According to Bowlby, "The roles of the care-giver 1 are first to be available and responsive as and when wanted and, second, to intervene judiciously should the child or older person who is being cared for be heading for trouble " (1979, p. 133). However, when the context of care-giving is in the acute medical setting, such as the neonatal and paediatric intensive care units, parents are presented with unique challenges that may effect their preconceived (in the case a newborn infant) or previous (in the case an older infant) styles of interacting with their child.

Allied health and medical professionals-specifically child and family therapists -will be familiar with referrals involving children who have been identified as exhibiting behavioral concerns of some description. This paper will propose that clarity regarding conceptualization of childhood behavioral concerns is aided by a knowledge of both attachment theory and family systems theory and that when applied simultaneously, these theories increase the relevance of the other. In particular, there will be a description of attachment classifications in systemic terms, thus highlighting the relevance of attachment classifications outside of the Strange Situation experiment. Second, the relevance of first-and second-order cybernetics will be discussed with the intention of describing differences between caregivers' approaches to the concerns at hand. Finally, it will be suggested that multiple levels of theory should be considered when responding to childhood behavioral concerns from an attachment/systemic perspective. A case vignette illustrating the application of attachment theory, embedded within a family systems and meta-systems perspective, will be detailed.Attachment theory and family systems theory each have the capacity to inform therapeutic work aimed at engaging children and families for whom childhood behavioral concerns represent a significant challenge. Attachment and systemic theories each inform a position that such concerns are better understood if the therapist questions the quality of the caregiver-child attachment. A description of attachment classifications using systemic terms highlights both behavioral and relationship patterns that may hold relevance for the presenting child and his caregiver/s. A description of second-order cybernetics further supports the position that the caregiver's behaviors and interactions with the child will significantly influence the course of the behavioral concerns in question. This is not to say that the caregiver is

Serious and life‐threatening illnesses in the infant population present complex theoretical and practical challenges for both the family unit and hospital staff. These challenges operate at a minimum of three levels, namely the infant's internal system, the parent—infant relationship and the acute medical context. This article describes infant‐directed singing as an intervention in restoring an attachment bond disrupted by serious illness. In particular, the following will be considered: the need for family focused interventions within the acute medical setting, the usefulness of attachment theory in the acute care context; a technical description of infant‐directed singing and a cybernetic conceptualisation of the relevant staff—mother—infant interactions.

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When marriages and long‐term relationships break down, parents may refer their children and adolescents to therapy for a variety of reasons. While the systemic therapist's preference may be to work with the family system/s, high conflict separation may prohibit such an approach. This article discusses family‐focused child therapy that prioritises the needs of children while seeking to preserve a systemic approach. At a practice level this may involve: (a) individual child therapy, (b) engaging with smaller subsystems including siblings, (c) joint therapeutic work involving child/ren plus parent/s, and (d) any of these combinations; all while continuing to maintain a systemic understanding of the work. The article discusses the challenges of working with children from separated families, where there is restricted or no possibility of engaging with the broader family system.