Attachment-based therapy (children)
Attachment-based therapy applies to interventions or approaches based on attachment theory, originated by John Bowlby. These range from individual therapeutic approaches to public health programs to interventions specifically designed for foster carers. Although attachment theory has become a major scientific theory of socioemotional development with one of the broadest, deepest research lines in modern psychology, attachment theory has, until recently, been less clinically applied than theories with far less empirical support. This may be partly due to lack of attention paid to clinical application by Bowlby himself and partly due to broader meanings of the word 'attachment' used amongst practitioners. It may also be partly due to the mistaken association of attachment theory with the pseudo-scientific interventions misleadingly known as attachment therapy. The approaches set out below are examples of recent clinical applications of attachment theory by mainstream attachment theorists and clinicians and are aimed at infants or children who have developed or are at risk of developing less desirable, insecure attachment styles or an attachment disorder.
Attachment measures
The MCAST is a semi-structured doll play 'story stem' methodology, developed by Jonathan Green, Charlie Stanley, Ruth Goldwyn and Vicky Smith, to evaluate and understand the internal (mental) representations of their attachment relationship with a specific primary caregiver in children of 4 to 8.5 years. The concepts and procedures used have a basis in the Strange Situation Procedure and Adult Attachment Interview, and involves 4 story stem vignettes involving two dolls representing the caregiver-child dyad of interest and a dolls house, presented with affective arousal to mobilise attachment representations in a way that children of this age range find accessible and engaging. Responses are usually videotaped in order to reliably rate aspects of the child's represented narrative content and behaviour, and the child's own behaviour, to ascertain an attachment classification, with a particular focus on disorganised attachment, as well as providing other supporting ratings. Clinical development of the MCAST started in 1992, validation was published in 2000, and it has been since used in a range of cultural contexts and clinical and at-risk groups. Training is required for its use.