Circle of Security in the Community

More than 60 years ago, John Bowlby argued that attachment had long term developmental consequences, a bold claim but one he backed with careful review of existing research. Since Bowlby's time, research on early experiences in relationships, and how those experiences influence a child's development, has exploded. Today, both governmental and non-profit agencies use terms like "early relational health" to highlight how public health investment early in life can impact health across time. Bowlby's focus on the developmental importance of attachment is now influencing policy and practice around the world.

The greatness of a community is most accurately measured by the compassionate actions of its members.

These days, investing in early development is viewed as a wise public health strategy. For example, the Nobel-prize winning economist from the United States, James Heckman, argues that the return on investment of quality programs in the preschool period is high. Dr. Heckman's analysis of the long-term health impacts of high quality early intervention is clear: promoting early relational health is a good investment!

Click here to read an example of one of Dr. Heckman's carefully crafted research summaries.

Governments are rightly interested in community-level interventions that target early relationships and prevent later health and/or mental health conditions. In the United States, for example, the Center for Disease Control and Prevention (CDC) recently focused their long-term strategy for the prevention of child maltreatment on promoting what they call SSNR's: safe, stable, nurturing relationships. How to best promote safe, stable, nurturing relationships is an empirical question and we expect that scalable interventions, such as Circle of Security Parenting, will need to be tested for broad efficacy.

Click here to watch a useful 2019 talk that highlights the importance of community-level interventions to promote "early relational health" by the US-based pediatrician David Willis, MD, with the Center for the Study of Social Policy.

Our team at Circle of Security International is interested in community-level applications that include parenting or caregiver support. There is a great deal of complexity in scaling up interventions; more research needs to be done about how best to promote early relational health in various communities. For example, do we work with parents, preschool providers or both?

We think John Bowlby would be excited that governments and public health agencies are investing in early relationships to improve health and development. For example, in 2021, the American Academy of Pediatrics (AAP) issued a statement on the importance of promoting relational health, particularly in light of the data on how toxic stress in childhood is moderated by safe, stable, nurturing relationships. We are thankful to the AAP who agreed to allow us to link to their statement, which you can find here.

We're interested in the stories of how interventions like Circle of Security Parenting and Circle of Security-Intensive are used in communities around the world to promote early relational health. The links on the left tell some of those stories; we hope they give you a sense of the various ways communities of differing types can be impacted by the use of programs like COSP.

We want to hear your community story too! Our Project Consultant for COS in the Community is Charlie Slaughter. Learn more about Charlie.

You can reach Charlie at charlie [at] circleofsecurityinternational [dot] com.

The end is reconciliation; the end is redemption; the end is the creation of the beloved community. It is this type of spirit and this type of love that can transform opposers into friends. It is this type of understanding goodwill that will transform the deep gloom of the old age into the exuberant gladness of the new age. It is this love which will bring about miracles in the hearts of men.

The currency for systemic change is trust, and trust comes through forming healthy working relationships. People, not programs, change people.

The term Early Relational Health has gained traction in recent years because developmental science suggests that supporting the development of healthy relationships early in life can impact community health over time. The quality of early relationships impacts children’s success in life: their health, their educational achievement, future employment success, and even relationships with other people in the community. But how do you scale up programs that enhance change in systems and communities so that safe, stable, nurturing relationships are available to all?

Relationships are powerful but often unharnessed forces in our communities. Our team at Circle of Security-International offers tools that focus on children’s early relational health so that communities can harness the force of safe, stable, nurturing relationships. The Circle offers a shared perspective and language about children’s attachment needs and can be used to increase in adults’ capacity to build such relationships. Safe, stable, nurturing relationships lead to the development of a community culture that promotes connection and caring.

Systems change is challenging and is an area where few of us have received training. We think lessons learned by global non-profits like the FSG group, which developed the Water of Systems Change model, can help practitioners apply tools like Circle of Security Parenting to support community-wide systems change. In the Water of Systems Change model, the first step is to address mental models to spur change. One of the things that the Circle of Security models provide is an attachment perspective on children’s relationship needs. The Circle is simple and clear--helping a wide variety of individuals appreciate the basics of how attachment works. By providing a useful mental model for understanding the underlying needs that drive behavior, the Circle opens up the possibility of addressing the root causes of “challenging behavior.” Our intervention programs provide the basic relationship tools needed to build a quality of relationship that best supports children in reaching their full potential. And by focusing on enhancing relationships at home and in the classroom, the Circle can be used in various settings to impact early relational health. The First Nations Australia story is an example of a group adopting the Circle model because it connects to their traditional wisdom regarding how caregiver-child relationships create family and community culture while also tying into spirituality and the inter-related nature of everything.

To sustain change, it is important to leverage attractors to change. Attractors to change touch people’s hearts while tapping into people’s internal motivation. Rather than expending effort to convince community members to make a change, focusing on attractors to change provides an emotional pay-off, helping to sustain the change. Group-based programs like COSP, for example, can help parents feel less isolated, less stressed by parenting and more satisfied with their family relationships. For example, the Heartland of America story focuses on how a multi-year effort in Nebraska, USA using the COSP program has led to reductions in parents’ and educators’ stress level, leading more providers to be trained and more caregivers to be reached across the state.

Each of our COS in the Community stories contains lessons learned from attempts to leverage one or another Circle of Security intervention to move toward a community-wide approach focused on improving caregiver-child relationships. By reaching more adults from an ever-widening number of disciplines and settings, it is possible to shift the way people in a community view and engage in relationships. This would be community building at its finest.

We encourage you to read our Community Stories and reflect on these lessons learned:

Prisons are communities unto themselves. In many countries, it is accurate to say that prisons are forgotten communities: places where men and women are housed with only limited contact with "the outside world." Having a parent in prison is often a major rupture for children--a disruption in an attachment relationship that goes without repair. The professionals who serve prison populations-- whether as part of teams that work within prison walls or teams that work to help reintegrate prisoners back into society--must find ways to help men and women create safe and stable relationships with others, including with their children.

Here are three stories of providers and programs using COSP as a tool with prison populations in Australia and the United States. Rosalie Martin is an attachment innovator who has been bringing COSP to men and women in Tasmania, Australia prisons over many years. Alden Woodcock has helped build a prison re-entry program in the small city of New Haven, Connecticut that supports providers in using COSP to help ex-prisoners turn their lives around. Finally, Wendy Norman and Tesha Clark work in Florida, USA at a program dedicated to supporting parents of young children to connect more deeply, including those in a re-entry program at their county jail. As you read about what these dedicated teams are doing, you will discover COSP Facilitators who embody the idea that it is never too late to repair ruptured relationships.

This is the story of a remarkable multiyear effort to bring Circle of Security Parenting to New York City, America's largest city, and one of its most diverse. Like most large cities, New York is not one community, but many. Funding for this project was provided by the city's Department of Health and focused on two communities within New York City where social risk factors were prevalent: Harlem and the Bronx. This multiyear effort to support parents was led by the Mental Health Association of New York (now called V!brant; see https://www.vibrant.org) and a remarkable group of paraprofessionals trained in COSP who held no-cost groups in community centers, schools, apartment complexes, and early education sites reaching many thousands of families! For example, in the last two years of the project (2019 and 2020), the team had 2,706 caregivers complete COSP groups and even held online groups as the COVID-19 pandemic struck New York.

It's hard to summarize a project of this scope; perhaps the best way to summarize the experience of bringing COSP to New York City is through pictures and video. We are grateful to the many people who brought COSP to New York, particularly our partners at V!brant and the thousands of caregivers who travelled the circle as part of this amazing project.

The state of Nebraska in the United States was one of the first states to support training for community-based providers in the Circle of Security Parenting (COSP) program. Nebraska began to offer COSP in 2011--just one year after COSP training was available-- and in the years since 2011 has built a collaborative statewide effort to spread COSP statewide.

Rooted in Relationships is an early childhood mental health initiative at Nebraska Children and Families Foundation, that has provided leadership for the effort to spread and support COSP across the state. They are providing support for COSP facilitators through building a statewide website (necosp.org), developing common evaluation and marketing tools, and supporting additional training of facilitators. The Rooted in Relationships effort has been recognized by the National Center for Children in Poverty: we recommend you read their report on Nebraska’s remarkable efforts here.

The team in Nebraska invested early on in peer reflective consultation sessions to support COSP facilitators. Nebraska’s efforts to support COSP facilitators as they facilitate the COSP program predated the gold-standard Fidelity Coaching process that Circle of Security-International has developed in recent years. It is no surprise, however, that the first Certified COSP Fidelity Coach, Mark Hald, Phd is from Nebraska.

Sami Bradley, Rooted in Relationships, leads the Nebraska State COSP Leadership Team. This team has worked diligently to build relationships and connections in order to build support for COSP in the state. For example Sami and the COSP Leadership Team worked to collaborate with the Nebraska Department of Health and Human Services to streamline a system to reimburse facilitators for court‐ordered parents to be able to participate in the program. The process is currently being managed by the Nebraska Association of Education of Young Children (NE AEYC) and the Nebraska Department of Education, Office of Special Education has also been a supporter of Nebraska’s COSP effort.

In the following short video, members of the Nebraska COSP Leadership Team, educators and parents from Nebraska talk about the ways in which COSP has impacted them; check out the interesting review of the evaluation data suggesting that Nebraska’s investment in COSP is paying off in measurable ways.

In Nebraska a COSP specific report is completed biannually. This was originally done annually, but due to consistent solid responses they elected to start every other year. The National Center for Children in Poverty has a summary of the statewide effort to deliver COSP in communities which can be accessed here: https://www.nccp.org/nebraska/. One of the noteworthy aspects of the statewide website is the capacity to collect post-group evaluations, which is then used to compile the annual reports.

Their 2021-2022 evaluation report revealed a decrease in the percentage of parents and teachers reporting that their level of stress was high. The percent of parents who completed the pre-and post-surveys and reported that their level of stress was high decreased from 55% at the beginning of their COSP group to 17% at the end of the group. More than 1700 parents across 25 Nebraska counties participated in COSP and there were no differences in finding comparing those whose COSP groups were in person and those who completed COSP online.

Interestingly, the findings were similar for childcare providers, about 300 of whom completed a COSP for Classroom providers group over the year across 15 counties either in person or in online groups. Those completing the pre- and post-surveys who reported their level of stress was high decreased from 57% at the beginning of their COS-Classroom group to 20% at the end of their group.

For both caregivers and classroom providers there were high levels of satisfaction with COSP and changes beyond stress levels were noted.

For information on the history and process of the COSP initiative in Nebraska can be accessed at their website: www.necosp.org. Click the Resources tab at the top of the page if you want to review one of their biannual evaluation reports.

This is the story of Anne Cathrine Scharning and Heidi Høgelid Mayi, two women who have been working to infuse Circle of Security Parenting into their community over many years. Anne is a family therapist and former preschool teacher whose primary career focus has been on supporting interaction and security in vulnerable families. Anne has a son and is the proud grandmother of two young grandchildren. Heidi is a clinical psychologist whose main focus has been on the perinatal period and working with young children and their families. She balances work with caring for her three children: 8, 12 and 14 years old.

Røyken is a former municipality of about 22,000 residents located in the southern part of Norway and about 38 kilometers southwest of Oslo, Norway's capital. This is the story of a shared journey to "infuse" COSP into a small community--and to manage the inevitable twists and turns that are a part of community-based implementation. In January 2020, Røyken was merged with two neighboring municipalities, forming the larger Asker municipality. Thus, the Røyken Story is told and written by Anne and Heidi, in shared effort with Neil Boris at COS International, and with the understanding that Heidi and Anne's journey of providing COS-knowledge in communities, will go on and find new paths.

Beginning with a Solid Anchor

"The Røyken model" was a politically established guiding framework that was developed in 2009, well before Heidi and Anne started working in Røyken. Some key principles of the model were to provide early intervention, low threshold help, competent leadership, and to promote interaction and more seamless cooperation across family services in the community. Implicit in this was an aim towards all people working in these services to have a common and shared "language" and understanding of children's development and needs. Explicit features of the model including co-locating child protection, family therapeutic and mental health services alongside school and health nurses and environmental therapists. The goal was making such services both more available and more coordinated.

While the Røyken model provided a solid anchor-point, it still takes the engagement and wisdom of someone capable of "attaching the anchor" by translating these initiatives into a professional focus for family services. In Røyken there were some key leaders who had a genuine engagement in, and commitment to, children's wellbeing as well as a relational way of thinking. Torgeir Mjellekås, an experienced clinical social worker with a lot of wisdom in his professional field, a supportive and trust-based way of leading teams, and a strong and genuine engagement in the quality of children's development was one such key leader. He knew of COSP and played a key role when COSP was suggested as a model that could be a framework for family support and intervention. Fortunately, Norway has a wonderful pair of certified COSP trainers and in 2014 funds were allocated to support local providers, including Anne, to be trained in COSP. (Heidi had not yet started working in Røyken, but she was trained as a COSP facilitator in 2010 and had gained solid experience with applying the model in other jobs.)

Building Capacity

Anne and her colleague Hanne Marte Johansen (a child and adolescent mental health provider working in child welfare) were the first to offer a COSP group in Røyken. Within weeks of the training they had 25 parents signed up for the initial group! While they immediately learned that a more ideal group size was 8-10 parents, the response among parents was positive and it was not difficult to recruit participants for further groups. What was lacking was a roll out plan to meet demand: more facilitators were needed and funds to develop a COSP implementation plan were required.

Hanne saw an opportunity to apply for external funding with the goal of making the COSP-related work in Røyken into a defined project. Fortunately, the funds were granted and within a year Røyken had 30 registered COSP facilitators from various disciplines and agencies represented. Facilitators reached out to parents through the municipality's official website, the school web portal and directly to parents through family services. Any parent could sign up regardless of the child's age. There were separate groups during daytime for parents with babies, and the babies often joined. The afternoon groups mixed parents of children and adolescents, all ages. Facilitators always contacted all who had signed up by phone to give a brief introduction, and to get some knowledge of each parent's expectations for joining the COSP group. Based on this initial contact some parents were offered COSP individually instead of in groups. Not all facilitators ended up delivering COSP groups, but all reported that the Circle of Security was a useful and valued lens or roadmap in their daily work with families. The goal of a common understanding of children's development and needs seemed to be within reach. COSP implementation was documented in annual plans and reports of services delivered in the community. COSP was becoming an expected and valued service provided by the Røyken municipality.

Coordinating the Work and Extending the Plan

By 2016, COSP parent groups were well established and 4 dedicated and skilled COSP enthusiasts-- Anne and Hanne along with family therapist Kirsti Brekke, and health nurse Laila Morland--were coordinating that work as a group. Nearly 300 parents had been given COSP either in groups or individually and the idea of introducing COS to preschool teachers and caretakers in kindergartens emerged. This was a passion that Heidi shared and when she started working in Røyken she immediately joined the work group. Besides planning and coordinating, the group served the important function of "keeping the fire burning." However, there were many dedicated COSP providers in Røyken, who all contributed by sharing experience, dedication and reflections around their work.

The work of bringing COSP to other caregivers besides parents gradually started. Once again, the support of relationally oriented leaders were essential. Bente Ingjerd Nielsen, who was the leader of the special education therapists and top leader of all the kindergartens in the municipality, was introduced to COSP and quickly developed a strong interest in supporting use of COSP with kindergarten (preschool and childcare) providers. Soon, she had found funds to have all her special education therapists who served the kindergartens in Røyken take the 4-day COSP training. Bente also distributed the book "Se barnet innenfra," by Brandtzæg, Torsteinson, and Øiestad, to each kindergarten that participated. The book is a valuable tool on how to work with attachment in kindergarten; it uses the Circle of Security as a central organizing frame for this work.

By this time, Anne, Heidi and the rest of the work group had consulted with Stig Torsteison and Ida Brandtzæg and created a 3-hour presentation that focused on COSP and the importance of the quality of early relationships offered to each child. The goal was for early educators in the community to be introduced to the Circle as a map to see the child from within. At the same time, professional caregivers gained a deeper understanding of attachment theory, and the main concepts and metaphors of the COSP model. Through dialogue with individual kindergarten sites, the material was adjusted to fit the context of professional caregiving relationships. The presentation borrowed inspiration from the COSP groups using music, video clips and other examples to help caregivers connect with the material emotionally. There was ample time for self-reflection or small group work. Sharing was encouraged, but that varied a lot between groups. However, the two presenters (Anne, Heidi, Laila or Kirsti) always shared their own stories in order to set an example and to emphasize that it is ok to experience struggles around the circle. Over a period of 1 year the presentation was given to all the 30 kindergartens in Røyken, except for one. All the adults working in these various settings were encouraged to participate-- from center directors to frontline providers.

After each COSP presentation at a given kindergarten, an evaluation was completed; participants were most often very positive about the experience. Reports that the Circle was being mentioned in meetings and dialogue with kindergartens were gratifying. One kindergarten chose to send one of their staff (and eventually three more) to COSP training, in order to further support adoption of "the COS lens" among her colleagues as well as for use in support of parents. Each kindergarten was offered ongoing contact with the COSP team. Looking back, it became clear to Anne and Heidi that the offer of further contact was not enough. Ideally, more structured follow-up to help providers implement COSP in their daily work would have been provided. The main goal of the effort was to support self-reflection and a single presentation with limited follow up was insufficient to meet that goal.

Parallel to this work with kindergartens, a similar COSP presentation was offered to other local providers such as child protection workers, school nurses and more. This was meant to further support the goal to introduce a common language and understanding to all working with children and families in Røyken, in hopes of improving continuity across services.

One area of consultation that soon started was with schools. The work in local schools started when the principal asked to have the three-hour presentation for his staff after Anne had worked with school staff on managing the needs of a highly insecure boy. Anne and Heidi considered this request thoroughly. They were well aware that adopting the material in their presentation to fit and address the relational context of the classroom-- and introducing attachment theory and relational thinking as a framework for schools to meet the social needs of the children they serve-- would be a very different challenge than presenting it to kindergartens. They were aware that taking on a challenge like that required solid and deep understanding of attachment theory. However, school consultation had been a long-held dream, and the insights they had gained from their work in Røyken with kindergartens gave them confidence and they decided to take on the challenge.

At the time, Norway was implementing a cross-disciplinary curriculum that included "life mastery" as one of its pillars. This focus on the schools' responsibility in supporting and preparing individuals to thrive in life is also present in leading guiding documents for kindergartens. As Anne and Heidi saw it, making the case that "life mastery" is related to the social environment of the school and the relational needs of its students, and reflecting on the implied "collective responsibility" in raising children, served as a good platform to connect with the school staff.

Their aim with their presentation was that they wanted the school to start seeing the value of attachment theory--and the COSP model-- as a framework for helping schoolchildren gain a greater ability to thrive, not only educationally and socially, but in their further journey in life. Most important to Anne and Heidi was that they wanted to highlight the child's underlying need for connection, and how offering a relation may fuel security and better learning for each child and for the class as a whole.

Work in schools is complex and translating the COSP program—which focuses on preschool aged children—for teachers of older children requires another level of knowledge and experience. Still, this part of the journey was rewarding for Anne and Heidi and was appreciated by many school personnel.

As work with parents in Røyken continued, follow-up COSP group support meetings were offered, and anyone who had attended COSP over the years could sign up. Parents who joined, reported that it was really good to meet other parents and reflect. In particular, single parents said they missed the group support and were thankful for the ongoing support.

A New Community - Making New Paths

In January 2020, Røyken was merged with two neighboring municipalities, forming the larger Asker municipality. As the Røyken story and Anne and Heidi's shared journey came to an end, several hundred parents had attended COSP in groups or individually, all kindergartens except one had gained knowledge of COSP, and schools were starting to show interest. Across family services, the COSP model was a valued tool.

As with all changes and transformations, the Asker merger added insecurity, and new structures were being created. The municipality had increased greatly in size and new leaders had stepped up. The system-based approach based on COSP and relational theory was tabled for the time being. While this is unfortunate, the shift also allowed for some reflections on what factors were present in Røyken that enabled the work that was accomplished over several years. COSP is still a valued tool to many family therapists, child welfare workers, health nurses, preschool teachers and school therapists in their work in Asker municipality. Today the journey continues along different paths, but Anne and Heidi will always keep the COS model among their most valued roadmaps as new stories of community work are in the making.

There were so many dedicated colleagues who contributed to bringing COSP more deeply into the Røyken community; we couldn't possibly name all the amazing people in our network. The support, warmth and genuine and generous giving that we shared as a team was wonderful.

Anne and Heidi's Advice on Community Implementation of COSP

This list is based on reflections and insights that Anne and I have shared along the way, and also after we finished our work in Røyken. We hope that the list will inspire, and that some of it may be useful to anyone who wants to introduce attachment thinking and the COS model within a community.

All Our Kin is a nationally recognised nonprofit that supports and sustains family child care educators using a high-touch, strength-based approach. All Our Kin is based in Connecticut and New York in the northeastern region of the United States. A 2015 evaluation of the impact of COSP on All Our Kin educators found a significant increase in reported self-efficacy for dealing with challenging behaviors. Qualitatively, 94% of providers reported that participation decreased their stress level; 97% reported that they viewed the behavior of children in their care differently; and 94% reported that the behavior of children in their care "is better" or "is much better" following their participation in the program. Click here to read an article about the published study based on the All Our Kin experience.

Since 2013, All Our Kin has facilitated COSP groups for 117 family child care educators who collectively serve over 936 children. Bringing COSP to educators and families has been possible thanks to support from donors such as, United Way of Greater New Haven, the William Caspar Graustein Memorial Fund, the Department of Social Services and the State of Connecticut, who have championed healthy attachment and social emotional learning for years. In addition to holding COSP groups for educators, with the support of the United Way of Greater New Haven, All Our Kin have also had over 40 parents/guardians participate in COSP groups.

The Story Behind the Data by Marina Rodriguez

At All Our Kin, the story behind the data is best told in Circle terms. At each of All Our Kin sites, a majority of our staff are trained in COSP, from the office assistant to the directors. COSP is part of our culture, and many of its phrases - including "Being With," "fill your cup," and "Hands" - are all part of a common vocabulary. All Our Kin staff view themselves as the Hands for family child care educators. This allows educators to care for their children with a full cup as they are the hands for the families and children in their family child care programs.

One of the most amazing transformations I have ever witnessed in my career facilitating COSP has been to watch the change in perspective of an adult who early in the group spoke adamantly about infants being spoiled by adults who hold/carry them too much. By the end of the 8 weeks that same adult had completely changed their mind, especially after reflecting on their own upbringing and where their own emotions were neglected. By the end of group, this caregiver vows to engage with infants differently.

One of the reasons why All Our Kin brought COSP to family child care is because we believe that adults' behaviors change through reflection that happens in the context of a trusted relationship with another adult. The family child care educators who are part of the All Our Kin network trust All Our Kin and our staff. In turn, the educators feel comfortable being vulnerable while learning and trusting that the information that is being presented to them through the COSP program will help them become better adults in the lives of children. They come to the group, they listen, reflect, go to their programs, try it out and return to the group with deep stories about how they tried and many times succeeded in creating a better quality relationship with kids in their care.

One story that I will never forget was a story an educator told me about a young toddler who was having a really hard time at her program and cried a lot during a particular day. The educator told me how she felt her own "shark music" when the child cried and realized she was reacting to the "shark music." She put the child down, told the child to calm down, and in the middle of that reaction, she remembered our conversations during the COS group, and said, "Wait" to herself. She paused, breathed, and said to the baby, "I know you need me to comfort you, and you need me to hold you." She held the toddler and walked and talked to her. While she was walking her, the toddler calmed down. The educator said that prior to being part of COSP she would have let that child cry. This story and many like this one are common stories I have heard from educators that have joined our COSP groups. Hearing this and witnessing these shifts in adults who work directly with children are some of the most rewarding experiences in my professional career and in my life in general.

In the following video, Marina Rodriguez reflects on how COSP has impacted she and her colleagues at All Our Kin.

More recently, with the support of the Connecticut Department of Children and Families, we have supported family child care educators to become COSP facilitators themselves. Eleven All Our Kin educators have been trained as COSP facilitators. With All Our Kin's support they are facilitating COSP groups for the families they serve as well as their colleagues.

Relationship based parenting resources developed by St John of God Social Outreach, part of St John of God Health Care

In 2013-14, while an experienced team of providers from the St John of God (SJG) Social Outreach team were delivering Aboriginal perinatal and infant mental health training across rural, remote and metropolitan communities of Western Australia, it became evident that Circle of Security principles strongly resonated with the participants. During training sessions, the team collectively wondered how they could deepen the connection between COS principles and the verbal and visual language of the Aboriginal communities they served. For Indigenous, First Nations communities in particular, having an element of the Circle of Security Parenting program that connected to the shared verbal and visual language of the community seemed important. The goal was to give Indigenous parents and caregivers a sense that COSP was not just another program imported from the dominant culture; in other words, the team wanted to build on the fact that COSP was already being received as a program that connected to universal elements of the caregiver-child experience.

In 2015, a stepwise process that led to the Connected Parenting resources was started. First, a literature review of relationship based parenting programs for Australian Indigenous parents and carers established the need for a culturally connected and sensitive caregiving resource that incorporates attachment principles. Then, a series of conversations with the team at Circle of Security-International about working together to adapt Circle materials for this population occurred. Next, the SJG Social Outreach team undertook extensive consultation with First Nations people, forming both a reference group and a working group, as well as running a number of focus groups. From there, the team was lucky enough to secure additional federal and state funding to develop what came to be called the Connected Parenting resources.

The centerpiece of the Connected Parenting resources are two handouts that can be used as supplements in delivering the COSP program in Indigenous communities. The Connected Parenting Big Picture visual resource is based on the lived experience of Australian First Nations People spanning more than 60,000 years. This handout puts the Circle of Security concept of “the Hands” at the center of a larger set of circles, highlighting what Indigenous people have always known - the importance of relationships to one another and to country, spirituality and culture as well as the interrelated nature of everything. Connected Parenting recognises that parenting is not designed to be done in isolation. The SJG Social Outreach focus groups attendees and the working group helped refine the content of the handout.

The second handout entitled Connected Parenting Coming Together arose from the focus groups and other conversations zeroed in on as the goal of Connected Parenting: to raise children with self-esteem, who are strong, able to trust and show respect. The Circle of Security concept of being Bigger, Stronger, Wiser and Kind is embedded in this diagram which also emphasizes the need to listen to children, to recognize their feelings, to set clear limits and to find time to play, laugh and talk together.

The following two-minute video presents the two Connected Parenting handouts and features several providers talking about how the resources have provided a way to “bring First Nation People's core cultural values back to the surface.”

From Resources to Training

The SJG Social Outreach team that created the Connected Parenting resources saw the opportunity to create a training package for providers interested in using these resources with Aboriginal and other First Nations communities. The feedback was incredibly positive and the demand for training soon outstripped their capacity to deliver face to face training. An eLearning package was developed in partnership with SJG Social Outreach and Western Australian Child and Adolescent Health Service, and was launched in February 2019. Uptake and feedback has been overwhelmingly positive and both the resources and the eLearning training has been accessed by over 600 providers across the world. Please visit Connected Parenting if you are interested in the eLearning training.

It has been a hugely rewarding experience for both of us and we attribute the success of the program to a number of factors: supportive management who appreciate the importance of developing mutually respectful relationships (and who afforded us the time to do this); consulting widely; being open to listen and learn; having the project appropriately funded; recruiting passionate staff; working collaboratively with the COS developers; and most importantly, the generosity and willingness of a wide range of people and organizations all wanting to support and enhance outcomes for Indigenous families.

Click here for more information about St John of God Health Care or here to access Connected Parenting.

United Way of Greater New Haven's (UWGNH) Secure Start Initiative

Barbara Stern, Secure Start Consultant

I imagine that when most people think of United Way, they think of a large charitable organization that provides funds to local non-profits who are doing good work in their communities. Many of us are asked at our place of work to donate a small percent of our paychecks to help United Way support social service, health and mental health agencies, food programs and shelter for the homeless, and early childhood services such as childcare. So, when I heard that our local United Way was launching an initiative to support "secure attachment between caregivers and their children" in our region, I was puzzled. Attachment? This is such an abstract concept. I knew secure attachment was absolutely vital for people to thrive in life, but how would a large organization like United Way go about improving the quality of attachment? Well, I was about to find out.

To give an even larger context, the United Way international website lists this as their mission: "United Way improves lives by mobilizing the caring power of communities around the world to advance the common good." Now this is starting to make sense because our Secure Start initiative is doing just that. What could be a more powerful lever for "mobilizing the caring power of communities" than implementing COSP throughout our region? Since 2013 UWGNH has been providing training and support for local agencies to implement Circle of Security Parenting groups to caregivers and early childhood teachers. Click here to learn about the history of this initiative, its early challenges and successes, its expansion and future plans.

United Way of Greater New Haven: Secure Start Initiative

Barbara Stern

Launched in 2013 under the umbrella of United Way of Greater New Haven's (UWGNH) Success by Six effort, the goal of the Secure Start initiative is to impact the quality of early relationships between young children and their caregivers in the twelve-town region that United Way serves, which includes a high percentage of young children living under the federal poverty level. With the understanding from attachment research that attuned early relationships between children and their caregivers can buffer the stress of poverty and challenging environments, while helping to put children on the road to school success, it was decided that impacting these early relationships could be an important lever in improving outcomes for children in the region. Circle of Security Parenting was chosen as the intervention because of its accessibility, non-judgmental stance, and its relationship focused orientation, versus a behavioral model focusing on changing children's behavior. Since 2010 many people from the New Haven area had been receiving training in COSP and there was already wide acceptance and appreciation for the model.

United Way initially identified five organizations for receiving staff training and funding support to offer COSP groups through an RFP. The grantees were required to participate in an evaluation conducted by the Yale Child Study Center. In addition, they were required to participate in quarterly meetings with other COSP facilitators and UWGNH leadership. The first year of implementation focused on shoring up agency capacity post-training and creating a learning lab for facilitators to share best practices, challenges and solutions. As a result, the Secure Start Network (SSN) was established, which continues to meet quarterly and now includes 10 grantee agencies as well as representatives of other agencies in the greater New Haven region who are offering COSP. As of 2020, the number of agencies involved, facilitators trained, groups offered and numbers of children served has expanded exponentially and include community health centers, Family Resource Centers in public schools, early childhood programs, social service agencies and a post-incarceration workforce preparation agency. Fifty percent of the groups are offered in Spanish.

When I attended my first Secure Start meeting, I was able to share my questions and concerns with how to start a Circle group with a transient population, and I got so much encouragement and resources to actually make it happen! Through the resources from the Secure Start Network, I was able to get trained as a facilitator, I connected with Tee Kemp (who has been the most extraordinary co-facilitator) and we were able to receive funding and operational support to run a Circle at CCA, plus one group online due to COVID-19.

With my continued engagement at Secure Start meetings, I've been able to learn more from other agencies about how they are running Circle groups and even attend the anti-racism training. During COVID-19 times, the Secure Start staff and meetings have been so helpful as we figured out how to do the Circle group online! I feel like the staff and members are so engaging, knowledgeable and passionate about Circle of Security!

TOTALS
Measures	FY13 - FY20	FY21
# of groups	105	3
# of sessions	830	24
# of caregivers/providers*	1,007	18
# of children 6 and under	5,219	5
# of coaching groups	5	0

Everyone working with children and families accepts that prevention is better than cure. Early Intervention is kinder to children and families, is more effective and is considerably more cost efficient. And yet, it remains the case that despite this accepted truth the vast majority of public funds in the United Kingdom (UK) are allocated to late, crisis-led support and help. No one program or scheme can solve this dilemma, but Circle of Security Parenting® groups now running across the UK are playing their part in changing the story.

Connected Lives: The Story of Our Non-Profit Organization By Jenny Peters

Dr. Clare Gates, child and adolescent psychiatrist, hosted the first Circle of Security training event in 2008. At the time, only the Circle of Security-Intensive protocol was available. Although the training drew significant interest, this intervention was not easily replicable within the constraints of the UK system of care. However, Dr. Gates couldn’t shake the idea that if we could get the profound truths and kindness of the Circle of Security approach to the people who needed it most, parents and other carers of young children, we could begin to make a significant difference.

As soon as the 4-day Circle of Security Parenting Training became available in 2010, Dr. Gates and I completed the training and ran the first UK Circle of Security Parenting group in our community, in Westminster, London. People got word of the approach and we began to get requests for groups across the city. One particular group we ran, in a school on the housing estate at the epicenter of the 2011 London riots, was pivotal. At the time, we had no idea if the approach would make sense and be helpful to parents from this largely black and minority ethnic community who were experiencing endemic racism and seeking to raise children in a highly scrutinized and stressful environment. However, the enduring wisdom of the approach worked its magic. One grandmother, who was extremely skeptical at the outset had a series of ‘ah-ha’ moments during the program and in the last session volunteered to spearhead a funding application to Haringey Council to ensure that everyone in her community could access a group!

Together with a brilliant team we set up a family support project, The Centre, from which the charity, Connected Lives was born. The mission of Connected Lives is to provide attachment-based, trauma-informed support for parents and partners. We are a community-based, early intervention charity and running Circle of Security Parenting groups is an important part of what we do.

Inspired by colleagues all over the world we have a vision for a network of community-based hubs across the country, working in partnership with statutory agencies to support family life at the earliest possible stage. So far, we have 2 established hubs (NW London and Cambridge) and 2 more are currently in development. Our hubs work with Early Help Teams, Perinatal mental health teams, health visitors and schools to deliver Circle of Security Parenting Groups across our communities. We have delivered groups for over 900 parents and carers and love it that every group is different, every caregiver has a new story and their own ‘ah-ha’ moments.

The ten-year journey from our first group to the increasingly widespread use of the Circle of Security Parenting program in the UK hasn’t been straightforward. If I had to characterize what helped bring the program to London and the wider UK, I’d say dogged persistence and refusal to go away! We hosted yearly 4-day COSP trainings, bent the ears of commissioners, practitioners, funders, like-minded organizations and politicians. We were hugely helped in this endeavor by generous supporters-- such as Gary and Catherine Grant-- who funded our work and even supported having a British voice actor to narrate the COSP program. Our work is being expanded by the hundreds of facilitators who’ve attended the 4-day COSP trainings we have hosted and got the Circle of Security Parenting® bug!

We’ve recently begun to focus on our systems design and systems building work and have added the following components to support COSP facilitators and parents who have received COSP:

We are into the second decade of our work and are ever more excited about the impact we are having; as we work with our colleagues at Circle of Security-International to build capacity (more trained COSP Facilitators) and capability (deeper reflection through Learning Communities, provision of Fidelity Coaching, etc) we feel that our dogged persistence is paying off.

Emma Liljestad and Karin Simonsson, two child psychologists in Boras, Sweden, began offering Circle of Security Intensive (COS-I) in spring of 2016, realizing that many families they took through Circle of Security Parenting (COSP) needed additional help. They work within a solid support structure both at a national and local level, with all organizations sharing a commitment to promote mental health and prevent mental illness for children 0-5 years of age.

Their work takes place at a Primary Health care unit of psychologists within a Maternity and Child Health Care Center. Such centers are part of public health care, and aim to provide all pregnant women and families with children 0-5 years of age with free support. Attendance rate is nearly universal. These centers form a platform supporting the healthy development of children’s attachment to parents. Some parents who need a little more support than offered by the midwives and nurses at the Centers are referred to the Psychology Unit.

Within this unit, a specialized clinic, Samspelsmottagningen (​​Clinic for Parent-Child Interaction), exists with the goal of “early identification and intervention for children 0-5 years at risk of attachment-related problems in their relationship to a parent, to prevent unhealthy mental development.” Today colleagues run 10 regular COSP groups a year through the psychology unit of the Child Health Care Center.

Parents who continue to struggle can be referred to Samspelmottagningen for additional help. Here the clinicians work to deepen parents’ understanding of their children’s emotional needs and begin individual therapeutic work with a focus on the relationship using COS-I.

The team runs 2-3 COS-I groups each semester with 3-6 parents in each group. The length of treatment varies from 14-20 weeks. They have found that the group format itself is helpful, as the group itself serves as a secure base to explore what they do and not yet do to meet the child’s emotional need. The group also provides a safe haven to return to when parents experience difficult feelings connected to parenting struggles. Parents gain insight into each other’s aspirations and share their experiences with each other.

As they have become wiser from offering COS-I groups, Karin and Emma have also shifted in how they engage and explore with parents about receiving COS-I. They have found it is very important to not put any pressure on a parent to take COS-I and to help parents understand the level of commitment needed to complete COS-I. It generally takes parents around 40 hours to complete COS-I and requires a lot of energy and effort from the parent. During the group, some parents may also experience and need to address struggles related to their own mental health or their relationship with their partner. As a result of this wiser approach, it is now rare to have a parent dropout from COS-I groups. In turn, this helps prevent the group from being impacted by a parent dropping out.

For more information on Karin and Emma's current intervention clinic, please visit their website: http://www.anknytningspsykologerna.se/

The National Institute of Psychiatry "Ramon de la Fuente Muniz," a highly specialized facility in Mexico City, serves a population with scarce socioeconomic resources. Our institute has been integrating Circle of Security Parenting (COSP) in two different, but complementary ways: 1) the treatment of the complex families we serve; and 2) the training and supervision of mental health professionals who rotate through our clinic and learn alongside our clinical team.

COSP Groups

A joint collaboration by our Perinatal Psychiatry Clinic, our Borderline Personality Disorder Clinic, and Circle of Security International has offered COSP to 74 people since 2019. We had eight sessions of face-to-face groups, switching to online sessions once the COVID pandemic began. It is our understanding that attachment security is a variable that contributes to cooperation and autonomous interdependence and that it is in the context of early relationships that this trajectory is scaffolded, which has oriented the collaboration between the Perinatal Clinic and Borderline personality Clinic. It is our conviction that early interventions such as COSP provides parents, even in high risk populations, with relational lenses that help their children and themselves.

Initially, our groups were formed for parents with some mental illness (psychotic, mood, personality or substance abuse disorder) who were also being treated at the Institute for their various conditions. The timing on when to offer the program has been decided around the age of their children and mostly parent's ability to enter the Relational-Affective and -Reflective process of the program. Our general understanding is that COSP can be implemented in such context as an integral process of being with parents focusing on the necessity to consider all the possible supports that these families require.

Thus far, no patient participating in COSP has required any additional interventions during or after their group as a result of their participation in the parenting group due to worsening of their diagnosis. It also has to be said that all participants are pharmacologically monitored by their corresponding psychiatrists and some of them are in DBT emotion regulation skills groups either before, during or after COSP. Our intention was not only to offer another way of parenting but also to put the model into the mind and experience of the institution.

In our Perinatal Psychiatry Clinic we use the circle in follow-up consultations where the relationship of mothers and fathers with their children is valued. We see this as implementing preventive strategies.

Integrating COSP into the Training of Mental Health Professionals

In addition we have offered the program to fellow psychiatrists who are also parents.The Circle of Security model allows us to look at caring relationships with others, especially at interactions that can remain hidden without one noticing.

A fundamental experience in the implementation of COSP has been the fidelity coaching process offered by Carlos Guerrero from Circle of Security International with whom in our sessions we have been able to connect with the shark music that can happen when one facilitates a group. Having the opportunity to look at the relationship, trying to help build secure attachment, and remaining hopeful that it can occur has been a very deep experience. This has allowed us not only to understand the painful stories of others, but also of our own. Fidelity coaching has been a continuous fascinating process to experiment the coherence of the model. It is through living what it means to be held, received and supported that “being with” the group of participants is possible. Alongside of the universality of the “circle” phenomena, Fidelity Coaching in Spanish provides the linguistic and cultural nuances that colour our colective and individual stories in our relationships.

Real connection, being with in the circle, being with in fidelity coaching, and being the hands of the hands requires loving kindness, intrinsically human, which in these times in not so easy to find. When one is trained in psychiatry the emphasis is placed above all on neurobiology, particularly on the fascinating and fundamental neuronal minutia. We find it supremely refreshing and beautiful to find evidence, not only in the literature, but also in our experience, of the power of resonance and accompaniment with another. Human beings are made to connect, and it is in the relationships between individuals and within the group that connection occurs.

We also offer the program to psychiatry residents when they rotate through the Borderline Personality Disorder clinic. While most are not parents, they are invited to take the program keeping in mind a significant person with whom they have a caring relationship.

“El círculo de seguridad para padres es una estrategia maravillosa que permite a los profesionales conocerse mejor y obtener herramientas para transmitir a los consultantes, facilitando estrategias que permitan establecer relaciones más sanas con otros. El círculo debería ser más conocido en el ámbito de la salud, no solo por profesionales del área de la salud mental o aquellos que deseen obtener la certificación, sino por otros especialistas, para favorecer el establecimiento de vínculos más sanos y amorosos entre padres/ cuidadores y los niños desde la infancia temprana, lo que finalmente repercutirá en la salud mental del individuo y de las familias”. Dra. Milena García, residente de psiquiatría.

“The Circle of Security for Parents is a wonderful strategy that allows professionals to get to know each other better and obtain tools to transmit to consultants, facilitating strategies that allow establishing healthier relationships with others. The circle should be better known in the health field, not only by mental health professionals or those who wish to obtain certification, but also by other specialists, to promote the establishment of healthier and more loving bonds between parents / caregivers. and children from early childhood, ultimately impacting the mental health of individuals and families”. Dr. Milena García, psychiatry resident.

Little by little, through all these efforts, the language of the circle becomes part of the discourse of the Institute. We bet on the relationship, on good enough parenting, on connection and on the construction of “being with” networks. Our networks are not perfect but they are strong enough, wise enough and kind enough.