Dyadic Treatment, Reflective Functioning, and Videofeedback: Fostering Attachment with Families in the Foster Care System

Abstract

ABSTRACTThe Building Blocks Program encourages parent-child bonding, attachment, and reflective functioning based on theories of nonverbal communication and mentalization. In the Building Blocks Program, young children who are in foster care or at risk of being in foster care are seen in dyadic sessions with their birth parents in a clinical setting. The parents come in with traumatic histories, including adverse childhood experiences, disrupted connections, mental illness, ongoing exposure to poverty and violence, and have little social support. The children have significant medical, emotional, and/or cognitive challenges. In this article, all aspects of the Building Blocks Program are described, including training for therapists, treatment for parents and children in supervised play/visitation sessions, Reflective Supervision with therapists in group and individual sessions, and the model of Nested Mentalization. Using video and videofeedback as a vehicle for positive change, therapists promote emotional healing and parent-child attachment. In Reflective Supervision, supervisors make every effort to understand the thoughts and feelings of the therapists. A holding environment is provided for the therapists who, in turn, hold the parent, who can then hold the child. Two cases are described that demonstrate the many layers of complexity in the Building Blocks model, and how the multifaceted levels of complicated systems are addressed.