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Preview Raising Parents

Cover Page Page: i Half Title Page Page: i Title Page Page: v Copyright Page Page: vi Dedication Page: vii Contents Page: ix List of illustrations Page: xiv Acknowledgements Page: xv PART 1 Yesterday's children Today's mothers and fathers Page: 1 1 Cherishing parents Page: 3 Helping professionals to help parents Page: 4 The Dynamic-Maturational Model of Attachment and Adaptation Page: 9 DMM Integrative Treatment Page: 12 Notes Page: 13 2 A primer of DMM theory: twelve crucial constructs Page: 14 The context of life: from genes to culture Page: 14 Developmental possibilities: diversity and change Page: 17 Treatment of maladaptation Page: 20 Conclusions Page: 23 Important concepts and terms Page: 25 PART 2 Growing up Page: 27 3 Early childhood: learning to be safe at home Page: 29 Protection, danger, and attachment figures Page: 29 Infancy (birth to 1–2 years) Page: 32 Preschool years (2–5 years of age): the preoperational shift and coy behavior Page: 36 Important concepts and terms Page: 47 Note Page: 47 4 Going to school: coping with a complex world Page: 48 School age (approximately 6–12 years) Page: 48 Issues for children using a compulsive Type A strategy Page: 51 Issues for children using a coercive Type C strategy Page: 56 Issues for children using a Type A/C strategy Page: 58 Adolescence (puberty–16 years) Page: 60 Important concepts and terms Page: 69 5 Becoming an adult: loving and leaving Page: 71 Transition to adulthood (16–25 years) Page: 71 Yesterday's children Page: 86 Important concepts and terms Page: 87 PART 3 Information processing Page: 89 6 Remembering the future: the process of mental representation Page: 91 Seven transformations of information Page: 91 Dispositional representations (DRs) Page: 93 Selection of a dispositional representation upon which to act Page: 103 Conclusions Page: 104 Important concepts and terms Page: 104 Notes Page: 105 7 How do parents affect children's representations? Page: 106 Representation and protective strategies Page: 106 Reorganization, trauma, depression, disorientation, and intrusions of forbidden negative affect Page: 111 How does perception of danger affect behavior? Page: 114 How do parents' strategies affect children's strategies? Page: 115 Important concepts and terms Page: 117 8 Representation and childrearing that endangers children Page: 119 Why parents behave as they do Page: 119 Interpersonal disorders in children Page: 125 Assessing transformations of information and DRs Page: 127 A hypothesis and questions for future research Page: 128 Conclusions Page: 130 Important concepts and terms Page: 130 PART 4 Parents' dispositional representations Page: 131 9 Cluster 1 – distortions of normal child-protective behavior: under-responding to children Page: 133 Inconsistency from mixed dispositional representations (DRs) Page: 133 Inconsistency from competing mother and father DRs Page: 134 Inconsistency from distraction Page: 135 Couples' issues and inconsistency Page: 139 Conclusions about Cluster 1 Page: 140 Outcomes Page: 141 Important concepts and terms Page: 142 Note Page: 143 10 Cluster 2 – distortions of normal child-protective behavior: over-responding to children Page: 144 Fear of loss: impairments and imagined medical threats Page: 144 ear of children doing the wrong thing: punishment and child abuse Page: 145 Immigrant populations Page: 152 Outcomes for children Page: 152 Conclusions Page: 154 Important concepts and terms Page: 154 11 Cluster 3 – distortions of perception: seeing yourself in your child Page: 155 Comfort me/you: paternal incest Page: 155 Give me sugar: spousification Page: 160 Oh, no! I can't!: mother's compulsive performance and postnatal depression Page: 163 Never again – the long reach of unresolved trauma Page: 167 Conclusions Page: 169 Important concepts and terms Page: 170 12 Cluster 4 – obscured perceptions: the disappearing child Page: 171 Depression and insufficient caregiving Page: 171 Unpredictable and changing dangerous parental behavior Page: 175 Triangulating parental behavior Page: 178 Disoriented parental behavior Page: 179 Important concepts and terms Page: 184 13 Cluster 5 – distortions that substitute erroneous information for accurate information: misconstruing children as being threatened Page: 186 Kate and the Cutters: a hard rock in search of balance Page: 187 Perceived on-going threat Page: 190 Child death Page: 197 Understanding Cluster 5 Page: 198 Important concepts and terms Page: 200 14 Cluster 6 – distortions that substitute deadly delusional information for accurate information: misconstruing the child as the threat Page: 202 A Type A example Page: 204 A Type C example Page: 210 Child homicide Page: 214 Understanding parents who intentionally kill their children Page: 214 Preventing child deaths Page: 215 Important concepts and terms Page: 220 Note Page: 220 PART 5 An integrative approach to treatment Page: 223 15 DMM Integrative Treatment with families Page: 225 A rationale for DMM Integrative Treatment Page: 226 Beginning the process of DMM Integrative Treatment with parents Page: 230 Using attachment to promote the goals of therapy Page: 235 Adaptation Page: 242 Important concepts and terms Page: 244 Notes Page: 244 16 When things fall apart Page: 246 Problems in treatment Page: 246 Alternatives to out-of-home placement Page: 260 IASA Family Attachment Court Protocol Page: 261 Foster care and out-of-home placement Page: 263 Research to learn what we do not now know Page: 265 Important concepts and terms Page: 266 17 Assessment that is relevant to differential treatment Page: 267 What sort of assessment is needed? Page: 267 What we need to know before beginning treatment Page: 268 What is assessment? Page: 271 Assessing attachment and information processing Page: 272 Contraindications: avoiding the wrong treatment Page: 276 On-going assessment following formal assessment Page: 277 Important concepts and terms Page: 277 18 Functional formulation and the plan for treatment Page: 278 Functional formulation Page: 278 The components of a functional formulation Page: 280 Constructing the functional family formulation Page: 281 The role of professionals Page: 281 Attachment, critical causes, and case planning Page: 284 Important concepts and terms Page: 285 19 DMM Integrative Treatment: three cases Page: 286 Mild and transient dysfunction (normal parenting) Page: 286 Moderately severe dysfunction (Cluster 3) Page: 291 Severe parenting dysfunction (Cluster 5) Page: 298 Conclusions Page: 302 Important concepts and terms Page: 302 Notes Page: 303 20 Do unto parents as you would have them do unto their children Page: 304 DMM Integrative Treatment Page: 305 Parenting, survival, and culture Page: 308 Ten ideas Page: 309 From survival through healing to living Page: 315 Important concepts and terms Page: 317 References Page: 318 Index Page: 343

Helping troubled parents to raise their children adequately is of crucial importance for parents, their children and society at large. Distressed parents have themselves often been endangered and, as a consequence, sometimes endanger their children either through maltreatment or through the effects of parental psychiatric disorder. Raising Parents explains how that happens and clusters parents in terms of the psychological processes that result in maladaptive childrearing. The book then delineates DMM Integrative Treatment in terms of assessment, formulation, and treatment. New formulations are offered for problems that have resisted treatment and cases demonstrate how the ideas can be applied in real treatment settings. The book closes with 10 suggestions for improving professionals’ responses to troubled families and endangered children. This edition of Raising Parents introduces DMM Integrative Treatment and demonstrates how to use it with vulnerable families. DMM Integrative Treatment is an interpersonal process and this book will be essential reading for clinicians from all disciplines, including psychiatry and psychology, social work, nursing and all types of psychotherapy.
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