Mental health articles

The central principles of intervention for children with attachment disorders are based on the need to allow these children to develop an alternative, more secure, attachment relationship to their current carer, a clinician or therapeutic setting. Any attempt to do this should only proceed if the child’s current safety is assured and if there has been a thorough assessment of the child’s psychological and emotional capacity to form relationships, cognitive development and overall level of ongoing disturbance related to early trauma. Extremely traumatised children with ongoing symptoms of Post-Traumatic Stress Disorder may need specific interventions for anxiety prior to looking at longer term interpersonal issues. Interventions all focus on improving the child’s understanding of interpersonal interaction—improving emotional regulation and building the ability to use a safe person as a secure base. Children who have experienced abuse will have fundamental difficulties in socio-emotional processing, basic trust and maintenance of reciprocal relationships. A decision based on clinical assessment needs to be made about whether individual work with the child or relationship-based work with the current
carers or both is best indicated.
Early intervention in the infant period may be particularly important in the
prevention of ongoing interpersonal difficulties. This type of intervention with
high-risk carers and infants aims to improve the carer’s capacity to provide a consistent attachment experience and sensitive care. Many carers in this group will have had early experiences of abandonment and neglect themselves and will
find the emotional tasks of parenting particularly difficult. Interactions should
involve the carer and child together and focus on the quality of the relationship,
maximising positive interaction and giving the child an experience of being with an adult who is safe and consistently available.

Tags: attachment, disorder