Trust, Attachment and The Early Intervention Programme

Naughton A., Thorpe J.
Community Health South London NHS Trust
Mary Sheridan Centre for Child Health
405 Kennington Road
London SE11 4QW

A baby is biologically driven to form a secure attachment to the mother or another caring adult. Trust is fundamental to how these early relationships develop over the first year of life. How it unfolds may influence everything from how we perform in school to what kind of partners and parents we become. The foundation for a child's feelings about himself and the world is how he feels in his relationship with the primary caregiver, though most babies form multiple attachments . This is nature's way of protecting them against the loss of their primary caretaker.

Our Trust's (Community Health South London) programme of early intervention in, and prevention of, child maltreatment arose in response to having one of the highest levels of Child Protection registrations in the United Kingdom, at between three to four times the national average. The programme is based on attachment theory and seeks to promote good and effective parenting practice in order to reduce damaging and abusive parenting. In particular attachment theory proposes that children's trust in the world, and their later capacity and responsiveness to their own children as parents, are influenced by the degree to which they form attachments with caring, responsive and sensitive adults.

The programme has a combination of features within a structured framework, including the identification of vulnerable parents during the ante-natal period, the use of Health Visitors in identification and intervention with families, an 'active engagement' strategy (to encourage and sustain attendance); the development of specialist non-stigmatising clinics for parents and the creation of a consultation service for generic workers.

A variety of interventions are used to support vulnerable families. These include ante-natal parenting workshops; baby massage; dedicated crying , sleeping and feeding clinics; and clinics to help parents manage toddler behaviour.

The programme explicitly promotes sensitive, responsive and engaged caregiving in the early years of a child's life. In addition Health Visitors try to help mothers and other caregivers review their own child- rearing histories and consequently make decisions about how they wish to care for their own children, reflecting on those influences arising in childhood. Finally, the Health Visitors seek to develop empathic, trusting relationships with the mothers and other family members, because experience in such relationships is expected to help women eventually to trust others and to promote more sensitive, empathic care of their children. In many ways this trusting relationship between the parents and the professionals they encounter at any stage of the programme is crucial for its successful outcomes.

Key words: Attachment, Prevention, Child Maltreatment, Parenting

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