Almost every mental health professional will remember the moment when they first discovered the counseling theory which really felt right for them and encapsulated their view of the world. For me, that moment came when I first began to learn about Attachment Theory, a concept which lays its foundations in the belief that we all yearn for an unconditional, secure attachment figure in our lives; usually a bond which forms with our caregiver in childhood, and is then carried forward into our adult lives as we search for love and a partnership.
The more I learned about Attachment Theory, the more convinced I was that it would help to not only explain so many of the issues which were frequently presented to me by my clients, but also to resolve them. By tracing back the origins of each client’s sense of attachment in their lives, so too could I begin to understand how this was affecting their relationships and choices in the present day, as they continued to wrangle with issues such as vulnerability , loyalty, commitment, and trust.
It wasn’t until I discovered Emotionally-Focused Therapy (EFT), though, that I truly felt I had found a means of incorporating my understanding of Attachment Theory into my work with my clients. Finally EFT seemed to offer a clear, concise, and empirically-supported way of practicing Attachment-Focused Therapy. But one problem still remained: I had a very clear understanding of how to use EFT to work with couples, but the definition of how to use this theory with individuals and families seemed far more complicated and vague. It was with great excitement, then, that I read this new Attachment-Focused Family Therapy Workbook, by Daniel A. Hughes.
The workbook begins with a brief introduction to the concept of Attachment, outlining the Core Principles, Components, and Implications for Treatment. Hughes explains that the belief that humans are essentially dyadic (meaning “relating to or based on two,” according to thefreedictionary.com) and social beings is at the heart of this theory:
“The brain and mind work best in relationship with others. Some theorists have described the human brain as being essentially a ‘dyadic brain,’ developing best and functioning best in concert with individuals with whom we are safe and interested in joint exploration… Attachment-Focused Family Therapy works to facilitate the neuropsychological development of members of the family by facilitating their readiness and ability to become engaged with each other in reciprocal, attuned, affective, and reflective interactions.”
Hughes highlights the ways in which this is observable in the reciprocal and intersubjective nature of parent-child relationships, and then explains that it is this affective-reflective dialogue which is also central to Attachment-Focused Family Therapy (AFFT). The idea of an intersubjective relationship between a counselor and their client is one that many therapists may not be familiar with, but Hughes devotes the second chapter to this topic, explaining exactly how it should be achieved, and how vital it is if this theory is to work effectively.
“Just as infants and older children would be disempowered if they did not have the capacity to have a positive impact on their parents, so too is a client disempowered when she gives expression to what one might view as courage or honest or compassion or love and the therapist does not experience those qualities in the client or, if he does, he conceals it from the client.”
Once these opening chapters have served as an introduction to the basics of this theory, Hughes moves on to very specific instructions of how to use it in session; giving detailed examples of actual dialogue with clients, and a step-by-step guide on how to become an Attachment-Focused Therapist.
As well as the aforementioned affective-reflective dialogue, Hughes also outlines the importance of the PACE approach: one in which the therapist responds to his clients with an attitude of Playfulness, Acceptance, Curiosity, and Empathy. Once these techniques have been used to establish a connection with the client, the counselor can then engage in what Hughes terms ‘The Deepening Sequential Process,’ addressing the client’s concerns and embarking on the therapeutic journey using a specific order of experiences and events:
“As in any therapy – and in any relationship for that matter – typical sequences of interactions and themes develop over time. The first session is not the same as a middle session, which is not the same as an ending session… This movement into deeper levels of experience is evident in the ongoing interactions between parents and infant. Each time they are together, they read each other more quickly and easily. The parent comes to know what is unique about her baby through increasingly more subtle reciprocal communications. From day to day the infant feels both safer with this parent and more able to discover aspects of self, other, and the world through the intersubjective interactions… Safety and intersubjective exploration are intimately interwoven.”
Hughes uses this technique throughout the book; comparing the relationships between an infant and a parent to an adult and their Attachment figure, be it a partner, parent, or therapist. He explains the ways in which this unique bond can develop over time, and how it manifests itself within the particular dynamic of the family. In every chapter Hughes provides detailed case studies and examples from a clinical setting, ensuring that the reader can visualize these ideas working in practice and not just as ideas on the page. Sample dialogues and a full body of suggested interventions are also provided, to aid the therapist in applying this therapy model effectively in clinical practice.
Finally Hughes takes us through the necessary stages to repair an Attachment Relationship, explaining the need for relationship repair on occasions where a break has occurred. He also ends the book with further explanation of the parent as an attachment figure, and of the specific techniques to use when employing this theory with Foster-Adoptive Families. Two appendices offer an overview of the DVD demonstration session, and a guide to further reading on this topic.
As with most counseling theories, I certainly wouldn’t say that simply reading this book would qualify you to practice Attachment-Focused Family Therapy, but it will give you a good understanding of the theory and provide a strong foundation from which to begin practicing. Although it is described as a ‘workbook,’ I think it is also important to point out that this book functions well as a guide to Attachment-Focused Therapy for anyone who has an interest in the topic; be they a student, a counselor, a client, or simply someone with an interest in psychology. As an MFT, I greatly appreciated the ‘workbook’ sections – a brief questionnaire or classroom-style exercise at the end of each chapter, and a DVD including a demonstration of a sample therapy session – but these did not detract from the main sections of the book at all. Hughes writes in a way that is both engaging and easy-to-read, and the book consistently flows well; never feeling like a chore or a traditional study guide.
I enjoyed reading this book, and watching the accompanying DVD; both of them serving as worthwhile additions to my understanding of Attachment Theory and Emotionally-Focused Therapy. Through completing the exercises and questionnaires in the workbook I feel much better prepared to use this theory in an individual or family context, as well as with the couples I currently see as clients. Any therapist with an interest in Attachment Theory should certainly have this in their library, and it will doubtless appeal to students and interns, as well as seasoned practitioners.
Attachment-Focused Family Therapy Workbook
By Daniel A. Hughes
W.W. Norton & Company: 2011
Paperback, 254 pages
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Walters, S. (2011). Attachment-Focused Family Therapy Workbook. Psych Central. Retrieved on March 11, 2014, from http://psychcentral.com/lib/attachment-focused-family-therapy-workbook/0007203
Last reviewed: By John M. Grohol, Psy.D. on 30 Jan 2013
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