DOCSLIB.ORG

Client Attachment As a Predictor of Therapist

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Client Attachment As a Predictor of Therapist ABSTRACT Title of Document: CLIENT ATTACHMENT AS A PREDICTOR OF THERAPIST INTERVENTIONS, THE WORKING ALLIANCE, AND THE REAL RELATIONSHIP IN THE INITIAL, MIDDLE, AND FINAL PHASES OF PSYCHOTHERAPY John Lawrence Jackson, Doctor of Philosophy, 2014 Directed By: Professor Clara E. Hill, Ph.D., Department of Psychology This study investigated client attachment style as a predictor of (a) therapist interventions in an early, middle, and late session of psychotherapy; (b) client and therapist post-session ratings of the working alliance over the course of therapy; and (c) client and therapist post-session ratings of the real relationship over the course of therapy. A total of 41 clients and 14 therapists completed measures prior to and throughout open-term courses of psychotherapy ranging from 8 to 106 sessions. Client attachment style was measured using the anxiety and avoidance subscale scores from the Experiences in Close Relationships scale (ECR; Brennan, Clark, & Shaver, 1998). Therapist interventions were coded by trained observers using the Psychotherapy Q-Set (PQS; Jones, 2000). A factor analysis of therapist interventions revealed four factors: Therapist Facilitative Approach (TFA), Therapist Psychodynamic versus Behavioral Interventions (TPB), Therapist Supportive Approach (TSA), and Therapist Process Comments (TPC). Client attachment avoidance was positively associated with Therapist Supportive Approach (TSA), such that therapists were more likely to use directly supportive interventions with clients who endorsed higher levels of attachment avoidance at the outset of therapy. Otherwise, client attachment ratings were not significantly associated to overall levels of therapist interventions or change in therapist interventions over the course of therapy. Neither client attachment anxiety nor avoidance significantly predicted initial levels, mean levels, or patterns of change in client or therapist ratings of the working alliance or the real relationship over the course of psychotherapy. The findings are discussed in the context of findings and methodological differences from other investigations of client attachment, therapist interventions, and client and therapist ratings of the working alliance and the real relationship. Implications for future research and clinical practice are also discussed. CLIENT ATTACHMENT AS A PREDICTOR OF THERAPIST INTERVENTIONS, THE WORKING ALLIANCE, AND THE REAL RELATIONSHIP IN THE INITIAL, MIDDLE, AND FINAL PHASES OF PSYCHOTHERAPY By John Lawrence Jackson Dissertation submitted to the Faculty of the Graduate School of the University of Maryland, College Park, in partial fulfillment of the requirements for the degree of Doctor of Philosophy 2014 Advisory Committee: Professor Clara E. Hill, Ph.D., Chair Professor Jude Cassidy, Ph.D. Professor Emeritus Charles J. Gelso, Ph.D. Professor Mary Ann Hoffman, Ph.D. Professor Jonathon Mohr, Ph.D. © Copyright by John Lawrence Jackson 2014 Acknowledgements I wish to thank my advisor, Clara E. Hill, for her invaluable guidance and patience throughout the process of writing this dissertation. Thank you, Clara, for what became and remains a truly Corrective Relational Experience. I also wish to thank Jon Mohr for the warmth and precision with which he served as a consultant for the statistical procedures used in this study. Finally, I am grateful to the clients and professors with whom I have worked in graduate study, great teachers of psychotherapy one and all. ii Table of Contents Acknowledgements ....................................................................................................... ii Table of Contents ......................................................................................................... iii Chapter 1: Introduction to the Problem ........................................................................ 1 Chapter 2: Literature Review ........................................................................................ 7 Chapter 3: Statement of the Problem ....................................................................... 118 Chapter 4: Method .................................................................................................... 123 Chapter 5: Results .................................................................................................... 147 Chapter 6: Discussion .............................................................................................. 198 References ................................................................................................................. 227 iii Chapter 1: Introduction to the Problem Over the past two decades, scholars from numerous disciplines within and outside the field of psychology have produced a sizeable body of literature on the implications of attachment theory for adult psychotherapy (Obegi & Berant, 2009). The origins of this literature can roughly be traced to John Bowlby’s (1988) chapter on what he believed were the essential therapeutic implications of attachment theory. Bowlby explained that psychotherapy involves a secure base attachment relationship within which the therapist collaborates with the client to explore, understand, and restructure the internal working models that underlie psychopathology and maladaptive relational patterns. Bowlby emphasized the therapeutic relationship as fundamental to a successful therapeutic endeavor, asserting that “unless a therapist can enable his patient to feel some measure of security, therapy cannot even begin” (p. 140). Bowlby noted, however, that the therapeutic relationship and therapeutic process will differ based to a large extent on client attachment patterns at the outset of therapy. Clients who enter therapy with pronounced attachment insecurity are likely to misconstrue the therapist’s attentiveness and empathy, responding with distrust and hostility or a yearning for more care and support than is realistic or advantageous. Bowlby noted that tailoring the therapeutic work to address such reactions is imperative to overcoming what are often substantial challenges to initiating and maintaining a secure base therapeutic relationship. Several scholars (most notably Wallin, 2007 and Holmes, 2001) have provided theoretically and empirically derived recommendations on how to best 1 conduct therapy with clients who exhibit pronounced attachment anxiety and/or avoidance. A review of these works reveals that a majority of the material is devoted to a description of likely relational occurrences in therapy, with a primary focus on client attitudes and behavior, rather than how a therapist may modify interventions when working with clients who present for therapy with different attachment styles. For example, Wallin (2007) asserted that the therapist stands to benefit from an initial assessment of a client’s attachment style and an approach to the therapeutic work that fits this assessment. However, in his respective chapters on therapy with preoccupied, dismissing, and disorganized clients, Wallin’s suggestions for working with each client type are largely indistinguishable. Wallin focused, for example, on the necessity of therapist empathy in successful treatment across all three client types. When distinguishable, suggested interventions appear theoretically rather than empirically based. Wallin indicated that metacommunicative confrontation (speaking in the here-and-now about the therapist’s feelings and thoughts regarding the client) is likely helpful for clients exhibiting a dismissive attachment style, whereas limit setting is likely helpful for clients exhibiting a preoccupied attachment style. He further indicated that clients with preoccupied or unresolved attachment styles stand to benefit from mindfulness practice. Although his insights, suggestions, and clinical anecdotes are highly informative, many of Wallin’s notions do not appear to have been empirically derived, nor have they been examined empirically. At present, psychotherapy and attachment researchers possess minimal information on whether or how therapists intervene differentially in their work with clients who present with different attachment styles. 2 In one empirical attempt to gain access to such valuable information, Hardy et al. (1999) used a qualitative method to examine therapist responsiveness in client- identified helpful events in brief-term psychodynamic-interpersonal psychotherapy. The authors adapted criteria from the Adult Attachment Interview (AAI; George, Kaplan, & Main, 1984) to classify clients as preoccupied, dismissing, or both (preoccupied and dismissing) based on client discourse patterns in transcripts of events. The authors found that therapist interventions in 9 of the 10 events involved providing the client with safety and structure and containing the client’s anxiety. Events were also discussed in terms of “interpersonal distance,” such that therapists also focused either on interventions that served to provide the client with understanding (e.g., reflections of feelings) or challenge and a push for change (e.g. interpretations and directives). Hardy et al. noted that preoccupied clients tended to pull more understanding and psychodynamic-interpersonal interventions from therapists, whereas dismissing clients tended to pull more challenging, cognitive- behavioral interventions from therapists. The authors concluded that therapists responses to clients likely differ based on client attachment style, such that therapists initially work to provide a secure base “holding” environment
Load more

Recommended publications
  • Attachment, Locus of Control, and Romantic Intimacy in Adult
    ATTACHMENT, LOCUS OF CONTROL, AND ROMANTIC INTIMACY IN ADULT CHILDREN OF ALCOHOLICS: A CORRELATIONAL INVESTIGATION by Raffaela Peter A Dissertation Submitted to the Faculty of The College of Education in Partial Fulfillment of the Requirements for the Degree of Doctor of Philosophy Florida Atlantic University Boca Raton, Florida December 2012 Copyright Raffaela Peter 2012 ii ACKNOWLEDGMENTS I would like to thank my family members and friends for their continuous support and understanding during this process of self-exploration which oftentimes called for sacrifices on their part. Not to be forgotten is the presence of a very special family member, Mr. Kitty, who silently and patiently witnessed all colors and shapes of my affective rainbow. Val Santiago Stanley has shown nothing but pure, altruistic friendship for which I will be forever grateful. The appreciation is extended to Val’s Goddesses Club and its members who passionately give to others in the community. Many thanks go out to Jackie and Julianne who, with true owl spirit and equipped with appropriate memorabilia, lent an open ear and heart at all times. Thank you to my committee who provided me with guidance and knowledge throughout my journey at Florida Atlantic University. Most of them I have known for nearly a decade, a timeframe that has allowed me to grow as an individual and professional. To Dr. Paul Ryan Peluso, my mentor and fellow Avenger, thank you for believing in me and allowing me to “act as if”; your metaphors helped me more than you will ever know. You are a great therapist and educator, and I admire your dedication to the profession.
    [Show full text]
  • On Ambivalence
    PROBLEMI INTERNATIONAL, vol.On 1 no.Ambivalence 1, 2017 © Society for Theoretical Psychoanalysis On Ambivalence Tadej Troha The term “ambivalence” was coined a little over hundred years ago by Eugen Bleuler, the then director of Burghölzli, who despite sympathizing with psychoanalysis refrained from becoming a genuine part of the emerging Freudian collective body. In the end, his insistence on maintaining his individuality produced an ironic twist: while Freud (and Jung, for that matter) became popular authors, Bleuler was left with the impossible trophy of being the author of popular signifiers, the author of terms that seem to have appeared out of nowhere: in addition to ambivalence, he ought to be credited for inventing “autism” and “schizophrenia.” It is well known that Freud was not very enthusiastic about the latter terms and kept insisting on paraphrenia and narcissism, respectively. As for ambivalence, he accepted it immediately and without hesitation. When introduced in Freud’s essays, ambiva- lence is accompanied with a whole series of laudatory remarks: the term is glücklich, gut, passend, trefflich, “happily chosen” (Freud 2001 [1905], p. 199), “excellent” (Freud 2001 [1912], p. 106), “appropriate” (Freud 2001 [1909], p. 239n), “very apt” (Freud 2001 [1915], p. 131). Although he rarely fails to point out that he is not the author of the term, he never bothers to present the reader with the particular clinical framework within which the term has been invented. The praise of the author is here transformed into the praise of the term itself, the quotation does not add anything to Bleuler’s authority; it is rather an excuse to repeatedly point to the authority and breakthrough nature of the 217 Tadej Troha very conceptual background that made the invention possible.
    [Show full text]
  • Nielsen Collection Holdings Western Illinois University Libraries
    Nielsen Collection Holdings Western Illinois University Libraries Call Number Author Title Item Enum Copy # Publisher Date of Publication BS2625 .F6 1920 Acts of the Apostles / edited by F.J. Foakes v.1 1 Macmillan and Co., 1920-1933. Jackson and Kirsopp Lake. BS2625 .F6 1920 Acts of the Apostles / edited by F.J. Foakes v.2 1 Macmillan and Co., 1920-1933. Jackson and Kirsopp Lake. BS2625 .F6 1920 Acts of the Apostles / edited by F.J. Foakes v.3 1 Macmillan and Co., 1920-1933. Jackson and Kirsopp Lake. BS2625 .F6 1920 Acts of the Apostles / edited by F.J. Foakes v.4 1 Macmillan and Co., 1920-1933. Jackson and Kirsopp Lake. BS2625 .F6 1920 Acts of the Apostles / edited by F.J. Foakes v.5 1 Macmillan and Co., 1920-1933. Jackson and Kirsopp Lake. PG3356 .A55 1987 Alexander Pushkin / edited and with an 1 Chelsea House 1987. introduction by Harold Bloom. Publishers, LA227.4 .A44 1998 American academic culture in transformation : 1 Princeton University 1998, c1997. fifty years, four disciplines / edited with an Press, introduction by Thomas Bender and Carl E. Schorske ; foreword by Stephen R. Graubard. PC2689 .A45 1984 American Express international traveler's 1 Simon and Schuster, c1984. pocket French dictionary and phrase book. REF. PE1628 .A623 American Heritage dictionary of the English 1 Houghton Mifflin, c2000. 2000 language. REF. PE1628 .A623 American Heritage dictionary of the English 2 Houghton Mifflin, c2000. 2000 language. DS155 .A599 1995 Anatolia : cauldron of cultures / by the editors 1 Time-Life Books, c1995. of Time-Life Books. BS440 .A54 1992 Anchor Bible dictionary / David Noel v.1 1 Doubleday, c1992.
    [Show full text]
  • Theorists and Theories of Child Development Learner Support Handbook
    Theorists and Theories of Child Development Learner Support Handbook Supporting the development of your career Introduction This information guide is designed to support the knowledge and understanding of child development, in particular the theories and theorists behind these. It details it looks at the seven most popular theorists and the research carried out by them to highlight the many fascinating ways in which children develop and learn Child development theories focus on explaining how children change and grow over the course of childhood. Such theories centre on various aspects of development including social, emotional and cognitive growth. The study of human development is a rich and varied subject. We all have personal experience with development, but it is sometimes difficult to understand: How and why people grow, learn, and act as they do. Why do children behave in certain ways? Is their behaviour related to their age, family relationships, or individual temperament? Developmental psychologists strive to answer such questions as well as to understand, explain, and predict behaviours that occur throughout the lifespan. In order to understand human development, a number of different theories of child development have arisen to explain various aspects of human growth. The guide covers the following theorists and details each of their theories: 1. Freud’s Psychosexual Developmental Theory 2. Erikson's Psychosocial Developmental Theory 3. Piaget's Cognitive Developmental Theory 4. Bowlby's Attachment Theory 5. Bandura's Social Learning Theory 6. Vygotsky's Sociocultural Theory Supporting the development of your career Child Development Theories: A Background Theories of development provide a framework for thinking about human growth and learning.
    [Show full text]
  • Information to Users
    INFORMATION TO USERS This manuscript has been reproduced from the microfilm master. UMI films the text directly from the original or copy submitted. Thus, some thesis and dissertation copies are in typewriter face, while others may be from any type of computer printer. The quality of this reproduction is dependent upon the quality of the copy submitted. Broken or indistinct print, colored or poor quality illustrations and photographs, print bleedthrough, substandard margins, and improper alignment can adversely affect reproduction. In the unlikely event that the author did not send UMI a complete manuscript and there are missing pages, these will be noted. Also, if unauthorized copyright material had to be removed, a note will indicate the deletion. Oversize materials (e.g., maps, drawings, charts) are reproduced by sectioning the original, beginning at the upper left-hand comer and continuing from left to right in equal sections with small overlaps. Each original is also photographed in one exposure and is included in reduced form at the back of the book. Photographs included in the original manuscript have been reproduced xerographically in this copy. Higher quality 6” x 9” black and white photographic prints are available for any photographs or illustrations appearing in this copy for an additional charge. Contact UMI directly to order. UMI A Bell & Howell Information Company 300 North Zeeb Road, Ann Arbor MI 48106-1346 USA 313/761-4700 800/521-0600 Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. ATTACHMENT STYLE, DEPRESSION AND LONELINESS IN ADOLESCENT SUICIDE ATTEMPTERS by Kolleen M.
    [Show full text]
  • What Is Mentalization? the Concept and Its Foundations in Developmental
    What is Mentalization? The Concept and its Foundations in Developmental Research and Social-Cognitive Neuroscience Peter Fonagy Elizabeth Allison Address for correspondence: Peter Fonagy PhD FBA Research Department of Clinical, Educational and Health Psychology University College London Gower Street London WC1E 6BT E-mail: [email protected] Tel: 44 20 7679 1791 Fax: 44 20 7916 8502 Chapter submitted for Nick Midgley & Ioanna Vrouva (eds) Keeping Children in Mind: Mentalization-based Interventions with Children, Young People and their Families, January 2011. What is mentalization? When we mentalize we are engaged in a form of (mostly preconscious) imaginative mental activity that enables us to perceive and interpret human behavior in terms of intentional mental states (e.g., needs, desires, feelings, beliefs, goals, purposes, and reasons) (Allen, Fonagy, & Bateman, 2008). Mentalizing must be imaginative because we have to imagine what other people might be thinking or feeling. We can never know for sure what is in someone else’s mind (Fonagy, Steele, Steele, & Target, 1997). Moreover, perhaps counterintuitively, we suggest that a similar kind of imaginative leap is required to understand our own mental experience, particularly in relation to emotionally charged issues. We shall see that the ability to mentalize is vital for self-organization and affect regulation. The ability to infer and represent other people’s mental states may be uniquely human. It seems to have evolved to enable humans to predict and interpret others’ actions quickly and efficiently in a large variety of competitive and cooperative situations. However, the extent to which each of us is able to master this vital capacity is crucially influenced by our early experiences as well as our genetic inheritance.
    [Show full text]
  • Bowlby & Attachment Theory
    Chapter 9 The Legacy of John Bowlby’s Attachment Theory Jools Page Introduction This chapter discusses the contribution of John Bowlby’s more than 50 years of thinking about attachments, separation, relationships and emotional stability. After a brief biography, the chapter considers his well-known, and sometimes controversial, ‘Attachment theory’ alongside the work of his collaborators at the time, including James Robertson and Mary Ainsworth. A key focus is attachment theory in relation to children in their home and early years environments, and how understanding this theory is important for early years practitioners to appreciate the lived experiences of children in out of home contexts. The chapter concludes with a consideration of the place of love and loving relationships in contemporary professional practice and the implications of ‘Modern Attachment Theory’ for early years and childcare practitioners working globally. John Bowlby [1907-1990]: A brief biography Bowlby (1907–1990) was the son of Sir Anthony Bowlby, a London surgeon. After serving briefly as a naval cadet, he read natural sciences and psychology at the University of Cambridge. Bowlby worked for a time in a school for boys with psychiatric problems, then trained as a doctor and child psychiatrist, working during the Second World War World as a psychiatrist for the War Office Selection Board. After the war, Bowlby was Deputy Director of the Tavistock Clinic in London, a world-renowned centre for child psychiatry and psychotherapy (For further detail see King & Rayner 1993). It was soon after he graduated from Cambridge in 1928 that Bowlby began to study separation and anxiety, building on observations of two young boys in a remedial home where he was working (Bretherton 1992; and Cassidy, 2008).
    [Show full text]
  • Transference: a Paradoxical Concept Pierre-Gilles Guéguen
    Volume 2, Issue 12 December 4, 2014 LCEXPRESS Transference: A Paradoxical Concept Pierre-Gilles Guéguen Précis In this issue we present a long anticipated lecture by Pierre-Gilles Guéguen from Clinical Study Days 7. His essay frames the transference as paradoxical and focuses on the conceptual arc of Lacan’s thinking about transference. Guéguen’s work here is thorough and in-depth. He argues that in the 21st century, the erosion of the symbolic order loosens the ties between the symbolic, imaginary and real. Transference can shore up these loose ties. Guéguen also recounts aspects of testimonies of the pass that illustrate the dynamic of the transference at the end of analysis. Gary Marshall, Co-Editor lacaniancompass.org !1 Volume 2, Issue 12 December 4, 2014 Transference: A Paradoxical Concept The LC EXPRESS delivers the Transference phenomena were first identified as "new editions, Lacanian Compass copies, of tendencies and fantasies (...) of which the characteristic feature is in a new format. Its aim is to deliver to replace a formerly known person by the person of the doctor."1 This is how relevant texts in a Freud expressed himself concerning the Dora case at the beginning of the dynamic timeframe for use in the clinic 20th century. He was already stressing the false attribution of tendencies and and in advance of fantasies to the analyst, reinforced by the particular conditions of analytic study days and treatment. In 1915, however, in “Observations on Transference-Love,”1 Freud conference meetings. The LC proposes a variation on his speech of 1900 by affirming that transference EXPRESS publishes love, as unreal as it may be, is nevertheless a “genuine” love and points out works of theory and that if it appears to be abnormal, it only reproduces the banal state of “being clinical practice and emphasizes both in love” that is always symptomatic.
    [Show full text]
  • A Secure Base for Adult Learning: Attachment Theory and Adult Education
    A Secure Base for Adult Learning: Attachment Theory and Adult Education ted fleming Abstract The attachment theory of John Bowlby has had an enduring impact on our under- standing of child development. But these ideas are a neglected and forgotten discourse in adult education. In this paper concepts such as secure and insecure attachments, internal working models, and the strange situation along with the more contemporary concept of mind-mindedness are explored. The paper also explores the implications for how adults deal with new situations and new ideas; how adult learners and teachers are influenced by their own attachment styles and internal working models. These models are interpreted as strategies that adults employ for dealing with stress, anxiety, change and the challenges of teaching and learning. In addition, the implications of these concepts for understanding trans- formative learning are identified and changing internal working models is pro- posed as a form of transformative learning. This paper outlines Bowlby’s main ideas, with a focus on recent research findings and, by extrapolation, reframes our current understanding of adult learning. The ideas presented here are not usually part of adult education debates but may provide useful insights for facilitators of adult learning and personal development. Keywords: Attachment theory; Secure attachments; Internal working models; Secure base; Mind-mindedness; Transformation theory; Adult learning. Introduction Adult education has grown accustomed to a particular palette of debates including lifelong learning and more critical understandings of learning. These critical understandings involve a reinterpretation of the meaning of lifelong learning that, if they are to be of value, need to be combined, with “a critical 33 9050 Adult Learn Interior.indd 33 22/08/2008 16:12:16 theory of society” (Murphy, 2001, p.
    [Show full text]
  • Wiley-Blackwell Handbook of Infant Development Wiley- Blackwell Handbooks of Developmental Psychology
    The Wiley-Blackwell Handbook of Infant Development Wiley- Blackwell Handbooks of Developmental Psychology This outstanding series of handbooks provides a cutting - edge overview of classic research, current research, and future trends in developmental psychology. • Each handbook draws together 25 – 30 newly commissioned chapters to provide a comprehensive overview of a subdiscipline of developmental psychology. • The international team of contributors to each handbook has been specially chosen for its expertise and knowledge of each fi eld. • Each handbook is introduced and contextualized by leading fi gures in the fi eld, lending coherence and authority to each volume. The Wiley - Blackwell Handbooks of Developmental Psychology will provide an invaluable overview for advanced students of developmental psychology and for researchers as an authoritative defi nition of their chosen fi eld. Published Blackwell Handbook of Childhood Social Development Edited by Peter K. Smith and Craig H. Hart Blackwell Handbook of Adolescence Edited by Gerald R. Adams and Michael D. Berzonsky The Science of Reading: A Handbook Edited by Margaret J. Snowling and Charles Hulme Blackwell Handbook of Early Childhood Development Edited by Kathleen McCartney and Deborah A. Phillips Blackwell Handbook of Language Development Edited by Erika Hoff and Marilyn Shatz Wiley - Blackwell Handbook of Childhood Cognitive Development, 2nd edition Edited by Usha Goswami Wiley - Blackwell Handbook of Infant Development, 2 nd edition Edited by J. Gavin Bremner and Theodore D. Wachs Forthcoming Blackwell Handbook of Developmental Psychology in Action Edited by Rudolph Schaffer and Kevin Durkin Wiley - Blackwell Handbook of Adulthood and Aging Edited by Susan Krauss Whitbourne and Martin Sliwinski Wiley - Blackwell Handbook of Childhood Social Development, 2nd edition Edited by Peter K.
    [Show full text]
  • Ninety Years of Service
    NINETY YEARS OF SERVICE HISTORY OF SOUTHAMPTON CHILDREN'S HOSPITAL 1884-1974 By David A.J. Williamson. M.D. ,F.R.C.P. ,D.C.H. Honorary Consultant Paediatrician April 1990 CONTENTS Foreword I. Preface II,“Voluntary” Days. III.In the N,H.S. IV,Special Departments. V. Staff, VI.League of Friends. VII.Paediatrics in Wessex. VIII. Memories. IX. The Last Lap. Appendix I. Hospital Staff. Appendix II. The Work Load, Analysis of Admissions and Deaths for the Year 1931 FORWARD by I.C.S.Normand. D.M. ,F.R.C.P. Professor of Child Health. David Williamson’s fascinating account of Southampton Children’s Hospital will be a source of nostalgia for all who knew or worked at Winchester Road but it is far from being just a nostalgic memoir. To many it may come as a surprise to learn how Southampton for so long has kept in the forefront of ideas and practice in the care of sick children. Above all we read a story of extraordinary professional devotion and commitment from a staff of minuscule size by modern standards but who, because of their common ideals, achieved so much for their small patients with such limited resource behind them. It is now fifteen years since the Children’s Hospital closed but the tale of continuing expansion and innovation in services has not changed. In particular the Children’s Unit increasingly functions as a tertiary and research centre as befits its position as the only University hospital along the South Coast. Inevitably some of the intimacy has gone but there still remains a real sense of the happy family bound together in its pursuit of excellence for the care of sick children.
    [Show full text]
  • Running Head: CAN QUALITY OVERCOME QUANTITY? 1
    Running head: CAN QUALITY OVERCOME QUANTITY? 1 Can Quality Overcome Quantity? The Impact of National Maternity Leave Policies on Child Development by Devon F. Patton Honors Thesis Appalachian State University Submitted to The Honor College in partial fulfilment for the requirements for the degree of Special Education Bachelor of Sciences May, 2015 Approved by: __________________________________________________ Denise Brewer, Ph.D., Thesis Director __________________________________________________ Lindsay Masland, Ph.D., Second Reader __________________________________________________ Leslie Sargent Jones, Ph.D., Director, The Honors College CAN QUALITY OVERCOME QUANTITY? 2 Abstract All developed countries in the Organization for Economic Co-operation and Development provide maternity leave, time away from work with the birth or adoption of a new child, to their citizens (Ray, 2008). However, there is wide variation in the amount of leave provided to individuals, and the United States (US) has one of the shortest policies. This thesis investigates the possible impacts that the length of maternity leave has on the social/emotional, cognitive, and health development of young children. To provide bearing of the US impact, a comparison of the impact of the Norwegian maternity leave policy is included. The author concludes by making recommendations of potential ways to lessen the developmental impact on US children as a result of the national maternity leave policies. CAN QUALITY OVERCOME QUANTITY? 3 Table of Contents Chapter 1: Introduction page 4 Chapter 2: US Legislation page 15 Chapter 3: Social Emotional Development Impact page 21 Chapter 4: Cognitive Development Impact page 34 Chapter 5: Health Development Impact page 44 Chapter 6: Norway Comparison page 50 Chapter 7: Discussion page 60 References page 72 CAN QUALITY OVERCOME QUANTITY? 4 Chapter 1: Introduction “After breakfast, I clean up just like mommy.
    [Show full text]