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==Use of Bowlby's Theory in Practice== ==Use of Bowlby's Theory in Practice==
Bowlby‘s ] looms large as a well-researched explanation of infant and toddler behavior and in the field of ]. It is hard to imagine any therapeutic work with an infant or toddler that is not about attachment, since dealing with that issue has been shown to be an essential developmental task for that age period. For older children, attachment theory‘s clinical application is more indirect. Many if not most contemporary clinicians treating troubled children and families are informed by attachment theory but deal with attachment as an emergent property in family relationships, one that needs monitoring, counseling and instruction (primarily for parents) rather than therapy. Relatively few clinicians have tried to treat presenting attachment problems or issues as if they are symptomatic of a mental disorder of the child (such as ], which is generally deemed to be very uncommon). Bowlby‘s ] looms large as a well-researched explanation of infant and toddler behavior and in the field of infant mental health. As a consequence, it is hard to imagine any therapeutic work with an infant or toddler that is not about attachment, since dealing with that issue has been shown to be an essential developmental task for that age period. For older children, attachment theory‘s clinical application is more indirect. Several evidence-based and effective treatments are based on ] including Theraplay and ](Becker-Weidman & Shell, 2005). Nearly all mainstream programs for the prevention and treatment of disorders of attachment ] use ]. For example, the Circle of Security Program, (Dr. Robert Marvin, University of VA) is one such early intervention program with demonstrated effectiveness. Dr. Marvin and Dr. Siegel (University of California) both also endorse ] Other promising treatment methods are not particularly controversial, but remain under clinical investigation, for example, the Circle of Security Program of Dr. Robert Marvin at the University of Virginia. Still others have disclosed an apparently sound evidence base and are fully informed by attachment theory; ''Developmental, Individual-difference, Relationship-based'' therapy (DIR or ''Floor Time'') by ]. (Mercer, p. 123) Another such program is ] (Becker-Weidman, A., & Shell, D., (Eds.) 2005).


Following Bowlby‘s leads, a few established child-development researchers suggested developmentally appropriate mental health interventions to sensitively foster emotional relationships between young children and adults. These approaches used tested techniques which were not only congruent with ], but with other established principles of ]. Among such researchers contemporarily are ] (parent education), ] (”Floor Time“), ] (autonomous states of mind), ] (”Circle of Security“), ] (intergenerational communication of trauma), and ] (”Safe Start Initiative“). Following Bowlby‘s leads, a few established child-development researchers and practitioners in the field suggested developmentally appropriate mental health interventions to sensitively foster emotional relationships between young children and adults. These approaches used tested techniques which were congruent with ] and other established principles of child development. Among such researchers and practitioners contemporarily are Alicia Lieberman (parent education), ] (”Floor Time“), Mary Dozier (autonomous states of mind), Robert Marvin (”Circle of Security“) endorses also ] deveoped by Daniel Hughes, Ph.D., Daniel Schechter (intergenerational communication of trauma), Phyllis Jernberg ("Theraplay"), and Joy Osofsky (”Safe Start Initiative“).


'''Dyadic developmental psychotherapy''' is an evidence-based treatment(1) approach for the treatment of ] and ]. Children who have experienced pervasive and extensive trauma, neglect, loss, and/or other dysregulating experiences can benefit from this treatment. Dyadic Developmental Psychotherapy is based on principles derived from ] and Research; see the work of ]. The treatment meets the standards of the American Professional Society on Child Abuse, The American Academy of Child Psychiatry, American Psychological Association, American Psychiatric Association, National Association of Social Workers, and various other groups' standards for the evaluation and treatment of children and adolescents. This is a non-coercive treatment.
A small number of clinicians presented proprietary interventions for sundry mental-health issues of children, often focusing on attachment. These approaches often used unresearched or under-researched techniques and ignored the cognitive element that Bowlby recognized as essential, especially for older children. As a consequence, the interventions generated little enthusiasm among researchers familiar with Bowlby‘s theories. Controversy also dogged these interventions because of their lack of congruence with established child-development principles, difficulties with accurate assessment of attachment, use of unsubstantiated diagnoses, and weak scientific evidence. Some developers of these proprietary interventions made particularly strong statements about their evidentiary bases but did not publish either Level I material or well-designed Level II material to support their claims, providing only weak Level II evidence without replication from any independent source. (see ])

Various organizations have adopted standards against the use of coercive interventions: APSAC, the American Academy of Child and Adolescent Psychiatry, the ], the ], the ]. Actually, all of the aforementioned organizations have adopted formal statements (in some cases practice parameters) opposing the coercive treatments. Recognized professional organizations have been unanimous in recommending against the use of coercive treatments. The approaches mentioned in the previous paragraph, ], and Theraplay being non-coercive approachs, meet these standards as evidenced by the support of ] by Dr. Daniel Siegel of the University of California at LA medical school and author of The Developing Mind, and Dr. Robert Marvin of the University of Virginia, among many other articles and books.

A task force of the ] (APSAC) concluded in 2006 that the controversial therapies contrast to traditional theories like Bowlby's by "commonly assert that their therapies, and their therapies alone, are effective for children with attachment disorders and that more traditional treatments are either ineffective or harmful". Instead of following Bowlby or accepted child development principles, these approaches encourage children to regress to an earlier age where trauma has been experienced, and such age regression is, according to APSAC, "contraindicated because of risk of harm and absence of proven benefit and should not be used." (APSAC, pp. 79,86) However, this quote does not refer to ], Theraplay, or the previously referenced approaches. The task force's conclusions were endorsed by APSAC as a whole and by the Child Abuse Section of the American Psychological Association.


==See also== ==See also==


]
]


]
]


] ]


]
==Bibliography==
* Bowlby, J. (1969,1982) ''Attachment'' . London: Hogarth Press; New York, Basic Books; Harmondsworth, UK: Penguin (1971). ISBN 0465005438.
* Bowlby, J. (1973) ''Separation: Anxiety & Anger'' . London: Hogarth Press; New York: Basic Books; Harmondsworth: Penguin (1975). ISBN 0465097162.
* Bowlby, J. (1980) ''Loss: Sadness & Depression'' . London: Hogarth Press; New York: Basic Books; Harmondsworth: Penguin (1981). ISBN 0465042376.
* Bowlby, J. (1988) ''A Secure Base: Parent-Child Attachment and Healthy Human Development''. London: Routledge; New York: Basic Books. ISBN 0415006406.
* Bretherton, I. (1992) "The origins of attachment theory". ''Developmental Psychology'', 28:759-775.
* Greenspan, S. (1993) ''Infancy and Early Childhood''. Madison, CT: International Universities Press. ISBN 0823626334.
* Holmes, J. (1993) ''John Bowlby and Attachment Theory''. London: Routledge. ISBN 041507729X.
* Siegler R., DeLoache, J. & Eisenberg, N. (2003) ''How Children develop''. New York: Worth. ISBN 1572592494.


==Selected bibliography==
==External Links==
* American Professional Society on the Abuse of Children (APSAC). (2006) Report of the APSAC Task Force on Attachment Therapy, Reactive Attachment Disorder, and Attachment Problems. ''Child Maltreatment''. Feb;11(1):76-89.
*
* Becker-Weidman, A., & Shell, D., (Eds.) (2005), ''Creating Capacity for Attachment'' Wood N Barnes, Oklahoma City, OK. ISBN 1885473729
*
* Bowlby, J. (1960) Separation anxiety. ''International Journal of Child Psychoanalysis'' 4t: 89-113.

* Bowlby, J. (1973) ''Separation: Anxiety & Anger''. Vol. 2 of'' Attachment and loss'' London: Hogarth Press; New York: Basic Books; Harmondsworth: Penguin (1975).
]
* Cassidy, J., & Shaver, P., (Eds.), ''Handbook of Attachment Theory Research and Practice'', NY: Guilford Press. ISBN 157230-087-6
* Greenspan, S. (1993) ''Infancy and Early Childhood''. Madison, CT: International Universities Press. ISBN 0823626334.
* Holmes, J. (1993) ''John Bowlby and Attachment Theory''. Routledge; ISBN 0415077303
* Mercer, J. (2006) ''Understanding Attachment: Parenting Child Care, and Emotional Development''. Westport, CT: Praeger. ISBN 0-275-98217-3.
* Robertson, James and Joyce (1989) "Separation and the Very Young" Free Association Books
* Zeanah, C., (Ed.) (1993) ''Handbook of Infant Mental Health''. Guilford Press, NY; ISBN 0898629969 ]
] ]
] ]

]
]
]
]

Revision as of 12:19, 27 May 2006

John Bowlby (1907 - 1990) was a British psychologist, notable for his pioneering work in attachment theory.

Background

John Bowlby was born in 1907 in London to an upper-middle-class family. He was the fourth of six children and was raised by a nanny in traditional English fashion of his class. His father, Sir Anthony Bowlby, second Baronet Bowlby, was a surgeon with a tragic history; at age five, his own father (John's grandfather) had been killed while serving as a war correspondent in the Anglo-Chinese Opium War. Normally, John saw his mother only one hour a day after teatime. During the summer she was more available. She thought that spoiling her children was dangerous, so that attention and affection was the opposite of what was required. When Bowlby was almost four years old, his beloved nanny, who was his primary caretaker, left the family. Later, he was to describe this as tragic as the loss of a mother.

At the age of seven he was sent off to boarding school. His later work, for example Separation: Anxiety and Anger, revealed that he regarded it as a terrible time for him. Because of such experiences as a child, he had an unusual sensitivity to children’s suffering during his entire life.

In 1990 Bowlby dead at age of 83. His lifelong devotion and sensitivity to questions of separation, loss, and mourning aren’t surprising given his history. Until today his work has been greatly appreciated. He had four children; Mary, Richard, Pia and Robert. Sir Richard Bowlby is fourth Baronet Bowlby.

Career

John Bowlby’s intellectual career started at the University of Cambridge, were he studied psychology and pre-clinical sciences. He won prizes for outstanding intellectual performance. After Cambridge he took some time to work with maladjusted and delinquent children, then at the age of twenty-two enrolled at University College Hospital in London. At the age of twenty-six he qualified in medicine. While still in medical school he also found time to enroll himself in the Institute for Psychoanalysis. After graduation of medical school he went off to train in adult psychiatry at the Maudsley Hospital. In 1937, he qualified as a psychoanalyst. Because of his former work with maladapted and delinquent children, he became interested in the development of children and began work at the Child Guidance Clinic in London.

Bowlby was interested in finding out the actual patterns of family interaction involved in both healthy and pathological development. He focused on how attachment difficulties were transmitted from one generation to the next. The three most important experiences for Bowlby’s future work and the development of attachment theory were his work with:

  • Maladapted and delinquent children.
  • James Robertson (in 1952) in making the documentary film ‘A Two-Year Old Goes to the Hospital’, which was one of the films about ”young children in brief separation“. The documentary illustrated the impact of loss and suffering experienced by young children separated from their primary caretakers.

The most famous and enduring work of John Bowlby was about attachment styles of infants with primary caretakers (see attachment theory). In his view, attachment behavior was an evolutionary survival strategy for protecting the infant from predators. According to him, initial development of attachment takes place in four phases. Mary Ainsworth, a student of Bowlby’s, extended and tested his ideas.

Use of Bowlby's Theory in Practice

Bowlby‘s attachment theory looms large as a well-researched explanation of infant and toddler behavior and in the field of infant mental health. As a consequence, it is hard to imagine any therapeutic work with an infant or toddler that is not about attachment, since dealing with that issue has been shown to be an essential developmental task for that age period. For older children, attachment theory‘s clinical application is more indirect. Several evidence-based and effective treatments are based on attachment theory including Theraplay and Dyadic Developmental Psychotherapy(Becker-Weidman & Shell, 2005). Nearly all mainstream programs for the prevention and treatment of disorders of attachment attachment disorder use attachment theory. For example, the Circle of Security Program, (Dr. Robert Marvin, University of VA) is one such early intervention program with demonstrated effectiveness. Dr. Marvin and Dr. Siegel (University of California) both also endorse Dyadic Developmental Psychotherapy Other promising treatment methods are not particularly controversial, but remain under clinical investigation, for example, the Circle of Security Program of Dr. Robert Marvin at the University of Virginia. Still others have disclosed an apparently sound evidence base and are fully informed by attachment theory; Developmental, Individual-difference, Relationship-based therapy (DIR or Floor Time) by Stanley Greenspan. (Mercer, p. 123) Another such program is Dyadic Developmental Psychotherapy (Becker-Weidman, A., & Shell, D., (Eds.) 2005).

Following Bowlby‘s leads, a few established child-development researchers and practitioners in the field suggested developmentally appropriate mental health interventions to sensitively foster emotional relationships between young children and adults. These approaches used tested techniques which were congruent with attachment theory and other established principles of child development. Among such researchers and practitioners contemporarily are Alicia Lieberman (parent education), Stanley Greenspan (”Floor Time“), Mary Dozier (autonomous states of mind), Robert Marvin (”Circle of Security“) endorses also Dyadic Developmental Psychotherapy deveoped by Daniel Hughes, Ph.D., Daniel Schechter (intergenerational communication of trauma), Phyllis Jernberg ("Theraplay"), and Joy Osofsky (”Safe Start Initiative“).

Dyadic developmental psychotherapy is an evidence-based treatment(1) approach for the treatment of attachment disorder and reactive attachment disorder. Children who have experienced pervasive and extensive trauma, neglect, loss, and/or other dysregulating experiences can benefit from this treatment. Dyadic Developmental Psychotherapy is based on principles derived from Attachment Theory and Research; see the work of Bowlby. The treatment meets the standards of the American Professional Society on Child Abuse, The American Academy of Child Psychiatry, American Psychological Association, American Psychiatric Association, National Association of Social Workers, and various other groups' standards for the evaluation and treatment of children and adolescents. This is a non-coercive treatment.

Various organizations have adopted standards against the use of coercive interventions: APSAC, the American Academy of Child and Adolescent Psychiatry, the American Psychological Association, the American Psychiatric Association, the National Association of Social Workers. Actually, all of the aforementioned organizations have adopted formal statements (in some cases practice parameters) opposing the coercive treatments. Recognized professional organizations have been unanimous in recommending against the use of coercive treatments. The approaches mentioned in the previous paragraph, Dyadic Developmental Psychotherapy, and Theraplay being non-coercive approachs, meet these standards as evidenced by the support of Dyadic Developmental Psychotherapy by Dr. Daniel Siegel of the University of California at LA medical school and author of The Developing Mind, and Dr. Robert Marvin of the University of Virginia, among many other articles and books.

A task force of the American Professional Society on the Abuse of Children (APSAC) concluded in 2006 that the controversial therapies contrast to traditional theories like Bowlby's by "commonly assert that their therapies, and their therapies alone, are effective for children with attachment disorders and that more traditional treatments are either ineffective or harmful". Instead of following Bowlby or accepted child development principles, these approaches encourage children to regress to an earlier age where trauma has been experienced, and such age regression is, according to APSAC, "contraindicated because of risk of harm and absence of proven benefit and should not be used." (APSAC, pp. 79,86) However, this quote does not refer to Dyadic Developmental Psychotherapy, Theraplay, or the previously referenced approaches. The task force's conclusions were endorsed by APSAC as a whole and by the Child Abuse Section of the American Psychological Association.

See also

Reactive attachment disorder

Attachment theory

Attachment disorder

Dyadic Developmental Psychotherapy

Selected bibliography

  • American Professional Society on the Abuse of Children (APSAC). (2006) Report of the APSAC Task Force on Attachment Therapy, Reactive Attachment Disorder, and Attachment Problems. Child Maltreatment. Feb;11(1):76-89.
  • Becker-Weidman, A., & Shell, D., (Eds.) (2005), Creating Capacity for Attachment Wood N Barnes, Oklahoma City, OK. ISBN 1885473729
  • Bowlby, J. (1960) Separation anxiety. International Journal of Child Psychoanalysis 4t: 89-113.
  • Bowlby, J. (1973) Separation: Anxiety & Anger. Vol. 2 of Attachment and loss London: Hogarth Press; New York: Basic Books; Harmondsworth: Penguin (1975).
  • Cassidy, J., & Shaver, P., (Eds.), Handbook of Attachment Theory Research and Practice, NY: Guilford Press. ISBN 157230-087-6
  • Greenspan, S. (1993) Infancy and Early Childhood. Madison, CT: International Universities Press. ISBN 0823626334.
  • Holmes, J. (1993) John Bowlby and Attachment Theory. Routledge; ISBN 0415077303
  • Mercer, J. (2006) Understanding Attachment: Parenting Child Care, and Emotional Development. Westport, CT: Praeger. ISBN 0-275-98217-3.
  • Robertson, James and Joyce (1989) "Separation and the Very Young" Free Association Books
  • Zeanah, C., (Ed.) (1993) Handbook of Infant Mental Health. Guilford Press, NY; ISBN 0898629969
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