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Attachment-Focused Family Play Therapy: An Intervention for Children and Adolescents after Trauma
I: Neurobiology of Trauma, Attachment, Behaviors, and Emotion Regulation
Rationale for an Attachment-based Family Play Therapy Approach Integrating Play and Expressive Arts
Three Decades of Research on Trauma and Attachment Neurobiology: An Overview
Family Systems Theory and Attachment Theory
Attachment and the Development of an Integrated Self
Rationale for Integrating Play and Family into the Treatment Process
Integrating Play and Expressive Therapies with Families
Integrating Attachment-based Treatment and Expressive Therapies
Overview of the Treatment Model
References
The Neurobiology of Trauma, Behavior, and Co-Regulation
Reptilian or Primitive Brain
Limbic System
Cortex: The Master Mapmaker
Frontal Cortex
Left/Right Brain
The Social Brain
Empathy
Neurobiology of Emotions and Affect Regulation
The Attachment and Affect Regulation Connection
References
Trauma and Relationships
Relationships and Memory
Implicit and Explicit Memory
Right Brain Processing, Affect Regulation, and Trauma
Dissociation
Dissociation as Adaptation
References
The Nuts and Bolts of Relationships
Attachment Styles in Children
Attachment Styles in Adults
Nitty Gritty of Attachment Relationships
Intersubjectivity, Affect Attunement, Shared Attention and Shared Intention
Mentalizing: Our Internal Stories of Self and Others
References
Repairing Ruptures in the Attachment Relationship
Good Enough
Relationship Skills Needed for Attachment Repair
Empathic Attunement
Reading Cues Effectively and Seeing the Child
Empathic Responding and Recognizing Parent Triggers
Structuring
Flexibility
Playfulness
References
II: Attachment-based Family Play Therapy: The Model
Framework of Attachment-based Family Play Therapy
Attachment-based Parenting Skills
Where to Begin
“How” Skills for Creating Family SPACE
“What” Skills to Use Family SPACE: The Three Rs of Relationship
Getting Started
Gathering Multigenerational Information
Things to Consider When Getting Started
Overview of the Treatment Framework
Overview of the Observational Assessment Phase
Overview of the Safety and Engagement Phase
Overview of the Realignment Phase
The Final Phase of Treatment Is the Attunement Phase
Use of Videotaping
Therapist Role and Modeling
References
Guiding Principles of the Model for Implementation
Core Principles of Attachment-based Family Play Therapy
Families Are Generationally Complex
Children Innately Desire to Have a Positive Relationship with Their Parents and Feel Connected to Their Siblings to Have a Sense of Belonging
Children Thrive When They Have a Positive Loving Relationship with Parents That Is Balanced with Structure and Limit Setting by Parents
Parents Provide the Foundation for Developing a Healthy Sense of Self and Developing a Sense of Security
An Effective Parent Is a Self-aware Parent
Parents Provide the Foundation for Learning to Regulate Emotions
Our Biology Directs Our Behavior and Is Heavily Influenced by Environment
References
Observational Assessment Phase
Purpose of the Observational Assessment Phase
Objectives Achieved during This Phase
Role of Therapist during Observational Assessment Phase
Purpose of the Interventions
Choosing Play and Expressive Therapy Interventions
Identifying Relationship Patterns
Parent Coaching Session
References
Safety and Engagement Phase
Purpose of the Safety and Engagement Phase
Tasks to Accomplish during This Phase and Choosing Interventions
Case Illustration with Bubbles for Deep Breathing
Therapist’s Role during Engagement and Safety Phase
Parent Coaching Session
References
Realignment Phase
Purpose of the Realignment Phase
Role of Therapists
Tasks to Accomplish in This Phase of Treatment
Choosing Interventions
Parent Coaching Sessions
References
Attunement Phase and Termination
Purpose of the Attunement Phase
Tasks to Accomplish
Helping Families Terminate Treatment
Therapist’s Role
Choosing Interventions in the Attunement Phase
Parent Coaching Sessions
References
Clinical Considerations When Working with Traumatized Families
Working with Challenging Families
When Additional Services Are Needed
Cultural Considerations
References
Resources for Play and Expressive Arts Family Play Therapy Interventions
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