Child Psychology and Psychiatry

Box 17.1
Examples of interventions
for attachment difficulties
•
Direct work to support parents, e.g. in
helping them to reframe behaviour via
knowledge of the effects of maltreat-
ment, and hence to manage it
differently. A ‘story stem’ narrative
assessment of the child can give a
picture of the child’s expectations and
perceptions of attachment
relationships, which can help parents
attune better to a child.
•
Standard parenting programmes, e.g.
Webster—Stratton, adapted to include
adoption-specific areas.
•
Active learning in the child—parent
interaction, with the therapist
supporting the parent’s responses, and
directing and facilitating the child [24].
•
‘Theraplay’ [25] involving active
engagement of the child in physical play
with the therapist, seen as modelled on
the healthy parent—infant relationship,
with the parent involved first as
observer and later as co-therapist.
•
Individual psychoanalytic psychotherapy
for the child, with concurrent work
with the parents, can help to alter
underlying negative expectations of
attachments and relationships [26].
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