Abstract
This paper describes an attachment-based intervention for mothers known to Child Welfare Services where past and current trauma complicates family preservation and promotion of child well being. The first part of the paper describes the innovative Attachment-Centered Parent–Child Therapy service that has been delivered to high-risk families with children from 0 to 3 years of age. The intervention uses a group format that has the added benefits of enhancing social support and being highly cost effective. The intervention also integrates video filming both in terms of capturing essential features of the group intervention for review and supervision of clinical staff, and is fundamental in the observation-based empirical assessments. Quantitative data from an initial pilot study supporting the efficacy of the intervention is presented. As well, qualitative data is presented including a case study that highlights therapeutic action shown to positively impact the quality of the mother–child relationship.
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References
Ainsworth, M. D., Blehar, M. C., Waters, E., & Wall, S. (1978). Patterns of attachment: Assessed in the strange situation and at home. Hillsdale, NJ: Lawrence Erlbaum.
Baradon, T., & Steele, M. (2008). Integrating the AAI in the clinical process of psychoanalytic parent-infant psychotherapy in a case of relational trauma. In H. Steele & M. Steele (Eds.), Clinical applications of the Adult Attachment Interview (pp. 195–212). NY: Guilford Press.
Berlin, L. J., Ziv, Y., Amaya-Jackson, L., & Greenberg, M. T. (2005). Enhancing early attachments: Theory, research, intervention, and policy. New York: Guilford.
Bowlby, J. (1988). A secure base: Clinical applications of attachment theory. London: Routledge; New York: Basic Books.
Briggs, R., Racine, A. D., & Chinitz, S. (2007). Preventive pediatric mental health care: A collocation model. Infant Mental Health Journal, 28(5), 481–495.
Caspi, A., Moffitt, T. E., Newman, D. L., & Silva, P. A. (1996). Behavioral observations at age 3 predict adult psychiatric disorders: Longitudinal evidence from a birth cohort. Archives of General Psychiatry, 53, 1033–1039.
Cicchetti, D., Rogosch, F. A., & Toth, S. L. (2000). The efficacy of toddler–parent psychotherapy for fostering cognitive development in offspring of depressed mothers. Journal of Abnormal Child Psychology, 28, 135–148.
Cicchetti, D., Rogosch, F. A., & Toth, S. L. (2006). Fostering secure attachment in infants in maltreating families through preventive interventions. Development and Psychopathology, 18, 623–650.
Dube, S. R., Felitti, V. J., Dong, M., Giles, W. H., & Anda, R. F. (2003). The impact of adverse childhood experiences on health problems: Evidence from four birth cohorts dating back to 1900. Preventive Medicine, 37(3), 268–277.
Felitti, V. J., Anda, R. F., Nordenberg, D., Williamson, D. F., Spitz, A. M., Edwards, V., et al. (1998). Relationship of childhood abuse and household dysfunction to many leading causes of death in adults: The adverse childhood experiences (ACE) study. American Journal of Preventive Medicine, 14, 245–258.
Fonagy, P., Target, M., Steele, H., & Steele, M. (1998). Reflective-functioning manual, version 5.2, for application to Adult Attachment Interviews. Unpublished document, University College London and New School for Social Research.
George, C., Kaplan, N., & Main, M. (1996). Adult Attachment Interview (3rd ed.). Unpublished manuscript, University of California at Berkeley.
Heinicke, C. M., & Levine, M. S. (2008). The AAI anticipates the outcome of a relation-based early intervention. In H. Steele & M. Steele (Eds.), Clinical applications of the Adult Attachment Interview (pp. 99–125). New York: Guilford Press.
Juffer, F., Bakermans-Kranenburg, M. J., & van IJzendoorn, M. H. (2007). Promoting positive parenting: An attachment-based intervention. New York/London: Lawrence Erlbaum Associates.
Lieberman, A., & Van Horn, P. (2008). Psychotherapy with infants and young children: Repairing the effects of stress and trauma on early attachment. New York: Guildford.
Lieberman, A. F., Van Horn, P., & Ghosh Ippen, C. (2005). Toward evidence-based treatment: Child-parent psychotherapy with preschoolers exposed to marital violence. Journal of the American Academy of Child and Adolescent Psychiatry, 44, 241–248.
Lieberman, A., Weston, D., & Pawl, J. (1991). Preventive intervention and outcome in anxiously attached dyads. Child Development, 62, 199–209.
Lyons-Ruth, K., & Jacobvitz, D. (2008). Attachment disorganization: Genetic factors, parenting contexts, and developmental transformation from infancy to adulthood. In J. Cassidy & P. R. Shaver (Eds.), Handbook of attachment: Theory, research and clinical applications (pp. 666–697). NY: Guilford Press.
Main, M., Hesse, E., & Goldwyn, R. (2008). Studying differences in language use in recounting attachment history. In H. Steele & M. Steele (Eds.), Clinical applications of the Adult Attachment Interview (pp. 31–68). New York: Guilford Press.
Main, M., Kaplan, N. & Cassidy, J. (1985). Security in infancy, childhood and adulthood: A move to the level of representation. In Waters, E., & Bretherton, I. (Eds.), Growing points in attachment: Theory and research. Monographs of the Society for Research in Child Development, 50 (1–2, serial no. 209, pp. 66–104).
Marvin, R., Cooper, G., Hoffman, K., & Powell, B. (2002). The circle of security project: Attachment-based intervention with caregiver-preschool dyads. Attachment and Human Development, 4, 1–17.
Moran, G., Neufeld Bailey, H., Gleason, K., Deoliveira, C. A., & Pederson, D. R. (2008). Exploring the mind behind unresolved attachment: Lessons from and for attachment-based interventions with infants and their traumatized mothers. In H. Steele & M. Steele (Eds.), Clinical applications of the Adult Attachment Interview (pp. 371–398). New York: Guilford Press.
Oppenheim, D., & Goldsmith, D. F. (2007). Attachment theory in clinical work with children. New York: Guilford Press.
Steele, H., & Steele, M. (2008). On the origins of reflective functioning. In F. Busch (Ed.), Mentalization: Theoretical considerations, research findings, and clinical implications (pp. 133–156). NY: The Analytic Press.
Steele, H., Steele, M., & Murphy, A. (2009). The Adult Attachment Interview: A clinical tool for facilitating and measuring process and change in psychotherapy. Psychotherapy Research, 19, 1468–4381.
Stern, D. N., Sander, L. W., Nahum, J. P., Harrison, A. M., Lyons-Ruth, K., Morgan, A. C., et al. (1998). Non-interpretive mechanisms in psychoanalytic therapy: The ‘something more’ than interpretation. International Journal of Psycho-Analysis, 79, 903–921.
Toth, S. L., Rogosch, F. A., Manly, J. T., & Cicchetti, D. (2006). The efficacy of toddler–parent psychotherapy to reorganize attachment in the young offspring of mothers with major depressive disorder: A randomized clinical trial. Journal of Consulting and Clinical Psychology, 74, 1006–1016.
Acknowledgments
We are grateful to the families participating in the ongoing work. Much appreciation is to be extended for funding from Einstein-Montefiore Institute for Clinical and Translational Research, the Children’s Evaluation and Rehabilitation Center, and the Robin Hood Foundation. At the Center for Attachment Research, the group of graduate students who have been exceptionally helpful with data collection and coding include Allison Splaun, Francisca Herreros, Ellie Neuman, Julia Broder, Kathleen Hartwig, Erica Rosenthal, Kim Nguyen, Kristen Stephenson, Kristen Capps, James Grimaldi, & Alex Kriss.
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Steele, M., Murphy, A. & Steele, H. Identifying Therapeutic Action in an Attachment-Centered Intervention with High Risk Families. Clin Soc Work J 38, 61–72 (2010). https://doi.org/10.1007/s10615-009-0257-6
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DOI: https://doi.org/10.1007/s10615-009-0257-6