Many clients who come to Wellspring for residential or outpatient services face problems of attachment that result from early trauma. These difficulties for a child and family extend on a continuum from less to more severe. Wellspring's assessment process is designed to clinically evaluate the nature, development and severity of these difficulties, so that appropriate treatment options can be determined by the family and clinical team.

Difficulties in attachment may occur from adoption, prolonged early separations, multiple care-givers, invasive and painful medical procedures, hospitalization at critical developmental periods, and parental neglect or abuse. Whatever the cause, the child's basic trust in parents and adults may not properly develop. The child typically will respond in defense against emotional pain by distancing from parents and care-givers. He/she tends to become either self-parenting (I don't need anyone) or anxiously and ambivalently dependent (come close, go away). The development of conscience that occurs through the internalization of parental care and values is also affected, so that severe behavioral problems may progressively emerge. Among the possible symptoms are conflicts with authority, rageful outbursts, senseless lying, stealing, exploitation of peers and younger children, and sadistic cruelty to animals.

Treatment is focused on the development of the child's trust in parents and primary care-givers, which is the basis for acceptance of parental authority and control. This process has three components.

1. Because attachment is a relationship, not a technique, committed parental involvement is essential.
2. Direct emotional expression between child and parent is necessary for the development of basic trust and heart-to-heart connection.
3. Successful attachment depends upon consistent parenting based on principles and practices that build attachment. Ways that work with securely attached children often do not work with children who have attachment problems, and new ways that can work have to be learned.

The Adolescent and Children's Residential Programs are recommended for children, who are unable to be contained safely at home and treated on an outpatient basis. The daily living experience in the residential milieu emphasizes therapeutic parenting by the staff and teaching these effective parenting skills to parents. Wellspring's staff has been trained to intervene with the child's distancing defenses and to help develop the child's basic trust in the care of adults. Wellspring's expressive therapy approaches help to release blocked emotion and to initiate heart-to-heart connection between parent and child. Families are actively involved in the residential program, so that the emotional connection, basic trust and parenting skills developed in the residential phase can be effectively transferred home.

If the child can be managed safely at home, the preferred treatment option may be Wellspring's outpatient program, which combines extended family therapy sessions with home-coaching.

Extended family sessions are designed to bring about emotional breakthroughs and experiences of heart- to-heart connection that can reverse the effects of trauma. They also provide a context for learning parenting skills to facilitate attachment. Home-coaching helps to sustain and build upon these processes within the home setting. While breakthrough experiences reveal what is possible in the parent-child relationship, consistent and sustained after-care is essential to solidify these gains.

Although the treatment process is demanding in either the residential or outpatient program, sustained and knowledgeable effort from committed parents can achieve long-term positive results.