Trauma and Psychotherapy: Implications from a Behavior Analysis Perspective
Prather, Walter, The International Journal of Behavioral Consultation and Therapy
Authors of recent studies on abuse have proposed that trauma and related traumatic experiences have important implications for parent-child relationships, and may disrupt normal attachment behavior in children. These studies have primarily examined previous trauma and long-term sequela of severe childhood and adolescent psychopathology from the perspective of attachment theory (Bowlby, 1969, 1973, 1980). The central premise of attachment theory is that the security of the early child-parent bond is reflected in the child's interpersonal relationships across the life span (Schneider, Tardif, & Atkinson, 2001). This article examines attachment theory as a theoretical context for understanding trauma and attachment based models of family therapy from the perspective of behavior analysis. The present article proposes a research model to provide the context to examine how abuse and neglect, separation or loss, family therapy, parent-child relationships, and secure attachments can be integrated to predict positive outcomes in families with adoptive and foster children.
Research studies focusing on mediating the long-term sequela of abuse have repeatedly argued that feeling secure is our most primary social need, and that a history of pathogenic care can interfere with secure attachment and disrupt healthy development in children (Howe, Brandon, Hinnings, & Schofield, 1999; Schneider, Tardif, & Atkinson, 2001). This is especially true in foster and adoptive families in which children have been abused or neglected as part of their early experiences. Research on foster children and problematic attachment has consistently found that long-term sequela of abuse creates strain on attachment with their adoptive parents (Berry & Barth, 1989; Dyer, 2004; O'Connor & Zeanah, 2003). This strain in the children's lives, often through multiple placements, increases the likelihood of difficulties across a range of development. Research investigating abuse and insecure attachment behavior in foster and adoptive children has linked these factors to emotional and behavioral difficulties in these children.
This article looks at the emotional and behavioral symptoms associated with abused children placed in foster and adoptive families from a multidimensional complex of systemic and contextual factors that impact behavior. The research model underlying this multidimensional complex provides the context to examine the many important roles of family members and other reinforcing agents, and presents a rationale for a behavioral treatment approach for abused children and their adoptive parents. The rationale underlying this behavioral approach assumes that overcoming long-term consequences of abuse is subject to the same lawful inevitability as other behavior (Wolpe, 1978), and challenges the allegation that children have a continued dependency on the external structure in behavioral treatment programs. Individual differences in abused and neglected children are determined by previous learning in relation to particular perceptions and unique experiences. Although much learning is reinforced though external consequences, the relative importance of this multidimensional behavioral approach assumes that the "character of an (abused child's) responses is inevitably controlled and is determined by previous learning, and in other instances subserved by other reinforcing agents" (Wolpe, 1978). Reasons are given for rejecting the views of traditional therapists and others that talking about trauma to "co-construct the meaning" or that recognition of "emotion" is necessary for healthy behavior change. Questions are raised which suggest that traditional family therapy provides an environment for learned dysfunctional habits that are then reinforced in therapy.
In the case of foster and adopted children, the development of a secure and coherent pattern of attachment behaviors toward their caregivers is heralded as the primary indicator of positive change in the family. …