A short while ago I had a colleague send me an interesting article from the Journal of Child and Adolescent Psychiatric Nursing (2007, 20, 1; p. 27-39). In it, Lyons Hardy tackles attachment theory and Reactive Attachment Disorder and some implications for treatment in a residential setting. In particular, Hardy makes a clear case for the need to move away from behavior modification interventions and makes a case for a longer-term residential relationship model.
An attachment-based approach would thus not rely on behavioral modification techniques or punitive approaches to change behaviors. Behaviors would be interpreted in terms of their underlying meaning, and interventions would be designed to address the childs need for emotional closeness, consistency, acceptance, and stability. A short-term residential treatment facility would be an undesirable location for treatment, because it involves frequent changes in both caregivers and peers and would discourage the formation of long-term bonds.
Periodically, we become aware of this type of research or theoretical work that supports what we do at Calo. When I see such evidence I like to find a place to share it and our blog made some sense. Let me add some other quotes that support what we do at Calo if I may.
Hardy is clear that therapy per se, sitting and talking, is not the most important factor in creating change. We could not agree more at Calo. To quote Hardy, the therapeutic milieu is seen as the most important factor in successful treatment of attachment disorders. The milieu is where our students get to practice all the relationship changes they are making. That environment coupled with experiential therapies and inventive interventions that tackle maladaptive emotional responses are foundational to good residential treatment from an attachment perspective. Treatment seeks to remediate the negative working model using experiential methods; modeling healthy attachment cycles, reducing shame, safe and nurturing physical contact, re-experiencing the affect associated with the trauma in order to integrate the experience and not dissociate.
I recognize that this research language is hard to wade through for those not in the field of psychology. Still, for some of you who read our blog I am hopeful that Hardys work resonates.