows clients to acknowledge and address the insecurities and fears that drive their behavior, better enabling them to modify their personal interactions.

Schnyders says that narrative therapy can also be useful, particularly with emerging adults. She guides clients as they create a narrative riddled with problems connected to their attachment style. Once that narrative is constructed, Schnyders and the client work to create an alternative storyline that focuses on elements of secure attachment and talk about how to work toward that story.

Attachment and romantic relationships

“Attachment drives the way we experience ourselves and our significant others,” Bennett says. “It provides a lens for how we see and interpret them.”

There is no consensus on whether attachment styles influence the selection of people’s romantic partners, says Bennett, who works with couples in her private practice. At the same time, she can’t help but noticing the number of anxious and avoidant pairings in her office.

“Put simply, one keeps pushing or nagging at the other to be present, and the other is a great escape artist,” Bennett says. “Both [are] driven by their styles and both [are] really chasing the other off, even though that is not what either one wants.” The doubts and fears that drive such behavior are barriers to real intimacy, she adds.

To help couples identify and break the patterns that are sowing discord, Bennett teaches them about attachment theory and how their individual styles can affect the relationship. She then helps couples develop secure attachment behavior by teaching them how to be more available, accessible and responsive to each other.

Bennett says she often finds that couples don’t know what a nonsexual warm connection looks like, so she teaches them how to greet, touch and talk in nonsexualized ways that express love and care. Vulnerability is also a big issue. Couples need to be willing to be vulnerable with their partners and, conversely, to react gently, she says.

Bennett also frequently works with couples on how to change their “demands” to “requests” and how to respond to each other’s requests with warmth. In addition, relationship partners often need to learn how to apologize to each other, how to talk about their fears and anxieties with each other, how to listen to each other and how to turn to each other for support, Bennett says. Finally, she advises couples to get in the habit of immediately repairing any relationship “ruptures” rather than allowing them to fester and build.

People with attachment issues often have difficulty expressing themselves, which can lead to frustration and misunderstanding. Partly for that reason, Schnyders does a good deal of assertiveness training with couples to improve their communication. Learning to be assertive allows clients to communicate their needs without discounting the feelings of their partners.

When teaching assertive communication, Schnyders instructs clients to use “I” statements such as I want this. I believe this. I need this. In the process, she strives to change the way clients see themselves.

Schnyders tells the story of a 60-something female client with a pattern of insecure attachment. Schnyders had been focusing on self-esteem with the client, encouraging her to believe that she was a person of value and worth. The client was also having problems communicating with her husband, who had a habit of speaking at her rather than to her and treating her dismissively.

One day, the client came in and told Schnyders about a breakthrough. A recent encounter with her husband had devolved, as it usually did, to him speaking disrespectfully to her. All of the sudden, the woman found herself exclaiming to her husband, “You can’t speak to me like that. I am a person with value and worth!”

Her declaration stopped the husband in his tracks and, soon thereafter, their relationship dynamic began to change. With the client standing up for herself and beginning to believe that she was worthy of respect, Schnyders asked her to consider what she needed from her husband. The woman said she wanted to be able to hear and understand his needs without diminishing her own. Schnyders and the client then talked about how she and her husband could work together rather than following their previous pattern, which involved the woman placating him rather than standing up for herself.

Sometimes, just slowing down an interaction can improve communication. In couples and family therapy, rather than letting clients have rapid back-and-forth exchanges, Schnyders will slow the conversation and have participants tell their partners or family members what they need from them. Schnyders will then ask the partners or family members to repeat what they have heard because sometimes conflict arises from an inability to listen to what someone else is saying.

Attaching to a career

Like all areas of life that involve interacting with others, work can sometimes be tricky for those with insecure attachments. As Schnyders explains, if a person doesn’t trust their co-workers and can’t communicate and interact with them effectively, that person’s performance is going to be hampered, perhaps even putting them at risk of losing their job.

But attachment style can also play a role in the job search itself, says Stephen Wright, a professor of applied psychology and counselor education at the University of Northern Colorado. Wright, an ACA member, studies how attachment style affects career choice and decision-making in college students.

When it comes to considering careers, people who are securely attached have an advantage because they are less likely to perceive career barriers, according to Wright. In other words, they have more confidence in their innate strengths and their ability to cope with challenges. Those with secure attachment also are more likely to have a stable support system of people who bolster their confidence and may even have contacts that will assist in the career search, Schnyders says.

In contrast, those with insecure attachment are more likely to perceive many reasons that they will not succeed in a particular career field or in the career search itself, Wright says. These individuals are also less likely to have a support system in place.

That’s one area where professional counselors can come in. Counselors not only serve as a secure base for clients but can also boost their feelings of self-efficacy in various areas, which can diminish the effects of insecure attachment, Wright says.

By providing a strong sense of support, counselors may help insecurely attached clients perceive fewer barriers. Setting and completing specific goals — even small ones, such as researching a new profession — can help strengthen these clients’ sense of accomplishment and confidence, Wright says. If clients have shown interest in a particular career area, helping them learn more about it and explore the various jobs available in the profession can increase their sense of self-efficacy in that area, he says. If clients lack the required skills for a specific job, counselors can assist them in developing a plan to acquire those skills rather than let them perceive their current situation as an insurmountable barrier, Wright says. He also suggests that counselors use career models to assist these clients with decision-making and identifying their job-related strengths and weaknesses.

Recovering from child sexual abuse

Research indicates that people with secure attachment style find it easier to recover from child sexual abuse, says Kristina Nelson, an assistant professor in the Department of Counseling and Educational Psychology at Texas A&M-Corpus Christi who studies and works with survivors of child sexual abuse. Having secure attachment provides these individuals with a safe base from which to explore and process their experiences, leaving them better able to regulate their emotions, she says. The feeling of security from healthy attachment serves as a form of support in and of itself, adds Nelson, who was previously a private practitioner in Florida.

Survivors with insecure attachment styles have typically received inconsistent or limited support throughout their lives, and this leaves them feeling unsure of whom to trust, Nelson says. In addition, they often don’t know how to regulate their emotions or how to begin the process of recovery.

Counselors can offer the support that those with insecure attachment styles have lacked throughout their lives, Nelson says. “Counselors can actually serve as a secure base for a client. [They can] be that consistent presence by providing that constant positive regard, allowing them to explore and make sense of their experiences.”

Counselors can also help these clients learn how to regulate their emotions. Nelson often recommends deep breathing techniques to her clients and adds that some people find meditation helpful. She cautions, however, that because meditation involves closing one’s eyes in a dark room, it may be a trigger for sexual abuse survivors, so counselors should proceed carefully.

Psychoeducation about attachment styles can also help clients gain awareness about why they react the way they do and how they developed their coping mechanisms, Nelson says.

Permanently attached?

So, is everyone stuck with their childhood attachment styles for life? Not necessarily, say Bennett and Lane. Although attachment style is usually pretty stable, there are cases in which it can change.

“The idea here is that we have core perspectives that tend to drive core styles,” Bennett says. “I’d venture that friendships and workplace relationships can have an impact, but our primary home styles are more likely to set the tone.”

“If impacted by social and work settings, we can repair by going home, by changing up friendships, by moving jobs,” she continues. “If stuck in an unhealthy work environment or social setting without recourse or the capacity to go home and mend, it makes sense that we’d alter to a less secure base, sadly.”

This is also true in relationships, Bennett says. For example, if a spouse repeatedly behaves in ways that erode the person’s trust in the spouse or in themselves, then that person’s attachment style can warp into a less secure one, she says.

Lane says there is some evidence that insecure attachments can become more secure throughout adulthood. He believes this may happen as people shift their attachment needs to people of their own choosing rather than the families they were born into or the caretakers they were placed with.

“I think that important interpersonal experiences influence and are influenced by one another,” he says. “When we regularly experience our needs being met as infants, we are more likely to be able to form healthy interpersonal relationships throughout life. However, adverse life and interpersonal experiences can still disrupt our attachment system, especially after multiple significant adverse experiences. The reverse also seems to be true — insecure attachments in childhood decrease the likelihood of healthy attachment relationships later in life. However, when those healthy relationships occur, they can influence our attachment orientations toward being more secure.”

 

****

Related reading

To learn more about issues related to attachment, read the following articles previously published in Counseling Today and available on the CT Online website at ct.counseling.org:

****

 

Laurie Meyers is the senior writer for Counseling Today. Contact her at lmeyers@counseling.org.

Letters to the editor: ct@counseling.org

 

****

 

Opinions expressed and statements made in articles appearing on CT Online should not be assumed to represent the opinions of the editors or policies of the American Counseling Association.

Remembering Minuchin and the democratization of therapy

By Charles F. Shepard February 25, 2018

Just after lunch on a Friday afternoon in late March 2017, Salvador Minuchin gently raised his hand to address the hundreds assembled to learn from him at the Psychotherapy Networker Symposium in Washington, D.C. If any of the attendees were drowsy from their meal or the demands of the week, they did not stay that way for long. Once the crowd quieted, the then-95-year-old giant of family therapy, his body and voice diminished by age, announced that this would be his last public appearance.

This was the first memory to hit me, nearly eight months later, when I saw Minuchin on the cover of The Washington Post on the first Sunday in November. Sadness and gratitude quickly followed when I learned that he had died, at age 96, on Oct. 30.

Minuchin’s face, voice and genius are familiar to many of us who have been trained to apply family systems theory to the practice of professional counseling. Many of us were introduced to what has become known as structural family therapy during our graduate training programs. Countless instructors have shown archived videos of Minuchin seeing, naming and changing the maladaptive patterns of families seeking his expertise at the renowned Philadelphia Child Guidance Clinic (CGC).

Salvador Minuchin (Photo via Wikimedia Commons)

Certainly, this is the contribution to the field for which Minuchin is best known, and it is my preferred mode of practice and teaching. However, it was Minuchin’s democratization of psychotherapy that I have found most inspiring.

Having earned his M.D. from the University of Cordoba in his native Argentina in 1947, Minuchin immigrated to the United States to be trained in child psychiatry and psychoanalysis. Minuchin was also Jewish, and his post-doctoral training was sandwiched around a stint serving in the Israeli army to support the fledgling state. By the mid-1950s, Minuchin had begun to work as a child psychiatrist at the Wiltwyck School for Boys along the Hudson River between New York City and Albany. The school was a treatment center for underprivileged boys, many of whom had been involved with the juvenile court system, between the ages of 8 and 12. It was at Wiltwyck that Minuchin first conceived of inviting a child’s family into the consulting room as a valuable contribution to the treatment process.

At the time, this move was revolutionary. Psychotherapeutic services were available almost exclusively to elite members of society and usually focused on individuals. Minuchin himself noted in “My Many Voices” — his contribution to the 1987 anthology The Evolution of Psychotherapy — that “parents were considered, frankly, destructive to the children. If they were seen at all, they were seen individually in the ‘main office.’”

Minuchin changed this system at Wiltwyck so that not only were children seen with their parents in the same room, but Minuchin and his colleagues observed each other providing and developing a style of family therapy through one-way mirrors. This innovation led Minuchin to develop a theory of family structure, his psychoanalytic training shining as he interpreted relational moves between family members and family subsets. Once he had developed his theory, he began to collaborate with other like-minded practitioners, namely Jay Haley, who joined Minuchin in Philadelphia at the CGC in the mid-1960s.

It was here that structural family therapy proliferated. Having accepted a position as director of the CGC in 1965, Minuchin published his first book, Families of the Slums, in 1967. A dozen books, some written with various co-authors, followed, including classics such as Families and Family Therapy (1974), Family Therapy Techniques (1981), and Working With Families of the Poor (second edition, 2007). At the CGC, Minuchin and his staff emphasized working with underprivileged families of the city — to the point that they were teaching laypeople to provide structural family therapy-influenced care to their neighbors in the nearby ghettos and barrios.

Clinicians from all over the world flocked to Philadelphia to learn from Minuchin and Haley. Among these trainees were Steve Greenstein and Dave Waters. By the late 1990s, Greenstein had moved on from the CGC and landed in Charlottesville, Virginia. In this small town, home to the University of Virginia (UVA) and set in the Blue Ridge Mountains, Greenstein furthered Minuchin’s democratic vision by taking structural family therapy outside the clinic walls and into the homes of families in crisis.

Greenstein founded the League of Therapists, a private agency that primarily provided intensive in-home counseling, a Medicaid-funded service aimed at helping prevent out-of-home placement for at-risk children. Clinicians were trained to help families from a variety of different circumstances. They helped reunite children in foster care with their birth families, prevent acute hospitalization and residential treatment, and prevent juvenile detention by working with the entire family system to see, name and change maladaptive relational patterns. Waters, who was a professor in the UVA medical school when Greenstein started his project, joined as a fellow supervisor.

Clinicians, who often were residents in counseling, marriage and family therapy or clinical psychology, videotaped their sessions and reviewed their work with Greenstein and Waters on a weekly basis. At its height, the League of Therapists had 12 offices across Virginia and as many as 300 providers. Thousands of families were served until the group closed its doors in 2011. Greenstein died three years later.

Nevertheless, the work continues. Several of the counselors who worked for Greenstein continue to provide home-based family therapy in Virginia. Waters continues to supervise and teach them through video review on a regular basis.

It bears mentioning that Minuchin was not without his critics. His obituary in The Washington Post noted that Minuchin came to the forefront of public discourse as the feminist movement was gaining strength. Activists from that end of civic discourse often found him “too willing to accept and reinforce traditional gender roles and stereotypical family units.” Furthermore, many of his colleagues found his methods, which at times could range from biting humor to blatant mockery, too confrontational.

This side of Minuchin is familiar to anyone who has viewed any of his archived video footage. It came through in the video he reviewed with the March symposium attendees. During the session, he referred to the father of the client family as a “brute” and made it bluntly explicit that he, Minuchin, was the expert in the room.

The tape was from the 1980s, when Minuchin was in his 60s and approaching the end of his career. On that Friday afternoon at the symposium, he was asked to comment on his perception of himself as he watched more than three decades later. He replied that he was embarrassed. “If I had it to do over again,” he said, “I would do it differently. I would do it more gently.” And so, the next generation may be inspired to take the core principles and techniques Minuchin developed but apply them with rounder edges.

The continued development and dissemination of structural family therapy has been centralized at the Minuchin Center for the Family, located just outside Philadelphia in Woodbury, New Jersey. However, clinicians who have been influenced personally and professionally by Minuchin are all over the world. A few of us were in the room with Minuchin this past March, and the moment was not lost on us. Minuchin was not only a great developer of the theory and practice of family therapy, but also one of the great advocates for giving the underserved access to a systemic approach to counseling. May we all carry his legacy forward in our respective communities.

 

****

Charles F. Shepard is a licensed professional counselor and national certified counselor in private practice and a student in the doctoral counseling and supervision program at James Madison University. He learned structural family therapy in the style of Salvador Minuchin from Steve Greenstein, David Waters and Gretchen Wilhelm. Contact Shepard at cshepard.lpc@gmail.com.

 

****

Opinions expressed and statements made in articles appearing on CT Online should not be assumed to represent the opinions of the editors or policies of the American Counseling Association.

Viewing fathers as attachment figures

By Ashley Cosentino September 5, 2017

The role of fatherhood has changed over the years. Hundreds of years ago, the father was the most important parent for raising the children, then he became the breadwinner, and today an expansive volume of research details a general lack of involvement by fathers in their children’s lives. Plenty of fathers want to be a part of their children’s lives and do whatever they can to stay involved. However, many fathers encounter barriers created by myths that limit, or in some cases prevent, their ability to engage with their children.

Many people may believe some common myths about fathers. These myths include:

  • Fathers are not interested in being involved.
  • Fathers do not have the capability to be involved.
  • Fathers are harmful if they are involved.
  • There is little to no effect if a father is not involved (or, relatedly, the hassle of dealing with the father is worse than any negative effects that his lack of involvement might have on children).

In reality, both fathers and mothers are important, and not just as a means of feeding, bathing and sheltering their children. Their importance extends beyond meeting the family’s physical and safety needs.

All of us likely know someone who has either grown up with a single parent or been a single parent, or perhaps we fall into one of those categories ourselves. A faulty assumption that people often make is that married fathers are always present, whereas divorced fathers (or unmarried fathers) are always absent. This assumption is based on the faulty idea that a father is only involved if he is present in the home and that when a man doesn’t live with his child, the father then becomes disinterested.

Research has shown that children who grow up without consistent father involvement commit more crimes, become teenage parents more frequently and are unemployed more often than are children who grow up living with both of their biological parents full time. This is regardless of the parents’ race, educational backgrounds, whether they were married at the time of their children’s births or if a parent remarries. According to the research, children growing up without father involvement were also found to perform more poorly in school, use drugs more frequently and have other social problems even when controlling for generally lower income.

The prevalence of single fatherhood has doubled in the United States throughout the past decade, and the number of nonresident households is growing. A residential household is the parental home where the child spends the majority of his or her time, whereas a nonresident household is the home where the child stays when spending time with the other parent. Escalations in divorce and nonmarital reproduction during the past 30 years have preceded escalations in the percentage of children living separately from their biological fathers. Between the 1970s and 2000, the percentage of children living with a single parent grew from 12 percent to 20 percent. In 2002, 69 percent of children younger than 18 lived with both biological parents, whereas 23 percent lived with their mother and 5 percent lived with their father. Fifty to 60 percent of children born in the 1980s and 1990s lived with only one parent for at least a year before reaching age 18.

These statistics help to illustrate the lack of attachment that many children have with their fathers. An attachment is characterized by intense feelings of intimacy, emotional security and physical safety in association with an attachment figure. Attachments are significant throughout one’s life, and they can vary over time. When established in early childhood, attachments can continue, but new ones can also be formed during later childhood or in adulthood, and current attachments can be reinterpreted with new perspective and conditions. The goal of attachment is to have a secure relationship with several caregivers to improve normal social and emotional development.

John Bowlby established attachment theory in the 1950s and 1960s as an addition to psychoanalytic theory. Attachment theory is a secure base from which to explore close relationships that can accommodate an extensive variability of methods and findings. Attachment theory proposes that affectional bonds are essential to the survival of humans. It has a protective function (e.g., a mother keeping her child safe in times of danger) and an instructive function (e.g., a mother providing a secure base so her child can explore the surroundings). Attachment occurs if there is closeness and active shared interaction between the child and the attachment figure. Attachment theory is the prevailing theory for understanding early social development in children.

Attachment styles

Mary Ainsworth and her associates experimentally defined three subgroupings of attachment associations: secure, anxious-avoidant and anxious-resistant (or ambivalent).

Secure attachments: A secure attachment is categorized by passionate feelings of intimacy, emotional security and physical safety in the company of an attachment figure. Features that accompany a secure attachment include remarkably good communication abilities, the use of productive coping tactics and the capability to assimilate inconsistent emotions, normalize negative emotions and resolve conflicts cooperatively and constructively. Secure children show little anxiety when separated from a caregiver and develop a sense of self-worth and belongingness. Secure attachment relationships provide a safe base from which to explore the world and an affirmative model of self in relation to others.

Insecure attachments: Insecure attachment relationships occur as the result of trauma or neglect. They create noteworthy shortfalls in the child’s development of self and his or her capacity to relate to others. These effects can have enduring negative psychological concerns such as not being able to compromise or form meaningful relationships. Forty to 45 percent of children in the United States and Great Britain are classified as insecurely attached based on research done in both countries.

Children with anxious-avoidant attachments are characterized by their insignificant need to receive physical contact from their parent(s) when united after a separation. Anxious-avoidant children use defense mechanisms such as having a low need to accept physical contact from caretakers. As adults, people who are anxious-avoidant withdraw in relationships and are emotionally distant.

Children with anxious-resistant (ambivalent) attachments demonstrate a lack of inclination to explore, a lack of precociousness and a lack of self-protection, while also showing intensification in irresponsibility and accident proneness. These children are characterized by intense misery at their caretaker’s parting and an inability to be pacified upon return of the caretaker. Children with an anxious-resistant attachment style appear to show infrequent amounts of inner conflict concerning the apparent physical and emotional accessibility of their parent. Research on the concerns of this attachment style signifies that anxious-ambivalent children experience developmental interruptions that are not typically experienced by securely attached children.

A fourth type of attachment, disorganized, could also be added. Disorganized attachment is a combination of anxious-avoidant and anxious-resistant. Regardless of the attachment style, children create an attachment blueprint for future interactions that will guide them throughout their lives.

Fathers as attachment figures

Bowlby’s original construction of attachment theory proposed the role of the father as ambiguous, but he later recognized that fathers are imperative as attachment figures. Bowlby’s philosophy about the role of fathers as attachment figures developed over time with the publication of applicable research findings.

The infant-father attachment turned out to be prevalent while Bowlby was working on his second, more clearly defined version of attachment theory, published in 1969. He found that the father’s reactions to the child form the pattern of the child-father attachment relationship. Bowlby’s son, Richard Bowlby, who has also lectured and written on attachment theory, has said that he suspects his father’s initial concentrated focus on mothers and their attachment role may have ended up prejudicing subsequent research and distorting cultural values.

Bowlby added fathers as significant attachment figures because two distinct attachment roles seemed to exist for two separate but equally important functions for a child’s development. One attachment role is to deliver love and security, and the other role is to participate in exciting and challenging practices. In other words, the bond of attachment is more than keeping children safe from danger, which is often seen as the mother’s role. Attachment is also a bond that promotes exploration and gives confidence to venture forth, which is often the father’s role.

For children to grow into proficient adults, it is recommended that they first need to develop psychological security, which consists of both secure attachment and secure exploration. Researchers have defined this as confident, attentive, eager and resourceful exploration of materials or tasks, especially in the face of disappointment. Secure exploration implies a social orientation, particularly when help is needed.

Understanding the difference between secure attachment and secure exploration helps us see how fathers have a distinct impact on the raising of children. A father’s behavior should create a feeling of safety for the child as the child explores new understandings. These instances will allow the father and child to become familiar.

Humans have an instinctive need for enjoyment, discovery and a sense of achievement. Bowlby considered play to be an important aspect of the father-child relationship. The role of father-child play is alleged to be critical for child development and adds to the expansion of attachment relationships. A father’s role becomes noticeable in child development later; consequently, the impact of father involvement may be progressively more important and observable as the child grows older. A father’s awareness of his child’s exploratory behaviors will contribute to the child’s sense of safety during difficult tasks and increases the chances for the child to focus, follow his or her curiosity and master new talents in an emotionally unhindered way.

Parents’ roles: Separate but important

Both parents are considered attachment figures in attachment theory, and the child-father attachment is autonomous from the child-mother attachment. Whereas mothers are commonly involved in caregiving and providing emotional refuge, fathers are particularly involved in play and exploratory undertakings. Healthy development depends on a child’s positive attachment to both parents because the parents provide separate but equally important secure bases for the child’s attachment needs.

In families in which two parents are raising children, one parent serves as the main attachment figure for providing a lasting secure base and refuge for safety in periods of distress, whereas the other parent serves as the primary attachment figure for providing opportunities for exploration and excitement. There are fluctuating amounts of commonality between the two attachment roles; however, each parent will offer one type or the other. Scholars have established that individuals who excel in social situations as young adults typically had mothers who delivered a stable secure base and a positive model for intimate relationships within the family and fathers who shared in exhilarating play and interactive encounters.

To optimize the chances of a child being successful, two distinctive systems need to be in place: a secure base for the child to come back to when the action ends or goes wrong, and a trustworthy confidant to show the child the way. Children can use their parents as a secure base in diverse ways, and each parent can attend to a child’s needs differently. For instance, fathers generally take part in more physical play, inspire more risk-taking and induce a greater assortment of excitement and stimulation in play than mothers do. Fathers typically encourage competition, challenge, initiative and independence. Parents who compete for their child’s love and devotion are more likely to have offspring who are insecurely attached to both parents.

Little is known with certainty about the behavioral correlates of secure child-father attachment. Measures of this attachment should include the assessment of warm, supportive and sensitive challenges during joint play. These are indicators of an activation relationship. If we begin to view men as primary attachment figures, a change might take place in the importance we ascribe to fathers.

Need for father involvement

The issue of fatherlessness is discussed in many books and articles, but it is primarily prioritized as a financial problem. These children are considered worse off because they may not have the same level of monetary resources that can give them a better life. Most of the initial early research concentrated on the regularity of contact with the father and payment of child support. The financial assistance of fathers is unquestionably a vital resource for children in all forms of families. However, if children truly are to “profit,” fathers also need to be obtainable and involved in their children’s lives.

There is a need to reevaluate the significance of fathers and to recognize that their worth in their children’s lives is equal to that of mothers. Regardless of the eminence of the mother-child bond, children who are close to their fathers are happier, more fulfilled and less anxious. According to the research, it is important to position the father within the larger context of family relationships. When nonresident fathers maintain parentlike contact, partake in an assortment of activities with their children and spend holidays together with their children, the children’s welfare is sustained. Positively involved fathers reduce their children’s probability of externalizing and internalizing difficulties, limit children’s school failures and avert children’s self-image problems during puberty. The social interactions between fathers and their children who are raised by a single parent are important predictors of healthy functioning in children in both cognitive and behavioral realms.

The transference of social capital between nonresident fathers and their children is calculated by the quality and quantity of involvement. High-quality father involvement is essential for children’s security because fathers who cultivate close relationships with their children are more effective in observing, teaching and communicating. When children sense love and care from their fathers, their sense of emotional security is reinforced. Emotional security helps children cope with stress and makes them less susceptible to anxiety and depression. When both parents are involved, children are more likely to respect and obey parental rules and imitate parental behavior.

Studies of nonresident fathers often indicate positive correlations between father involvement, regular payment of child support and children’s behavioral adjustment, psychological welfare and academic achievement. Frequency of noncustodial father visits has been found to be linked to greater academic achievement, self-esteem, social competition and overall well-being of children. Father involvement is also positively related with children’s social capability, internal locus of control and capability to empathize. A father’s involvement in making key decisions that impacted his children also led to grown children looking to him for support. A longitudinal study of 12th-graders in divorced families found that children with recurrent contact with their fathers received more guidance and provision and were less depressed.

According to the literature, the lack of a father in a child’s life can have damaging effects on both boys and girls. Male and female adolescents from divorced and remarried families exhibit higher rates of conduct disorders and depression, and they are more likely to become teenage parents.

Boys whose biological fathers do not live with them have increased chances of conduct problems and acting out more frequently at home or school, whereas girls are more likely to become depressed. Many researchers believe that boys respond longer and further to the separation from their father attachment figure. Boys, more so than girls, can suffer from lack of contact with a father attachment figure, causing them to struggle in school.

Bowlby’s attachment theory presents that both parents are needed as attachment figures in a child’s early development. We have a long way to go before our society considers fathers to be just as important as mothers, but each step is a step closer. A successful future depends on children having secure relationships with their fathers. This means fathers being able to see their children often and being regarded as more than just financial support. Fathers are attachment figures who challenge their children and are right there with their children to explore the scary world ahead of them.

 

****

 

Knowledge Share articles are developed from sessions presented at American Counseling Association conferences.

Ashley Cosentino is an assistant professor in the Counseling Department at the Chicago School of Professional Psychology. She is a licensed clinical professional counselor and a national certified counselor. Contact her at acosentino@thechicagoschool.edu.

Letters to the editor: ct@counseling.org

 

 

****

 

Opinions expressed and statements made in articles appearing on CT Online should not be assumed to represent the opinions of the editors or policies of the American Counseling Association.

 

****

Bringing the family counseling perspective into schools

By S. Kent Butler, Tony D. Crespi and Mackenzie McNamara May 8, 2017

Children in schools today come from increasingly diverse and complex families. As illustration, more than 1 million families are impacted annually by divorce. In fact, approximately 13.7 million single parents are raising 21.8 million children, and 1 in 3 Americans are stepparents, stepchildren, stepsiblings or part of a stepfamily. Furthermore, according to a 2009 article published in the journal Family Relations, it is estimated that only 31 percent of fathers who no longer live with their children maintain weekly contact with those children. It is easy to conclude that the issue of divorce alone has a profound impact on many millions of children in the U.S.

Now imagine that a young student and her mother walk into the professional school counselor’s office on a Monday morning. Mom explains that she and her husband are pursuing a divorce — he recently told her that he’s been having an affair and has decided to move in with his girlfriend. The daughter acknowledges feelings of depression and admits to having angry outbursts at home. Mom says she is concerned because her daughter’s grades have been dropping.

Considering the large number of children and adolescents coping with parental divorce, it’s not surprising that this fragmented family came to the school counselor’s office. In fact, it’s a good thing. Both daughter and mother need someone to talk to, and schools are a natural access point for services. However, many professional school counselors are not trained in family dynamics and are not familiar with key tenets that impact family counseling, so they may not know how to proceed.

A sample case

Susie is 15. A high school freshman, she knows only that her father left the house two months ago to move in with his girlfriend. Susie’s parents had been together for 16 years, getting married shortly after college.

Susie’s father hasn’t called since leaving. Susie is unaware that her father told her mother that although he loves Susie and her younger sister, who is in seventh grade, he hasn’t missed seeing them in the least. Mom decided not to share this comment with the children, but she does confide this secret to you, the professional school counselor.

Sitting in your office, Susie suddenly looks up and exclaims that she is scared she will have to move and change schools. She also says that she’s having a really tough time paying attention in class and explains that her grades are slipping. “I hate my dad for doing this!” she yells.

Suddenly, Susie starts shaking and breaks down in tears. After a few minutes, Susie tells you that she is spending a lot of time with her boyfriend, partly to stay out of her house. She acknowledges feeling depressed. After pausing for a moment, she looks at her mom and states, “I really hate Dad. His girlfriend is so young. She’s in her 20s. She’s not much older than me!”

Academically, Susie has been an A and B student, but her grades have fallen since her father left. Her mother acknowledges that things are tough at home and reveals that she didn’t learn about her husband’s affair until the day he moved out. “I really don’t know what’s going to happen,” she tells you. “I know we’re getting a divorce, but beyond that I just don’t know.”

Your school doesn’t have a social worker. However, you have a colleague who has been studying family counseling, so you knock on her door to ask for a consultation. After sitting down, you share a few thoughts.

You note that, fundamentally, Susie needs someone to talk to about these issues. Acknowledging that you are speculating, you openly wonder what type of impact the obviously poor communication in Susie’s family is having on her. After all, her father has not called in two months, her mother was completely unaware of the affair and her mother is keeping the father’s confession of not missing his kids a secret. These facets alone highlight poor family communication. In addition, Susie is scared that she might have to move and change schools. Clearly the issues are widespread.

Risk points

Here are some risk points to consider as you work with Susie:

  • Parenting after a divorce differs significantly from parenting prior to
    a divorce.
  • Single-parent families in the United States are increasing.
  • Children of divorce have more mental health problems in comparison with their peers.
  • Suicide is the third-leading cause of death among U.S. youth.
  • Brain regions responsible for decision-making are not fully developed in youth.
  • Changes in family structure can have an affect on school grades.
  • Anxiety, depression and behavior problems are elevated after divorce.
  • Children of divorce often feel a sense of instability.

An understanding of these risk points is essential for moving forward with children and families because the risk points can provide direction for the work that needs to be done. For example, knowing that mental health symptoms are elevated following divorce and impulsive decision-making is greater among youth, you should assess Susie’s level of safety. In this case, Susie also makes many “red flag” statements.

These are things that counselors know how to address but might not always consider without an awareness of the data. In addition, parents can become defensive, or they might blame themselves for their children’s difficulties. For this reason, it is imperative to educate parents on these risk points. It is also important to realize that family issues may require clinical supervision.

Supervision around work with families 

Susie is not alone. As your colleague notes, Susie is one of many children and adolescents who are coping with family stressors. With the prevalence of so many family issues, a growing number of states have enabled licensed marriage and family therapists (LMFTs) to work in the schools. Connecticut, New Mexico, Maine, Texas and Illinois have passed specific laws to allow LMFTs to work in schools, whereas Massachusetts allows LMFTs to work under a general mental health designation.

Schools clearly represent an important access point for mental health professionals. But with only six states utilizing LMFTs in schools, it is extremely important for professional school counselors and their supervisors to know how to manage these situations with families.

As you ponder your next meeting with Susie, you need information. Direct supervisors are often part of the structure of many agencies, but professional school counselors might need to seek support from a colleague with training in family counseling. Such supervision might come from a guidance director, a school psychologist, a consulting psychologist, a marriage and family counselor, or a local family agency.

Two popular family therapy models that might help Susie are presented below.

Symbolic-experiential family therapy 

This model, derived from the work of Carl Whitaker, addresses both individual and relational patterns. It is focused on both personal growth and family relations.

Fundamentally, the therapist helps dislodge rigid patterns and stimulates flexibility using a family’s natural pull toward growth. Focusing on the present, the therapist helps people recognize their real feelings, express those feelings and move forward, individually and as a family. Key points follow.

  • The “battle for structure” involves clients (a family) “sizing up” a therapist. There is no “identified patient”; rather, the family is the therapy unit. In this model, the therapist must win the battle and control therapy. For instance, if the therapist invites the entire family and one member does not show up to the session, the therapist may refuse to meet until everyone attends. In the case with Susie, you might note that you, Susie, her mother and Susie’s sister must all attend.
  • The family must win the “battle for initiative”; this involves their decision to take charge of their lives and decisions. Is Susie committed to resolving her feelings? Will she commit to six counseling sessions? Is she willing to confront her father about calling his children? Is she motivated to initiate change?

Therapy progresses through stages:

1) Engagement: This is the “meet and greet” phase. You have already started this stage with Susie and her mom.

2) Middle phase: Families are encouraged to change through confrontations, encouragement and interventions. Can Susie’s family meet to start this process?

3) Late phase: Increased flexibility is a focus for the family. Can Susie’s family talk through how the divorce will change their life?

4) Separation: As the therapist separates, the family takes responsibility.

Symbolic-experiential family therapy often advocates the use of co-therapy, making it a great model to use with a more “senior” therapist. In this fashion, supervision can be active and ongoing as you acquire firsthand skills in family counseling.

Structural family therapy

The structural approach, typically associated with Salvador Minuchin, views problems as being rooted in family interactions. Fundamentally, if we can help change the family’s organization (structure), its members typically find that they feel better and their symptoms are often relieved. Key points follow.

  • Enmeshment or disengagement: Family members may range from those who are overly connected to those who are disengaged. Enmeshment tends to prevent growing maturity, whereas disengagement may lead a child to feel abandoned. Most families are not one or the other but have subsystems that reflect their tendencies. For example, a disengaged father who is overly involved at work may neglect the family. In response, the mother may compensate by becoming overly involved. Is Dad really connected? What is the structure
  • Boundaries: Are parental boundaries rigid or flexible? Are grandparents a resource? Can a child visit Dad at work, or does the family maintain a rigid rule against it? Can Susie ask Dad questions? What are the boundaries? What is spoken? What is unspoken?
  • Alignments: Who joins together? Are children aligned against the parents? Did a parent resent and refuse to attend a child’s sporting activities? Did a parent require everyone to attend? What are the alignments?
  • Triangulation: The permutations of triangulation in families can be abundant. A child and parent may triangulate against another parent. A parent having an affair can create a triangle with the other spouse. Will Susie triangulate with Mom against Dad? What triangles exit?

The structural model also features several stages:

1) Joining and accommodating

2) Assessing family interactions

3) Monitoring dysfunction

4) Restructuring patterns

Summary and considerations

When a student walks into a professional school counselor’s office, we are presented with a rare opportunity. When a student and parent walk in together, we are handed an even rarer opportunity.

Family counseling offers unique and engaging ways of reframing problems. Rather than blaming an individual for a particular problem, family counselors look at the family system. Perhaps a child’s acting-out behaviors allow parents to avoid looking at their relational problems. Perhaps a child’s failing grades reflect more on family anxiety and stress than on individual issues. Fundamentally, family counseling takes a larger, more systemic perspective of presenting issues.

Professional school counselors possess wonderful skill sets. They understand rapport building. They understand relational dynamics. They understand problem assessment and the utility of interventions. The connection between families and school adjustment is undeniable. At the same time, school counselors will likely find continuing education and supervision indispensable in helping families.

In our experience, students and families can often benefit from a family counseling perspective. With so many students in the schools coping with changing family structures, it is vital that we expand our skill sets. Fortunately, there are multiple platforms through which we can provide help. Some of these options include:

  • Individual counseling from a family perspective
  • Co-therapy with single families
  • School-based divorce groups with multiple children
  • Single-parent support groups

This article is intended to stimulate thinking and provide a preliminary glimpse into two prominent family counseling theories. Our advice? Be available. Be sensitive. Consider finding a supervisor who is capable of expanding your knowledge and skills in this invaluable area. Truly, children, families and the community stand only to benefit.

 

****

 

 

S. Kent Butler is an associate professor at the University of Central Florida. He is a licensed professional counselor, national certified counselor and national certified school counselor. He is particularly interested in mentoring, supervision and multicultural issues in counseling. Contact him at skbutler@ucf.edu.

Tony D. Crespi is a professor at the University of Hartford. He is a certified school counselor, licensed marriage and family therapist, and licensed psychologist. He is particularly interested in family counseling and legal issues that affect supervision.

Mackenzie McNamara is a doctoral student in the counseling psychology program at the University at Albany, State University of New York. She most recently worked for New London Public Schools in Connecticut.

Letters to the editor: ct@counseling.org

Counseling Today reviews unsolicited articles written by American Counseling Association members. To access writing guidelines and tips for having your article accepted for publication, go to ct.counseling.org/feedback.

 

****

 

Opinions expressed and statements made in articles appearing on CT Online should not be assumed to represent the opinions of the editors or policies of the American Counseling Association.

Helping children and families address and prevent sibling abuse

By Diane M. Stutey February 28, 2017

Counselors play a fundamental role in the well-being of children and adolescents, including serving as advocates against abuse. We are trained to assess and intervene if clients are experiencing sexual, physical or emotional abuse or neglect. Children are a particularly vulnerable population given their size, power status and general lack of knowledge about how to protect and defend themselves against such threats.

Unfortunately, the abuse of children by adults continues in today’s society, even though it is illegal. Yet abuse of children by adults may not be as prevalent as other forms of abuse that children experience. For instance, they might suffer physical or emotional abuse from other children or peers, which is commonly referred to as bullying.

A less frequently explored form of peer-to-peer violence is sibling abuse. In the past, sibling abuse, which was often mislabeled as “sibling rivalry,” was considered to be a normal rite of passage that most children experienced. Today, many researchers posit that sibling abuse may be more prevalent than other types of family violence.

In 2007, Mark S. Kiselica and Mandy Morrill-Richards reported in the Journal of Counseling & Development that up to 80 percent of children may experience some form of sibling maltreatment. In 2010, Deeanna Button and Roberta Gealt reported in the Journal of Family Violence that 3 to 6 percent of children experience severe physical abuse (which may include the use of weapons) by a sibling. In addition to potentially being the most prevalent form of abuse for children, sibling abuse is often the least reported and least researched form of family violence.

As a former school counselor and elementary teacher, I was very surprised when I first learned about the possible high rates of children experiencing maltreatment by a sibling. I was researching the topic of teen dating violence for my dissertation, and one of the articles mentioned the possibility that teenagers who enter into violent dating relationships might have experienced violence with a sibling as a child. I knew there was a link between child abuse and dating violence, but I had never considered that sibling violence might also be a precursor. I became very curious about sibling abuse and ultimately changed the focus of my dissertation to examine school counselors’ attitudes and beliefs about sibling abuse.

Initially, I wondered if other counselors had already learned about sibling abuse; perhaps this was something I had simply missed during my training on child abuse and neglect. However, as I examined the literature on sibling abuse, I found that only one article had been published in the counseling literature on sibling maltreatment (the article by Kiselica and Morrill-Richards). My dissertation findings confirmed that school counselors were often unaware of sibling abuse and received little to no training on the subject, meaning that it might continue to go unaddressed. It seemed imperative to me that our field needed to start a dialogue and research around the topic of sibling abuse, especially as I continued to learn about the negative psychological ramifications associated with it.

Consequences and complications

Through my review of the literature, I discovered that children who suffer from sibling abuse experience myriad negative consequences over time. Many of these harmful side effects are similar to those faced by survivors of child abuse.

Survivors of sibling abuse have reported problems with depression, drugs and alcohol, sexual risk behaviors, low self-esteem, eating disorders, posttraumatic stress disorder and an increased risk of continuing the cycle of violence into their teenage years and adult lives. Counselors work diligently to prevent clients from experiencing adverse childhood experiences, but we may not be addressing sibling abuse because of a lack of awareness about this issue or a lack of reporting by clients and family members. This could result in the possibility of clients being harmed, both in the short and long term.

Further complicating this problem is the fact that there are currently no federal laws, and few state laws, to protect children and adolescents from abuse by a sibling, other than in cases of sexual abuse. So, even when counselors determine that sibling abuse might be occurring, it can be difficult to protect children from this form of abuse.

Counselors have shared that when they call child protective services (CPS) to report sibling abuse, they are typically instructed to call the police. When they call the police, they are generally told that this is a “family matter” and the counselor should contact the parents. One problem with this scenario is that sibling abuse occurs at higher rates within families in which domestic violence or child abuse is present. So, working with the child’s parents or guardians may not always be beneficial because of the presence of intrafamilial violence.

There is often a cultural silence that exists with all forms of intrafamilial violence, including sibling abuse, wherein children are told to keep family matters private. When family violence occurs, there are often threats made not to report it to anyone. So even children who might recognize that they are being abused by a sibling may not seek help because of the fear of breaking family bonds or the threat of retribution. In addition, many people normalize violence between siblings, excusing it as sibling rivalry without fully understanding the damage that can be caused both short and long term. Children may seek help from their parents, only to be told that what they are experiencing is normal or to “toughen up” or “fight back.”

Counselors can take several precautions to ensure that they are advocating for all clients when it comes to sibling abuse. First, counselors who are unfamiliar with this phenomenon should educate themselves about the topic. Sibling abuse can occur across the same domains as child abuse, including sexual, physical and emotional. Sexual abuse of a sibling is often referred to as incest and may include touching, fondling, indecent exposure, attempted penetration, intercourse, rape or sodomy. Physical abuse of a sibling might include slapping, hitting, biting, kicking or causing injury with a weapon.

Sexual and physical abuse may be the easier forms of sibling abuse to detect and report because of the physical evidence and a clear line being crossed. However, verbal or emotional abuse can occur along with or independent of sexual or physical sibling abuse. This psychological maltreatment might include name-calling, ridicule, threatening, blackmail or degradation. Abuse between siblings might also include property or pet abuse and relational aggression.

Similar to the definition of bullying, sibling abuse is viewed as a unilateral relationship in which one child uses his or her power to control and harm the other. With sibling abuse, however, the perpetrator has greater access to his or her victim. This close proximity can lead to additional layers of emotional abuse, such as damaging a sibling’s property or torturing or killing a pet.

Once counselors have more insight into sibling abuse, they can begin to integrate this knowledge into their work with clients. Elysia Clemens, of the University of Northern Colorado, and I adapted a five-step model to assess and intervene with sibling abuse. Heather A. Johnstone and John F. Marcinak developed the original model to be used in the nursing field when there was a suspicion of sibling abuse. Although our adapted model was specifically designed for implementation by school counselors, I have adapted it here to be useful to all counselors.

Our adapted model consists of counselors working with clients through five phases to assess, conceptualize, plan, intervene and evaluate for sibling aggression. Detailed information about each of the five steps can be retrieved from an article we wrote for the Professional School Counseling journal in 2014. That article includes a decision-making tree to help school counselors determine when to stop and report sibling abuse versus when to continue working with the client and family through each of the model’s five phases.

Assess for sibling abuse

In the first phase of this model, the counselor should assess for sibling abuse if there are red flags similar to those we might observe with child abuse (e.g., unexplained bruises, the child seems fearful of his or her sibling, etc.). This can be done by asking a series of questions: Is the client being hurt by his or her brother or sister? What kind of aggression is the child experiencing? How often is this occurring? Is the child afraid to be left alone with his or her sibling? Has the child reported this to anyone in the family? If so, what happened?

Remember that although it may be easier to identify and document physical or sexual violence or abuse, counselors will also want to inquire about emotional or verbal abuse. It is also important to note that the term sibling might pertain to a variety of people living in the home, including biological siblings, half brothers or sisters, stepsiblings, adoptive siblings and foster siblings. In some cases, there may also be what is described as a “fictive” sibling — a child living in the home who is not related but who assumes the role of a brother or sister.

It is important during the assessment phase for counselors to determine whether the sibling aggression would be defined as violence or abuse. If it is determined that the aggression is bilateral, there may need to be intervention on multiple levels within the family. The family may need some psychoeducation about sibling violence, including ways to intervene more effectively and provide proper supervision for all siblings.

If it is clear that there is a perpetrator and a victim of sibling abuse, then it is important to first assess how best to protect the client being victimized. Options may include reporting the case immediately to CPS, calling law enforcement or consulting with the client’s parents or guardians to determine whether they are willing to work to put a stop to the sibling abuse. Counselors will need to make this decision on a case-by-case basis. In our model, we emphasize the importance of working with the parents or guardians if at all possible. However, if the counselor assesses that the parents or guardians seem unwilling or unable to protect their child or may also be involved in intrafamilial abuse, then reporting to CPS or law enforcement would be the best decision.

Conceptualize with clients

Assuming that the parents are willing and able to work with the counselor to protect their child, the counselor will move on to the second phase, which involves helping the client and family conceptualize what type of sibling abuse is occurring. During this time, it is important to provide the family with some psychoeducation about sibling aggression. Helping the client and family understand the difference between sibling abuse and sibling rivalry is a key piece of this conceptualization.

The counselor will also want to differentiate between mild and severe sibling aggression. In the book Sibling Aggression: Assessment and Treatment, Jonathan Caspi explains sibling aggression on a continuum from sibling conflict to sibling abuse. Conflict or competition between siblings (e.g., fighting over who gets to pick the movie you watch or who has the best report card) would be considered mild sibling aggression, whereas severe sibling aggression would include violence and abuse. Examples include the aforementioned forms such as sexual, emotional and physical abuse. Counselors can also help parents conceptualize when and where the abuse is occurring and discuss ways in which providing better supervision and interventions would be beneficial.

Another key component to the conceptualization phase is to help the family gather more information about the goals and misbehavior of the sibling perpetrator. It is important to put mental health services in place for both the victim and the perpetrator of sibling abuse. The sibling perpetrator may have also experienced abuse or neglect of some kind, or the child may have some underlying mental health issues that need to be addressed.

In addition, other siblings in the family may have witnessed the abuse without experiencing it firsthand. It is important to work with the parents or guardians to ensure that these siblings who were not targeted also receive counseling services if necessary. The counselor can help the client and the family to conceptualize each of their roles in promoting better and healthier sibling interactions.

Plan for safety

Initially, parents or guardians may be unaware that sibling abuse is occurring in their home. One of their children might have complained about a sibling’s behavior, but the parents or guardians may not have realized the magnitude of the situation or didn’t possess the awareness that it went beyond normal sibling rivalry. During the conceptualization phase, the counselor works with the client and family to increase this awareness. With this knowledge, the family can start putting a safety plan in place. 

It is important for counselors to work with their child clients to create plans that ensure they are safe and being properly supervised in the home. As counselors, we may be working with multiple family members throughout this process. Our work may include counseling the sibling victim, sibling perpetrator and nontargeted siblings, as well as consulting with the parents or guardians.

It is also critical for all members of the family to have input on the safety plan and for the counselor to ensure that they understand their role in the plan. If it is determined that the sibling abuse is occurring during a certain time of day or in a particular place, the counselor will want to address this in the plan. For instance, if the sibling perpetrator shares a room with the victim, the counselor should explore with the family how this might be escalating the problem and creating an unsafe and unsupervised environment. Part of the safety plan might include setting aside a space in the house where the sibling perpetrator is not allowed to go, thus ensuring that the victim always has a “safe zone.” In addition, if weapons such as belts, knives or other objects have been used to inflict sibling abuse, then removing or restricting access to these objects is another element to address in the safety plan.

Choose interventions

Once the family is able to conceptualize the sibling abuse that has been occurring and has a safety plan in place, the counselor can work with the family to implement additional interventions. Sometimes, simply providing a greater level of awareness of the sibling abuse and establishing safety boundaries within the home might put an end to the abuse, making these additional interventions unnecessary. However, this will more likely be the case if no other forms of family violence are present and if the sibling abuse that occurred was milder in nature.

In instances in which intrafamilial violence may exist or the sibling abuse is more severe, it is important for the counselor to address the long-term impact of sibling abuse on the child victim, the sibling perpetrator, the nontargeted siblings and the family. Counselors can look at interventions that might help young children or adolescents break the cycle of abuse. There are no evidence-based programs for sibling abuse at this time. However, one way for counselors to help these clients is to explore evidence-based programs that have proved effective in working with children and abuse, including trauma-focused cognitive behavior therapy, game-based cognitive behavior group therapy and play therapy.

In addition, counselors may want to recommend some parenting programs aimed at preventing child abuse and neglect, such as the Incredible Years parents training program, SafeCare and Project 12-Ways.

Evaluate if the plan is working

A key component of the evaluation process is for counselors to consult and collaborate with other professionals. As previously mentioned, the five-step plan discussed in this article was originally designed for school counselors. One piece of advice we give to school counselors is to work as part of an interdisciplinary team within the school setting to help sibling victims and perpetrators. This may include working with school administrators, teachers, nurses, social workers or psychologists. In addition, school counselors can seek permission from the parents or guardians to consult with outside counselors who may be providing services to their students outside of the school setting.

It is just as imperative for clinical mental health counselors to consult with school counselors regarding sibling abuse that is occurring in families. Establishing and maintaining an ongoing dialogue between mental health professionals is essential to evaluating if the family’s safety plan is working and if the client feels safe and supported.

In addition, counselors will want to continually evaluate with the client and the parents or guardians regarding whether the safety plan is working and if the sibling abuse within the home has stopped. Counselors should recognize that it might take some time for sibling aggression to stop completely. However, during this transition we want to ensure that the sibling victim is feeling safe and that the parents or guardians are providing proper support and supervision. At any point within these five phases, counselors can report sibling abuse to CPS or law enforcement. Although there are no federal, and few state laws, to protect children from sibling abuse, parents and guardians can be reported to CPS for parental neglect if they fail to provide proper supervision for their children.

Summary

Sibling abuse occurs more often than is reported and can cause serious ongoing psychological damage. Counselors can play an instrumental role in helping their clients acknowledge and put a stop to sibling abuse. Utilizing the five-step plan discussed here is one way for counselors to assess and intervene on behalf of child and adolescent clients who are experiencing sibling abuse.

In addition, counselors have the ability to increase awareness about the topic of sibling abuse in their communities and schools. We can educate those around us about sibling abuse, collaborate with others in the mental health and social services fields to better define what constitutes sibling abuse, and advocate for state and federal laws to protect children from sibling abuse.

There are several excellent resources for counselors and parents who want to learn more about ways to address and intervene with sibling abuse. I have listed a few of them here.

  • Sibling Abuse Trauma: Assessment and Intervention Strategies for Children, Families and Adults by John V. Caffaro and Allison Conn-Caffaro (1998)
  • Sibling Aggression: Assessment and Treatment by Jonathan Caspi (2012)
  • Sibling Abuse: Hidden Physical, Emotional, and Sexual Trauma by Vernon R. Wiehe (1997)
  • What Parents Need to Know About Sibling Abuse: Breaking the Cycle of Violence by Vernon R. Wiehe (2002)

 

****

 

Knowledge Share articles are developed from sessions presented at American Counseling Association conferences.

Diane M. Stutey is an assistant professor of counseling and counseling psychology in the School of Applied Health and Education Psychology in the College of Education at Oklahoma State University. She is a registered play therapist supervisor, licensed professional counselor, licensed school counselor and national certified counselor. Contact her at diane.stutey@okstate.edu

Letters to the editor: ct@counseling.org

 

****

 

Opinions expressed and statements made in articles appearing on CT Online should not be assumed to represent the opinions of the editors or policies of the American Counseling Association.