One of my favourite topics in psychology actually comes from developmental psychology because I love learning about attachment and attachment styles. Since our attachment styles are critical to our mental health, the relationships we form and attachment impacts so many aspects of our lives. Therefore, some people need therapy to help readjust their attachment styles and help them so they can have healthier relationships and improve their lives. That’s why in this clinical psychology podcast episode, we’re going to be looking at what is attachment-based therapy, how does it work, when is it used and more. If you enjoy learning about developmental psychology, mental health and attachment then this will be a brilliant episode for you.
Today’s psychology podcast episode has been sponsored by Developmental Psychology: A Guide To Developmental And Child Psychology. Available from all major eBook retailers and you can order the paperback and hardback copies from Amazon, your local bookstore and local library, if you request it. Also available as an AI-narrated audiobook from selected audiobook platforms and library systems. For example, Kobo, Spotify, Barnes and Noble, Google Play, Overdrive, Baker and Taylor and Bibliotheca.
What Is The Difference Between Attachment-Based Therapy and So-called Attachment Therapies?
Before we dive into the main topic for today’s episode, I want to confirm a very dangerous, disgusting and outrageous misconception that I would rather not have to deal with. In this episode, we are NOT talking about the disgraceful, unproven and possibly harmful “attachment therapy” that was developed in the 1970s for children with behavioural challenges. Especially autism. These so-called therapies involved physical deprivation, restraint, boot camp-like activities, discomfort and physical manipulation. These so-called therapies are a disgrace and thankfully they have been investigated and firmly rejected by mainstream psychology as well as medicine.
We are not talking about those therapies in this podcast episode.
What Is Attachment-Based Therapy?
Instead, we’re talking about attachment-based therapy that is a type of brief, process-oriented counselling where the therapeutic alliance is based on rebuilding and developing trust and centres on the client expressing emotion. Also, the attachment-based approach to therapy examines the connection between a client’s early attachment experiences with their caregivers and their ability to develop normal and healthy emotional and physical relationships as an adult.
The ultimate goal of the therapy is to build or rebuild a trusting and supportive relationship that will help the client to prevent and/ or treat mental health conditions, like depression and anxiety.
In addition, attachment-based therapy was developed, as you would expect, from Bowlby’s attachment work in the 1960s. Since Bowlby proposed that strong early attachment to at least one caregiver was needed for a child to have a sense of security and a supportive foundation to explore the environment (also known as the secure base). Then Bowlby described there being four types of attachment which we know as secure attachment, avoidance attachment, anxious attachment and disorganised attachment.
How Does Attachment-Based Therapy Work?
I think every single reader and listener here must be familiar with Bowlby’s attachment work therefore out of respect for all you wonderful people, I will not be explaining Bowlby’s work again in any real depth. I know none of you are stupid.
As a result, because babies without a healthy attachment foundation grow up to be fearful, insecure, confused and ultimately become depressed and even suicidal in adolescence. It’s important that babies form trusting relationships with caregivers or with a therapist so the client is better prepared to form strong bonds in other relationships.
Personally, I would like to add that depression and becoming suicidal in adolescents is a little more complex than attachment style, at least in my personal experience. Yet I certainly think having an insecure attachment style doesn’t help matters and it would have been lovely to have a secure attachment style growing up.
Anyway, in Attachment-Based Therapy, clients explore their childhood so they might need to discuss their early relationship with their caregiver and their family dynamics growing up as well as any significant childhood experiences. Afterwards, the client and therapist might explore the connection between their childhood relationships and their adult ones to see how the past could have influenced the present. Also, this could lead to the client and therapist talking about what skills the client might want to improve in their current relationships and improve their emotions and behaviours.
Interestingly, attachment-based therapy can involve working with a family member too as well as this type of therapy can be used alongside other forms of therapy too.
Personally, I love the idea of doing attachment work with a client and family member, because that is the root cause of the attachment style. It was the caregiver that caused the attachment difficult so getting the client and the family member to work together now to improve the client’s attachment is actually a brilliant idea that would have a lot of good benefits.
Also, I understand how attachment work can fit very nicely alongside other mental health approaches like systemic and humanistic.
When Is Attachment-Based Therapy Used?
Since this sort of doubles as an approach instead of a pure therapy in its own right, an attachment-based approach to mental health can be very useful in couple, group, family and individual therapy. Due to this approach helps both children and adults to mend and recover from fractured family relationships.
That’s why adopted children, Care Experienced children, adolescents who are depressed and/ or suicidal, children of depressed parents and children who have experienced abuse and trauma even more so at the hands of a caregiver, can all benefit from attachment-based therapy.
Overall, I should note that whilst some studies have shown Attachment-based therapy to be effective and it does have benefits for clients, the evidence base isn’t as strong as other forms of therapy.
What Can Clients Expect In Attachment-Based Therapy?
When a client goes for Attachment-Based Therapy, they know that the goal of this therapy isn’t only to repair their family relationship, because the therapist can work with the client alone or with the family as a group. Also, the therapist works with the family to build and strengthen their caregiver-child bond as well as the therapist helps the child to develop into an independent adult with high self-sufficiency.
In addition, when it comes to therapeutic work with individuals, the therapist aims to help the client overcome any effects of the negative early attachment difficulties that they have by establishing a secure bond with the client. Then after this relationship is solidified, the therapist can help the client to communicate more openly and help them to better explore and understand how their current feelings and behaviours are associated with their early childhood experiences.
Clinical Psychology Conclusion
In my experience and because of my own attachment difficulties in the past (to a much lesser extent the present), I always enjoy looking at attachment because I know it is absolutely critical. And whilst we always think of it as traditionally a development psychology topic, it does have a massive impact on mental health and clinical psychology too.
Therefore, I think what I want to unofficially say at the end of this podcast episode, is that whether you’re a current or future clinical psychologist or another type of therapist, definitely have an understanding of attachment-based work. Learn some of the tips, tricks and techniques that will help a client to overcome their attachment difficulties, because you will probably need it in the future and your clients could very well find it to be invaluable.
Even though I never went for attachment-based therapy, my therapist still used a few ideas and notions from this type of work, and it has been really, really useful. So I know in the future as I continue on my clinical psychology journey, I’ll want to learn some more about attachment-based work and I hope you will too.
I really hope you enjoyed today’s clinical psychology podcast episode.
If you want to learn more, please check out:
Developmental Psychology: A Guide To Developmental And Child Psychology. Available from all major eBook retailers and you can order the paperback and hardback copies from Amazon, your local bookstore and local library, if you request it. Also available as an AI-narrated audiobook from selected audiobook platforms and library systems. For example, Kobo, Spotify, Barnes and Noble, Google Play, Overdrive, Baker and Taylor and Bibliotheca.
Have a great day.
Clinical Psychology References and Recommended Reading
American Association for Marriage and Family Therapy. Adult Attachment Relationships.
Cicchetti, D., Toth, S. L., & Rogosch, F. A. (1999). The efficacy of toddler-parent psychotherapy to increase attachment security in offspring of depressed mothers. Attachment & Human Development, 1(1), 34-66.
Collado‐Navarro, C., Navarro‐Gil, M., Pérez‐Aranda, A., López‐del‐Hoyo, Y., Garcia‐Campayo, J., & Montero‐Marin, J. (2021). Effectiveness of mindfulness‐based stress reduction and attachment‐based compassion therapy for the treatment of depressive, anxious, and adjustment disorders in mental health settings: A randomized controlled trial. Depression and Anxiety, 38(11), 1138-1151.
Collado‐Navarro, C., Navarro‐Gil, M., Pérez‐Aranda, A., López‐del‐Hoyo, Y., Garcia‐Campayo, J., & Montero‐Marin, J. (2021). Effectiveness of mindfulness‐based stress reduction and attachment‐based compassion therapy for the treatment of depressive, anxious, and adjustment disorders in mental health settings: A randomized controlled trial. Depression and Anxiety, 38(11), 1138-1151.
Daniel, S. I. (2006). Adult attachment patterns and individual psychotherapy: A review. Clinical psychology review, 26(8), 968-984.
Diamond, G., Diamond, G. M., & Levy, S. (2021). Attachment-based family therapy: Theory, clinical model, outcomes, and process research. Journal of affective disorders, 294, 286-295.
Dozier, M. (2003). Attachment-based treatment for vulnerable children. Attachment & Human Development, 5(3), 253-257.
Ewing, E. S. K., Diamond, G., & Levy, S. (2015). Attachment-based family therapy for depressed and suicidal adolescents: Theory, clinical model and empirical support. Attachment & human development, 17(2), 136-156.
Levy, S., Mason, S., Russon, J., & Diamond, G. (2021). Attachment‐based family therapy in the age of telehealth and COVID‐19. Journal of Marital and Family Therapy, 47(2), 440-454.
Lewis, A. J. (2020). Attachment-based family therapy for adolescent substance use: A move to the level of systems. Frontiers in Psychiatry, 10, 486200.
Russon, J., Morrissey, J., Dellinger, J., Jin, B., & Diamond, G. (2021). Implementing attachment-based family therapy for depressed and suicidal adolescents and young adults in LGBTQ+ services. Crisis.
Russon, J., Smithee, L., Simpson, S., Levy, S., & Diamond, G. (2022). Demonstrating attachment‐based family therapy for transgender and gender diverse youth with suicidal thoughts and behavior: A case study. Family Process, 61(1), 230-245.
Russon, J., Smithee, L., Simpson, S., Levy, S., & Diamond, G. (2022). Demonstrating attachment‐based family therapy for transgender and gender diverse youth with suicidal thoughts and behavior: A case study. Family Process, 61(1), 230-245.
Tsvieli, N., Lifshitz, C., & Diamond, G. M. (2022). Corrective attachment episodes in attachment-based family therapy: The power of enactment. Psychotherapy Research, 32(2), 209-222.
Waraan, L., Rognli, E. W., Czajkowski, N. O., Aalberg, M., & Mehlum, L. (2021). Effectiveness of attachment-based family therapy compared to treatment as usual for depressed adolescents in community mental health clinics. Child and Adolescent Psychiatry and Mental Health, 15, 1-14.
Waraan, L., Rognli, E. W., Czajkowski, N. O., Mehlum, L., & Aalberg, M. (2021). Efficacy of attachment-based family therapy compared to treatment as usual for suicidal ideation in adolescents with MDD. Clinical child psychology and psychiatry, 26(2), 464-474.
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