Attachment-based family therapy is an empirically supported, manualized treatment spanning over 15 years of research and clinical practice. Increasingly, research and clinical evidence emphasize the modification of family therapy models to meet the needs of diverse clients. Best practices require culturallysensitive therapists to attend to issues of race, gender identity, sexual orientation, ethnicity, class, and ability. The ABFT model has been evolving to address the health disparities associated with marginalization and attend to the specialized needs of diverse families. This clinical case study demonstrates how ABFT clinicians must adopt an intersectional approach to be successful in building and sustaining relational repair. Transcripts from a case with a religious, African-American family and their bisexual daughter outline the structure and sequence of ABFT. An analysis of this case illustrates the impact of intersectionality on clinical processes and mechanisms of change.
KEYWORDSAdolescents; attachment; bisexuality; family therapy aims to repair interpersonal ruptures in parent/caregiver-child relationships. ABFT is designed to improve a family's capacity for affect regulation, interpersonal problem solving, and negotiation of attachment and autonomy. These improved capacities strengthen family cohesion creating a buffer against depression, suicidal thoughts, and risky behaviors (Garber, Robinson, & Valentiner, 1997;Restifo & Bögels, 2009). Once relationship ruptures are repaired, the later stages of treatment emphasize autonomybuilding and identity development. ABFT was designed specifically to address adolescent depression, suicide, and trauma and has been adapted to be used with other populations. ABFT has evolved over 15 years of research evaluating its efficacy, effectiveness, processes, and mechanisms of change .