A T “Deborah’s contribution to parenting adopted children with attachment problems is substantial. […] T After reading her book, many parents will feel certain that Deborah understands their child and their family. These same parents will also be likely to understand their child more deeply themselves, and A at the same time be able to develop the unique practical skills that parenting their child requires.” C —Dan Hughes, Ph.D., author ofFacilitating Developmental Attachment andBuilding the Bonds of Attachment H “I will be extremely comfortable recommending Attaching in Adoptionto parents and professionals. I also think it is suitable for adolescents to read. It would help them understand so many of their I N issues—particularly around the entire birth family ‘web’ and issues of shame and self-blame. I like this book!” —Gregory C. Keck, Ph.D., Founder/Director of The Attachment and Bonding Center G of Ohio, co-author ofAdopting the Hurt Child andParenting the Hurt Child “This book will be a powerful tool to help families with their children wounded by attachment I breaks. My wish would be that every adoptive parent could read this book before beginning their N journey.” —Nancy Thomas, founder of Families by Design, parent trainer, presenter, and author of When Love is Not Enough: A Guide to Parenting Children with RAD A Attaching in Adoptionis a comprehensive guide for prospective and actual adoptive parents on how D to understand and care for their adopted child and promote healthy attachment. This classic text provides practical parenting strategies designed to enhance children’s happiness O and emotional health. It explains what attachment is, how grief and trauma can affect children’s emotional development, and how to improve attachment, respect, cooperation, and trust. Parenting P techniques are matched to children’s emotional needs and stages, and checklists are included to T help parents assess how their child is doing at each developmental stage. The book covers a wide range of issues including international adoption, Fetal Alcohol Spectrum Disorder, and learning I disabilities, and combines sound theory and direct advice with case examples throughout. O This book is a must read for anyone interested in adoption and for all adoptive families. It will also N be a valuable resource for adoption professionals. Deborah D. Grayis a clinical social worker specializing in attachment, grief, and trauma based in Kirkland, Washington, USA. She grew up in an extended family with many adopted members. Her website can be found at D Deborah D. Gray www.deborahdgray.com. e b o r a ATTACHING h D . G Jessica Kingsley Publishers r ADOPTION 116 Pentonville Road a IN London N1 9JB, UK y 400 Market Street, Suite 400 Philadelphia, PA 19106, USA www.jkp.com Practical Tools for Today’s Parents Cover design: del norte (Leeds) Ltd 1 Advance Comments on Deborah Gray’s Attaching in Adoption “This positive, but realistic book is an important resource for all adoptive fami- lies, at any stage of pre and post-adoption. The information on attachment chal- lenges will allow prospective adoptive parents to understand the possible issues of their new children. Those that have adopted will be able to recognize some behav- iors of their children and learn methods of parenting that will help all to achieve success. As an adoptive parent and adoption professional, I found the vignettes heart warming and at other times, heart wrenching, but realistic and achievable within a hectic family setting. The clear explanations of the phases allows parents to easily measure where they are, where their children are and how they can improve their parenting and health of the entire family. Attaching in Adoption is also a valuable resource for professionals who work with parents. It will assist them to help parents to maneuver the sometimes-chal- lenging path of adoptive parenting. Deborah’s focus on the health of the family helps to normalize the specialized skills and techniques taught.” Yolanda Comparan, MSW, Program Manager, Adoption Resource Center Northwest Region (Seattle) Children’s Home Society of Washington “Attaching in Adoption: Practical Tools for Today’s Parents is a brilliantly written and sensitive educational journey into the developmental world of attachment. The book is a comprehensive and clear depiction of the importance of attachment, the challenge faced by parents adopting high risk children, and the negative effects of trauma and grief on the development of a secure attachment. The book reflects Ms. Gray’s depth of perception, understanding of child de- velopment, empathy, and attunement with the children and families she has served in her therapeutic practice. Ms. Gray provides practical common sense tools for parents that can support them in developing skills that will enhance healthy relationships and connections with their children. Ms. Gray is realistic and honest as she speaks to parents. She empowers them to take charge in a nurturing way. She respects the importance of the balance of nurture and structure. The chapters on building emotional intelligence, forming a team of support, and suggestions of when and where to seek professional help provide a hopefulness that there is a way out of the darkness of emotional chaos into the light of safety and trust for children suffering from attachment problems. Although “Attaching in Adoption” is written primarily for parents, I would encourage my fellow professionals to include this book on their “must read” list. It 1 2 ATTACHING IN ADOPTION will assist them in their overall understanding of attachment and in their therapeu- tic work with adoptive parents and children.” Beverly Cuevas, LCSW, ACSW, Co-founder of Attachment Center Northwest, Founding member and Board member of ATTACh, Founding Board member of ADI (Attachment Disorder Institute) “This book is a must for adoptive parents, adoption professionals and thera- pists. It stands out because Deborah writes with tremendous empathy and a pro- found understanding of challenges faced by children who have experienced trauma, attachment and neglect issues. It is a valuable resource for all types of adoption, including infant adoption. Adoptive parents will feel understood, supported and encouraged. Profession- als will find therapeutic techniques that promote attachment and increase the like- lihood of success during the course of therapy. Deborah conveys a positive and hopeful outlook based on her extensive experience in working with hurt children and their families. Throughout the book, there are a multitude of practical suggestions for man- aging and strengthening attachments. Her guidance is easily understood, each page offering insight and useful tools for a wide array of situations. She emphasizes the importance of working with skilled therapists and provides guidelines on how to find them. Always respectful of the issues surrounding the adoption experience, Deborah has produced a gem which should become required reading.” Patricia Martinez Dorner, MA, LPC, LMFT, Adoptive parent, adoption pro- fessional, co-author of Children of Open Adoption, author of How To Open An Adoption-A Guide For Parents And Birthparents of Minor Children; Talking To Your Child About Adoption and Search: An Ethical Guide For Professionals “In Attaching in Adoption: Practical Tools for Today’s Parents, Deborah Gray is able to translate into the written word the same caring, compassion, and respect that she shows toward both child and parent in her person-to-person contacts. In this book she returns again and again to the importance of both nurturing and structure in working to form close family relationships; the striking part is how well she is able to provide both for parents in the writing of this book. She emotionally nurtures parents while providing clear structure for them in creating a family envi- ronment that will promote attachments. In identifying ways to promote attachment, she follows a clear developmental approach, recognizing the needs of children of varying ages and helping parents identify how and where their child might be stuck in earlier stages of development. This is a very important aspect of this work; what is necessary at one stage may be inappropriate at another. 3 My favorite chapters of the book, however, are two of the shorter ones. Both fill gaps in the adoption literature for parents. The chapter on Trauma and Traumatic Loss translates the more recent information on the physiologic and psychologic ef- fects of trauma, as reported in the professional literature, into material that parents can understand and use in their day to day parenting. The second chapter that I particularly like is the one on Building Emotional Intelligence. In this section, Deborah again takes material from non-adoption sources and translates it into very practical ideas for adoptive parents to use in helping their child build and maintain healthy friendships. She identifies the gaps that children may have in their skills and provides ideas for remediation. As Deborah points out, “Skill in building and retaining healthy friendships is highly correlated with future happiness in life—much more so than are academic skills.” Although this book is primarily written for parents, most professionals in the area of adoption will find a wealth of practical ideas for helping parents be success- ful in building attachments with their adopted children.” Vera I. Fahlberg, M.D., author of A Child’s Journey through Placement “Deborah Gray has written an excellent book on parenting adopted children who resist being parented. It is not a cookbook, but rather a comprehensive book on parenting adopted children with attachment problems. That is why it is excellent. Deborah does not take the easy road of simply giving recommendations for various behavior problems. Instead she takes the more arduous route of first trying to help parents understand the meaning of their adopted child’s behaviors. After helping par- ents to understand the reasons for their child’s behaviors, she then gives them the tools for developing interventions that are most likely to fit their unique child. Deborah asks us to go beyond concluding that an adopted child has Reactive Attachment Disorder because they manifest a list of symptoms. She asks us first to also understand the impact of grieving and trauma on a child’s functioning. She also asks us to know more about the effects of anxiety, cultural changes, and various other diagnoses, such as ADHD, FAE/FAS, and Learning Disorders. Most impor- tantly, Deborah teaches us about the seven stages of attachment, beginning at birth and extending through adolescence, and she helps us to be aware of various inter- ventions that can facilitate development at each stage. Finally, she tells us about emotional intelligence, its failure to develop following early abuse and neglect, and the importance of understanding ways to facilitate it. Deborah’s contribution to parenting adopted children with attachment prob- lems is substantial. It is based on understanding and having empathy for the mean- ing behind a child’s symptoms, along with effective, sensitive, and well-matched parental interventions. At the same time, she addresses the necessity of parental self- care, if parents are to persistently provide the quality of care that their adopted child requires. 4 ATTACHING IN ADOPTION After reading her book, many parents will feel certain that Deborah under- stands their child and their family. These same parents will also be likely to under- stand their child more deeply themselves, and at the same time be able to develop the unique practical skills that parenting their child requires.” Dan Hughes, Ph.D. author of Facilitating Developmental Attachment and Building the Bonds of Attachment. “Deborah Gray’s work captures theory, practicality, and sensitivity toward trau- matized children—all in one book. Too many books have only one of these compo- nents, and her integration of may important facets of all three, comfortably leads the reader to a clear understanding of how children are hurt and how families can help them heal. I will be extremely comfortable recommending Attaching in Adoption to par- ents and professionals. I also think that it is suitable for adolescents to read. It would help them understand so many of their issues—particularly around the entire birth family “web” and issues of shame and self-blame. I like this book!” Gregory C. Keck, Ph.D., Founder, Attachment and Bonding Center of Ohio and co-author of Adopting the Hurt Child and Parenting the Hurt Child “Attaching in Adoption is a valuable resource for parents not only as they contem- plate building their family through adoption, but also as they travel their child’s emo- tionally challenged path towards mental health and happiness. Deborah Gray has de- scribed attachment and all of the skills and responses that relate to an individual’s attachment style and degree of attachment, and she has done so in a manner easily understood by non-professionals. The chapter on developmental stages is an invalu- able tool for parents to assess their child’s emotional age and determine what tasks have yet to be mastered. Parents who understand and implement the wisdom and methods described in this book will certainly strengthen their families!” Nancy Spoolstra, D.V.M., adoptive and foster parent and Executive Director of the Attachment Disorder Network “This is the most comprehensive work on the subject I have ever enjoyed read- ing. Deborah’s incredible insight from her years of experience with difficult kids shines through in this enlightening book. No stone is left unturned in her effort to give a clear understanding of attachment. This book will be a powerful tool to help families with their children wounded by attachment breaks. My wish would be that every adoptive parent could read this book before beginning the journey to adopt.” Nancy Thomas, founder of Families by Design, parent trainer, presenter, and author of When Love is Not Enough—A Guide to Parenting Children with RAD. 5 Attaching in Adoption Practical Tools for Today’s Parents Deborah D. Gray Jessica Kingsley Publishers London and Philadelphia 6 ATTACHING IN ADOPTION Front cover image source: Can Stock Photo®. Th e cover image is for illustrative purposes only, and any person featuring is a model. Circle of Security diagram on p.20 is reproduced by permission of Cooper, Hoff man and Powell LLC. DSM-IV defi nitions 313.89 and 309.81 on pp.363–366 are reprinted with permission from the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision. Copyright © 2000 American Psychiatric Association. Defi nitions of FAS and ARND on pp.366–369 are reproduced by permission of the National Academy Press. Th is edition published in 2012 by Jessica Kingsley Publishers 116 Pentonville Road London N1 9JB, UK and 400 Market Street, Suite 400 Philadelphia, PA 19106, USA www.jkp.com First published in 2002 by Perspectives Press Copyright © Deborah D. Gray 2002 All rights reserved. No part of this publication may be reproduced in any material form (including photocopying or storing it in any medium by electronic means and whether or not transiently or incidentally to some other use of this publication) without the written permission of the copyright owner except in accordance with the provisions of the Copyright, Designs and Patents Act 1988 or under the terms of a licence issued by the Copyright Licensing Agency Ltd, Saff ron House, 6–10 Kirby Street, London EC1N 8TS. Applications for the copyright owner’s written permission to reproduce any part of this publication should be addressed to the publisher. Warning: Th e doing of an unauthorized act in relation to a copyright work may result in both a civil claim for damages and criminal prosecution. Library of Congress Cataloging in Publication Data Gray, Deborah D., 1951- Attaching in adoption : practical tools for today's parents / Deborah D. Gray. p. cm. Includes bibliographical references and index. ISBN 978-1-84905-890-2 (alk. paper) 1. Adoption. 2. Attachment behavior in children. 3. Attachment disorder in children. 4. Adopted children--Family relationships. I. Title. HV875.G69 2012 649'.145--dc23 2011040123 British Library Cataloguing in Publication Data A CIP catalogue record for this book is available from the British Library ISBN 978 1 84905 890 2 eISBN 978 0 85700 606 6 Printed and bound in the United States 7 Dedication This book is dedicated to my family: Tricia, Joey, Summerlea, and Joseph. Thanks for your acceptance and encouraging words throughout this project; And to my much-loved parents, Patricia and Gerald Gray, who passed the torch. 8 ATTACHING IN ADOPTION Acknowledgments I am blessed to be part of an intentional community of collaborative children’s advocates who are working on behalf of families. My mind fl ashes to the creative Mary-Carter Creech, who works with me using the Nurturing Attachments approach, Brian Andersen (Cascadia Training/Northwest Adoption Resource Exchange), Suzanne Hunsley, Dr. Gwen Lewis, Yolanda Comparan, (Adoption Referral and Information Service), MaryAnn Curran, (WACAP). I have learned and been supported by the clinicians in the Attachment-focused therapy post-graduate certifi cate program in Seattle (NWARE/Cascadia Training) and the Foster care and Adoption Post-Graduate Certifi cate Program (Portland State University). Care Th erapy post-graduate certifi cate program participants in Seattle (NWAE/Cascadia Training) and in Oregon (Portland State University). Th e Center for Adoption Medicine and the Seattle Clinical Consult Groups have been resource rich and generous in support. Th ese relationships show up in the pages of this book, in the pages of my life. Th ank you, honey, to my husband, Joseph MacKenzie, not only for the intangibles of valuing my life’s work and this book, but for the practicalities of building and maintaining computers that run well and fast. Tricia MacKenzie helped me with those fast computers. Th anks! My sincere thanks to the families with whom I work. Th ey have been patient with my restricted hours in order to fi nish the book. I am also grateful for the many lessons and techniques shared by families as they work with their children. Th ank you for teaching me. Th ank you for the joy of getting to work with you. Linda Katz and Norma Spoonamore, leaders in child welfare’s permanency planning, took time to mentor my development. Th eir imprint is on many sections of this book. My thanks to Dr. Elinor Ames, who fi rst encouraged me to write and then took time to critique the writing. Vera Fahlberg, MD, fostered my developmental understanding of children with multiple moves. I am grateful for her templates in understanding children. 8