Unconditional Care: Relationship-Based, Behavioral Intervention with Vulnerable Children and Families

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This Clinician-Friendly Guide presents a model for engaging the most challenging children and families who are served by the child welfare, mental health, juvenile justice, and special education systems. These children have been failed by every adult, every treatment modality, and every system of care that they have encountered.

Unconditional Care, a breakthrough guide from the founder and clinical director of California's Seneca Center for Children and Families, offers both a theoretical model and practical guidelines for working with this most difficult group of children. The approach weaves together attachment theory and learning theory into a relationship-based intervention strategy built around a no-fail policy: a child can never be discharged from a program for exhibiting the behaviors that resulted in the placement. Professionals working with these families instead focus on rebuilding relationships that teach children to secure safe and supportive relationships with caregivers using new behaviors and skills to replace the destructive ones that have, until now, organized their worldview.

Rich case examples, quick-reference and boxes, and sample assessment and planning worksheets make this a handy clinical reference and training tool for mental health and child welfare professionals.

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Editorial Reviews

From the Publisher
"Brilliant...Clinicians and treatment programs will find Unconditional Care indispensable in understanding traumatized children and helping them change and grow."
—Douglas Davies, MSW, PhD, Lecturer, School of Social Work, University of Michigan

"Sprinson and Berrick take on the task of integrating behavioral approaches with what we now know about attachment-based research and child development, offering phase-oriented, practical approaches to help anguished children heal."
—Sandra L. Bloom, MD, Associate Professor of Health Management and Policy, School of Public Health, Drexel University

"This book is one of the most interesting and useful integrations of clinical science and successful intervention strategies that I have ever encountered. Highly recommended!"
—Phillip R. Shaver, PhD, Distinguished Professor of Psychology, University of California, Davis and coeditor of Handbook of Attachment: Theory, Research, and Clinical Interventions

"Unconditional Care succeeds in clearly articulating both attachment theory and behavioral learning theory...The book is highly recommended..." —PsycCRITIQUES

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Product Details

  • ISBN-13: 9780199733033
  • Publisher: Oxford University Press, USA
  • Publication date: 1/26/2010
  • Edition description: New Edition
  • Pages: 304
  • Sales rank: 971,485
  • Product dimensions: 6.10 (w) x 9.20 (h) x 0.60 (d)

Meet the Author

John S. Sprinson, PhD, is Clinical Director of Seneca Center for Children.

Ken Berrick is Founder and Chief Executive Officer of Seneca Center for Children.

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Table of Contents

Introduction xv

1 Relationship and Engagement as Treatment 1

Opportunities for Engagement 4

2 Strengths and Risk Factors of Children with Intensive Needs 9

Risk Factors and Vulnerabilities 9

Strengths, Protective Factors, and Exceptions 25

A Final Note on Assessment, Treatment Planning, and Intervention 27

3 Attachment 28

Some Examples of Relationship in Practice 28

Commonalities of the Case Examples 30

Attachment Principles of Assessment and Intervention 31

Relationship, Attachment, and the Development of Psychopathology 47

From Attachment Theory to "Relationship-Based Intervention" 56

4 Assessment, Diagnosis, and Case Formulation 63

History of the Child and the Parents' Attachments 68

Current Relationships as They Emerge in Program 68

Traumatic Events 70

Strengths of the Child and the Family 70

Adaptive Capacities 71

Other Observational Categories 73

5 Relational Assessment and Intervention 77

Underlying Assumptions in Two Diagnostic Models 78

Assessment and Description of the Internal Working Model 81

The Child's Experience with Caretakers 85

The Child's Current Interpersonal Behavior 97

Relational Intervention: Using the Description of the Child's Internal Working Model to Drive Treatment 107

6 Positive Behavioral Intervention 113

Behavioral Intervention and Relationship-Based Work 114

Why Do Behavioral Intervention? 116

Methods of Behavioral Intervention 119

The Behavior Itself 120

Useful Dimensions for Describing Behavior 122

Criteria for Evaluating Descriptions 124

Behavioral Assessment I: How Much of the Behavior Is Happening? Does It Meet a Defined Standard? 126

Behavioral Assessment II: Attempting to Discern the Function of Behavior 128

The Questions that Drive a Functional Analysis 130

Key Ingredients in Implementing Positive Behavioral Change 136

General Considerations on the Use of Negative Consequences 151

7 Phases of Treatment and Key Activities 153

Preintake and Initial Screening 154

Assessment 155

Behavioral Intervention 163

Relational Assessment and Treatment 169

The Treatment Process Flowchart 173

8 Case Illustrations of the Model 176

The Case of David S. 176

The Case of Sarah P. 202


A Note Regarding Values 229

Love and Compassion 230

Respect 231

Curiosity 231

Hope and Courage 232

Joy 232

Appendices 235

Appendix A Relational Assessment Worksheet 235

Appendix B Relational Treatment Plan 239

Appendix C Target Behavior Definition Form 240

Appendix D Behavioral Assessment Planning Worksheet 243

Appendix E Observation Form-Frequency 247

Appendix F Observation Form-Intensity 248

Appendix G Observation Form-Frequency/Duration 248

Appendix H Observation Form-Duration 249

Appendix I Functional Assessment Worksheet 250

Appendix J Client Variables Form 255

Appendix K Functional Behavior Assessment Form 257

Appendix L ABC Observation Form 257

Appendix M Behavior Log 258

Appendix N Replacement Behavior Worksheet 259

Appendix O Behavioral Treatment Plan Worksheet 261

Notes 265

References 267

Index 275

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