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
Afterword
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
