| Abstract | Since Bowlby devised his theory of attachment, originally for clinical purposes,
refinements and extensions have developed its clinical utility. The research
question asked how experienced contemporary clinicians now perceive the role of
attachment in the formulation and treatment of distress by reference to their clinical
work.
Using grounded theory methodology, underpinned by a relativist, moderate social
constructionist epistemology, initial sampling consisted of 16 in-depth interviews
with experienced clinicians. The tentative theoretical categories that emerged were
then developed in theoretical sampling in further interviews with 5 of the initial
interviewees. The final theoretical categories to emerge concerned the prevalence
of caregiver-related problems, the provision of safety together with the prioritisation
of the relationship with self as attachment-related treatment strategies, and
attachment theory’s provision of understanding in problem formulation. Whilst this
suggests that attachment-related ideas are integrated in contemporary practice, it
also suggests that the clinical utility now offered by attachment theory, as
established in the literature, has not found broad appeal amongst clinicians despite
the commonness of attachment-related presenting problems.
The implications of this are manifold. To begin with, attachment theorists have
largely failed to bring the potential now offered by attachment-related therapeutic
interventions to the market. This situation makes it incumbent on the next
generation of attachment researchers to more clearly articulate techniques with
which clinicians, of whatever theoretical orientation, can better leverage
attachment-related knowledge in their clinical work. In this enterprise, perhaps the
knowledge and experience of expert clinicians could be harvested, as this research
has done. Moreover, researchers must expand the evidence base that such
interventions actually work. Beyond the implications for clinical utility and
efficacy, the findings strengthen counselling psychology’s influence on society’s
perception and treatment of attachment-related problems. |
|---|