Erin M. Dugan, Ph.D., LPC-S, RPT/S Adrianne L. Frischhertz, Ph.D., LPC-S, RPT/S Karen Taheri, LPC, NCC, RPT What is Attachment?  …special emotional relationship that involves an exchange of comfort, care, and pleasure.

 Freud’s beginnings… Bowlby’s credits…. What is Attachment?  "lasting psychological connectedness between beings" (Bowlby, 1969, p. 194).

 “…early experiences in childhood have an important influence on development and behavior later in life.”

 “Our early attachment styles are established in childhood through the / relationship.”

 "The propensity to make strong emotional bonds to particular individuals [is] a basic component of human nature" (Bowlby, 1988, 3). How Do You Assess Your Client’s Attachment Style in Therapy?  ’s Report  Observations of  Assessments  Not at all VIDEO  https://www.youtube.com/watch?v=6bul1meciGE

4 Distinguishing Characteristics  Proximity Maintenance - The desire to be near the people we are attached to.  Safe Haven - Returning to the attachment figure for comfort and safety in the face of a fear or threat.  Secure Base - The attachment figure acts as a base of security from which the child can explore the surrounding environment.  Separation Distress - Anxiety that occurs in the absence of the attachment figure. BOWLBY

Bowlby’s Attachment 10 Basic Tenets of  Intrinsic  Security equals enhanced autonomy  Security offers a safe haven  Attachment offers a secure base  Accessibility and responsibility builds bonds  Fear and uncertainty activate attachment needs  Separation distress is predictable  Insecure forms of engagement can be identified  Separation and loss are traumatizing  Working models of self and others Johnson & Whiffen, 2003 Review of Attachment

 Attachment Theory  Goal-Corrected Behavioral System  Sense of Felt Security  Emergence of Self  Autonomous Self Formation of Attachment  Representational Models  Internal Working Models  Development of Self and Self and Others  Intergenerational Attachment Styles  Internal/External Factors Ainsworth  “further expanded upon Bowlby's groundbreaking work in her now-famous "" study.”

 The study involved observing children between the ages of 12 to 18 months responding to a situation in which they were briefly left alone and then reunited with their mother (Ainsworth, 1978). Ainsworth and Main & Solomon  Ainsworth  secure attachment,  ambivalent-insecure attachment,  and avoidant-insecure attachment.

 Main and Solomon (1986) added a fourth attachment  disorganized-insecure attachment.

 “these early attachment styles can help predict behaviors later in life.” Strange Situation Videos…  https://www.youtube.com/watch?v=QTsewNrHUHU

 https://www.youtube.com/watch?v=DH1m_ZMO7GU

Studies also report….  “Researchers Hazen and Shaver (1987) found a number of different beliefs about relationships amongst with differing attachment styles.  Securely attached adults tend to believe that romantic is enduring.  Ambivalently attached adults report often, while those with  avoidant attachment styles describe love as rare and temporary.”

Kendra Cherry – About.com Research States…  Studies show that there are correlations between the attachment representation of the , their observable behavior in caregiving and the interaction between their and the later development of attachment quality in their children. (Grossmann, Grossmann, & Zimmermann, 1999, p. 760-786) Research Shows…  Children with secure attachment styles are:  More socially adept  Have enhanced cognitive abilities  Are more competent in problem-solving  Are more independent  Have a more positive self-concept

Johnson & Whiffen, 2003; Levy & Orlans, 1998 The Clinician’s Tools

Scale of Parental Attachment (ASPA; Snow, Martin, & Helm, 2008)

Theraplay (Jernberg, 1993b)

• The Marschak Interaction Method Rating System (MIM-RS; O’Connor, Ammen, Hitchcock, & Backman, 2004)

• Filial Problem Checklist (Horner, 1974)

• Child Parent Relationship Training (CPRT; Landreth & Bratton, 2006)

Attachment Styles  Secure  Insecure  MIM-RS  Secure  Insecure  Ambivalent  Disorganized  ASPA  Safe  Dependent  Parentified  Distant  Fearful

ASPA  Adult Scale of Parental Attachment  5 Subscales  Safe  Dependent  Parentified  Distant  Fearful The Adult Scale of Parental Attachment  Safe. This pattern measures the extent to which the child felt the relation provided comfort and security. A child with a safe pattern of relating may have experienced confidence in the parent’s availability and support.  Dependent. This pattern measures the extent to which the child felt a need for the parent to be available. A child with a dependent pattern of relating may have experienced helplessness and uncertainty when the parent was not available. Snow et al., 2008 The Adult Scale of Parental Attachment  Parentified. This pattern measures the extent to which the child felt responsible for meeting the parent’s needs. A child with a parentified pattern of relating may have experienced feelings of importance and enjoyed being helpful  Distant. This pattern measures the extent to which the child experienced disappointment in the parent’s support and availability. A child with a Distant pattern of relating may have experienced a need to distance from the parent and may have experienced anger toward the parent.

Snow et al, 2008 The Adult Scale of Parental Attachment  Fearful. This pattern measures the extent to which the child experienced a fear of abandonment and a that the parent would not be available for support. A child with a fearful pattern of relating may have experienced anger toward the parent or frustration with the parent.

Snow et al, 2008

MIM-RS  Marschak Interaction Method Rating System  4 Dimensions  Structure  Engage  Nurture  Challenge MIM-RS  8 Summary Rating  Mother’s Ability to  Structure, Challenge, Engage, Nurture, Facilitate Child’s Regulatory Processes  Child’s Ability to  Demonstrate Exploratory Behaviors, Reciprocity with Their Parents, and Regulatory Behaviors INFLUENCE OF ATTACHMENT ON  Determining the attachment style of the primary caregiver is important to issues concerning play therapy.  Determining the attachment style of the child through an MIM-RS influences the direction of play therapy.  Attachment issues in play therapy can influence the success of play therapy. Psychosocial History Info Intake interview helps the therapist understand the following types of questions (Jernberg, 1993b, 47-48):  What kind of world was the child born into?  How did the come about?  What kind of world greeted each of his or her parents?  What is this marriage like today?  What about ?  What is the degree of emotional overlay?  What are the most effective methods for instituting growth?

Filial Problem Checklist  Horner, 1974  Measure the effectiveness of filial in reducing children’s problematic behaviors by comparing pre-test and post-test scores.  Not true for my child  Some: do not view as problem  Viewed as moderate problem  Severe problem

Horner, 1974

Filial Therapy  Goal of Filial Therapy “To allow parents to become the primary change agents as they learn to conduct child-centered play sessions with their own children.” (VanFleet, p.1, 2005) Filial Therapy Core Values

◦ Honesty - Relationship ◦ Humility - Playfulness and humor ◦ Openness - Emotional expression ◦ Collaboration - strength ◦ Respect - Balance ◦ Genuineness - , acceptance, ◦ Empowerment, self-understanding efficacy, education

(Ginsberg, 2003, L.F. Guerney, 997, 2003b; VanFleet, 2004) Filial Therapy Goals for Children….

Goals for Parents…

Goals for Child –Parent Relationship…

(VanFleet, R., 2005, p.4)

Summary  Eliminate the presenting problems at their sources  Develop positive interactions between parents and their children  Increase ’ communication, coping, and problem-solving skills so they are better able to handle future problems independently and successfully (VanFleet, R., 2005, p.4) Filial Therapy Skills  Structuring

 Empathetic Listening

 Child Centered Imaginary Play

 Limit-Setting (VanFleet, R., 2005, p.4) Child Parent Relationship Therapy  Objectives ◦ Play = child’s language ◦ Communication of experiences, thoughts, feelings, and wishes ◦ “keen observers” of child ◦ to understand that the child’s play provides you with a window to your child’s world ◦ Child feels better = child behaves better Landreth & Bratton, 2006

Child Parent Relationship Therapy  Goals  Tools that parents need to better understand their child  Strengthens the parent child relationship  Parent regains control  Child develops self-control  Effective discipline

Landreth & Bratton, 2006 Child Parent Relationship Therapy Skills - Reflective Responding - Limit Setting - Empowerment - Encouragement - Esteem Building Responses - Rules of Thumb Landreth & Bratton, 2006 Child Parent Relationship Therapy Rules of Thumb - Focus on the donut, not the hole - Be a thermostat, not a thermometer! - What’s most important may not be what you do, but what you do after what you did! - The parent’s toes should follow his/her nose! - You can’t give away which you don’t posses! - “Be With” Attitudes - When a child is drowning, don’t try to teach her to swim! - If you can’t say it in 10 words or less, don’t say it! (Landreth & Bratton, 2006)

References  Grossmann, K.E., Grossmann, K.., & Zimmermann, P. (1999). A wider view of attachment and exploration: Stability and change during the year of immaturity. In J. Cassidy & P.R. Shaver (Eds). Handbook of attachment: Theory, research, and clinical applications. New York, NY: Guilford Press, 760-786.  Horner, P. (1974). Dimensions of child behavior as described by parents: A monotonicity analysis. Unpublished masters thesis, Pennsylvania State University, College Park, PA.  Landreth, G.L. & Bratton, S. C. (2006). Child parent relationship therapy (CPRT): A 1-session filial therapy model. New York, NY: Routledge.  O’Connor, K., Ammen, S., Hitchcock, D., & Backman, T. (2004). The MIM Rating System Administration and Scoring Manual. Fresno, CA.  Snow, M. Sullivan, K., Martin, E., Helm, H. (in review). The adult scale of attachment: Psychometric properties, factor analysis and multidimensional scaling in two studies. Journal of Attachment & Human Development.  VanFleet, R. (2005). Strengthening parent-child relationships through play. Sarasota, FL: Professional Resource Press.

References  Bratton, S. C., & Landreth, G. (1995). Filial therapy with single parents: Effects on parental acceptance, empathy, and . International Journal of Play Therapy, 4(1), 61-80.  Chau, I. Y., & Landreth, G. L. (1997). Filial therapy with Chinese parents: Effects on parental empathic interactions, parental acceptance of child and parental stress. International Journal of Play Therapy, 6(2), 75-92.  Costas, M., & Landreth, G. (1999). Filial therapy with nonoffending parents of children who have been sexually abused. International Journal of Play Therapy, 8(1), 43-66.  Glass, N. (1986). Parents as therapeutic agents: A study of the effects of filial therapy (Doctoral Dissertation, University of North Texas, 1986). Dissertation Abstracts International, A 47 (07), 2457.  Glover, G. & Landreth, G. (2001). Filial therapy with Native Americans on the Flathead Reservation. International Journal of Play Therapy, 9(2), 57-80  Jang, M. (2000). Effectiveness of filial therapy for Korean parents. International Journal of Play Therapy, 9(2), 39-56.  Johnson, S., & Whiffen, V. (2003). Attachment processes in couple and . New York, NY: The Guilford Press.  Lahti, S. L. (1992). An ethnographic study of the filial therapy process (Doctoral Dissertation, University of North Texas, 1992). Dissertation Abstracts International, A 53 (08), 2691.  Levy, T., & Orlans, M. (1998). Attachment, trauma, and healing: Understanding and treating in children and families. Washington, DC: Child League of America, Inc.  www.play-therapy.com (2007.)“Play and Culture” Rise Van Fleet


 Ainsworth, M.; Blehar, M.; Waters, E.; and Wall, S. (1978). Patterns of Attachment. Hillsdale, NJ: Erlbaum.

Bowlby, J. (1969/1982). Attachment and Loss, Vol. 1: Attachment. New York: Basic Books.

Bowlby, J. (1979). The Making and Breaking of Affectional Bonds. London: Tavistock.

Bowlby, J. (1988). A Secure Base. New York: Basic Books.

Feeney, J. A.; Noller, P.; and Patty, J. (1993). "Adolescents' Interactions with the Opposite Sex: Influence of Attachment Style and Gender." Journal of 16, 169–186.

Hazen, C. & Shaver, P. (1987) Romantic love conceptualized as an attachment process. Journal of Personality and Social , 52, 511-524.

Main, M. & Cassidy, J. (1988) "Categories of response to reunion with the parent at age 6: predictable from infant attachment classifications and stable over a 1-month period. 24, 415-426.

Main, M., & Hesse, E. (1990). Parents' unresolved traumatic experiences are related to infant disorganized attachment status: Is frightened/frightening parental behavior the linking mechanism? In M. T. Greenberg, D. Cicchetti, & E. M. Cummings (Eds.), Attachment in the Years: Theory, Research, and Intervention, 161-182. Chicago, IL: University of Chicago Press.  Diagrams and figures obtained online via aboutus.com Kendra Cherry