Attachment therapy refers to a variety of therapeutic approaches aimed at addressing issues related to early life experiences or trauma. These therapies aim to improve emotional connections and relationships, typically between caregivers and children or adults and their partners. I use attachment-based therapy for families, individuals, and couples, and I mix attachment-based interventions with other methods to have an integrative approach that can be uniquely tailored to each client or family. Attachment-based family therapy is a cornerstone treatment.
If you have any questions about how these methods might benefit you, a loved one, or your family, please feel free to schedule a consultation or contact me anytime.
Categories of Attachment Therapy Approaches
Attachment therapy can be used in various ways. Here are the most common and how they relate to my services.
1. Child-Centered Attachment Therapy
- Attachment-Based Family Therapy (ABFT): Focuses on repairing trust and communication between parents and children, often used for adolescents struggling with depression or conflict.
- Dyadic Developmental Psychotherapy (DDP): Helps children with trauma or disruptions form secure relationships through improved emotional connection and communication.
- Theraplay: Engages children and their caregivers in structured, playful activities to promote trust.
2. Trauma-Focused Attachment Therapy
- Trust-Based Relational Intervention (TBRI): An evidence-based approach for children who have experienced trauma, focusing on connection, empowerment, and correcting behavior through trust.
- Eye Movement Desensitization and Reprocessing (EMDR): Often used with individuals who have experienced trauma, helping them process painful memories and develop healthier emotional patterns.
3. Adult-Focused Attachment-Based Therapy
I do provide these types of treatment for older adolescents and adults.
- Emotionally Focused Therapy (EFT): Commonly used with couples to address insecurities and improve emotional bonds, but emotionally focused individual therapy is also an option.
- Internal Family Systems (IFS): A therapy that addresses inner emotional conflicts often rooted in early attachment wounds by working with different “parts” of the self.
Attachment-Based Interventions
The attachment-based interventions I use are designed to address issues stemming from relationships, typically rooted in early interactions between children and their caregivers. These interventions aim to improve relational dynamics, enhance emotional security, and resolve difficulties. Below is an overview of the attachment-based interventions I use.
1. Attachment-Based Family Therapy (ABFT)
- Purpose: These attachment-based interventions are primarily for adolescents struggling with depression, trauma, or suicide risk.
- Approach:
- Focuses on repairing and strengthening the parent-child relationship.
- Encourages open communication and rebuilding trust.
- Addresses family conflict and emotional disconnection.
I provide more information about ABFT below.
2. Dyadic Developmental Psychotherapy (DDP)
- Purpose: Helps children with trauma or disrupted attachment develop healthy relationships.
- Approach:
- Relies on a supportive and emotionally attuned environment.
- Encourages co-regulation of emotions between the child and caregiver.
- Uses playful, accepting, curious, and empathic interactions (PACE).
3. Theraplay
- Purpose: A structured play-based therapy to improve parent-child attachment.
- Approach:
- Uses guided activities to promote connection, engagement, and joy.
- Focuses on four dimensions: structure, engagement, nurture, and challenge.
- Strengthens the caregiver’s ability to meet the child’s emotional needs.
4. Trust-Based Relational Intervention (TBRI)
- Purpose: Designed for children from hard places, such as those with trauma or adoption experiences.
- Approach:
- Based on three principles: empowering, connecting, and correcting.
- Helps children feel safe and understood while addressing behavioral challenges.
5. Circle of Security (COS)
- Purpose: A set of attachment-based interventions for parents to enhance security in young children.
- Approach:
- Helps parents recognize their child’s needs.
- Encourages responsive caregiving and emotional availability.
- Strengthens the child’s sense of safety and ability to explore.
6. Emotionally Focused Therapy (EFT)
- Purpose: These attachment-based interventions are often used in couples therapy to address insecurities and relationship distress.
- Approach:
- Focuses on identifying and reshaping negative interaction patterns.
- Strengthens emotional bonds by fostering secure relationships.
- Encourages vulnerability and open communication.
7. Mentalization-Based Therapy (MBT)
- Purpose: Enhances the ability to understand and reflect on one’s own and others’ emotions and intentions.
- Approach:
- Particularly helpful for individuals with deep-seated difficulties, including borderline personality disorder (BPD).
- Encourages development of a secure sense of self and healthier interpersonal relationships.
8. Parent-Child Interaction Therapy (PCIT)
- Purpose: Improves behavior in children with emotional challenges.
- Approach:
- Combines coaching for parents with live observation and feedback.
- Strengthens the parent-child bond while managing difficult behaviors.
Key Goals of Attachment-Based Interventions
- Repairing Relationships: Attachment-based interventions foster trust, safety, and secure relationships.
- Regulating Emotions: Attachment-based interventions teach co-regulation and self-regulation strategies.
- Enhancing Sensitivity: Attachment-based interventions improve caregivers’ ability to respond to emotional needs.
- Promoting Resilience: Attachment-based interventions help individuals form healthier relationships and cope with stress.
Attachment-Based Family Therapy (ABFT)
Attachment-Based Family Therapy (ABFT) is a structured, evidence-based therapeutic approach to address family relational ruptures. It is particularly effective for adolescents and young adults experiencing depression, trauma, suicidal ideation, or family conflict. ABFT aims to repair trust and improve emotional bonds between family members.
Core Principles of Attachment-Based Family Therapy
- Theoretical Framework:
- Attachment-based family therapy focuses on the emotional connection between adolescents and caregivers.
- It aims to create a secure base where the adolescent feels safe, supported, and understood.
- Relational Repair:
- Attachment-based family therapy prioritizes resolving relational ruptures that may contribute to emotional or behavioral difficulties.
- It encourages caregivers to be emotionally available and responsive to their child’s needs.
- Emotion-Focused Approach:
- Attachment-based family therapy helps family members express and understand underlying emotions driving conflict or disconnection.
- It facilitates open communication to strengthen relational bonds.
Five Treatment Phases of Attachment-Based Family Therapy
- Relational Reframe (Phase 1):
- Establishes trust between the therapist and family members.
- Shifts focus from the adolescent’s symptoms (e.g., depression, suicidal ideation) to repairing relationships as the root cause.
- Adolescent Alliance Building (Phase 2):
- Creates a safe space for the adolescent to express their thoughts and feelings without fear of judgment.
- Encourages exploration of pain, such as feeling unsupported or misunderstood.
- Parent Alliance Building (Phase 3):
- Helps caregivers reflect on their own emotions and behaviors that may contribute to the relational strain.
- Prepares caregivers to listen empathetically and respond constructively to the adolescent’s concerns.
- Attachment Task (Phase 4):
- Brings the adolescent and caregiver(s) together for emotionally focused discussions.
- Facilitates conversations about past hurts, unmet needs, and desires for change.
- Strengthens emotional bonds and builds a foundation of trust and security.
- Autonomy and Competence (Phase 5):
- Supports the adolescent in developing independence and problem-solving skills.
- Reinforces the caregiver’s role as a supportive and secure base while allowing appropriate autonomy.
Attachment-Based Family Therapy Target Population
Attachment-based family therapy is typically used for:
- Adolescents and young adults (12–24 years old).
- Families experiencing high levels of conflict or disconnection.
- Youth struggling with depression, anxiety, trauma, or suicidal ideation.
Therapeutic Goals
- Repair ruptures and restore trust between family members.
- Treats depression, anxiety, or suicidal thoughts.
- Improve communication and emotional expression within the family.
- Foster a secure relationship, allowing adolescents to feel supported while developing autonomy.
Benefits of Attachment Therapy for Families
- Empirically supported for reducing suicidal ideation and depression when providing therapy for teens.
- Strengthens family relationships, promoting long-term emotional resilience.
- Tailored to the unique dynamics of each family.
Evidence and Effectiveness of Attachment Therapy for Families
Research consistently supports attachment-based family therapy as an effective treatment for:
- Adolescent depression.
- Family conflict.
- Suicide prevention in at-risk youth.
Attachment-Based Therapy for Couples
My use of attachment-based therapy for couples focuses on strengthening emotional bonds by addressing certain dynamics in the relationship. The therapy helps couples identify and heal disconnection, conflict, or insecurity patterns, fostering a secure and supportive partnership.
Key Principles of Attachment-Based Therapy for Couples
- Addressing the Foundation of Relationships:
- Partners seek safety, connection, and emotional support from each other.
- Insecure styles (e.g., anxious, avoidant) can lead to conflict, miscommunication, or emotional distance.
- Emotionally Focused Therapy (EFT) as a Model:
- EFT is the most widely used attachment-based therapy for couples.
- It identifies and transforms negative interaction patterns to rebuild trust and closeness.
- Focusing on Emotional Needs:
- It helps partners recognize and express their relational needs (e.g., love, acceptance, and reassurance).
- Encourages vulnerability to foster deeper intimacy and understanding.
Therapeutic Goals
- Strengthen emotional connection and intimacy.
- Heal past relational wounds or betrayals.
- Improve communication and reduce conflict.
- Foster a secure relationship.
- Empower couples to co-regulate emotions and provide mutual support.
Common Techniques in Attachment Therapy for Couples
- Identifying Negative Interaction Patterns:
- Explore how each partner’s style influences conflicts or emotional distance.
- Break cycles of blame, criticism, or withdrawal.
- Creating a Safe Emotional Environment:
- Develop trust so partners feel safe expressing their fears, needs, and emotions.
- Use nonjudgmental listening and empathy to promote connection.
- Promoting Vulnerability:
- Help partners share deeper emotions (e.g., fear of rejection, loneliness) rather than surface-level frustrations.
- Encourage meaningful conversations that address the root of issues.
- Reprocessing Emotional Injuries:
- Address unresolved hurts or betrayals that undermine trust.
- Work through painful memories to foster forgiveness and repair.
- Building Secure Bonds:
- Teach partners how to respond to each other’s needs in ways that create safety and reassurance.
- Reinforce positive interactions that nurture the relationship.
Key Concepts for Couples
- Relational Styles:
- Secure: Partners feel comfortable with intimacy and autonomy.
- Anxious: A partner may seek constant reassurance, fearing abandonment.
- Avoidant: A partner may distance themselves emotionally to maintain independence.
- Disorganized: A mix of anxious and avoidant behaviors, often rooted in unresolved trauma.
- Protest Behaviors:
- Behaviors like nagging, withdrawing, or criticizing often stem from unmet needs.
- Secure Base:
- The goal is to create a relationship where both partners feel emotionally safe and supported.
Who Can Benefit from Attachment Therapy for Couples?
- Couples experiencing emotional distance or disconnection or fear of intimacy.
- Those struggling with frequent arguments or communication issues.
- Partners dealing with infidelity or betrayal.
- Couples navigating life transitions (e.g., becoming parents, job changes, aging).
- Individuals with attachment insecurities affect their relationships.
Benefits of Attachment-Based Couples Therapy
- Improved emotional intimacy and trust.
- Greater understanding of each other’s needs and fears.
- Reduced conflict and healthier communication patterns.
- Healing of relational wounds and increased resilience as a couple.
- A stronger, more secure partnership.
This form of Couples Therapy can transform relationships by addressing the core emotional needs of both partners.
Attachment Therapy for Individuals
Attachment-based therapy for individuals focuses on understanding how early experiences influence current thoughts, emotions, behaviors, and relationships. It aims to help individuals develop secure relationship patterns, heal from wounds, and build healthier bonds with themselves and others.
Key Principles of Attachment Therapy for Individuals
- Attachment as a Lifelong Process:
- Early patterns formed in childhood with caregivers shape adult relationships, self-esteem, and emotional regulation.
- Insecure styles (e.g., anxious, avoidant, disorganized) can lead to difficulties in relationships or coping with stress.
- Healing Relational Wounds:
- Attachment-based therapy addresses unresolved trauma, neglect, or abandonment from early life.
- Attachment-based therapy focuses on developing a secure sense of self and the ability to form healthy connections.
- The Therapist as a Secure Base:
- The therapeutic relationship models a secure attachment, providing a safe space for exploration and healing.
- Through consistent and empathetic interactions, clients can reprocess past injuries through attachment-based therapy.
Goals of Attachment Therapy for Individuals
- Develop Emotional Awareness: Understand how relational patterns influence emotional reactions.
- Heal from Trauma: Process childhood traumas and treat unresolved grief or loss.
- Improve Relationships: Build healthier, more secure relationships by addressing maladaptive patterns.
- Enhance Self-Worth: Cultivate a stronger sense of identity and self-esteem.
- Learn Emotional Regulation: Develop tools to manage anxiety, anger, or fear effectively.
Attachment-Based Interventions for Individuals
- Exploration of Early Experiences:
- Reflect on childhood relationships with caregivers to identify patterns (secure, anxious, avoidant, disorganized relationships).
- Understand how these patterns affect current relationships and behaviors.
- Creating a Secure Therapeutic Relationship:
- I offer empathy, consistency, and validation to model secure attachment.
- This relationship helps clients feel safe to explore difficult emotions and experiences.
- Processing Emotional Pain:
- Focus on unprocessed feelings of rejection, neglect, or abandonment.
- Use techniques like mindfulness-based stress reduction, narrative therapy, or EMDR (Eye Movement Desensitization and Reprocessing) to process trauma.
- Rewriting Narratives:
- Challenge and reframe negative beliefs formed through insecure relationships (e.g., “I’m unlovable,” “People will always leave me”).
- Build a healthier internal narrative centered on self-compassion and resilience.
- Building Emotional Regulation Skills:
- Teach strategies like grounding, mindfulness, and co-regulation to manage intense emotions.
- Help clients learn to self-soothe and develop a secure sense of self.
- Developing Healthy Relationship Skills:
- Address unhealthy patterns like people-pleasing, avoidance, or fear of intimacy.
- Practice assertiveness, setting boundaries, and vulnerability in relationships.
Who Can Benefit?
- Individuals with Insecure Styles:
- Anxious: Fear of rejection, constant need for reassurance.
- Avoidant: Emotional distancing, fear of dependence.
- Disorganized: Conflicting needs for closeness and avoidance, often linked to trauma.
- People Struggling with Relationships:
- Difficulty maintaining close, healthy relationships.
- Patterns of conflict, dependency, or emotional withdrawal.
- Those with Trauma or Loss Histories:
- Early childhood trauma, neglect, or abuse.
- Experiences of significant loss or separation.
- Individuals Facing Anxiety, Depression, or Emotional Challenges:
- Chronic feelings of unworthiness, loneliness, or emotional instability.
Common Therapeutic Approaches
- Emotionally Focused Individual Therapy (EFIT):
- Focuses on identifying and transforming negative emotional patterns rooted in emotional needs.
- Internal Family Systems (IFS):
- Works with “parts” of the self, such as the wounded inner child, to address pain.
- Mentalization-Based Therapy (MBT):
- Helps individuals understand and reflect on their own and others’ emotions and intentions.
- Trauma-Focused Interventions:
- EMDR (Eye Movement Desensitization and Reprocessing): Processes traumas.
- Somatic Experiencing: Addresses how trauma is stored in the body.
- Relational Psychotherapy:
- It focuses on the dynamics of relationships and how past experiences influence them.
Benefits of Attachment Therapy for Individuals
- Greater self-awareness of emotional needs and patterns.
- Healing from relational wounds and past trauma.
- Enhanced ability to form and maintain healthy, secure relationships.
- Improved self-esteem and emotional resilience.
- Reduction in anxiety and depression symptoms and feelings of isolation.
Attachment-based therapy is deeply transformative for individuals. It helps clients uncover the root causes of their struggles and develop the skills needed for a healthier, more connected life.
Summary and My Work
I provide attachment-based therapy as a stand-alone treatment and also as an adjunct to other forms of couples, family, and individual therapy. I provide most of this work virtually, which works well for older children and adults and particularly for families with adult children who do not live in the same place. This treatment tends to be one of the longer-term methods, but you should feel meaningful improvement along the way. If you have any questions about attachment therapy or how it could benefit you or your family, schedule a consultation or contact me anytime
