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• W72871005 abstract "This book has an interesting title. The bold attempt to bring the vast research related facts and findings to clinician’s life may have been a mamothian task for editors, but it is an absolute delight for readers. In merely 256 pages, the editors have invited contributions from well known authors in the attachment field, and all of them have done a superb job. This book came into existence through a recognized gap between research findings and clinical practice in the attachment field.This book has two parts. The first part has five chapters devoted to the clinical applications of research based methodology. The second part has four chapters that describe psychological interventions based on the attachment paradigm.Each chapter has a message for clinicians which is relevant to their clinical practice. Take for example chapter one, written by Charles Zeanah, who is a well known infant psychiatrist. Dr Zeanah gently weaves the observable recurrent patterns of the parent-infant interaction and the parent’s representations of the infant through a semi structured interview, the Working Model of the Child Interview” (WMCI). He does this by using a clinical example, and that approach was appealing. This chapter is a good example of conveying research-related information (in this case the WMCI) to translate the mother-infant relationship in clinical formulation.The second chapter is written by Nina Koren with contributions from the book’s editors. Here we learn the utility of assessing and modifying maternal insightfulness as to how parents respond sensitively to the child’s emotional life. The focus is on the maternal representation of the child through understanding of maternal insightfulness. With very engaging clinical examples, authors describe pre and post treatment assessment of insightfulness and its utility.The third chapter by Miriam Steele and others brings important research maneuvers into clinical practice. Important observations are made through the “Attachment Representations and Adoption” study. These authors found that parental states of mind were influential in clinical procedures such as a story stem assessment. An important point about this study is that it highlighted the intergenerational transmission of attachment in nonbiologically related dyads. This factor is particularly useful for clinicians to understand the attachment process in adopted children. Their research procedure of using co-construction tasks to study dyadic interaction is well explained. This chapter is a must read for those clinicians who deal with children who are adopted and are using attachment facilitating interventions.Chapter four by Mary Dozier et al focuses on the role of caregiver commitment in foster care. I have never read such a refreshing description of the role of “commitment” and its place in attachment theory. They also described their This Is My Baby (TIMB) Interview and its rating scale. There was a new aspect introduced in the discussion, originating from Primatologists, that is the strange situation experiment which does not take into account whether the child expects the parent to protect him or her. This triadic function of the assessment is termed by the authors as commitment. By providing clinical excerpts, the distinctions between low commitment and high commitment parents are demonstrated. I liked learning about this comparatively new concept, but I wondered about its clinical utility. In our province, the foster parents are not encouraged to become adoptive parents, and disrupted attachment bonding experiences for foster parents and children are commonplace. If we want to increase the commitment by foster parents, then we need to work not only on clinical grounds but with policy makers. Of course, observation of the fine balance between the biological parents’ responsibilities and other caregiver’s commitment is going to be a big challenge.The discussion theme of the book now takes us to chapter five which explores insights from the Reaction to Diagnosis Interview (RDI). This is a beautifully crafted chapter that deals with the acceptance of a serious developmental disorder diagnosis by parents, their resolution with respect to a diagnosis of the child, and the description of the Reaction to Diagnosis Interview. The RDI asks five questions 1) initial thoughts of parents upon hearing the diagnosis; 2) parent’s feelings about the child’s difficulties; 3) their feelings and thoughts/actions at the time they learned about the child’s diagnosis; 4) changes in their feelings from the day they received the diagnosis until the present; and 5) their thoughts about why the child has that specific diagnosis. Authors discuss clinical examples of when parents receive the diagnosis of autism spectrum disorder for their children. It is expected that parental complete resolution vis-a-vis their child’s diagnosis would enhance parental capacities. However, in order to classify the parents as resolved or unresolved, much expertise is needed in the correct use of the coding procedure.We now come to the second part of this book that is titled “Attachment Theory and Psychotherapy.” It contains three chapters from chapter six to nine, and all of these chapters are mini informational books. Chapter six is written on attachment and trauma by Amy Busch and Alicia Liberman. Two main points in this chapter are the use of dual attachment and trauma work in the assessment of traumatized children. There is an actual case study using the principles of child parent psychotherapy (CPP) and some evidence based review of use of the CPP with preschoolers.The next chapter gives us another intervention tool: the Circle of Security project (COS) and how it can be used as an early intervention program to alter the developmental pathway of at-risk parents and their young children. This intervention is described by Powell et al to reevaluate caregiver’s accuracy of their internal representations of child and self. It is very well operationalized and the protocol described uses visual props and is free of much psychological jargon. I felt that this group approach would work with many insecure parent-child interactions, but I was not sure about the disorganized attached dyads.Skeptical readers like me do not have to wait too long to have that question answered. In the next chapter, the use of mentalizing capacities to enhance affect dysregulation in disorganized dyad is described by Arietta Slade. She provided the brief review of the construct of disorganized attachment with the help of clinical examples.I kept this penultimate chapter the last to report, intentionally, as the intervention described occurs in therapeutic preschools that I believe are the best places to start preventive intervention. Douglas Goldsmith describes again, with the help of clinical examples, how a child’s negative internal models can be modified. There is a good evidence-based discussion on how creation of a secure base is important. With the help of emotional mirroring, reflection and unconditional positive regard techniques, the child’s negative models are challenged through therapy.Most practitioners in the infant mental health field are already applying principles outlined in this book. It still offers new information, and confirms our beliefs. Most importantly, it is likely to be useful for all early childhood mental health specialists.I think this book is very well organized and every page is worth reading as it gives a new combo of research-practice dimension. I could have gladly given a rating of 10 but it does have one major flaw. It did not discuss the area of research that is growing in leaps and bounds i.e.: neurobiological domain of attachment research. My rating is 9/10." @default.
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• W72871005 title "Attachment Theory in Clinical Work with Children: Bridging the Gap between Research and Practice" @default.
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