Building a Home Within: Meeting the Emotional Needs of Children and Youth in Foster Care / Edition 1

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All children need stable, lasting relationships with caring adults to ensure their healthy emotional, cognitive, and social development. But for children and adolescents in foster care, these essential relationships are often absent. This book presents a proven solution based on over 10 years of groundbreaking work by the Children's Psychotherapy Project (CPP): When young people work with the same therapist for as long as they need to, they'll make better progress toward developing strong, healthy relationships and hope for the future. More than a dozen experts from the CPP give psychologists, social workers, counselors, and program administrators a complete, research-supported introduction to this successful "one child, one therapist, for as long as it takes" model as they share their triumphs and challenges. Through the lessons these therapists learned as they donated their time to weekly psychotherapy sessions, readers will gain new insight on how to build positive relationships with children. They'll learn how to address various aspects of foster care.

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Editorial Reviews

Cindy S. Lederman

"A compassionate and insightfulÂjourney into the lives of children who have been fortunate to have been touched by the inspirational work of A Home Within. A story of hope, a story of healing, a story ofÂhow weÂcan and must address theÂsuffering of maltreated children in the child welfare system."
Executive Director, New York State Permanent Judicial Commission on Justice for Children - Sheryl Dicker
"Provides a blueprint that can be replicated nationwide . . .illustrated by beautifully written stories involving real children in foster care and the longterm work of their talented therapists."
PsycCRITIQUES (APA Publication)
"The training of interns who will be working with these youngsters requires that they become deeply aware of how long and complex the therapeutic journey with these young clients will be and how crucial for a child's healing will be a regularly scheduled, committed, long-term relationship rather than a brief rotation in a clinical placement. How courageous the therapists contributing to this volume are in sustaining such relationships with foster children despite cancelled sessions, chronic instability, and constant changes over time in their work with foster children!"
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Product Details

  • ISBN-13: 9781557668394
  • Publisher: Brookes, Paul H. Publishing Company
  • Publication date: 10/1/2005
  • Edition description: New Edition
  • Edition number: 1
  • Pages: 245
  • Product dimensions: 6.00 (w) x 9.00 (h) x 0.60 (d)

Meet the Author

Diane Ehrensaft, Ph.D., is a senior clinician and founding member of the Children's Psychotherapy Project and Vice President of the board of directors of A Home Within. A developmental and clinical psychologist, she received her doctoral degree from the University of Michigan. She has lectured and published nationally and internationally on the subject of parenting and child development. Dr. Ehrensaft has served on the faculty of The Wright Institute in Berkeley, the Psychoanalytic Institute of Northern California, and the University of California, Berkeley, and has been in private clinical practice in the San Francisco Bay Area since the late 1970s. She is the author of Mommies, Daddies, Donors, Surrogates: Answering Tough Questions and Building Strong Families (The Guilford Press, 2005); Spoiling Childhood: How Well-Meaning Parents Are Giving Children Too Much but Not What They Need (The Guilford Press, 1997); and Parenting Together: Men and Women Sharing the Care of Their Children (The Free Press, 1987).

Toni Vaughn Heineman, D.M.H., is the founder of the Children's Psychotherapy Project (CPP) and Executive Director of A Home Within, the national nonprofit organization that houses the 12 chapters of CPP across the United States. She received her master's degree in social work from the University of California, Berkeley, and her doctoral degree in mental health from the University of California, San Francisco. Dr. Heineman has taught for the Psychoanalytic Institute of Northern California, the San Francisco Psychoanalytic Institute, and many local and national training programs. She is the author of numerous articles and presentations about clinical work with foster children and of The Abused Child: Psychodynamic Understanding and Treatment (The Guilford Press, 1998). Dr. Heineman has been in private practice in San Francisco since the late 1970s and is Associate Clinical Professor of Pediatrics and Psychiatry at the University of California, San Francisco.

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Read an Excerpt

Excerpted from Section IV of Building a Home Within: Meeting the Emotional Needs of Children and Youth in Foster Care, edited by Toni Vaughn Heineman, D.M.H., & Diane Ehrensaft, Ph.D.

Copyright © 2006 by Paul H. Brookes Publishing Co. All rights reserved. No part of this excerpt may be reproduced or reprinted without permission in writing from the publisher.

This clinical vignette illustrates the challenges encountered by one infant, Lilly, and her family as they navigated the disruptions of separation, foster care, and reunification. Interruptions of attachment are particularly significant during infancy and early childhood, when healthy brain development relies on consistent, contingent caregiving. This narrative describes an infant’s extraordinary attempts to survive the multiple breaking of primary bonds and the efforts of a family to reconnect.


Lilly’s parents, Jill and Mark, had extensive histories of homelessness, drug and alcohol dependence, and drug-related incarcerations. Each of their children from previous relationships experienced removal from the home by child protective services and placement in foster care due to severe neglect. Two of the older children had drug-related problems and had spent time in juvenile hall.

Mark was incarcerated at the time of Lilly’s birth and when released from jail was sent to a residential recovery program for men. At birth, Lilly tested positive for methamphetamines and was removed from Jill’s care at age 2 days. She was returned to her mother 2 weeks later, and Jill was ordered by the court to participate in a substance recovery program. Following relapses in her mother’s recovery, Lilly was removed from her mother’s care. Each time she was returned to Jill from foster care homes. By her first birthday Lilly had experienced five disruptions of primary caregiving and safe havens were few.

When Lilly was 9 months old and in her third foster home, Jill rejoined her drug treatment program as a condition of reunification. Two months later, Lilly was enrolled in a therapeutic child care center staffed by teachers, a psychologist, a psychiatrist, and a special education teacher. The center was designed to provide child care for young children whose parents’ substance abuse and other psychological disorders made them vulnerable to attachment and mental health disorders. The therapeutic program had a preventive focus that included assessment of all developmental domains and treatment when concerns emerged.

Prior to attending the therapeutic center, 11-month old Lilly was visited in her fost–adopt home by me, the psychologist. She seemed to have an emotional connection with her foster mother, Sarah, who had cared for Lilly for 2 months. Lilly seemed curious about me as the visitor, crawled to a nearby table, and cautiously initiated a game of tapping on the table. Sad, weak smiles were Lilly’s responses to reciprocal tapping. It was evident that the infant was capable of attending to her world and interacting purposefully. However, her affect was constricted, and there seemed to be minimal energy and pleasure during exchanges. Throughout the visit, Lilly was silent and she frequently made eye contact with Sarah. Her foster mother gently supported Lilly’s mild curiosity about me and was warm in her responses to the infant’s soundless bids for reassurance.

During daily activities at the child care center, Lilly was found to have difficulty remaining calm and attentive during exchanges with caregivers and peers. When calm, she was able to engage in Peekaboo and other games, to which she responded slowly and with her characteristic sad smile that did not reach her eyes. Exchanges were brief and often lacked vitality. In addition, her appetite was poor and her sleeping patterns included frantic flailing when falling asleep and frequent sleep disrup

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Table of Contents

About the Editors
Foreword, by Anne Alvarez
More About A Home Within

I. Introduction
  1. The Children's Psychotherapy Project: One Child. One Therapist. For as Long as it Takes
    Toni Vaughn Heineman
II. Holding the Child, Knowing the System: Theories for Bridging Internal and External Worlds
  1. Walking Through Walls: The Mind of a Foster Child
    Peter G.M. Carnochan

  2. In Search of the Fuzzy Green Pillow: Fragmented Selves, Fragmented Institutions
    Rebecca B. Weston

  3. Seeing and Thinking: Bringing Theory to Practice
    Julie Stone
III: Therapists at Work: The Children's Psychotherapy Project in Practice
  1. Doctor Forever: Acute Loss in the Context of Chronic Loss
    Norman Zukowsky

  2. Beyond the 50-Minute Hour: A Continuum of Care for a Foster Child
    Martha P. Harris

  3. Falling Through the Cracks: The Complications of Reunification for an Adolescent in Foster Care
    Christopher Bonovitz

  4. Sunset in December: Working with Young Adults in Foster Care
    Isabelle Reiniger

  5. Many Parents, One Child: Working with the Family Matrix
    Diane Ehrensaft

  6. Beyond the Comfortable Edge: The Experience of Being a Therapist for Foster Children
    Richard Ruth
IV: Clinical Moments: Case Studies for Exploration and Discussion

Case Study: Infant–Parent Psychotherapy
Barbara Reed McCarroll

Case Study: A Boy Referred for Alleged Sexual Perpetration
Thetis Rachel Cromie

Case Study: Therapy in the Process of Reunification
Susan R. Bernstein

Case Study: Resiliency in the Context of Foster Care
Michael LoGuidice

Case Study: Parents Bonding with Nonbiological Children
Barbara Waterman

Toni Vaughn Heineman and Diane Ehrensaft

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