Misevičė Monika, Gervinskaitė-Paulaitienė Lina, Lesinskienė Sigita
Clinic of Psychiatry, Faculty of Medicine, Vilnius University, 01513 Vilnius, Lithuania.
Institute of Psychology, Faculty of Philosophy, Vilnius University, 01513 Vilnius, Lithuania.
Behav Sci (Basel). 2024 Jul 13;14(7):595. doi: 10.3390/bs14070595.
Children growing up in institutions lack a stable relationship-essential for development. A significant proportion of them have disorganised attachment, which is associated with negative outcomes. Therefore, interventions aimed at improving attachment security are needed. We conducted a case series study (involving five participants aged 8-11 years) in a newly established psychosocial rehabilitation daycare centre to describe the changes in attachment security and mental health of institutionalised children after one year of attendance. The intervention consisted of individualised care focusing on staff building a trusting relationship with participants using the principles of Trust-Based Relational Intervention (TBRI). Measures such as the Child Attachment Interview, SDQ, CBCL6/18, TRF6/18, and clinical interviews were used to follow change. The descriptive data of five participants are presented. All five children improved in mental health, and for two participants, organisation of attachment changed. Three children experienced relational ruptures. The findings suggest that psychosocial interventions that focus on building trusting relationships may be beneficial in institutionalised children. For these children, given their life history, it can be damaging to experience repeated breakdowns. Thus, the practical implication is that any new relationship for them with an adult should be established after an assessment of whether the relationship can be sustained.
在福利院长大的儿童缺乏对成长至关重要的稳定关系。他们中很大一部分人有紊乱型依恋，这与负面结果相关。因此，需要采取旨在改善依恋安全性的干预措施。我们在一个新成立的心理社会康复日托中心进行了一项病例系列研究（涉及5名8至11岁的参与者），以描述入院一年后福利院儿童在依恋安全性和心理健康方面的变化。干预措施包括个性化护理，重点是工作人员运用基于信任的关系干预（TBRI）原则与参与者建立信任关系。采用儿童依恋访谈、SDQ、CBCL6/18、TRF6/18和临床访谈等措施来跟踪变化。呈现了5名参与者的描述性数据。所有5名儿童的心理健康状况都有所改善，其中2名参与者的依恋组织发生了变化。3名儿童经历了关系破裂。研究结果表明，专注于建立信任关系的心理社会干预措施可能对福利院儿童有益。对于这些儿童来说，鉴于他们的生活经历，反复经历关系破裂可能会造成伤害。因此，实际意义在于，在评估与他们与成年人建立的新关系能否持续之后，才应该建立这种关系。
