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Circle of Security (COS)

Scientific Rating:
3
Promising Research Evidence
See scale of 1-5
Child Welfare Relevance Level:
Medium

See descriptions of 3 levels

Brief Description

The information in this program outline is provided by the program representative and edited by the CEBC staff. The Circle of Security (COS) program has been rated by the CEBC in the areas of: Home Visiting for Child Well-Being, Infant and Toddler Mental Health (0-3) and Parent Training.

The COS protocol is an early intervention program designed to prevent insecure attachment and child mental disorders. It uses a user-friendly, visually based approach (utilizing extensive use of both graphics and video clips) to help parents better understand the needs of their children. It is based extensively upon attachment theory and current affective neuroscience.

All of the learning is informed around the following themes:

  • Teaching the basics of attachment theory via the Circle of Security™
  • Increasing parent skills in observing parent/child interactions
  • Increasing capacity of the caregiver to recognize and sensitively respond to children's needs
  • Supporting a process of reflective dialogue between clinician and parent to explore both strengths and areas of parent difficulties (i.e., being "Bigger, Stronger, Wiser, and Kind," supporting exploration, and supporting attachment)
  • Introducing parent to a user-friendly way to explore defensive process.

The COS protocol has the following goals:

  • Teach caregivers the fundamentals of attachment theory (i.e., children’s use of the caregiver as a secure base from which to explore and a safe haven in times of distress) by introducing a user-friendly graphic to the caregivers that they can refer to throughout the program.
  • Focus intervention on both parenting behaviors and internal working models.
  • Present caregivers with a simple structure for considering the ways in which their internal working models influence their cognitive, affective, and behavioral responses to their children. The goal is to provide language that gives caregivers awareness and understanding of the non-conscious, problematic responses they sometimes have to their children’s needs.
  • Teach caregivers the skills to understand their children’s behavior, and the skills to understand and regulate their own cognitive, affective, and behavioral responses to their children.

Essential Components

  • Individualized treatment plans for each caregiver are developed by reviewing videos from a laboratory setting of both a semi-structured parent interview and a parent/child interactional assessment.
  • The video is used to formulate the “linchpin issue” for each participant. A linchpin issue is defined as the single, most problematic pattern related to attachment and caregiving, which, if changed successfully, is expected to have the greatest positive impact on the child’s attachment pattern.
  • Over the course of the program, the caregiver is the focus for three video review sessions, during which clips of the caregiver interacting with his or her own child are used to enhance individual strengths and address linchpin struggles.

Child Component

Circle of Security (COS) was designed with a child component that addresses the following presenting problems and symptoms:

  • Low income, incarcerated parents, higher risk of being in a potentially abusive or neglectful home.

Age range: 0 – 5

Developmental Delays:

This program was developed for children with developmental delays; but has not been tested for children with developmental delays.

Parent / Caregiver Component

Circle of Security (COS) was designed with a parent/caregiver component that addresses the following presenting problems and symptoms:

  • Insensitive, unresponsive caregiving or frightening parental behavior

Group Format

Circle of Security (COS) was designed to be conducted in a group setting, and has been tested for use in a group setting.

Recommended group size:

6 participants

Testing References:

Hoffman, K., Marvin, R., Cooper, G. & Powell, B. (2006). Changing toddlers’ and preschoolers’ attachment classifications: The Circle of Security intervention. Journal of Consulting and Clinical Psychology, 74(6), 1017-1026.

Cassidy, J., Ziv, Y., Stupica, B., Sherman, L. J., Butler, H., Karfgin, A., … Powell, B. (2010). Enhancing maternal sensitivity and attachment security in the infants of women in a jail-diversion program. In J. Cassidy, J. Poehlmann, & P. R. Shaver (Eds.), Incarcerated individuals and their children viewed from the perspective of attachment theory. Special issue of Attachment and Human Development.

Delivery Setting

This program is typically conducted in a(n):

  • Birth Family Home

Homework

Circle of Security (COS) includes a homework component:

Each session starts with asking parents to offer stories of how they saw and used the material from the previous session.

Languages

Circle of Security (COS) does not have materials available in a language other than English.

Resources Needed to Run Program

The typical resources for implementing the program are:

Use of lap top with speaker to show video

Minimum Provider Qualifications

Mental health professionals, who receives 10 days of training and were supervised for all visits.

Education and Training Resources

There is a manual that describes how to implement this program, and there is training available for this program.

Training is obtained:

Training is held in Spokane every June but training can also be negotiated for on-site. Information is available on www.Circleofsecurity.net.

Number of days/hours:

8 hours a day for 10 days

Relevant Published, Peer-Reviewed Research

This program is rated a "3 - Promising Research Evidence" on the Scientific Rating Scale based on the published, peer-reviewed research available. The practice must have at least one study utilizing some form of control (e.g., untreated group, placebo group, matched wait list study) establishing the practice's benefit over the placebo, or found it to be comparable to or better than an appropriate comparison practice. Please see the Scientific Rating Scale for more information.

Child Welfare Outcome: Child/Family Well-Being

Show relevant research...

Hoffman, K. T., Marvin, R. S., Cooper, G., & Powell, B. (2006). Changing toddlers’ and preschoolers’ attachment classifications: The Circle of Security intervention. Journal of Consulting and Clinical Psychology, 74(6), 1017-1026.

Type of Study: One group Pretest/Posttest study
Number of Participants: 65 children and their caregivers

Population:

  • Age range — 11 to 58 months
  • Race/Ethnicity — 86% Caucasian
  • Gender — Not Specified
  • Status — Children in Head Start or Early Head Start programs.

Location / Institution: Washington State

Summary: (To include comparison groups, outcomes, measures, notable limitations)
Prior to beginning the intervention, the caregiver/child pairs were assessed in a 90-minute laboratory session using the Strange Situation protocol to determine the child’s attachment security. The group Circle of Security intervention was conducted starting 6 to 8 weeks later and continuing for 20 weekly sessions.  After the intervention was completed, the child’s attachment security was tested again in the laboratory using a second experience with the Strange Situation protocol. During the laboratory sessions, caregiver behavior was also assessed using the Caregiver Behavior System, which is an observational protocol looking at caregiver interaction patterns.  In order to help develop individualized treatment plans, caregivers also participated in a videotaped interview which focused on his or her developmental history, perceptions of his or her relationship with the child, and his or her own relationship to his or her parents.  After the intervention, a statistically significant proportion of children had shifted from disorganized to organized attachment classification than had shifted in the other direction. A higher proportion of children also showed an increase in security of attachment as compared with those showing a decrease. Limitations include lack of a comparison group and long-term follow-up. Participants were also selected based on their willingness to participate and may not represent the target population as a whole.  

Length of post-intervention follow-up: None.

Cassidy, J., Ziv, Y., Stupica, B., Sherman, L. J., Butler, H., Karfgin, A., … Powell, B. (2010). Enhancing maternal sensitivity and attachment security in the infants of women in a jail-diversion program. In J. Cassidy, J. Poehlmann, & P. R. Shaver (Eds.), Incarcerated individuals and their children viewed from the perspective of attachment theory. Special issue of Attachment and Human Development, 12, 333-353.

Type of Study: Non-matched comparison groups
Number of Participants: 20 infant/mother pairs

Population:

  • Age range — 31.59 years on average
  • Race/Ethnicity — 65% African American, 33% Caucasian, 2% Hispanic
  • Gender — Not Specified
  • Status — Pregnant women in a jail diversion program with a mandatory supervision term of greater than 3 years, a history of substance abuse, no current charge or conviction for violent crime, and no diagnosis of psychosis.

Location / Institution: Baltimore, MD

Summary: (To include comparison groups, outcomes, measures, notable limitations)
Participants were mother-infant pairs who completed a 15-month intervention program, the Circle of Security Perinatal Protocol (COS-PP).  During the intervention, women and their children spent 6 months in a residential facility and 6 months in a community-living phase. At 12 months, women and their children participated in the Strange Situation attachment assessment.  They were also observed and coded on maternal responsiveness during a free-play session. In addition, mothers completed the Experiences in Close Relationships Scale (ECR), the Warmth/Acceptance and Hostility/Rejection Subscales of the Parental Acceptance/Rejection Questionnaire (PARQ), the Beck Depression Inventory (BDI), Dissociative Experiences Scale (DES), the Rosenberg Self-Esteem Scale (RSES), the Social Support Questionnaire (SSQ), and the Traumatic Antecedents Questionnaire, which assesses lifetime traumatic experiences.  Results showed that women receiving the COS-PP had rates of secure and disorganized attachment and also maternal sensitivity comparable to those typically found in low-risk samples of women and also showed improved maternal depression scores. Study limitations include a lack of matched comparison groups and lack of long-term post-intervention follow-up.  

Length of post-intervention follow-up: None.

Cassidy, J., Woodhouse, S.S., Sherman, L.J., Stupica, B., & Lejuez, C.W. (2011). Enhancing infant attachment security: An examination of treatment efficacy and differential susceptibility. Journal of Development and Psychopathology,  23, 131-148.

Type of Study: Randomized controlled trial
Number of Participants: 220

Population:

  • Age range — 1-12 months
  • Race/Ethnicity — 43.2% African American/Black, 20.5% White, 18.6% multiracial, 14.1% Hispanic, 2.7% Asian, 0.5% Native American/Alaska Native, 0.5% Hawaiian Native/Pacific Islander
  • Gender — 122 Males, 98 Females
  • Status — Participants were irritable infants and their economically stressed mothers recruited at birth.

Location / Institution: 14 hospitals within a large metropolitan area

Summary: (To include comparison groups, outcomes, measures, notable limitations)
The study evaluated a brief attachment-based intervention aimed at increasing infant-mother attachment security for irritable infants from economically stressed families. Study goals included increasing attachment security in economically stressed families and examining maternal attachment styles in positive and negative environments. Mothers completed the Neonatal Behavioral Assessment Scale (NBAS) and Experiences in Close Relationships (ECR) and dyads were conducted during in-home visits twice during an infant’s first month. Infants were classified as either highly or moderately irritable. At infant age 12 months, mothers and their infants participated in the laboratory Strange Situation procedure. Participants assigned to the intervention condition received the Circle of Security – Home Visiting-4 (COS-HV4 ) intervention and those assigned to the control group received three one-hour psychoeducational sessions. The COS-HV4 intervention consisted of three, one-hour home visits that occurred approximately every three weeks when infants were between 6.5 and 9 months of age. Approximately 2 weeks later, a brief fourth visit occurred. When separate analyses were conducted with maternal attachment styles, there were significant three-way interactions among treatment, irritability, and each of the examined maternal attachment style dimensions. Limitations included lack of infants with low irritability which may affect generalizability.

Length of post-intervention follow-up: 2 weeks.

References

Powell, B., Cooper, G., Hoffman, K. & Marvin, R. (2009).The Circle of Security. In Zeanah, C., Handbook of Infant Mental Health (Third Edition), Guilford Press.

Powell, B., Cooper, G., Hoffman, K. & Marvin, R. (2007). The Circle of Security: A Case Study. In Oppenheim, D. & Goldsmith, D. (eds.) The added value of attachment theory for clinical work:  Bridging the gap between research and practice. Guilford Press.

Cooper, G., Hoffman, K., Powell, B., & Marvin, R. (2005). The Circle of Security Intervention. In L. J. Berlin, Y. Ziv, L. M. Amaya-Jackson, & M. T. Greenberg, Enhancing early attachments: Theory, research, intervention, and policy. New York: Guilford Press.

Contact Information

Name: Bert Powell
Agency/Affiliation: Circle of Security
Website: www.circleofsecurity.net
Email:
Phone: (509) 455-7654 x27
Fax: (509) 455-4112

Date Reviewed: November 2011 (originally reviewed in June 2008)