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The Hexagon: An Exploration Tool
The Hexagon can be used as a planning tool to guide selection and evaluate potential programs and practice for use.
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Core Components
Circle of Security Parenting (COSP) is designed for parents of young children, 4 months to 6 years. In particular, it is aimed at parents who would benefit from support to recognise and improve their relationship with their child. The programme can be used for high risk and highly vulnerable families, often as an entry point to a wider programme of support and intervention, offered by the implementing organisation.
COSP is an 8-session educational group programme which uses video vignettes, reflective questions posed by a trained facilitator and a series of graphics including the Circle of Security graphic to introduce attachment theory in an accessible manner. Each session introduces a concept of the theory, and then caregivers are prompted to observe the concept in action within a video clip and reflect on what they have seen. Using the Circle Security graphic caregivers learn about providing a secure base from which their child can explore, and a safe haven to which their child can return. The key message to caregivers is that their role is “Always: be BIGGER, STRONGER, WISER, and KIND. Whenever possible, follow your child’s need and whenever necessary, take charge.”
COSP is clearly operationalised. It is a manualised programme, where each session is highly structured, with detailed instructions on content and managing the group processes. Animations, video clips and handouts articulate key messages of the programme. It is an adaptation of Circle of Security Intensive program, specifically designed to be implemented widely and easily. Handouts have been written using clear and simple language, and require minimal literacy skills.
Fidelity
The core features are clearly defined. The programme needs to be delivered as a minimum of 8 sessions of 90 minutes, over a period of a minimum of 8 weeks. Additional sessions can be added to cover the topics, but the programme must not be compressed. Fidelity is managed by adherence to the manual. In addition, COSP has a reflective Fidelity Journal. Fidelity coaching is available, at different levels of intensity, including video review.
Modifiable Components
COSP is a modified version of the COS Intensive programme. COSP can be delivered in group format, or with individuals or couples. COSP can also be delivered to other caregivers such as foster carers, or childminders. Video footage is available with British English narration. The programme can be delivered in more, but not fewer than 8 sessions. Materials have been translated in to other languages. In order to maintain fidelity, further modification of the components of the programme is not supported.
Circle of Security International is based in the US. Circle of Security Parenting training is offered within the UK and can be delivered on site.
Support for Organisation/Practice
Implementation Support
On completion of training, practitioners have access to a manual which includes detailed session plans and handouts. They also receive the 8-session narrated video. On the members section of the Circle of Security International website, further resources are available including a fidelity journal and tip videos on implementation.
For additional cost, fidelity coaching is available at a range of levels to support practitioner development. There is a programme to support practitioners become fidelity coaches.
Licence Requirements
There are no licence requirements.
Start-up Costs.
Cost are limited to initial training (approx. $1000 USD per place), and the costs for equipment for showing video clips if this is not already available. Optional fidelity coaching costs start at $540 USD per practitioner for a nine-session initial level coaching programme.
Building Staff Competency
Qualifications Required
Practitioners need to have experience working with parents of young children. There are no set qualifications or specific prerequisites for training. The programme outlines the key competencies for practitioners which includes ability to understand and model the key concepts of the programme. They need to be able to manage the group and recognise issues that may be raised such as disclosure of trauma.
Training Requirements
Training consists of four days of face-to-face training. It is regularly offered in the UK and can be commissioned for on-site delivery. Training includes all the materials required to run the programme and access to the facilitators section of the website.
Supervision Requirements
Specific COSP supervision is not mandated. Practitioners will require access to reflective supervision. Practitioners can complete a fidelity journal. Circle of Security International offers a fidelity coaching programme.
Evidence - Rating: 3 - 4+
Theory of Change
COSP has an explicit logic model based on knowledge and theory about attachment and the link between secure attachment as a protective factor for child development. It has the long term goal of enhancing secure attachment between caregivers and children. The mechanism by which the program intends to deliver these outcomes is:
• Demonstrate, using video review, an attachment-based model of children’s developmental needs emphasising the role of the caregiver in an accessible manner.
Through these mechanisms, the programme aims for caregivers to develop more reflective and empathetic responses to their child.
Infants and Toddlers: 0-36 months - Rating: 3
Research Design & Number of Research Studies
One randomised controlled trial which included, but was not limited to, parents with children age 0-36 months and included a child outcome was identified. This was conducted independently of the programme originators.
Outcomes Achieved
Attendance at Circle of Security Parenting, in addition to standard treatment was associated with:
Child outcome
Significantly improved child-caregiver interaction from baseline to 12-month follow-up.
Parent outcome
Significant increase in emotionally available interactions, which were maintained at follow-up.
In the COSP group, from baseline to the 12 months follow-up, there was a significant increase number of caregivers that had a balanced narrative of their child. That is that caregivers were able to think of their child as having its own thoughts, feelings, intentions and desires in a coherent way. (There was no significant change for parents in the control group).
There were non-significant improvements with the control group, and there were not significant differences in any outcome between the COSP group and controls.
Reference
Mothander, PR., Furmark, C, & Neander, K. (2018). Adding “Circle of Security -Parenting” to treatment as usual in three Swedish infant mental health clinics. Effects on parents’ internal representations and quality of parent-infant interaction. Scandinavian Journal of Psychology, 59(3), 262-272.
Preschool: 3 to 5 years - Rating: 4+
Research Design & Number of Studies
One randomised controlled trial (RCT) which was conducted with parents with children aged 3-5 years was identified. This was conducted independently of the programme originators. In addition, the evidence presented above included parents of children aged 3-5, and remains relevant.
Outcomes Achieved
In addition to the outcomes already stated, attendance at Circle of Security Parenting, in comparison with waiting list control was associated with:
Child outcome
Significantly increased inhibitory control.
Parent outcome
Significant change in maternal response to child distress, with fewer unsupportive behaviours.
Reference
Cassidy, J., Brett, B., Gross, JT., et al. (2017). Circle of Security-Parenting: A randomized control trial in Head Start. Development and Psychopathology 29, 651-673
Need
Comparable Population
Circle of Security Parenting (COSP) is a programme for parents of young children, where parents would benefit from greater understanding of attachment behaviours. It can be delivered as a universal programme, or to more vulnerable groups as part of a wider package of care.
Do you have sufficient demand for an attachment focused parenting intervention to sustain a group or individual delivery of COSP? Desired Outcome
Circle of Security Parenting programme aims for caregivers to develop more reflective and emphatic responses to their child, and therefore improve the child-caregiver relationships and attachment security.
Are the improvements in child-caregiver relationships a priority for your organisation? Do you have other existing initiatives that would be supportive of addressing this need and achieving these outcomes?
Need Score
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Fit
Values
The Circle of Security Parenting (COSP) programme focuses on the importance of understanding attachment to support child wellbeing, using a structured approach.
Does this align with the key values of your organisation? Priorities
Is working with parents of babies and young children in an early intervention approach a priority for your organisation? If your service is providing support to highly vulnerable families, would COSP fit as part a wider intervention package? Existing Initiatives
Does your service already provide early intervention programmes aiming to improve child development and mental health outcomes? Do you have links with CAMHS, Adult Mental Health Services and Child Protection Services to refer onto if required?
Fit Score
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Capacity
Workforce
The Circle of Security Parenting programme requires a trained practitioner to deliver this programme weekly over 8 weeks. Facilitators are encouraged to follow up with caregivers who miss any sessions. The practitioner needs to be able to understand and communicate the key concepts of attachment as outlined in the programme, have experience working with parents of young children, and be able to manage any disclosures of trauma or mental health difficulties and appropriately direct for additional support. Practitioners delivering COSP require access to regular reflective supervision.
Do you have practitioner with appropriate experience and competencies? Can your organisation protect time needed for training, delivery and supervision for these practitioners? Can your organisation provide supervision for practitioners? Technology Support
Showing video clips, either by playing a DVD, inserting a USB drive or streaming the material from the web is integral to the programme.
Do you have facilities to deliver this? Administrative Support
Do your current administrative procedures support your practitioners to implement a group parenting programme? Do you have access to a group room with suitable technology support for group delivery? Do you have administrative procedures that can support attendance, such as reminders? Financial Support
Training to deliver Circle of Security Parenting costs $1000 and includes the required materials. Optional fidelity coaching costs from $540 per practitioner, for the initial level of the coaching programme.
Do you have the finances to pay for practitioners to attend this training? Do you have the finances to support fidelity coaching? In addition, there will be running costs for materials such as printing of worksheets, leaflets and handouts. Attendance at groups can be supported by the provision childcare, food and transport.
Do you have the finances to pay for theses running costs?
Capacity Score
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