A “transmission gap” between research and practice? A Q-methodology study of perceptions of the application of attachment theory among clinicians working with children and among attachment researchers

Abstract

Clinical practitioners are frequently encouraged, through literature, training, and policy, to learn, understand, refer to and use their knowledge of attachment theory and research when working to meet the needs of children and families. However, there has been very little empirical study of how practitioners understand and perceive the relevance of attachment concepts and methods. Q-methodology was used to examine the perceptions of attachment knowledge and its applications for practice among 30 UK clinicians working with children and an international group of 31 attachment researchers. Factor analysis revealed three perspectives, described as: i) pragmatic, developmental, and uncertain, ii) academic, and iii) autodidactic and therapeutic. Participants agreed on core tenants of theory, their aspirations for clinical practice and the inaccessibility of current assessment measures for practitioners. Yet they diverged on their understandings of attachment insecurity, disorganisation, and the implications of both for various aspects of child development.

The Perspectives of Senior Researchers in Applied Disciplines on the Current State of Developmental Attachment Research: An Interview Study

“…Recent consensus statements by attachment researchers have alleged considerable ''conceptual confusion'' in appeals to attachment concepts by clinicians and social workers (Granqvist et al, 2017). However, it should be noted, this allegation has been based primarily on anecdote, and there remains need for more empirical research on the extent or nature of convergence or divergence in understanding between attachment researchers and their applied audiences (Beckwith et al, 2022).…”

“…The use of attachment research within social work has come under scrutiny, for example, prompted by concerns about the misapplication of attachment theory and assessments in child welfare contexts (Granqvist, 2016; White et al, 2019), or at least materially different conceptualizations of attachment theory between basic and applied contexts (Barone & Cassibba, 2022; Duschinsky et al, 2021). Such concerns have led to two recent international consensus statements by the community of attachment researchers (Forslund et al, 2022; Granqvist et al, 2017) and a small number of emergent empirical studies (e.g., Beckwith et al, 2022; Hammarlund et al, 2022; North, 2019; Søberg Bjerre et al, 2023).…”

“…However, these discussions have been commentaries rather than based on empirical research. Despite some new studies (e.g., Beckwith et al, 2022;Schuengel et al, 2021), relatively little still remains known about the reception of developmental attachment research among non-attachment researchers in applied and clinical areas, such as public health, child and adolescent psychiatry and developmental health sciences. The need for better understanding of this reception has been highlighted through calls by attachment researchers and commentators for stock-taking regarding the current and potential relevance and contributions of attachment research to the rest of the clinical and developmental sciences (e.g., Behrens, 2021;Thompson et al, 2021;Waters et al, 2021).…”

Adoptive parents’ satisfaction with child and adolescent mental services and their mental health concerns over time: A question of fit?

“…One question that follows from this is what adoptive parents meant by “attachment concerns”? It is likely to vary considerably, as we already know that practitioners vary considerably in how they conceptualise what attachment means applied to clinical settings (Beckwith et al, 2022), but also regarding what the appropriate services are for attachment problems (Woolgar & Baldock, 2015; Wright et al, 2023). It seems reasonable to expect that adopters’ own understanding of attachment concerns, interacting with the variation in understanding present in clinical services is likely to lead to significant mismatches between parental expectations around attachment concerns, and the services offered, something that has been hypothesised previously as driving adopters’ dissatisfaction; namely that therapists blame the parents for the current problems and, conversely adoptive parents have difficulties trusting therapists who do not take the child’s history into account (Barth et al, 2005).…”

Matters of Significance

“…A misleading and potentially damaging translation of science to practice is the application of attachment measures in clinical and social work assessments or diagnostics and family court proceedings (Hammarlund et al, 2022). A common misunderstanding is the idea that attachment instruments that are valid at the group level can also be used to draw conclusions about individual children or caregivers (Beckwith et al, 2022;Forslund et al, 2022). Several attachment measures can be validly used in group-level research because they fulfil the essential psychometric criteria of reliability and validity (see, e.g., the Adult Attachment Interview, .…”