Effects of Attachment Disorder on Psychosocial Development

By Nasreen S. Shah
2015, Vol. 7 No. 02 | pg. 3/3 |

Suggestions for Counselors

The counseling relationship contains many features which may activate a client’s ingrained expectations. Similar to a caregiver, the therapist is emotionally available, offers a comforting presence, and creates a secure base from which the client can explore inner experiences (Holmes, 1999). The counselor should initially meet the client where they are at, in terms of emotional relatedness, which is based on their attachment style. Knowing the client’s attachment style allows the counselor to help the client process past traumas, the goal of which is to bring them to a level where they can experience more balance in their current relationships.

It is critical that counselors use objective, balanced interventions, and carefully monitor their responses. Knowing the importance of the counselor’s responses to the client, it is crucial that counselors are aware of their own patterns of relatedness in order to be able to identify and distinguish between areas of personal conflict and genuine counter transference responses (Skourteli, 2011).

The counselor has a unique opportunity to re-shape the client’s attachment style through the therapeutic relationship. Remembering Roger’s conditions of warmth, kindness and unconditional positive regard, serves as a great foundation for working with clients of attachment disorder. Being genuine and purposeful in the use of interventions, as well as maintaining a stable, consistent presence in session, serves as a powerful learning experience for clients to integrate into their existing framework on relationships; along with their understanding of a secure base.

In working with adolescents, it is imperative that interventions are consistent, positive, and client driven in nature. One such example is a case study involving a 12 year old boy who exhibited behaviors related to an attachment disorder. For the first course of treatment, the counselor took the boy on outings and allowed him to choose the activity, and set his own limits; providing unconditional positive support, even when he was acting out. This provided a safe, positive relationship in which the boy could learn to make choices and have control for setting his own limits.

The next phase of treatment involved a behavior chart where the counselor told the foster parents to simply check the box if he acted out, but to not say anything else. When he did something well, the counselor taught the parents to praise, show love, and reward him for it. This intervention allowed for immediate consequences without repeating the current negative communication attachment pattern and for immediate praise, which allowed the boy to internalize a model of other as available and a model of self as worthy (Pickover, 2012).

After one week, he appeared calmer and showed increased impulse control, exhibiting the ability to stop himself in the middle of a behavior, apologize, and then correct the error. This case study shows a small example of how addressing behavioral problems from an attachment perspective may help decrease acting out (Pickover, 2002).The principles mentioned above can also be used with adults and younger clients to increase compliance and positive behavior patterns while reshaping the client’s view of self, and view of others.

Based on the work of Fredderick and Goddard in 2008, one of the most helpful goals for clients with insecure attachment styles would be connection with community. The study mentioned above highlighted the need for belonging and lack of support for these individuals. Counselors can help by teaching personal connection skills and creating goals on social relatedness, as well as networking with local resources to provide support for these clients.


This report provided a brief look into the history, causes and contributing factors surrounding reactive attachment disorder and insecure attachment types by summarizing recent studies and key literature on the topic. Of course, further research into the causes and concomitant methods of coping with insecure attachment disorders later in life are needed. As our understanding of attachment disorders becomes more complete, the goal of helping affected individuals sustain healthy and emotionally fulfilling relationships later in life becomes more tangible.


American Psychiatric Association. (2000). Diagnostic and Statistical Manual of Mental Disorders (4th ed., text rev.). Arlington, VA: APA.

Aideuis, D. (2007). Promoting attachment and emotional regulation of children with complex trauma disorder.International Journal Of Behavioral Consultation And Therapy,3(4), 546-554.

Chambers, H., Amos, J., Allison, S., & Roeger, L. (2006). Parent and Child Therapy: An Attachment-Based Intervention for Children With Challenging Problems.ANZJFT Australian And New Zealand Journal Of Family Therapy,27(2), 68-74.

Frederick, J., & Goddard, C. (2008). Living on an island: Consequences of childhood abuse, attachment disruption and adversity in later life.Child & Family Social Work,13(3), 300-310. doi:10.1111/j.1365-2206.2008.00554

Hardy, L. T. (2007). Attachment Theory and Reactive Attachment Disorder: Theoretical Perspectives and Treatment Implications.Journal Of Child And Adolescent Psychiatric Nursing,20(1), 27-39. doi:10.1111/j.1744-6171.2007.00077.

Heller, S., Boris, N. W., Fuselier, S., Page, T., Koren-Karie, N., & Miron, D. (2006). Reactive attachment disorder in maltreated twins follow-up: From 18 months to 8 years.Attachment & Human Development,8(1), 63-86. doi:10.1080/14616730600585177

Holmes, J. (1999). Ghosts in the consulting room – an attachment perspective on Intergenerational transmission. Attachment and Human Development, 1(1), 115–131

McCarthy, G., & Maughan, B. (2010). Negative childhood experiences and adult love relationships: The role of internal working models of attachment. Attachment & Human Development,12(5), 445-461. doi:10.1080/14616734.2010.501968

Miljkovitch, R., Pierrehumbert, B., & Halfon, O. (2007). Three-year-olds' attachment play narratives and their associations with internalizing problems.Clinical Psychology & Psychotherapy,14(4), 249-257. doi:10.1002/cpp.535

Pearce, C. (2010). An integration of theory, science and reflective clinical practice in the care and management of attachment-disordered children: A Triple-A approach.Educational And Child Psychology,27(3), 73-86.

Pickover, S. (2002). Breaking the cycle: A clinical example of disrupting an insecure attachment system. Journal Of Mental Health Counseling,24(4), 358-366.

Reyome, N. (2010). The effect of childhood emotional maltreatment on the emerging attachment system and later intimate relationships.Journal Of Aggression, Maltreatment & Trauma,19 (1), 1-4. doi:10.1080/10926770903486007


Riggs, S. A. (2010). Childhood emotional abuse and the attachment system across the life cycle: What theory and research tell us.Journal Of Aggression, Maltreatment & Trauma,19(1), 5-51. doi:10.1080/10926770903475968

Santrock, W. J. (2009). Life-Span Development Twelfth Edition. New York, NY: McGraw-Hill.

Skourteli, M. (2011). The therapeutic relationship from an attachment theory perspective.Counselling Psychology Review,26(1), 20-33.

Zeanah, C. H., & Smyke, A. T. (2008). Attachment disorders in family and social context.Infant Mental Health Journal,29(3), 219-233. doi:10.1002/imhj.20176

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