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Circle of Security Parenting

Evidence rating
2
Cost rating
1
Review: January 2019

Circle of Security Parenting (COS-P) is a parenting programme for caregivers of children between the ages of 4 months and 6 years. It is a targeted-selective programme delivered in a variety of settings (e.g. children's centres, CAMHS units, fostering and adoption units) and aims to improve children’s attachment.

Circle of Security Parenting is based on attachment theory and aims at helping parents reflect on their own attachment experiences and thus reduce their negative mental attributions to the child’s normal attachment-seeking behaviours. Parents are then better able to provide a secure base for their distressed child and their exploratory behaviours, which, in turn, improves their child’s attachment.

The programme is designed for a broad group of caregivers who may have widely varying levels of risk. This includes but is not limited to parents (mothers and fathers, sometimes couples together), foster carers and childcare providers. Sometimes the programme is delivered with a focus on caregivers with particular risks such as substance abuse or perinatal depression.

The programme is delivered in a group setting where facilitators use videos for reflective discussions about caregivers’ own attachment experience and their behaviour towards their child. In eight sessions, parents learn how they can respond sensitively to their child’s distress.

EIF Programme Assessment

Evidence rating
2

Circle of Security Parenting has preliminary evidence of improving a child outcome, but we cannot be confident that the programme caused the improvement.

What does the evidence rating mean?

Level 2 indicates that the programme has evidence of improving a child outcome from a study involving at least 20 participants, representing 60% of the sample, using validated instruments. 

This programme does not receive a rating of 3 as its best evidence is not from a rigorously conducted RCT or QED evaluation.

What does the plus mean?

The plus rating indicates that a programme’s best available evidence is based on an evaluation that is more rigorous than a level 2 standard but does not meet the criteria for level 3. 

Cost rating
1

A rating of 1 indicates that a programme has a low cost to set up and deliver, compared with other interventions reviewed by EIF. This is equivalent to an estimated unit cost of less than £100.

Child outcomes

According to the best available evidence for this programme's impact, it can achieve the following positive outcomes for children:

Enhancing school achievement & employment

Improved inhibitory control - based on study 1

This programme also has evidence of supporting positive outcomes for couples, parents or families that may be relevant to a commissioning decision. Please see About the evidence for more detail.

Circle of Security Parenting

Key programme characteristics

Who is it for?

The best available evidence for this programme relates to the following age-groups:

  • Preschool
  • Primary school

How is it delivered?

The best available evidence for this programme relates to implementation through these delivery models:

  • Group

Where is it delivered?

The best available evidence for this programme relates to its implementation in these settings:

  • Children's centre or early-years setting

The programme may also be delivered in these settings:

  • Community centre
  • Out-patient health setting

How is it targeted?

The best available evidence for this programme relates to its implementation as:

  • Targeted selective

Circle for Security Parenting is offered in a variety of different settings such as children's centres, CAMHS units, early help teams, fostering and adoption units, perinatal mental health teams, and schools.

Where has it been implemented?

Australia, Canada, Denmark, England, Finland, Germany, Hong Kong, Ireland, Japan, Mexico, New Zealand, Norway, Singapore, Spain, South Africa, Sweden, United States, Wales

UK provision

This programme has been implemented in the UK.

UK evaluation

This programme’s best evidence does not include evaluation conducted in the UK.

Spotlight sets

EIF does not currently include this programme within any Spotlight set.

Circle of Security Parenting

About the programme

What happens during delivery?

How is it delivered?
  • Circle of Security Parenting is delivered in eight to 10 sessions of 1.5–2 hours’ duration each by practitioners with a university-level degree (QCF-6) to groups of 8–15 caregivers.
What happens during the intervention?
  • Interveners use video to facilitate reflective discussions about caregivers’ attachment experiences – more specifically:
    • what they learned from their own parents growing up
    • understanding the importance of a secure relationship for children to be able to manage their emotions
    • reasons why caregivers struggle to meet their children’s needs.
  • Interveners teach a simple form of attunement. 

What are the implementation requirements?

Who can deliver it?
  • The practitioner who delivers this programme is a practitioner with QCF-6 level qualifications.
What are the training requirements?
  • Practitioners complete a four-day programme training. Booster training of practitioners is not required.
How are the practitioners supervised?
  • Supervision is not required.

  • Opt-in supervision arrangements (known as 'fidelity coaching') are available. In supervision sessions, practitioners reflect on their experiences leading the sessions. 

What are the systems for maintaining fidelity?

Programme fidelity is maintained through the following processes:

  • Training manual

  • Other printed material

  • Other online material

  • Video or DVD training

  • Face-to-face training

  • Fidelity monitoring.

Additionally, fidelity coaching, a form of reflective supervision, is available.

Is there a licensing requirement?

There is no licence required to run this programme.

How does it work? (Theory of Change)

How does it work?
  • Increasing caregivers’ reflective and empathic responses to their infant or young child's emotional distress decreases prolonged emotional distress in the infant or young child and enhances attachment security. A decrease in negative mental attributions by the caregiver regarding the infant or young child's normal attachment and exploratory behaviours increases caregiver’s availability and reinforces the child's capacity to use the caregiver as a secure base to explore the environment and as a safe haven to come to in times of distress. Increasing caregivers’ self-reflection regarding the fearful, angry and disengaging emotional triggers evoked by their child enhances caregivers’ emotional regulation, self-reflection, and the potential for the caregiver to choose a more secure response to their child.
  • The programme aims to give caregivers an easy-to-follow 'roadmap' (the Circle of Security diagram); this roadmap underscores that babies' or young childrens' behaviour is motivated by their attachment needs and focuses the caregiver's attention on their role in identifying and meeting those needs. Through video review of caregiver–child interactions, paired with the trained facilitator using their manual to ask reflective questions and explore with caregivers how to identify children's needs as they explore and as they return to the caregiver, caregivers develop more reflective and empathic responses to child behaviour or distress.
  • In the short term, caregivers are able to identify their infant or young child's attachment needs and respond to those needs. Caregivers are also able to identify which needs on the Circle of Security they most often struggle to identify or respond empathically to and are able to reflect on why those particular needs are a struggle.
  • In the longer term, as caregivers identify and manage normal ruptures in their relationships with their young children, they are able to promote secure attachment through recognition and repair of these ruptures.
Intended outcomes

Supporting children's mental health and wellbeing
Enhancing school achievement & employment
Preventing crime, violence and antisocial behaviour
Preventing substance abuse

Contact details

Jenny Peters
Circle of Security Parenting Fidelity Coach
jenny.peters@thecentrelondon.com

www.circleofsecurity.org

Circle of Security Parenting

About the evidence

Circle of Security Parenting’s most rigorous evidence comes from an RCT which was conducted in the United States.  

This study identified statistically significant positive impact on one child outcome.

This programme is underpinned by one study with a level 2+ rating, hence the programme receives a level 2+ rating overall.

Study 1

Citation: Cassidy et al 2017
Design: RCT
Country: United States
Sample: 141 mothers, with children between 3 and 5 years old (mean age 4 years), where families are enrolled in a Head Start centre (USA).
Timing: Post-test
Child outcomes: Improved inhibitory control
Other outcomes: Improved maternal response to child distress
Study rating: 2+

Cassidy, J., Brett, B. E., Gross, J. T., Stern, J. A., Martin, D. R., Mohr, J. J., & Woodhouse, S. S. (2017). Circle of Security–Parenting: A randomized controlled trial in Head Start. Development and Psychopathology, 29(2), 651–673.

Available at
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5543687/

Study design and sample

This study involved random assignment of children to a Circle of Security Parenting treatment group group and a waitlist control group. 

It was conducted in the USA, with a sample of children aged between 3 and 5 years (average age 4) whose families were enrolled in Head Start centres. These families tend to have a low socio-economic background, to be single-parent households, and to be less educated (one-third of parents have less than a high school education). Exposure to violent crime is increased in these families and mothers have an elevated risk of depression.  

Mother–child dyads included in this sample were mainly African American.

Measures

Children’s attachment security and avoidance, inhibitory control, and cognitive flexibility were measured using expert observation of behaviour. Children's internalising and externalising behaviour was measured using mothers' reports. Mothers' outcomes were measured using self-report. 

Findings

This study identified statistically significant positive impact on one child outcome. After participating in the programme, children had significantly more inhibitory control compared to the control group.

However, for a subgroup of children whose mothers were low on attachment avoidance, intervention group children tended to be less secure compared to control group children. This finding is based on a limited sample size and has to be treated cautiously.

The conclusions that can be drawn from this study are limited by methodological issues pertaining to concerns that group differences have been introduced by attrition, hence why a higher rating is not achieved.

More Less about study 1

Other studies

The following studies were identified for this programme but did not count towards the programme's overall evidence rating. A programme receives the same rating as its most robust study or studies.

Horton, E., & Murray, C. (2015). A quantitative exploratory evaluation of the Circle of Security-Parenting Program with mothers in residential substance-abuse treatment. Infant Mental Health Journal, 36(3), 320–336.

Horton, G. E. (2013). The impact of the circle of security-parenting© program on mothers in residential substance abuse treatment: An action research study. The University of North Carolina at Greensboro.

Kamal, L., Strand, J., Jutengren, G., & Tidefors, I. (2017). Perceptions and experiences of an attachment-based intervention for parents troubled by intimate partner violence. Clinical Social Work Journal, 45(4), 311–319.

Kohlhoff, J., Stein, M., Ha, M., & Mejaha, K. (2016). The Circle of Security Parenting (COS-P) intervention: pilot evaluation. Australian Journal of Child and Family Health Nursing, 13(1), 3.

McMahon, C., Huber, A., Kohlhoff, J., & Camberis, A. L. (2017). Does training in the Circle of Security framework increase relational understanding in infant/child and family workers? Infant mental health journal, 38(5), 658-668.

Risholm Mothander, P. R., Furmark, C., & Neander, K. (2018). Adding “Circle of Security–Parenting” to treatment as usual in three Swedish infant mental health clinics. Effects on parents’ internal representations and quality of parent-infant interaction. Scandinavian Journal of Psychology, 59(3), 262–272.

Rennie, K. D. The effects of the “Circle of Security Parenting” group intervention on a community sample of parents of 1 to 3-year-olds. Unpublished master’s thesis. New South Wales Institute of Psychiatry, New South Wales, Australia.

Gray, S. A. (2015). Widening the Circle of Security: A quasi‐experimental evaluation of attachment‐based professional development for family child care providers. Infant mental health journal, 36(3), 308-319.

Page, T., & Cain, D. (2010, January). A pilot application of the Circle of Security parenting intervention to child welfare-involved mothers. In Poster presentation at the Society for Social Work and Research Fourteenth Annual Conference.

Haugaard, K., & De Lopez, K. J. (2015). Testing the efficacy of Circle of Security–Parenting programme with Danish at risk career mothers: a pilot Randomized Controlled Trial. In International Attachment Conference.

Published February 2019