These range from individual therapeutic approaches to public health programs to interventions specifically designed for foster carers.
Child–Parent Psychotherapy (CPP) is an intervention designed to treat the relationship between children ages 0–5 and their caregivers after exposure to trauma or in high risk situations.
In addition to the focus on the parents early relationships the intervention also addresses current life stresses and cultural values.
[5][6]) CPP also incorporates developmental theories by considering the influences of risk factors and treatment on biological, psychological, social, and cultural development of both the child and caregiver.
The main goal of CPP treatment is to support the parent-child relationship in order to strengthen cognitive, social, behavioral, and psychological functioning.
[3] CPP is supported by five randomized trials showing efficacy in increasing attachment security, maternal empathy and goal-corrected partnerships.
It is a 10-week long intervention that consists of 10 one-hour sessions conducted on a weekly basis, usable by therapists, social workers, and parenting coaches.
The three goals of the intervention are to: The ability of young children to regulate their behaviors, emotions, and physiology is strongly associated with the quality of the relationship they have with their caregiver.
It was initially designed for caregivers and infants who had experienced early adversity such as abuse, neglect, poverty, and/or placement instability, and was expanded to provide attachment-based parenting education for any family.
Presenting problems included feeding, sleeping, behavioural regulation, maternal depression and feelings of failure in bonding or attachment.
The randomly assigned group received 3 treatment sessions, between the ages of 6 and 9 months, based on maternal responsiveness to negative and positive infant cues.
Follow ups at 18, 24 and 42 months using Ainsworth's Maternal Sensitivity Scales, the Bayley Scales of Infant Development, the Child Behaviour Checklist (Achenbach) and the Attachment Q-sort showed enduring significant effects in secure attachment classification, maternal sensitivity, fewer behaviour problems, and positive peer relationships.
[29] Developed and evaluated by Juffer, Bakermans-Kranenburg and Van IJzendoorn, this collection of interventions aim to promote maternal sensitivity through the review of taped infant–parent interactions and written materials.
Findings from randomized controlled trials are mixed but overall supportive of efficacy, particularly for "highly reactive infants" and in reducing later externalising behaviours.
They developed an experimental paradigm informed by attachment theory called the Clinician Assisted Videofeedback Exposure Sessions to test whether traumatized mothers, who often suffered psychological sequalae from a history of abuse and violence, could "change their mind" about their young children.
[40] This is a scheme in which a version of the Circle of Security intervention was added to a jail diversion program for pregnant women with a history of substance abuse.
It is a multidisciplinary approach involving psychiatrists, psychologists, social workers, paediatricians and paraprofessionals—all with expertise in child development and developmental psychopathology.
The aim of the intervention is to support the building of an attachment relationship between the child and foster carers, even though about half of the children eventually return to their parents after about 12 to 18 months.
There is a conscious effort to build on recent, although limited, research into the incidence and causes of reactive attachment disorder and risk factors for RAD and other psychopathologies.
The authors claim the programme not only assists the building of new attachments to foster parents but also has the potential impact a families development long after a returned child is no longer in care.
[47] They were characterized by forced restraint of children in order to make them relive attachment-related anxieties, or to invoke the child into a state of rage from with catharsis and healing was thought would follow.
[47] These practices and their related diagnostic methods were scientifically invalidated and considered incompatible with attachment theory and its emphasis on a 'secure base,' safety, and protection from danger.
[2][48][49] In 2003 and 2005, well-known experts in the field of attachment science research condemned these therapy models as empirically unfounded, theoretically flawed, clinically unethical, potentially abusive, and dangerous from at least six documented child fatalities.