Carlow College

Masters in Therapeutic Child Care

Dissertation Proposal
In part fulfilment of Masters in Therapeutic Child Care

By Ms. Geraldine Maughan 1st of December2007

MINI PROPOSAL OUTLINE

Title
Marte Meo A Valuable Intervention In Enhancing and (Re) Establishing Attachment Relationships.

Abstract
This Dissertation introduces attachment theory as a practical approach to understanding attachment disorders along with the work of Marte Meo Therapists which is to promote emotionally secure children.

Attachment theory provides a structure within which parents/caregivers can somewhat easily realise the basic relationship needs of children. Bowlby (1969/1988) believed that young children are designed through evolution to stay close to at least one particular protective adult. Likewise the parents caregiving methods are similarly devised. The child is provided with a sense of security once the circumstances are favourable. When the child feels safe they explore the physical, emotional and social world and develop the competence necessary to realise their proficiency as self-reliant adult. Ainsworth et al., (1978) realisation of the balance and interaction between the attachment system and the exploratory system combined to give superior evolutionary gains is possibly her most significant contribution to the study of early relationships.

A theory introduced by John Bowlby and advanced by Mary Ainsworth claims that human security depends on others; and that our psychological approach to the world and others depends on the trustworthiness of this connection. It defines a persons willingness to encounter new challenges.

The Marte Meo method was founded by Maria Aarts and was originally developed to work with multiproblem families and children in danger of neglect and abuse. The Marte Meo method is a video-based interaction programme that provides a practical approach based on attachment and child development theories. The thrust of the Programme is prevention, early intervention and treatment. The words Marte Meo means "on one's own strength".

This is a solution focussed method that identifies the parents/caregivers current level of functioning and builds on this. In this way, it aspires to develop the competence of parents and carers. Parents can enhance the quality of life for their family using this method to support the social, emotional and communication development of their children. Following video analysis of their moment-by-moment interactions

information is conveyed to the parents/caregivers, which can be incorporated into the individuals unique mode of communicating.

Several Community studies have shown that it is the quality of the immediate moment to moment behaviour of the parent towards the child that has the major influence on the childs wellbeing rather than on their lifes circumstances. Rutter

Aims and Objectives

1.

Discover the validity of Marte Meo with families with particular

emphasis on Attachment. 2. 3. 4. Read relevant literature. Consider key developments in Attachment Theory and Research. To discuss Stern and Aarts joint presentation at Marte Meo conference

2004 in Berlin. 5. 6. Ireland. 7. To consider where the information from the literature review To interview Maria Aarts (founder of Marte Meo). To interview the Assistant Marte Meo Co. Co-ordinator of Marte Meo

corresponds to therapists/parents views.

Questions I hope to answer

1. What place Marte Meo has in the midst of Attachment Theory? 2. What elements of Marte Meo Therapy if any contribute to enhancing, establishing, or re-establishing attachment? 3. Does Marte Meo Therapy assist parents forming attachments with their children? 4. Has Marte Meo assisted families where other interventions havent?

Rationale for the Study

Approximately 80% of my current workload consists of Marte Meo Therapy. I believe my delivery of Marte Meo Therapy can become more proficient due to studying Attachment Theory as part of the MATCC course.

For those working with children in troubled families, attachment has become an increasingly important construct for deciding on placements, and for planning and implementing treatment (Byrne, O'Connor, Marvin & Whelan, 2005).

For numerous reasons parents want interventions to focus solely on their problematic child. Interventions enquiring about parents experiences are not

always successful for a number of reasons. Parents often do not understand why the focus is on them and not about their child. Both parents and workers regularly feel frustrated at this impasse. Marte Meo is successful in this regard, it always delivers information from the perspective of the childs needs and how parents can best support the child in his development. New insights may be brought into the experiences of Marte Meo therapists. Using this research method I hope to contribute to the development and or revisiting of knowledge by exploring how therapists and parents/caregivers interpret and make sense of their experiences of Marte Meo as a therapeutic intervention. (Denzin NK & Lincoln YS (eds) 2000)

Brief Literature Review

Literature from multiple disciplines will be reviewed to explore attachment theory. The patterns of attachment will be considered looking at the working model of the child and when this is activated what can be expected, with reference to the role of attunement. The use of video can demonstrate that remarkable changes can occur

during interaction between parent/caregiver and child once the adult grasps the appropriate information and support the child requires in moment to moment interactions.

The work of Aarts, Ainsworth, Bowlby, Perry, Stern and Overide/Hafstad will be considered while others will be briefly mentioned. Literature will be sourced from books, Journals and Internet websites.

Bowlby concluded the Epilogue to the last volume of Attachment and Loss by saying:

"Intimate attachments to other human beings are the hub around which a person's life revolves, not only when he is an infant or a toddler or a schoolchild but throughout his adolescence and his years of maturity as well, and on into old age. From these intimate attachments a person draws his strength and enjoyment of life and, through what he contributes, he gives strength and enjoyment to others. These are matters about which current science and traditional wisdom are at one. (Bowlby 1981, p. 442).

Whatever the form of attachment, infant and mother must still manage the developmental phases that lead to the formation of an individuated personal identity and a sense of self as a complete entity with the capacity to function independently.

Strange Situation is a 20-minute procedure in which the attachment figure is twice briefly separated from, and then reunited with, the child. Trained coders classify videotaped Strange Situations to assign children to patterns of attachment. The results

are considered in terms of how well they differentiate maltreated from non-maltreated children and the extent to which the classifications are associated with assessments of child, mother, and whole-family functioning.

Concepts like attachment and bonding became the framework for studies in childcaregiver interaction. In the eighties, psychiatrist Daniel Stern (1985) described an incredibly fine-tuned reciprocal communication between infants and their mothers through mutual use of sounds, mimicking and movement.

Using video technology, Stern (1985) began looking at the interactions of mothers and babies in the early 1970s. His minute analysis of the interactions between mothers and babies has offered realistic support and modification for many theories of development. Analysing them frame by frame presented a completely new

understanding of early development that had not been previously available. In his interesting incorporation of child developmental psychology research and

psychoanalytical theory, amongst other concepts, Stern illustrates research on attunement which specifies how the childs impression of self can be augmented or stifled

Methodology
I expect to use a qualitative approach; Qualitative research involves disciplined inquiry that examines peoples lives, experiences and behaviours, and the stories and meanings individuals ascribe to them. My research approach will involve the studied use and collection of a variety of empirical materials.such as, professional experience

from providing the therapy and receiving clinical supervision in addition to interviews and questionnaires.

Obtaining information from participating therapists who have completed interventions with families no later than one year ago is the optimum method. I will select my sample from Therapists currently using the method with families and conversely from the families who have completed the therapy. Detailed information will accompany the Questionnaires covering such topics as: Outline of the study. Aims and Objectives. Guidance on what is required. Inform parents that they have them in mind. The information is anonymous. It is likely to benefit other therapists in how they work with families. It gives parents an opportunity to have their say. It will benefit the researchers academic achievement and practice. Any required information in order to complete the Questionnaires

It is possible for this Dissertation to perform the research on adults i.e. Marte Meo Therapists as they are ethically best placed to answer the questions raised by this research. Ethics can be defined as a set of moral principles and modes of conduct. Ethics in research as Sieber put it, relates to

the application of a system of moral principle to prevent harming or wronging others, to promote the good, to be respectful, and to be fair (Sieber 1993 p14)

There will be strict adherence to the dignity and rights of participants throughout the process. Non-therapeutic research is undertaken to produce more knowledge and there is not a direct intended benefit to research participants from the research (Dimond 1996, Tyson 1995). This study presents a reasonable opportunity to further the understanding of a serious problem affecting the health and welfare of children. Information will be given to therapists as outlined above. The results presumably would not directly benefit those in the study unless they wish to explore further their own practice. For this reason, it is necessary to state clearly that their involvement is not necessarily for their own benefit but may influence their view of the Method.

I would endeavour to carry out a semi-structured interview with Maria Aarts the founder of the Marte Meo method and Ms. Patricia Byrne the Assistant Co-ordinator of the Marte Meo Project in Ireland. I have chosen Ms. Byrne since she has not trained or supervised me and to ensure impartiality.

Videotape recordings will be made of the interviews. These records are research data in themselves, but most likely will be transcribed. Interviews will be conducted in locations and at a time mutually acceptable to participants and interviewer.

Interviews will be semi-structured, which will use an interview guide listing a set of issues to be explored and unstructured interviews, which involve spontaneous

generation of questions in the natural flow of interaction, and where the interview is driven by the interviewee rather than the interviewer. The participants will be

informants, the reason for choosing an informant for the interview is to allow interviews to be conducted with individuals with specific knowledge or expertise about the issue being explored.

I hope to triangulate the Questionnaires, Interviews, and Literature review and examine the themes that materialise. I would be expecting strong evidence to emerge validating the benefits of Marte Meo as a valuable Intervention in enhancing and (re) establishing attachment relationships.

Scope and Limitations of the Research

1. There is a time limit on the research. 2. It is not possible within the time to evaluate similar methods used around the world. 3. Many of the literature on Marte Meo is not translated into English. Marte Meo is in it is infancy in Ireland concerning research which allows little scope to review literature. 4. Information taken from the questionnaires will be the therapists interpretation of the reality. Given more time it would be beneficial to hear directly from the parents with a view to comparing 5. Attachment and Marte Meo is where my professional interest lies. Writing this dissertation will be a valuable tool in advancing my delivery of Marte Meo.

Timetable
I would envisage this Dissertation to be complete by the end of April 2008. This proposal is now due in, the literature review by mid January with additional chapters to follow every three weeks. Questionnaires will also be ready to be posted to Marte Meo Therapists by mid January including the detailed guidance as outlined in the Methodology section.

The outline of this Dissertation will have

Title page Abstract List of contents List of Illustrations or tables Acknowledgements Definitions of key terms and abbreviations Introduction and aims of the research Review of the literature Methodology and data-collection techniques Results Conclusions and implications for practice. Strengths and weaknesses of this research will be included and suggestions for future research Appendices Bibliography of references cited in the text Bibliography of references not cited in the text

References

Ainsworth, M.D.S., Blehar, M.C., Waters, E., & Wall, S. (1978). Patterns of attachment: A psychological study of the strange situation. Hillsdale, NJ: Lawrence Erlbaum Associates.

Bowlby, J. (1988). A secure base: Parent-child attachment and healthy human development. New York: Basic Books. Bowlby, J. (1969). Attachment and loss: Vol. 1. Attachment. New York: Basic Books.

Denzin NK & Lincoln YS (eds) 2000 Handbook of Qualitative Research, Sage: California)

Dimond, S. 1996. The evaluation of information systems: a protocol for assembling information auditing packages. International Journal of Information Management 16, (5)

Haldor vreeide & Reidun Hafstad (1996), The Marte Meo Method and Developmental Supportive Dialogues. Aarts Productions.

Practitioner Review: The contribution of attachment theory to child custody Assessments JG Byrne, TG O'Connor, RS Marvin, WF Whelan - Journal of Child Psychology and Psychiatry, 2005 - Blackwell Synergy

Sieber, J. (1993) The ethics and politics of sensitive topics, London: Sage

Stern, D. (1985). The Interpersonal World of the Infant, New York: Basic Books.

Stern, Daniel N. (2004), The present moment in psychotherapy and everyday life. New York: Norton.

Tyson, K. (1995). New foundations for scientific social and behavioral research: The heuristic paradigm. Boston, MA: Allyn and Bacon.

Quinton D, Rutter M. Family pathology and child psychiatric disorder: A four-year prospective study. In: Nicol AR, ed. Longitudinal studies in child psychology and psychiatry. Chicester: John Wiley & Sons; 1985: