Content area
Full Text
TOPIC: Applying the current evidence to treating clinical populations with attachment disorders.
PURPOSE: This study aims to review the literature regarding the treatment of childhood attachment disorders, with the goal of guiding clinicians towards evidence-based practice.
SOURCES USED: MEDLINE, CINAHL, PsychBooks, EMBASE and PsychINFO were searched and all articles reporting results of a treatment intervention for attachment disorder were reviewed. Ancestry analysis garnered additional sources.
CONCLUSIONS: There are few studies addressing therapeutic interventions for attachment disorder, but the literature supports benefits to the child-parent attachment relationship in biological families in the application of both psychoeducational and psychotherapeutic treatment modalities. A summary of the important components of applying these techniques in therapy is included. Foster and adoptive families with attachment disorders require different types of intervention than biological families. In particular, foster and adoptive parents need to help repair their child's negative internal representations by responding appropriately to their child's cues. Advanced practice psychiatric nurses are well-prepared to provide evidence-based interventions to both biological and foster families with attachment problems. More research is needed to determine the most appropriate treatment interventions for children with attachment disorders.
Search terms: Attachment, intervention, reactive attachment disorder, treatment
Introduction
The purpose of this paper is to examine treatment interventions for children with attachment disorder for the purpose of guiding clinical practice with this population. Currently many psychiatric nurse practitioners are treating children identified as having "attachment problems." In addition, the child mental health community has not agreed upon a gold standard for treating this population. For these reasons, it is important that psychiatric nurse practitioners be aware of the current evidence on attachment interventions. This paper will examine treatment interventions for both reactive attachment disorder (RAD) and the nonsecure attachment categories as frequently defined in research, as the literature concludes that children with both these labels are at risk for negative outcomes (Egeland & Farber, 1984; Hall & Geher, 2003). Preventive interventions are not a focus of this paper, but interested readers may see Lieberman and Zeanah (1999) for a review. Attachment theory is used as the theoretical framework to provide an understanding of the importance of early relationships. The major research questions are: Which interventions does the evidence support as best practices for infants and children with existing...