Trust-Based Relational intervention[TM]: Interactive Principles for Adopted Children with Special Social-Emotional Needs

Article excerpt

Children who experience abuse, neglect, and/or trauma are disproportionately represented among those who deteriorate into challenging and pervasive behavioral disorders. The TrustBased Relational Intervention [TM] Interactive Principles, described in this article, have been used effectively in a variety of settings, including camps, homes, schools, and residential treatment facilities.

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In the United States, there are approximately 127,000 adoptions annually (Child Welfare Information Gateway, 2004). Currently, about 15% of these adoptions are intercountry adoptions, 39% are conducted through publicly funded agencies, and 46% are private adoptions. This can be contrasted with data from the early 1990s when, although the total number of children adopted was similar, only 5% were intercountry, 18% were publicly funded, and 77% were private adoptions. Currently, over half of the children adopted are from the child welfare system and from overseas, and many of these children are at risk for various relationship-based disturbances stemming from histories of abuse, neglect, and/or trauma prior to their adoptions by caring families.

Despite the stable caring homes that these children are often adopted into, attachment problems, behavioral problems, and social problems are manifested in these children frequently. A recent meta-analysis on the reports of behavior problems in internationally adopted, domestically adopted, and nonadopted control children found that adopted children showed more behavior problems (both internalizing behaviors such as depression and externalizing behaviors such as aggression) than did nonadopted children (Juffer & van IJzendoom, 2005). It was also found that adopted children were overrepresented among clientele presenting for mental health services.

The current article is an abbreviated version of the Hope Connection [TM] manual (Purvis & Cross, 2002) and is based on an interactive principles framework developed in the context of Trust-Based Relational Intervention[TM] (TBRI[TM]). These interactive principles (see Figure 1) form the basis of our various intervention programs that target behaviorally at-risk adopted children. The interactive principles were first developed for our research-based summer day camp for behaviorally at-risk adopted children and have been integrated into home program interventions (Purvis, Cross, & Sunshine, 2007), family camp interventions, and summer camp interventions (Purvis, Cross, Federici, Johnson, & McKenzie, 2007). They have been used to facilitate positive outcomes with children as young as 3 years and as old as 17 years. They have been applied in homes, schools, orphanages, and residential treatment facilities with equal efficacy and are shared here with the hope that they will enrich services for children in other domains.

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The principles are classified into three categories: empowering principles, connecting principles, and correcting principles. The empowering principles include ecology and physiology, the connecting principles include awareness and interacting, and the correcting principles include proactive strategies and redirective strategies.

EMPOWERING PRINCIPLES

The TBRI[TM] empowering principles address the physical and physiological needs of the child. The foundation of these principles is that a child's mind is housed in her or his body and that the needs of the body influence the child's ability to do higher level tasks. This is an important realization but one that is all too often overlooked when crafting interventions for children. The empowering principles are founded on research from various domains, including Tiffany Field's work on touch (Field, 2001; Field, Hernandez-Reif, & Diego, 2005), Stephen Porges's work on the polyvagal system (Porges, 1998, 2003), work carried out on regulatory and sensory processing disorders (see Barton & Robins, 2000; Greenspan & Wieder, 1993; Kranowitz, 2005), and efforts to determine the effect of nutritional interventions on children's psychopathology (e. …