Attachment-Based Therapy

What Is Attachment-Based Therapy?

Attachment-based therapy is a brief, process-oriented form of psychological counseling. The client-therapist relationship is based on developing or rebuilding trust and centers on expressing emotions. An attachment-based approach to therapy looks at the connection between an infant’s early attachment experiences with primary caregivers, usually with parents, and the infant’s ability to develop normally and ultimately form healthy emotional and physical relationships as an adult. Attachment-based therapy aims to build or rebuild a trusting, supportive relationship that will help prevent or treat anxiety or depression.

When It's Used

An attachment-based approach can be used in individual, family, couple, and group therapy, with both children and adults, to helps clients mend or recover from fractured family relationships. Those who may benefit from attachment-based therapy include adoptees, children in foster care, children of depressed mothers, and victims of trauma, such as children of divorce or children who have been sexually abused or otherwise mistreated, particularly at the hands of a caregiver. Attachment-based family therapy (ABFT) has been shown to be helpful in treating adolescents who are depressed and/or thinking about suicide.

What to Expect

Since the goal of ABFT extends to repairing the family relationship, the therapist will work with the individual adolescent client alone, and also with the family as a group. The therapist works with the family to build and strengthen the parent-child bond and help the child to develop into an independent, self-sufficient adult. With individual adults, the therapist aims to help the client overcome the effects of negative early attachment issues by establishing a secure bond between the client and the therapist. Once this relationship is solidified, the therapist can help the client communicate more openly and better explore and understand how their current feelings and behaviors are associated with earlier experiences. Attachment-based therapy as described here should not to be confused with unconventional, unproven, and potentially harmful treatments referred to as "attachment therapy" that involve physical manipulation, restraint, deprivation, boot camp–like activities, or physical discomfort of any kind.

How It Works

Attachment-based therapy developed from the 1960s work of British psychologist John Bowlby, who first proposed that strong early attachment to at least one primary caregiver is necessary for children to have a sense of security and the supportive foundation they need to freely interact with their environment, to explore, to learn from new experiences, and to connect with others.

Without a healthy foundation, babies may grow to be fearful, confused, and insecure, ultimately becoming depressed or even suicidal as adolescents. Theoretically, by forming a trusting relationship with parental figures or with the therapist, the client is better prepared to form strong bonds in other relationships. Attachment-based therapy may be used in conjunction with other forms of therapy.

What to Look For in an Attachment-Based Therapist

A qualified attachment-based therapist is a psychologist, psychotherapist, clinical social worker, marriage and family therapist, or other licensed clinician with an attachment-based treatment approach and experience in the field. Once you have established that a therapist has the credentials and experience you are looking for, it is important to make sure you are comfortable working with that person.

Sources

Ewing ES, Diamond G, Levy S. Attachment-based family therapy for depressed and suicidal adolescents; theory, clinical model and empirical support. Attachment & Human Development. 2015; 17(2): 136-156.

Dozier M. Attachment-based treatment for vulnerable children. Attachment & Human Development. 2003; 5(3): 253-257.

Cicchetti D, Toth SL and Rogosch FA. The efficacy of toddler-parent psychotherapy to increase attachment security in offspring of depressed mothers. Attachment & Human Development. 1999; 1(1): 34-66. Published online 2 June 2006.