DMM体系课程概览
  • DMM体系课程概览
    Dr. Patricia Crittenden has developed a developmental sequence of assessments of attachment and self-protective strategy. All are tied to the Dynamic-Maturational Model (DMM) of attachment. She and her colleagues offer several courses that teach these methods. The Attachment and Psychopathology course is an overview of the DMM and is prerequisite for the other courses.
    Patricia Crittenden博士开发出一套基于发育次序的依恋及自我保护策略评估工具。所有评估都和依恋的动态成熟模型(DMM)紧密关联。她和她的同事们提供了多种不同的课程来教授这些评估方法。(学习)依恋与精神病理课程为DMM提供了概览,并且是进修其他课程的预设条件。

    DMM评估体系,有以下课程:

    • 依恋与精神病理A&P):Attachment & Psychopathology
      This course introduces the Dynamic-Maturational Model (DMM) of attachment and ties it to risk assessment and treatment.
      该课程引入了依恋动态成熟模型(DMM)的概念,并将其与风险评估和治疗相结合。
      参阅:依恋与精神病理(A&P)课程介绍

    • 依恋与精神病理研讨(A&P ST)Attachment & Psychopathology Consultation
      This course permits clinicians to apply DMM principles to specific cases in a seminar discussion. 
      参与该课程的临床工作者可通过研讨的形式将DMM理论应用于具体的案例中。
      参阅:依恋与精神病理(A&P ST)课程介绍

    • 关爱指数(CI):CARE-Index
      This is the simplest and most versatile of the DMM assessments. It was developed under Ainsworth's guidance and with consultation from John Bowlby. It assesses mother-infant interaction from birth to about four years of age based on a short, videotaped play interaction of 3-5 minutes.
      这是DMM评估工具中最简单、用途最广泛的一项。这项工具的开发经过Ainsworth的指导,并征询了John Bowlby的意见。它可以通过3-5分钟的(亲子)游戏互动,评估从出生到四岁左右的母婴(亲子)互动质量。
      参阅:关爱指数(CI):CARE-Index(待审校)

    • 婴儿陌生情境实验(SSP):Infant Strange Situation
      This procedure was developed by Dr. Mary D.S. Ainsworth and is the classic assessment of attachment from which all other assessments are derived and validated. It is suitable for 11-17 month-old infants. 
      该程序由Mary D.S. Ainsworth开发,是经典的依恋评估方法,也是其他所有通过验证的依恋测评工具的依据来源。它的适用对象是11-17个月的婴儿。
      参阅:婴儿陌生情境实验(SSP)(待审校)

    • 学前期依恋评估(PAA):Preschool Assessment of Attachment
      PAA is an instrument for assessing patterns of attachment in 18-month to five-year-old children. It was developed with assistance from Ainsworth. 
      PAA用于评估18个月-5岁儿童的依恋模式。它的开发受到了Ainsworth的协助。
      参阅:学前期依恋评估(PAA)
    • 学龄期依恋评估(SAA):School-age Assessment of Attachment
      SAA consists of picture cards, such as those developed by Hansburg and Bowlby & Klagsbrun, that are used to elicit fantasy stories and recalled episodes. It is suitable for 6 years until puberty. 
      SAA测评由Hansburgh,Bowlby及Klagsbrun开发的图卡组成,用来引出幻想故事及回忆片段。它的适用年龄范围是6岁至青春前期。
      参阅:学龄期依恋评估(SAA)(待审校)

    • 青春期依恋访谈(TAAI):Transition to Adulthood Attachment Interview
      TAAI is an adaptation of the AAI for assessing older adolescents' and young adults' strategies for identifying, preventing, and protecting the self from perceived dangers, particularly dangers tied to intimate relationships. 
      TAAI改编自AAI,可以测评大龄青少年及年轻成年人在面对他们认为的,尤其是和亲密关系相关的危险时,识别、预防和保护自己的策略。
      参阅:青春期依恋访谈(TAAI)(待审校)

    • 成人依恋访谈(AAI):Adult Attachment Interview
      The DMM-AAI is an interview (developed by George, Kaplan, & Main) for assessing adults' strategies for identifying, preventing, and protecting the self from perceived dangers, particularly dangers tied to intimate relationships. 
      (由George,Kaplan,及Main开发的)DMM-AAI用于评估成人在面对他们认为的,尤其是和亲密关系相关的危险时,识别、预防和保护自己的策略。
      参阅:成人依恋访谈(AAI)(待审校)
    本篇由DMM翻译小组的曹萌韵翻译审校




    A&P
    Attachment & Psychopathology
    依恋与精神病理

    This 3-day course focuses on the development, prevention, and treatment of psychological disorder. It weaves together theory, human development, assessment, case examples, and treatment applications to reframe maladaptive behavior in terms of strategies for self-protection. The course focuses on development from infancy to adulthood, emphasizing the process of adaptation and developmental pathways that carry risk for psychopathology. The model used, the Dynamic-Maturational Model (DMM) of Attachment and Adaptation. The DMM is an expansion of the Bowlby-Ainsworth model to ages beyond infancy. The DMM is relevant to individuals who are at-risk, have been exposed to danger, display disturbed or maladaptive behavior, or are diagnosed as having a psychiatric disorder.
    这个3天的课程聚焦于精神障碍的发展、预防及治疗。它将理论、人类发展、评估、案例和治疗应用相结合,重新从策略及自我保护的角度去看待适应不良的行为。本课程关注婴儿期至成人期的发展,着眼于适应的过程,以及带来精神病理风险的成长路径。所使用的模型为依恋及适应的动态成熟模型(DMM)。它同时也是Bowlby-Ainsworth模型的拓展,将适用年龄段延伸到了婴儿期之外。DMM与正处于或曾暴露于危险中的、表现出受干扰或适应不良行为的、或被诊断为有精神障碍的人群有着密不可分的关系。

    The DMM describes an array of self-protective attachment strategies that develop from infancy to adulthood (including old age). The course emphasizes the process of adaptation and those developmental pathways that carry risk for psychopathology. At each age, the approaches to prevention and treatment are considered. The DMM differs from the ABC+D (plus "disorganization") model of attachment by (1) focusing on differences within the risk group, (2) highlighting a strengths approach to working with parents and children at risk, and (3) presuming that maturation and development increase individuals' potential for adaptation. A particular emphasis is cultural influences on attachment and the distribution of individual differences in protective attachment strategies.
    DMM描述了从婴儿期到成人期(包括老年期)所发展出的一系列自我保护性的依恋策略。课程着眼于适应的过程,以及带来精神病理风险的成长路径。同时它也考虑了每个年龄段的防治方法。DMM与ABC+D(即disorganization,混乱型)依恋模型有以下不同之处:(1)关注风险组内的差异,(2)强调与处于危险的家长及儿童工作时关注优势的工作方法,(3)假设心理及生理的发育和成熟可提升个体的适应潜能。DMM还特别强调文化对于依恋及个体保护性依恋策略差异的影响。

    Readings from Raising Parents: Attachment, Representation, and Treatment accompany each day's lecture and video. Each participant will receive a copy of Raising Parents.
    阅读材料出自《养育父母:依恋、表征及治疗》,会伴随每天的课程及视频进行。每个学员会收到一份《养育父母》的文本。

    With additional assignments, the course may be applied to the DMM-informed Mental Health Practitioner Certificate. For further information, contact Dr. Andrea Landini, Director FRI (andrealandini@mac.com).
    和附加的作业一起,本课程可应用于基于DMM的精神卫生执业者证书申请过程中。进一步信息,有意者可联系Andrea Landini博士(andrealandini@mac.com),家庭关系研究所的主席。

    The course is appropriate for: psychology, social work, counseling, medical professions (nursing, psychiatry, pediatrics, occupational therapy, etc.), and early education.
    本课程适用于心理学、社会工作、咨询、医学专业(护理、精神病学、儿科、职业治疗等)和早期教育。

    The course is structured developmentally and consists of lecture with slides, videotapes, and interview transcripts to demonstrate the patterns and principles of development. With the readings, it offers a sound overview of development and an introduction to diagnostic procedures, family formulation, and treatment principles.
    课程的结构和顺序遵循发育发展阶段,包含带幻灯片的讲课、视频和访谈文字稿等多种形式的内容,以说明发展的模式和原理。与阅读一起,提供对发展过程的充分概述和对诊断程序、家庭功能解析及治疗原则的介绍。

    Each day includes:每一天包括:
    • a developmental overview,
      发展概述
    • information processing as it affects self- and child-protective behavior,
      信息加工及其对自我/儿童保护行为的影响
    • description of new self-protective strategies that develop at the age level,
      描述在年龄层级发展的新的自我保护策略,
    • an application of DMM ideas to generate a novel approach to disorder
      应用DMM的视角去获得一种看待障碍的全新方法或策略
    • • treatment strategies drawn from all the major theories of treatment and selected on the basis of information processing and strategy.
      通过信息加工及策略的基础,从所有主流治疗理论中汲取治疗策略


    An introduction is given to the DMM assessments of attachment:
    关于依恋的DMM评估的介绍:
    • CARE-Index (infancy from birth to 24 months)
      婴儿期关爱指数(ICI,从出生到24个月的婴儿)
    • Ainsworth Strange Situation (SSP, 11-15 months)
      陌生情景实验(SSP,11-15个月)
    • Toddler CARE-Index (15-36 months)
      学步期关爱指数(TCI,15-36个月)
    • Preschool Assessment of Attachment (PAA, 2 - 5 years)
      学前期依恋评估(PAA,2 - 5岁)
    • School-age Assessment of Attachment (SAA, 6-13 years)
      学龄期依恋评估(SAA,6-13岁)
    • Transition to Adulthood Attachment Interview (TAAI, 16-25 years)
      青少年依恋访谈(TAAI,16-25岁)
    • Adult Attachment Interview (AAI, 25 years and older)
      成人依恋访谈(AAI,25岁及以上)
    • Parents Interview 
      家长访谈(PI)


    Text:
    Crittenden, P. M. (2015). Raising parents: Attachment, representation, and treatment, 2nd edition. London: Routledge.
    《养育父母:依恋、表征及治疗》作者Crittenden,P.M.(2015)第二版伦敦Routledge出版社

    The A & P is part of the DMM-informed Mental Health Practitioner Certificate and prerequisite to all assessment courses, e.g., the Adult Attachment Interview.
    本课程是基于DMM的精神卫生执业者证书要求的一部分,并且是学习其他所有评估课程(如成人依恋访谈)的基础要求。


    Approximate Daily Schedule
    Actual times may vary depending upon delegates' input
    大概的日程安排
    实际的时间可能根据现场情形而变化


    Day 1
    AM
    Overview of the principles and clinical applications of the DMM
    The transition to Adulthood (best time for prevention)
    Dangerous gaps in services & preventive opportunities
    PM
    Infancy & parental protection
    CARE-Index videos
    Child abuse and neglect
    第一天
    上午
    DMM的原理和临床应用概述
    向成年期的过渡(预防的最佳时机)
    服务中的危机和预防机遇
    下午
    婴儿期及家长的保护
    关爱指数视频
    儿童虐待和忽视


    Day 2
    AM
    The Ainsworth patterns of attachment
    Disorders versus diseases
    Mothers' post-natal depression & adult psychoses
    PM
    Preschool development and the dynamic-maturational model
    The coercive and compulsive self-protective strategies
    Preschool videos
    第二天
    上午
    Ainsworth的依恋类型
    (精神)障碍与(生理)疾病
    母亲的产后抑郁症和成人精神病
    下午
    学前期发展与动态成熟模型
    胁迫性和强制性的自我保护策略
    学前期关爱指数视频


    Day 3
    AM
    School-age: Peers, obsessive & deceptive strategies
    The School-age Assessment of Attachment & discourse analysis
    Conduct problems & children's psychotic intrusions
    PM
    Adolescence: Integrating sexuality with attachment
    Sexual disorders and sexual offending
    Transition to Adulthood Attachment Interview
    第三天
    上午
    学龄期:同伴、强迫和欺骗性策略
    学龄期儿童的依恋和语篇分析
    品行问题和儿童的精神病性侵入
    下午
    青春期:性与依恋的整合
    性障碍和性犯罪
    青少年依恋访谈


    Summary & overview
    总结与概述
    New skills to be learned
    要学会的新技能
    • Perceiving discrepant behavior: seeing commonly overlooked clues to trouble
      观察不一致的行为:从常被忽略的线索中见到问题所在
    • Identifying false positive affect: uncovering hidden problems in their early stages
      识别虚假的积极情感:隐藏问题的早期发现
    • Differentiating symptoms & self-protective strategies: specifying how symptoms function
      区分症状和自我保护策略:详细说明症状的作用
    • Using functional formulations: moving beyond diagnoses to understanding behavior
      使用功能性配方:超越诊断,理解行为 
    • Treatment planning: choosing treatment strategies to
      治疗规划:选择治疗策略(以做到):
      *increase efficiency提高效率
      *lower cost降低成本
      *
      reduce risk of iatrogenic harm降低医源性危害的风险

    Take-away Tools
    可带走的工具
    • Level of Family Functioning Scale
      家庭功能量表
    • Gradient of Intervention Scale
      梯度的干预量表
      Downloadable materials可下载的材料 (on www.familyrelationsinstitute.org)
    • Daily text of slides (with registration only)
      日常文本幻灯片(登记后可使用)
    • Color models of strategies
      策略的颜色模型
    • Numerous published papers
      众多发表论文


    Language: This course is offered in English with English materials. A corresponding course is available in Italian with Italian materials and in Chinese with Chinese materials. The course is being developed in Spanish. Courses in successive translation necessarily take longer or cover less material.
    语言:本课程提供英语教学及材料。也有相应的意大利语、中文课程及材料。本课程的西班牙语版本正在开发中。提供连续翻译的课程会耗时更长,或覆盖较少的资料。 

    本篇介绍由DMM翻译组曹萌韵翻译审校



    Overview Course: Attachment and Psychopathology Consultation
    概述课程:依恋和精神病理学咨询研讨会


    This seminar will be open to a small group of clinicians who have attended Attachment and Psychopathology. Each attendee will bring a case that will be presented to the group for formulation and case planning. The case itself will include a focused clinical question for the group to address, 5-20 minutes of selected videotaped sequences (the context to be chosen by the clinician), a written history, and consent for presentation. The product will be a brief strategic formulation and suggestions of next steps to take, either in obtaining needed information or in provision of treatment. Treatment suggestions will be accompanied by ways to access with the treatment is having the desired effect.

    本研讨会对少量学习过病理课程的临床工作者开放。每位与会者提交一个案例,供小组进行案例规划及功能解构。案例本身需包括一个可供小组探讨的重点临床问题,经过选择的5-20分钟的录像组(录像内容由提问者本人选择),以及书面的过往史和知情同意书。出于获取所需信息及为治疗提供必需准备的目的,研讨会的成果将包括简要的策略解析和后续的步骤建议。在治疗达到预期疗效的前提下,会在给出治疗建议的同时提供实操思路。

    本篇介绍由DMM翻译组曹萌韵翻译审校



    The Preschool Assessment of Attachment (PAA)
    学前期依恋评估

    The Preschool Assessment of Attachment (PAA) is an instrument for assessing patterns of attachment in 18-month to five-year-old children*. The procedure involves a dynamic-maturational expansion of the Ainsworth classificatory method (Crittenden, 1992). Like the Ainsworth Strange Situation for infants, the PAA involves a 20-minute laboratory procedure and takes three people to carry out (plus the child and mother). Classification is based on careful review of the videotape and takes approximately one-half hour per videotape.
    学前期依恋评估(PAA)是评估18个月至5岁儿童依恋模式的工具。这套评估体系是基于Ainsworth依恋分类动态成熟模型的扩展。(Crittenden,1992)。 像Ainsworth的婴儿陌生情境实验一样,PAA包括20分钟的实验过程,需要三个人共同完成(加上孩子和母亲)。 分类基于仔细查看录像带,每个录像带需要大约一个半个小时。

    Dynamic-Maturational Classifications in the Preschool Years
    学前期的动态成熟分类系统
    The classificatory system includes all of the categories of the infant procedure (i.e., A1-2, B1-4, C1-2, A/C), plus several patterns that develop during or after the preoperational shift at the end of the second year of life. Specifically, Ainsworth's three basic strategies for negotiating interpersonal relationships are modified to fit preschoolers' more sophisticated mental skills and organizations of behavior. Thus, the patterns are renamed as secure/balanced (Type B), defended (Type A) and coercive (Type C).
    这一分类系统包括了所有的婴儿依恋类型(例如,A1-2,B1-4,C1-2,A / C),在婴儿出生第二年的末期开始增加几种类型,形成在前运算期间或者之后的转变。确切的说,修改了Ainsworth协调人际关系的三个基本策略,以适应学龄前儿童更复杂的心理技能和行为。因此,这些模式被重命名为安全/平衡型(B型),防御型(A型)和胁迫型(C型)。

    With the addition of several new subpatterns, the PAA sets the stage for the even more complex patterns of behavior that are observed at later ages, especially in the school years. Furthermore, a particular advantage of the expanded classificatory system used in the PAA as compared to other classificatory systems is that it differentiates "unendangered" A1-2 and C1-2 children from those using the compulsive (A+) and obsessive (C+) subpatterns. These patterns, i.e, the compulsive caregiving A3, compulsive compliant A4, aggressive C3 and feigned helpless C4 subpatterns, identify the children most likely to come from troubled homes and most likely to experience psychological, social, developmental, and learning problems. These coercive and defended subpatterns as well as the compulsive/obsessive A/C pattern have implications for emotional and behavioral problems that develop during the preschool and school years.
    随着几个新的子模式的添加,PAA为更复杂的行为模式奠定了基础,这些行为模式出现在之后的年龄段,特别是在学龄期。此外,与其他分类系统相比,PAA中使用的扩展分类系统有一个特别的优势,它将“没有危险的”的A1-2和C1-2儿童与使用强迫型(A +)和胁迫型(C +)子模式的儿童区分开来。通过这一分类系统(如:强迫性照护A3,强迫性顺从A4,攻击C3和假装无助C4等子模式),可识别出最有可能来自问题家庭的孩子,也最有可能经历心理、社会、发展和学习问题的孩子。这些强制型和防御型子模式以及强迫/胁迫A / C模式对于在学龄前和学龄期间发展的情感和行为问题都有影响。

    Training courses
    培训课程

    The two-week course is taught from videotapes and depends upon both maternal and child behavior. Non-verbal behavior, interpersonal strategies, and developmental processes are emphasized. The course includes a preliminary reliability test based on a standardized set of American mother-child dyads. During the course, participants generate a set of videotapes that reflect their intended applications and culture(s). These tapes are used to assess the participant's competence in administering the procedure.
    这两周的课程是通过录像带授课的,并且取决于母亲和孩子的行为。课程强调非言语行为,人际关系策略和发展过程。课程包含一个初步的信度测试,该测试基于一组标准化的美国的母子对。在课程中,学员需要用一组录像带来反映其应用范围和文化背景。这些录像带用于评估学员在执行拍摄程序方面的能力。

    As with all courses offered by Dr. Crittenden, participants are given a written and signed statement of their percent agreement with the standard. This reliability can be reported in research articles. Evidence of reliability should be requested if the participant will code data for another researcher.
    与Crittenden博士提供的所有其他课程一样,课程学员将获得一份标准化的书面协议证明。该证明的可靠性可以报告在研究文献中。如果课程学员的录像由另外的研究人员进行数据编码,需要提供相应的信度证明。

    To inquire about the course in general, interested parties can contact Dr. Crittenden directly. To register for courses, individuals should check the training section listed on this web page and contact the relevant organizer. Dr. Crittenden does not handle registration or fee payment. Requests to run a new course can be directed to Dr. Crittenden.
    如需要询问课程,有兴趣的团体可以直接与Crittenden博士联系。需要报名课程,个人请查询网页上给出的培训信息,并联系相关组织者。Crittenden博士不负责报名或费用支付事宜。如需开办一个新课程可以直接联系Crittenden博士。

    * The period from 15-21 months must be interpolated between the Ainsworth infancy and the preschool systems.
    *在Ainsworth的婴儿期与学前期之间必须添加15-21个月这个时期。


    Studies using the Preschool Assessment of Attachment (PAA)
    学员对PAA的使用
    * Barnett, D., Butler, C. M., & Vondra J. I. (1999). Atypical patterns of early attachment: Discussion and future directions. Monographs of the Society for Research in Child Development, 64 (3), 119-144.
    * Chisholm, K. (1998). A three year follow-up of attachment and indiscriminate friendliness in children adopted from Romanian orphanages. Child Development, 69, (4), 1090-1104.
    * Chisholm, K. (2000). Attachment in children adopted from Romanian orphanages: Two case studies. In P. M. Crittenden & A. H. Claussen (Eds.), The organization of attachment relationships: Maturation, culture, and context. New York: Cambridge University Press.
    * Claussen, A. H., & Anderson, W. (April, 1997). Attachment in children prenatally exposed to cocaine: Disorganization and the emergence of new subpatterns of attachment. Paper presented in P. M. Crittenden (Chair), Continuity and change in quality of attachment: A dynamic-maturational model and expanded classificatory system. Symposium conducted at the Biennial meeting of the Society for Research on Child Development, Washington, D.C.
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