* ATTACHMENT-FOCUSED THERAPY

 PURPOSE OF THE PROGRAM:

A child's primary attachment is the foundation for all future relationships and is critical in human development.  When a child has experienced a disruption in the attachment cycle, every effort should be made to repair the damage and create a healthy attachment with a responsible, trustworthy caregiver.  Provision of attachment-focused therapy is dependent on the prognosis for successful treatment and determination of the child's best interest. 

 TARGET POPULATION:

Attachment-Focused therapy services can be provided to families of children who have some type of attachment difficulty, which can range from minor attachment problems to serious attachment disturbances. Recipients of attachment-focused therapy will be selected from referrals specifically requesting these services. Referrals can be made by an individual, an insurance company, or an agency. Attachment-focused therapy services can be provided to biological, foster, and adoptive families with various ethnic backgrounds. Co-morbid diagnoses may include Attention Deficit Hyperactivity Disorder, Oppositional Defiant Disorder, Depressive Disorders, Bipolar Disorder, Posttraumatic Stress Disorder, and Generalized Anxiety Disorder.

 QUALIFICATIONS OF ATTACHMENT-FOCUSED THERAPISTS:

Attachment-Focused therapy will only be provided by master's level mental health professionals who are registered clinicians with ATTACh. In order to become a registered clinician with ATTACH, a minimum of 80 hours of training in attachment theory and the treatment of Reactive Attachment Disorder is required. In addition, there is a minimum requirement of three years of direct clinical experience working with children who have experienced attachment disruptions, such as through abuse/neglect or multiple placements/caregivers. An additional 10 hours of training in attachment theory/therapy is required every year thereafter.

 DESCRIPTION OF SERVICES:

The intake/admission process includes obtaining informed consent to treat and review of privacy practices and client rights and responsibilities. The assessment phase of treatment includes gathering information about placement history, developmental information, attachment history, treatment history, medical history and educational history. Behavior checklists, parent reports, and observational data are used in making a diagnosis. These include diagnostic criteria checklists, sensory integration screening questionnaire, and a sentence completion form. In cases where Reactive Attachment Disorder is suspected, the Attachment Disorder Assessment Scale-Revised and attachment rubric are used to gather information about the child. A lifescript and parenting profile for developing attachment are used to gather information about the parent(s). The Marschak Interaction Method may also be used in the assessment phase to assess parent-child interaction patterns. The Attachment Story Completion Task may be used to assess the child's thought patterns and beliefs about attachment and caregiver-child relationships.

 SAFETY / RISK MANAGEMENT PLAN:

During attachment-focused therapy, parents participate in or observe the therapy process. If, during this process, a child becomes physically aggressive, verbal de-escalation techniques are utilized first. If the child continues to be physically aggressive toward self or others, approved restraint techniques may be utilized by the parent until the child is able to regain self-control. Interventions that interfere with breathing, circulation, or basic life functions are never utilized. If a child is not able to gain self-control and continues to exhibit physical aggression toward self or others, the local police department may also be notified. If necessary, the child will be involuntarily hospitalized for crisis stabilization. If there is ongoing risk, a written risk management plan is created to ensure the safety of the child and family.

 EVALUATIONS / OUTCOME / FOLLOW-UP:

Progress in treatment is assessed at each session using the Outcome Rating Scale and Session Rating Scale. In addition, treatment plans are reviewed periodically (at least every six months) to assess progress toward each objective and changes are made as needed. In attachment-focused therapy cases, progress is also measured through periodic attachment questionnaires (parenting profile for developing attachment, Attachment Disorder Assessment Scale-Revised and attachment rubric).

* Please see the download section of this website for Attachment-Focused Therapy intake forms