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Three case studies illustrate pre– and post–eye movement desensitization and reprocessing (EMDR) adult attachment status as measured by the Adult Attachment Interview (AAI). Two adult males and one adult female presented for outpatient therapy; all of them were categorized with an insecure or disorganized attachment status at pretreatment. All presented with symptoms of depression and anxiety and complaints regarding problems in their current marital and family relationships. The three patients received 10 to 15 EMDR sessions over the course of approximately 1 year, interspersed with talk therapy sessions for the purpose of debriefing and psychoeducation. The EMDR approach utilized all eight phases of treatment within the three-pronged approach. Following EMDR therapy, all three patients made positive changes in attachment status as measured by the AAI, and all three reported positive changes in emotions and relationships. This article provides an overview of the literature related to adult attachment categories and summarizes the effect of adult attachment status on emotional and social functioning. The rationale and scoring procedures for the AAI are explained.

This case series study investigated the effectiveness of an integrative eye movement desensitization and reprocessing (EMDR) and family therapy model, specifically the Integrative Attachment Trauma Protocol for Children (IATP-C), for improving traumatic stress, attachment relationships, and behaviors in children with a history of attachment trauma; specifically, adopted children with a history of maltreatment and foster or orphanage care. Of the 23 child participants, one family dropped out at 6 months, and 22 completed treatment in 6–24 months. Mean treatment length was 12.7 months. Statistical analysis demonstrated significant improvement in scores on children's traumatic stress symptoms, behaviors, and attachment relationships by the end of treatment. Statistical analysis of secondary measures showed significant improvement in mothers' scores related to symptomology and attitudes toward their child. Gains were maintained for the 15 families who complied with completion and returning of follow-up measures. Limitations of the study include the lack of a control group and small sample size. Future directions include controlled efficacy studies with larger sample sizes as well as exploration of application of the model to a similar population of children in other cultures and to children who are not residing in permanent placements.

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