A Learning Theory Approach to Attachment Theory: Exploring Clinical Applications

Abstract

Although clinicians typically acknowledge the importance of insecure attachment as one factor that can contribute to children’s psychopathology, translating attachment theory into clinical practice has proved a challenge. By specifying some of the mechanisms through which the child’s attachment develops and changes, learning theory can enhance attachment based approaches to therapy. Specifically, interventions building on operant (parent management training) and classical (exposure therapy) learning can be used to stimulate new learning that increases the child’s security and confidence in the parent’s availability and responsiveness. To explore the clinical application and utility of a Learning Theory of Attachment (LTA), we focus on two attachment-focused interventions: Video-feedback Intervention to promote Positive Parenting and Sensitive Discipline (VIPP-SD) and Middle Childhood Attachment-based Family Therapy (MCAT). VIPP-SD is an evidence-based parent management training designed to promote sensitive parenting and secure attachment in early childhood. MCAT is a recently developed intervention that uses exposure to stimulate secure attachment in middle childhood. LTA sheds light on the mechanisms set in train by VIPP-SD and MCAT facilitating the induction of professionals in clinical applications.

In Which Situations Do Adolescents Seek Parental Support and What Do They Need?

“…If such a mismatch occurs between adolescents' needs and fears and parents' responses, it is likely that attachment ruptures occur (Bosmans et al, 2022). However, if parents are able inhibit their problem solving responses and provide more emotional response, the attachment relationship can be restored (Bosmans et al, 2022). Moreover, the current study suggests that after such an emotionally supportive response, adolescents do highly appreciate parents' more practical support as well.…”

“…The parental responses adolescents seem to mostly desire during distress related primarily to emotional support, while practical support and problem solving were either less frequently mentioned or even less positively evaluated. Hence, stimulating or restoring secure attachment development in adolescents requires increasing the probability that parents are experienced as emotionally supportive to the adolescent (Bosmans et al, 2022). One can imagine that it is especially challenging when adolescents are distressed because of the fear that they are incompetent and when parents are inclined to protect them from that distress and take over or try to solve their child's problems.…”

“…Such responses proof the adolescents' greatest fear: being incompetent and unable to thrive once in adulthood. If such a mismatch occurs between adolescents' needs and fears and parents' responses, it is likely that attachment ruptures occur (Bosmans et al, 2022). However, if parents are able inhibit their problem solving responses and provide more emotional response, the attachment relationship can be restored (Bosmans et al, 2022).…”

Conduct Problems and Hair Cortisol Concentrations Decrease in School-Aged Children after VIPP-SD: A Randomized Controlled Trial in Two Twin Cohorts

“…Poehlmann-Tynan and colleagues [ 17 ] found that after cognition-based compassion training (CBCT) with 25 parents and their children between 4 months and 5 years, child hair cortisol levels were significantly lower than those of children in the waitlist control group. We replicated these results in a well-powered twin study, implementing a parenting intervention based on attachment theory and the social learning model of coercive cycles [ 1 , 37 ]. A recent meta-analysis of 19 parenting intervention studies found no significant effect on salivary cortisol [ 12 ].…”

Attachment Representation Moderates the Effectiveness of Behavioral Parent Training Techniques for Children with ADHD: Evidence from a Randomized Controlled Microtrial

“…The learning theory of attachment can help integrate attachment theory into clinical practice (Bosmans et al, 2020). Attachment based elements can strengthen regular antecedent-and consequent-based techniques in BPT (Bosmans et al, 2022). Evidence from parenting interventions in young children that specifically focus on parental sensitivity and the parent-child relation (e.g., Parent-Child Interaction Therapy [PCIT], Video-feedback Intervention to promote Positive Parenting and Sensitive Discipline [VIPP-SD]) show a beneficial effect of parenting programs on children's attachment (Allen et al, 2014;Bakermans-Kranenburg et al, 2003;Juffer et al, 2017).…”