Name of Model

Circle of Security Parenting Enrichment Program.

Introduction

The impact of the family system – especially parenting – is understood to leave long lasting impressions on children. From being a child’s teacher, mentor, and protector, parents serve in many roles for their children. To optimally prepare for success, parents look for strategies and interventions to assist them in promoting individual and family resiliency. Various studies have found that parent-training courses often aid in decreasing parent stress and increasing perceived competency in ability (Neece et al., 2012; Meirsschaut et al., 2010). Others have described how parents feel more capable in handing difficult parenting challenges when exposed to workshops or direct interventions rather than personal research (Keen et al., 2010). One well-known, evidence-based parenting intervention is called Circle of Security.

Circle of Security Parenting Enrichment Program is an evidence-based parenting intervention used to address concerns around attachment and security. Over the course of the last decade, Circle of Security (COS) has grown in research and developed into a widely used model that is available in at least ten languages with ongoing research to continue improving the program. Lindquist and Watkins (2014) reviewed seven different parenting training programs to determine common core concepts that impact effectiveness. They found that a majority of parenting programs aim to do the same task by “promoting a better understanding of the basic needs and motivations that underlie a child’s behavior while also improving communication and fostering mutual respect” (Lindquist and Watkins, 2014, p. 161). Where programs differ are with respect to their theoretical roots.

Prominent Associated Figures

Developed by Glen Cooper, Kent Hoffman, and Bert Powell, Circle of Security is embedded in family systems, object relations, and attachment theory. Hoffman, Cooper, and Powell have run a clinical practice in Spokane, WA, for more than 30 years working with families and adult clients. They have worked together for the last few decades converting research around attachment styles in early parent-child relationships to develop a treatment model meant to promote healthy attachment.

Theoretical Framework

As previously noted, Circle of Security is grounded within object relations and attachment theory. Originated by Bowlby and Ainsworth, object relations and attachment theory reflect on the development of one’s personality by exploring the complex relationship between oneself and others, particularly, how one becomes independent from others while also having a profound attachment to them (Bowlby, 1969). Ainsworth is known for her exploration and identification of attachment styles through her laboratory-based observations of an infants’ response to the brief separation and reunion with a parent called the Strange Situation (Ainsworth et al., 1978). Ainsworth identified four basic attachment styles that have been later linked to the development of adverse mental health issues later in life.

The first is a secure attachment, which is characterized by a child’s confidence in that their attachment caregiver will be available to their needs (Ainsworth et al., 1978). The second is insecure avoidant attachment. This attachment style is characterized by a child’s physical and emotional independence from the caregiver, as the child does not seek out the caregiver when distressed (Ainsworth et al., 1978). The next is insecure ambivalent or resistant attachment. This style is characterized by a child’s duel dependence and rejection of the caregiver (Ainsworth et al., 1978). The final attachment style is disorganized, which is characterized by fearful, anxious, or inconsistent responses towards the caregiver (Ainsworth et al., 1978). This style is often associated with neglect, abuse, or other adverse relationship with the caregiver.

Each attachment style found in children is correlated with parenting response styles that promote the child’s attachment to the caregiver. Using the Circle of Security model, the primary belief around therapeutic change is that once the attachment style has been identified, parents are provided with necessary skills and tools to assist them in breaking adverse patterns that perpetuate insecure attachment styles in order to promote more secure attachments with their children. Hoffman, Marvin, Cooper, and Powell (2006) created their own video-based examples similar to Ainsworth’s Strange Situation intervention. These videos are used for the education of parents on attachment styles to assist with identifying their own interactions with their young children. Circle of Security aims to educate parents through use of video education, individual consultation with clinicians, and group work to not only understand the principles of attachment theory, but also to develop behavioral management strategies to enhance a more secure attachment style. Much of this work is also done through the use of self-reflection steps that allow parents to explore the material and connect their parent-child interactions with attachment styles.

Populations in Focus

Previous research indicates that the Circle of Security method mainly focuses on child development concerning attachment within the parent or caregiver-child relationship. Majority of studies have focused on examining caregiver-child dyads including children who are at risk for attachment issues because they are insecurely attached to their caregiver (Hoffman et al., 2006; Marvin et al., 2002; Fardoulys and Coyne, 2016; Huber et al., 2016). Psychosocial factors related to insecure attachment have included parent mental health problems, parental divorce or separation, substance abuse by a family member, family violence or abuse, and abuse or neglect of the children (Huber et al., 2016; Horton and Murray, 2015). Since attachments develop early in life between children and caregivers, studies were mainly concerned with toddlers – or preschool-aged children. However, the age range for child participants across the research spanned from as early as 11 months to 10 years of age. Parent and caregiver ages ranged from 16 to 55 years of age (Hoffman et al., 2006; Marvin et al., 2002; Fardoulys and Coyne 2016; Horton and Murray 2015). The Circle of Security-Parenting (COS-P) serves as the only group-based attachment program available in a manualized, multilingual format (Horton and Murray 2015). This program has been implemented in many countries such as the United States, Italy, New Zealand, and Germany, which increases the model’s applicability across cultures (Horton and Murray 2015; Pazzagli et al., 2014; Ramsauer et al., 2014; Fardoulys, and Coyne 2016).

Strategies and Techniques Used in Model

The Circle of Security model utilizes a group treatment modality, parent education, and psychotherapy intervention to promote a healthy attachment development process (Marvin et al., 2002; Hoffman et al., 2006; Fardoulys, and Coyne 2016). To achieve this goal, the protocol has several main tenets. First, it is imperative to establish the caregiver as a safe and secure base so that the child can feel comfortable exploring their environment as well as returning to the caregiver when distressed or seeking reconnection. As such, the therapist helps increase the caregiver’s level of sensitivity and responsiveness to the child’s signals of need for soothing. An additional goal is to increase caregiver empathy and ability to reflect upon one’s own, as well as the child’s, behavior, thoughts, and feelings concerning attachment-related interactions. Lastly, the therapist helps to increase caregiver reflection regarding personal developmental history that may be affecting present caregiving behavior (Marvin et al., 2002; Hoffman et al., 2006).

The COS program typically lasts 20 weeks, although a shortened 10-week version is available. As outlined by Marvin et al., (2002), and Fardoulys and Coyne (2016), the program begins with a pre-intervention assessment using the Circle of Security Interview (COSI), which is semi-structured interview designed to assess the caregiver’s internal working models of self and child, developmental attachment history, and to identify individual treatment goals for each dyad. Based on Ainsworth’s infant system (Ainsworth et al., 1978) and the adult classification, each dyad is coded as Secure/Autonomous, Avoidant/Dismissing, Preoccupied/Ambivalent, Disorganized/Abdicating, or Insecure-Other/Unclassifiable. During the intervention phase, the therapist meets with a group of caregivers, once per week, to review edited video-vignettes of caregiver-child interactions. The meetings focus on caregiver education regarding becoming the safe haven, increasing caregiver sensitivity to meet their child’s attachment needs, and the caregiver’s vulnerabilities within the caregiver-child interactions. Concepts unique to COS include “limited circles of security,” or insecure interactions between the caregiver and child, and “shark music,” or a caregiver’s vulnerabilities. Each week, one dyad’s video interaction becomes the focus of the group to allow for reflective dialogue. Four vignettes are implemented to highlight the parent’s caregiving system, areas of struggle, successful moments with the child, as well as celebrations of the parent-child relationship. At the conclusive sessions, the group reviews changes that have occurred within each caregiver-child dyad. A post-intervention assessment, consisting of caregiver rating scales and child and caregiver questionnaire data, is implemented to demonstrate each dyad’s changes from insecure patterns of attachment to secure ones.

Research about the Model

Mercer (2015) conducted a literature review of outcome studies and other reports which have examined the effectiveness of the COS program. The researcher reviewed 116 texts, which included books, journal articles, and dissertations. Following the review, Mercer concluded that the COS program is an emerging treatment with much promise. It was reported that the intervention is theoretically sound given that it stands on well-established principles of attachment theory, but that it cannot yet be considered an evidence-based intervention, as more empirical studies involving randomized controlled trials need to be conducted, particularly by independent researchers without an allegiance to the development of the model (Mercer 2015).

In one study, Hoffman et al., (2006) examined the effectiveness of the COS program with children living within disadvantaged environments that put them at risk for mental health issues later in development. The study consisted of 65 parent-child dyads pooled from Head Start and Early Head Start programs, set in an average sized city in the state of Washington. Approximately 6–8 weeks before the intervention, the participants underwent a pre-assessment phase, in which the participants’ attachment patterns were assessed using the Strange Situation Procedure and the Circle of Security Interview (COSI). The full 20-week COS intervention was implemented with groups of five to six parents. The researchers found that prior to the intervention, 60% of the children fell into one of two of the high risk attachment classification groups: Disorganized-controlling or Insecure-other. However, after the intervention, only 25% of the children fell into these two groups. Additionally, prior to the intervention, 20% of the children were identified as securely attached; following the intervention, 54% were classified as securely attached. In sum, such results are encouraging about the value of COS to improve attachment between caregiver and child. Limitations of this study and several others examining the effectiveness of the COS program are that there was no control group and the sample size was small (e.g., Marvin et al., 2002; Hoffman et al., 2006; Huber et al., 2016; Fardoulys and Coyne 2016). More studies are needed to demonstrate COS’s effectiveness compared to other parenting education programs in improving the caregiver-child relationship.

Case Example

Karen is a 34-year-old divorced, single mother with an 18-month-old daughter named Jessica. Karen entered into individual therapy due to her struggle with recurrent bouts of depression. She reported that she grew up in a volatile environment in which her mother also struggled with depression, and she characterized the relationship between her and her mother as very distant. Furthermore, she expressed that her mother was emotionally unavailable. Throughout treatment, Karen vowed to be a much better parent than her mother, but she was worried that her daughter presented as withdrawn and shut down, which reminded her of how she presented when she was a young girl. As a result, Karen’s therapist recommended that she and her daughter enter into the COS program being held at a local community center. Karen agreed to participate.

At the beginning of the COS program, Karen’s psychosocial history, as well as her internal working model for herself and her child were gathered using the Circle of Security Interview (COSI) (Hoffman et al., 2006). In addition, the interactions between Karen and Jessica were video recorded and assessed using the Strange Situation Procedure (Hoffman et al., 2006). During this procedure, the clinician noticed that Jessica played with the toys in the room while Karen was present in the playroom. Karen was looking through her phone for much of the procedure, and Jessica never cued her mother to become involved in her play. A stranger then entered the room, and Karen was asked to leave. When this occurred, Jessica stopped playing and she sobbed silently by the door. Karen then entered back into the room, and Jessica did not seek closeness with her mother, rather she went back to playing, as if using her explorative system to defend against the excitation of her attachment system. Based upon this dynamic, it was determined that Jessica exhibited an Insecure-Avoidant attachment style.

To follow, Karen was shown the video recording, and she was provided psychoeducation on attachment theory. In addition, she was informed that Jessica exhibited Insecure-Avoidant attachment characteristics. The clinician explained to Karen that it is important that she show an interest in Jessica’s play activity and praise the creativity exhibited within her play. In addition, Karen was informed that Jessica may often miscue that she does not need her mother by playing or exploring independently when the mother returns to the room following a separation, but that this is often a self-protective behavior due to a concern that she may not receive the emotional responsiveness that she seeks. This explanation resonated with Karen, as she reported often feeling this way with her own mother. By the end of the program, Jessica appeared a lot less withdrawn, evidenced by her tendency to smile more and reach for her mother when there was a separation of some kind. Jessica appeared more securely attached, and Karen exhibited fewer depressive symptoms, as she felt like a more competent parent.

Cross-References