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Revision as of 11:13, 11 May 2007

Psychology NA‑class

This page is within the scope of WikiProject Psychology, a collaborative effort to improve the coverage of Psychology on Misplaced Pages. If you would like to participate, please visit the project page, where you can join the discussion and see a list of open tasks.PsychologyWikipedia:WikiProject PsychologyTemplate:WikiProject Psychologypsychology NA This page does not require a rating on Misplaced Pages's content assessment scale.

This article was nominated for deletion on July 9 2006. The result of the discussion was no consensus.

The subject of this article is controversial and content may be in dispute. When updating the article, be bold, but not reckless. Feel free to try to improve the article, but don't take it personally if your changes are reversed; instead, come here to the talk page to discuss them. Content must be written from a neutral point of view. Include citations when adding content and consider tagging or removing unsourced information.

Please stay calm and civil while commenting or presenting evidence, and do not make personal attacks. Be patient when approaching solutions to any issues. If consensus is not reached, other solutions exist to draw attention and ensure that more editors mediate or comment on the dispute.

POV concerns

This article appears to be an essay. Consider the following sections:

• An analysis of the actual theoretical basis of Attachment Therapy would be inappropriately lengthy )see mercer, 2003), but there are clear connections between AT and such psychoanalytic outliers as Fernczi, Groddeck, Rank, and Reich,all of whom emphasized the role of very early experience and considered physical interaction part of therapy.

• In every case, the evidencepresented has failed to meet the criteria for evidence-based treatment (see Mercer, 2002). The most serious problem of these studies has involved the confounding of variables created by self-selection of treatment and comparison groups.

• From the recently-deleted "Conclusions" section: Attachment Therapy, with the characteristics described above, are not appropriate otr effective mental health interventions for children. It should be noted that most conventional psychotherapies for children work with social relationships and with parent-child interactions and thus are effective techniques for dealing with problems of attachment where they exist.

All of this appears to violate Misplaced Pages's neutral point of view and original research policies. WP:OR says this kind of writing is probably not acceptable: It introduces an analysis or synthesis of established facts, ideas, opinions, or arguments in a way that builds a particular case favored by the editor, without attributing that analysis or synthesis to a reputable source... I'd suggest that someone who knows more about the subject clean it up to make it more balanced. Aplomado 22:34, 8 July 2006 (UTC)

Does this mean that no article on Misplaced Pages can reject a dangerous or inappropriate practice-- that "pseudosymmetry" is a requirement?

As for sources, in this case, I, the author, am a reputable source, and I have cited my own work. I just didn't finish typing out all the references yet. Jean Mercer

Misplaced Pages can't "reject" anything. It's an encyclopedia, not a place to publish essays that draw conclusions. If there are people out there who say that this is a dangerous practice, then you can point that out and cite it using verifiable sources. However, Misplaced Pages is not a publisher of original thought or essays. You can include information from public and verifiable work, but you cannot draw conclusions from them. Aplomado 00:04, 9 July 2006 (UTC)

This page should be completely deleted. It is written by a member of a fringe group, ACT whose leaders include mercer, sarner, and rosa. They are not interested in a NPVO. Alternative pages exist that address issues surrounding the diagnosis and treatment of children and teens, those with attachment issues, attachment disorder, and resarch in the area of attachment. DPeterson 00:08, 9 July 2006 (UTC)

I didn't ask whether Wiki could reject things-- I asked whether an article can do so, or whether the principle to follow is pseudosymmetry, the practice of appearing to present a balance of information when no such balance exists.I am a legitimate scholar and can provide a good deal of evidence to that effect, as i believe Mr. Peterson will see if he consults Google, which he should do before dismissing my comments. I would like to inquire of "Aplomado" why it is acceptable for an article to state that a practice has an evidentiary basis, but not acceptable for me to state that it does not? Surely both statements draw conclusions, although they don't stress that that's what they're doing. Jean Mercer

The problem with what you're doing is that you're saying Source A says this (which is acceptable), Source B says this (which is acceptable), so therefore I come to Conclusion C (not acceptable). If you have a source that can back up your conclusion in the same way you backed up your premises, then this would be acceptable. You can't cite yourself, I'm afraid, unless you have a published work to that effect.

Also, as DPeterson noted, "attachment therapy" has already been addressed at "Attachment disorder." Is there a reason why we need a seperate article? Aplomado 00:29, 9 July 2006 (UTC)

In Attachment therapy is already in existance. One final point, mercer is not a licensed mental health professioal nor a clinician, so while mercer may have some knowledge, mercer is not a professional therapist with experience in this area. DPeterson 01:00, 9 July 2006 (UTC)

• • I have completed the reference list, as I said I would do when i had to stop yesterday. As you will see, where I cite myself, the material has been published, so the statements may be original to me, but they are not original to this article.

Now, Mr. Peterson, I must say that your arguments are not at all what I expected them to be. You say that there is already a discusssion of Attachment Therapy, but the only treatments discussed as far as I can see are Theraplay and DDP. You also take my comments on the connection between Bowlby's theory and Attachment Therapy and comment on them with respect to DDP. This would seem to indicate that you acknowledge DDP to be a form of Attachment Therapy as I've defined it in this article. If this is the case, I wonder whether you want to continue to defend these forms of treatment. If it is not the case, you will surely have to acknowledge that the topic of Attachment Therapy is not covered elsewhere in Misplaced Pages and that therefore there is a reason for this article.

Perhaps the best way to proceed here would be for you to state your definition of Attachment Therapy and to say whether you consider DDP to belong to the group of treatments as I have defined them here or as you define them yourself. That should help establish some rationale for inclusion or exclusion of the topic. Jean Mercer 13:59, 9 July 2006 (UTC)

This article has been largely taken over by Attachment Therapy proponents to whitewash their unvalidated practices. Please refer to the article on Quackwatch, the APSAC Task Force on Attachment Therapy, and childrenintherapy.org for accurate information. Particularly helpful are the latter's quotes pages where Attachment Therapists say more about how abusive AT is than any critic could. -- Health Consumer Advocate 8/31/06

The article is much improved now that a broad range of people have had an opportunity to edit and comment. I disagree with the previous comment. While the APSAC task force has many importnat things to say, it does not support the previous commentor's thesis. Quackwatch and Advocates for Children in Therapy are two closely related fringe groups that lack credibility, unlike APSAC. DPeterson 23:34, 31 August 2006 (UTC)

To correct an error in the comment by the previous editor, the APSAC Task force did not comment on "Attachment Therapy." The APSAC report does not describe "Attachment Therapy", it uses the term "attachment therapy" (no caps or quotation marks). They state, “The terms attachment disorder, attachment problems, and attachment therapy, although increasingly used, have no clear, specific, or consensus definitions. Pg 77 Furthermore, what seems to be focus of this proposed page only addresses a very narrow area, “Controversies have arisen about potentially harmful attachment therapy techniques used by a subset of attachment therapists.” Pg 76 Attachment therapy is better discussed in context, especially if the focus is on “a particular subset of attachment therapy techniques developed by a subset of attachment therapy practitioners” pg 77. The controversy is a narrow one and should be placed in context so that readers understand the full range of issues. “ The attachment therapy controversy has centered most broadly on the use of what is known as “holding therapy” (Welch, 1988) and coercive, restraining, or aversive procedures such as deep tissue massage, aversive tickling, punishments related to food and water intake, enforced eye contact, requiring children to submit totally to adult control over all their needs, barring children’s access to normal social relationships outside the primary parent or caretaker, encouraging children to regress to infant status, reparenting, attachment parenting, or techniques designed to provoke cathartic emotional discharge” pg 83. I hope this helps clarify the issues and clear up any misunderstanding or misconceptions. DPeterson 23:37, 31 August 2006 (UTC)

Blanking the article

Isn't there a procedure for requesting the deletion of an article? Just blanking it, as "DPeterson" did, is an act of vandalism. (He has, I believe, committed other acts of vandalism, and has been warned.)

Yes, there is a need for a separate article. Attachment Therapy (note the proper name) is a separate phenomenon, especially in the United States. It is the subject of white papers and position statements by professional organizations. In addition to therapy, it encourages certain readily distinguishable child discipline (or parenting, or "teaching") techniques. It has been noticed by the media, prosecutors, and legislatures (including Congress).

Dr Mercer's original attempt at an article may indeed be more of an essay than an encyclopedic article, and consequently needs some work. I, and possibly others, would like to do that, but it should remain up for that purpose. I think the notices placed by Aplomado do more than enough to alert readers to the article's tentative editing state. We should be allowed to work on it.

I also want to protest the personal attacks here by DPeterson, who is possibly a sock puppet of Dr Becker-Weidman (they at least share the same IP address, 68.66.160.228). Attacking anyone's affiliations is specifically mentioned as a personal attack. Attacking anyone's right to comment or edit based on their alleged lack of clinical experience is diametrically opposed to Wiki philosophy. I (and separately, Dr Mercer) have had to put up with such boorishness elsewhere, but I'm going to have zero tolerance for it here, and will protest it immediately to Wiki administrators.

Larry Sarner 03:45, 9 July 2006 (UTC)

There already exits articles Attachment therapy Attachment disorder etc. This page is irrelevant and is being used as a forum for a fringe group, ACT, of which mercer and sarner are leaders. There was discussion and comment that this article was not Misplaced Pages appropriate. Larry Sarner continues to pursue personal attacks and is now taking his firght elsewhere since his attacks on the Bowlby page are not having the result he wants. His continued disrespect of Dr. Becker-Weidman and allegations that I am a "sock-puppet" when that has been shown to be false is clearly antagonistic and diametrically opposed to Misplaced Pages philosophy. It is a fact that neither Larry Sarner nor Mercer are clinicians, licensed mental health professionals, and have no clinical experience. DPeterson 04:30, 9 July 2006 (UTC)

• Turning a page into a redirect isn't the same as "blanking." Nevertheless, I strongly recommend that this article be listed at Misplaced Pages:Articles for deletion so that some consensus can be reached. Aplomado 07:11, 9 July 2006 (UTC)
  • Never mind, I'll list it myself. Aplomado 07:17, 9 July 2006 (UTC)

Shameful

Well, if the article survives, I suggest that the editors here obtain a copy of the full-text of the PubMed study I included, and simply refute any misinformation with the facts. This article reads like many of its nature: they include all kinds of medical references, which may have nothing to do with the price of beans in China, but make the topic appear to have medical respectability. The way to put out *accurate* information is to get the study, and quote it. Sandy 01:26, 10 July 2006 (UTC)

• Well then, why don't you do that? Be bold. Aplomado 01:29, 10 July 2006 (UTC)

Your additions are good. The reference is excellent...improves the article. DPeterson 21:41, 10 July 2006 (UTC)

Clean Up

Most of what was on this page is on other pages. The Also See links can bring readers to those related pages. Also tried to make this article more appropriately neutral in its point of view. DPeterson 20:29, 16 July 2006 (UTC)

I reverted your edits because all you did was axe 90% of the article. It would be far more beneficial if you instead added balance to the article by, perhaps, adding a criticism section that cites verifiable sources since this seems to be a controversial subject. Just chopping out large chunks of text you don't like doesn't really help the situation and is probably just going to provoke an edit war. Aplomado 00:29, 17 July 2006 (UTC)

I have added material and tried to present additional information to present a NPOV on this very controversail topic. I believe the notices remain relevant as there is still dispute about this article (see the page comments on whether or not not to maintain the page. Since no consensus was reached on that, the page remains in dispute, therefore the notices are relevant, I think). In fact, most of the comments were against this being a separate page. DPeterson 02:25, 17 July 2006 (UTC)

The APSAC report does not describe "Attachment Therapy", it uses the term "attachment therapy" (no caps). They state, “The terms attachment disorder, attachment problems, and attachment therapy, although increasingly used, have no clear, specific, or consensus definitions. Pg 77 Furthermore, what seems to be focus of this proposed page only addresses a very narrow area, “Controversies have arisen about potentially harmful attachment therapy techniques used by a subset of attachment therapists.” Pg 76 Attachment therapy is better discussed in context, especially if the focus is on “a particular subset of attachment therapy techniques developed by a subset of attachment therapy practitioners” pg 77. In which case, the material would belong on the existing pages, attachment therapy or Attachment therapy, which redirect the reader to Attachment disorder. The controversy is a narrow one and should be placed in context so that readers understand the full range of issues. “ The attachment therapy controversy has centered most broadly on the use of what is known as “holding therapy” (Welch, 1988) and coercive, restraining, or aversive procedures such as deep tissue massage, aversive tickling, punishments related to food and water intake, enforced eye contact, requiring children to submit totally to adult control over all their needs, barring children’s access to normal social relationships outside the primary parent or caretaker, encouraging children to regress to infant status, reparenting, attachment parenting, or techniques designed to provoke cathartic emotional discharge” pg 83.

To include the full range of issues on this proposed page would then have to duplicate material on the previously cited Misplaced Pages articles or duplicate the APSAC report. A better solution would be to include a reference and brief description of the controversy on the previously mentioned page with a link to the APSAC report for details 'DPeterson 02:29, 17 July 2006 (UTC)'

OK, I'll leave the tags up. As for the capitalization, I tried to move it to "attachment therapy", but that has already been made into a redirect page. I may at some point in the future nominate that redirect for deletion so this page can be moved there. That way we can preserve the article history.

I honestly don't see your point on "duplicate material." I have found very little of the information in this article, if any, in the articles mentioned. If I'm missing something, feel free to point it out. However, I'd advise not turning this article into a redirect unless a consensus for deletion is reached, which we haven't accomplished yet. Aplomado 00:03, 18 July 2006 (UTC)

I removed the original research tag. I put it up there originally because the author drew conclusions that were not cited, but the offending statements have since been removed so I don't think it applies anymore. I've left up the NPOV tag out of respect to the editors who still have a problem with the article, and I've left the wikify tag because the article could use some editing. Aplomado 00:06, 18 July 2006 (UTC)

I see--- Attachment Therapy, capital A, capital T, is something that doesn't exist any more? But it must have at one time; Hughes said so (and so did Cline, Hage, Levy, Keith Reber, etc.). So I assume there will be no problem about a historical overview of these practices, which is certainly not included in any other topic? And I also assume that everyone contributing here objects to those old adjuvant practices such as withholding food or forcing food or water consumption? Or is there a POV problem, so that you'd all like to see discussion of the bright side of child starvation? (I know at least one of you has read Nancy Thomas, because he used to have a link to her material on his web site.) Jean Mercer 21:26, 18 July 2006 (UTC)

Mercer, your snide comments are not relevant or helpful to this discussion. Your position as a spokesperson and leader of what some might call a fringe group, ACT, Advocates For Children in Therapy, may lead you to want to tar everyone who practices what your group considers evil...but the fact is that there is no "Attachment Therapy" as a field in the CPT code book or DSM or related texts. The literature I read discusses it as "attachment therapy." Additionally, to use past and old material to "discredit" is not professional. If you feel it is ok to do that, than I suppose you might feel it would be ok to continue to raise the fact that a cancer surgeon did "radicals" as a matter of course in treating breast-cancer (ten years ago, even though that is no longer part of the practice)? You do recognize that practice and practices change, don't you? Historical reviews, when relevant, are appropriate. When used for other purposes, it is not relevant...unless the author has some specific agenda; but that is not the purpose of an encyclopedia article; to argue points from a soapbox. RalphLender 21:37, 18 July 2006 (UTC)

Perhaps you'd like to tell us when Attachment Therapy ended? Or will you say it never existed because there was no code for it? If we could revert to my statement that this was/is a CAM practice, not in the mainstream, perhaps the intention of my original statements will be made clearer. Every edit and statement made here by certain users makes it appear more likely that they have something to gain by preventing the public from hearing any criticisms of physically intrusive treatments. A number of usernames have associated themselves with the view that there is no AT, maybe even that there never was, and therefore there's no need to discuss it-- what admirable motives could be associated with these actions? This obfuscation will certainly not bring dead children back to life, and it does make it more likely that there will be more deaths and injuries in the future. Why do it? Can you explain it either to me or to yourselves?Jean Mercer 12:51, 19 July 2006 (UTC)

As a spokesperson and leader of the "fringe group" (meaning a group not recognized by such professional groups as APA, AMA, NASW, etc) you make their points very clearly. Put into a section marked "criticism" and with a "NPOV of this section is disputed" it might be appropriate; at least I would not object, unless an administrator felt it inappropriate. SamDavidson 13:49, 19 July 2006 (UTC)

Others Comments

I would be interested in other contributor's and editor's comments about this topic. "Attachment therapy" is a broad name for a difuse range of interventions about which there is little agreement regading definition. For example, the AMA's CPT code book has nothing for this. In addtion, I know of no insurance company that covers "attachment therapy," primarily because it is not a "recognized" form of treatment in the same way that family therapy, Cognitive Behavioral Therapy, EMDR, and other forms of treatment are (having a recognized body of literature and practice). DPeterson 02:24, 17 July 2006 (UTC)

While I agree with you that the page may be redundant...it is now a fact of life and so I suggest focusing instead on helping make contributions so that the article is balanced, fair, and has a neurtal point of view. I have taken a step in that direction by explicitly making a distinction between "attachment therapy" as a coercive practice and more generally accepted methods. JohnsonRon 16:26, 17 July 2006 (UTC)

Balnced and fair-- yes, please. Will someone kindly add some material that supports the use of physical intrusiveness and denial of ordinary physical needs? That would be most interesting. As for insurance company coverage, generally the billing states a diagnostic category such as 313.89, which is said to be treated-- in psychotherapy without medication, there would usually be no statement of the specifics of the treatment. The insurance covers treatment of reactive attachment disorder, not a specific intervention. Jean Mercer 21:34, 18 July 2006 (UTC) 'Not correct.' If you were a licensed mental health provider you'd be aware that you must state put a procedure code, such as "family therapy" on the form. In addition, the regular periodic reviews for quality and utilization purposes require detailed explainations of the specifics of the treatment and modality being used. Insurance benefits may cover the diagnosis of Reactive Attachment Disorder, or not, and will also only cover certain specific treatments and modalities. RalphLender 21:40, 18 July 2006 (UTC)

The treatment code is extremely general, as you know. "Family therapy", for example, could cover anything from Minuchin to Martha Welch. But this is of course a red herring, aimed at evading the question about a fair and balanced presentation of abusive practices.Jean Mercer 12:42, 19 July 2006 (UTC)

You have not addressed the specific point about periodic reviews for qualitya nd utilization purposes. Please address that issue. RalphLender

Copyediting and NPOV

I made these edits today. Most were just some copyediting, but I removed a few statements that were showing the problems of their original author. For example:

• "The term (attachment therapy) would not be applicable to generally accepted and main-stream approaches to the treatment of children and adolescents and disorders of attachment. These accepted approaches used tested techniques which are not only congruent with attachment theory, but with other established principles of child development. In addition, nearly all mainstream approaches for the prevention and treatment of disorders of attachment disorder use attachment theory."

This is original research. It's acceptable to say "such and such says this is not an accepted approach to treating people with attachment disorder" and cite the appropriate source, but simply declaring it isn't acceptable.

• "As in any profession, individuals may practice outside the scope of their training and provide "treatment" that is not ethical. Medical malpractice is a problem in all disciplines and across many domanins of practice."

The basic implication here is that an ethical cloud hangs over attachment therapy, so it is ripe for abuse. That's a judgment call and it also requires a "such and such said this" and a source.

--Aplomado 00:28, 18 July 2006 (UTC)

However, Aplomado, it's an excellent judgment call. I don't know whether you are aware of the deaths and injuries that have resulted from the types of treatments I attempted to describe here under the term Attachment Therapy (which I used because the APSAC task force started a new practice of using attachment therapy, lc,lc, in a more general way.) There is a serious need for the public to know that these treatments have existed in the very recent past, and that they should be avoided in spite of seductive Internet advertising. Jean Mercer 21:39, 18 July 2006 (UTC) Inserting your comments 'out of order is very disruptive' to the flow of discussion. In the future, please add your comments at the 'end of a section or create a new section.' If you don't mind I may move your comments to the appropriate point. You may respond either here or on my talk page. A final point, advertising your group's views and agenda (Advocates for Children in Therapy) has a place, but perhaps not on this page or in Misplaced Pages articles. It is best done, as you have done, on your webpage. Please consider that as you make comments and suggestions DPeterson 00:35, 19 July 2006 (UTC)

Added citation and other material. The approaches listed as main stream all cite attachment theory as the basis for their work and congruence with many principles of child development that are generally accepted in the profession. What do you, Aplomado, think...OK?DPeterson 00:58, 18 July 2006 (UTC)

It's better, but I still have a couple problems with it.

• "Attachment therapy" is not a mainstream approach to treating children experiencing attachment disoder. The term is not applicable to generally accepted approaches to the treatment of children and adolescents with disorders of attachment. Treatment and prevention programs that use methods congruent with attachment theory and with well established principles of child development include: (etc.)

Saying things like "not applicable to generally accepted approaches" and "well established principles" really need a citation from a reputable organization or people are going to read over it and ask themselves "says who?"

• "Attachment therapy" treatments may be accompanied by parenting interventions that are coercive, painful or shaming.

Is there some way you can quote from some source on attachment therapy that the interventions are indeed "coercive, painful or shaming"? I see a book cite, but I don't have the book on hand so I can't verify it. Perhaps I'm too reliant on internet sources. Is there an excerpt from the book that you could include that would explain this attitude?

--Aplomado 01:12, 18 July 2006 (UTC)

APSAC report would support the idea that "attachment therapy" is not mainstream or accepted generally, as would the Amer Assoc of Child and Adol Psychiatry's report.

The treatment methods listed, such as Floor time, etc are the sources for the statement that they are congruent with attachment theory and child development principles.

There are no "attachment therapy" sources as there is no such discipline. The APSAC report talks about not using such interventions and parenting methods...The problem is that there is no such discipline as "attachment therapy" or "holding therapy" and so there really are not sources as there are for Cognitive Behavioral Therapy or Floor Time or Circle of Security or even Family Therapy. DPeterson 02:13, 18 July 2006 (UTC)

Added a few citation...better???DPeterson 02:25, 18 July 2006 (UTC)

Yeah I think that'll be fine for now. I really would like more editors to weigh in though at some point. Aplomado 02:52, 18 July 2006 (UTC)

Thanks. I just hope that when others contribute it is not the same group that created the problems on the Bowlby page as this topic is another area of interest to that group. DPeterson 12:14, 18 July 2006 (UTC)

Good points. I added some additional references. RalphLender 14:07, 18 July 2006 (UTC)

I believe one problem here is the distinction between "attachment therapy" and "Attachment Therapy." Certainly most child psychotherapies today are relationship-focused, and therefore may be called "attachment therapies" for short. "Attachment Therapy" (capital A, capital T) is a term that has been used specifically for the practices I described in my draft of this page. Whereas other topics deal with the lc-lc attachment therapies, I don't see any that address the capital A, capital T group. I can't imagine that the other users in this discussion are claiming that the therapies they discuss elsewhere employ coercion and "rage reduction" and that therefore those treatments are covered elsewhere. If they are claiming this, perhaps they'd like to add material to this draft, supporting the use of holding and similar practices.

Would a change of vocabulary cover the objections that are being raised? Suppose the topic were changed to Coercive Restraint Therapies, with Attachment Therapy listed as one of the possible names? I suggest this although there is in fact a "discipline" called Attachment Therapy, with an extensive literature published primarily by small printer-ready publishing houses. It would be a simple matter to add a considerable list of references of that type.

I believe it is a mistake to simply deny the existence of these practices. The state of Georgia, for instance, is offering training to social workers that includes the Attachment Therapy belief system. The useof coercive approaches with children appears to be growing, rather than shrinking, and I believe that professionals-- and Misplaced Pages itself-- have some obligations to contribute to accurate public knowledge in this area. Jean Mercer 14:02, 18 July 2006 (UTC)

I think it would be more beneficial to note how ambiguous the term "attachment therapy" is and note what falls under that umbrella. Aplomado 19:08, 18 July 2006 (UTC)

Describing how ambiguous is the term and how it is not one used generally to characterize an approach would be helpful for readers. What falls under that umbrella, then, would be unclear and stated as such, would provide a NPOV on the issue. RalphLender 20:45, 18 July 2006 (UTC)

APSAC report uses attachment therapy...there is 'no recognized term "Attachment Therapy"' (See CPT book or DSM IV or Bergin's text on Psychotherapy Outcome Research.) AT may be a term you and ACT uses, but it has no meaning in the mainstream professional literature.

"Coercive Restrain Therapies" is a term mercer coined, which, again, has no meaning in the professional literature and is not used among licensed mental health professionals. If you make statements you must support them...what is the basis for stating that the use of coercive treatments is growing? Other than what is stated on the Advocates for Children in Therapy page?RalphLender 14:07, 18 July 2006 (UTC)

That is true. The term "coercive restraing therapy" is not a term found in the literature on treatment, nor is it in the Bergin book. Dr. Arthur Becker-Weidman 18:19, 18 July 2006 (UTC)

Strange that you say that about AT, because Daniel Hughes used that term to refer to Foster Cline's methods in his 1998 book, where he spoke of those methods as acceptable if other things didn't work. The constant alteration of terms and definitions made me and others propose CRT as descriptive of the intervention, but AT is fine-- that's why I originally used it. I want this matter to be talked about because I believe the practice is harmful and undesirable. Perhaps you could explain why you don't want this message to be conveyed to the public? Or, if it's simply a matter of language, name a term that you can deal with, that covers the interventions I described in this little article. Jean Mercer 15:49, 18 July 2006 (UTC)

It is vital to maintain a 'NPOV' and that articles not become soapboxes for fringe groups or as venues for individuals to act as spokespersons for a particular group's point of view. Dr. Hughes recent publications provide a quite different presentation of material than his 1997 book. In addition, I don't believe the 1997 book, Facilitating Developmental Attachment describes Dyadic Developmental Psychotheray...I don't believe the name for the approach was coined till later. (Hughes, D., (2003). Psychotherapeutic interventions for the spectrum of attachment disorders and intrafamilial trauma. Attachment and Human Development 5-3, 271-279.) for a description of Dyadic Developmental Psychotherapy. RalphLender 16:19, 18 July 2006 (UTC)

Hughes also has an article in the 2004 issue of Attachment and Human Development. I'll look up that citation. Hughes, D. (2004). An attachment-based treatment of maltreated children and young people. Attachment & Human Development, 3, 263–278. 'Dr. Arthur Becker-Weidman 18:20, 18 July 2006 (UTC)'

That is more current. Practice and therapeutic approaches do change over time as new research and practice wisdom accumulates. RalphLender 18:33, 18 July 2006 (UTC)

Very good points. Current references are more useful than old ones. Practices do change and that must be recognized in any discussion. DPeterson 01:46, 19 July 2006 (UTC)

"Attachment Therapy" vs. "attachment therapy"

I must say that the distinction between "Attachment Therapy" and "attachment therapy" has me a bit confused. I found an explanation of "attachment therapy" by Arthur Becker-Weidman here: http://www.attachmentdisorder.net/Dr._Art_Treatment.htm. Among other things he says:

"Attachment therapy is the only form of treatment that is effective with trauma-attachment disordered children. It is the only "evidence-based" treatment, meaning that there has been research published in peer-reviewed journals. Attachment therapy is primarily an experiential-based treatment, designed to facilitate experiences of safety and security so that a secure attachment may grow."— Preceding unsigned comment added by IPaddress (talk • contribs) .

Is "attachment therapy" something that Becker-Weidman still practices? Or is this an outdated page? How does the "attachment therapy" described by Becker-Weidman differ from "Attachment Therapy"? There does appear to be something called "Attachment Therapy," as this person claims to have studied it: http://www.dianefeinberg.com/; and these people claim to offer an "Intensive Attachment Therapy Program": http://www.attachmenttherapy.com/. At the same time, a U.S. Senate Resolution, while specifically critizing "rebirthing," also notes that several children have died from other forms of "attachment therapy": http://salazar.senate.gov/images/pdf/051018%20Rebirthing%20Resolution%20Res%20276.pdf (see the third "whereas" clause on page 2 of the document.)— Preceding unsigned comment added by IPaddress (talk • contribs) .

I'm very confused. Could someone please enlighten me on this issue? — Preceding unsigned comment added by 69.170.233.237 (talk • contribs) -- Unsigned comments are not helpful for this disucssion. This person appears to have a somewhat suspect history. In fact most of this person's comments regard mercer and so could be that person or related in some way. This contributor may just be a sock-puppet for ACT, or not, but in any event this is suspect as it mirrors language by ACT and by the leaders of ACT.

The previous discussion elaborates that "Attachment Therapy is not a used term. "Attachment therapy is what the APSAC report refers to. Your quote of the article by Dr. Becker-Weidman is on a site and appears to be many years old, so its currency and value is unclear at this time. Probably a better references are his current articles and the book he co-edited, if you are wanted to cite his current thinking and practice. DPeterson 01:56, 19 July 2006 (UTC)

Furthermore, the comments are provocative and appear to be a soapbox harrangue. I suggest that such inflamatory comments be edited by an administrator. DPeterson 02:01, 19 July 2006 (UTC)

I'm not taking sides here. I just want to better understand this discussion. I am certainly not implying that Becker-Weidman's statements on the cited page are still his view. In fact, I specifically asked whether the page is "outdated."— Preceding unsigned comment added by IPaddress (talk • contribs) .

Ah, well it is outdated. Contact the site owner and this will be confirmed DPeterson 02:13, 19 July 2006 (UTC)

On what basis do you say that? — Preceding unsigned comment added by 69.170.233.237 (talk • contribs)

So, your remaining hidden does raise the spectre of your merely being a sock-puppet and spokesperson for mercer (or relative of mercer?), ACT, and other leaders of ACT; We just don't know. This practice of continually making accusations and going on and on with the same accusation is quite similiar to the tactic of other leaders of ACT on Wiki pages. DPeterson 02:21, 19 July 2006 (UTC)

As for remaining anonymous, due to the personal attacks that have been made as part of these topics, I'd rather stay that way.— Preceding unsigned comment added by IPaddress (talk • contribs) .

Anyway, if someone could clarify these issues it would be greatly appreciated. Clearly, if the U.S. Senate refers to people dying in "attachment therapy," it is a matter to be discussed. The current discussion seemed to a bit unfocused, and I was hoping that by raising these issues I could get some real dialogue going. The question is, what, precisely, are "attachment therapy" and "Attachment Therapy" as these terms have been used on the pages I linked to above? — Preceding unsigned comment added by 69.170.233.237 (talk • contribs)

Not U.S. Senate, but a private bill.

No, it's a resolution that was passed by the U.S. Senate: http://thomas.loc.gov/cgi-bin/bdquery/z?d109:SE00276:@@@L&summ2=m& (as noted at the link, "Passed Senate, without amendment") — Preceding unsigned comment added by 69.170.233.237 (talk • contribs)

I stand corrected. It refers to "rebirthing" which is a practice that no one accepts and which has no validity.DPeterson 02:21, 19 July 2006 (UTC)

Yes, but it also says: "Whereas between 1995 and 2005, at least 4 other children in the United States have died from other forms of attachment therapy;" Look, I don't mean to imply in any way that Becker-Weidman is harming children. I have no reason to think that he is, and I don't think he is. My question is just a request for clarification. What was it Becker-Weidman was talking about versus what the U.S. Senate is talking about? If it were me, and I had written a past article saying I use "attachment therapy", and the Senate later makes these statements, I would try to clarify. — Preceding unsigned comment added by 69.170.233.237 (talk • contribs) — Preceding unsigned comment added by IPaddress (talk • contribs) .

You are now misrepresenting the facts. The senate resolution speaks to "rebirthing." Show me anyting in Dr. Becker-Weidman's article or materials that promotes "rebirthing." I am sure you cannot. Your comments sound strikingly like those of sarner or other leaders of ACT. Using this forum as a soapbox is counter to the intention of Misplaced Pages and I encourage you to not use this as a platform to promote a provocative or fringe POV as that is not in the spirit of consensus building, which is a corner stone or Misplaced Pages. DPeterson 02:40, 19 July 2006 (UTC)

Yes, I know, the focus of the resolution is on "rebirthing." But it also says "Whereas between 1995 and 2005, at least 4 other children in the United States have died from other forms of attachment therapy;" What do they mean by "other forms of attachment therapy"? I don't know. I was just hoping someone could enlighten me.— Preceding unsigned comment added by IPaddress (talk • contribs) .

Just to be clear, I am not saying or implying that Becker-Weidman does anything that the Senate was referring to. I'm just trying to figure out what both are referring to when they use the term "attachment therapy." — Preceding unsigned comment added by 69.170.233.237 (talk • contribs)

So, your remaining hidden does raise the spectre of your merely being a sock-puppet and spokesperson for mercer (or relative of mercer?), ACT, and other leaders of ACT; We just don't know. DPeterson 02:13, 19 July 2006 (UTC)

Let's avoid making accusations of sock-puppetry. Assume good faith.

To IP Address 69.170.233.237, you need to sign your comments by putting ~~~~ at the end of your comments regardless. It's a requirement for talk pages. Aplomado 03:01, 19 July 2006 (UTC)

OK, sorry. I had seen other comments where people did not sign, so I didn't realize it was a rule. Anyway, I really would like some clarification here, so if anyone has thoughts they would be welcome. 69.170.233.237 03:07, 19 July 2006 (UTC)

Unless I am mistaken, I don't see anything inflammatory in the user's comments, and frankly I don't understand the implications of the terms myself. The article needs better writing to help the article make sense to a reader who is unfamiliar with the term. Aplomado 03:14, 19 July 2006 (UTC)

Yes, that seems to be the point. The terms have no generally accepted meaning and are not descriptive of a professionally recognized approach as, as family therapy or Cognitive Behavioral Therapy are. As mentioned somewhere, in the "bible" of Psychotherapy outcome research, Bergin & Garfield's text, there is no mention of the term "Attachment Therapy." RalphLender 14:26, 19 July 2006 (UTC)

It was pretty clear what was being discussed until someone edited it to make it ambiguous, presumably with the goal of supporting deletion of the whole topic. Jean Mercer 12:38, 19 July 2006 (UTC)

Please don't let that discourage you from continuing to edit. If you think those previous edits would clear things up, I would like to see them. Just make you cite verifiable sources and avoid original research. Aplomado 15:15, 19 July 2006 (UTC)

Appropriate References

I see that the reference by Jean Mercer was deleted. Self-promotion is not allowed in encyclopedia articles. I agree with this deletion. SamDavidson 13:39, 19 July 2006 (UTC)

While I see your point that the reference appears to be self-promotion, I disagree with deleting the reference. I think it is fine if Dr. Jean Mercer puts it in. Dr. Mercer is certainly clever enough to be able to create material in the article for which her book is an appropriate citation. Whether or not that is still self-promoting, I'll leave to an administrator to decide. While the text is more of a polemic or broad-side by the leaders or spokespersons of ACT (Mercer, Sarner and Sarner's spouse, Rosa) presenting their positions and views, it is still a published reference in the public domain. So, if Dr. Mercer wants to put the reference back, I have no objection. Dr. Arthur Becker-Weidman 14:09, 19 July 2006 (UTC)

Referencing the article with one's own material is very likely a conflict of interests. See: Misplaced Pages:External links#Links_normally_to_be_avoided, where it says, "A website that you own or maintain, even if the guidelines above imply that it should be linked to. This is because of neutrality and point-of-view concerns; neutrality is an important objective at Misplaced Pages, and a difficult one. If it is relevant and informative, mention it on the talk page and let other — neutral — Misplaced Pages editors decide whether to add the link." Although this rule specifically pertains to external links, I think the spirit of the law applies here.

References also have to meet certain criteria. See: Misplaced Pages:No_original_research#Reputable_publications and Misplaced Pages:Reliable_sources#Self-published_sources. Aplomado 15:22, 19 July 2006 (UTC)

I agree with that. I beleive a reference, such as was deleted by SamDavidson, represents just such a conflict and should be avoided. RalphLender 17:34, 19 July 2006 (UTC)

Good points. MarkWood 20:40, 19 July 2006 (UTC)

Exceptions to this may be when a well-known, professional researcher writing within his field of expertise JPotter 21:58, 19 July 2006 (UTC)

Well, that would not apply here since mercer is not a licensed mental health professional nor has mercer done any clinical practice or research in this area. But, be that as it may, can you point me to the exception for that in the Misplaced Pages policies, such as those Aplomado cited? Thanks. DPeterson 22:51, 19 July 2006 (UTC)

Sure. It's in the second paragraph of Misplaced Pages:Reliable_sources#Self-published_sources JPotter 16:44, 20 July 2006 (UTC)

Thank you. That reinforces the opinion of the majority of those who have posted here that the mercer citation would not re appropriate and would violate the exception when there is a well-known, professional researcher writing within his field of expertise. Mercer is not a licensed mental health professional and the text is more of a polemic for an advocacy group. RalphLender 19:42, 20 July 2006 (UTC)

This is certainly an interesting approach. By the line of reasoning above, in which one can't cite one's own work, it would appear that only people who have done no work in a field can write for Misplaced Pages-- if they identify themselves. Those who refuse to identify themselves can of course cite themselves freely. Perhaps I should have imitated Jane Austen and signed "A Lady".

For those who are interested in my expertise, I have provided a link to my c.v. below (in a later part of this discussion). I leave it to you to judge.

In any case, all these issues are simply red herrings to conceal the fact that DPeterson & Co. want to prevent the public from having information about holding therapy,Dyadic Synchronous Bonding, Prolonged Parent-Child Embrace, or any of the flock of names I've categorized as Attachment Therapy, following Foster Cline, and, of course, Daniel Hughes.Jean Mercer 12:41, 20 July 2006 (UTC)

Please keep your comments 'neutral' and try to 'avoid personal attacks.' This is not helpful to building conensus. A review of your CV shows you are not 'a licensed mental healh provider' and do not have expertise in the fields of child therapy or expereince in treatment or as a researcher doing research on treatment efficacy or related subjects. As such you do not fit the defination of an expert. For example, you would not be allowed to testify in those areas as your testimony would not meet the "Daubert" test. The book is really a publication by the leaders of ACT (Rosa being the Executive Director, Sarner being her husband, and you being a leader of the group). RalphLender 19:46, 20 July 2006 (UTC)

For what it's worth,Daubert applies only to systematic empirical research, not to a narrative discussing a case and its background. And testimony does not meet Daubert standards-- it's the evidence on which the testimony is based that has to meet them. And of course, your statements about my background are perfectly accurate, as anyone can see who looks at my c.v. However, people can look at my c.v.; your background and identity remain, shall we say in our clinical way, confidential. Jean Mercer 14:23, 21 July 2006 (UTC)

I agree with you RalphLender. It is vital that comments aim to build consensus and avoid personal attacks...so a neutral point of view is more productive. Since mercer's expertise is not in this area, it would be good to continue to collect material from those who are not affilitated with ACT and who have a clinical background. If it is not true that mercer is a leader of ACT, then she should say so. In a related matter, postings and references that are promote ones book and activities in which one has a financial interest (as mercer has regarding the book and related activities) is not consistent with Wiki policy. SamDavidson 16:21, 21 July 2006 (UTC)

"Attachment Therapy" vs. "attachment therapy" - One more try

My first attempt at a clarification failed miserably, so I'm going to try one more time with a slightly altered version of my question. There does appear to be something called "Attachment Therapy," as this person claims to have studied it: http://www.dianefeinberg.com/; and these people claim to offer an "Intensive Attachment Therapy Program": http://www.attachmenttherapy.com/. At the same time, a U.S. Senate Resolution, while specifically critizing "rebirthing," also notes that several children have died from "other forms of attachment therapy": http://salazar.senate.gov/images/pdf/051018%20Rebirthing%20Resolution%20Res%20276.pdf (see the third "whereas" clause on page 2 of the document.) 69.170.233.237 21:18, 19 July 2006 (UTC)

Could anyone offer some thoughts on what the "attachment therapy" and "Attachment Therapy" referred to in these documents are? 69.170.233.237 21:18, 19 July 2006 (UTC)

"Attachment therapy" also sometimes called "holding therapy" is an 'ambiguous' term which is sometimes used to describe a form of treatment for behavioral difficulties in children suffering from attachment disorder. However, because 'the term has no common meaning', its actual definition is unclear. As such, it has 'little commonly agreed upong meaning' in the professional literature. For example, it is not a term found in the Amereican Medial Association's Physician's Current Procedural Manual. A number of advocacy groups, such as Advocates For Children in Therapy have undertaken to label nearly all treatments for children with disorders of attachment as "attachment therapy" and attempt to discredit those therapies. Some components of "attachment therapy" have been disapproved by a task force of the American Professional Society on Abuse of children (APSAC). (Chaffin et al.,2006, PMID 16382093). Specifically, the task force addressed coercive methods and practices as inappropriate for treatment. So, who knows what those documents mean by this ill-defined and ambiguous term. DPeterson 21:54, 19 July 2006 (UTC)

Citation Needed

I don't have a citation for the reference, but maybe someone else can provide that. Otherwise, maybe just a link to the other page may suffice. Perhaps Mercer (IP 69.170.233.237) could provide one, or other contributors. DPeterson 23:28, 19 July 2006 (UTC)

To clarify, I am not Mercer. 69.170.233.237 23:48, 19 July 2006 (UTC)

I assumed that since you are in FL and mercer is in FL.

Those geographic IP traces are not always as accurate as they purport to be. I have seen a number of instances where the IP my ISP assigns shows up as a very different location than where I actually am. Anyway, just to repeat, I am not Mercer. 69.170.233.237 00:15, 20 July 2006 (UTC)

Oh, but you are her son. You go by the previous name or mercer, Lester, and proport to be a graduate of Harvard Law. DPeterson 00:25, 20 July 2006 (UTC)

You are certainly free to speculate all you want, but given what I've seen on these pages in terms of personal attacks in the past, I'm not going to identify myself. 69.170.233.237 00:41, 20 July 2006 (UTC)

Anyway, whoever that is who's writing, I'm not in Florida. I'm in New Jersey, where I live and work. I sign my name (although occasionally I seem to have flubbed my sign-in), I'm not afraid to have people identify me-- and if you'd all like to examine my c.v. it's at http://www.jeanmercer.org/jeanmercercv.pdf. You are in NY and your son is in FL. RalphLender 19:48, 20 July 2006 (UTC)

Sir, do you think I don't know where I live? Jean Mercer 14:16, 21 July 2006 (UTC)

So what RalphLender reports is correct regarding you and your son. ok, whatever that implies.SamDavidson 15:58, 21 July 2006 (UTC)

RalphLender said "NY" -- she said "New Jersey". Not quite the same thing. 74.225.124.98 16:56, 21 July 2006 (UTC)

User 74.225...may be mercer's son (Miami Fla again) and she lives in NJ. OK, good to know.DPeterson 17:49, 21 July 2006 (UTC)

Incidentally, I think the word you want is "purport", DPeterson.Jean Mercer 12:31, 20 July 2006 (UTC)

Care to comment on your son? You certainly don't dispute that you, mercer live in NJ and your son lives in FL, do you?DPeterson 01:47, 22 July 2006 (UTC)

Let's leave the material up there for a few days and see what develops. If a citation can be provided that might help. What do other editors think?DPeterson 00:31, 20 July 2006 (UTC)

Pro:

Con:

No Opinion:

DPeterson 00:31, 20 July 2006 (UTC)

I believe this issue is settled. Citations have been provided to support the material. RalphLender 19:48, 20 July 2006 (UTC)

A Proposal

I wonder if the following might be helpful for this topic. First, a page on the "History and Origins" of attachment therapy. Questions such as these could be answered: Who coined the term? What did it mean to that person? What was involved in the practice of attachment therapy at this time? Second, a page on the "Subsequent Development" of attachment therapy, focusing on these questions: How did attachment therapy develop over time? What kinds of practices were involved? At what point did harmful practices such as "rebirthing" enter into it? Who were some of the groups performing it? What does the term mean to those who still practice it now? 69.170.233.237 23:53, 19 July 2006 (UTC)

Why don't you write something and post it here and then editors can comment on the value of what you prepare. DPeterson 00:06, 20 July 2006 (UTC)

I am completely unqualified to do anything like that, unfortunately. I was proposing it in the hopes that someone with some expertise in this area might do it. 69.170.233.237 00:08, 20 July 2006 (UTC)

Good point, since you are completely unqualified in this area, your off point suggestions and points now are understandable. "Attachment therapy" also sometimes called "holding therapy" is an 'ambiguous' term which is sometimes used to describe a form of treatment for behavioral difficulties in children suffering from attachment disorder. However, because 'the term has no common meaning', its actual definition is unclear. As such, it has 'little commonly agreed upong meaning' in the professional literature. For example, it is not a term found in the Amereican Medial Association's Physician's Current Procedural Manual. A number of advocacy groups, such as Advocates For Children in Therapy have undertaken to label nearly all treatments for children with disorders of attachment as "attachment therapy" and attempt to discredit those therapies. Some components of "attachment therapy" have been disapproved by a task force of the American Professional Society on Abuse of children (APSAC). (Chaffin et al.,2006, PMID 16382093). Specifically, the task force addressed coercive methods and practices as inappropriate for treatment. So, a history and origin section would have no scope and there would be no basis for that. Your questions presume that "attachment therapy" is an organized field as is Cognitive Behavioral Thearpy or, even, EMDR. If it were, your suggestions would be good ones and possible. Given the amorphous and uncertain nature of the terms involved, it is not really possible for this vague subject. DPeterson 00:29, 20 July 2006 (UTC)

Well, DPeterson doesn't like the idea, but if anyone else would like to take it up, I really think it would be valuable here. 69.170.233.237 00:39, 20 July 2006 (UTC)

'Pro:'I have asked for assistance from WikiProject Medicine on this topic and on Dyadic Developmental Psychotherapy, where the nature of evidence-based treatment is an issue. I would like to hold off on any decisions or editing until someone from that group becomes involved.Jean Mercer 12:45, 20 July 2006 (UTC)

1.

'Con:'

'1' See my points above on why it may not be possible to answer those questions. The subject areas is ill defined, with no clear meaning to the terms and therefore no agreement. May be difficult or impossible to create material with a 'NPOV' DPeterson 01:22, 20 July 2006 (UTC)

'2' I have agree with the reasoning of DPeterson on this. The term is very vague and has no common body of knowledge or clear defination as a treatment modality in the same way that family therapy does or play therapy, for example.

'No Opinion:'

1. DPeterson 00:31, 20 July 2006 (UTC)

I've added some references to work that specifies a set of treaments by using the terms "attachment therapy" in quotation marks or Attachment Therapy with caps. I tried to remove the quotation marks that did not refer to this type of treatment. Much more editing is needed-- the references to Lieberman and so on are really irrelevant -- but the advice of the WikiProject Medicine people should be useful. I would appreciate it if people would not delete the references to my work, which followed other authors in the use of the terms. I have not deleted the previously added references, but someone should.Perhaps in writing this there should be some thought given to the potential reader who would be very confused as things stand.Jean Mercer 20:32, 20 July 2006 (UTC)

Self-serving references cannot be included are are not a NPOV. Citing your own book, which is a merely a bit of broadside and polemic for the fringe group, Advocates for Children in Therapy, of which you are a leader is not NPOV and represents a conflict of interest as well as a financial conflict since you and your group get support form those publications. You have already been warned once about this.

The references to Lieberman are quite relevant to make a clear distinction between an ill-defined vague "approach" and other approaches that are clearly defined and unrelated. Your material could lead a naive reader to think that Lieberman and other's are using coercive and unacceptable methods since "attachment therapy" and therapy using attachment principles or based in attachment theory are so similiar. RalphLender 23:30, 20 July 2006 (UTC)

Yes, that is true. Again, it is a conflict to be promoting a book in which you and your colleagues have a financial interest, as well as your gorup, Advocates for Children in Therapy. SamDavidson 16:25, 21 July 2006 (UTC)

Ah, what it is to be rich! Rich on the royalties from an obscure book put out by a poor but respectable publishing house! You all must wish you were rolling in wealth the way we are, but you don't get that kind of money from The Old Oaken Bucket Publishing Company.... You know, in early childhood circles, your line of argument is known as "I'm rubber, you're glue...". I can only gather that you folks are determined to use any foolishness to make sure that the public has as little access as possible to the facts about physically intrusive treatments. Are you prepared to do the same thing with respect to denying "age regression" techniques? If so, perhaps a little alteration of some web sites would be in order. Jean Mercer 17:58, 21 July 2006 (UTC)

Please respond to the 'salient' issue. Misplaced Pages 'disallows your promoting your book' since you have a financial interest in it and are directly connected with ACT (Advocates for Children in Therapy)(as a leader of that advocacy group) and there is also a financial interest there. The fact that so few people have considered the text worthy of purchase that you are not getting "rick on the royalties from an obscure book," is beside the point. DPeterson 19:33, 21 July 2006 (UTC)

I already responded elsewhere, as well as earlier on this page. Citing is not promoting-- if it were, I would never have cited Monica Krenner or Terry Levy, or Becker-Weidman for that matter. And I have disclosed my entire puny commercial interest. Your turn!

Why do I keep up this annoying interaction? You must wonder. Well, it's that periodically I receive e-mails from people who are concerned about specific children who have been in Attachment Therapy (I believe you're familiar with the term)and who need guidance about what to do next. I also get messages from therapists who are trying to help families who have been caught up in AT-- I'm talking to one who's working with children in Massachusetts who had received periodic "intensive" visits from a fellow who lives in Evergreen, until the parents caught on that this was not a good idea. There's another noncustodial mother whose child lives in upstate New York with a stepmother who's into AT, which the mother didn't know enough about to prevent at the beginning. My goal is to try to prevent other people from having to make uninformed decisions. If they have the information and still want to have someone help abuse their children, there's not much I can do about it.

Not being a licensed mental health professional or an expert in this topic I wonder about your ability to adequately advise such individuals and why they would contact you in the first place. If you are practicing outside the scope of your licensure that might be a problem and you should be very cautious. Citing anon stories is interesting, but the veracity of what your stories is in question without sources and, frankly, is not relevant to this discussion. DPeterson 01:16, 22 July 2006 (UTC)

It will be interesting when I write an article about what's been said here. This I can do with impunity, because of course I have no idea who you are, so I can't name you-- and my name is already known, so there's no problem about naming myself.Jean Mercer0:15, 22 July 2006 (UTC)

I do note that many of your "publications" are '"self-promotional"' letters and notes in "publications" in which you are in a deciion making role and largely are a function of your role as a leader of ACT. DPeterson 01:16, 22 July 2006 (UTC)

Well, you are off point. You self-promotion is against Wiki policy. You should respond to the salient issue

You are promoting your book which you have a financial interest in and with your fring advocacy group, ACT, has a financial interest in. This is just not acceptable. Please respond to the point and side issues or red-herrings. Responding to the salient issue would do much to achieving some resolution of this problem. DPeterson 01

11, 22 July 2006 (UTC)

Time For Civility/Self-Promotion is against Wiki policy

The focus of the talk page should be on material in the article, not on persons or personal attacks. If an editor is engaged in self-promotional actions (as may be the case as described above) then that should be brought to the attention of an administrator for action. JonesRD 16:56, 22 July 2006 (UTC)

I agree. WP:CIVIL is not optional. JPotter 00:52, 24 July 2006 (UTC)

All such self-promotional references should be removed. SamDavidson 15:03, 27 July 2006 (UTC)

Agreed. DPeterson 01:29, 4 August 2006 (UTC)

can you just add on to this?

Well, as an adoptive parent conned by attachment therapy, I like the article. Something needs to be done to stop the spead of these attachment therapist claiming 100% success. I had the horrifing experience of dragging my family though a group pretty much using the re-birthing process. Do any of these groups ever have success? All I see ever helping these kids tends to be the meds. they get put on.

Something in the blurb really should address the fact that there are many cons out there taking advantage of very desperate parents trying to help their adoptive kids.

PLEASE DON"T DELETE THE Attachment therapy article... I wished I'd had it to read before what all we went through. Our city even pays for adoptive families to go their. All therapy consists of is parents being held down on air mats to do that deep breathing stuff. It was very hurtful to our family. This was since 2002. These programs are all over the country. It really is a big scam. Lots of kids are getting hurt.

I think that the above comments may not meet Misplaced Pages standards in that they include what appear to be personal attacks. I'd suggest removing the comments. What do others think? I'd leave a comment on the individual's talk page, but that person is an anon user with no prior posts. DPeterson 20:30, 5 August 2006 (UTC)

So long as individual's names are not mentioned, actually claims about/against individuals that are not verified, opinions belong on talk pages. But I agree, personal attacks do not belong here and are not consistent with the Misplaced Pages policy of civility. JonesRD 11:19, 6 August 2006 (UTC)

Reason for changes to edits

1. The links to other articles are consistent with the , "The use of links to other Misplaced Pages articles, for example, Ant, is encouraged. Use the links for all words and terms that are relevant to the article. The purpose of internal links is to allow readers to easily and conveniently follow their curiosity or research to other articles. These links should be included where it is most likely that a reader would want to follow them elsewhere — for example, in article introductions, the beginnings of new sections, table cells, and image captions. Generally, where it is likely that a reader may wish to read about another topic, the reader should not have to hunt for a link elsewhere in the page." and does not meet the criteria for "over-linking."

2. The Also see section also belongs. The purpose of that section is to provide a convenient location for the reader to find relevant and related links without having to search the entire article.

3. The statement, "A number of advocacy groups, such as Advocates for Children in Therapy and Quackwatch have undertaken to label nearly all treatments for children with disorders of attachment as "Attachment Therapy" and attempt to discredit those therapies." is accurate. The citation would be the ACT webpage. ACT clearly states that there is no place for "Attachment Therapy" in treatment. (note they use the term "Attachment Therapy" and not Attachment therapy or attachment therapy, so their defination is specific to that term.

4. The statement, "label nearly all treatments for children with disorders of attachment as Attachment Therapy and attempt to discredit those therapies." is supported, for example, by ACT's criticism of EMDR, affective attunement, Theraplay, therapeutic parenting, developmental attachment therapy, dyadic developmental therapy, dyadic developmental psychotherapy, which are not coercive restraint therapies and, some of which, have a clear evidence base.

However, at this point it would be best to involve others in this discussion and see what other editors think about this. DPeterson 13:59, 3 September 2006 (UTC)

You have continually failed to provide any source for the assertion that they "label nearly all treatments for children with disorders of attachment as Attachment Therapy and attempt to discredit those therapies." They, in fact, specifically state that there are "conventional therapies" used to treat such disorders, and provide clear differentiations they believe exist between Attachment Therapy and acceptable practices - such as the use of force, coercion, threats, fear and denial of child's concerns. FCYTravis 21:36, 3 September 2006 (UTC)

'PLEASE VOICE YOUR VOTE BELOW ON WHETHER TO KEEP OR DELETE THE FOLLOWING:"A number of advocacy groups, such as Advocates for Children in Therapy and Quackwatch have undertaken to label nearly all treatments for children with disorders of attachment as "Attachment Therapy" and attempt to discredit those therapies." (See point 3 above). Be sure to sign your name.

'For Keeping Language in point 3'

1. It is the language of ACT and what is stated on their website. DPeterson 14:01, 3 September 2006 (UTC)
2. I added a quote and link to provide verification for this statement. The current version is excellent. In addition, I strongly object to the continued deletion of the Also see section without comment or reason. It is a valid section and must remain. JonesRD_talk 16:47, 3 September 2006 (UTC)
3. the language is NPOV, fair and accurate. Dr. Becker-Weidman 19:15, 3 September 2006 (UTC)
4. The statement, "label nearly all treatments for children with disorders of attachment as Attachment Therapy and attempt to discredit those therapies." is supported, for example, by ACT's criticism ( http://www.childrenintherapy.org/essays/overview.html) of EMDR, affective attunement, Theraplay, therapeutic parenting, developmental attachment therapy, dyadic developmental therapy, dyadic developmental psychotherapy, which are not coercive restraint therapies and, some of which, have a clear evidence base. DPeterson 23:04, 3 September 2006 (UTC)
5. 'Agree'RalphLender 13:50, 5 September 2006 (UTC)
6. 'agree'the quote is well documented and has appropriate citations. SamDavidson 13:54, 6 September 2006 (UTC)

'Against Keeping Language in point 3'

'Neutral about either one'

Notorious Cases

Wouldn't it be worthwhile to add information about some cases like the Cassandra Killpack death to this entry? Possibly in a "Criticisms" section? I'm afraid I don't have the time to add something like this myself right now, but I was surprised that there wasn't something like it here already. -- HiEv 07:18, 16 December 2006 (UTC)

That case would fit better in the article on Child Abuse in the section there on notable cases. The reference you cite describes parent inflicted child abuse. DPeterson 13:18, 16 December 2006 (UTC)

I'm sure it could fit in several sections, but in this case the abuse and death was due to an attempt to follow Attachment Therapy practices. The point would be to make people reading the article aware of the potential dangers of Attachment Therapy in the course of a fuller understanding of the subject matter. Any article should give a good complete overview of the subject, and that means including both the supporting arguments and the criticism, if there are any good ones. I think that "death" is a pretty important fact that potential users should be aware of and could help prevent further deaths, so I believe that adding this kind of information would improve the article. -- HiEv 04:48, 19 December 2006 (UTC)

While your conclusion may be true, the newspaper articles don't clearly support your conclusion that in this instance the parents were acting as you say (following "attachment therapy"). In fact they had no professional working with them or advising them. DPeterson 13:41, 19 December 2006 (UTC)

Not a "low priority article"!

As a childhood victim of so-called "attachment therapy," I, too, beg you not to remove this article. People need to know what they're getting into when they subject their children to this horrible, insane business. Y'all don't want to know some of the stuff that was done to me by a particular psychiatrist in the 70's who had adopted these quack beliefs, in the name of forcing my behavior to conform to expected norms. I was thrown to the ground with huge adults sitting on my back (I fainted once because I could not breathe), I had my hair pulled, was forced to sit in isolation for long periods of time, was berated over matters that were completely opaque to me, was repeatedly forced to witness punishments of other children...all the while, as I found out as an adult, my little sister was being threatened with the same (although she was allowed to imagine that I was suffering even worse punishments than I really was) if she did not behave herself; she spent her childhood terribly frightened that the punishments visited upon me might be inflicted upon her as well. One day I remember I was made to pretend to drive an invisible shopping cart around an invisible grocery store, and kept being "held" in punishment for "running into" invisible items, and this in front of an entire therapy group of children and their parents. Another day I was forced to witness a lengthy hair-pulling episode--the therapist was pulling a little girl's hair because she had had a fight with her father in the lobby and he apparently had yelled out a loud curse word which she was being forced to repeat in front of the group but would not because she was embarrassed, and she was crying and crying and crying (a few years later, I heard this little girl had gotten pregnant and run away from home).

I am not kidding. Although some of the particular practices that were inflicted upon me and the other children in my "therapy" group may have changed in the intervening decades, the overall philosophy of breaking the child's "bad behavior" (I would say "breaking the child," really) by the application of weird, horrendous, often irrational aversives is still the same, and yes, sometimes it kills, as I have heard (and I wonder how many children have committed suicide years later as a result of this treatment, which can be devastating to the self-esteem as it was to mine?). This is "attachment therapy." It is quackery and child abuse, pure and simple, and it is horrifying. It teaches the child all about power and who has it (adults, who can use it any way they want) and who doesn't (children, who must conform, succumb, and submit), it teaches children that the world is all about the necessity for absolute conformity to irrational authority, it teaches cruel treatment, it teaches about evil, and I don't think it teaches any children to love their parents any better!

I think a neutral point of view specifying the current state of research into this matter and citing various authorities about its nature and consequences should be sufficient to awaken confused parents to what they're getting into. This is not a "low priority article"! And thanks to Dr. Mercer. Songflower 07:34, 30 December 2006 (UTC)

songflower,

i have seen just a little of this 'attachment therapy' and was completely shocked. how this can be happening in this day is beyond me. and the money these people make doing this. i think that is the problem

""it teaches children that the world is all about the necessity for absolute conformity to irrational authority""

how well put! exactly!

email me. i am trying to change some things about this

raspor 13:17, 30 December 2006 (UTC)

Hi, Raspor, I would email you but do not know how to access your email address...pls. advise? ThanksSongflower 07:32, 3 January 2007 (UTC)

http://en.wikipedia.org/User:Raspor

just go there and click the email use button. or go to your control box and allow me to mail you.

i am very involved in this and i want to stop it. i have seen enough of this and i have seen very little

your phrase about 'irrational authortiy' was right on

raspor 12:13, 3 January 2007 (UTC)

hurry Songflower email me

i am working with a reporter in a major newspaper on this

we could really use your input

thanks

Prevalence

It seems to me that there should be a section on the prevalence of this treatment. From what I can tell, it is unusual at this point in time. Now that the Ameerican Psychological Association, National Association of Social Workers, APSAC, Association for the Treatment and Training in the Attachment of Chilren, American Academy of Child Psychiatry, etc. all have practice protocals prohibiting "Attachment Therapy" as defined in this article, none of the members of those groups and professions can use such techniques and remain members. Obviously, unlicensed persons can do what they want and there are cases of malpractice in all professions, but beyond that, it does seem that the prevalence of "Attachment Therapy" as defined in this article is probably very very low. Unless there is some strong objections, I will add such a section. RalphLender 22:46, 4 January 2007 (UTC)

Can you provide a reliable verifiable source for this statement? DPeterson 02:17, 5 January 2007 (UTC)

I don't think they were licensed individuals or members of any professional organization...but if you can point me to a reliable source that states that they were licensed mental health professionals in the state of Ohio, we'd all like to see that. DPeterson 02:17, 5 January 2007 (UTC)

Thanks for the links, that is very helpful. It appears that Thompson is not a licensed therapist and that Parshall is not facing any charges. DPeterson 14:30, 5 January 2007 (UTC)

https://license.ohio.gov/Lookup/SearchDetail.asp?ContactIdnt=3600351&DivisionIdnt=97&Type=L i think is see what happened raspor 16:24, 5 January 2007 (UTC) Yes, neither one is facing disciplinary action per your links. JohnsonRon 20:09, 5 January 2007 (UTC)

The links you provide only show no disciplinary actions being taken...perhaps you could provide a link to a news paper article indicating that both, or either one, have been indicted...Of course, being indicted is not the same as a guilty verdict. In the U.S. everyone is innocent unless and until 'proven' guilty. DPeterson 20:55, 5 January 2007 (UTC)

Good citation...it does appear that both are licensed therapists...but neither one has any action pending against them with the licensing board, based on your link. However, it is important to remember that all professions experience a tiny amount malpractice, which seems to be the case hereRalphLender 17:07, 5 January 2007 (UTC)

The section looks good that you added, Ralph. Furthermore, your points are excellent...there are probably very very few people practicing "AT" as defined in this article.

"Attachment Therapy is a growing, underground movement for the 'treatment' of children who pose disciplinary problems to their parents or caregivers. There is a hands-on treatment involving physical restraint and discomfort. Attachment Therapy is the imposition of boundary violations - most often coercive restraint - and verbal abuse on a child, usually for hours at a time...Typically, the child is put in a lap hold with the arms pinned down, or alternatively an adult lies on top of a child lying prone on the floor. Attachment Therapy almost always involves extremely confrontational, often hostile confrontation of a child by a therapist or parent (sometimes both). Restraint of the child by more powerful adult(s) is considered an essential part of the confrontation."

Few, if any licensed individuals or members of the professional organizaitons listed use these practices...to do so would result in their loosing their license and loosing memberhip in their professional organization.

DPeterson 02:17, 5 January 2007 (UTC)

Thanks...I think I will add a note about malpractice to the section. RalphLender 17:07, 5 January 2007 (UTC)

I would say there are about 700 attachment therapists in the US. do you consider that a high number. and in Ohio about 70% of the funds set aside for post adoptive services go to attachment therapists. its big biz and big bucks here raspor 18:14, 5 January 2007 (UTC)

You will need to provide reliable sources that adhere to the Misplaced Pages standard of being verifiable for each of those statements. And, don't forget that in defiing "Attachment Therapy" you should use the def. used in this article. So, can you provide reliable and Misplaced Pages policy on verifiability of information

This page documents an English Misplaced Pages policy.It describes a widely accepted standard that editors should normally follow, though exceptions may apply. Changes made to it should reflect consensus.

Shortcuts WP:V WP:PROOF

This page in a nutshell: People must be able to check that any of the information within Misplaced Pages articles is not just made up. This means all material must be attributable to reliable, published sources. Additionally, quotations and any material challenged or likely to be challenged must be supported by inline citations.

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In the English Misplaced Pages, verifiability means that people are able to check that information comes from a reliable source. Its content is determined by previously published information rather than editors' beliefs, experiences, or previously unpublished ideas or information. Even if you are sure something is true, it must have been previously published in a reliable source before you can add it. If reliable sources disagree with each other, then maintain a neutral point of view and present what the various sources say, giving each side its due weight.

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Other issues

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See also

Guidelines

• Reliable sources
• Identifying reliable sources (medicine)

Information pages

• Misplaced Pages is not a reliable source
• How to mine a source
• Independent sources
• Identifying and using primary sources
• Identifying and using self-published works
• Video links
• When to cite

Resources

• Backlog – links to articles that need citations added
• Template index/Sources of articles – maintenance templates for articles with sourcing problems
• The Misplaced Pages Library – free access to newspapers, journals, and magazines for experienced editors
• WikiProject Resource Exchange – where you can ask for help with checking an individual source

Essays

• Citation overkill
• Identifying and using tertiary sources
• Verifiability, not truth
• You are not a reliable source

Notes

1. This principle was previously expressed on this policy page as "the threshold for inclusion is verifiability, not truth". See the essay, Misplaced Pages:Verifiability, not truth.
2. ^ A source "directly supports" a given piece of material if the information is present explicitly in the source, so that using this source to support the material is not a violation of Misplaced Pages:No original research. The location of any citation—including whether one is present in the article at all—is unrelated to whether a source directly supports the material. For questions about where and how to place citations, see Misplaced Pages:Citing sources, Misplaced Pages:Manual of Style/Lead section § Citations, etc.
3. Once an editor has provided any source they believe, in good faith, to be sufficient, then any editor who later removes the material must articulate specific problems that would justify its exclusion from Misplaced Pages (e.g. why the source is unreliable; the source does not support the claim; undue emphasis; unencyclopedic content; etc.). If necessary, all editors are then expected to help achieve consensus, and any problems with the text or sourcing should be fixed before the material is added back.
4. It may be that the article contains so few citations it is impractical to add specific citation needed tags. Consider then tagging a section with {{unreferenced section}}, or the article with the applicable of either {{unreferenced}} or {{more citations needed}}. For a disputed category, you may use {{unreferenced category}}. For a disambiguation page, consider asking for a citation on the talk page.
5. When tagging or removing such material, please keep in mind such edits can easily be misunderstood. Some editors object to others making chronic, frequent, and large-scale deletions of unsourced information, especially if unaccompanied by other efforts to improve the material. Do not concentrate only on material of a particular point of view, as that may appear to be a contravention of Misplaced Pages:Neutral point of view. Also, check to see whether the material is sourced to a citation elsewhere on the page. For all these reasons, it is advisable to clearly communicate that you have a considered reason to believe the material in question cannot be verified.
6. This includes material such as documents in publicly accessible archives as well as inscriptions in plain sight, e.g. tombstones.
7. ^ Note that any exceptional claim would require exceptional sources.
8. ^ When there is a dispute as to whether a piece of text is fully supported by a given source, direct quotes and other relevant details from the source should be provided to other editors as a courtesy. Do not violate the source's copyright when doing so.

References

1. Self-published material is characterized by the lack of independent reviewers (those without a conflict of interest) validating the reliability of the content. Further examples of self-published sources include press releases, the material contained within company websites, advertising campaigns, material published in media by the owner(s)/publisher(s) of the media group, self-released music albums, and electoral manifestos:
   • The University of California, Berkeley, library states: "Most pages found in general search engines for the web are self-published or published by businesses small and large with motives to get you to buy something or believe a point of view. Even within university and library web sites, there can be many pages that the institution does not try to oversee."
   • Princeton University offers this understanding in its publication, Academic Integrity at Princeton (2011): "Unlike most books and journal articles, which undergo strict editorial review before publication, much of the information on the Web is self-published. To be sure, there are many websites in which you can have confidence: mainstream newspapers, refereed electronic journals, and university, library, and government collections of data. But for vast amounts of Web-based information, no impartial reviewers have evaluated the accuracy or fairness of such material before it's made instantly available across the globe."
   • The "College of St. Catherine Libraries Guide to Chicago Manual of Style" (DEKloiber, December 1, 2003) states, "Any site that does not have a specific publisher or sponsoring body should be treated as unpublished or self-published work."
2. Rekdal, Ole Bjørn (1 August 2014). "Academic urban legends". Social Studies of Science. 44 (4): 638–654. doi:10.1177/0306312714535679. ISSN 0306-3127. PMC 4232290. PMID 25272616.
3. See Extraordinary claims require extraordinary evidence

Further reading

• Wales, Jimmy. "Insist on sources", WikiEN-l, July 19, 2006: "I really want to encourage a much stronger culture which says: it is better to have no information, than to have information like this, with no sources."—referring to a rather unlikely statement about the founders of Google throwing pies at each other.

citations for the following:

1. 700 attachment therapists in the US.
2. in Ohio 70% off the funds set aside for post adoptive services go to attachment therapists.

RalphLender 18:44, 5 January 2007 (UTC)

i dont think i have time for that. but what i wanted to find out if you think 700 is a lot. i have talked to several ohio counties about this. they push attachment therapy aggressively and like i said most of the post adoption funds go to these therapists. its a very big biz here raspor 18:47, 5 January 2007 (UTC)

Without there being reliable and verifiable citations provided, the statements and questions do not meet Misplaced Pages standards for inclusion in an encyclopedia article. The purpose of the talk page is to discuss the article and its development. Original research is not valid for inclusion RalphLender 18:54, 5 January 2007 (UTC)

"Therefore there are very few practitioners of "AT" as defined in this article." is there a verifiable citation for this? raspor 18:56, 5 January 2007 (UTC)

I suppose the basis for that statement would be that a member of any of the cited professional organizations which have practice parameters or papers opposed to the use of such coercive methods cannot be a member of that organization, that several states have outlawed the use of "rebirthing," and that the practices would be malpractice. JohnsonRon 20:09, 5 January 2007 (UTC)

so you are logically determining the fact? i thought we had to quotes sources. am i wrong about that. few states have outlawed it. it is very common here in ohio. raspor 14:49, 6 January 2007 (UTC)

cites needed

"Attachment Therapy" involves the use of practices prohibited by a large number of professional organizations such as the following: American Psychological Association, National Association of Social Workers, APSAC, Association for the Treatment and Training in the Attachment of Children, American Academy of Child and Adolescent Psychiatrry.

To the best of my knowledge the above organizations do not prohibit attachment therapy. Many State Boards actually certify it.

need cites —The preceding unsigned comment was added by 68.109.232.53 (talk) 23:29, 26 February 2007 (UTC). There are no reliable statistics on how many professionals actually practice "Attachment Therapy" or "rebirthing as it is also known. However, as defined in this article, "Attachment Therapy" involves the use of practices prohibited by a large number of professional organizations such as the following: American Psychological Association, National Association of Social Workers 3, American Professional society on the Abuse of Children (APSAC0 4, Association for the Treatment and Training in the Attachment of Children, American Academy of Child and Adolescent Psychiatrry, and the American Psychiatric Association. 5. Therefore there are very few practitioners of "AT" as defined in this article. Furthermore, several states have outlawed "rebirthing," and anyone using such methods would be guilty of malpractice, which is a small problem in all professions

68.109.232.53 22:19, 27 February 2007 (UTC)

the American Psychology Association and the Natl Social Workers Org do not take a stance on AT. And AT is approved and encouraged by most States. Yes 'rebirthing' has been outlawed in Utah but everything else is still OK.

69.211.150.60 13:39, 1 March 2007 (UTC)

both those groups have position papers on the subject RalphLender 19:06, 1 March 2007 (UTC)

Again the American Psychological Association does not take stances on types of therapies. And your reference is for the Utah Social Workers not the National. If you say there are very few give a cite. You cannot use personal research. 69.211.150.60 14:25, 2 March 2007 (UTC)

Cites have been added that these various national professional organizations have positions against coercive interventions. RalphLender 16:17, 2 March 2007 (UTC)

This looks fine to me as it is with all the citations added to support the stmts. As described in this article, AT is rare thing.In this article, AT is:

"Attachment Therapy is a growing, underground movement for the 'treatment' of children who pose disciplinary problems to their parents or caregivers." In discussing Attachment Therapy they state, "there is a hands-on treatment involving physical restraint and discomfort. Attachment Therapy is the imposition of boundary violations - most often coercive restraint - and verbal abuse on a child, usually for hours at a time...Typically, the child is put in a lap hold with the arms pinned down, or alternatively an adult lies on top of a child lying prone on the floor."

DPeterson 21:56, 2 March 2007 (UTC)

I've been following this debate with some interest. Can I just say that I don't see why proponents of respectable therapies to deal with attachment disorders need to be quite so defensive about 'Attachment Therapy'. The issues seem quite simple. If 'Attachment Therapy' as described in this article exists then it clearly warrants a straightforward informative article. At the moment the article reads as if it's drafted by people afraid that mud might stick to any therapy designed to address attachment disorders. Clearly it is important to point out that governmental and professional organisations outlaw such techniques, but if in fact some local government bodies or regulated bodies are sanctioning such techniques that's equally important.Fainites 23:30, 10 March 2007 (UTC)

There is no evidence I can find that any governmental body or rregulated bodies are sanctioning the techniques described in this article. DPeterson 13:49, 11 March 2007 (UTC)

Is there any evidence that practitioners of this 'Attachment Therapy' are getting in under the wire as it were and actually being used by official bodies such as adoption agencies out of ignorance? Somebody must be funding the practice. It's unlikely to be private clients only, surely.Fainites 14:22, 11 March 2007 (UTC)

No, there is no evidence that meets Misplaced Pages standards of being verifiable or attributable to a reliable source that I can see. DPeterson 16:42, 11 March 2007 (UTC)

I know that ACT is a pressure group and therefore likely to be a little excitable, but is all the information at completely wrong? 'Attachment Therapy' wouldn't be the first pseudoscientific therapy to worm it's way in, despite the general stand taken against it.Fainites 19:18, 11 March 2007 (UTC)

Can anybody from ACT explain why Theraplay and Dyadic Developmental Psychotherapy are named on the ACT site as Attachment Therapy by another name, and why for example EMDR (on which extensive research has been done) and NLP are named in a sort of 'guilt by association' list and derided as quackery on the same page? If it is alleged DDP and Theraplay are Attachment Therapy by another name, where is the evidence ? If there is none, this article should make it clear.Fainites 21:04, 11 March 2007 (UTC)

ACT is an advocacy group with a specific agenda and so may be extreme in its statements. Unlike an encyclopedia article, they do not need to cite sources or use reliable information. They seem to tar any treatment that is used for those who have experienced a history of trauma and Complex Post Traumatic Stress Disorder or disorders of attachment with the same brush. There is no evidence that Dyadic Developmental Psychotherapy, Theraplay, NLP, or EMDR are "Attachment Therapy" as defined in this article. If you'd like to take a stab at clarifying that, please do so below in the section marked for that purpose. I am only suggesting you do it here to avoid an edit war with those who may disagree since you can see there is a long and extensive history of conflict around this article. I'd be glad to work with you on this.DPeterson 22:42, 11 March 2007 (UTC)

The list including EMDR etc is a sort of 'guilt by association' list (to completely different therapies) that hardly seems worth bothering with. I am however, more interested in their list of "Attachment Therapy' by another name. Would I be right in thinking that the 'link' with DDP is Hughes. What's the supposed link for Theraplay? I'm sorry if this has all been gone over before. I just think that it's equally important that desperate parents don't either accidently walk into 'Attachment Therapy' or miss valid therapies because they're wrongly listed as AT. I'll give it some thought.Fainites 22:57, 11 March 2007 (UTC)

I think it important to address all misconceptions (EMDR, Theraplay, etc.). The link may just be that any treatment that proports to be useful for treating disorders of attachment is defined as "Attachment Therapy" by this group. But who really knows what is their thinking!DPeterson 01:32, 12 March 2007 (UTC)

It looks like they're saying that these therapies are all 'Attachment Therapy' masquarading under different names. That's quite a big thing to say. If they're wrong on any of the therapies in the list it is quite undermining of their credentials. If however, they are right on all of them, that is equally important. It's quite a big piece of research. I must say, however, including EMDR (which is evidence based in parts) and Feldenkrais (which makes no scientific claims), just because they're in 'Quackwatch' (a dubious enterprise), does not inspire confidence. Fainites 17:48, 12 March 2007 (UTC)

Just looking at Hughes site, he makes it very clear that he did previously advocate some techniques which might come within the description of AT, but now does not, and indeed has developed a therapy that specifically excludes these techniques. If ACT are naming DDP as AT by another name, should this page not deal more specifically with this issue? Are there therapists still following the old, pre-DPP Hughes methods? As for Theraplay, I can't find anything that suggests any link to AT type techniques or beliefs.Fainites 17:04, 13 March 2007 (UTC)

Precisely, there is no relationship between "AT"(as defined in this article) and Theraplay or Dyadic Developmental Psychotherapy or EMDR or other mainstream evidence-based treatments. ACT really seems to be a fringe group. None of its leaders are licensed mental health professionals. Clearly Dyadic Developmental Psychotherapy and Theraplay and EMDR, etc as described in the relevant peer-reviewed publications and texts are not AT as defined in this article...I do think the article states that too in the treatment characteristics section...so that's already addressed in the article. RalphLender 18:38, 13 March 2007 (UTC)

My concern is that the article seems to be more of an attack on ACT and a defense of eg DPP than an article about Attachment Therapy. If I were a parent and had read about Candace Newmaker or Foster Cline and then read this article, I'd be puzzled. If I then went to the ACT site for more info, I'd see a list of therapies described as AT 'by another name' which includes DPP and Theraplay, and a list of 'adjunct' therapies alongside, like EMDR and Feldenkrais. This is all next to links with stories about starved and bullied children! I don't think this article is doing it's job which is to inform, on the basis of verified and credible evidence. If 'Attachment Therapy' as described by ACT exists, it should be described in this article, with evidence, as it is a serious matter even if it is 'fringe'. The article should also clarify what it is not given the allegations by ACT. I appreciate that the article states that ACT tar all sorts of therapies by association, but at the moment the article gives the feeling that because AT is not mainstream, we'd like to all pretend it doesn't really exist.Fainites 21:57, 13 March 2007 (UTC)

I don't think the article reads as, "an attack on ACT and a defense of eg DDP than an article about Attachment Therapy." Why are you focusing on Dyadic Developmental Psychotherapy when it is mentioned with equal weight with several other mainstream evidence-based approaches? Specifically those other approahces mentioned equally are: Alicia Lieberman (Parent-child Psychotherapy) (Lieberman & Pawl in Infant Mental Health, 1993 )(Lieberman 2003), Stanley Greenspan (Floor Time), Mary Dozier (autonomous states of mind), Robert Marvin (Circle of Security) (Marvin & Whelan 2003), Phyllis Jernberg (Theraplay), Daniel Schechter (Clinician Assisted Videofeedback Exposure Sessions) (Schechter, 2003), and Joy Osofsky (Safe Start Initiative) (in Infant Mental Health, 1993). I think the article does a decent job of trying to describe and define an ambigious term with no clear definations. It also does a good job, by using material from professional peer-reviewed publications, of describing how those previously mentioned approahces are not AT. Finally, the article does a pretty good job of describing AT and does so in a manner that it is clear what are the distinctions between AT and Parent-Child Psychotherapy, Floor Time, Theraplay, Circle of Security, Dyadic Developmental Psychotherapy, etc. But, if you have specific ideas for additions to this article please make those below in the section created for that so that other editors can comment and a consensus can be built. DPeterson 22:24, 13 March 2007 (UTC)

I did say 'eg DDP', not 'just' DDP! I will give amendments some thought and post them below.Fainites 22:41, 13 March 2007 (UTC)

OK, I just wasn't understanding why you were focusing on that, as opposed, to say, Theraplay, Circle of Security, etc. Just wondering is all. Will look forward to seeing your thoughts on additions below. Thanks for taking the time to work on this...I know you have other interests beyond this article. DPeterson 23:11, 13 March 2007 (UTC)

I have been giving this matter some thought, and with all due respect to the current editors I think this article needs refocussing. It is apparent that 'Attachment Therapy' whether it is spelt with one capital, two or none, in the sense of coercive restraint therapies as described in the article is a significant problem. If it wasn't, why would all the main professional bodies and a number of states outlaw it, however it is described? Why would Chaffin be commissioned to write his report? I would propose de-emphasising ACT and attempting to focus the article on it's subject in broader terms. I would agree with the current editors that ACT are not justified in including in their 'lists of shame' various therapies, including EMDR, Feldenkrais, Theraplay and DDP. Also some items on their list, such as 'attachment disorder therapy' are far to vague and general. This does need to be made clear, but should not be the focus of this article. Fainites 14:18, 6 April 2007 (UTC)

Adding material could be quite useful. I don't think the article is emphasising ACT; ACT had a lot of material about this subject. I think the article makes clear that EMDR, etc are not Attachment Therapy as defined in this article and does so quite well. I would certainly support adding material to this article to expand it further. I hope you will put your suggestions in the section below so that we can build on it. RalphLender 14:50, 6 April 2007 (UTC)

Actually I was thinking of rearranging the existing article first, then adding more material. Fainites 15:17, 6 April 2007 (UTC)

Good, so why don't you either describe what you are thinking of doing...or just put your proposed changes in the section below and then other interested editors can comment. That would be the best approach. RalphLender 15:38, 6 April 2007 (UTC)

Yes, I support that approach. Let's have suggested changes made in the next section and then those interested can improve the material and then it can be added to the article. This is a great way to build agreement. SamDavidson 17:14, 6 April 2007 (UTC)``

Hooray! Fainites 20:10, 6 April 2007 (UTC)

Suggested Additions to Article to clarify difference between Attachment Therapy and other Methodologies

'Pls add your suggestions below'

Proposed amendments to article

(I have in fact substantially rewritten the article. I haven't added a ref section here. Everything cited is reffed. The main cites are Chaffin, Speltz, Prior and Glaser and ACT. We could also include actual refs to Zaslow/ K=Cline/Hughes etc if necessary)

This is a great start. I added references and a see also list, among other edits to add material and make some suggestions. I removed some material that may appear to be too POV and/or that are without referecnes to support the statements. DPeterson 00:55, 14 April 2007 (UTC)

Thanks! Unfortunately I don't see how anybody else can comment on it as you've removed great chunks of it and then added back in most of the existing article!! Talk pages should not be refactored. We could put it onto a seperate page so as not to make the talk page too long. For now, I've replaced the proposed new article and left your amended version below it so that we can keep playing with it.

On content, I think adding holding and rebirthing in the first sentence confuses the issue. Holding and rebirthing are terms used as similiar terms to "Attachment Therapy." DPeterson 12:22, 14 April 2007 (UTC) It's 'attachment therapy' that's the ambiguous term. (and all it's meanings, inlcluding rebirthing, etc. DPeterson 12:22, 14 April 2007 (UTC)) I would have thought 'holding therapy' was pretty non-ambiguous. Also although Quackwatch/ACT are, in my opinion somewhat cavalier in their inclusion on various lists they don't actually list any of the verifiably mainstream attachment treatments. As far as I can see the controversy relates mostly to Theraplay and DDP and there is plenty of information on that controversy. (I don't see that there is a a controversay regarding those treatments...ACT and Quackwatch seem to go after all treatments for children who have experienced RADDPeterson 12:22, 14 April 2007 (UTC)) I think therefore we need to rephrase this bit. My intention was to take this article away from the ACT wars so that it gives a fair and balanced description of it's subject.

Do you have any references for the list of therapies in your version of the article that state they are all effective and evidence based? (Yes, see the reference listDPeterson 12:22, 14 April 2007 (UTC)) The trouble is, some of them don't have specific names. Chaffin etc avoid naming specific therapies but instead describes what the characteristic of appropriuate therapies. Perhaps we should just quote him on that. On references, could you please be specific about which bits you've removed as being 'unreferenced' or 'POV'? Do you have the dates of when various organisations and states beefed up their codes to outlaw this sort of thing? Fainites 09:00, 14 April 2007 (UTC)

Actually, I just had an idea! We could comment on your amendments in italics in the text. I'll give it a try. Fainites 09:12, 14 April 2007 (UTC)

I've removed the see also and refs as they just make the talk page longer and any way it's not a proper ref list for this article. We can easily do that when we amend the article. The refs I've used are the English version of Chaffin at ], 'Speltz, Matthew L.(2002). Description, History and Critique of Corrective Attachment Therapy. The APSAC Advisor, 14 (3) 4-8. and 'Understanding Attachment and Attachment Disorders. Theory, Evidence and Practice. Vivien Prior and Danya Glaser. The Royal College of Psychiatrists Research and Training Unit. (2006) Pub. Jessica Kingsley. Heres the Amazon link. ] Fainites 10:01, 14 April 2007 (UTC)

I'll go ahead and comment on your version below. Italics is a good ideaDPeterson 12:22, 14 April 2007 (UTC)

'proposal by Fanities for new article PLEASE COMMENT ON THIS VERSION'

(Added capsDPeterson 19:59, 15 April 2007 (UTC))

"Attachment Therapy", ”attachment therapy” "holding therapy," rebirthing therapy, these terms are synonyms for attachment therapy when one looks at the web and such sites as the ACT, etc. sitesDPeterson 12:31, 14 April 2007 (UTC)(We should not be basing this article around ACT. The report by Chaffin et al contains alot of serious players in this field and was specifically commissioned to address this whole area. Clearly they should be the lead authority, not ACT!Fainites 17:48, 14 April 2007 (UTC)) Actually, that is not the case. The article is about coercion in treatment and attachment therapy not "Attachment Therapy." ACT has the clearest definations of this construct and deserves a central place. I actually like the other editors suggestion of maybe just having a very brief article that defines the construct using a few sources. DPeterson 18:30, 14 April 2007 (UTC) (attachment therapy redirects here. This article isn't about just Attachment Therapy with capital letters just because ACT use capital letters! It's about the whole phenomenon. One of the features of this type of therapy as explained by Chaffin is the proliferation of names.Fainites 05:40, 15 April 2007 (UTC))Therefore, using all the various names it goes by, such as rebirthing, etc. is relevant, and the ambiguity of the term should be clearly stated throughout the article so readers don't get the misimpression that it is a discrete phenomenon DPeterson 14:54, 15 April 2007 (UTC)or ‘’corrective attachment therapy’’ is an ambiguous term often used to describe a variety of controversial, non-mainstream "treatments" for children allegedly suffering from attachment disorder which is itself an ambiguous term. However, because the term has no common meaning, or generally accepted meaning, in the professional community, its actual definition is unclear. A number (who else?Fainites 17:48, 14 April 2007 (UTC)) ACT and QuackWatchDPeterson 18:30, 14 April 2007 (UTC) of advocacy groups, such as Advocates for Children in Therapy and Quackwatch have undertaken to label nearly all (hardly nearly allFainites 17:48, 14 April 2007 (UTC)) Actually they do seem to label nearly all DPeterson 18:30, 14 April 2007 (UTC) treatments for children with disorders of attachment as "Attachment Therapy" and attempt to discredit those therapies. (Added some details here and bring the controversary into the intro so the reader can see that at the beginning DPeterson 12:31, 14 April 2007 (UTC)) (which controversy? I don't think this article should revolve around disagreements with ACT as it has in the past. That can be done on the ACT page. ACT are not the prime authority for this subjectFainites 17:48, 14 April 2007 (UTC)) (There is substantial disagreements on what this ambig. term means...it's sort of like an inkblotDPeterson 18:30, 14 April 2007 (UTC)) . ( yes but we ought to tackle this by giving the clearest global definition which is Chaffin et al, not ACT) Fainites 05:42, 15 April 2007 (UTC)) Actually, I think ACT has the clearest definition...but as I suggested below, we could put Chaffin's material first and then the ACT material section. Would that be an acceptable compromise for you? DPeterson 14:54, 15 April 2007 (UTC) Yes, that would be great.JonesRD_talk 18:54, 15 April 2007 (UTC) OK. Thats fineFainites 20:51, 15 April 2007 (UTC)

The treatments often involve coercive and intrusive methods including variants of holding therapy or rebirthing or rage-reduction. According to Prior and Glaser (2006), ‘these therapies are not based on an accepted version of attachment theory and there is no objective evaluation of them’. Attachment Therapy came to the attention of professional bodies and the wider public following a series of prosecutions for deaths or serious maltreatment of children allegedly at the hands of 'attachment therapists' or parents following their instructions, the most well known case being that of Candace Newmaker. Many professional bodies and some American States have outlawed rebirthing (it is rebirthing that has been outlawedDPeterson 12:31, 14 April 2007 (UTC)(Haven't other practices been outlawed? Fainites 17:48, 14 April 2007 (UTC)) Such as? If you can find evidence of such, by all means put in it with the source. DPeterson 18:30, 14 April 2007 (UTC)such practices but because there is no common definition of the terms, such regulation tends to refer to a range of coercive and intrusive practices considered counter-therapeutic rather than ‘attachment therapy’. Care should be taken to distinguish between this subset of therapies and more mainstream therapies which may also be loosely described as attachment or attachment disorder therapy. For the purposes of this article, the term used to describe this subset is ‘Attachment Therapy’ as defined by the advocacy group ACT They have the most clear defination of this termDPeterson 12:31, 14 April 2007 (UTC)

I like the changes above. They should be retained.JonesRD_talk 17:01, 14 April 2007 (UTC)

(I think we should prioritise the definition of verified, credible sources such as Chaffin et al and Prior and Glaser, not ACT. ACT are a POV group!Fainites 17:48, 14 April 2007 (UTC))

ACT has spend a lot of time and effort advocating in this area and so their material is very relevant and appropriate. If you want the Chafin para's first and then the ACT para's that would be fine with me...What do others think? DPeterson 18:30, 14 April 2007 (UTC)

(OK. I agree ACT is relevent. But this article is not about ACT and their definition. It's about the phenomenon of attachment therapy, with or without capitals, as a non-mainstream, subset of 'therapies' with a particular belief system and mode of therapy.Fainites 06:01, 15 April 2007 (UTC))

Why don't you want ACT material in the article? I don't understand your objection. They have written the most material about this subject. Why would you want to cut out there material? It clearly is relevant.DPeterson 14:54, 15 April 2007 (UTC)

What is wrong with the ACT material...it should be included...If there is some reason for not including it, please state that. While I don't agree with that group, they do have material that is relevant to this article.JonesRD_talk 18:54, 15 April 2007 (UTC)

I don't have a problem with ACT. The world needs dedicated campaigning groups! It's just that for an encyclopaedia the prime need is verified and credible sources and there is an obvious heirarchy on any subject that is scientific. Chaffin et al have very thoughtfully provided us with a complete analysis of the whole subject, just when we needed it! I think their definitions are not only more comprehensive in the scientific sense but also more likely to meet Wiki standards for evidence based, peer reviewed stuff or expert opinion that's genuinely expert. ACT play a supporting role in an encyclopaedia I think.Fainites 20:57, 15 April 2007 (UTC)

Definitions of Attachment Therapy

There is no generally accepted definition of "Attachment Therapy," and it is not a term that is found in generally recognized texts on treatment modalities, such as Bergin & Garfield's Handbook of Psychotherapy and Behavior Change, nor is there any specific text that describes this "treatment" approach. However, the advocacy group, Advocates for Children in Therapy does offer guidance on this subject. While this group is not a professional mental health group in the same manner that the American Psychiatric Association or American Psychological Association or National Association of Social Workers are, and none of the leaders are licensed mental professionals or clinicians, they do offer some ideas for a description of what this term can mean. ACT states, "Attachment Therapy is a growing, underground movement for the 'treatment' of children who pose disciplinary problems to their parents or caregivers." In discussing Attachment Therapy they state, "there is a hands-on treatment involving physical restraint and discomfort. Attachment Therapy is the imposition of boundary violations - most often coercive restraint - and verbal abuse on a child, usually for hours at a time...Typically, the child is put in a lap hold with the arms pinned down, or alternatively an adult lies on top of a child lying prone on the floor." ACT further defines "Attachment Therapy" as, "Attachment Therapy almost always involves extremely confrontational, often hostile confrontation of a child by a therapist or parent (sometimes both). Restraint of the child by more powerful adult(s) is considered an essential part of the confrontation." The group also uses the terms "rebirthing" and "holding therapy" as terms for "Attachment Therapy." They have the most clear set of definations for this term, so we should put the details here. DPeterson 12:38, 14 April 2007 (UTC)

Yes, it is important to clearly demonstrate that this is a very very vague term with many divergent meanings. JonesRD_talk 17:03, 14 April 2007 (UTC)(Who says ACT have the clearest set of definitions? Verified, credible sources please.Fainites 17:48, 14 April 2007 (UTC))(it is important to do our best to present the most verified and credible sources. I don't undestand your logic in using ACT as your best sourceFainites 17:48, 14 April 2007 (UTC))

It is important to present all relevant views in a NPOV. What is your objection to ACT? They have spend a lot of time on this issue and written lots of material. If changing the order helps, that's fine with me...After all, we do have to create a consensus here. No one editor owns the article, right? DPeterson 18:34, 14 April 2007 (UTC)

I agree with that. JonesRD_talk 18:57, 15 April 2007 (UTC) Nobody owns the article but there are policies on sources. I think Chaffin not only gives the clearest description but also the most authoritative.Fainites 21:07, 15 April 2007 (UTC)

The term has little commonly agreed upon meaning in the professional literature. For example, it is not a term found in the American Medical Association's Physician's Current Procedural Manual. The American Professional Society on Abuse of children (APSAC) (Chaffin et al.,2006, PMID 16382093) does not use the term "Attachment Therapy," but has disapproved of coercive and intrusive methods of treatment as inappropriate for treatment while approving a broad range of effective treatments for children with disorders of attachment that do not use coercive methods. Begin with a clear statement that there are differences in the meaning of this term and its use or non-use DPeterson 12:34, 14 April 2007 (UTC)(This is misleading. It implies that Chaffin et al ducked the issue when they didn'tFainites 17:48, 14 April 2007 (UTC)) There are clear differences in usage and meaning that should be reflected in a comprehensive encyclopedia article. DPeterson 18:34, 14 April 2007 (UTC) (I agree there are clear differences in meaning and usage and the article must reflect that, but in a way that makes it plain what the article is about. Not in a way that effectively says the article is about nothing at allFainites 06:09, 15 April 2007 (UTC))

Well, in some ways, this is an article about "smoke." This is an ill-defined term that means many different things to many different groups and is not a term used in the clinical literature (not in the AMA's CPT book, not in Bergin and Garfields seminal text, etc.). So, the article should make clear throughout that this is an ill-defined term. DPeterson 14:59, 15 April 2007 (UTC)

Exactly, therefore we need an article that clearly delineates this ambiguity and the many facets to the disagreements or confusions that exist. JonesRD_talk 18:57, 15 April 2007 (UTC) This article is not about 'smoke'. It's about a subculture of therapies and theories that are of sufficient public importance for the ASPAC to have commissioned more than one report. The fact that it's difficult to describe neatly in oner sentence and has grey areas and fuzzy borders doesn't mean it doesn't really exist. Chaffin and Glaser don't duck the issue so we should seek to clarify not obfuscate.Fainites 21:07, 15 April 2007 (UTC)

The report of the APSAC Task Force on Attachment Therapy, Reactive Attachment Disorder and Attachment Problems (Chaffin et al 2006) describe it as follows (If this is a direct quote, we need a page number)DPeterson 19:50, 15 April 2007 (UTC) "The attachment therapy controversy has centred most broadly on the use of what is known as “holding therapy” (Welch, 1988) and coercive, restraining, or aversive procedures such as deep tissue massage, aversive tickling, punishments related to food and water intake, enforced eye contact, requiring children to submit totally to adult control over all their needs, barring children’s access to normal social relationships outside the primary parent or caretaker, encouraging children to regress to infant status, reparenting, attachment parenting, or techniques designed to provoke cathartic emotional discharge. Variants of these treatments have carried various labels that appear to change frequently. They may be known as “rebirthing therapy,” “compression holding therapy,” “corrective attachment therapy,” “the Evergreen model,” “holding time,” or “rage-reduction therapy” (Cline, 1991; Lien, 2004; Levy & Orlans, 1998; Welch, 1988). Popularly, on the Internet, among foster or adoptive parents, and to case workers, they are simply known as “attachment therapy,” although these controversial therapies certainly do not represent the practices of all professionals using attachment concepts as a basis for their interventions.” Good quote. DPeterson 14:59, 15 April 2007 (UTC) p77.

Speltz (2002) in a paper for the APSAC

Was the paper for the APSAC or merely in the journal Child Maltreatment...that is a very important distinction that should be clarified. DPeterson 14:59, 15 April 2007 (UTC) He was ASPAC advisor and it was printed by permission of the ASPAC.Fainites 21:07, 15 April 2007 (UTC)

describes ‘corrective attachment therapy’ as follows: ‘… the holding therapies included in “corrective” attachment therapy do not address safety needs. They differ in that a therapist or parent initiates the holding process for the purpose of provoking strong, negative emotions in the child (e.g., fear, anger), and the child’s release is typically contingent upon his or her compliance with the therapist’s clinical agenda.

Prior and Glaser (2006) describe ‘Attachment therapy’ as a combination of ‘loose’ diagnosis of attachment disorders and a variety of treatments offered to desperate carers of troubled, maltreated children which often include variants of holding, eg holding time (Welch 1998), therapeutic holding (Howe and Fearnley 2003), rage reduction therapy (Cline 1991) and rebirthing. They also cite age regression as ‘key to the holding therapy approach.’ p265. (Better to have a direct quote and not paraphrase as you are doing...also be sure when you add the quote to include a page number for the citation. I think this should be left out unless you want have a section defining "age regression," whatever that means.DPeterson 19:53, 15 April 2007 (UTC)) Direct quote set out in new version below. I would also point out that Chaffin includes it in his description of 'attachment therapies' and in his list of guidelines of what not to do.Fainites 21:09, 15 April 2007 (UTC) The advocacy group campaigning group is not a term generally used. ACT is an advocacy group DPeterson 12:35, 14 April 2007 (UTC),(OK. That may just be a transatlantic thing.Fainites 17:48, 14 April 2007 (UTC)) Advocates for Children in Therapy define, "Attachment Therapy (AT)..’ as ‘…a growing, underground movement for the treatment of children who pose disciplinary problems to their parents or caregivers. AT practitioners allege that the root cause of the children’s misbehavior is a failure to 'attach' to their caregivers. The purported correction by AT is — literally — to force the children into loving (attaching to) their parents ...there is a hands-on treatment involving physical restraint and discomfort. Attachment Therapy is the imposition of boundary violations - most often coercive restraint - and verbal abuse on a child, usually for hours at a time...Typically, the child is put in a lap hold with the arms pinned down, or alternatively an adult lies on top of a child lying prone on the floor."

ACT seems to have the clearest description of this very vague term. Yes, include this. JonesRD_talk 17:03, 14 April 2007 (UTC)(Again, why this fondness for ACT as the best source?Fainites 17:48, 14 April 2007 (UTC))

I agree that ACT does provide a clearly worded description of this vague term. Why not use ACT, given their work in this area? What is your objection of this group and it's work? DPeterson 18:34, 14 April 2007 (UTC)

(I have no objection as such to ACT. Pressure groups like ACT are important. I just think this subject goes beyond ACT, otherwise why are the ASPAC commissioning reports from swathes of experts in the field? Why do Prior and Glaser devote the better part of a chapter to it?Fainites 06:12, 15 April 2007 (UTC))

Again, why not include the ACT material. Please clarify your objection so that I can better understand. Also, we need to be careful about using older references...Remeber that a text published in 2004 probably was submitted in 2002 and may have material from only up to 2001 or so. DPeterson 14:59, 15 April 2007 (UTC)

Yes, using old materials can be dangerous. Even the APSAC report is from 2005 and based on information that is 2004 and earlier...three years old now.JonesRD_talk 18:57, 15 April 2007 (UTC) Actually the ASPAC report is 2006. Prior and Glaser is August 2006. We have to use verified and credible sources. Are you suggesting that we know better? Based on what sources? Also, calling them 'old materials' is nonsense. We have to be as up to date as we can but what is your source for suggesting the ASPAC report might be out of date? They've only relatively recently published their reply to the correspondance that followed publication.Fainites 21:07, 15 April 2007 (UTC)

history and underlying principles

In a paper for the APSAC by Speltz (2002) the roots of ‘Attachment Therapy’ are traced to Robert Zaslow in the 1970’s. Zaslow attempted to force attachment in those suffering from autism by creating pain and rage whilst enforcing eye contact. He believed that holding someone against their will would lead to a breakdown in their defence mechanism’s making them more receptive to others. Speltz point’s out that these ideas have been dispelled by research into autism and that, conversely, techniques based on behavioural principles have proved effective.

Speltz cites Martha Welch and ‘holding time’ (1984 and 1989) as the next significant development. Mothers were instructed to hold their defiant child, provoking anger and rage, until such time as the child ceased to resist at which point a bonding process was believed to begin. Similar techniques were subsequently promoted by Foster Cline and associates at the Attachment Centre at Evergreen, Inc. (now renamed the Institute For Attachment and Child Development) and duplicated elsewhere in other clinics such as ‘The Center’ in the Pacific northwest. Do you have a citation to support these last accusations? If not, it should be removed.DPeterson 12:40, 14 April 2007 (UTC)

remove the above paragraphJonesRD_talk 17:04, 14 April 2007 (UTC)(The source is Speltz. We can remove the name of the Center. The Evergreen name change is quite recent I think.Fainites 17:48, 14 April 2007 (UTC)) 0-p+

I think we have to be very very careful here. I'd recommend just leaving it out. DPeterson 18:39, 14 April 2007 (UTC)

I'm happy to leave out actual names.Fainites 06:17, 15 April 2007 (UTC))

A substantial rewrite of the above paragraph will then be needed.DPeterson 15:04, 15 April 2007 (UTC) Actually Foster Cline and the Evergreen Attachment Centre are historical and well documented.Fainites 21:12, 15 April 2007 (UTC)

According to Prior and Glaser (2006) ‘there is no empirical evidence to support Zaslows theory. The concept of suppressed rage has, nevertheless, continued to be a central focus explaining the children’s behaviour (Cline 1991)’.

Chaffin et al describe the underlying principles as follows; “In contrast to traditional attachment theory, the theory of attachment described by controversial attachment therapies is that young children who experience adversity (including maltreatment, loss, separations, adoption, frequent changes in child care, colic or even frequent ear infections) become enraged at a very deep and primitive level. As a result, these children are conjectured to lack an ability to attach or to be genuinely affectionate to others. Suppressed or unconscious rage is theorized to prevent the child from forming bonds with caregivers and leads to behavior problems when the rage erupts into unchecked aggression. The children are described as failing to develop a conscience and as not trusting others. They are said to seek control rather than closeness, resist the authority of caregivers, and engage in endless power struggles. From this perspective, children described as having attachment problems are seen as highly manipulative in their social relations and actively trying to avoid true attachments while simultaneously striving to control adults and others around them through manipulation and superficial sociability. Children described as having attachment problems are alleged by proponents of the controversial therapies to be at risk for becoming psychopaths who will go on to engage in very serious delinquent, criminal, and antisocial behaviors if left untreated’. need a page number if this is an actual quoteDPeterson 15:04, 15 April 2007 (UTC)

Prior and Glaser cite the one published study which ‘purports to be an evaluation of holding therapy’ by Myeroff et al (1999). The methodology of this study is heavily criticised, including the use of the Child Behaviour Checklist they don't criticize the use of the CBCL, so this error should be deletedDPeterson 12:42, 14 April 2007 (UTC). (actually that bit is a bit unclear as to whether they're criticising the list or the way its used.Fainites 17:48, 14 April 2007 (UTC)) provide a direct quote and then others can determine. They don't criticize the use of CBCL This is a very reputable instrucment widely used in the field of mental health. DPeterson 18:39, 14 April 2007 (UTC)) (as I said, it's unclear. Therefore it should not be included from 'Including' onwardsFainites 06:17, 15 April 2007 (UTC))This study covers the ‘across the lap’ type holding therapy, described as ‘not restraint’ by Howe and Fearnley (2003) but ‘being held whilst unable to gain release.’ According to Prior and Glaser, regression is key to the holding therapy approach,Do you have a specific page number and quote to support this interpretation of their work...it would be good to include that as well as what they mean by age-regression.DPeterson 15:04, 15 April 2007 (UTC) but was explicitly rejected by Bowlby (1988) who stated that ‘a theory of developmental pathways should replace theories that invoke specific phases of development in which it is held a person may become fixated and/or to which he may regress.’ This last line really is irrelevant and should be removed.DPeterson 12:42, 14 April 2007 (UTC)( It's not irrelevant. It's part of the underlying 'theory' of this type of therapy. How can it be irrelevant if Prior and Glaser say it's 'key' and Chaffin et al list it in their description?Fainites 17:48, 14 April 2007 (UTC)) I don't read the Bowlby quote as rejecting this notion. Furthermore, if this included then you will need to include clarifying material (just two or three para's would do) that "age regression" is not the same as treating a child at the child's developmental level, not chronological age; which is widely accepted in treatment of children with trauma (See Dr. Brue Perry's materal, 2006, for example) DPeterson 18:39, 14 April 2007 (UTC) (we can expand this as necessary. I can put in the whole bit from Glaser, including the Bowlby quote and then readers can see it allFainites 06:17, 15 April 2007 (UTC)) Yes, let's take a look at that so that other editors can also comment.DPeterson 15:04, 15 April 2007 (UTC) Prior and Glaser cite the one published study which ‘purports to be an evaluation of holding therapy’ by Myeroff et al (1999). This study covers the ‘across the lap’ type holding therapy, described as ‘not restraint’ by Howe and Fearnley (2003) but ‘being held whilst unable to gain release.’ This would be better DPeterson 12:43, 14 April 2007 (UTC)

I'd go with the shorter version suggested.JonesRD_talk 17:04, 14 April 2007 (UTC)

Attachment Disorder

Prior and Glaser (2006) describe ‘two discourses’ on attachment disorder. One science based, found in academic journals and books with careful reference to theory, international classifications and evidence. They list Bowlby, Ainsworth, Tizard, Hodges, Chisholm, O’Connor and Zeanah and colleagues as respected attachment theorists and researchers in the field. The other discourse is found in clinical practice, non-academic literature and on the Internet where claims are made which have no basis in attachment theory and for which there is no empirical evidence. In particular unfounded claims are made as to efficacy of ‘treatments’.

Attachment disorders are classified in DSM-IV-TR and ICD-10. DSM describes Reactive Attachment Disorder of Infancy or Early Childhood, divided into two subtypes, Inhibited Type and Disinhibited Type. The ICD classification describes two types, Reactive Attachment Disorder of Childhood and Disinhibited Attachment Disorder of Childhood. Both classifications are under constant discussion and both warn against automatic diagnosis based on abuse or neglect. Many ‘symptoms’ are present in a variety of other more common and more easily treatable disorders.

DSM and ICD are limited and some researchers in the field of attachment such as Zeannah have proposed alternative diagnostic criteria to describe broader disorders of attachment but the exact parameters are not yet established.

Chaffin et al and Prior and Glaser describe the proliferation of alternative ‘lists’ and diagnoses, particularly on the Internet, by proponents of Attachment Therapies that do not accord with either DSM or ICD classifications and which are partly based on the unsubstantiated views of Zaslow and Menta (1975) and Cline (1991). Neither do these lists accord with alternative diagnostic criteria as proposed above. According to Chaffin et al 'These types of lists are so nonspecific that high rates of false-positive diagnoses are virtually certain.' Prior and Glaser state that many of the behaviors in the lists are likely to be the consequences of neglect and abuse rather than located within the attachment paradigm.

This section is very good as it is...I support keeping it unchanged.JonesRD_talk 17:05, 14 April 2007 (UTC) (Yay!Fainites 17:48, 14 April 2007 (UTC))

::I concur. DPeterson 18:40, 14 April 2007 (UTC)

Treatment characteristics

Traditional use of the term "traditional" is irrelvant. It is Attachment theory. DPeterson 12:44, 14 April 2007 (UTC) (Actually I think this is a quote from Chaffin. I'll checkFainites 17:48, 14 April 2007 (UTC)) (Yes it is a quote. I just forgot the comma.Sorry.Fainites 21:14, 15 April 2007 (UTC)) attachment theory holds that caregiver qualities such as environmental stability, parental sensitivity, and responsiveness to children’s physical and emotional needs, consistency, and a safe and predictable environment support the development of healthy attachment. From this perspective, improving these positive caretaker and environmental qualities is the key to improving attachment. From the traditional don't need "traditional" here DPeterson 12:45, 14 April 2007 (UTC) attachment theory viewpoint, therapy for children who are maltreated and described as having attachment problems emphasizes providing a stable environment and taking a calm, sensitive, nonintrusive, nonthreatening, patient, predictable, and nurturing approach toward children (Haugaard, 2004a; Nichols, Lacher,&May, 2004). (Chaffin et al).Treatment and prevention programs that use methods congruent with attachment theory and with well established principles of child development (American Academy of Child and Adolescent Psychiatry) include: Alicia Lieberman (Parent-child Psychotherapy) (Lieberman & Pawl in Infant Mental Health, 1993 )(Lieberman 2003), Stanley Greenspan (Floor Time), Daniel Hughes (Dyadic Developmental Psychotherapy) (Becker-Weidman & Shell, 2005) (Becker-Weidman, 2006a) (Becker-Weidman, 2006b) (Hughes, 2003), Mary Dozier (autonomous states of mind), Robert Marvin (Circle of Security) (Marvin & Whelan 2003), Phyllis Jernberg (Theraplay), Daniel Schechter (Clinician Assisted Videofeedback Exposure Sessions) (Schechter, 2003), and Joy Osofsky (Safe Start Initiative) (in Infant Mental Health, 1993. These are evidence based treatments; citations in peer reviewed professional publications.DPeterson 12:47, 14 April 2007 (UTC)

Yes, remove "traditional." I also agree that the paragraph as edited is better and relies on more current data.JonesRD_talk 17:07, 14 April 2007 (UTC)( I think if we're going to go with the list of evidence based treatments it all needs citations from verified, credible sources. Shouldn't be too difficult to do. I put in the Glaser ones because they are the source. It takes some time to become 'evidence based'.Fainites 17:48, 14 April 2007 (UTC))

The citations are already there. All the citations are from professional peer-reviewed publicataions and thus support the statement to which the list applies. DPeterson 18:46, 14 April 2007 (UTC)

(actually they're not sufficient citations. This article doesn't have a proper wiki ref section at all yet. One ought to be able to click on a little number which takes you to the full name of the article or source. If you then 'google' or use an appropriate library for the source you should be able to find it, including PMID and IBSN numbers. They need to be verifiable in this way for readers etc to check the validity of the sources. We can do all this when we've sorted the wording. I did it for you for the main sources on the EMDR site DP! Fainites 06:31, 15 April 2007 (UTC))

Well, the full citations are in the reference list for the cites in the article. The link between the two may be missing, but my point is that there is sufficient evidence in the article and reference list now. do you disagree?DPeterson 15:15, 15 April 2007 (UTC)

Yes, I checked the list and all those references are present and in reputable professional journals.JonesRD_talk 18:59, 15 April 2007 (UTC)

I don't know until I've read them all.Fainites 21:29, 15 April 2007 (UTC)

No need for this para now. DPeterson 12:53, 14 April 2007 (UTC)Prior and Glaser (2006) describe evidence based treatments, all of which revolve around enhancing caregiver sensitivity, or change of caregiver if that is not possible. Based on meta-analyses by Bakermans-Krananburg et al (2003) This is now old and leaves out material published after 2000DPeterson 12:52, 14 April 2007 (UTC) (Prior and Glaser was published August 2006. As I say. It takes time to be accepted as 'evidence based'. Also, they are another credible verified source supporting the description of what proper therapies areFainites 17:48, 14 April 2007 (UTC)) So their material is based on sources from 2004 and before. Again, each approach listed has a reliable source and thus meets the wiki standard of being verifiable and shold be included. DPeterson 18:46, 14 April 2007 (UTC)(see above for verifiability.Fainites 06:31, 15 April 2007 (UTC)) All the citations are in the reference list, just the links are missing. DPeterson 15:15, 15 April 2007 (UTC) covering 70 published studies for assessing sensitivity, 81 studies on sensitivity and 29 on attachment security and many further randomised intervention studies involving over 7,000 families, the methods singled out to have shown good results were 'Watch, wait and wonder' (Cohen et al 1999), manipulation of sensitive responsiveness, (van den Boom 1994 and 1995), modified 'Interaction Guidance' (Benoit et al 2001), 'Preschool Parent Psychotherapy', (Toth et al (2002) and 'Circle of Security' (Marvin et al 2002).

Agree. Delete above lines.JonesRD_talk 17:07, 14 April 2007 (UTC)

(You need some basis to delete properly sorced and verified editsFainites 17:55, 14 April 2007 (UTC))

The basis for deleting it is that it repeats the material in the previous paragraph, but that para has more methods listed. Therefore the previous paragraph is better.DPeterson 15:23, 15 April 2007 (UTC) Only one treatment is in both oaragraphsFainites 21:19, 15 April 2007 (UTC)

I like the prev. paragraph better too. Let's go with that. JonesRD_talk 18:59, 15 April 2007 (UTC)

It's not 'old'. Glaser is published 2006. There is no basis for saying the treatments she describes as evidence based are out of date! Furthermore, Chaffin quotes the same meta-analysis they do. How long do you guys think it takes to do this kind of research on children? It takes years and years to develop a therapy and do the research and earn the title 'evidence based' Fainites 21:19, 15 April 2007 (UTC)

This para is unneed and could be seen as POVDPeterson 12:54, 14 April 2007 (UTC)The focus of non-evidence based Attachment Therapies is somewhat different. According to Prior and Glaser ‘These include work directed at parents interactions with the children such as behaviour management, life story work and work on the meanings of the child’s experience, and some approaches are directed at the child and may or may not include the child’s primary carer. Attachment therapy often however, also includes some other interventions including a number of variants of holding, eg holding time (Welch 1998) and therapeutic holding (Howe and Fearnley) as well as others such as rage-reduction therapy (Cline 1991) and rebirthing.’ They also refer to the ‘Handbook of Attachment Interventions’ (Levy 2000), Levy and Orlans and the ‘Holding Nurturing Process.’ The evidence based treatments mentioned in the prev, uneeded par, also focus on parents interactions with children. This is a confusing para ...it should goDPeterson 12:55, 14 April 2007 (UTC)

Agree, delete above linesJonesRD_talk 17:07, 14 April 2007 (UTC)

(POV is about editors or material from unverified, non-credible sources. It's not POV when it's from a relevant, appropriate source. I agree it's perhaps confusing here and may be better in another section.Fainites 17:48, 14 April 2007 (UTC)) (I would propose putting in the Glaser bit first and then adding afterwards any other therapies that we can verify according to WikiFainites 06:34, 15 April 2007 (UTC))

I think the previous paragraph includes all the therapies in one simple paragraph...lets try to keep the article focused and short, not wordy. Since each of the methods has at least one professiona peer-reviewed publication next to the name, each one has a citation that meets the wikipedia standard of being verifiable. DPeterson 15:15, 15 April 2007 (UTC)

According to O’Connor and Zeanah (2003 p235) "The holding approach would be viewed as intrusive and therefore non-sensitive and counter therapeutic".

Chaffin et al (2006) describe how the conceptual focus of these treatments is the childs individual internal pathology and past caregivers rather than current parent-child relationships or current environment, to the extent that if the child is well behaved outside the home this is seen as manipulative. It was noted that this perspective has its attractions because it relieves the caregivers of responsibility to change aspects of their own behavior and aspirations. Proponents of the controversial therapies emphasize the child’s resistance to attachment and the need to break down the child’s resistance (Institute for Attachment and Child Development, n.d.).'

the above lines are good...keepJonesRD_talk 17:07, 14 April 2007 (UTC)

Like the standards on bio's of living persons, you must really be careful about making statements about the practice of an existing entity. The Speltz material is many years old now. Are you sure the Center still does this? If so, I think you must provide a relevant current citation. DPeterson 12:58, 14 April 2007 (UTC)(OK we can remove the name. The description is pretty central tho'. Chaffin etc were following on where Speltz left off and in psychology terms, 4 years is not very long.Fainites 17:48, 14 April 2007 (UTC)) I isn't really central to an article on Attachment Therapy as I see it. DPeterson 18:46, 14 April 2007 (UTC) (this article isn't just about the capital letter version. Chaffin is not the only person to make the point that one of the attractions of this kind of therapy is that it focuses on there being something wrong with the child that needs to be changed rather than focussing on the caregiver. The key to all the therapies that Glaser gives as evidence based is that they ALL revolve around caregiver sensetivityFainites 06:31, 15 April 2007 (UTC)) However, all the current protocols regarding trauma treatment DO call for the exploration and revisting of past trauma...this material is not a direct quote and so may be a mis-interpretation. I'd suggest leaving it out or putting in their direct quote so that that reader can understand what they actually said. The line there now "focus of these treatments is the childs individual internal pathology and past caregivers," is misleading because it leads one to conclude that a focus on past trauma is "bad," while that is precisely what is required to resolve trauma (See The National Child Trauma Center's White Paper on Complex Trauma, J. Briere's book Principles of Trauma Treatment, etc., etc.)DPeterson 15:15, 15 April 2007 (UTC) Trauma treatment and attachment treatment are not the same thing. The Chaffin quote is verified and credible. If there is another source, like the one you've mentioned, that's also verified and credible and relevant to attachment, then stick it in. The two don't mutually cancel each other. Anyway, I don't read that as saying dealing with past traumas is bad. It's about the false notions of what is an attachment issue. Both sources highlight the attachment therapies concentration on changing the child when all the evidence based therapies concentrate on carer sensitivity. Therapy for trauma is something different.Fainites 21:28, 15 April 2007 (UTC)

Speltz describes a typical treatment taken from The Center’s material as follows; ‘Like Welsh (1984, 1989), The Center induces rage by physically restraining the child and forcing eye contact with the therapist (the child must lie across the laps of two therapists, looking up at one of them). In a workshop handout prepared by two therapists at The Center, the following sequence of events is described: (1) therapist “forces control” by holding (which produces child “rage”); (2) rage leads to child “capitulation” to the therapist, as indicated by the child breaking down emotionally (“sobbing”); (3) the therapist takes advantage of the child’s capitulation by showing nurturance and warmth; (4) this new trust allows the child to accept “control” by the therapist and evenutally the parent. According to The Center’s treatment protocol, if the child “shuts down” (i.e., refuses to comply), he or she may be threatened with detainment for the day at the clinic or forced placement in a temporary foster home; this is explained to the child as a consequence of not choosing to be a “family boy or girl.” If the child is actually placed in foster care, the child is then required to “earn the way back to therapy” and a chance to resume living with the adoptive family. This whole para should go since it is merely a POV attack on that program and not central to this article.DPeterson 12:59, 14 April 2007 (UTC)

Yes, delete. The material adds no value to the article and appears inflamatory and not NPOV JonesRD_talk 17:07, 14 April 2007 (UTC)

(How can it possibly be 'POV'? I suggest you look at the policy. It's a quotation from a peer reviewed report to the ASPAC! A verified, credible source, completely on the point of this article!Fainites 17:48, 14 April 2007 (UTC))

Again, leave out material, like bio material, about the Center, unless you have verifiable and reliable sources that that is their 'CURRENT' practice. It's best just to leave it out. DPeterson 18:46, 14 April 2007 (UTC) Quite happy to leave out the name but not the description. How can it possibly be POV when it's in a report by the ASPAC advisor, on this very issue, and it's a direct quote from a clinics material!Fainites 21:28, 15 April 2007 (UTC)

Often parents are required to follow programmes of treatment at home, for example, obedience-training techniques such as "strong sitting" (frequent periods of required silence and immobility) and withholding or limiting food (Thomas, 2001). Also requiring children to submit totally to adult control over all their needs and barring children’s access to normal social relationships outside the primary parent or caretaker.

ACT’s site contains descriptions of the more extreme versions of these attachment therapies, including a link to the transcript of the ‘rebirthing’ process that lead to the death by suffocation of Candace Newmaker at the hands of her ‘therapists’. According to ACT "Attachment Therapy almost always involves extremely confrontational, often hostile confrontation of a child by a therapist or parent (sometimes both). Restraint of the child by more powerful adult(s) is considered an essential part of the confrontation."

Keep this. JonesRD_talk 17:07, 14 April 2007 (UTC)

I agreeDPeterson 18:46, 14 April 2007 (UTC)

Prevalence

This intro para is better. It clearly defines the issue and subjectDPeterson 13:01, 14 April 2007 (UTC)

There are no reliable statistics on how many professionals actually practice "Attachment Therapy" or "rebirthing as it is also known. However, as defined in this article, "Attachment Therapy" involves the use of practices prohibited by a large number of professional organizations such as the following: American Psychological Association], National Association of Social Workers], American Professional society on the Abuse of Children (APSAC) ], Association for the Treatment and Training in the Attachment of Children, American Academy of Child and Adolescent Psychiatrry ("Practice Parameter for the Assessment of Children and Adolescent with Reactive Attachment Disorder of Infancy and Early Childhood" in the Journal of the American Academy of Child and Adolescent Psychiatry, vol 44, Nov 2005 and at ]),and the American Psychiatric Association. ]. Members of those organizations are prohibited from using methods and techniques proscribed by those organizations codes of ethics and practice parameters. Violations of those standards would result in expulsion of the organization. Therefore there are very few practitioners of "AT" as defined in this article. Furthermore, several states have outlawed "rebirthing," and anyone using such methods would be guilty of malpractice, which is a small problem in all professions. DPeterson 13:01, 14 April 2007 (UTC)

The above edited paragraph is good. JonesRD_talk 17:10, 14 April 2007 (UTC)

(Saying 'therefore there are very few practitioners' is a) not a logical conclusion of the previous paragraph and b) is OR.Fainites 06:39, 15 April 2007 (UTC))

It is rebirthing that is outlawed. I think the above paragraph states the concept most simply. DPeterson 15:19, 15 April 2007 (UTC)

It is difficult to ascertain the prevalence of these therapies but they are sufficiently prevalent to have prompted reactions as outlined by Chaffin et al as follows;

Delete the following lines...not relevant here. JonesRD_talk 17:10, 14 April 2007 (UTC)(This is the conclusion of the report of the ASPAC on prevalence. How can it possibly be irrelevant?Fainites 17:48, 14 April 2007 (UTC))

The practice of some forms of these treatments has resulted in professional licensure sanctions against some leading proponents of the controversial attachment therapies. There have been cases of successful criminal prosecution and incarceration of therapists or parents using controversial attachment therapy techniques and state legislation to ban particular therapies. Position statements against using coercion or restraint as a treatment were issued by mainstream professional societies (American Psychiatric Association, 2002) and by a professional organization focusing on attachment and attachment therapy (Association for Treatment and Training in the Attachment of Children , 2001). Despite these and other strong cautions from professional organizations, the controversial treatments and their associated concepts and foundational principles appear to be continuing among networks of attachment therapists, attachment therapy centers, caseworkers, and adoptive or foster parents (Hage, n.d.-a; Keck, n.d.)’. This is not related to prevelance and should be deleted.DPeterson 13:02, 14 April 2007 (UTC)(Suggest we rename the 'prevalence ' section then. The statement that there are 'very few' practitioners is OR and POV. The quote from Chaffin is not. I think it would be less confusing if we could outline which organisations prohibited these practices and when, and who did so following the Chaffin report. Chaffin laid down guidelines. Two organisations adopted the report wholesale. Your suggestion is confusing but it isn't clear whether all these things were always prohibited and therefore it's completely beyond the pale, or whether the spate of regulation is in response to prevalence.Fainites 17:48, 14 April 2007 (UTC))

Chaffin describes the polarization between the proponents of ‘Attachment Therapy’ and mainstream therapies stating ‘This polarization is compounded by the fact that attachment therapy has largely developed outside the mainstream scientific and professional community and flourishes within its own networks of attachment therapists, treatment centers, caseworkers, and parent support groups. Indeed, proponents and critics of the controversial attachment therapies appear to move in different worlds.’ not related to prev DPeterson 13:02, 14 April 2007 (UTC)(Central to prevalence and highly releventFainites 17:48, 14 April 2007 (UTC))(Completely relevent to prevalence.Fainites 18:03, 14 April 2007 (UTC))A particular concern of both Chaffin et al and Prior and Glaser is the use of the Internet to advertise these therapies and the use of unscientific and 'wildly inclusive' lists of 'symptoms' (Prior and Glaser). According to Chaffin et al 'These types of lists are so nonspecific that high rates of false-positive diagnoses are virtually certain. Posting these types of lists on Web sites that also serve as marketing tools may lead many parents or others to conclude inaccurately that their children have attachment disorders.' Many of the behaviors in the lists are likely to be the consequences of neglect and abuse rather than located within the attachment paradigm. Descriptions of children are frequently highly perjorative and 'demonising'. According to Chaffin et al 'Proponents of controversial attachment therapies 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’. They also express concern over claims by therapies to be 'evidence based' or indeed the 'only' evidence based therapy when the Task Force found no credible evidence base for any such therapy so advertised. This para is unnecessary...not related to this subject headingDPeterson 13:04, 14 April 2007 (UTC)

Yes, this prev section should go for the reasons already stated. JonesRD_talk 17:10, 14 April 2007 (UTC)

(I'd be happy to rename the section, but the point being made by Chaffin and Glaser is a substantial part of their report.Fainites 18:03, 14 April 2007 (UTC))

I think a better approach would be to edit it down to a much briefer quote. DPeterson 18:49, 14 April 2007 (UTC)

Prior and Glaser (2006) state ‘The practice of holding therapy is not confined to the USA.’ And give an example of a center in the UK practising ‘therapeutic holding’ of the across the lap variety.cite a page# if you are going to provide a direct and accurate quoteDPeterson 13:04, 14 April 2007 (UTC)(p263Fainites 17:48, 14 April 2007 (UTC))

the article should not be a springboard for one POV by ACTDPeterson 13:05, 14 April 2007 (UTC)( I agree. That's why it suprises me that so many of the above amendments put ACT in the driving seat for definitions and descriptions. Surely it makes sense to use the valid, peer reviewed authorities for this, not an advocacy group. I'd be quite happy to put everything relating to ACT in a seperate section.Fainites 17:48, 14 April 2007 (UTC))The advocacy group ACT claim "Attachment Therapy is a growing, underground movement for the 'treatment' of children who pose disciplinary problems to their parents or caregivers." The ACT site also contains a list of alleged "Attachment Therapies' by another name, some of whose proponents vehemently deny being derived from or in any way related to 'Attachment Therapy' as described by ACT or this article. The list also contains descriptions too broad to be a ‘name’ of any particular therapy such as ‘attachment disorder therapy’. Fainites 12:09, 13 April 2007 (UTC)Don't think this para is necessary...but maybe it goes under the defination if anywhereDPeterson 13:05, 14 April 2007 (UTC)

See also

References

Becker-Weidman, A., & Shell, D., (2005) Creating Capacity for Attachment. Oklahoma City, OK: Wood 'N' Barnes.

Becker-Weidman (2006a) Treatment for Children with Trauma-Attachment Disorders: Dyadic Developmental Psychotherapy, Child and Adolescent Social Work Journal. 23(2), April 2006

Becker-Weidman, A., (2006b) Dyadic Developmental Psychotherapy: a multi year follow-up. in Sturt, S., (ed) New Developments in Child Abuse Research. NY: Nova

Becker-Weidman, A., (2006c) “Treatment For Children with Reactive Attachment Disorder: Dyadic Developmental Psychotherapy,” Child and Adolescent Mental Health Published article online: 21-Nov-2006 doi: 10.1111/j.1475-3588.2006.00428.x.]

Berliner, L. (2002).Why caregivers turn to "attachment therapy" and what we can do that is better. APSAC Advisor, 14(4), 8-10.

Bowlby, J. (1982). Attachment. New York: Basic.

Chaffin M, Hanson R, Saunders BE, Nichols T, Barnett D, Zeanah C, Berliner L, Egeland B, Newman E, Lyon T, LeTourneau E, Miller-Perrin C. Report of the APSAC task force on attachment therapy, reactive attachment disorder, and attachment problems. Child Maltreat. 2006 Feb;11(1):76-89. PMID 16382093

Cline, F. (1994). Hope for high risk and rage-filled children. Evergreen, CO: EC Publications.

Hughes, D., (2003). Psychotherapeutic interventions for the spectrum of attachment disorders and intrafamilial trauma. Attachment and Human Development 5-3, 271-279.

Hughes, D. (2004). An attachment-based treatment of maltreated children and young people. Attachment & Human Development, 3, 263–278.

Krenner, M. (1999). Ein Erklaerungsmodell zur "Festhaltetherapie" nach Jirina Prekop. Retrieved Oct. 25, 2000, from http://wwwalt.uni-wuerzburg.de/gbpaed/mixed/work/mkrenner1.html.

Levy, T.M., Ed. (2000). Handbook of attachment interventions. San diego: Academic.

Lieberman, A., (2003). The treatment of attachment disorder in infancy and early childhood. Attachment and Human Development 5-3, 279-283.

Marvin, R., & Whelan, W., (2003) Disordered attachment: toward evidence-based clinical practice. Attachment and Human Development 5-3, 284-299.

O'Connor, C., & Zeanah, C., Attachment disorder: assessment strategies and treatment approaches, Attachment and Human Development 5, 223-244.

Schechter, D.S. (2003). Intergenerational communication of maternal violent trauma: Understanding the interplay of reflective functioning and posttraumatic psychopathology. In S.W. Coates, J.L. Rosenthal, & D.S. Schechter (Eds.), September 11: Trauma and Human Bonds. New York, NY: The Analytic Press, pp. 115-143.

Thomas, N. (2001). Parenting children with attachment disorders. In T.M. Levy (Ed.), Handbook of attachment interventions. San Diego, CA: Academic.

Verny, T., & Kelly, J. (1981). The secret life of the unborn child. New York: Dell.

Welch, M.G. (1989) Holding time. New York:Fireside.

Welch, M.G., Northrup, R.S., Welch-Horan, T.B., Ludwig, R.J., Austin, C.L., & Jacobson, J.S.(2006). Outcomes of prolonged parent-child embrace therapy among 102 children with behavioral disorders. Complementary Therapies in Clinical Practice, 12, 3-12.

Zaslow, R., & Menta, M. (1975) The psychology of the Z-process: Attachment and activity. San Jose, CA: San Jose University Press.

Zeanah, C., (1993) Infant Mental Health. NY: Guilford.

DPetersons amendments

(This section contains DPetersons proposed amendments to Fainites proposed article, and Fainites comments in italics. Fainites 09:48, 14 April 2007 (UTC))

"Attachment Therapy", ”attachment therapy,” holding therapy, rebirthing therapy, or ‘’corrective attachment therapy’’ is an ambiguous term often used to describe a variety of controversial, non-mainstream "treatments" for children allegedly suffering from attachment disorder, which is itself an ambiguous term. However, because the term has no common meaning, or generally accepted meaning, in the professional community, its actual definition is unclear. A number of advocacy groups, such as Advocates for Children in Therapy and Quackwatch have undertaken to label nearly all treatments for children with disorders of attachment as "Attachment Therapy" and attempt to discredit those therapies. (this bit should be in a seperate section that deals with the ACT controversy aspect Fainites 09:28, 14 April 2007 (UTC)) The treatments often involve coercive and intrusive methods including variants of holding therapy or rebirthing or rage-reduction. According to Prior and Glaser (2006), ‘these therapies are not based on an accepted version of attachment theory and there is no objective evaluation of them’. Many professional bodies and some American States have outlawed rebirthing therapy.(haven't they outlawed a bit more than just rebirthing? Didn't some base their codes on Chaffin's recommendations? Fainites 09:34, 14 April 2007 (UTC)) Care should be taken to distinguish between this subset of therapies and more mainstream therapies which may also be loosely described as attachment or attachment disorder therapy. For the purposes of this article, the term used to describe this subset is ‘Attachment Therapy.’

Definitions of Attachment Therapy

The term has little commonly agreed upon meaning in the professional literature. For example, it is not a term found in the American Medical Association's Physician's Current Procedural Manual. The American Professional Society on Abuse of children (APSAC) (Chaffin et al.,2006, PMID 16382093) does not use the term "Attachment Therapy," but has disapproved of coercive and intrusive methods of treatment as inappropriate for treatment while approving a broad range of effective treatments for children with disorders of attachment that do not use coercive methods. (this proceeding sentence doesn't quite make sense here because the whole point of Chaffin is that he is attempting to define and describe the issue. I think we need to amalgamate these two section more carefullyFainites 09:28, 14 April 2007 (UTC)) The report of the APSAC Task Force on Attachment Therapy, Reactive Attachment Disorder and Attachment Problems (Chaffin et al 2006) describe it as follows; "The attachment therapy controversy has centred most broadly on the use of what is known as “holding therapy” (Welch, 1988) and coercive, restraining, or aversive procedures such as deep tissue massage, aversive tickling, punishments related to food and water intake, enforced eye contact, requiring children to submit totally to adult control over all their needs, barring children’s access to normal social relationships outside the primary parent or caretaker, encouraging children to regress to infant status, reparenting, attachment parenting, or techniques designed to provoke cathartic emotional discharge. Variants of these treatments have carried various labels that appear to change frequently. They may be known as “rebirthing therapy,” “compression holding therapy,” “corrective attachment therapy,” “the Evergreen model,” “holding time,” or “rage-reduction therapy” (Cline, 1991; Lien, 2004; Levy & Orlans, 1998; Welch, 1988). Popularly, on the Internet, among foster or adoptive parents, and to case workers, they are simply known as “attachment therapy,” although these controversial therapies certainly do not represent the practices of all professionals using attachment concepts as a basis for their interventions.”

Speltz (2002) in a paper for the APSAC (Was it written for APSAC or merely printed in one of their publications such as Child Maltreatment?DPeterson 19:42, 15 April 2007 (UTC)) describes ‘corrective attachment therapy’ as follows; ‘… the holding therapies included in “corrective” attachment therapy do not address safety needs. They differ in that a therapist or parent initiates the holding process for the purpose of provoking strong, negative emotions in the child (e.g., fear, anger), and the child’s release is typically contingent upon his or her compliance with the therapist’s clinical agenda.

Prior and Glaser (2006) describe ‘Attachment therapy’ as a combination of ‘loose’ diagnosis of attachment disorders and a variety of treatments offered to desperate carers of troubled, maltreated children which often include variants of holding, eg holding time (Welch 1998), therapeutic holding (Howe and Fearnley 2003), rage reduction therapy (Cline 1991) and rebirthing. They also cite age regression as ‘key to the holding therapy approach.’ p265.

The advocacy group, Advocates for Children in Therapy define, "Attachment Therapy (AT)..’ as ‘…a growing, underground movement for the treatment of children who pose disciplinary problems to their parents or caregivers. AT practitioners allege that the root cause of the children’s misbehavior is a failure to 'attach' to their caregivers. The purported correction by AT is — literally — to force the children into loving (attaching to) their parents ...there is a hands-on treatment involving physical restraint and discomfort. Attachment Therapy is the imposition of boundary violations - most often coercive restraint - and verbal abuse on a child, usually for hours at a time...Typically, the child is put in a lap hold with the arms pinned down, or alternatively an adult lies on top of a child lying prone on the floor."

There is no generally accepted definition of "Attachment Therapy," and it is not a term that is found in generally recognized texts on treatment modalities, such as Bergin & Garfield's Handbook of Psychotherapy and Behavior Change, nor is there any specific text that describes this "treatment" approach.(this preceding sentence needs to be amalgamated with the above paragraph. The bit below merely duplicates what has already been put in. Fainites 09:28, 14 April 2007 (UTC)) However, the advocacy group, Advocates for Children in Therapy does offer guidance on this subject. While this group is not a professional mental health group in the same manner that the American Psychiatric Association or American Psychological Association or National Association of Social Workers are, and none of the leaders are licensed mental professionals or clinicians, they do offer some ideas for a description of what this term can mean.(this last sentence is misleading as it suggests that nobody knows what 'Attachment Therapy' means when it has in fact been carefully described by Chaffin, Speltz and Prior and Glaser. We don't need to depend on ACT for a description of Attachment Therapy. Fainites 09:28, 14 April 2007 (UTC))

ACT states, "Attachment Therapy is a growing, underground movement for the 'treatment' of children who pose disciplinary problems to their parents or caregivers." In discussing Attachment Therapy they state, "there is a hands-on treatment involving physical restraint and discomfort. Attachment Therapy is the imposition of boundary violations - most often coercive restraint - and verbal abuse on a child, usually for hours at a time...Typically, the child is put in a lap hold with the arms pinned down, or alternatively an adult lies on top of a child lying prone on the floor."

ACT further defines "Attachment Therapy" as, "Attachment Therapy almost always involves extremely confrontational, often hostile confrontation of a child by a therapist or parent (sometimes both). Restraint of the child by more powerful adult(s) is considered an essential part of the confrontation."

The group also uses the terms "rebirthing" and "holding therapy" as terms for "Attachment Therapy."

history and underlying principles

In a paper for the APSAC by Speltz (2002) the roots of ‘Attachment Therapy’ are traced to Robert Zaslow in the 1970’s. Zaslow attempted to force attachment in those suffering from autism by creating pain and rage whilst enforcing eye contact. He believed that holding someone against their will would lead to a breakdown in their defence mechanism’s making them more receptive to others. Speltz point’s out that these ideas have been dispelled by research into autism and that, conversely, techniques based on behavioural principles have proved effective.

Speltz cites Martha Welch and ‘holding time’ (1984 and 1989) as the next significant development. Mothers were instructed to hold their defiant child, provoking anger and rage, until such time as the child ceased to resist at which point a bonding process was believed to begin. Similar techniques were subsequently promoted by Foster Cline and associates at the Attachment Centre at Evergreen, Inc. (now renamed the Institute For Attachment and Child Development) and duplicated elsewhere in other clinics such as ‘The Center’ in the Pacific northwest.

According to Prior and Glaser (2006) ‘there is no empirical evidence to support Zaslows theory. The concept of suppressed rage has, nevertheless, continued to be a central focus explaining the children’s behaviour (Cline 1991)’.

Chaffin et al describe the underlying principles as follows; “In contrast to traditional attachment theory, the theory of attachment described by controversial attachment therapies is that young children who experience adversity (including maltreatment, loss, separations, adoption, frequent changes in child care, colic or even frequent ear infections) become enraged at a very deep and primitive level. As a result, these children are conjectured to lack an ability to attach or to be genuinely affectionate to others. Suppressed or unconscious rage is theorized to prevent the child from forming bonds with caregivers and leads to behavior problems when the rage erupts into unchecked aggression. The children are described as failing to develop a conscience and as not trusting others. They are said to seek control rather than closeness, resist the authority of caregivers, and engage in endless power struggles. From this perspective, children described as having attachment problems are seen as highly manipulative in their social relations and actively trying to avoid true attachments while simultaneously striving to control adults and others around them through manipulation and superficial sociability. Children described as having attachment problems are alleged by proponents of the controversial therapies to be at risk for becoming psychopaths who will go on to engage in very serious delinquent, criminal, and antisocial behaviors if left untreated’.

Prior and Glaser cite the one published study which ‘purports to be an evaluation of holding therapy’ by Myeroff et al (1999). This study covers the ‘across the lap’ type holding therapy, described as ‘not restraint’ by Howe and Fearnley (2003) but ‘being held whilst unable to gain release.’( why did you remove the rest of this paragraph? Its verified, credible and properly sourced and cited. Fainites 09:36, 14 April 2007 (UTC))

Attachment Disorder

Prior and Glaser (2006) describe ‘two discourses’ on attachment disorder. One science based, found in academic journals and books with careful reference to theory, international classifications and evidence. They list Bowlby, Ainsworth, Tizard, Hodges, Chisholm, O’Connor and Zeanah and colleagues as respected attachment theorists and researchers in the field. The other discourse is found in clinical practice, non-academic literature and on the Internet where claims are made which have no basis in attachment theory and for which there is no empirical evidence. In particular unfounded claims are made as to efficacy of ‘treatments’.

Attachment disorders are classified in DSM-IV-TR and ICD-10. DSM describes Reactive Attachment Disorder of Infancy or Early Childhood, divided into two subtypes, Inhibited Type and Disinhibited Type. The ICD classification describes two types, Reactive Attachment Disorder of Childhood and Disinhibited Attachment Disorder of Childhood. Both classifications are under constant discussion and both warn against automatic diagnosis based on abuse or neglect. Many ‘symptoms’ are present in a variety of other more common and more easily treatable disorders.

DSM and ICD are limited and some researchers in the field of attachment such as Zeannah have proposed alternative diagnostic criteria to describe broader disorders of attachment but the exact parameters are not yet established.

Chaffin et al and Prior and Glaser describe the proliferation of alternative ‘lists’ and diagnoses, particularly on the Internet, by proponents of Attachment Therapies that do not accord with either DSM or ICD classifications and which are partly based on the unsubstantiated views of Zaslow and Menta (1975) and Cline (1991). Neither do these lists accord with alternative diagnostic criteria as proposed above. According to Chaffin et al 'These types of lists are so nonspecific that high rates of false-positive diagnoses are virtually certain.' Prior and Glaser state that many of the behaviors in the lists are likely to be the consequences of neglect and abuse rather than located within the attachment paradigm.

Treatment characteristics

Attachment theory holds that caregiver qualities such as environmental stability, parental sensitivity, and responsiveness to children’s physical and emotional needs, consistency, and a safe and predictable environment support the development of healthy attachment. From this perspective, improving these positive caretaker and environmental qualities is the key to improving attachment. From the traditional attachment theory viewpoint, therapy for children who are maltreated and described as having attachment problems emphasizes providing a stable environment and taking a calm, sensitive, nonintrusive, nonthreatening, patient, predictable, and nurturing approach toward children (Haugaard, 2004a; Nichols, Lacher,&May, 2004). (Chaffin et al). ( I'm not to sure about this list business. I put the list in from Prior and Glaser and you have your list here, but I'm wondering if this isn't all a bit unwise. This article is about the OTHER therapies. Should we in fact like Chaffin confine ourselves to describing the characteristics of mainstream treatment rather than getting involved in lists, every entry in which will need to be independently and credibly verified and about which there are bound to be disagreements about who's in and who's out.Fainites 09:37, 14 April 2007 (UTC)) ((I've commented above in your article to keep all comments in one place. I think it is important to list these reputable approaches...once you begin to list approaches, leaving out affiliated approaches, like Theraplay, is damming by omission. We don't need to confine the list to Chafin, especially since that article only covers material through about 2004 and more recent material should be included. The other approaches included have the appropriate citations necessarry to include them. Not including them appears POV.JonesRD_talk 17:34, 14 April 2007 (UTC)) (I think however we do the list looks POV which is perhaps why Chaffin etc wisely decided not to do a list. Maybe we should follow his exampleFainites 18:31, 14 April 2007 (UTC))Treatment and prevention programs that use methods congruent with attachment theory and with well established principles of child development (American Academy of Child and Adolescent Psychiatry) include: Alicia Lieberman (Parent-child Psychotherapy) (Lieberman & Pawl in Infant Mental Health, 1993 )(Lieberman 2003), Stanley Greenspan (Floor Time), Daniel Hughes (Dyadic Developmental Psychotherapy) (Becker-Weidman & Shell, 2005) (Hughes, 2003), Mary Dozier (autonomous states of mind), Robert Marvin (Circle of Security) (Marvin & Whelan 2003), Phyllis Jernberg (Theraplay), Daniel Schechter (Clinician Assisted Videofeedback Exposure Sessions) (Schechter, 2003), and Joy Osofsky (Safe Start Initiative) (in Infant Mental Health, 1993.

Prior and Glaser (2006) describe evidence based treatments, all of which revolve around enhancing caregiver sensitivity, or change of caregiver if that is not possible. Based on meta-analyses by Bakermans-Krananburg et al (2003) covering 70 published studies for assessing sensitivity, 81 studies on sensitivity and 29 on attachment security and many further randomised intervention studies involving over 7,000 families, the methods singled out to have shown good results were 'Watch, wait and wonder' (Cohen et al 1999), manipulation of sensitive responsiveness, (van den Boom 1994 and 1995), modified 'Interaction Guidance' (Benoit et al 2001), 'Preschool Parent Psychotherapy', (Toth et al (2002) and 'Circle of Security' (Marvin et al 2002).

According to O’Connor and Zeanah (2003 p235) "The holding approach would be viewed as intrusive and therefore non-sensitive and counter therapeutic".

Chaffin et al (2006) describe how the conceptual focus of these treatments is the childs individual internal pathology and past caregivers rather than current parent-child relationships or current environment, to the extent that if the child is well behaved outside the home this is seen as manipulative. It was noted that this perspective has its attractions because it relieves the caregivers of responsibility to change aspects of their own behavior and aspirations. Proponents of the controversial therapies emphasize the child’s resistance to attachment and the need to break down the child’s resistance.'

Often parents are required to follow programmes of treatment at home, for example, obedience-training techniques such as "strong sitting" (frequent periods of required silence and immobility) and withholding or limiting food (Thomas, 2001). Also requiring children to submit totally to adult control over all their needs and barring children’s access to normal social relationships outside the primary parent or caretaker.

The APSAC report does not describe "Attachment Therapy", it uses the term "attachment therapy" (no caps or quotation marks). They state, “The terms attachment disorder, attachment problems, and attachment therapy, although increasingly used, have no clear, specific, or consensus definitions. Pg 77 Furthermore, what seems to be focus of this proposed page only addresses a very narrow area, “Controversies have arisen about potentially harmful attachment therapy techniques used by a subset of attachment therapists.” Pg 76 Attachment therapy is better discussed in context, especially if the focus is on “a particular subset of attachment therapy techniques developed by a subset of attachment therapy practitioners” pg 77. The controversy is a narrow one and should be placed in context so that readers understand the full range of issues. “ The attachment therapy controversy has centered most broadly on the use of what is known as “holding therapy” (Welch, 1988) and coercive, restraining, or aversive procedures such as deep tissue massage, aversive tickling, punishments related to food and water intake, enforced eye contact, requiring children to submit totally to adult control over all their needs, barring children’s access to normal social relationships outside the primary parent or caretaker, encouraging children to regress to infant status, reparenting, attachment parenting, or techniques designed to provoke cathartic emotional discharge” pg 83.( I frankly don't understand why you've put this paragraph in here. The issue of descriptions/capitals/non-capitals should be dealt with in the intro or definition section, and indeed is. Also the fact that this is a subset. That's what this article is all about! Who says the 'controversy is a narrow one'? I also think we need to establish the context in the intro and the definition section. I think we should stick to the commentators on this. Fainites 09:28, 14 April 2007 (UTC))

ACT’s site contains descriptions of the more extreme versions of these attachment therapies, including a link to the transcript of the ‘rebirthing’ process that lead to the death by suffocation of Candace Newmaker at the hands of her ‘therapists’. According to ACT "Attachment Therapy almost always involves extremely confrontational, often hostile confrontation of a child by a therapist or parent (sometimes both). Restraint of the child by more powerful adult(s) is considered an essential part of the confrontation."

Prevalence

There are no reliable statistics on how many professionals actually practice "Attachment Therapy" or "rebirthing as it is also known. However, as defined in this article, "Attachment Therapy" involves the use of practices prohibited by a large number of professional organizations such as the following: American Psychological Association], National Association of Social Workers], American Professional society on the Abuse of Children (APSAC) ], Association for the Treatment and Training in the Attachment of Children, American Academy of Child and Adolescent Psychiatrry ("Practice Parameter for the Assessment of Children and Adolescent with Reactive Attachment Disorder of Infancy and Early Childhood" in the Journal of the American Academy of Child and Adolescent Psychiatry, vol 44, Nov 2005 and at ]) , and the American Psychiatric Association. ]. Members of those organizations are prohibited from using methods and techniques proscribed by those organizations codes of ethics and practice parameters. Violations of those standards would result in expulsion of the organization. Therefore there are very few practitioners of "AT" as defined in this article. Furthermore, several states have outlawed "rebirthing," and anyone using such methods would be guilty of malpractice, which is a small problem in all professions.

by Chaffin et al state, ‘The practice of some forms of these treatments has resulted in professional licensure sanctions against some leading proponents of the controversial attachment therapies. There have been cases of successful criminal prosecution and incarceration of therapists or parents using controversial attachment therapy techniques and state legislation to ban particular therapies. Position statements against using coercion or restraint as a treatment were issued by mainstream professional societies (American Psychiatric Association, 2002) and by a professional organization focusing on attachment and attachment therapy (Association for Treatment and Training in the Attachment of Children , 2001). Despite these and other strong cautions from professional organizations, the controversial treatments and their associated concepts and foundational principles appear to be continuing among networks of attachment therapists, attachment therapy centers, caseworkers, and adoptive or foster parents (Hage, n.d.-a; Keck, n.d.)’.

( I think it makes more sense to put Chaffins views on prevalence first and then list the organisations and states that have outlawed it afterwards. However, Chaffin does make the point that just because people regulate against it doesn't mean it goes away. What is the source for saying it is 'rare'? I think Chaffin is the best source we have on prevalence. Also, why have you removed Prior and Glaser on the UK? and why have you removed Chaffin on polarization?Fainites 09:45, 14 April 2007 (UTC))

Comments on suggested changes

This is a really good start!. I'll be interested to see what other editors think and the read their suggested additions etc. I'll make mine above in the prev section. I encourage other editors to review the above material and make their suggested edits and changes to it so we can build consensus. DPeterson 00:28, 14 April 2007 (UTC)

Good. I will add my comments above to keep everything in one place.JonesRD_talk 17:00, 14 April 2007 (UTC)

Suggested Article by DPeterson

"Attachment Therapy", ”attachment therapy,” holding therapy, rebirthing therapy, or ‘’corrective attachment therapy’’ is an ambiguous term often used to describe a variety of controversial, non-mainstream "treatments" for children allegedly suffering from attachment disorder, which is itself an ambiguous term. However, because the term has no common meaning, or generally accepted meaning, in the professional community, its actual definition is unclear. A number of advocacy groups, such as Advocates for Children in Therapy and Quackwatch have undertaken to label nearly all treatments for children with disorders of attachment as "Attachment Therapy" and attempt to discredit those therapies. The treatments often involve coercive and intrusive methods including variants of holding therapy or rebirthing or rage-reduction. According to Prior and Glaser (2006), ‘these therapies are not based on an accepted version of attachment theory and there is no objective evaluation of them’. Many professional bodies and some American States have outlawed rebirthing therapy. Care should be taken to distinguish between this subset of therapies and more mainstream therapies which may also be loosely described as attachment or attachment disorder therapy. For the purposes of this article, the term used to describe this subset is ‘Attachment Therapy.’

Definitions of Attachment Therapy

The term has little commonly agreed upon meaning in the professional literature. For example, it is not a term found in the American Medical Association's Physician's Current Procedural Manual. The American Professional Society on Abuse of children (APSAC) (Chaffin et al.,2006, PMID 16382093) does not use the term "Attachment Therapy," but has disapproved of coercive and intrusive methods of treatment as inappropriate for treatment while approving a broad range of effective treatments for children with disorders of attachment that do not use coercive methods. The report of the APSAC Task Force on Attachment Therapy, Reactive Attachment Disorder and Attachment Problems (Chaffin et al 2006) describe it as follows; "The attachment therapy controversy has centred most broadly on the use of what is known as “holding therapy” (Welch, 1988) and coercive, restraining, or aversive procedures such as deep tissue massage, aversive tickling, punishments related to food and water intake, enforced eye contact, requiring children to submit totally to adult control over all their needs, barring children’s access to normal social relationships outside the primary parent or caretaker, encouraging children to regress to infant status, reparenting, attachment parenting, or techniques designed to provoke cathartic emotional discharge. Variants of these treatments have carried various labels that appear to change frequently. They may be known as “rebirthing therapy,” “compression holding therapy,” “corrective attachment therapy,” “the Evergreen model,” “holding time,” or “rage-reduction therapy” (Cline, 1991; Lien, 2004; Levy & Orlans, 1998; Welch, 1988). Popularly, on the Internet, among foster or adoptive parents, and to case workers, they are simply known as “attachment therapy,” although these controversial therapies certainly do not represent the practices of all professionals using attachment concepts as a basis for their interventions.”

Speltz (2002) in a paper for the APSAC describes ‘corrective attachment therapy’ as follows; ‘… the holding therapies included in “corrective” attachment therapy do not address safety needs. They differ in that a therapist or parent initiates the holding process for the purpose of provoking strong, negative emotions in the child (e.g., fear, anger), and the child’s release is typically contingent upon his or her compliance with the therapist’s clinical agenda.

Prior and Glaser (2006) describe ‘Attachment therapy’ as a combination of ‘loose’ diagnosis of attachment disorders and a variety of treatments offered to desperate carers of troubled, maltreated children which often include variants of holding, eg holding time (Welch 1998), therapeutic holding (Howe and Fearnley 2003), rage reduction therapy (Cline 1991) and rebirthing. They also cite age regression as ‘key to the holding therapy approach.’ p265.

The advocacy group, Advocates for Children in Therapy define, "Attachment Therapy (AT)..’ as ‘…a growing, underground movement for the treatment of children who pose disciplinary problems to their parents or caregivers. AT practitioners allege that the root cause of the children’s misbehavior is a failure to 'attach' to their caregivers. The purported correction by AT is — literally — to force the children into loving (attaching to) their parents ...there is a hands-on treatment involving physical restraint and discomfort. Attachment Therapy is the imposition of boundary violations - most often coercive restraint - and verbal abuse on a child, usually for hours at a time...Typically, the child is put in a lap hold with the arms pinned down, or alternatively an adult lies on top of a child lying prone on the floor."

There is no generally accepted definition of "Attachment Therapy," and it is not a term that is found in generally recognized texts on treatment modalities, such as Bergin & Garfield's Handbook of Psychotherapy and Behavior Change, nor is there any specific text that describes this "treatment" approach. However, the advocacy group, Advocates for Children in Therapy does offer guidance on this subject. While this group is not a professional mental health group in the same manner that the American Psychiatric Association or American Psychological Association or National Association of Social Workers are, and none of the leaders are licensed mental professionals or clinicians, they do offer some ideas for a description of what this term can mean.

ACT states, "Attachment Therapy is a growing, underground movement for the 'treatment' of children who pose disciplinary problems to their parents or caregivers." In discussing Attachment Therapy they state, "there is a hands-on treatment involving physical restraint and discomfort. Attachment Therapy is the imposition of boundary violations - most often coercive restraint - and verbal abuse on a child, usually for hours at a time...Typically, the child is put in a lap hold with the arms pinned down, or alternatively an adult lies on top of a child lying prone on the floor."

ACT further defines "Attachment Therapy" as, "Attachment Therapy almost always involves extremely confrontational, often hostile confrontation of a child by a therapist or parent (sometimes both). Restraint of the child by more powerful adult(s) is considered an essential part of the confrontation."

The group also uses the terms "rebirthing" and "holding therapy" as terms for "Attachment Therapy."

history and underlying principles

In a paper for the APSAC by Speltz (2002) the roots of ‘Attachment Therapy’ are traced to Robert Zaslow in the 1970’s. Zaslow attempted to force attachment in those suffering from autism by creating pain and rage whilst enforcing eye contact. He believed that holding someone against their will would lead to a breakdown in their defence mechanism’s making them more receptive to others. Speltz point’s out that these ideas have been dispelled by research into autism and that, conversely, techniques based on behavioural principles have proved effective.

Speltz cites Martha Welch and ‘holding time’ (1984 and 1989) as the next significant development. Mothers were instructed to hold their defiant child, provoking anger and rage, until such time as the child ceased to resist at which point a bonding process was believed to begin. Similar techniques were subsequently promoted by Foster Cline and associates at the Attachment Centre at Evergreen, Inc. (now renamed the Institute For Attachment and Child Development) and duplicated elsewhere in other clinics such as ‘The Center’ in the Pacific northwest.

According to Prior and Glaser (2006) ‘there is no empirical evidence to support Zaslows theory. The concept of suppressed rage has, nevertheless, continued to be a central focus explaining the children’s behaviour (Cline 1991)’.

Chaffin et al describe the underlying principles as follows; “In contrast to traditional attachment theory, the theory of attachment described by controversial attachment therapies is that young children who experience adversity (including maltreatment, loss, separations, adoption, frequent changes in child care, colic or even frequent ear infections) become enraged at a very deep and primitive level. As a result, these children are conjectured to lack an ability to attach or to be genuinely affectionate to others. Suppressed or unconscious rage is theorized to prevent the child from forming bonds with caregivers and leads to behavior problems when the rage erupts into unchecked aggression. The children are described as failing to develop a conscience and as not trusting others. They are said to seek control rather than closeness, resist the authority of caregivers, and engage in endless power struggles. From this perspective, children described as having attachment problems are seen as highly manipulative in their social relations and actively trying to avoid true attachments while simultaneously striving to control adults and others around them through manipulation and superficial sociability. Children described as having attachment problems are alleged by proponents of the controversial therapies to be at risk for becoming psychopaths who will go on to engage in very serious delinquent, criminal, and antisocial behaviors if left untreated’.

Prior and Glaser cite the one published study which ‘purports to be an evaluation of holding therapy’ by Myeroff et al (1999). This study covers the ‘across the lap’ type holding therapy, described as ‘not restraint’ by Howe and Fearnley (2003) but ‘being held whilst unable to gain release.’

Attachment Disorder

Prior and Glaser (2006) describe ‘two discourses’ on attachment disorder. One science based, found in academic journals and books with careful reference to theory, international classifications and evidence. They list Bowlby, Ainsworth, Tizard, Hodges, Chisholm, O’Connor and Zeanah and colleagues as respected attachment theorists and researchers in the field. The other discourse is found in clinical practice, non-academic literature and on the Internet where claims are made which have no basis in attachment theory and for which there is no empirical evidence. In particular unfounded claims are made as to efficacy of ‘treatments’.

Attachment disorders are classified in DSM-IV-TR and ICD-10. DSM describes Reactive Attachment Disorder of Infancy or Early Childhood, divided into two subtypes, Inhibited Type and Disinhibited Type. The ICD classification describes two types, Reactive Attachment Disorder of Childhood and Disinhibited Attachment Disorder of Childhood. Both classifications are under constant discussion and both warn against automatic diagnosis based on abuse or neglect. Many ‘symptoms’ are present in a variety of other more common and more easily treatable disorders.

DSM and ICD are limited and some researchers in the field of attachment such as Zeannah have proposed alternative diagnostic criteria to describe broader disorders of attachment but the exact parameters are not yet established.

Chaffin et al and Prior and Glaser describe the proliferation of alternative ‘lists’ and diagnoses, particularly on the Internet, by proponents of Attachment Therapies that do not accord with either DSM or ICD classifications and which are partly based on the unsubstantiated views of Zaslow and Menta (1975) and Cline (1991). Neither do these lists accord with alternative diagnostic criteria as proposed above. According to Chaffin et al 'These types of lists are so nonspecific that high rates of false-positive diagnoses are virtually certain.' Prior and Glaser state that many of the behaviors in the lists are likely to be the consequences of neglect and abuse rather than located within the attachment paradigm.

Treatment characteristics

Attachment theory holds that caregiver qualities such as environmental stability, parental sensitivity, and responsiveness to children’s physical and emotional needs, consistency, and a safe and predictable environment support the development of healthy attachment. From this perspective, improving these positive caretaker and environmental qualities is the key to improving attachment. From the traditional attachment theory viewpoint, therapy for children who are maltreated and described as having attachment problems emphasizes providing a stable environment and taking a calm, sensitive, nonintrusive, nonthreatening, patient, predictable, and nurturing approach toward children (Haugaard, 2004a; Nichols, Lacher,&May, 2004). (Chaffin et al). Treatment and prevention programs that use methods congruent with attachment theory and with well established principles of child development (American Academy of Child and Adolescent Psychiatry) include: Alicia Lieberman (Parent-child Psychotherapy) (Lieberman & Pawl in Infant Mental Health, 1993 )(Lieberman 2003), Stanley Greenspan (Floor Time), Daniel Hughes (Dyadic Developmental Psychotherapy) (Becker-Weidman & Shell, 2005) (Hughes, 2003), Mary Dozier (autonomous states of mind), Robert Marvin (Circle of Security) (Marvin & Whelan 2003), Phyllis Jernberg (Theraplay), Daniel Schechter (Clinician Assisted Videofeedback Exposure Sessions) (Schechter, 2003), and Joy Osofsky (Safe Start Initiative) (in Infant Mental Health, 1993.

Prior and Glaser (2006) describe evidence based treatments, all of which revolve around enhancing caregiver sensitivity, or change of caregiver if that is not possible. Based on meta-analyses by Bakermans-Krananburg et al (2003) covering 70 published studies for assessing sensitivity, 81 studies on sensitivity and 29 on attachment security and many further randomised intervention studies involving over 7,000 families, the methods singled out to have shown good results were 'Watch, wait and wonder' (Cohen et al 1999), manipulation of sensitive responsiveness, (van den Boom 1994 and 1995), modified 'Interaction Guidance' (Benoit et al 2001), 'Preschool Parent Psychotherapy', (Toth et al (2002) and 'Circle of Security' (Marvin et al 2002).

According to O’Connor and Zeanah (2003 p235) "The holding approach would be viewed as intrusive and therefore non-sensitive and counter therapeutic".

Chaffin et al (2006) describe how the conceptual focus of these treatments is the childs individual internal pathology and past caregivers rather than current parent-child relationships or current environment, to the extent that if the child is well behaved outside the home this is seen as manipulative. It was noted that this perspective has its attractions because it relieves the caregivers of responsibility to change aspects of their own behavior and aspirations. Proponents of the controversial therapies emphasize the child’s resistance to attachment and the need to break down the child’s resistance.'

Often parents are required to follow programmes of treatment at home, for example, obedience-training techniques such as "strong sitting" (frequent periods of required silence and immobility) and withholding or limiting food (Thomas, 2001). Also requiring children to submit totally to adult control over all their needs and barring children’s access to normal social relationships outside the primary parent or caretaker.

The APSAC report does not describe "Attachment Therapy", it uses the term "attachment therapy" (no caps or quotation marks). They state, “The terms attachment disorder, attachment problems, and attachment therapy, although increasingly used, have no clear, specific, or consensus definitions. Pg 77 Furthermore, what seems to be focus of this proposed page only addresses a very narrow area, “Controversies have arisen about potentially harmful attachment therapy techniques used by a subset of attachment therapists.” Pg 76 Attachment therapy is better discussed in context, especially if the focus is on “a particular subset of attachment therapy techniques developed by a subset of attachment therapy practitioners” pg 77. The controversy is a narrow one and should be placed in context so that readers understand the full range of issues. “ The attachment therapy controversy has centered most broadly on the use of what is known as “holding therapy” (Welch, 1988) and coercive, restraining, or aversive procedures such as deep tissue massage, aversive tickling, punishments related to food and water intake, enforced eye contact, requiring children to submit totally to adult control over all their needs, barring children’s access to normal social relationships outside the primary parent or caretaker, encouraging children to regress to infant status, reparenting, attachment parenting, or techniques designed to provoke cathartic emotional discharge” pg 83.

ACT’s site contains descriptions of the more extreme versions of these attachment therapies, including a link to the transcript of the ‘rebirthing’ process that lead to the death by suffocation of Candace Newmaker at the hands of her ‘therapists’. According to ACT "Attachment Therapy almost always involves extremely confrontational, often hostile confrontation of a child by a therapist or parent (sometimes both). Restraint of the child by more powerful adult(s) is considered an essential part of the confrontation."

Prevalence

There are no reliable statistics on how many professionals actually practice "Attachment Therapy" or "rebirthing as it is also known. However, as defined in this article, "Attachment Therapy" involves the use of practices prohibited by a large number of professional organizations such as the following: American Psychological Association], National Association of Social Workers], American Professional society on the Abuse of Children (APSAC) ], Association for the Treatment and Training in the Attachment of Children, American Academy of Child and Adolescent Psychiatrry ("Practice Parameter for the Assessment of Children and Adolescent with Reactive Attachment Disorder of Infancy and Early Childhood" in the Journal of the American Academy of Child and Adolescent Psychiatry, vol 44, Nov 2005 and at ]) , and the American Psychiatric Association. ]. Members of those organizations are prohibited from using methods and techniques proscribed by those organizations codes of ethics and practice parameters. Violations of those standards would result in expulsion of the organization. Therefore there are very few practitioners of "AT" as defined in this article. Furthermore, several states have outlawed "rebirthing," and anyone using such methods would be guilty of malpractice, which is a small problem in all professions.

by Chaffin et al state, ‘The practice of some forms of these treatments has resulted in professional licensure sanctions against some leading proponents of the controversial attachment therapies. There have been cases of successful criminal prosecution and incarceration of therapists or parents using controversial attachment therapy techniques and state legislation to ban particular therapies. Position statements against using coercion or restraint as a treatment were issued by mainstream professional societies (American Psychiatric Association, 2002) and by a professional organization focusing on attachment and attachment therapy (Association for Treatment and Training in the Attachment of Children , 2001). Despite these and other strong cautions from professional organizations, the controversial treatments and their associated concepts and foundational principles appear to be continuing among networks of attachment therapists, attachment therapy centers, caseworkers, and adoptive or foster parents (Hage, n.d.-a; Keck, n.d.)’.

Suggestion for another approach

I'd like to hear what other editors think of the following proposal. Instead of trying to cover the waterfront and all aspects here. Why not just have an article that defines attachment therapy using available mateirals? JonesRD_talk 17:13, 14 April 2007 (UTC)

SUGGESTION FOR ARTICLE

Definitions of Attachment Therapy

"Attachment Therapy", ”attachment therapy,” holding therapy, rebirthing therapy, or ‘’corrective attachment therapy’’ is an ambiguous term often used to describe a variety of controversial, non-mainstream "treatments" for children allegedly suffering from attachment disorder, which is itself an ambiguous term. However, because the term has no common meaning, or generally accepted meaning in the professional community, its actual definition is unclear. A number of advocacy groups, such as Advocates for Children in Therapy and Quackwatch have undertaken to label nearly all treatments for children with disorders of attachment as "Attachment Therapy" and attempt to discredit those therapies. The treatments often involve coercive and intrusive methods including variants of holding therapy or rebirthing or rage-reduction. According to Prior and Glaser (2006), ‘these therapies are not based on an accepted version of attachment theory and there is no objective evaluation of them’. Many professional bodies and some American States have outlawed rebirthing therapy. Care should be taken to distinguish between this subset of therapies and more mainstream therapies which may also be loosely described as attachment or attachment disorder therapy. For the purposes of this article, the term used to describe this subset is ‘Attachment Therapy.’

Attachment Therapy is a term with little commonly agreed upon meaning in the professional literature. For example, it is not a term found in the American Medical Association's Physician's Current Procedural Manual. It is not a term that is found in generally recognized texts on treatment modalities, such as Bergin & Garfield's Handbook of Psychotherapy and Behavior Change (2006), nor is there any specific text that describes this "treatment" approach. However, the advocacy group, Advocates for Children in Therapy does offer guidance on this subject. While this group is not a professional mental health group in the same manner that the American Psychiatric Association or American Psychological Association or National Association of Social Workers are, and none of the leaders are licensed mental professionals or clinicians, they do offer some ideas for a description of what this term can mean.

The advocacy group, Advocates for Children in Therapy define, "Attachment Therapy (AT)..’ as ‘…a growing, underground movement for the treatment of children who pose disciplinary problems to their parents or caregivers. AT practitioners allege that the root cause of the children’s misbehavior is a failure to 'attach' to their caregivers. The purported correction by AT is — literally — to force the children into loving (attaching to) their parents ...there is a hands-on treatment involving physical restraint and discomfort. Attachment Therapy is the imposition of boundary violations - most often coercive restraint - and verbal abuse on a child, usually for hours at a time...Typically, the child is put in a lap hold with the arms pinned down, or alternatively an adult lies on top of a child lying prone on the floor."

The American Professional Society on Abuse of children (APSAC) (Chaffin et al.,2006, PMID 16382093) does not use the term "Attachment Therapy," but has disapproved of coercive and intrusive methods of treatment as inappropriate for treatment while approving a broad range of effective treatments for children with disorders of attachment that do not use coercive methods. The report of the APSAC Task Force on Attachment Therapy, Reactive Attachment Disorder and Attachment Problems (Chaffin et al 2006) describe it as follows: "The attachment therapy controversy has centred most broadly on the use of what is known as “holding therapy” (Welch, 1988) and coercive, restraining, or aversive procedures such as deep tissue massage, aversive tickling, punishments related to food and water intake, enforced eye contact, requiring children to submit totally to adult control over all their needs, barring children’s access to normal social relationships outside the primary parent or caretaker, encouraging children to regress to infant status, reparenting, attachment parenting, or techniques designed to provoke cathartic emotional discharge. Variants of these treatments have carried various labels that appear to change frequently. They may be known as “rebirthing therapy,” “compression holding therapy,” “corrective attachment therapy,” “the Evergreen model,” “holding time,” or “rage-reduction therapy” (Cline, 1991; Lien, 2004; Levy & Orlans, 1998; Welch, 1988). Popularly, on the Internet, among foster or adoptive parents, and to case workers, they are simply known as “attachment therapy,” although these controversial therapies certainly do not represent the practices of all professionals using attachment concepts as a basis for their interventions.”

Prior and Glaser (2006) describe ‘Attachment therapy’ as a combination of ‘loose’ diagnosis of attachment disorders and a variety of treatments offered to desperate carers of troubled, maltreated children which often include variants of holding, eg holding time (Welch 1998), therapeutic holding (Howe and Fearnley 2003), rage reduction therapy (Cline 1991) and rebirthing. They also cite age regression as ‘key to the holding therapy approach.’ p265.

ACT states, "Attachment Therapy is a growing, underground movement for the 'treatment' of children who pose disciplinary problems to their parents or caregivers." In discussing Attachment Therapy they state, "there is a hands-on treatment involving physical restraint and discomfort. Attachment Therapy is the imposition of boundary violations - most often coercive restraint - and verbal abuse on a child, usually for hours at a time...Typically, the child is put in a lap hold with the arms pinned down, or alternatively an adult lies on top of a child lying prone on the floor."

ACT further defines "Attachment Therapy" as, "Attachment Therapy almost always involves extremely confrontational, often hostile confrontation of a child by a therapist or parent (sometimes both). Restraint of the child by more powerful adult(s) is considered an essential part of the confrontation." ACT’s site contains descriptions of the more extreme versions of these attachment therapies, including a link to the transcript of the ‘rebirthing’ process that lead to the death by suffocation of Candace Newmaker at the hands of her ‘therapists’. According to ACT "Attachment Therapy almost always involves extremely confrontational, often hostile confrontation of a child by a therapist or parent (sometimes both). Restraint of the child by more powerful adult(s) is considered an essential part of the confrontation."

JonesRD_talk 17:26, 14 April 2007 (UTC)

Comments

I think that the above defines the term reasonably well and could be the entire article. What do other contributors think?JonesRD_talk 17:26, 14 April 2007 (UTC)

With all due respect Mr Jones, I don't think your proposal addresses what is wrong with the existing article. It prioritises ACT over and above valid credible verified and relevant sources like Chaffin et al, Speltz, Prior and Glaser. Why give ACT the lead in definitions and descriptions? The entire Chaffin report is about the subject matter of this article. It was compiled by all the big names in this field. Lets use that guys! Lets quote their definition, not ACT's. Better still, lets write the whole article without even mentioning ACT! ACT didn't invent this controversy about Attachment Therapy, attachment therapy or coercive attachment therapy. Chaffins definition is as good as it's going to get. Also, The article ought to include the theoretical base of these 'therapies' and point out the history and differences. I thought you liked those bits!Fainites 18:15, 14 April 2007 (UTC)

By the way, the italics thing was fun but it got a little messy. We all need to read all the versions and comments though to avoid repeating ourselves.Fainites 18:15, 14 April 2007 (UTC)

evidence based treatments

Actually this might be a great consensus builder. If the material were reordered to put Chafin first as Fainities wants, then it would be a nice tightly focused article that defines, or attempts to define, this vague term. The entirel Chafin report is really about a broader set of issues. Put their relevant quotes first, and then the others. This way all the material about "other treatments" can be avoided, and a lot of other material can be left out. DPeterson 18:53, 14 April 2007 (UTC)

As I reread it, I think it flows well. The Chafin material is up there and so are other sources. ACT is quoted, as it should be along with the other sources so we get several descriptions. DPeterson 18:55, 14 April 2007 (UTC)

I don't agree that Chaffin is about a 'broader set of issues'. If that's going to be the basis of editing of this article, then the only solution is to have two articles. One which is called Attachment Therapy with capitals and deals with the ACT side of things only and another which tackles the whole issue of the 'attachment therapy' controversy as per Speltz/Chaffin/Glaser etc. You guys presumably wouldn't be interested in editing that article so you could concentrate on the ACT one here. Then we can disambiguate 'Attachment Therapy' and 'attachment therapy'.Fainites 09:26, 15 April 2007 (UTC)

On the issue of ACT's 'list', that's actually quite a big topic in itself. This is the list; Z-therapy- rage-reduction therapy- Theraplay- holding therapy-attachment holding therapy-attachment disorder therapy-holding time-cuddle time-gentle containment-holding-nurturing process-emotional shuttling-direct synchronous bonding-breakthrough synchronous bonding-therapeutic parenting-dynamic attachment therapy-humanistic attachment therapy-corrective attachment therapy-developmental attachment therapy-dyadic attachment therapy-dyadic developmental psychotherapy-dyadic support environment-affective attunement-some of these are just so vague they're not individual therapies at all. Most of them however (I have actually looked them up!) look like a true bill. The two most controversial inclusions here are Theraplay and Dyadic Developmental Psychotherapy. I don't really want to get involved in DDP's ongoing feud with ACT, but the point is, none of the other therapies in Glasers list or the current articles list apart from these two are in this ACT list. I don't therefore see how we can say (in the introduction no less) that ACT have labelled nearly all treatment's as attachment therapy. I've tried to think of a way of wording it in a more encyclopaedic way but it's a bit tricky.Fainites 12:51, 15 April 2007 (UTC)

ACT and Quackwatch also take aim at EMDR and some other therapies. Dyadic Developmental Psychotherpay has professional peer reviewed research (meets the wikipedia standard of being verifiable) to support it as being effective and the descriptions of it in the various articles and books are clearly consistent with the other treatments. It looks like they just took a bunch of words and there them together...what is the basis for their labeling these as intrusive and problematic? What methods does ACT label as acceptable? I don't see any listed on their site. So, it probably is accurate to say they label nearly all...DPeterson 15:29, 15 April 2007 (UTC)

As you know I also take issue with their 'list of shame' of other therapies offhandedly condemned as quackery. I'm also no fan of Quackwatch. However, there is no reason why they should list acceptable therapies. That's not their thing! But none of the therapies named by Glaser are in their list. I managed to find examples of most of whats on ACT's list. Also their beef with Dyadic developmental Psychotherapy is set out pretty plainly on their page on Hughes. Basically they say a leopard doesn't change it's spots, whereas Hughes himself in various places makes it clear that he has discarded 'attachment therapy' type methods and developed a new therapy that he clearly means to be congruent with attachment theory. Whether he has suceeded or not is not for us to say unless we can find verified or credible sources to speak authoritatively on this point. Also I have seen a study on theraplay which makes it plain that it is in some respects 'intrusive' but this was not being said in a perjorative sense. Maybe ACT have other sources, or maybe they just picked up on this. The point I'm making is that it is a big piece of work to decide whether various therapies are 'evidence based' or congruent with attachment theory or all the professional codes and something that really needs to be dealt with individually for each therapy. Chaffin avoided specifically naming therapies. I think we should too, or we get into difficulties about what is and what isn't evidence based. Wiki can't accept self-report for evidence base or compliance with codes of professional conduct.Fainites 20:24, 15 April 2007 (UTC)

We don't have to decide whether anything is evidence based. We only need to list sources that meet the Misplaced Pages standard for being WP:verifiable. If the source makes a statement and it is verifiable, then we can use that statement. The list of therapies and citations is consistent with Misplaced Pages standards for being verifiable. But, anyway, lets stick with getting the article written and focus on the intro paragraph and move along. OK?DPeterson 12:49, 17 April 2007 (UTC)

We do have to ascertain if they're evidence based if we are going to say they are evidence based. eg on 'Circle' we can say Prior and Glaser say it's evidence based. On Dyadic Developmental Psychotherapy we can't say it's evidence based just because it's proponents say it is. We could only say it claims to be evidence based unless we can find a verified and credible source that says its evidence based. As you know, 'evidence based' has a fairly specific meaning in science and doesn't just mean it's published a peer-reviewed study. This is why I think it's fairer and wiser to do what Chaffin et al did and not start listing therapies as evidence based. It's all too complicated and it's not necessary for the scope of this article. Fainites 20:53, 19 April 2007 (UTC)

The fact that the material is published in professional peer-reviewed journals (and that these are all empirical studies) means they are evidence based. Therefore, the material should be included. My reading of the comments above, is that most editors, so far, agree with this view and so the mateiral should be included. JohnsonRon 21:02, 19 April 2007 (UTC)

No. Having a peer-reviewed study is not the same as 'evidence based'. A peer reviewed study is a verified and credible source for Wiki purposes so we can cite it. There's alot more than that to calling a therapy 'evidence based' which is a term used in the scientific world, not a 'Wiki' term. This is set out in many places but for now I'll just give you Chaffin;"In general, we believe that designating a treatmentas evidence based is a job for an independenttreatment review panel (e.g., AmericanPsychologicalAssociation,Substance Abuse and Mental HealthServices Administration , Office forVictims of Crime Task Force, Cochrane Collaborative,etc.) applying accepted and established scientificreview criteria. The fact that most editors agree is irrelevent if most editors are in fact, wrong.Fainites 21:23, 19 April 2007 (UTC)

Heres another bit of Chaffin for you;"Moreover, the sides do not agree on the rules for determining the risks and benefitsof psychological treatments or how questions about risks and benefits should be resolved. Critics" (of attachment therapy) "tend to rely on the well-established and accepted principlesof clinical science. Central to the clinical science perspective is testing outcomes using rigorous scientific research designs and methods that control for well-known confounds such as spontaneous recovery, the placebo effect, patient expectancy effects, investigator effects, and other forces that may influence the perceived outcomes of any clinical intervention. Critics tend to rely on scientific peer-review of research findings, publishing results in the scientific literature for wider scrutiny and review, and independent replication of findings before labeling a treatment as efficacious with an acceptable level of risk."Fainites 21:59, 19 April 2007 (UTC)

The materials and statements meet Misplaced Pages standards for being verifiable and that is all that matters here. The articles are published in PROFESSIONAL PEER-REVIEWED JOURNALS and that makes the material evidence based as it has had blinded independent professional review. Regardless, the material and statements are verifiable and so can be included. Since wikipeidis operates on consensus, it is VERY RELEVANT to a discussion if there is consensus and most editors agree on a point and on the inclusion or exclusion of an item. That's how Misplaced Pages works. You just are not the final decider and you have not "veto" power if the consensus is against your view. Wikkipedia is sort of ruthless that way. JohnsonRon 02:12, 20 April 2007 (UTC) On the other hand, if there is no agreement, then it is best to leave the section as is without any changes. JohnsonRon 02:13, 20 April 2007 (UTC)

I'm not objecting to citations from peer reviewed journals. I'm objecting to the use of the term 'evidence-based' which does not mean 'published in a peer reviewed journal'. Presumably if you agree relevent citations from verified and credible sources you don't object to everything Chaffin et al say on the subject of 'attachment therapies' claiming to be evidence based when they are not going in? Fainites 06:45, 20 April 2007 (UTC)

If the material has been peer-reviewed and the article is empirical in nature, then it is, by definition, evidence-based. You may have some other definition or criteria in mind, but that is not the only view. Other views are valid and acceptable. So, the various treatments, if they have evidence-based articles to support the efficacy of the approach, can be cited as such. Again, we can disagree, and see that other editors think and then what will go into this article is the consensus, even if the consensus is not what you, or I, prefer...This is how Misplaced Pages works. JohnsonRon 13:10, 20 April 2007 (UTC)

Actually Misplaced Pages is not a democracy and there are rules about sources. Chaffin et al is a verified and credible source and they have a great deal to say on the subject of attachment therapies claiming to be evidence based. You will not be able to remove such evidence by 'consensus'. So both views will have to go in, yours (if you have a source for it) and Chaffins, and Prior and Glasers, and any other verified and credible source. I'm quite happy to put in all views. Fainites 14:35, 20 April 2007 (UTC)

Yes, of course. I find it surprising that this needs to be said. There is a strong difference between "some papers concerning this therapy made it past a referee" and "this therapy is evidence-based". shotwell 15:03, 20 April 2007 (UTC)

'YES' It is fine for Chaffin et al to be included and the other references to evidence-based material. Empirical evidence in a peer-reviewed professional publication is evidence-based...so including both is fine. Again, we'll see what other editors have to say and the consensus will determine the outcome. JohnsonRon 17:47, 20 April 2007 (UTC)

No. Wiki policies will determine the outcome. That includes sources and NPOV and all the policies designed to achieve a measure of accuracy and common sense. Lets go over this again. Peer reviewed studies are appropriate sources to be referred to in Wiki. Science/therapies etc being 'evidence based' is a completely different thing. For a newish therapy to be accepted as evidence based it needs (amongst other things) to have been the subject of rigorous clinical trials and it's results need to have been replicated by others (which means it's methods, theories etc must have been fully explained) and then be accepted as evidence based by the wider scientific community. Not being evidence based doesn't mean a therapy is crap! It can take a long time to become evidence based and some never do. What propnents of new therapies usually hope is that their propsals are sufficiently sound, and their preliminary studies are sufficiently promising for others in the field to want to attempt to replicate their findings, thus hopefully leading towards 'evidence based'. Describing therapies as evidence based when they are plainly not probably has the opposite effect so it's quite important not to bandy these words around lightly. My proposal to get away from this problem is not to list any therapies at all in this way. It's not necessary for the article. The article is about 'attachment therapy' ie, as described. We can put in what Chaffin/Glaser etc say about what mainstream therapy as opposed to attachment therapy is, and the underlying principles, but it is not necessary to then try and list all the therapies that are considered evidence based and such a process would be fraught with difficulty. (We could I suppose contact the bodies listed by Chaffin and ask them for lists of what they have verified as evidence based)Fainites 11:59, 21 April 2007 (UTC)

Including the material is fully within wiki policies. The references are clearly WP:verifiability. The sources and statement meet wP:NPOV as NPOV. And the citations are accurate. You present one view...which is fine. Evidence-based does mean that there is scientific evidence for a statement. In this instance empirical studies in professional peer-reviewed journals is evidence-based support. I really don't understand what is the AX you are grinding here. Publication in a professional peer reviewed journal is clear evidence of acceptabnce by a wider scientific community. The material should be included as written and the consensus here seems to be for it's inclusion. JonesRD_talk 22:05, 21 April 2007 (UTC)

I'm not against including the material. Peer reviewed sources are includable. Its the naming of therapies as 'evidence based' when they are not that I object to. This has a specific meaning within science. Chaffin is very specific on this point. If therapies are to be quoted as evidence based that needs to be from a verified and credible source, not self report or OR. If therapies are put in as evidence based on a self report then it is inevitable that what Chaffin has to say about that claim will also be cited, and properly so under Wiki policies. I repeat that one way out of this dilemma is not to attempt to list therapies as evidence based or not in this article, it being entirely unecessary.Fainites 00:19, 22 April 2007 (UTC)

The therapies are evidence based for the reasons I, and others, stated above. You seem to be assuming that only your view is correct and that is just not so. The therapies are evidence based. Chaffin may be specific, but that is not the end all and be all in this regardd. The citations are from a "verified and crredible source; peer reviewed blind reviews in professional publications. These are not "self-reported," but independent studies. So, we just don't agree and the final decison will be based on whatever consensus develops here based on all reviewer comments. As I said before, you do not own this article nor have veto power if the consensus is against you. JonesRD_talk 02:14, 22 April 2007 (UTC)

Please stop altering my edits. We are writing an encyclopaedia. There are policies and aims. Are you suggesting that if enough accounts could gang up and vote on one site to say that eg the Bible was first written on an Amstrad in Wrexham in 1979 and there is no record of it's existence before that date that everybody would have to accept that 'consensus' ?Fainites 10:32, 22 April 2007 (UTC)

I am 'NOT alterning your edits. Indenting to keep threats togther if just format and is makes all this easier to follow. Randomly placing comments makes it impossible to follow the tread of the conversation. Your example is interesting, but silly. It is a RED HERRING as "they" say. Misplaced Pages operates on consensus and when then large marjority agree, that is the tack to be taken. Agreement does not have to be 100% and that is not what 'CONSENSUS' means anyway. wikipedia articles are built on consensus. JonesRD_talk 12:28, 22 April 2007 (UTC)

Threads don't need to be indented to be 'kept together'. They follow on from each other, only in your case, more and more thinly.Fainites 22:13, 22 April 2007 (UTC)

That is the "form" uses on Misplaced Pages Talk pages and the convention suess. Please WP:Assume good faith and try to avoid 'No Personal Attacks'. Your sarcasim is not conducise to developing consensus or a collaboration. JonesRD_talk 02:57, 23 April 2007 (UTC)

I haven't made any personal attacks. I have politely asked you not to keep interfering with my edits, yet you continue to do so. I merely took your indentophilia to it's logical conclusion. Shall we get back to the subject in hand? Fainites 20:21, 23 April 2007 (UTC)

amended proposed new article

'LETS COMMENT IN ONLY ONE PLACE. THE FIRST VERSION IS THE BEST PLACE TO DO SO...ALL MY COMMENTS ARE THERE. WE CAN BEGIN LOOKING AT THIS SECTION BY SECTION. SEE MY FIRST STAB AT CONSENSUS BELOW'JonesRD_talk 18:35, 15 April 2007 (UTC) Another attempt.Fainites 12:34, 15 April 2007 (UTC)

I agree...see my comments above.DPeterson 19:47, 15 April 2007 (UTC)

"Attachment Therapy", ”attachment therapy,” holding therapy, rebirthing therapy, or ‘’corrective attachment therapy’’ is an ambiguous term often used to describe a variety of controversial, non-mainstream "treatments" for children allegedly suffering from attachment disorder, which is itself an ambiguous term.DPeterson 15:39, 15 April 2007 (UTC) (see previous comment. There is nothing ambiguous about holding or rebirthing. It's the term 'attachment therapy that's ambiguous. Your version makes no sense factually or grammaticallyFainites 17:53, 15 April 2007 (UTC))

"Attachment Therapy", ”attachment therapy” or ‘’corrective attachment therapy’’ is an ambiguous term often used to describe a variety of controversial, non-mainstream "treatments" for children allegedly suffering from attachment disorder. The term has little commonly agreed upon meaning in the professional literature and is not a term found in the American Medical Association's Physician's Current Procedural Manual. In a report for the ASPAC, Chaffin et al state 'controversies have arisen about a particular subset of attachment therapy techniques developed by a subset of attachment therapy practitioners, techniques that have been implicated in several child deaths and other harmful effects.' They attempt to define this subset of therapies (see below) and state that 'popularly, on the Internet, among foster or adoptive parents, and to case workers, they are simply known as “attachment therapy,” although these controversial therapies certainly do not represent the practices of all professionals using attachment concepts as a basis for their interventions.” Care should be taken to distinguish between the subset of 'therapies' covered by this article and more mainstream therapies, particularly as what is and was is not legitimately described as an 'attachment therapy' within the meaning of this article is controversial and advocacy groups and commentators such as ACT and Quackwatch include a broad range of therapies in their 'list' who's proponents would vehemently deny such a charge.

The 'treatments' often involve coercive and intrusive methods including variants of holding therapy or rebirthing or rage-reduction. According to Prior and Glaser (2006), ‘these therapies are not based on an accepted version of attachment theory and there is no objective evaluation of them’. Many professional bodies have codes of practice against these practices and some American States have outlawed rebirthing.

(phrases like 'offer some guidance' are POV and non-encyclopaedic. ACT are not offering guidance. They make a plain statement about what they sya AT is, which we can either quote or accurately summarise, and we can put in opposing views provided they're from a verified and credible source and not our own views.Fainites 18:26, 15 April 2007 (UTC))

Definitions of Attachment Therapy

There is no generally accepted definition of "Attachment Therapy", with or without capital letters. It is not a term found in the American Medical Association's Physician's Current Procedural Manual nor in generally recognized texts on treatment modalities, such as Bergin & Garfield's Handbook of Psychotherapy and Behavior Change, nor is there any specific text that describes this "treatment" approach. Chaffin et al describe the polarization between the proponents of ‘Attachment Therapy’ and mainstream therapies stating ‘This polarization is compounded by the fact that attachment therapy has largely developed outside the mainstream scientific and professional community and flourishes within its own networks of attachment therapists, treatment centers, caseworkers, and parent support groups. Indeed, proponents and critics of the controversial attachment therapies appear to move in different worlds.’

The report of the APSAC Task Force on Attachment Therapy, Reactive Attachment Disorder and Attachment Problems (Chaffin et al 2006), having said 'The terms attachment disorder, attachment problems, and attachment therapy, although increasingly used, have no clear, specific, or consensus definitions', attempt to describe this subset as follows; "The attachment therapy controversy has centred most broadly on the use of what is known as “holding therapy” (Welch, 1988) and coercive, restraining, or aversive procedures such as deep tissue massage, aversive tickling, punishments related to food and water intake, enforced eye contact, requiring children to submit totally to adult control over all their needs, barring children’s access to normal social relationships outside the primary parent or caretaker, encouraging children to regress to infant status, reparenting, attachment parenting, or techniques designed to provoke cathartic emotional discharge. Variants of these treatments have carried various labels that appear to change frequently. They may be known as “rebirthing therapy,” “compression holding therapy,” “corrective attachment therapy,” “the Evergreen model,” “holding time,” or “rage-reduction therapy” (Cline, 1991; Lien, 2004; Levy & Orlans, 1998; Welch, 1988). Popularly, on the Internet, among foster or adoptive parents, and to case workers, they are simply known as “attachment therapy,” although these controversial therapies certainly do not represent the practices of all professionals using attachment concepts as a basis for their interventions.” (If this is a direct quote, we need a pg #DPeterson 15:43, 15 April 2007 (UTC)) (p83 Fainites 18:20, 15 April 2007 (UTC))

Speltz (2002) in a paper for the APSAC was this for APSAC or merely published in the journal Child Maltreatment? DPeterson 15:45, 15 April 2007 (UTC) (it's headed 'Speltz, Matthew L. (2002). Description, History, and Critique of Corrective Attachment Therapy. The APSAC Advisor, 14(3), 4-8 Reprinted by permission of the American Professional Society on the Abuse of Children' Fainites 17:56, 15 April 2007 (UTC)) describes ‘corrective attachment therapy’ as follows; ‘… the holding therapies included in “corrective” attachment therapy do not address safety needs. They differ in that a therapist or parent initiates the holding process for the purpose of provoking strong, negative emotions in the child (e.g., fear, anger), and the child’s release is typically contingent upon his or her compliance with the therapist’s clinical agenda.

Prior and Glaser (2006) describe ‘Attachment therapy’ as a combination of ‘loose’ diagnosis of attachment disorders and a variety of treatments offered to desperate carers of troubled, maltreated children which often include variants of holding, eg holding time (Welch 1998), therapeutic holding (Howe and Fearnley 2003), rage reduction therapy (Cline 1991) and rebirthing. They also cite age regression as ‘key to the holding therapy approach.’ p265.

See comments in your first version...this still does not address what was said.DPeterson 15:45, 15 April 2007 (UTC) The entire quote is 'There are many ways in which holding therapy/attachment therapy contradicts Bowlby's attachment theory, not least attachment theory's fundamental and evidence-based statement that security is promoted by sensitivity. Moreover, Bowlby (1988)explicitly rejected the notion of regression, which is key to the holding therapy approach: 'present knowledge of infant and child development requires that a theory of developmental pathways should replace theories that invoke specific phases of development in which it is held a person may become fixated and/or to which he may regress' '. This is on p.265. Also Chaffin includes age regression as a feature of these therapies. They obviously didn't feel the need to refine it further but the Glaser passage encapsulates it rather neatlyFainites 18:14, 15 April 2007 (UTC))

The campaigning group, Advocacy group```` Advocates for Children in Therapy define, "Attachment Therapy (AT)..’ as ‘…a growing, underground movement for the treatment of children who pose disciplinary problems to their parents or caregivers. AT practitioners allege that the root cause of the children’s misbehavior is a failure to 'attach' to their caregivers. The purported correction by AT is — literally — to force the children into loving (attaching to) their parents ...there is a hands-on treatment involving physical restraint and discomfort. Attachment Therapy is the imposition of boundary violations - most often coercive restraint - and verbal abuse on a child, usually for hours at a time...Typically, the child is put in a lap hold with the arms pinned down, or alternatively an adult lies on top of a child lying prone on the floor."

history and underlying principles

You'v not included all the comments and suggestions from above. DPeterson 15:51, 15 April 2007 (UTC) I don't agree with them allFainites 18:01, 15 April 2007 (UTC))

In a paper for the APSAC by Speltz (2002) the roots of ‘Attachment Therapy’ are traced to Robert Zaslow in the 1970’s. Zaslow attempted to force attachment in those suffering from autism by creating pain and rage whilst enforcing eye contact. He believed that holding someone against their will would lead to a breakdown in their defence mechanism’s making them more receptive to others. Speltz point’s out that these ideas have been dispelled by research into autism and that, conversely, techniques based on behavioural principles have proved effective.

Speltz cites Martha Welch and ‘holding time’ (1984 and 1989) as the next significant development. Mothers were instructed to hold their defiant child, provoking anger and rage, until such time as the child ceased to resist at which point a bonding process was believed to begin. Similar techniques were subsequently promoted by Foster Cline and associates at the Attachment Centre at Evergreen, Inc. (now renamed the Institute For Attachment and Child Development) and duplicated elsewhere in other clinics.

According to Prior and Glaser (2006) ‘there is no empirical evidence to support Zaslows theory. The concept of suppressed rage has, nevertheless, continued to be a central focus explaining the children’s behaviour (Cline 1991)’.

Chaffin et al describe the underlying principles as follows; “In contrast to traditional attachment theory, the theory of attachment described by controversial attachment therapies is that young children who experience adversity (including maltreatment, loss, separations, adoption, frequent changes in child care, colic or even frequent ear infections) become enraged at a very deep and primitive level. As a result, these children are conjectured to lack an ability to attach or to be genuinely affectionate to others. Suppressed or unconscious rage is theorized to prevent the child from forming bonds with caregivers and leads to behavior problems when the rage erupts into unchecked aggression. The children are described as failing to develop a conscience and as not trusting others. They are said to seek control rather than closeness, resist the authority of caregivers, and engage in endless power struggles. From this perspective, children described as having attachment problems are seen as highly manipulative in their social relations and actively trying to avoid true attachments while simultaneously striving to control adults and others around them through manipulation and superficial sociability. Children described as having attachment problems are alleged by proponents of the controversial therapies to be at risk for becoming psychopaths who will go on to engage in very serious delinquent, criminal, and antisocial behaviors if left untreated’.

Prior and Glaser cite the one published study which ‘purports to be an evaluation of holding therapy’ by Myeroff et al (1999). The methodology of this study is heavily criticised. This study covers the ‘across the lap’ type holding therapy, described as ‘not restraint’ by Howe and Fearnley (2003) but ‘being held whilst unable to gain release.’ According to Prior and Glaser, regression is key to the holding therapy approach, but was explicitly rejected by Bowlby (1988) who stated that ‘a theory of developmental pathways should replace theories that invoke specific phases of development in which it is held a person may become fixated and/or to which he may regress.’ p263

Attachment Disorder

Prior and Glaser (2006) describe ‘two discourses’ on attachment disorder. One science based, found in academic journals and books with careful reference to theory, international classifications and evidence. They list Bowlby, Ainsworth, Tizard, Hodges, Chisholm, O’Connor and Zeanah and colleagues as respected attachment theorists and researchers in the field. The other discourse is found in clinical practice, non-academic literature and on the Internet where claims are made which have no basis in attachment theory and for which there is no empirical evidence. In particular unfounded claims are made as to efficacy of ‘treatments’.

Attachment disorders are classified in DSM-IV-TR and ICD-10. DSM describes Reactive Attachment Disorder of Infancy or Early Childhood, divided into two subtypes, Inhibited Type and Disinhibited Type. The ICD classification describes two types, Reactive Attachment Disorder of Childhood and Disinhibited Attachment Disorder of Childhood. Both classifications are under constant discussion and both warn against automatic diagnosis based on abuse or neglect. Many ‘symptoms’ are present in a variety of other more common and more easily treatable disorders.

DSM and ICD are limited and some researchers in the field of attachment such as Zeannah have proposed alternative diagnostic criteria to describe broader disorders of attachment but the exact parameters are not yet established.

Chaffin et al and Prior and Glaser describe the proliferation of alternative ‘lists’ and diagnoses, particularly on the Internet, by proponents of Attachment Therapies that do not accord with either DSM or ICD classifications and which are partly based on the unsubstantiated views of Zaslow and Menta (1975) and Cline (1991). Neither do these lists accord with alternative diagnostic criteria as proposed above. According to Chaffin et al 'These types of lists are so nonspecific that high rates of false-positive diagnoses are virtually certain.' Prior and Glaser state that many of the behaviors in the lists are likely to be the consequences of neglect and abuse rather than located within the attachment paradigm.

Treatment characteristics

According to Chaffin et al 'although focused primarily on specific attachment therapy techniques, the controversy also extends to the theories, diagnoses, diagnostic practices, beliefs, and social group norms supporting these techniques, and to the patient recruitment and advertising practices used by their proponents. The controversy deepened after the death of 10-year-old Candace Newmaker during a therapy session in 2000 (Crowder & Lowe, 2000), and a number of child deaths occurring at the hands of parents who claim that they acted on attachment therapists’ instructions (Warner, 2003). Criminal charges have been brought against some attachment therapists and against parents who claimed to be using what is known as attachment parenting.'

'Traditional attachment theory holds that caregiver qualities such as environmental stability, parental sensitivity, and responsiveness to children’s physical and emotional needs, consistency, and a safe and predictable environment support the development of healthy attachment. From this perspective, improving these positive caretaker and environmental qualities is the key to improving attachment. From the traditional attachment theory viewpoint, therapy for children who are maltreated and described as having attachment problems emphasizes providing a stable environment and taking a calm, sensitive, nonintrusive, nonthreatening, patient, predictable, and nurturing approach toward children (Haugaard, 2004a; Nichols, Lacher,&May, 2004).' (Chaffin et al p77).

Prior and Glaser (2006) describe evidence based treatments, all of which revolve around enhancing caregiver sensitivity, or change of caregiver if that is not possible. See comments in prev version....listing names and using very old date (Welch 1998, for example) may not reflect current practice. I suggest leaving all that out unless you can verify that this is the current practice eight or ten years later!!!!!DPeterson 15:56, 15 April 2007 (UTC) Prior and Glaser was first published August 2006. Chaffin is also 2006. These are up-to date sources about the provenance, sourcers and practices of this type of therapy. That's what they're about!Fainites 18:03, 15 April 2007 (UTC))

The focus of non-evidence based Attachment Therapies is somewhat different. According to Prior and Glaser ‘These include work directed at parents interactions with the children such as behaviour management, life story work and work on the meanings of the child’s experience, and some approaches are directed at the child and may or may not include the child’s primary carer. Attachment therapy often however, also includes some other interventions including a number of variants of holding, eg holding time (Welch 1998) and therapeutic holding (Howe and Fearnley) as well as others such as rage-reduction therapy (Cline 1991) and rebirthing.’ They also refer to the ‘Handbook of Attachment Interventions’ (Levy 2000), Levy and Orlans and the ‘Holding Nurturing Process.’

According to O’Connor and Zeanah (2003 p235) "The holding approach would be viewed as intrusive and therefore non-sensitive and counter therapeutic".

Chaffin et al (2006) describe how the conceptual focus of these treatments is the childs individual internal pathology and past caregivers rather than current parent-child relationships or current environment, to the extent that if the child is well behaved outside the home this is seen as manipulative. It was noted that this perspective has its attractions because it relieves the caregivers of responsibility to change aspects of their own behavior and aspirations. Proponents of the controversial therapies emphasize the child’s resistance to attachment and the need to break down the child’s resistance (Institute for Attachment and Child Development, n.d.).'

Speltz describes a typical treatment taken from a clinic's material as follows; ‘Like Welsh (1984, 1989),' the clinic 'induces rage by physically restraining the child and forcing eye contact with the therapist (the child must lie across the laps of two therapists, looking up at one of them). In a workshop handout prepared by two therapists ...... the following sequence of events is described: (1) therapist “forces control” by holding (which produces child “rage”); (2) rage leads to child “capitulation” to the therapist, as indicated by the child breaking down emotionally (“sobbing”); (3) the therapist takes advantage of the child’s capitulation by showing nurturance and warmth; (4) this new trust allows the child to accept “control” by the therapist and evenutally the parent. According to the ...... treatment protocol, if the child “shuts down” (i.e., refuses to comply), he or she may be threatened with detainment for the day at the clinic or forced placement in a temporary foster home; this is explained to the child as a consequence of not choosing to be a “family boy or girl.” If the child is actually placed in foster care, the child is then required to “earn the way back to therapy” and a chance to resume living with the adoptive family.

Often parents are required to follow programmes of treatment at home, for example, obedience-training techniques such as "strong sitting" (frequent periods of required silence and immobility) and withholding or limiting food (Thomas, 2001). Also requiring children to submit totally to adult control over all their needs and barring children’s access to normal social relationships outside the primary parent or caretaker.

ACT’s site contains descriptions of the more extreme versions of these attachment therapies, including a link to the transcript of the ‘rebirthing’ process that lead to the death by suffocation of Candace Newmaker at the hands of her ‘therapists’. According to ACT "Attachment Therapy almost always involves extremely confrontational, often hostile confrontation of a child by a therapist or parent (sometimes both). Restraint of the child by more powerful adult(s) is considered an essential part of the confrontation."

Prevalence

It is difficult to ascertain the prevalence of these therapies but they are sufficiently prevalent to have prompted reactions as outlined by Chaffin et al as follows;

‘The practice of some forms of these treatments has resulted in professional licensure sanctions against some leading proponents of the controversial attachment therapies. There have been cases of successful criminal prosecution and incarceration of therapists or parents using controversial attachment therapy techniques and state legislation to ban particular therapies. Position statements against using coercion or restraint as a treatment were issued by mainstream professional societies (American Psychiatric Association, 2002) and by a professional organization focusing on attachment and attachment therapy (Association for Treatment and Training in the Attachment of Children , 2001). Despite these and other strong cautions from professional organizations, the controversial treatments and their associated concepts and foundational principles appear to be continuing among networks of attachment therapists, attachment therapy centers, caseworkers, and adoptive or foster parents (Hage, n.d.-a; Keck, n.d.)’.

A particular concern of both Chaffin et al and Prior and Glaser is the use of the Internet to advertise these therapies and the use of unscientific and 'wildly inclusive' lists of 'symptoms' (Prior and Glaser). According to Chaffin et al 'These types of lists are so nonspecific that high rates of false-positive diagnoses are virtually certain. Posting these types of lists on Web sites that also serve as marketing tools may lead many parents or others to conclude inaccurately that their children have attachment disorders.' Many of the behaviors in the lists are likely to be the consequences of neglect and abuse rather than located within the attachment paradigm. Descriptions of children are frequently highly perjorative and 'demonising'. According to Chaffin et al 'Proponents of controversial attachment therapies 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’. They also express concern over claims by therapies to be 'evidence based' or indeed the 'only' evidence based therapy when the Task Force found no credible evidence base for any such therapy so advertised.

The report of Chaffin et al, which contains proposed guidelines for therapies, was endorsed by was endorsed by the American Psychological Association’s Division 37 and the Division 37 Section on Child Maltreatment.

Prior and Glaser (2006) state ‘The practice of holding therapy is not confined to the USA.’ And give an example of a center in the UK practising ‘therapeutic holding’ of the 'across the lap' variety.

The advocacy group ACT claim "Attachment Therapy is a growing, underground movement for the 'treatment' of children who pose disciplinary problems to their parents or caregivers."

There are no reliable statistics on how many professionals actually practice "Attachment Therapy" as described in this article. However the practices it often involves are now prohibited by a large number of professional organizations such as the following: American Psychological Association30, National Association of Social Workers31, American Professional society on the Abuse of Children (APSAC) 32, Association for the Treatment and Training in the Attachment of Children, American Academy of Child and Adolescent Psychiatrry ("Practice Parameter for the Assessment of Children and Adolescent with Reactive Attachment Disorder of Infancy and Early Childhood" in the Journal of the American Academy of Child and Adolescent Psychiatry, vol 44, Nov 2005 and at 33), and the American Psychiatric Association. 34. Members of those organizations are prohibited from using methods and techniques proscribed by those organizations codes of ethics and practice parameters. Violations of those standards would result in expulsion of the organization. Furthermore, several states have outlawed "rebirthing," and anyone using such methods would be guilty of malpractice.

Fainites 12:34, 15 April 2007 (UTC)

References

Becker-Weidman, A., & Shell, D., (2005) Creating Capacity for Attachment. Oklahoma City, OK: Wood 'N' Barnes.

Becker-Weidman (2006a) Treatment for Children with Trauma-Attachment Disorders: Dyadic Developmental Psychotherapy, Child and Adolescent Social Work Journal. 23(2), April 2006

Becker-Weidman, A., (2006b) Dyadic Developmental Psychotherapy: a multi year follow-up. in Sturt, S., (ed) New Developments in Child Abuse Research. NY: Nova

Becker-Weidman, A., (2006c) “Treatment For Children with Reactive Attachment Disorder: Dyadic Developmental Psychotherapy,” Child and Adolescent Mental Health Published article online: 21-Nov-2006 doi: 10.1111/j.1475-3588.2006.00428.x.]

Berliner, L. (2002).Why caregivers turn to "attachment therapy" and what we can do that is better. APSAC Advisor, 14(4), 8-10.

Bowlby, J. (1982). Attachment. New York: Basic.

Chaffin M, Hanson R, Saunders BE, Nichols T, Barnett D, Zeanah C, Berliner L, Egeland B, Newman E, Lyon T, LeTourneau E, Miller-Perrin C. Report of the APSAC task force on attachment therapy, reactive attachment disorder, and attachment problems. Child Maltreat. 2006 Feb;11(1):76-89. PMID 16382093

Cline, F. (1994). Hope for high risk and rage-filled children. Evergreen, CO: EC Publications.

Hughes, D., (2003). Psychotherapeutic interventions for the spectrum of attachment disorders and intrafamilial trauma. Attachment and Human Development 5-3, 271-279.

Hughes, D. (2004). An attachment-based treatment of maltreated children and young people. Attachment & Human Development, 3, 263–278.

Krenner, M. (1999). Ein Erklaerungsmodell zur "Festhaltetherapie" nach Jirina Prekop. Retrieved Oct. 25, 2000, from http://wwwalt.uni-wuerzburg.de/gbpaed/mixed/work/mkrenner1.html.

Levy, T.M., Ed. (2000). Handbook of attachment interventions. San diego: Academic.

Lieberman, A., (2003). The treatment of attachment disorder in infancy and early childhood. Attachment and Human Development 5-3, 279-283.

Marvin, R., & Whelan, W., (2003) Disordered attachment: toward evidence-based clinical practice. Attachment and Human Development 5-3, 284-299.

O'Connor, C., & Zeanah, C., Attachment disorder: assessment strategies and treatment approaches, Attachment and Human Development 5, 223-244.

Schechter, D.S. (2003). Intergenerational communication of maternal violent trauma: Understanding the interplay of reflective functioning and posttraumatic psychopathology. In S.W. Coates, J.L. Rosenthal, & D.S. Schechter (Eds.), September 11: Trauma and Human Bonds. New York, NY: The Analytic Press, pp. 115-143.

Thomas, N. (2001). Parenting children with attachment disorders. In T.M. Levy (Ed.), Handbook of attachment interventions. San Diego, CA: Academic.

Verny, T., & Kelly, J. (1981). The secret life of the unborn child. New York: Dell.

Welch, M.G. (1989) Holding time. New York:Fireside.

Welch, M.G., Northrup, R.S., Welch-Horan, T.B., Ludwig, R.J., Austin, C.L., & Jacobson, J.S.(2006). Outcomes of prolonged parent-child embrace therapy among 102 children with behavioral disorders. Complementary Therapies in Clinical Practice, 12, 3-12.

Zaslow, R., & Menta, M. (1975) The psychology of the Z-process: Attachment and activity. San Jose, CA: San Jose University Press.

Zeanah, C., (1993) Infant Mental Health. NY: Guilford. Added also see and reference section so that other editors can easily see material to be in article.

Comments on Revised article

A lot of this is very good. However, it is difficult to read it since it does not address all the concerns raised in the previous version. I suggest we stick with that one since it has all the relevant comments until consensus is reached. Maybe go section by section and create a new section below this for the consensus sections. I'd suggest beginning at the beginning.DPeterson 16:02, 15 April 2007 (UTC)

I've just noticed that you've changed my post. Please don't do this! Talk pages should not be refactored. It's my post. I shall now have to replace it as it was, either by posting my version AGAIN or by reverting your edits of my post. Do you have any preferences? You can always insert italicised suggestions.Fainites 17:12, 15 April 2007 (UTC)

It is too difficult to follow the "new" "new" article by Fainites. So, I agree, let's stick with commenting on the first Fainites and DPeterson proposals and go line by line to get a consensus among those and the current article. I'll take a stab by suggesting a first new section below. JonesRD_talk 18:30, 15 April 2007 (UTC)

Yes, I'll keep my comments to the first version so that if it is deleted, we don't loose comments. Also, this way, all the comments and suggestions will be in one place and not spread over the ballpark.DPeterson 19:38, 15 April 2007 (UTC)

SUGGESTION FOR THIS PAGE

This page is getting too long. I'd suggest deleting the "new" new version above, and one of the two DPeterson versions and then working on the last section in this page to discuss each paragraph.JonesRD_talk 19:06, 15 April 2007 (UTC)

Are we allowed to delete items from the talk page? If so, I'll be glad to delete one of my versions to simplify things. DPeterson 19:37, 15 April 2007 (UTC)

We should never mess about with talkpage contributions. It's meant to be a record. However, what we can delete is the reference list that keeps being put in. It's only being copied from the main page so we all know where to find it to look something up. I really don't understand why it keeps appearing here.Fainites 21:49, 15 April 2007 (UTC)

Actually the reference list has more materials on in than are in the article. Also, it is helpful to see the full citations.DPeterson 00:01, 16 April 2007 (UTC)

Only once surely. Whats the point of filling up the talkpage with the same list over and over again. This is the talkpage! Fainites 06:58, 16 April 2007 (UTC)

I just thought that it should be part of an proposed article since it is different than what is in the article...otherwise, by that logic, whatever is the same in a proposal as is already on this talk page would be left out...there seems to be at least one section that has not had any disagreements; at least among those few editors who have commented so far.DPeterson 12:44, 16 April 2007 (UTC)

Everything in the article must be properly sourced and referenced. All of my edits are sourced. It's silly to keep listing the same sources. When we have an agreed version the ref list naturally follows. I have already said that this ref list is not properly set up. Fainites 10:51, 17 April 2007 (UTC)

You only list names and dates, not the citation. Furthermore, as you pointed out, this page is to be a record and so we should not delete any entries. DPeterson 12:16, 17 April 2007 (UTC)

I have given you my citations. I just don't keep repeating them on the talkpage.Fainites 22:24, 19 April 2007 (UTC)

CONSENSUS VERSION

INTRODUCTION/FIRST SECTON

"Attachment Therapy", ”attachment therapy” "holding therapy," "rebirthing therapy," or "corrective attachment therapy" is an ambiguous term often used to describe a variety of controversial, non-mainstream "treatments" for children allegedly suffering from attachment disorder which is itself an ambiguous term. However, because the term has no common meaning, or generally accepted meaning, in the professional community, its actual definition is unclear. The term is not a term found in the American Medical Association's Physician's Current Procedural Manual. A number of advocacy groups, such as Advocates for Children in Therapy and Quackwatch have undertaken to label a large number of treatments for children with disorders of attachment as "Attachment Therapy" and attempt to discredit those therapies. The treatments often involve coercive and intrusive methods including variants of holding therapy or rebirthing or rage-reduction. According to Prior and Glaser (2006), ‘these therapies are not based on an accepted version of attachment theory and there is no objective evaluation of them’. Many professional bodies and some American States have outlawed rebirthing.

In a report for the ASPAC, Chaffin et al state 'controversies have arisen about a particular subset of attachment therapy techniques developed by a subset of attachment therapy practitioners, techniques that have been implicated in several child deaths and other harmful effects.' They attempt to define this subset of therapies (see below) and state that 'popularly, on the Internet, among foster or adoptive parents, and to case workers, they are simply known as “attachment therapy,” although these controversial therapies certainly do not represent the practices of all professionals using attachment concepts as a basis for their interventions.” (We need a page number if this is an acutal direct quoteJonesRD_talk 18:50, 15 April 2007 (UTC))

Care should be taken to distinguish between the subset of 'therapies' covered by this article and more mainstream therapies, particularly as what is and was is not legitimately described as an 'attachment therapy' within the meaning of this article is controversial and advocacy groups and commentators such as ACT and Quackwatch include a broad range of therapies in their 'list' who's proponents would vehemently deny such a charge.

Comment on Intro section

I think this captures the essential elements of what is being proposed.JonesRD_talk 18:50, 15 April 2007 (UTC)

It may need a little work...but I think this is a very good start. I'll wait to see what other editors suggest here. If there is agreement, I'll support this as is.DPeterson 19:36, 15 April 2007 (UTC)

The content is fine but I think it needs a little rearranging. Including 'holding' and 'rebirthing' in the first line is confusing. Neither are ambiguous terms. It is attachment therapy that's the ambiguous term. How about putting (sometimes called holding or rebirthing therapy) in brackets. On the AT point 'large number' is better than 'nearly all'. Good idea! It's still not quite right though as alot of the therapies in it's list actually are variants of holding or Zaslow type therapies. This is a very tricky sentence to get right without getting too involved in irrelevancies. Also, how about putting this sentence at the end of the first para.? We ought to paraphrase people as accurately as possible and the line 'Attachment Therapy and attachment therapy actually come from the beginning of Chaffin and corrective attachment therapy comes from Speltz. The ACT line where it is sort of cuts the para in half. We ought to do the description first, then outline the ACT controversy.Fainites 20:05, 15 April 2007 (UTC)

I think that is the point. Attachment therapy is an ambigious term for which a lot of other terms are used. How about the following:

"Attachment Therapy", (also know as ”attachment therapy” "holding therapy," "rebirthing therapy," or "corrective attachment therapy") is an ambiguous term often used to describe a variety of controversial, non-mainstream "treatments" for children allegedly suffering from attachment disorder which is itself an ambiguous term.

. I like the term "large number." I think it accurately caputures ACT's view. In addition not all those on their list are Z-therapies or related to Zaslow. I'd vote to keep the suggestion of "large number." DPeterson 20:13, 15 April 2007 (UTC)

I didn't say they were all Z therapies. I don't mind 'large number' that much. Fainites 20:32, 15 April 2007 (UTC)

I think it flows ok as is. The intro paragraph includes references to all those who will be cited/used later. How would you reword it?DPeterson 20:16, 15 April 2007 (UTC)

I'd put both ACT bits with the sentence that starts 'care should be taken...' because that's really partly on the same point. We're warning our readers AND giving an example of why they are being warned. It would then read :

Instead of: DPeterson 21:26, 15 April 2007 (UTC))"Attachment Therapy", ”attachment therapy” or "corrective attachment therapy" (also sometimes called rebirthing or holding therapy)is an ambiguous term often used to describe a variety of controversial, non-mainstream "treatments" for children allegedly suffering from attachment disorder which is itself an ambiguous term. However, because the term has no common meaning, or generally accepted meaning, in the professional community, its actual definition is unclear. The term is not a term found in the American Medical Association's Physician's Current Procedural Manual.

(Use this:

)DPeterson 21:26, 15 April 2007 (UTC)

The treatments often involve coercive and intrusive methods including variants of holding therapy or rebirthing or rage-reduction. According to Prior and Glaser (2006), ‘these therapies are not based on an accepted version of attachment theory and there is no objective evaluation of them’. Many professional bodies and some American States have outlawed rebirthing. In a report for the ASPAC, Chaffin et al state 'controversies have arisen about a particular subset of attachment therapy techniques developed by a subset of attachment therapy practitioners, techniques that have been implicated in several child deaths and other harmful effects.' They attempt to define this subset of therapies (see below) and state that 'popularly, on the Internet, among foster or adoptive parents, and to case workers, they are simply known as “attachment therapy,” although these controversial therapies certainly do not represent the practices of all professionals using attachment concepts as a basis for their interventions.” Care should be taken to distinguish between the subset of 'therapies' covered by this article and more mainstream therapies, particularly as what is and was is not legitimately described as an 'attachment therapy' within the meaning of this article is controversial and advocacy groups and commentators such as ACT and Quackwatch have undertaken to label a large number of therapies as 'Attachment Therapy' to discredit them (end here...or, instead state, "while the proponents of some of these approaches have presented evidence that the approaches are not corcive and do not use prohibited methods DPeterson 21:23, 15 April 2007 (UTC)) when their proponents deny using coercive or prohibited methods.

Or actually your version of putting them all in brackets except 'Attachment Therapy' is pretty good. I'd be happy with either. On the other point, did you mean just end the last sentence after '...discredit them'. ? Fainites 20:34, 15 April 2007 (UTC)

I'd suggest changing "who's proponents would vehemently deny such a charge." from the last line in either of the following two ways. First, "that (or some of which) are not coercive or use prohibited methods. Or, Second, just leave it out and end with a period after list, without quotes.DPeterson 20:20, 15 April 2007 (UTC)

Yes, put all the terms in brackets, since the article is just about Attachment Therapy and those are just other terms used for it. See belowDPeterson 21:20, 15 April 2007 (UTC)

What do you mean when you say 'this article is just about Attachment Therapy'? Fainites 21:45, 15 April 2007 (UTC)

That is what this article is about, what is Attachment Therapy? Yes? DPeterson 12:46, 16 April 2007 (UTC)

No. It's about 'what is this subset of non-mainstream therapies popularly called attachment therapy, Attachment therapy, Attachment Therapy, coercive attachment therapy or what ever other names proponents think up in order to keep on the move'! Fainites 14:09, 16 April 2007 (UTC)

Yes, just what I said, the article is about what is Attachment Therapy...What do you mean, "whatever other names proponents think up in order to keep on the move?" Are you suggesting something we should consider in this article?DPeterson 12:22, 17 April 2007 (UTC)

Suggestion for Intro

"Attachment Therapy", (also known as attachment therapy, holding therapy, rebirthing therapy, or corrective attachment therapy) is an ambiguous term often used to describe a variety of controversial, non-mainstream "treatments" for children allegedly suffering from attachment disorder which is itself an ambiguous term. However, because the term has no common meaning, or generally accepted meaning, in the professional community, its actual definition is unclear. The term is not a term found in the American Medical Association's Physician's Current Procedural Manual. A number of advocacy groups, such as Advocates for Children in Therapy and Quackwatch have undertaken to label a large number of treatments for children with disorders of attachment as "Attachment Therapy" and attempt to discredit those therapies. The treatments often involve coercive and intrusive methods including variants of holding therapy or rebirthing or rage-reduction. According to Prior and Glaser (2006), ‘these therapies are not based on an accepted version of attachment theory and there is no objective evaluation of them’. Many professional bodies and some American States have outlawed rebirthing.

In a report for the ASPAC, Chaffin et al state 'controversies have arisen about a particular subset of attachment therapy techniques developed by a subset of attachment therapy practitioners, techniques that have been implicated in several child deaths and other harmful effects.' They attempt to define this subset of therapies (see below) and state that 'popularly, on the Internet, among foster or adoptive parents, and to case workers, they are simply known as “attachment therapy,” although these controversial therapies certainly do not represent the practices of all professionals using attachment concepts as a basis for their interventions.” (We need a page number if this is an acutal direct quoteJonesRD_talk 18:50, 15 April 2007 (UTC))

Care should be taken to distinguish between the subset of 'therapies' covered by this article and more mainstream therapies, particularly as what is and what is not described as an 'Attachment Therapy' within the meaning of this article is controversial and advocacy groups such as ACT and Quackwatch include a broadly defined range of therapies in their description of Attachment Therapy, some of which are not coercive or intrusive as described in this article. DPeterson 21:20, 15 April 2007 (UTC)

comment

It's fine apart from the Quackwatch ACT bit. We're saying the same thing twice in two paragraphs in what is meant to be a brief descriptive opening which is stylistically horrible. I invented the second form of words to be used instead of the first, not as well as. It sounds wierd to say the same thing twice in different words. The first bit doesn't fit at all where it is in the opening paragraph and is merely confusing. It gives the impression that the word 'treatments' in the following sentence refers to the 'treatments' described by ACT which I don't think is the effect you meant to achieve but the opposite. The opening paragraph should be a brief description of it's subject. There should be no more than one brief description of a main controversy. I don't mind if you take out the first sentence or amalgamate it with the second or replace the second but as an example of encyclopaedic English we can't leave it as it is.Fainites 21:41, 15 April 2007 (UTC)

I made a small change. I don't see how we can not have both references in. The first reference describes how ACT defines many trts as AT while the last para is a cautionary para that also needs to be present. So, we are not saying the same precise thing twice. I think it reads ok and suggest we leave it as is and move on the the next section...Alternatively we could do nothing, wait a week or so and see what others think before closing this section and moving on to the next section....Now that I put it like that, it is probably best to leave this as is for a week or so and see what others think...but I am certainly willing to continue working with you on the next section, if you wish. DPeterson 01:50, 16 April 2007 (UTC)

OK we'll leave it for a bit. I don't mind having both sentences in although I think it's unecessary but I don't think it reads OK. I think its disjointed and confusing to have a bit of the controversy slap bang in the middle of what is meant to be a description. I don't understand your reason for wanting it there. Saying 'it reads OK' is not a reason. It would 'read OK' if it were moved to join the other ACT sentence. Anyway, lets move on.Fainites 06:38, 16 April 2007 (UTC)

OK, maybe a week or ten days would allow sufficient time. To exaplain my thinking a bit more on this question. It seems that the conecept or definition of Attachment Therapy is not only vague, but is fraught with controversary. Therefore, that belongs in the description of the term. The three leaders of ACT are vocal spokespersons on the subject and have produced a lot of material, therefore, their words or salient. Since the two lines about ACT are pointed in different directions, I'm not sure joining the two lines would work. Regards. DPeterson 12:50, 16 April 2007 (UTC)

They're not pointing in different directions. If the controversy is too complicated to explain in one simple line then it's too much for the intro. The intro should not create terminal confusion for the reader. We should say simply what AT is, and then outkine briefly the main controversy. At the moment, the main controversy cuts the description in half. I don't understand why you're so keen to keep it as I'm not proposing removing any lines.Fainites 14:06, 16 April 2007 (UTC)

I support replacing the existing article intro with the intro proposed above. I the material in this intro about the disagreements and ACT is fine. Let's move on, if we can.MarkWood 14:59, 16 April 2007 (UTC)

The first reference lays out ACT's position. The second reference is part of a cautionary statement. Having both is fine, it's only two lines, and it really does not dilute anything here. If anything, it lays out the disputed points. Since ACT is such a major contributor to this debate I don't think two lines is over the top. I support the intro section as above. MarkWood 15:02, 16 April 2007 (UTC)

I don't object to the two lines for the sake of compromise even tho' it's clearly POV. It's the obfuscation created by it's position that is nonsensical. It's about time this article grew up and away from the feud with ACT and concentrated on it's subject. I've added a tag at the top in the hope of attracting more editors. Fainites 22:08, 16 April 2007 (UTC)

I don't see how it is POV to have material included by a group that has written so extensively on the subject...if anything, excluding their views might be seen as POV. Feud with ACT? I don't understand. Including their material hardly seems to be indicative of a feud with their view and materials. DPeterson 22:58, 16 April 2007 (UTC)

This is a nonsensical reply. You know very well I am not talking about excluding their views. I am talking about moving a wrongly and confusingly placed sentence about 2cms. What is you reason for wanting to leave that sentence where it is?Fainites 08:52, 17 April 2007 (UTC)

Hold on...let's try to keep the dialogue WP:Civil. Again, what is the feud with ACT you reference? I think the material is relevant and belongs...there are two points being made in that section...I don't understand your vehemanceDPeterson 12:25, 17 April 2007 (UTC)

Looks ok to me. Go ahead and use it. SamDavidson 14:24, 19 April 2007 (UTC)

I agree. JonesRD_talk 22:06, 21 April 2007 (UTC)

OK I agree with the prev two comments. It's ok to use. RalphLender 16:16, 27 April 2007 (UTC)

Tag removal

I removed the tag because in order to put the tag on certain criteria must be met: "Drive-by tagging is not permitted. The editor who adds the tag must address the issues on the talk page, pointing to specific issues that are actionable within the content policies, namely Misplaced Pages:Neutral point of view, Misplaced Pages:Attribution, and Misplaced Pages:Biographies of living persons. Simply being of the opinion that a page is not neutral is not sufficient to justify the addition of the tag. Tags should be added as a last resort." "The accuracy of an article may be a cause for concern if: it contains a lot of unlikely information, without providing references." There are other criteria too. The relevant criteria can be found at WP:NPOVD and WP:AD Once those are met, then the tag can be added. In addition, there is the tag at the top of this page. DPeterson 23:04, 16 April 2007 (UTC)

There is a clear dispute and this is made evident above. Since we lack a "this article is best read while drinking purple kool-aid" template, {{totallydisputed}} is a good choice. shotwell 03:25, 17 April 2007 (UTC)

This is not a drive by tagging. I am an existing editor. I have read the entire talkpage of this and related articles. I have made it clear that I dispute the neutrality of this article which has been distorted by a dispute between two polarised parties. I have attempted to edit by consensus but some of the main areas of disputed neutrality appearing are

claiming that the two main authorities in this field, Chaffin et al, and Prior and Glaser, both published in 2006 and both still much discussed and not superceded by new scientific research or thought or peer reviwed report, are 'out of date'.

claiming that one of the main conclusions of the lead comprehensive verified and credible sources is 'POV'!

claiming that substantial conclusions of the credible authorities and important issues addressed by these authorities, (such as marketing on the internet, age regression etc) are 'irrelevant', when on any reading of the materials they are central.

I could in fact carry on in this vein for some time, but hopefully this is sufficient to justify a tag. A tag is not an attack on anybody. It is a way of alerting other editors. We need fresh editors to help on this article. Adding a tag is advised as a method of attracting new editors. You do not own this article. I am replacing the tag.Fainites 08:55, 17 April 2007 (UTC)

APSAC & 'Attachment Therapy' vs. 'attachment therapy'

The article says "The American Professional Society on Abuse of children (APSAC) (Chaffin et al.,2006, PMID 16382093) does not use the term 'Attachment Therapy'", but then links to an abstract that uses the term. Using the citation in this way will probably confuse an ordinary reader. The article goes on to say that they use the term 'attachment therapy' without capitals. This wins the "ridiculously trivial distinction" award. Is there a difference between the definitions of 'Attachment Therapy' and 'attachment therapy'? shotwell 03:06, 17 April 2007 (UTC)

It seems that ACT specifically uses the term Attachment Therapy while more mainstream groups use the term attachment therapy. It seems to be a salient point in the debated literature that we should keep consistent with in our writing here. DPeterson 12:31, 17 April 2007 (UTC)

The purpose of the Chaffin report is to address the whole phenomenon of what is, according to them, popularly known as 'attachment therapy'. They have it with capitals in the title, but so what? They clearly do not limit themselves to with or without capitals. ACT happen to use capitals but are clearly discussing the same issue, as are Prior and Glaser who use capital A, small case t. There is nothing remotely confusing about this. Attempts to prioritise this merely obfuscates the subject, as does so much of the existing article. The most obvious way to deal with it is to list the variations in the opening sentence, something I proposed many inches above. It is an ambiguous term, not because different authors may or may not use capitals, but because it may loosely be used to cover mainstream therapies as well as this subset. That is why the opening paragraph needs to make it very clear what the article is about. That is why interupting the description s given by the prime authorities in the field with a loose sentence about a controversy is inappropriate and obfuscating.Fainites 09:02, 17 April 2007 (UTC)

I figured as much. The current revision puts a rather large emphasis on ACT's writings. This obscures the broadly accepted research by the likes Chaffin. The artificial distinction concerning capitalization doesn't help. shotwell 10:14, 17 April 2007 (UTC)

Actually this should be an easy article to write as there are so many good quality up-to-date sources. Chaffin et al were commissioned to write their report and the many authors contain a very fair chunk of the known experts in this field (people like Zeannah for example). It's a comprehensive review of what was obviously percieved to be an issue. It wasn't the first either. Speltz, an APSAC advisor wrote a history and description for the ASPAC a couple of years earlier. Chaffin have included a comprehensive list of guidelines. Alot of associations now have guidelines but I haven't yet researched which ones are pre Chaffin and which ones are a consequence of Chaffin. There was alot of correspondance after Chaffin came out with those who took issue with Chaffin. The report on the issues raised and the response of the authors is also published in Child Maltreatment. The Prior and Glaser book was only recently published over here in the UK. It's from the Royal Psychiatric Research Unit. Glaser is a big noise over here in child psych. There are concerns that AT is making it's way into the UK. Glaser also deals with what treatments are evidence based. Of course it takes along time to become evidence based as your studies have to fufil the criteria and need to be replicable by others and you need the wider scientific community to acknowledge your work as evidence based. It's very difficult to do RCT's on children. We're very lucky on this article to have so many good authorities. The problem is getting them into the article in a coherent form. I don't have problem with using ACT's material but they are not the primary source. Fainites 10:31, 17 April 2007 (UTC)

Again, we cannot leave out the ACT material as they have written the most on this subject and have the largest inventory of materials about the subject. For example, their definition is probably the most clear and specific of all those floating around. This article is about what is Attachment Therapy; it's definition, maybe some history, and a description in context of its component parts.DPeterson 12:31, 17 April 2007 (UTC)

Nobody is suggesting leaving out their material so I don't know why you keep replying as if somebody is. Anyway the disputed sentence is not their material but is in fact an OR POV statement about them.This article is about a subset of therapies commonly called attachment therapy, with or without capital letters. Fainites 12:43, 17 April 2007 (UTC)

Please don't interpose your comments on the talk page when another editor is replying to the first editor as you did at 12.31 above. Also, what do you mean by 'more mainstream groups'? Do you mean mainstream as in not targeted by Chaffin as in the subset or a more mainstream version of AT?Fainites 13:59, 17 April 2007 (UTC)

I agree with Fainities and others that the ACT material should be included. Since the article is about AT, all views about what this is should be represented. I don't follow the dispute about "mainstream," but, regardless, Speltz's article in the APSAC advisor (not sure he is an "Apsac advisor"), the Chaffin paper, Glaser, and ACT material all have a place here. We don't need to belabor points...let's just make the points clearly and to the point...making a concise, complete, and relevant article. RalphLender 14:10, 17 April 2007 (UTC)

Can we all accept that we are writing an article about the phenonmenon of a subset of non-mainstream therapies as described by Chaffin, Glaser and ACT whether we or they use capital letters or not? Fainites 14:32, 17 April 2007 (UTC)

Hasn't that been clear? As I read all the various editors comments, that seems to cearly be the focus here. The article is about what is this thing called A(a)ttachment T(t)heray, and all the other names it goes by: rebirthing, holding, coercive restraint therapy. RalphLender 15:39, 17 April 2007 (UTC)

It hasn't been clear in the past but if it's clear now then jolly good! Fainites 16:06, 17 April 2007 (UTC)

Oh. It seems clear from reading the comments in this section, at least. I don't have a lot of time to devote to idle chatter, so I do hope you, I, and others who wish to contribute, can focus on writing and gettinig some level of consensus. RalphLender 18:04, 17 April 2007 (UTC)

It's not idle chatter. It's been a major part of the talkpage from the outset that some editors have pushed the POV that AT with capitals is really just an ACT thing, and they can't be trusted, and that Chaffin et al are talking about something different. If we no longer have to waste our time with that then hooray! But we do need to be clear. Fainites 18:30, 17 April 2007 (UTC)

'INTRODUCTION READY?'

"Attachment Therapy", (also known as attachment therapy, holding therapy, rebirthing therapy, or corrective attachment therapy) is an ambiguous term often used to describe a variety of controversial, non-mainstream "treatments" for children allegedly suffering from attachment disorder which is itself an ambiguous term. However, because the term has no common meaning, or generally accepted meaning, in the professional community, its actual definition is unclear. The term is not a term found in the American Medical Association's Physician's Current Procedural Manual. A number of advocacy groups, such as Advocates for Children in Therapy and Quackwatch have undertaken to label a large number of treatments for children with disorders of attachment as "Attachment Therapy" and attempt to discredit those therapies.]. The treatments often involve coercive and intrusive methods including variants of holding therapy or rebirthing or rage-reduction. According to Prior and Glaser (2006), ‘these therapies are not based on an accepted version of attachment theory and there is no objective evaluation of them’. Many professional bodies and some American States have outlawed rebirthing.

In a report for the ASPAC, Chaffin et al state 'controversies have arisen about a particular subset of attachment therapy techniques developed by a subset of attachment therapy practitioners, techniques that have been implicated in several child deaths and other harmful effects.' They attempt to define this subset of therapies (see below) and state that 'popularly, on the Internet, among foster or adoptive parents, and to case workers, they are simply known as “attachment therapy,” although these controversial therapies certainly do not represent the practices of all professionals using attachment concepts as a basis for their interventions.” . p77(We need a page number if this is an acutal direct quoteJonesRD_talk 18:50, 15 April 2007 (UTC))

Care should be taken to distinguish between the subset of 'therapies' covered by this article and more mainstream therapies, particularly as what is and what is not described as an 'Attachment Therapy' within the meaning of this article is controversial and advocacy groups such as ACT and Quackwatch include a broadly defined range of therapies in their description of Attachment Therapy, some of which are not coercive or intrusive as described in this article.

(I think this is ready now. Let's get some comments on this over the next week or two and then we can move on to the next sectionDPeterson 12:35, 17 April 2007 (UTC)

COMMENTS ON INTRO AS WRITTEN

Let's see what various editors think about this paragraphy and see if we have a consensus, or at least a broad and large group agreeing, even if not all agree. DPeterson 12:50, 17 April 2007 (UTC)

1. OKWith addition of the page number requested by Jones. DPeterson 12:35, 17 April 2007 (UTC) ACT is a major writer on the subject and and produced significant amounts of material on this topic and so should be given substantial weight as they do offer a clear definition and specific materials. DPeterson 21:53, 17 April 2007 (UTC)
2. Don't agree with the placement of the first sentence about ACT. Fainites 12:44, 17 April 2007 (UTC)
3. Acceptable I've read all the comments and suggestions and think this version represents a concensus (My Webster's defines this as "...a general agreement...the judgment arrived at by most of those concerned."). I think it is time to move along to next sections. RalphLender 14:05, 17 April 2007 (UTC)
4. The ACT bit doesn't deserve such prominence. shotwell 21:40, 17 April 2007 (UTC)
5. It's done now and just fine. MarkWood 14:10, 18 April 2007 (UTC)

No it isn't done. We're not agreed. It's not fine. I could live with that disputed sentence in an appropriate place even though it's OR, POV and inaccurate (although it's not as bad as it was) but it's absurd to have an attack like that in the middle of the introduction. The point it's trying to make is better made in the last sentence, ie, be careful of ACT's list. Chaffin does a much better job of discrediting some of those therapies than ACT. Shall we put him in instead? We can't deal with all the controversies and arguments in the Intro. and we certainly shouldn't be prominently taking sides with out of place POV statements there. Fainites 22:12, 18 April 2007 (UTC)

Let's see how others feel about this. Remember, no one owns this editing and concensus means consensus among most individuals who have an interest here. Attack? The intro does a very good job of sketching out, briefly, the controversaries and arguments that are later expanded upon. DPeterson 23:21, 18 April 2007 (UTC)

I am waiting to see how others feel. MarkWood was indicating it was all sorted. Fainites 06:18, 19 April 2007 (UTC)

I think EVERYONE should wait and see what other editors think and what may be contributed. DPeterson 12:42, 19 April 2007 (UTC)

6. Use it This is ok with me as written. SamDavidson 14:25, 19 April 2007 (UTC)

7. Fine with me' This section is ok. JohnsonRon 20:46, 19 April 2007 (UTC)

8. Good as writtenJonesRD_talk 22:53, 20 April 2007 (UTC)

proposed second section Definitions of Attachment Therapy

There is no generally accepted definition of "Attachment Therapy". It is not a term found in the American Medical Association's Physician's Current Procedural Manual nor in generally recognized texts on treatment modalities, such as Bergin & Garfield's Handbook of Psychotherapy and Behavior Change. There is not any specific text that describes this "treatment" approach. Chaffin et al (2006) describe the polarization between the proponents of ‘Attachment Therapy’ and mainstream therapies stating, "This polarization is compounded by the fact that attachment therapy has largely developed outside the mainstream scientific and professional community and flourishes within its own networks of attachment therapists, treatment centers, caseworkers, and parent support groups. Indeed, proponents and critics of the controversial attachment therapies appear to move in different worlds." p85 (We need a page number hereRalphLender 20:04, 17 April 2007 (UTC))

The report of the APSAC Task Force on Attachment Therapy, Reactive Attachment Disorder and Attachment Problems (Chaffin et al 2006), having said "The terms attachment disorder, attachment problems, and attachment therapy, although increasingly used, have no clear, specific, or consensus definitions", (p 83) (Need page #DPeterson 21:58, 17 April 2007 (UTC)) it's got oneFainites 22:00, 17 April 2007 (UTC) (page numbers go after each discrete quoteDPeterson 22:07, 17 April 2007 (UTC)) attempt to describe this subset as follows: "The attachment therapy controversy has centred most broadly on the use of what is known as “holding therapy” (Welch, 1988) and coercive, restraining, or aversive procedures such as deep tissue massage, aversive tickling, punishments related to food and water intake, enforced eye contact, requiring children to submit totally to adult control over all their needs, barring children’s access to normal social relationships outside the primary parent or caretaker, encouraging children to regress to infant status, reparenting, attachment parenting, or techniques designed to provoke cathartic emotional discharge. Variants of these treatments have carried various labels that appear to change frequently. They may be known as “rebirthing therapy,” “compression holding therapy,” “corrective attachment therapy,” “the Evergreen model,” “holding time,” or “rage-reduction therapy” (Cline, 1991; Lien, 2004; Levy & Orlans, 1998; Welch, 1988). Popularly, on the Internet, among foster or adoptive parents, and to case workers, they are simply known as “attachment therapy,” although these controversial therapies certainly do not represent the practices of all professionals using attachment concepts as a basis for their interventions." p83

Speltz (2002) in a paper published by the APSAC (not for APBSAC, but in one of it's pubs RalphLender 20:04, 17 April 2007 (UTC)) (are you sure? It says ASPAC advisor on the paper or is that the name of their pub? Fainites 21:05, 17 April 2007 (UTC)) (The APSAC Advisor is a newsletter of that organization...not peer reviewed.DPeterson 22:00, 17 April 2007 (UTC)) it looks like the name of the pub.On what basis do you say it's not peer reviewed?Fainites 22:07, 17 April 2007 (UTC) (changed itFainites 23:04, 18 April 2007 (UTC)) describes ‘corrective attachment therapy’ as follows: "… the holding therapies included in “corrective” attachment therapy do not address safety needs. They differ in that a therapist or parent initiates the holding process for the purpose of provoking strong, negative emotions in the child (e.g., fear, anger), and the child’s release is typically contingent upon his or her compliance with the therapist’s clinical agenda." p4.(if a quote need pg num.RalphLender 20:04, 17 April 2007 (UTC))

Prior and Glaser (2006) describe ‘Attachment therapy’ as a variety of treatments offered to desperate carers of troubled, maltreated children which often include variants of holding, eg holding time (Welch 1998), therapeutic holding (Howe and Fearnley 2003), rage reduction therapy (Cline 1991) and rebirthing. They state, (If this is a direct quote, quotes " are needed and page number listed...DPeterson 22:07, 17 April 2007 (UTC)) "There are many ways in which holding therapy/attachment therapy contradicts Bowlby's attachment theory, not least attachment theory's fundamental and evidence-based statement that security is promoted by sensitivity. Moreover, Bowlby (1988)explicitly rejected the notion of regression, which is key to the holding therapy approach: 'present knowledge of infant and child development requires that a theory of developmental pathways should replace theories that invoke specific phases of development in which it is held a person may become fixated and/or to which he may regress." p265. (if a direct quote...need a page number...it's unclear here what are quotes and what are your statements...try using " "RalphLender 20:04, 17 April 2007 (UTC))

(This seems out of place...either delete or put with Chaffin material maybe.DPeterson 22:07, 17 April 2007 (UTC))Chaffin et al also cite 'encouraging children to regress to infant status'as a feature of these therapies at p83 and include 'age regression' as a technique to avoid in their guidelines at p86.(page # and direct quoteRalphLender 20:04, 17 April 2007 (UTC)) (it goes OK now with the expanded Glaser bitFainites 23:08, 18 April 2007 (UTC))

The advocacy group Advocates for Children in Therapy define, "Attachment Therapy (AT).. as …a growing, underground movement for the treatment of children who pose disciplinary problems to their parents or caregivers. AT practitioners allege that the root cause of the children’s misbehavior is a failure to 'attach' to their caregivers. The purported correction by AT is — literally — to force the children into loving (attaching to) their parents ...there is a hands-on treatment involving physical restraint and discomfort. Attachment Therapy is the imposition of boundary violations - most often coercive restraint - and verbal abuse on a child, usually for hours at a time...Typically, the child is put in a lap hold with the arms pinned down, or alternatively an adult lies on top of a child lying prone on the floor." They state "Attachment Therapy almost always involves extremely confrontational, often hostile confrontation of a child by a therapist or parent (sometimes both). Restraint of the child by more powerful adult(s) is considered an essential part of the confrontation." The group identify rebirthing as a form of "attachment therapy". Fainites 23:08, 18 April 2007 (UTC) The group also uses the terms "rebirthing" and "holding therapy" as terms for "Attachment Therapy."] (Their book uses the terms frequentlyDPeterson 11:51, 18 April 2007 (UTC)) ] (now proposed this be replaced by "The group identify rebirthing as a form of attachment therapy". Fainites 20:04, 18 April 2007 (UTC))

Comments on second section

I've put in the bits about it not being defined in various manuals from your version. I've also put in the full quote from Glaser and Prior about age regression that you requested and added that Chaffin includes it in his list. On p83 he calls it 'encouraging children to regress to infant status'. On p86 in his 'guidelines' he just calls it 'age regression'. ACT include it in their definition as well somewhere I think. If you want that too I'll look it up. The polarization bit from Chaffin of course explains why there's nothing in professional manuals about this thing. Fainites 18:42, 17 April 2007 (UTC)

Does this mean we are done with the intro and that the version above, with the requested page notation is to go in? I guess we should wait a bit to see what other editors think too. Agreed? RalphLender 19:12, 17 April 2007 (UTC)

No we're not done with the intro. I don't agree with the weird line in the middle, but DP suggested leaving it there for a while (actually he said 2 weeks I think) to see what other editors think. We haven't even left it a day yet! That needn't stop us having a bash at the other sections.Fainites 19:16, 17 April 2007 (UTC)

I've put the page number in the intro. Do you not have Chaffin? Fainites 19:19, 17 April 2007 (UTC)

OH, good. Ok then. I'll take a look at the second section when I get some time. RalphLender 19:58, 17 April 2007 (UTC)

I added some material and made a few edits. I'm ok with this section now as it stands...maybe as DP suggested, we can leave it for a week or two and see what other editors think...hopefully we will have consensus and can move on...I do hope so. RalphLender 20:08, 17 April 2007 (UTC)

I've added the page numbers. I've put the Glaser as just the full quote and also the actual words from Chaffin. On the issue of your additions, is that last sentence a quote? Can we have the page number or link? It's not my understanding of how they state their information, but if it's a direct quote then fair enough. Otherwise best leave it out or find a direct quote of some kind.Apart from this it's fine as a compromise. Fainites 21:54, 17 April 2007 (UTC)

On your last sentence again Ralph, just looking at the AT site, they list 22 therapies which they call attachment therapy and specifically do not include rebirthing and indeed explain why. I think it's best to stick to direct quotes if we're saying various people or organisations say things. Fainites 22:10, 17 April 2007 (UTC)

Very nice work, Fainites. As I read the very last line it is a direct quote with a cite. As I surf the net, rebirthing is a term used and it is the procedure used in the Candace Newmaker case, in which ACT was quite involved. DPeterson 22:13, 17 April 2007 (UTC)

Thanks. But on the last line, either it is or it isn't a direct quote. If it is a direct quote, lead us to it! I clicked on the link which I understood related to the previous passage (and indeed does). I could not find the last line as a quote. I'm quite happy to be proved wrong if you produce it! On the age regression point, it's obviously important but I don't mind whether it goes in this section or the 'underlying principles' section. Leave it here for now and see what other editors say. Also, when we're trying to write a paragraph we can all agree on, do you guys have to keep cluttering the page up with headmistressy remarks about quotation commas. If you think it should have " instead of ' just do it! Fainites 22:19, 17 April 2007 (UTC)

I just looked at the diffs and there was a quotation mark round Glaser. You removed it DP to put in your bit about quotation marks! Cheers Fainites 22:25, 17 April 2007 (UTC)

Well, one quote from them is "who taught that re-enactment of the birth process might be a useful script for some holding sessions. That script he and others called “rebirthing” for short.)" DPeterson 22:43, 17 April 2007 (UTC)

However, if you think it better to just say, "sometimes also called rebirthing" and leave out the attribution, that's fine too. The media and on the web we see the term used alot. DPeterson 22:47, 17 April 2007 (UTC)

I'm sorry but your missing the point here. The introduction properly says that it's also sometimes called rebirthing, which in the media it is. But you added a sentence in the definition section that states specifically that ACT specifically call it rebirthing and holding. When queried you state this is a quote. Well if it is, provide the source. If you can't provide the source then it isn't a quote. If you are saying it's a paraphrase you still need to provide the source. You also said the previous link was the source. I looked at it and it says the opposite. How can we reach consensus if you just put in OR statements, claiming they're quotes then refusing to give the source? As I say, I am, quite willing to be proved wrong if you provide the source. After all, you're very keen to demand exact quotes, page numbers, descriptions and names of publications from me all of which I have provided. As for the script quote you put above, this is interesting material but doesn't support the end sentence. It could go in in it's own right but who is 'He' ? Source or direct link please! I've put in a citation needed so we don't forhet and so other editors can easily see what we're talking about. Fainites 06:55, 18 April 2007 (UTC)

I'd given citations above in this very section! From their book. "Both bills follow on the 2000 death in Colorado of a North Carolina girl, Candace Newmaker, during a “two-week intensive” in Attachment Therapy (AT)." They describe rebirthing as Attachcment Therapy.] DPeterson 11:51, 18 April 2007 (UTC)

They consider rebirthing to be a form of attachment therapy, but they do not use the term 'rebirthing' as a term for all attachment therapies. There should be no confusion concerning ACT's definition given that it's explicitly stated at http://www.childrenintherapy.org/essays/overview.html under the heading "Varying Nomenclature". This is rather confusing because you have previously claimed their definition is too broad. Now you are stating that they have this very narrow definition of attachment therapy. It can't be both. shotwell 16:50, 18 April 2007 (UTC)

The other confusing thing is that you're so insistent on giving ACT such prominence in this article. On the Advocates for Children in Therapy article, you have described them as a fringe group that receives no serious attention from the professional community. You have portrayed the leaders as being unqualified with respect to attachment therapy. If this is what you truly believe, it seems that you would want to avoid giving their voice undue weight in this article. shotwell 16:58, 18 April 2007 (UTC)

You did not provide this link above for this line. I have now looked at the link you provide in yoiur reply now. Here is the exact quote "Though its preamble (to the bill)correctly identifies “rebirthing” as a form of Attachment (Holding) Therapy....." Therefore it is inaccurate to say they call rebirthing attachment therapy as if the two terms were synonymous. An accurate quote would be to put in that they identify rebirthing as a form of AT. They in fact list 22 different names for AT and in that essay they more or less say they specifically do not consider rebirthing synonymous with AT. Again, here is the quote,

"Note may be taken that the list above does not include “rebirthing” or “rebirthing therapy.” This is a label that the press and others put on the procedure that Connell Watkins and Julie Ponder supposedly used to kill Candace Newmaker. Watkins and Ponder were trained in the approaches of Douglas Gosney, an Attachment Therapist practicing in California, who taught that re-enactment of the birth process might be a useful script for some holding sessions. That script he and others called “rebirthing” for short.)" Unless you provide a specific quote, I do not agree to inaccurate, OR, POV statements suddenly appearing and being put in in this way. To what end? For what purpose? There's loads of real material. Fainites 17:03, 18 April 2007 (UTC)

ACT seems to use holding therapy and rebirthing as elements, aka's, or the same as Attachment Therapy. DPeterson 23:26, 18 April 2007 (UTC)

Sometime elements of; yes. Same as; no. This is plainly obvious from their literature. Quotes have been provided above. Specific source and quote for your contention please. Fainites 20:11, 19 April 2007 (UTC)

My reading of the ACT website is that, in fact, they use a variety of terms, including rebirthing and holding therapy as synon. with AT. The links provided in this long thread support that reading, so I support the statement as written. JohnsonRon 21:19, 19 April 2007 (UTC)

SECOND SECTION DONE?

Editors: is the second section acceptable for inclusion now? Please limit your comments to yes or no and one or two lines. Longer comments can go above. DPeterson 12:24, 18 April 2007 (UTC)

1. _'OK' with me. It is fine with me and can replace the existing second paragraph in the article. MarkWood 14:10, 18 April 2007 (UTC)
2. Yes This is fine to go in as it has been edited up to this point. I agree it can replace the existing second paragraph. RalphLender 15:16, 18 April 2007 (UTC)

Hey Ralph! You're back! You were the one that put in the quote about ACT calling rebirthing AT. DP's been defending it for you but he hasn't been able to show us the exact quote of hwere it comes from. Please can you give us the exact quote and source so we can resolve this problem.Fainites 17:26, 18 April 2007 (UTC)

The support is provided above via the links. However, your suggestion below is also fine, "ACT identifies rebirthing as a form of AT." I'd support that. RalphLender 18:52, 18 April 2007 (UTC)

3. No Unless the inaccurate and unecessary last phrase is removed or replaced by an accurate and sourced quotation. I would accept "ACT identify rebirthing as a form of AT". Do I take it that you all agree to the bit on regressing to infancy remains in ? Fainites 17:07, 18 April 2007 (UTC)

See my comment in number 2 above. RalphLender 18:52, 18 April 2007 (UTC)

OK. I'll change it unless anyone else objects.Fainites 20:00, 18 April 2007 (UTC)

Sounds good to me. Without the change, however, I do not think the second section is "done". shotwell 20:13, 18 April 2007 (UTC)

OK, I like, "ACT identifies rebirthing and holding therapy as terms for "Attachment Therapy."...so can we go with that?DPeterson 23:26, 18 April 2007 (UTC)

Perhaps I'm just extremely pedantic, but that is still not correct. I would agree with "ACT identifies rebirthing and holding therapy as types of attachment therapy". How's that sound to you? shotwell 07:54, 19 April 2007 (UTC)

They use rebirthing and holding as terms for AT...what is the difference between writing this is AKA that and this is a type of that. A pine is a type of tree and pines are AKA trees.DPeterson 12:46, 19 April 2007 (UTC)

Sorry DP but with all due respect you've missed the point. They do not use rebirthing and holding as terms for AT. They identify rebirthing and holding as forms or types of AT. In other words not synonymous. Ralph, Shotwell and I can see a clear difference. If you can't what is your objection to Shotwells version going in? Fainites 15:52, 19 April 2007 (UTC)

I have to agree that my reading is that the terms are used at terms for AT. rebirthing and holding therapy as types of AT and are AT. JohnsonRon 02:04, 20 April 2007 (UTC)

Still waiting for a direct quote from a verified and credible source showing that ACT treat the terms rebirthing and AT as synonymous. Fainites 11:46, 21 April 2007 (UTC)

The quotes have already been provided as links to their page and a reading makes it very clear that ACT treats the terms as synonymous. 'KEEP'JonesRD_talk 22:08, 21 April 2007 (UTC)

The links given show the opposite to what you claim on rebirthing. Still waiting for a direct quote that ACT use Rebirthing and AT as synnonymous. Happy to accept an actual quote.Fainites 00:28, 22 April 2007 (UTC)

No, the links show that they see all these are similiar terms for similiar procedures. As I said before, we may disagree, so we'll just have to go with the consensus that develops and follow that; which seems to be that the terms are all similliar and used by ACT as largely the same. Remember, although you wrote a lot of this, you do not own the article, nor do you have veto power if the consensus is not your view. JonesRD_talk 02:17, 22 April 2007 (UTC)

4. 'YES' This section is fine to go in as written. SamDavidson 14:26, 19 April 2007 (UTC)

What do you mean 'as written'? DP's last line or the one agreed by the others? Fainites 15:56, 19 April 2007 (UTC)

5. FINE with the line as DP has it. I read the ACT material and their website as using the various terms there, including rebirthing and holding therapy as synonymous with AT. JohnsonRon 20:48, 19 April 2007 (UTC)

6. Yes I agree the section is ok as written (with the line that rebirthing/holding therapy/Attachment Therapy are synonymous. For all the reasons stated above, I won't repeat arguments already presented.JonesRD_talk 22:55, 20 April 2007 (UTC)

Proposed Third Section

history and underlying principles--Third section

Speltz (2002) states that the roots of "Attachment Therapy" are traced to Robert Zaslow in the 1970’s. Zaslow attempted to force attachment in those suffering from autism by creating pain and rage whilst enforcing eye contact. He believed that holding someone against their will would lead to a breakdown in their defence mechanism’s making them more receptive to others. Speltz point’s out that these ideas have been dispelled by research into autism and that, conversely, techniques based on behavioural principles have proved effective.

('DELETE THIS PARAGRAPH' JohnsonRon 20:54, 19 April 2007 (UTC)) Speltz cites (provide a direct quote instead of paraphrasingDPeterson 23:32, 18 April 2007 (UTC)) (actually theres nothing wrong with a paraphrase if it's accurate and sourced. Wiki deprecates articles that are long lists of quotes. I'll post the full quote below so you can see if you think its a fair paraphrase.Fainites 16:23, 19 April 2007 (UTC) Martha Welch and "holding time" (1984 and 1989) as the next significant development. Mothers were instructed to hold their defiant child, provoking anger and rage, until such time as the child ceased to resist at which point a bonding process was believed to begin. Similar techniques were subsequently promoted by Foster Cline and associates at the Attachment Centre at Evergreen, Inc. and duplicated elsewhere in other clinics. (you need a citation for this last sentance if you name names and a specific quoteDPeterson 23:32, 18 April 2007 (UTC)) OK the specific quote is "Foster Cline (1991) and associates at the Attachment Center at Evergreen, Inc. (Evergreen, Colorado) began to promote the use of the same or similar holding techniques with adopted, maltreated children who were said to have an attachment disorder (not to be confused with DSM-IV’s reactive attachment disorder)." Is this OK? Fainites 16:23, 19 April 2007 (UTC)

(WOW! Speltz is old, 2002. I think this section should not be here. Incuding such a large amount of material that is probably seven or more years old (and 18 to 16 in two other cases) is just bad...it may even be an inaccurate represesntation of what those people are doing now. Either delete it completely, or cite the current works of those involved. I'd suggest just leaving it out. The paragraph really is unneeded.JohnsonRon 20:53, 19 April 2007 (UTC))

Its a history section. See title above.Fainites 22:17, 19 April 2007 (UTC)

According to Prior and Glaser (2006) "there is no empirical evidence to support Zaslows theory. The concept of suppressed rage has, nevertheless, continued to be a central focus explaining the children’s behaviour (Cline 1991)." p263. (page numberDPeterson 23:32, 18 April 2007 (UTC))

Chaffin et al describe the underlying principles of Attachment Therapy as follows; “In contrast to traditional attachment theory, the theory of attachment described by controversial attachment therapies is that young children who experience adversity (including maltreatment, loss, separations, adoption, frequent changes in child care, colic or even frequent ear infections) become enraged at a very deep and primitive level. As a result, these children are conjectured to lack an ability to attach or to be genuinely affectionate to others. Suppressed or unconscious rage is theorized to prevent the child from forming bonds with caregivers and leads to behavior problems when the rage erupts into unchecked aggression. The children are described as failing to develop a conscience and as not trusting others. They are said to seek control rather than closeness, resist the authority of caregivers, and engage in endless power struggles. From this perspective, children described as having attachment problems are seen as highly manipulative in their social relations and actively trying to avoid true attachments while simultaneously striving to control adults and others around them through manipulation and superficial sociability. Children described as having attachment problems are alleged by proponents of the controversial therapies to be at risk for becoming psychopaths who will go on to engage in very serious delinquent, criminal, and antisocial behaviors if left untreated." p 78 page #DPeterson 23:32, 18 April 2007 (UTC)

Prior and Glaser cite the one published study which "purports to be an evaluation of holding therapy" by Myeroff et al (1999). The methodology of this study is heavily criticized. (please do not remove other peoples talk page posts DPeterson. This is the third time I have had to ask you. If you disagree with this line, don't just silently remove it. Say you disagree and why and we'll discuss it below. Now we don't know whether the other editors are agreeing to my post or my post as altered by you.Fainites)This study covers the "across the lap" type holding therapy, described as "not restraint" by Howe and Fearnley (2003) but "being held whilst unable to gain release."

Prior and Glaser also state, "There are many ways in which holding therapy/attachment therapy contradicts Bowlby's attachment theory, not least attachment theory's fundamental and evidence-based statement that security is promoted by sensitivity. Moreover, Bowlby (1988)explicitly rejected the notion of regression, which is key to the holding therapy approach: "present knowledge of infant and child development requires that a theory of developmental pathways should replace theories that invoke specific phases of development in which it is held a person may become fixated and/or to which he may regress." " p265. Chaffin et al also cite "encouraging children to regress to infant status" as a feature of these therapies (p83) and include "age regression" as a technique to avoid in their guidelines at p86. Fainites 22:54, 18 April 2007 (UTC)

Comments

I think this covers all the comments made. I've put the full 'age regression' bit in here aswell. I don't mind if it goes in here in 'underlying principles' or in 'definition'. It's arguably both but there's no point repeating ourselves unless necessary for the sake of clarity.Fainites 22:57, 18 April 2007 (UTC)

1. 'GOOD'I made a few minor changes...as it is now I could support this as our third section. But, as I've said before, no one or two editors own this article, so let's give it a week or two for others to comment and edit and build consensus before we act. DPeterson 23:34, 18 April 2007 (UTC)
2. 'YES' This section is fine as written and, as far as I am concerned, can go in. It is balanced and includes verifiable references/sources. SamDavidson 14:27, 19 April 2007 (UTC)
3. 'YES' including the line removed by DP about Myeroffs study being heavily criticised (which I've put back. How can other editors comment on it if it's been removed?). See comment below. I'll do the page numbers and things in a moment.Fainites 16:05, 19 April 2007 (UTC)
4. 'YES' With the paragraph with the extensive quote from an article five years old quoting material nearly twenty years old. Leave out the line about the Meyeroff study...JohnsonRon 20:56, 19 April 2007 (UTC) I re-read it a couple of more times, and I take back what I sais....the line about the Meyeroff study being heavy criticized, as Fainites has it is fine. It is accurate, and brief. So, 'YES' but with the paragraph I noted deleted or severely edited to reflect how out of date the material is. JohnsonRon 20:59, 19 April 2007 (UTC)
5. (#'YES' if we leave Myeroff in. Also put in a direct quote from Speltz re Foster Cline as suggested by DP. Leave paraphrase of martha welch. On the old material point, this is a history section!!!! It starts by saying things like 'the roots are traced back to...' Howmuch clearer can it be? Fainites 22:20, 19 April 2007 (UTC)) I agree with u that the Myeroff line can stay in...it's relevant. But I still object the the outdated material being present. I actually don't think it is necessary for this article and it is too misleading. Maybe if you rewrote it so that it wasn't so misleading and provocative it might be ok...JohnsonRon 02:06, 20 April 2007 (UTC)
6. I thought it was fantastic when first posted. This nonsense about things being "out of date" is absurd. shotwell 14:43, 20 April 2007 (UTC)

You are entitled to your view. However, it appears that your view is in the minority here. As others have said, no one ownes the articles on Misplaced Pages. JohnsonRon 17:52, 20 April 2007 (UTC)

7. Yes It is fine with the Meyeroff material. I do think the paragraph under dispute in the history section could be deleted. I can see how the material could be misinterpreted, so let's just leave it out...It doesn't add much to an article whose purpose is to define attachment therapy. JonesRD_talk 22:57, 20 April 2007 (UTC)

8. Yes The disputed paragraph in the history section is best left out. The Meyeroff stuff is fine. MarkWood 17:47, 24 April 2007 (UTC)

'9.' 'Yes' The material is good to go with the Myeroff material and it's fine to leave out the disputed paragraph so we can move this along. That paragraph really doesn't add anything that is essential and vital to this article. RalphLender 16:18, 27 April 2007 (UTC)

Re Myeroff. This is the only 'holding therapy' study. The Prior/Glaser full quote is as follows;

"Only one published study which purports to be an evaluation of holding therapy was found (Myeroff et al. 1999). In this study the comparison sample was inadequate (families who contacted the Attachment Centre at Evergreen, Colorado, but did not attend), the children were not randomly assigned to treatment conditions, and the pre- and post-treatment assessment of the children depended on a questionnaire (the Child behaviour Checklist) completed by mothers. This paper clearly illustrates the leap proponents of holding therapy make from Bowlby's theory to their advocated treatment." I can give you the rest about how it's not really based on Bowlby if anyone wants it.

A similar criticism is made by Chaffin et al:

"For example, perhaps the most widely cited study in the holding therapy literature, and possibly the only empirical study on the topic available in a mainstream peer-reviewed journal, suffered from a number of major limitations. The study used a very small sample (12 in the treatment group, 11 in the comparison group), participants were selfselected into treatment and comparison groups, and the statistical analysis did not include any direct test of group differences in change over time (Myeroff, Mertlich, & Gross, 1999)."

I'm quite happy to reduce all this to an accurate paraphrase, but removing it altogether creates a misleading impression of why Prior and Glaser cited this study.Fainites 16:16, 19 April 2007 (UTC)

Re martha welch. DP has asked for the full quote from Speltz. Here it is:

"A decade later, Martha Welsh (1984, 1989) described a technique for children with attachment problems called holding time. Mothers were instructed to take hold of their defiant child at these times, holding them tightly to the point of inducing anger. Mothers were told to expect that the child may spit, scream, swear, attempt to get free, bite, and try to cause alarm by saying that he is in pain, cannot breathe, will vomit, is going to die, or needs to urinate. In this approach, parents were encouraged to accept these behaviors calmly and silently. Welsh described a subsequent stage (marked by the child’s weeping and wailing) in which parents were encouraged to resist the temptation to feel sorry for the child or to feel guilty about what they are doing. Mothers were told that if they could successfully resist these temptations, the child would enter an acceptance stage in which the child would fight less and become relaxed and tired. The mother was then instructed to loosen her hold on the child, at which point a bonding process was believed to begin, in which the child would find comfort from the mother in this relaxed state. To my knowledge, no evidence for the efficacy of this method has ever been provided." Fainites 16:25, 19 April 2007 (UTC)

This material is 'VERY OUT OF DATE' It is not needed in this article. JohnsonRon 20:56, 19 April 2007 (UTC)

Its in a history section! It's the history of AT. ie where it comes from. That implies the past. This section traces the provenance of underlying theories behind AT. Also its clearly still being practised! Are we going to leave out everything about attachment in this article because Bowlby is 1988 and therefore very out of date? (By the way, there's no need to SHOUT). Fainites 22:13, 19 April 2007 (UTC)

Leave it out then. It is way to OUT OF DATE to be meaningful...or, as I suggested above, rewrite it substantially so it is not as misleading as it currently is. In any event, the best course is to just leave it out...but we can take a vote and build consensus that way. JohnsonRon 02:15, 20 April 2007 (UTC)

Out of date? This is the history section. In the history section, we need to write about notable developments since the beginnings of attachment therapy. These papers are still earning citations in major works by leading experts -- this establishes notability. Your argument here is too bewildering to take seriously. shotwell 14:38, 20 April 2007 (UTC)

Yes, the material cited is out of date and 'MAY' misrepresent the approaches....'BETTER' is to just leave out the section in full as suggested above...Concensus will determin what will occur and a vote seems like a good idea now. JohnsonRon 17:52, 20 April 2007 (UTC)

VOTE ON DELETING THE PARAGRAPH DISCUSSED ABOVE

1. 'YES'Just delete it and move on. JohnsonRon 17:52, 20 April 2007 (UTC)
2. Yes I agree. JonesRD_talk 22:59, 20 April 2007 (UTC)
3. Actually that makes DPeterson, Samdavidson, Shotwell and me in favour of this paragraph! But as Shotwell says, this argument that the history is too out of date can't really be taken seriously. Why don't you pop along and delete the Hitler page on the grounds that he's now dead! The history is from a credible and verified source that is still being cited. It's not even an old paper. 2002 is nothing in science terms! Are you suggesting that history has changed retrospectively in the last 4 years? Lastly, Wiki is not a democracy. You can't just vote to remove verified and credible sources. As for the suggestion by Ralph, that we leave in tthe history the Myeroff study on holding therapy but leave out development of holding therapy, can anybody explain this? I am quite happy to attempt a different paraphrase of Speltz on Martha Welch, or indeed put in the entire quote, but we cannot in all seriousness leave it out of a history section.Fainites 11:31, 21 April 2007 (UTC)
4. It's ok to delete the paragraph under dispute. I can see why it might be confusing as written and if it is included needs significant explainations. DPeterson 16:47, 24 April 2007 (UTC)

If you don't like a paraphrase, (and nobody else seems willing to attempt one), I would propose a direct quote from Speltz (published in the ASPAC publication). :"A decade later, Martha Welsh (1984, 1989) described a technique for children with attachment problems called holding time. Mothers were instructed to take hold of their defiant child at these times, holding them tightly to the point of inducing anger." p 4. "Foster Cline (1991) and associates at the Attachment Center at Evergreen, Inc. (Evergreen, Colorado) began to promote the use of the same or similar holding techniques with adopted, maltreated children who were said to have an attachment disorder (not to be confused with DSM-IV’s reactive attachment disorder)." p 4.Fainites 11:39, 21 April 2007 (UTC)

Really? I don't see the comments that way. We certainly should give others a chance to comment. While you have written the material underdiscussion here, you do not OWN it and there must be broad and generally agreement, but no one person has a veto. Maybe if you put something in the clearly indicate that the statements are based on material over a decade and half old and that this may not reflect current practice it could be ok...See, now, that would be a good compromise. JonesRD_talk 22:12, 21 April 2007 (UTC)

The material comes from an article that specifically states it deals with the history. It all states it comes from this article. How much clearer can it be? Speltz writes the article which deals with the history. We cite and quote Speltz. Speltz is a verified and credible source. it's not rocket science! Fainites 00:23, 22 April 2007 (UTC)

This is the fourth time of asking, please don't mess around with other peoples edits. Fainites 00:27, 22 April 2007 (UTC)

I am merely formating so that your comments are in the proper form...indentented and with the thread they apply to. I think a good compromise would be for you to clearly indicte that the statements are based on material that is fifteen or more years old and that it may not reflect their current practice. That seems like a reasonable request. What is your problem with doing that? If you just don't have the time, then let's just leave it out. JonesRD_talk 02:21, 22 April 2007 (UTC)

If it clearly states that Speltz is describing the history and development that should be sufficient. Fainites 10:27, 22 April 2007 (UTC)

Please don't mess around with or refactor my edits.Fainites 10:28, 22 April 2007 (UTC)

I am not '"MESSING AROUND"' or "refactoring" your edits. It is custom and form to keep the threads of a conversation together on a talk page by progressivly indenting the comments. Makes it easier to read. Placing comments randomly and all over the place makes it impossible to follow a conversation here. It isn't sufficient since I and others find it misleading. Why not just add a line. Why object to a little suggetion that would build consensus here. Compromise is an important value on wikipedia. Remember, although you did write a lot of the above, you don't own it and it is 'CONSENSUS' that will the the ultimate decider of what goes in or does not and what is edited how. JonesRD_talk 12:33, 22 April 2007 (UTC)

It does make it easier to follow discussion threads if we stick with the Misplaced Pages practice of indentation. DPeterson 16:47, 24 April 2007 (UTC)

'5' 'YES' Let's get rid of it or have it clarified...I think it is fine to just leave it out and move on. It's doesn't add much to the article. MarkWood 17:47, 24 April 2007 (UTC)

6. Yes For all the reasons stated above, it can be excluded. RalphLender 16:21, 27 April 2007 (UTC)

Well we're obviously not going to be able to agree on history. We seem to be stuck between "History is bunk" (H.Ford), and "Those who do not learn from history are condemned to repeat it", (can't remember). Or perhaps it's "History is the propaganda of the victors", (can't remember). Lets move on. (unsigned comment by 'User:Fainites')

I can appreciate your unhappiness with how this has developed and the outcome. We don't have to all agree to move forward. It seems we have five editors in favor of deleting the paragraph in question so that constitutes a consensus on that. DPeterson 23:59, 2 May 2007 (UTC)

I'm not unhappy and I don't have to accept your 'consensus', particularly not when you originally called it 'good'! One more go!

history and underlying principles--Third section

Speltz (2002) states that the roots of "Attachment Therapy" are traced to Robert Zaslow in the 1970’s. Zaslow attempted to force attachment in those suffering from autism by creating pain and rage whilst enforcing eye contact. He believed that holding someone against their will would lead to a breakdown in their defence mechanism’s making them more receptive to others. Speltz point’s out that these ideas have been dispelled by research into autism and that, conversely, techniques based on behavioural principles have proved effective.

According to Speltz, "a decade later, Martha Welsh (1984, 1989) described a technique for children with attachment problems called holding time. Mothers were instructed to take hold of their defiant child at these times, holding them tightly to the point of inducing anger." p 4. "Foster Cline (1991) and associates at the Attachment Center at Evergreen, Inc. (Evergreen, Colorado) began to promote the use of the same or similar holding techniques with adopted, maltreated children who were said to have an attachment disorder (not to be confused with DSM-IV’s reactive attachment disorder)." p 4.

According to Prior and Glaser (2006) "there is no empirical evidence to support Zaslows theory. The concept of suppressed rage has, nevertheless, continued to be a central focus explaining the children’s behaviour (Cline 1991)." p263.

Chaffin et al describe the underlying principles of Attachment Therapy as follows; “In contrast to traditional attachment theory, the theory of attachment described by controversial attachment therapies is that young children who experience adversity (including maltreatment, loss, separations, adoption, frequent changes in child care, colic or even frequent ear infections) become enraged at a very deep and primitive level. As a result, these children are conjectured to lack an ability to attach or to be genuinely affectionate to others. Suppressed or unconscious rage is theorized to prevent the child from forming bonds with caregivers and leads to behavior problems when the rage erupts into unchecked aggression. The children are described as failing to develop a conscience and as not trusting others. They are said to seek control rather than closeness, resist the authority of caregivers, and engage in endless power struggles. From this perspective, children described as having attachment problems are seen as highly manipulative in their social relations and actively trying to avoid true attachments while simultaneously striving to control adults and others around them through manipulation and superficial sociability. Children described as having attachment problems are alleged by proponents of the controversial therapies to be at risk for becoming psychopaths who will go on to engage in very serious delinquent, criminal, and antisocial behaviors if left untreated." p 78

Prior and Glaser cite the one published study which "purports to be an evaluation of holding therapy" by Myeroff et al (1999). The methodology of this study is heavily criticized. This study covers the "across the lap" type holding therapy, described as "not restraint" by Howe and Fearnley (2003) but "being held whilst unable to gain release."

Prior and Glaser also state, "There are many ways in which holding therapy/attachment therapy contradicts Bowlby's attachment theory, not least attachment theory's fundamental and evidence-based statement that security is promoted by sensitivity. Moreover, Bowlby (1988)explicitly rejected the notion of regression, which is key to the holding therapy approach: "present knowledge of infant and child development requires that a theory of developmental pathways should replace theories that invoke specific phases of development in which it is held a person may become fixated and/or to which he may regress." " p265. Chaffin et al also cite "encouraging children to regress to infant status" as a feature of these therapies (p83) and include "age regression" as a technique to avoid in their guidelines at p86.

Fainites 23:56, 2 May 2007 (UTC)

Proposed Fourth Section

Attachment Disorder

Prior and Glaser (2006) describe ‘two discourses’ on attachment disorder. One science based, found in academic journals and books with careful reference to theory, international classifications and evidence. They list Bowlby, Ainsworth, Tizard, Hodges, Chisholm, O’Connor and Zeanah and colleagues as respected attachment theorists and researchers in the field. The other discourse is found in clinical practice, non-academic literature and on the Internet where claims are made which have no basis in attachment theory and for which there is no empirical evidence. In particular unfounded claims are made as to efficacy of ‘treatments’.

Attachment disorders are classified in DSM-IV-TR and ICD-10. DSM describes Reactive Attachment Disorder of Infancy or Early Childhood, divided into two subtypes, Inhibited Type and Disinhibited Type. The ICD classification describes two types, Reactive Attachment Disorder of Childhood and Disinhibited Attachment Disorder of Childhood. Both classifications are under constant discussion and both warn against automatic diagnosis based on abuse or neglect. Many ‘symptoms’ are present in a variety of other more common and more easily treatable disorders.

DSM and ICD are limited and some researchers in the field of attachment such as Zeannah have proposed alternative diagnostic criteria to describe broader disorders of attachment but the exact parameters are not yet established.

Chaffin et al and Prior and Glaser describe the proliferation of alternative ‘lists’ and diagnoses, particularly on the Internet, by proponents of Attachment Therapies that do not accord with either DSM or ICD classifications and which are partly based on the unsubstantiated views of Zaslow and Menta (1975) and Cline (1991). Neither do these lists accord with alternative diagnostic criteria as proposed above. According to Chaffin et al 'These types of lists are so nonspecific that high rates of false-positive diagnoses are virtually certain.' Prior and Glaser state that many of the behaviors in the lists are likely to be the consequences of neglect and abuse rather than located within the attachment paradigm.

Please do not alter this and then vote on a Bowdlerised version. This is my post. Comment below or in italics.Fainites 23:45, 2 May 2007 (UTC)

'COMMENTS ON FOURTH SECTION PROPOSAL'

1. Probably ok Let's see what other editors have to say. DPeterson 00:08, 3 May 2007 (UTC) Change to 'Good', let's go with this version. DPeterson 22:15, 4 May 2007 (UTC)

'CONSENSUS VERSION FOR PARAGRAPHS ONE, TWO, AND THREE

The following represents the consenus on the first three paragraphs. I think we can now agree to put this into the article and replace the first three paragraphs

"Attachment Therapy", (also known as attachment therapy, holding therapy, rebirthing therapy, or corrective attachment therapy) is an ambiguous term often used to describe a variety of controversial, non-mainstream "treatments" for children allegedly suffering from attachment disorder which is itself an ambiguous term. However, because the term has no common meaning, or generally accepted meaning, in the professional community, its actual definition is unclear. The term is not a term found in the American Medical Association's Physician's Current Procedural Manual. A number of advocacy groups, such as Advocates for Children in Therapy and Quackwatch have undertaken to label a large number of treatments for children with disorders of attachment as "Attachment Therapy" and attempt to discredit those therapies.]. The treatments often involve coercive and intrusive methods including variants of holding therapy or rebirthing or rage-reduction. According to Prior and Glaser (2006), ‘these therapies are not based on an accepted version of attachment theory and there is no objective evaluation of them’. Many professional bodies and some American States have outlawed rebirthing.

In a report for the ASPAC, Chaffin et al state 'controversies have arisen about a particular subset of attachment therapy techniques developed by a subset of attachment therapy practitioners, techniques that have been implicated in several child deaths and other harmful effects.' They attempt to define this subset of therapies (see below) and state that 'popularly, on the Internet, among foster or adoptive parents, and to case workers, they are simply known as “attachment therapy,” although these controversial therapies certainly do not represent the practices of all professionals using attachment concepts as a basis for their interventions.” . p77 Care should be taken to distinguish between the subset of 'therapies' covered by this article and more mainstream therapies, particularly as what is and what is not described as an 'Attachment Therapy' within the meaning of this article is controversial and advocacy groups such as ACT and Quackwatch include a broadly defined range of therapies in their description of Attachment Therapy, some of which are not coercive or intrusive as described in this article.

Defination of Attachment Therapy There is no generally accepted definition of "Attachment Therapy". It is not a term found in the American Medical Association's Physician's Current Procedural Manual nor in generally recognized texts on treatment modalities, such as Bergin & Garfield's Handbook of Psychotherapy and Behavior Change. There is not any specific text that describes this "treatment" approach. Chaffin et al (2006) describe the polarization between the proponents of ‘Attachment Therapy’ and mainstream therapies stating, "This polarization is compounded by the fact that attachment therapy has largely developed outside the mainstream scientific and professional community and flourishes within its own networks of attachment therapists, treatment centers, caseworkers, and parent support groups. Indeed, proponents and critics of the controversial attachment therapies appear to move in different worlds." p85

The report of the APSAC Task Force on Attachment Therapy, Reactive Attachment Disorder and Attachment Problems (Chaffin et al 2006), having said "The terms attachment disorder, attachment problems, and attachment therapy, although increasingly used, have no clear, specific, or consensus definitions", (p 83) attempt to describe this subset as follows: "The attachment therapy controversy has centred most broadly on the use of what is known as “holding therapy” (Welch, 1988) and coercive, restraining, or aversive procedures such as deep tissue massage, aversive tickling, punishments related to food and water intake, enforced eye contact, requiring children to submit totally to adult control over all their needs, barring children’s access to normal social relationships outside the primary parent or caretaker, encouraging children to regress to infant status, reparenting, attachment parenting, or techniques designed to provoke cathartic emotional discharge. Variants of these treatments have carried various labels that appear to change frequently. They may be known as “rebirthing therapy,” “compression holding therapy,” “corrective attachment therapy,” “the Evergreen model,” “holding time,” or “rage-reduction therapy” (Cline, 1991; Lien, 2004; Levy & Orlans, 1998; Welch, 1988). Popularly, on the Internet, among foster or adoptive parents, and to case workers, they are simply known as “attachment therapy,” although these controversial therapies certainly do not represent the practices of all professionals using attachment concepts as a basis for their interventions." p83 Chaffin et al also state, "encouraging children to regress to infant status" as a feature of these therapies and as a technique to be avoided. p83

Speltz (2002) in a paper published in the APSAC newsletter APSAC Advisor and describe ‘corrective attachment therapy’ as follows: "… the holding therapies included in “corrective” attachment therapy do not address safety needs. They differ in that a therapist or parent initiates the holding process for the purpose of provoking strong, negative emotions in the child (e.g., fear, anger), and the child’s release is typically contingent upon his or her compliance with the therapist’s clinical agenda." p4.

Prior and Glaser (2006) describe ‘Attachment therapy’ as a variety of treatments offered to desperate carers of troubled, maltreated children which often include variants of holding, eg holding time (Welch 1998), therapeutic holding (Howe and Fearnley 2003), rage reduction therapy (Cline 1991) and rebirthing. They state, "There are many ways in which holding therapy/attachment therapy contradicts Bowlby's attachment theory, not least attachment theory's fundamental and evidence-based statement that security is promoted by sensitivity. Moreover, Bowlby (1988)explicitly rejected the notion of regression, which is key to the holding therapy approach: 'present knowledge of infant and child development requires that a theory of developmental pathways should replace theories that invoke specific phases of development in which it is held a person may become fixated and/or to which he may regress." p265.

The advocacy group Advocates for Children in Therapy define, "Attachment Therapy (AT).. as …a growing, underground movement for the treatment of children who pose disciplinary problems to their parents or caregivers. AT practitioners allege that the root cause of the children’s misbehavior is a failure to 'attach' to their caregivers. The purported correction by AT is — literally — to force the children into loving (attaching to) their parents ...there is a hands-on treatment involving physical restraint and discomfort. Attachment Therapy is the imposition of boundary violations - most often coercive restraint - and verbal abuse on a child, usually for hours at a time...Typically, the child is put in a lap hold with the arms pinned down, or alternatively an adult lies on top of a child lying prone on the floor." They state "Attachment Therapy almost always involves extremely confrontational, often hostile confrontation of a child by a therapist or parent (sometimes both). Restraint of the child by more powerful adult(s) is considered an essential part of the confrontation." The group identify rebirthing as a form of Attachment therapy.

History and underlying principles Speltz (2002) states that the roots of "Attachment Therapy" are traced to Robert Zaslow in the 1970’s. Zaslow attempted to force attachment in those suffering from autism by creating pain and rage whilst enforcing eye contact. He believed that holding someone against their will would lead to a breakdown in their defence mechanism’s making them more receptive to others. Speltz point’s out that these ideas have been dispelled by research into autism and that, conversely, techniques based on behavioural principles have proved effective.

According to Prior and Glaser (2006) "there is no empirical evidence to support Zaslows theory. The concept of suppressed rage has, nevertheless, continued to be a central focus explaining the children’s behaviour (Cline 1991)." p263.

Chaffin et al describe the underlying principles of Attachment Therapy as follows; “In contrast to traditional attachment theory, the theory of attachment described by controversial attachment therapies is that young children who experience adversity (including maltreatment, loss, separations, adoption, frequent changes in child care, colic or even frequent ear infections) become enraged at a very deep and primitive level. As a result, these children are conjectured to lack an ability to attach or to be genuinely affectionate to others. Suppressed or unconscious rage is theorized to prevent the child from forming bonds with caregivers and leads to behavior problems when the rage erupts into unchecked aggression. The children are described as failing to develop a conscience and as not trusting others. They are said to seek control rather than closeness, resist the authority of caregivers, and engage in endless power struggles. From this perspective, children described as having attachment problems are seen as highly manipulative in their social relations and actively trying to avoid true attachments while simultaneously striving to control adults and others around them through manipulation and superficial sociability. Children described as having attachment problems are alleged by proponents of the controversial therapies to be at risk for becoming psychopaths who will go on to engage in very serious delinquent, criminal, and antisocial behaviors if left untreated." p 78

Prior and Glaser cite the one published study which "purports to be an evaluation of holding therapy" by Myeroff et al (1999). This study covers the "across the lap" approach, described as "not restraint" by Howe and Fearnley (2003) but "being held whilst unable to gain release." Prior and Glaser also state, "There are many ways in which holding therapy/attachment therapy contradicts Bowlby's attachment theory, not least attachment theory's fundamental and evidence-based statement that security is promoted by sensitivity. Present knowledge of infant and child development requires that a theory of developmental pathways should replace theories that invoke specific phases of development in which it is held a person may become fixated and/or to which he may regress." p265. DPeterson 00:30, 3 May 2007 (UTC)

Comments on Consensus Version for Paragraphs 1-3

1. GREAT! Ready to be added for all the reasons cited previously. RalphLender 13:30, 3 May 2007 (UTC)
2. OK We're never going to agree on every last little bit but this is a huge improvement on the existing article. Lets stick it in. Any further additions can still be discussed at leisure. we don't have to agree evry last line before putting bits that are agreed into the article. Who knows, a whole bunch of people we've never heard will probably come along in a few weeks and redo the whole thing again! Fainites 17:38, 4 May 2007 (UTC)
3. Good so far...but let's not be hastie...let's be sure to give other editors an opportunity to express their views. I agree with Fainities here. Overall, this is ok, even if I don't agree with every comma and line....Let's keep this moving along. The article does need work and this is a good step forward. DPeterson 22:07, 4 May 2007 (UTC)
4. I like it it's fine to go in as it is now. JohnsonRon 20:13, 5 May 2007 (UTC)
5. OK for all the reasons above. JonesRD_talk 14:48, 6 May 2007 (UTC)
6. 'Yes' flows well, is coherent, reads well, and is focued. SamDavidson 22:30, 6 May 2007 (UTC)

PROPOSED: Treatment characteristics Fourth Section

Attachment theory holds that caregiver qualities such as environmental stability, parental sensitivity, and responsiveness to children’s physical and emotional needs, consistency, and a safe and predictable environment support the development of healthy attachment. From this perspective, improving these positive caretaker and environmental qualities is the key to improving attachment. From the traditional attachment theory viewpoint, therapy for children who are maltreated and described as having attachment problems emphasizes providing a stable environment and taking a calm, sensitive, nonintrusive, nonthreatening, patient, predictable, and nurturing approach toward children (Haugaard, 2004a; Nichols, Lacher,&May, 2004). (Chaffin et al). Prior and Glaser (2006) describe evidence based treatments, all of which revolve around enhancing caregiver sensitivity, or change of caregiver if that is not possible. Based on meta-analyses by Bakermans-Krananburg et al (2003) covering 70 published studies for assessing sensitivity, 81 studies on sensitivity and 29 on attachment security and many further randomised intervention studies involving over 7,000 families, among the methods singled out to have shown good results were 'Watch, wait and wonder' (Cohen et al 1999), manipulation of sensitive responsiveness, (van den Boom 1994 and 1995), modified 'Interaction Guidance' (Benoit et al 2001), 'Preschool Parent Psychotherapy', (Toth et al (2002) and 'Circle of Security' (Marvin et al 2002). Treatment and prevention programs that use methods congruent with attachment theory and with well established principles of child development (American Academy of Child and Adolescent Psychiatry) include: Alicia Lieberman (Parent-child Psychotherapy) (Lieberman & Pawl in Infant Mental Health, 1993 )(Lieberman 2003), Stanley Greenspan (Floor Time), Daniel Hughes (Dyadic Developmental Psychotherapy) (Becker-Weidman & Shell, 2005) (Hughes, 2003), Mary Dozier (autonomous states of mind), Robert Marvin (Circle of Security) (Marvin & Whelan 2003), Phyllis Jernberg (Theraplay), Daniel Schechter (Clinician Assisted Videofeedback Exposure Sessions) (Schechter, 2003), and Joy Osofsky (Safe Start Initiative) (in Infant Mental Health, 1993.

According to O’Connor and Zeanah (2003 p235) "The holding approach would be viewed as intrusive and therefore non-sensitive and counter therapeutic". Chaffin et al (2006) describe how the conceptual focus of these treatments is the childs individual internal pathology and past caregivers rather than current parent-child relationships or current environment, to the extent that if the child is well behaved outside the home this is seen as manipulative. It was noted that this perspective has its attractions because it relieves the caregivers of responsibility to change aspects of their own behavior and aspirations. Proponents of the controversial therapies emphasize the child’s resistance to attachment and the need to break down the child’s resistance. Often parents are required to follow programmes of treatment at home, for example, obedience-training techniques such as "strong sitting" (frequent periods of required silence and immobility) and withholding or limiting food (Thomas, 2001). Also requiring children to submit totally to adult control over all their needs and barring children’s access to normal social relationships outside the primary parent or caretaker.

The APSAC report does not describe "Attachment Therapy", it uses the term "attachment therapy" (no caps or quotation marks). They state, “The terms attachment disorder, attachment problems, and attachment therapy, although increasingly used, have no clear, specific, or consensus definitions." Pg 77 (Furthermore, what seems to be focus of this proposed page only addresses a very narrow area,) “Controversies have arisen about potentially harmful attachment therapy techniques used by a subset of attachment therapists.” Pg 76 (Attachment therapy is better discussed in context, especially if the focus is on “a particular subset of attachment therapy techniques developed by a subset of attachment therapy practitioners” pg 77. The controversy is a narrow one and should be placed in context so that readers understand the full range of issues.) “ The attachment therapy controversy has centered most broadly on the use of what is known as “holding therapy” (Welch, 1988) and coercive, restraining, or aversive procedures such as deep tissue massage, aversive tickling, punishments related to food and water intake, enforced eye contact, requiring children to submit totally to adult control over all their needs, barring children’s access to normal social relationships outside the primary parent or caretaker, encouraging children to regress to infant status, reparenting, attachment parenting, or techniques designed to provoke cathartic emotional discharge” pg 83.

ACT’s site contains descriptions of Attachment Therapy, including a link to the transcript of the rebirthing process that lead to the death by suffocation of Candace Newmaker at the hands of her unlicensed ‘therapists’. According to ACT "Attachment Therapy almost always involves extremely confrontational, often hostile confrontation of a child by a therapist or parent (sometimes both). Restraint of the child by more powerful adult(s) is considered an essential part of the confrontation."

DPeterson 00:39, 3 May 2007 (UTC)

COMMENTS ON PROPOSED FOURTH SECTION: TREATMENT CHARACTERISTICS SECTION

1. _Yes As is it is just fine...let's keeping moving on. RalphLender 13:31, 3 May 2007 (UTC)
2. The first bits OK except for the list of therapies. This passage is about the treatment characteristics of the AT therapies. We don't need to list other therapies that aren't AT or that claim not to be AT. We only need to quote Chaffin and Glaser on the salient feature of proper therapy, ie carer sensitivity. If we try and devise a list of 'good' therapies we'll just get into a pickle about what to include and what to leave out, and it isn't necessary anyway. I think its confusing. People might read it quickly and come away just remembering 'rebirthing', 'dead children' and 'Circle of Security' if you see what I mean. We could instead provide a link if there's an article on this. How about to 'Attachment theory' ? I don't understand the inclusion of the third paragraph at all. We've already dealt with the lack of precise definition and why that is the case earlier and I don't see what the stuff about capital letters has to do with 'treatment characteristics'. A whole chunk of it is also already in para.2. I think we should keep treatment characteristics precise and identifiable.Fainites 17:45, 4 May 2007 (UTC)
3. Good Since C&G list therapies, we should list these too...Alternatively we can mention none. I think the omission of treatments "damns" them by ommission, and so the listing with the citations to support their inclusion is fine. It's only one long line, so let's let it go. The third para describes treatment characteristics. The lack of defination continues ot make it difficutl to described "treatment characteristics, and so the additional different material is relevant. Without a clear defination of what this thing is, it is difficult to define treatment characteristics. I think as it is written is salient. DPeterson 22:10, 4 May 2007 (UTC)

Actually the only bit in para.3 that's about treatment characteristics is the bit about holding therapy. The rest is partly a repeat from earlier in the proposed article which doesn't need repeating, but if you look carefully DPeterson you'll see that you've included bits and pieces of various commentaries from earlier parts of the talkpage. Ralph's missed this aswell. In relation to the 'list', I'm sorry I wasn't being clear. I meant no list at all, not from Chaffin or Glaser. Just the bits where they describe what proper therapy is so I think we can agree on that Fainites 23:09, 4 May 2007 (UTC)

Gee, I see all in this section as a description of the characteristics of the treatment called Attachment Therapy. How is this material a repeat of what is in sections 1-3 above? I don't see the same quotes or lines in both. Again, since this is such a vague term, some overlap will occur, but I don't see it as substntial.DPeterson 00:51, 5 May 2007 (UTC)

Are you suggesting no treatments or therapies be listed at all? DPeterson 00:51, 5 May 2007 (UTC)

So, the following would be deleted:

Based on meta-analyses by Bakermans-Krananburg et al (2003) covering 70 published studies for assessing sensitivity, 81 studies on sensitivity and 29 on attachment security and many further randomised intervention studies involving over 7,000 families, among the methods singled out to have shown good results were 'Watch, wait and wonder' (Cohen et al 1999), manipulation of sensitive responsiveness, (van den Boom 1994 and 1995), modified 'Interaction Guidance' (Benoit et al 2001), 'Preschool Parent Psychotherapy', (Toth et al (2002) and 'Circle of Security' (Marvin et al 2002). Treatment and prevention programs that use methods congruent with attachment theory and with well established principles of child development (American Academy of Child and Adolescent Psychiatry) include: Alicia Lieberman (Parent-child Psychotherapy) (Lieberman & Pawl in Infant Mental Health, 1993 )(Lieberman 2003), Stanley Greenspan (Floor Time), Daniel Hughes (Dyadic Developmental Psychotherapy) (Becker-Weidman & Shell, 2005) (Hughes, 2003), Mary Dozier (autonomous states of mind), Robert Marvin (Circle of Security) (Marvin & Whelan 2003), Phyllis Jernberg (Theraplay), Daniel Schechter (Clinician Assisted Videofeedback Exposure Sessions) (Schechter, 2003), and Joy Osofsky (Safe Start Initiative) (in Infant Mental Health, 1993.

???DPeterson 00:52, 5 May 2007 (UTC)

Yes. For now it is enough to to quote what Chaffin, Glaser etc. say about the characteristics of non-AT therapy if you see what I mean. Fainites 13:50, 5 May 2007 (UTC)

On the other point " Furthermore, what seems to be focus of this proposed page only addresses a very narrow area" and " Attachment therapy is better discussed in context, especially if the focus is on “a particular subset of attachment therapy techniques developed by a subset of attachment therapy practitioners” pg 77. The controversy is a narrow one and should be placed in context so that readers understand the full range of issues." are bits of talk page commentary! Fainites 13:51, 5 May 2007 (UTC)

I think the paragraph should list the various therapies that are not coercive...or list none. RalphLender 14:47, 5 May 2007 (UTC)

So, if the first paragraph was only: 'Attachment theory holds that caregiver qualities such as environmental stability, parental sensitivity, and responsiveness to children’s physical and emotional needs, consistency, and a safe and predictable environment support the development of healthy attachment. From this perspective, improving these positive caretaker and environmental qualities is the key to improving attachment. From the traditional attachment theory viewpoint, therapy for children who are maltreated and described as having attachment problems emphasizes providing a stable environment and taking a calm, sensitive, nonintrusive, nonthreatening, patient, predictable, and nurturing approach toward children (Haugaard, 2004a; Nichols, Lacher,&May, 2004). (Chaffin et al). Prior and Glaser (2006) describe evidence based treatments, all of which revolve around enhancing caregiver sensitivity, or change of caregiver if that is not possible.' I'd consider that. RalphLender 14:49, 5 May 2007 (UTC)

'4.' 'I like it as is' As written it is fine. I prefer the listing of therapies so that no mistakes are made in assuming a trt is or isn't attachment therapy as defined in this article. But, if most want this without a listing, I could go for that. JohnsonRon 20:15, 5 May 2007 (UTC)

I'd agree with Ralphs on this one. Lets stick with the broad definition of what proper therapies should be in contrast to what AT is and leave it at that. Its simple, taken from good sources, uncontroversial and easily understood. And lets keep the stuff about the lability of the definition in the definition paragraph. Fainites 20:22, 5 May 2007 (UTC)

It's ok to leave out all therapies, not my preference, but acceptable. I also think the last two paragraphs can and should stay...so that would that be an acceptable compromise for you? In the interests of building consensus, since most editors, so far, are accepting the leaving out of the listing of therapies and the inclusion of the last two paragraphs, I can go along with that; in the spirit of collaboration. DPeterson 21:14, 5 May 2007 (UTC)

I'm sorry DP? Are you seriously saying you want to keep odd ungrammatical remarks from the talkpage accidently included in paragraph 3, in the article? I'm all in favour of compromise but compromise is usually about the substance of the content, not accidental edits! Have you read it? Fainites 09:37, 6 May 2007 (UTC)

My lack of clarity, sorry. I put what I think are the comments in () and those ought not be included. Is this better? If I missed something, just note that, and use the same format to mark it, ok? DPeterson 13:34, 6 May 2007 (UTC)

OK. I still think the stuff about definition is unecessary here but I can live with it :) Fainites 22:08, 6 May 2007 (UTC)

5. 'GOOD' Just as it is above, but with the lines redacted () as DP notes in the comment just previous to this one. JonesRD_talk 14:50, 6 May 2007 (UTC) 6 Yes I agree that the section can go in the marked items deleted. SamDavidson 22:29, 6 May 2007 (UTC)

Actually, looking at it again, apart from the line about capital letters (which I thought we had agreed to abandon earlier) the rest of para 3 of this section is a word for word repeat of a chunk of the definition section. Fainites 17:46, 7 May 2007 (UTC)

Also, looking at Chaffin, they use capitals in the title. They're plainly talking about the same subset of therapies/phenomenon as ACT or indeed anybody else. Can we just agree to get rid of all this weird stuff about capital letters please? See Ralphs comment on this above where he wrote a(A)ttachment t(T)herapy to illustrate the point. Fainites 21:19, 7 May 2007 (UTC)

Article

I've put in the three first paras with refs, and also the fourth one which was a description of attachment disorder/DSM/IC 10 etc which people agreed as far as I recall. I'm having a bit of trouble with the Prior and Glaser ref which keeps repeating itself instead doing abcdef like it should, but I'm sure I'll get to bottom of it. I'm also proposing to turn all the other 'mentions' of eg Cline/Zeannah into proper refs, but it may take a little time. Fainites 17:36, 7 May 2007 (UTC)

Refs fixed Fainites 18:37, 7 May 2007 (UTC)

Now the Cline ref is doing the same thing.Fainites 21:29, 7 May 2007 (UTC)

Despite the "problems" with references, nicely done. I can agree with what is up there so far. SamDavidson 01:29, 8 May 2007 (UTC)

What do you say about para 3 in the treament section which is a repeat of the definition section? (aprt from the line about capital letters) Fainites 08:59, 8 May 2007 (UTC)

Final Section

Prevalence

('SUGGESTION': Begin with the original statment: "There are no reliable statistics on the prevalence of these therapies or of how many professionals actually practice "Attachment Therapy" or "rebirthing as it is also known. However, they are sufficiently prevalent...continue as you did.)SamDavidson 00:54, 8 May 2007 (UTC) It is difficult to ascertain the prevalence of these therapies but they are sufficiently prevalent to have prompted reactions as outlined by Chaffin et al as follows;

‘The practice of some forms of these treatments has resulted in professional licensure sanctions against some leading proponents of the controversial attachment therapies. There have been cases of successful criminal prosecution and incarceration of therapists or parents using controversial attachment therapy techniques and state legislation to ban particular therapies (remove particular therapiesSamDavidson 11:46, 8 May 2007 (UTC)) replace with "rebirthing" That is what is banned in law. SamDavidson 11:46, 8 May 2007 (UTC).)(its a quote! You can't replcae words you don't like in a quote.Fainites 18:58, 9 May 2007 (UTC)) Position statements against using coercion or restraint as a treatment were issued by mainstream professional societies (American Psychiatric Association, 2002) and by a professional organization focusing on attachment and attachment therapy (Association for Treatment and Training in the Attachment of Children , 2001). Despite these and other strong cautions from professional organizations, the controversial treatments and their associated concepts and foundational principles appear to be continuing among networks of attachment therapists, attachment therapy centers, caseworkers, and adoptive or foster parents (LEAVE OUT NAMES...WITHOUT CLEAR EVIDENCE THIS IS TOO CLOSE TO SLANDERSamDavidson 00:54, 8 May 2007 (UTC)) (Hage, n.d.-a; Keck, n.d.)’. p83 (nonsense. Its a direct quote from Chaffin, a publically available document. These papers are specifically cited by Chaffin et al.Fainites 08:50, 8 May 2007 (UTC))

Well, they use a direct quote and don't put it in your own words...lets see how that looks.SamDavidson 11:46, 8 May 2007 (UTC)

(It is a direct quote, inside quotation marks.Fainites 18:22, 9 May 2007 (UTC))

A particular

What is your basis for saying this is a "particular concern?" It is just a section of the report. What word did they use to express this, did they use the word concern? SamDavidson 11:46, 8 May 2007 (UTC)) (P&G say 'this version is not discernably related to attachment theory, is based on no sound empirical evidence and has given rise to interventions whose effectiveness is not proven and which may be harmful'. Chaffin says 'These types of lists are so nonspecific that high rates of false-positive diagnoses are virtually certain. Posting these types of lists on Web sites that also serve as marketing tools may lead many parents or others to conclude inaccurately that their children have attachment disorders.' amongst other things. I would have thought 'concern' was a mild paraphrase.Fainites 18:53, 9 May 2007 (UTC)

concern of both Chaffin et al and Prior and Glaser is the use of the Internet to advertise these therapies and the use of unscientific and 'wildly inclusive' lists of 'symptoms' (Prior and Glaser p186). According to Chaffin et al 'These types of lists are so nonspecific that high rates of false-positive diagnoses are virtually certain. Posting these types of lists on Web sites that also serve as marketing tools may lead many parents or others to conclude inaccurately that their children have attachment disorders.'p83 (need page numberSamDavidson 00:54, 8 May 2007 (UTC)) Many of the behaviors in the lists are likely to be the consequences of neglect and abuse rather than located within the attachment paradigm. Descriptions of children are frequently highly perjorative and 'demonising'. According to Chaffin et al 'Proponents of controversial attachment therapies 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’.p78 (need page numberSamDavidson 00:54, 8 May 2007 (UTC)) They also express concern over claims by therapies to be 'evidence based' or indeed the 'only' evidence based therapy when the Task Force found no credible evidence base for any such therapy so advertised.p85 (need page number or quoteSamDavidson 00:54, 8 May 2007 (UTC))

The report of Chaffin et al, which contains proposed guidelines for therapies, was endorsed by was endorsed by the American Psychological Association’s Division 37 and the Division 37 Section on Child Maltreatment. (leave out...already cited...or cite all the guidelinesSamDavidson 00:54, 8 May 2007 (UTC)) (Leave out...cited in last paragraph...SamDavidson 00:54, 8 May 2007 (UTC)) (the previous mention was in relation to a position statement. Here it is being said that The APA specifically endorsed Chaffin. Its on the front page of Chaffin.Fainites 08:50, 8 May 2007 (UTC)) The report and its adoption should be in the paragraph with the list of other organizations and standards...not here. SamDavidson 11:46, 8 May 2007 (UTC)

Prior and Glaser (2006) state ‘The practice of holding therapy is not confined to the USA.’(page number needed here. SamDavidson 00:54, 8 May 2007 (UTC)) And give an example of a center in the UK practising ‘therapeutic holding’ of the 'across the lap' variety.p263.

The advocacy group ACT claim "Attachment Therapy is a growing, underground movement for the 'treatment' of children who pose disciplinary problems to their parents or caregivers."

There are no reliable statistics on how many professionals actually practice "Attachment Therapy" as described in this article. However the practices it often involves are now prohibited by a large number of professional organizations such as the following: American Psychological Association30, National Association of Social Workers31, American Professional society on the Abuse of Children (APSAC) 32, Association for the Treatment and Training in the Attachment of Children, American Academy of Child and Adolescent Psychiatrry ("Practice Parameter for the Assessment of Children and Adolescent with Reactive Attachment Disorder of Infancy and Early Childhood" in the Journal of the American Academy of Child and Adolescent Psychiatry, vol 44, Nov 2005 and at 33), and the American Psychiatric Association. 34. Members of those organizations are prohibited from using methods and techniques proscribed by those organizations codes of ethics and practice parameters. Violations of those standards would result in expulsion of the organization. (ADD:Therefore there are very few practitioners of "AT" as defined in this article.)SamDavidson 00:54, 8 May 2007 (UTC) (whats your source for saying there are very few? Why would ASPAC have commissioned that huge and no doubt expensive taskforce if there were very few?Fainites 08:50, 8 May 2007 (UTC)) Furthermore, several states have outlawed "rebirthing," and anyone using such methods would be guilty of malpractice.

Needs more work and editing...a bunch more. SamDavidson 00:54, 8 May 2007 (UTC)

It needs some minor tweeks...your additions are acceptable to me, if this leads to consensus. But I don't have very strong feelings. DPeterson 03:33, 9 May 2007 (UTC)

What is the source for saying there are very few, or, its very rare? Is there a better source than the Taskforce on prevalence? Fainites 21:12, 9 May 2007 (UTC)

Addition of citations

The recent edit by Davidson to add a reference and clean up a line or two are fine with me. I think this is an improvement and I support it. DPeterson 14:52, 9 May 2007 (UTC)

Very nice...I agree. JonesRD_talk 15:20, 9 May 2007 (UTC)

Rubbish. The passage from Chaffin is in fact 99% quotation, with a small paraphrase, as was made clear above. I have now made it a full quotation. The citations Chaffin et al give are part of the quotation. It is from the passage on non-controversial and accepted treatments. I assume you do in fact have Chaffin if you're trying to edit this site? Including Becker-Weidman in this passage as if Chaffin had quoted him in this passage is utterly misleading. This would be misleading if Becker-Weidman was merely unknown as he is not cited in this context by Chaffin. In view of the fact that he is specifically quoted on three occasions in the report to illustrate their criticism of aspects of attachment therapy its so misleading its beyond funny and into the surreal. I can give you the full quotes if you wish.Fainites 18:19, 9 May 2007 (UTC)

I think the material was well written and so I have restored it. However, if you strongly disagree, we should seek consensus among other editors. The paragraph as written is not a paraphrase of Chaffin and so stands as well sourced and adequately referenced. DPeterson 20:35, 9 May 2007 (UTC)

You're right, the paragraph is not a paraphrase of Chaffin; its a direct quote. The only difference was that the word 'traditional' was removed at the very beginning. To insert another reference that Chaffin does not cite into a passage from Chaffin wherein he cites three other notable attachment experts is misleading to the highest degree. What on earth is your motivation? Consensus is hardly the point. It would be misleading to add other references into a decent paraphrase. Its rank intellectual dishonesty to add it into a direct quote.Fainites 21:08, 9 May 2007 (UTC)

As written, the paragraph is not a quote or paraphrase of Chaffin or any other particular author. It should stay as is. It appears three editors favor the improvements/editsDPeterson 21:31, 9 May 2007 (UTC)

I have replaced the consensus version which consisted of a long direct quote from Chaffin (except for the word traditional) and included Chaffins citations. As you do not seem to have Chaffin, here is a direct copy taken from the report below;

"Traditional attachment theory holds that caregiver qualities such as environmental stability,parental sensitivity, and responsiveness to children’sphysical and emotional needs, consistency, and a safeand predictable environment support the developmentof healthy ttachment. From this perspective,improving these positive caretaker and environmentalqualities is the key to improving attachment. Fromthe traditional attachment theory viewpoint, therapyfor children who are maltreated and described as havingattachment problems emphasizes providing astable environment and taking a calm, sensitive, nonintrusive,nonthreatening, patient, predictable, and nurturing approach toward children (Haugaard,2004a; Nichols, Lacher,&May, 2004)." p 77.

Otherwise, what was the point of discussing and reaching consensus on the talkpage? As for citing Becker-Weidman as if Chaffin cited him in support, I am a little puzzled. The only mentions of Becker-Weidmans work I could find in Chaffin was these:

"Proponents of controversial attachment therapies commonly assert that their therapies, and their therapies alone, are effective for children with attachmentdisorders and that more traditional treatments areeither ineffective or harmful (see, e.g., Becker-Weidman, n.d.-b; Kirkland, n.d.; Thomas, n.d.-a)." p78

"Similarly, many controversial treatments hold that children described as attachment disordered must be pushed to revisit and relive early trauma. Children may be encouraged to regress to an earlier age where trauma was experienced (Becker-Weidman, n.d.-b)" p79

"Some proponents have claimed that research exists that supports their methods, or that their methods are evidence based, or are even the sole evidence-based approach in existence, yet these proponents provide no citations to credible scientificresearch sufficient to support these claims (Becker-Weidman, n.d.-b). This Task Force was unable to locate any methodologically adequate clinical trials in the published peer-reviewed scientific literature to support any of these claims for effectiveness, let alone claims that these treatments are the only effective available approaches. Most of the data offered on these Web sites is so methodologically compromised that the Task Force believes it could not support any clear conclusion." p85

Did you want to include any of this? I am happy to provide any more excerpts of Chaffin if you wish. My preference however would be to stick to the subject in hand and prioritise Chaffin, Glaser etc. Fainites 21:54, 9 May 2007 (UTC)

Three of four editors prefer the version up there now. As far as the other quotes go, that is old and Chaffin recognized that in a response to a letter to the editor. There are not three or four empirical studies that were not in Chaffin's hands when the article was written in 2000-2002. I suggest leaving this alone and seeing what others think. No one owns any articles and we have to go with consensus. DPeterson 22:44, 9 May 2007 (UTC)

Chaffin is not old. I also have their reply to Becker-Weidmans objections which is even more recent. The Chaffin version was agreed by consensus on this talkpage. Or are we not bothering with consensus on the talkpage any more? Presumably if you don't consider yourself in anyway bound by consensus on the talkpage, neither is anybody else and you won't object to me editing the article how I wish? It is misleading to include Becker-Weidman within either a paraphrase or quote from Chaffin as if Chaffin had included it and it is nonsense to cite Becker-Weidman as if he were a mainstream proponent of traditional attachment theory and therapies when he is specifically criticised by Chaffin for being the reverse. I do not see the necessity for him to come into this article at all. Fainites 22:56, 9 May 2007 (UTC)

The APSAC report was written in 2002 or so and did not include any material from 2005, maybe not even 2004, or later. DPeterson 23:10, 9 May 2007 (UTC)

I have also noticed that you have yet again interfered with my edits, presumably to make them less easily readable by others. For I think what must be about the seventh if not the eighth time, please leave my edits alone.Fainites 23:00, 9 May 2007 (UTC)

I have tried to keep your comments on the talk page consistent. When you don't indent, it is very hard to follow threads of conversations...This is the Misplaced Pages convention...Following this convention makes following threads easier to follow. DPeterson 23:10, 9 May 2007 (UTC)

Chaffin is older, it was written in 2000 or 02 or so. It did not include materials from 2005, 2006, or 2007, which are the publication dates for the Becker-Weidman empirical studies. Chaffin is not being quoted here. The version above is not a quote, therefore you are just wrong on that point. It seems that at least three of four editors are happy with this versioni. Remeber, no one owns any article. Consensus can evolve over time. I suggest leaving this as is and seeing if other editors have thoughts one way or the other. I understand that you've put a lot of time and effort in the edits, but you have to let of the material and allow others to edit the meterial if consensus calls for that or if your thoughts are not part of the consensus. DPeterson 23:10, 9 May 2007 (UTC)

a)Becker-Weidmans studies are simply later follow ups of the same group of children, or do you not have these sources either? His claim to be evidence based was specifically criticised by Chaffin et al following open correspondance with him after the releas of the report. To include him in a list of proponents of traditional attachment therapy as if Chaffin had so included him is flagrant intellectual dishonesty. It also doesn't do Becker-Weidman any favours. Does he know you're doing this kind of thing? I wouldn't thank you if I were him. You're making him look like a charlatan!

No, the Becker-Weidman studies are empirical studies, one a one year followup, the other four years later. Chaffin does not dispute evidence-basis of studies because the studies were published 'AFTER' his article! Furthermore, Craven & Lee, 2006 (using 2004 data, not the 2005 & 2006 much stronger studies, found the material "evidence-based." DPeterson 12:34, 10 May 2007 (UTC)

But regardless, this is irrelevant to the discussion. The citations are verifiable per wiki DPeterson 12:34, 10 May 2007 (UTC)

b) Chaffin cites papers published in 2005 and websites from August '05, and there is also the follow up paper from later in '06 after the publication of the original report in February '06. You're unsourced assertion that it was written in 2000, or even 2002 is therefore entirely wrong.

The Taskforce did it's work in 2002, etc and was published in 2005. It did not reference the current studies. And, regardless, this is irrelevant to the discussion. The citations are verifiable per wiki DPeterson 12:34, 10 May 2007 (UTC)

c)Also your constant petty wrist slapping admonishments about 'owning' the article are misplaced. WP:OWN is about articles, not talkpages. I have sought entirely to achieve consensus on the talkpage and only made any edits to the article in order to include the consensus version. It is you who have then almost immediately made a travesty of the agreed article, yet you admonish me! Also, I do in fact own my edits on the talkpage, with which you frequently interfere. Funny! Fainites 06:25, 10 May 2007 (UTC)

I am talkin about the article not the talk page, read my comments above to verify that. The edits are about the article. You seem very unhappy with the relatively small changes made that all editors, except you, prefer. It is that to which I am referring the comments regarding ownership. Not me, but at least three editors. I suggest that you do not own this article and that changes made by a consensus of editors be abided by. DPeterson 12:34, 10 May 2007 (UTC)

Remember, no one owns any article. Consensus can evolve over time. I suggest leaving this as is and seeing if other editors have thoughts one way or the other. I understand that you've put a lot of time and effort in the edits, but you have to let of the material and allow others to edit the meterial if consensus calls for that or if your thoughts are not part of the consensus.DPeterson 12:34, 10 May 2007 (UTC)

I suggest letting the article stay as it is for now and seeing if any other editors chime in. So far three prefer the current version and you do not. Lets let it sit and see what develops. I do understand you feel very strongly, but engaging in an edit war is not productive. We'd made excellent progress on 95% of the article by building collaboration and consensus. DPeterson 12:36, 10 May 2007 (UTC)

Support Count me as the "fourth" who supports the edits. I think these, while slightly minor, are improvements. The section is clearer and the cites added are relevant to support the statement regarding attuned and sensitive parenting being important. Let's keep these improvements. MarkWood 16:17, 10 May 2007 (UTC)

Let's let cool heads prevail. I'd suggest the version up there stay and that DPeterson and Fainites take a break, take a breath, and see what other's have to say. RalphLender 17:11, 10 May 2007 (UTC)

I'd be interested to hear your reasons for altering a cited quotation from a verified and credible source and then including the studies that are part of the series that were specifically criticised by that report, as if they supported the report or were cited in support by the report. Can you explain how this fits with policies on the use of sources? (Or indeed common sense). It would be even more interesting to hear why 4 other editors so swiftly support what is plainly a misleading edit in violation of all policies. To what end? Fainites 17:46, 10 May 2007 (UTC)

'Please' Let's keep a cool head here and avoid any hint of Personal Attacks. I'd suggest taking a day or two to cool off and let other's comment. It is difficult when you've put so much work into an article to see other's editing it in ways you may not approve but in ways that a consensus supports. As I read the report and the comments, the report did not criticize the articles since the articles were published after the report was prepared and subsequently published. RalphLender 17:56, 10 May 2007 (UTC)

OK Good advice. I'll abide by it. DPeterson 21:17, 10 May 2007 (UTC)

Hi all. I came across AT from my research into hypnotherapy. From the diffs I think there is no problem with the current version (DPeterson et al's version). The line is in quotes and the words are in order and it holds the correct meaning. Maypole 03:31, 11 May 2007 (UTC)

If we're going to leave it a while it should be left with the consensus version. By the way, here are the Becker-Weidman citations from the first report "Becker-Weidman, A. (n.d.-a). Attachment therapy: What it is and what it isn’t. Retrieved June 4, 2004, from www.attachmentdisorder .net/Dr._Art_Treatment.htm Becker-Weidman, A. (n.d.-b). Dyadic developmental psychotherapy: An attachment-based therapy program. Retrieved July 2, 2004, from www.center4familydevelop.com/therapy.htm"

Here is what Chaffin et al said in November 2006 in reply to Becker-Weidmans letter about, amongst other things, his new study;

"Regarding the issue of empirical support, it is encouraging to see that outcome research on DDP was recently published in a peer-reviewed journal. This is an important first step toward learning the facts about DDP outcomes. We congratulate Dr. Becker-Weidman on this work and hope he will continue to expand these efforts. The published study was not available until after the Task Force report was in press, so its findings were not discussed in the report. The question at this point is whether the published study might modify our original statements. In our estimation, DDP still does not meet criteria as an evidence-based treatment, although the published findings do raise hopes that DDP may be promising. Examining the study, it shares many of the same limitations noted in the Task Force’s evaluation of the Myeroff study (p. 85)."

here are the refs they cite; Becker-Weidman, A. (2005). Reader’s response to “Coercive restraint therapies: A dangerous alternative mental health intervention.” Medscape General Medicine, 7(3). Available at www.medscape.com/viewarticle/516359 Becker-Weidman, A. (2006a). Attachment disorder checklist. Retrieved May 15, 2006, from www.center4familydevelop.com/checklist.htm Becker-Weidman, A., (2006b). Letter to the editor. Child Maltreatment, 11(4), 379-380.

This was published in the November 2006 issue of Child Maltreat. If you wish to include in the article a discussion about criticism of Chaffin et al and why Becker-Weidman thinks they are wrong, then fine. What you can't do is pretend by misleading edits that Chaffin et al cited Becker-Weidman in their report as if he was one of the mainstream authorities on which they relied. This is misleading, and, as I have pointed out before, doesn't do Becker-Weidman any favours. Verified and credible sources have to actually be source for what they are attached to. Becker-Weidman is not a source for Chaffins description of traditional treatments for attachment disorders. Altering Chaffins quote by a few words to pretend it's not a quote doesn't make it OK! Fainites 10:16, 11 May 2007 (UTC)

A couple of quick questions

• What methods or adjuncts are used with AT?
• Why exactly do certain bodies refuse to use AT or criticise AT?

And of course, where can I find the relevant literature if any? Maypole 03:31, 11 May 2007 (UTC)

The main source is a report by the Taskforce set up by the ASPAC (American Society for the Prevention of Abuse against Children). There is a link provided in the notes and refs section (unless it has been removed. Originally this article provided a link in German!). It was compiled by a very substantial number of the experts in the field of attachment and various aspects of child development. It criticises the theory and practice of 'attachment therapy'. It has been specifically endorsed by some professional bodies and it set out a comprehensive set of guidelines. It was published end 05/early 06. Thereafter there was some published open correspondence with those who felt unjustly criticised, to which there was a reply later in 2006. Most of this reply relates to Becker-Weidman, who is specifically criticised by the report on three counts, claiming an evidence base when there is none, overblown advertising on the internet, and use of 'age-regression techniques'. He is not criticised for using coercive or restraining methods but he is quoted as an example of the very 'attachment therapy' the report is dealing with. The argument here is about the fact that a consensus version of the article contained a quote from Chaffin et al about the characteristics of traditional and established therapies for attachment difficulties, by way of contrast to 'attachment therapy', and included citations to two papers. The supporters of Becker-Weidman who edit this page firstly inserted a paper by Becker-Weidman into the quote to make it look as if Becker-Weidman was an authority cited by Chaffin et al in support of their conclusions, rather than someone criticised by them as an 'attachment therapy'. They subsequently altered the quotation from Chaffin et al so it was no longer exactly a quote, and included Becker-Weidman again, to make it look as if he is a mainstream contributor in line with those quoted by Chaffin it al. Fainites 10:07, 11 May 2007 (UTC)

By the way its not clear which version you were looking at. The DP version does not have the line in quotes in its more recent manifestation. It is my version which has the first paragraph of 'treatment characteristics' in quotes as it is a quote from Chaffin (who did not include Becker-Weidman here).There is also a recent book by Prior and Glaser, also in the refs, which covers the whole topic of attachment disorders pretty comrehensively.Fainites 10:11, 11 May 2007 (UTC)

Chaffin quote

I'm getting a little lost. Could someone please clarify for me what the Chaffin quote dispute is all about? Where exactly is the passage in question? StokerAce 01:25, 11 May 2007 (UTC)

See my reply above. it's the first paragraph under 'treatment characteristics'. Fainites 10:09, 11 May 2007 (UTC)

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