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Description, History, and Critique of Corrective Attachment Therapy
... Martha Welch vytvorila v 80. rokoch svoju holding terapiu (tzv. "holding time") ako intervenciu zameranú na nápravu porúch attachmentu (Speltz, 2002). Jadro metódy je podľa nej pomerne jednoduché -matka ma svoje dieťa držať v objatí a to aj napriek jeho protestom, prosbám a plaču až do doby, kým sa dieťa neupokojí. ...
... Nie je jasné, do akej miery Welch vychádza zo starších Zaslowových experimentov, ktoré tiež zahŕňali držanie dieťaťa proti jeho vôli. U Zaslowa bol však následný odpor a hnev dieťaťa žiaduci -práve v jeho zlomení spočíval údajný terapeutický efekt metódy, po absolvovaní ktorej malo byť dieťa vnímavejšie a ochotnejšie k spolupráci (Speltz, 2002). ...
... Navyše sú pri držaní činy rodičov v protiklade k ich verbálnym vyjadreniam (uisťovanie o láske napriek ignorovaniu jasného nepohodlia dieťaťa) a nie je jasné, ako dokážu malé deti spracovať ambivalenciu vo verbálnom vyjadrovaní zmesi negatívnych a láskavých emócií. Pokles negatívnych prejavov a zdanlivé upokojenie sa dieťaťa sprevádzajúce koniec niekoľkohodinovej "terapie" boli v úplne rovnakej podobe pozorované u Zaslowa a iných attachment terapeutov, ktorých deklarovaným cieľom však nebolo "rozprúdenie lásky", ale vyvolanie potlačenej agresivity a zlomenie odporu, čo spochybňuje Prekopovej interpretáciu tohto stavu ako autentického uzmierenia a obnovy lásky (Speltz, 2002). Sugestívne techniky, podpora viery v pôrodné a sexuálne traumy ako príčiny psychických problémov, ich pochybná diagnostika a rovnako pochybné regresné terapeutické techniky uplatňované pri liečení týchto údajných tráum môžu napáchať závažné škody na psychickom zdraví nielen u detí, ale aj u dospelých, ktorí sú inak TPO ohrození v relatívne menšej miere (Dawes, 1994). ...
Predkladaná práca je založená predovšetkým na štúdiu Prekopovej publikácie Pevné objetí: Cesta k vnitřní svobodě, ktorú dr. Prekopová i doc. Šturma na viacerých miestach odporúčajú ako informačný zdroj. Na konkrétnych citáciách je ukázaná ideologická povaha Prekopovej prístupu, časté protirečenia si a hlavne absencia akejkoľvek významnej odlišnosti od v USA odsudzovaných " attachment terapií ". Tento záver je ďalej podporený analýzou prístupov, ktoré Prekopová uvádza ako inšpiračné zdroje svojej terapie a ukázaním jasných paralel s " attachment terapiami " v teórii aj praxi.
... Holding therapy, for example, is a manipulative, body-based therapy that stems from the erroneous notion that autism is caused by a parent's failure to bond with his or her child [12]. In a holding therapy session, caregivers physically restrain children and force eye contact, hoping to repair the emotional detachment [13]. Because of the intense physical pressure applied by caregivers, this practice is risky and has even led to fatalities [14]. ...
... Because of the intense physical pressure applied by caregivers, this practice is risky and has even led to fatalities [14]. This treatment is dangerous, there is no evidence to support its efficacy, and it is founded upon a hypothesis inconsistent with medical models [13]. ...
... Coercive attachment therapy models may be termed Holding Therapy, Rebirthing Therapy, or simply Attachment Therapy; they have been controversial models of treatment, in some cases have led to the harm or death of children, and have been warned against in the ethical guidelines of many major mental health professional associations (American Psychiatric Association, 2002;ATTACh, 2007;Weir, 2006). Speltz (2002), Mercer (2002), and Mercer (2005) provide an excellent history and critique of coercive attachment theories. ...
This article regarding the effectiveness of Theraplay for the clinical treatment of adoptive families both outlines a model for integrating family systems theory with Theraplay to create a new approach entitled Whole Family Theraplay (WFT), as well as provides a preliminary report of a pilot study demonstrating the efficacy of that model. WFT integrates Theraplay with family systems approaches (Structural and Experiential Family Therapies) to treat parents and all the siblings within adoptive families. The findings indicate that WFT treatment may lead to statistically significant benefits in regard to family communication, adults’ interpersonal relationships, and children's overall behavioral functioning.
... As argued by Minnis et al. (2006, p. 340), problematic ''attachment is one of a range of downstream factors along a set of developmental trajectories stemming from a primary disorder of concordant intersubjectivity''. Following this line of thought, traumatising events within the intersubjective field that is created by the attachment dynamic do not call for some newly minted ''Attachment Therapy'', a reification of theory that can mask a potentially hazardous approach (Chaffin et al., 2006;O'Connor & Zeanah, 2003;Prior & Glaser, 2006;Speltz, 2002). Such traumatised and unhappy children have been worked with for many years in therapeutic communities without any mention of attachment at all (e.g. ...
This paper suggests that the behaviours associated with the formal diagnosis of the "disinhibited" form of reactive attachment disorder (RAD) might be seen as a functional adaptation rather than a mental health problem, a facultative response enhancing the probability of survival that is triggered by certain conditions. Although disinhibited RAD is most commonly observed in institutionalised children, similar behaviours may also be a part of the emotional difficulties displayed by some fostered and adopted children (the latter includes those once institutionalised), and these may demonstrate not so much a discrete attachment disorder as either the need to fend for oneself following loss of dedicated caregiving or a lack of opportunity to build specific intimate relationships with dedicated caregivers. In many cases this may be inextricably mixed with the neurobiological and psychological seqelae of maltreatment. Indiscriminate attachment behaviour, from this proposed evolutionary perspective, is less a syndrome of mental ill-health than an astute survival manoeuvre following being orphaned, abandoned or fecklessly reared. Such a response, allied to the innate facility to access caregiving from different adults, could be expected to be initiated by specific events as are the other attachment configurations. Classing disinhibited RAD as an adaptation has implications for helping children brought up under extreme duress when their caregiving environment has changed for the better.
... Solid research on holding therapy remains thin, but anecdotal reports, self-help parenting guides, and unsubstantiated treatment accolades proliferate in the popular media. This method has also generated much controversy (James, 1994;O'Connor & Zeanah, 2003;Speltz, 2002) for its coercive methods and dangerous techniques, which have directly or indirectly caused the deaths of at least three children. Despite this criticism and perhaps in part because of the paucity of definitive typologies and tested treatments of RAD, a number of recent journal articles on attachment disorders (Hall & Geher, 2003;Sheperis et al., 2003;Wilson, 2001) have begun to cite the holding therapy literature without critical analysis. ...
Reactive attachment disorder is a relatively new diagnosis that is not well studied. Conflicting ideas about its etiology and presentation pervade the theoretical, research, clinical, and popular literature. Clarifying core characteristics of this disorder and distinguishing them from comorbid conditions are critical for improved diagnosis and treatment of children with attachment problems.
... In addition to the lack of empirical support for attachment therapies such as holding and rebirthing therapies for RAD, numerous mental health professionals and professional societies warn against the use of these therapies (e.g., Barth, Crea, John, Thoburn, & Quinton, 2005; Boris & Zeanah, 2005; Chaffin et al., 2006; Haugaard & Hazan, 2004; Mercer, 2001; Speltz, 2002). Use of holding-type therapies is cautioned for several reasons. ...
Reactive Attachment Disorder (RAD) is a childhood disorder characterized by extremely inappropriate social relating across a variety of interactions that must be present by age 5. Although children diagnosed with RAD appear to demonstrate significantly more behavioral problems and psychosocial difficulties than children without RAD, there have been few examinations of empirically informed treatments for this disorder. One avenue that may be particularly promising is the use of treatments that have been successfully used to decrease similar problematic behaviors in children. The present case study outlines the use of behavior management training (BMT) in the treatment of a 7-year-old female child with RAD. Given the marked reduction in problematic behaviors exhibited by this child as a result of a typical course of BMT, it is recommended that randomized clinical trials be conducted to test the efficacy of BMT for RAD.
The concept of chronic sorrow offers a fresh perspective for understanding the negative emotional impact of parental rejection on children. Additionally, it provides a clinical alternative to coercion for breaking through children's emotional defenses against further rejection in caregiving relationships.
This chapter deals with integrating play therapy for attachment disorders of children. It focuses on the concept of Marble Playing. The main benefit of this playing therapy is that several positive qualities are developed such as confidence, daring, and the most important, permanence of relationships between family members. While playing, parents start thinking as per the level of their children. This helps them to understand the correct psychology of their children. Children, on the other hand, get to know that playing together helps to generate a strong bond between them and their parents as also raises the percentage of emotional attachment for their parents. This is truly a good Therapy. It opens a new dimension in the parent–child relationship.
In this article, the author describes a discrepancy between popular media accounts of reactive attachment disorder (RAD) and its clinical and scientific description. The literature on serious disturbances of attachment in children adopted out of institutions is reviewed. The author concludes that children adopted from institutions are at dramatically increased risk for disturbances, although the majority of such children do not demonstrate problems. Both the duration of deprivation and the postinstitutional caregiving environment seem to be importantly related to outcome. Inhibited/withdrawn RAD is exceedingly uncommon in children adopted from institutions (at least after 1 or more years), but disinhibited/indiscriminate RAD is quite persistent. Long after children become attached to adoptive parents, a number of them continue to exhibit indiscriminate sociability. Three explanations for this divergence of recovery curves are considered. It is likely that future systematic studies will illuminate many areas that are unclear at this time.