Using attachment theory in practice: top tips

Ask specific questions about the child's relationships, not general ones about the 'nature' of their attachment to a carer

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Photo: S Mitarart/Fotolia

Attachment theory is one of the most well-known theories used in child and family social work, and increasingly in adult social work. At first glance, it provides a simple, psychologically appealing way to understand the intense nature of relationships between, primarily, parents and children.

However, as academic David Wilkins writes in a guide for Community Care Inform Children: “As with any body of theory or research, but particularly one as potent as attachment theory, it is important to think critically about its application in practice. Part of the reason why attachment theory has become so commonplace is because it appears to provide a simple explanation for the incredibly complex business of human development: that secure attachment in childhood leads to positive outcomes in adulthood, including good mental health and happy relationships, while insecure attachment leads to more negative outcomes.”

Below is an excerpt from the guide on using attachment theory in practice with children and families. Inform Children subscribers can read the in-depth guide, and access more content on our attachment knowledge and practice hub.

Avoid using the word ‘attachment’

As previously argued by Shemmings (2016), you can accomplish just as much, if not more, in practice by avoiding the word ‘attachment’. ‘Good’ and ‘strong’ attachments are not part of attachment theory and parents are not ‘attached’ to their children (although they are bonded with them).

Phrases such as ‘attachment problems’ are generally meaningless and any references to ‘attachment disorders’ should be avoided completely (unless quoting psychiatric or clinical reports). So common are these types of mistakes that it is best to start thinking in terms of relationships rather than attachments, if you haven’t already. You can observe, describe and analyse the child’s routines, the sensitivity of the child’s close carers, and their availability and attunement all without referring to ‘attachment’.

Think about the mind-mindedness of the carer

There is a reasonably clear correlation between secure attachment and the carer’s ability to treat their child as an individual with a mind of her own. This ability is sometimes called ‘mind-mindedness’ or ‘mindfulness’.

In a recent study, Meins (2017) found lower levels of maternal mindfulness predicted insecure attachment relationships for pre-school children. It can be disconcerting to imagine how a carer might treat a child ‘as if’ they do not have a mind of their own but there are times when all of us behave in this way towards other people. But what does it mean to say a carer is demonstrating mind-mindedness? Such carers will tend to act as if their child’s behaviour has meaning, that it represents and results from an internal world of feelings, thoughts, ideas and motivations. When the child cries, the carer might ask questions such as “Are you feeling fed-up?” or “Did I make you jump?” or “Are you trying to tell me something?” Equally, if a child is happily playing with a toy, the carer may say things like “You like that one because it is red, don’t you?” or “You’re such a happy boy, aren’t you?“.

The opposite of this would be a carer who either tells the child why they are behaving in a certain way, saying things such as “Stop crying, you are just being silly” or denies the child’s behaviour is linked to an internal state at all, perhaps saying “Stop crying, there’s nothing the matter with you”. They might also say things that contradict the child’s behaviour. If a child were happily playing with a toy, a carer lacking in mind-mindedness may say something like “You’re getting bored with this game now, aren’t you?” or they may attribute motivations to the child that the child is unable to hold. For example, asking a baby “Why do you always cry when I’m about to sit down?” (said without any sense of it being a joke).

Ask specific questions about the individual child’s relationships

Waters and McIntosh (2011) have argued that practitioners often ask questions about individual children that are too general, based on their knowledge of attachment theory. For example, “Is this child insecurely attached to her close carer?” or “How is the discord in the parents’ relationship affecting the child’s attachment”.

These questions are not specific enough. Even if we could answer them, they do not offer much basis to conclude an assessment or provide help and support. A better question would be “How does the relational discord affect the mother or father’s ability to support the child’s exploration?” (ibid). This question helps us – and the family – to see more clearly what is being asked (and why). If the mother were too angry with the child’s father, too impatient, too frightened or too exhausted, this could disrupt her ability to support the child’s exploration (the child’s use of her mother as a secure base). We then have a much clearer idea of what we are looking for in our assessment – is the mother too angry, too exhausted, too frightened (and so on) to support the child in this way?

Of course, the exact same questions could be asked with regards the child’s father/mother’s partner. The key is to think more clearly about what it is you are interested in or worried about and to go beyond broad questions such as ‘How is the child affected…’ or ‘What is the nature of…’ and identify more specific questions such as “How does the child cope when his mother is frightened of being hurt by his father?”

References

Meins, E (2017)
‘Overrated: The predictive power of attachment’
The Psychologist, Volume 30, pp20-24

Shemmings D (2016)
‘Never use the word ‘attachment’ again’
Community Care

Waters, E and McIntosh, J (2011)
‘Are we asking the right questions about attachment?’
Family Court Review, Volume 49, Issue 3, pp474-482

4 Responses to Using attachment theory in practice: top tips

  1. Tom January 22, 2018 at 11:49 pm #

    A point regarding what makes positive mind-mindedness in a parent/careers interaction. While interpretation of a child’s wants and needs are key indicators of a tuned in adult, the use of closed questions like the ones used in the examples are not the most productive as they project the adult’s concepts rather than those of the child. By all means give a commentary on what they’re doing, but, as any speech and language therapist might tell you, rhetorical questions like “you’re a happy boy, aren’t you?” aren’t great for generating verbal exchange or promoting self-expression.

  2. londonboy January 23, 2018 at 10:59 am #

    I find attachment theory a horribly judgemental and othering theory as a parent.
    ‘Mind-mindedness’ seems to avoid this particularly when it comes to children who experience relationships differently – I’m thinking of autistic children particularly.

    Perhaps there is a discussion about cultural contexts to be had though. In some cultures children are expected to conform to more collectivist norms around individuality.

    I would also say that anyone who is experiencing coercion or trying to manage very high anxiety is likely to have very high levels of mind-mindfulness, ( walking on eggshells) and still have very high levels of difficulty – not necessarily around parenting capacity. This is all common sense I might add…

  3. Angela Gunning January 25, 2018 at 9:58 am #

    Yes I agree well said

  4. londonboy January 29, 2018 at 11:29 am #

    Using attachment theory in practice: top tips
    – so in summary – D’ont (use attachment theory in practice)