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Attachment Focused Therapy: What Is It?

Susie was becoming increasingly aggressive toward her family, simultaneously being more friendly to strangers. Susie refused to look at her mother unless she was lying about something her mother was asking her about. Then, her eye contact was steady and penetrating, downright uncomfortable. Potty trained at 3, she was wetting her bed again at 5 and wetting her pants at school.

Susie’s mom and dad were arguing over her behavior, increasing stress in the home and in her dysregulation within her family. Susie’s mother, Robin, had taken her daughter to 4 therapists. Each therapist had taken her daughter to a play room assessing the problems and begin to develop a relationship with Susie. Each therapist called Robin back to complete the assessment by saying that there didn’t seem to be anything wrong with Susie and denying seeing any of the reported behaviors. Each therapist suggested Love and Logic and 1 2 3 Magic as options for Robin to try, pointing out that the parents are often the major problem in behavior issues with children. Robin felt angry and defeated.

Traditional therapy with children who have spent time in an institutional setting, or experienced multiple caregivers such as in foster care means one on one sessions. Play therapy may include working with children to resolve childhood abuse issues with the therapist using toys. Art therapy utilizes art mediums in the assessment and treatment of their clients. Traditional talk therapy requires the therapist to take the child or youth off alone to develop a therapeutic alliance with the young client.

Attachment focused therapy seeks to strengthen the relationship between the child or youth and his parents and family. Attachment disorder is a relational disorder. It is caused by a severe rift between the child’s primary caretakers and the child. The child’s basic needs for food, care, nurturance, and safety have not been met inconsistently, or from multiple caretakers. The child develops a dysfunctional worldview whereby the child must take care of himself or die. In order for the child to repair these erroneous beliefs in the comfort of a stable home where needs are met and parents are available, relationship therapy MUST involve the family. A primary relationship between the child and the therapist will not suffice to help the child to connect to the family.

Attachment focused therapy is fun for the child as the family and the child learn how to play, accept healthy nurturing and touch, how to repair and change those maladaptive beliefs about the world and the adults that care for children in healthy families. Therapy is never done with just the child. The therapeutic relationship is with the entire family but most importantly, the parents. The therapist defers to the parents in speaking with the child, as the parents are touted as loving, capable, and consistent in their parenting. Through Attachment Focused therapy, the child learns to trust his family, to connect with his parents and siblings, and to challenge his beliefs that the world. Now that is therapy that makes sense.