Enhancing Attachment Organization Among Maltreated Children: Results of a Randomized Clinical Trial

Department of Psychology, University of Delaware, Newark, DE 19716, USA.
Child Development (Impact Factor: 4.92). 01/2012; 83(2):623-36. DOI: 10.1111/j.1467-8624.2011.01712.x
Source: PubMed


Young children who have experienced early adversity are at risk for developing disorganized attachments. The efficacy of Attachment and Biobehavioral Catch-up (ABC), an intervention targeting nurturing care among parents identified as being at risk for neglecting their young children, was evaluated through a randomized clinical trial. Attachment quality was assessed in the Strange Situation for 120 children between 11.7 and 31.9 months of age (M = 19.1, SD = 5.5). Children in the ABC intervention showed significantly lower rates of disorganized attachment (32%) and higher rates of secure attachment (52%) relative to the control intervention (57% and 33%, respectively). These results support the efficacy of the ABC intervention in enhancing attachment quality among parents at high risk for maltreatment.

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Available from: Erin Lewis-Morrarty, Jan 29, 2015
    • "33%) exhibited secure attachment and 32% (vs. 57%) exhibited disorganized attachment approximately 1 month after the intervention (Bernard et al., 2012). ABC has also shown success in normalizing foster child stress responses (i.e., cortisol reactivity) relative to the control children, which indicates the plasticity of their neurobiological systems and the capacity for recovery. "

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    • "Recently, the search for relevant clinical tools has turned to the " toolbox " ' of attachment research methods with fertile results for clinicians delivering infant-parent (Dozier et al., 2006, 2011; Bernard et al., 2012; Juffer, Bakermans-Kranenburg, & Van Ijzendoorn, 2008, 2006; Powell et al., 2013; Slade et al., 2005; Lieberman et al., 2005a, 2005b, 2006a, 2006b), child and family (Asen & Fonagy, 2012; Hopkins, 2000), adolescent (Bevington et al., 2013; Roussouw & Fonagy, 2012), and adult psychotherapy (Fonagy & Bateman, 2006; Bateman & Fonagy, 2009; Diamond et al., 2008). For example, out of the Strange Situation Procedure literature arose the Circle of Security Intervention (Powell et al., 2013), and out of the Adult Attachment Interview arose the measurement and validation of reflective functioning (Fonagy et al., 1991; Fonagy et al., 1998), with the follow on development of mentalization-based treatments for all range of clinical problems (Fonagy et al., 2002). "
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    ABSTRACT: This article aims to illustrate the central underpinning role that observation has had in the development of attachment theory and research, and in clinical work informed by attachment theory. Also, the paper aims to highlight reflective functioning in clinical practice and how it can be shown to ignite positive change processes, with illustrations provided from our ongoing trauma-informed clinical work with our Group Attachment Based Intervention or GABI in our work with vulnerable parents and their infants and toddlers. In pointing to how reflective functioning informs clinical practice in GABI, the paper aims to highlight what is proposed as fundamental to therapeutic action with infants, toddlers, children, adolescents, adults/parents and that is a strikingly new relationship with a benign, supportive other, who helps one practice novel ways of thinking, feeling and acting that may later become habitual across contexts.
    Full-text · Article · Jul 2015 · Journal of Infant Child and Adolescent Psychotherapy
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    • "Interactions between the caregiver and the child are videotaped; the caregiver and assigned parent coach review the footage and discuss strengths and barriers, which allows the caregiver to learn how to interact in a sensitive manner with their foster child to increase their attachment security (Dozier, Dozier and Manni, 2002). Evaluation of this intervention found that foster and at-risk parents can be taught and coached on how to be sensitive parents and that this can, in turn, affect their children's regulatory and attachment systems in a positive way (Bernard, et al., 2012; Dozier, et al., 2006). "
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    ABSTRACT: It is well established that looked after children are more likely to develop complex behavioural and emotional difficulties that can leave many carers struggling to help and understand the child. This can lead to the breakdown of placements whereby the lack of placement stability leaves the child even more vulnerable. The Family Minds (FM) psycho-educational and interactive programme is a newly developed intervention for groups of foster and adoptive parents. It lasts for nine hours and comprises elements of mentalisation-based family therapy, lectures, group exercises and homework, with the aim that parents will be able to better understand and support their fostered or adopted child through increased reflective functioning. In a study undertaken in Texas we evaluated whether there was a change in the parents’ reflective functioning (verbal mentalisation) pre- to post-FM training compared to a comparison group who experienced a ‘treatment as usual’ intervention comprising four hours of lecture information about trauma and attachment. Using five-minute speech samples pre- and post-training, we coded whether the capacity to think reflectively about oneself and one’s child altered in either training group. We found that, unlike the comparison group, parents in the FM group significantly increased their reflective functioning. This outcome was independent of several factors such as the age of the parent, age of the child and time as a carer. The only factor influencing the significant change was the training group in which the parent was placed. These findings suggest that this novel mentalisation-based psycho-educational training programme can successfully increase parents’ reflective functioning which, in turn, should enhance and strengthen the understanding and relationship between the foster/adoptive parent and the child and reduce negative outcomes.
    Full-text · Article · Mar 2015
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