1. Attachment Dependency
The Influence of Phases of Parent-Child Interaction Therapy on Attachment Erin Neary, Michelle Harwood, Stephen Bell, and Sheila Eyberg Department of Clinical and Health Psychology University of Florida, Gainesville, Florida
ABSTRACT
RESULTS
PARTICIPANTS
This study examined the effects of the two phases of Parent-Child Interaction Therapy (PCIT), Child-Directed Interaction (CDI) and Parent-Directed Interaction (PDI), on the attachment domains of security and dependency. Participants were 14 preschoolers referred for treatment of disruptive behavior and their mothers. Although the goal of CDI is to improve the parent-child attachment relationship, only attachment dependency changed during CDI. From pre to post treatment, however, both attachment domains improved significantly. The period of exposure to CDI required for change in both domains of attachment may be longer than the typical CDI phase of treatment. If this is the case, the continued exposure to CDI that occurs during the second phase of treatment, PDI, may be responsible for the effects of treatment on the mother-child attachment relationship. Alternatively, PDI may contribute independent effects to parent-child attachment.
Repeated measures ANOVAs used
From pre to mid treatment (CDI phase of treatment)
Attachment security showed no change F(1,13) = 2.11, p = .17, power = .99
Attachment dependency decreased F(1,13) = 7.61, p < .05, power = .72
From mid to post treatment (PDI phase of treatment)
Attachment security increased F(1,13) = 17.57, p < .01, power = .97
Attachment dependency decreased F(1,13) = 7.91, p <.05, power = .74
From pre to post treatment (Both phases of PCIT)
Attachment security increased F(1,13) = 19.05, p < .01, power = .98
Attachment dependency decreased F(1,13) = 28.76, p < .001, power = 1.00
Mothers (n = 14) of 3- to 6-year-old children who completed PCIT
All children met DSM-IV criteria for Oppositional Defiant Disorder
Child gender % boys (n = 9)
Child age M = 4.5 years (SD = 1.02)
Child ethnicity 86% Caucasian (n = 12)
14% Bi-racial (n = 2)
Family annual income M = $36,269 (range $7,800 - $70,800)
MEASURE & PROCEDURE
Attachment Security
INTRODUCTION
The Attachment Q-Set (Waters et al., 1985) measures child attachment-related behaviors in security and dependency. It consists of 90 behaviorally descriptive items. Parents are asked to sort the items into 9 piles according to how characteristic they are of the child.
Waters et al. reported correlations between parent and observer Q-sorts of the same child from .59 to .93, with a mean correlation of .80. Ainsworth et al. (1978) demonstrated significant relationships between Q-sorts based on home observations and laboratory-based classifications of attachment security using the Strange Situation.
The Attachment Q-Set was administered to mothers during assessments at pre, mid, and post treatment.
Attachment is a lasting psychological connectedness between parent and child. Attachment security involves secure-base behavior in which the child uses the caregiver as a base of exploration and is confident that assistance, nurturance, and protection will be available when needed. Attachment dependency refers to a state of interpersonal helplessness.
A secure, stable attachment relationship and positive parent-child interactions are key to development of a healthy self concept, optimal emotional/behavioral regulation, and the ability to express empathy. Maladaptive attachment is consistently linked to children’s aggressive behavior, low social competence, poor coping skills, low self esteem, and poor peer relationships.
In Parent-Child Interaction Therapy, parents learn to restructure their relationship with their child. The first phase of treatment, Child-Directed Interaction (CDI), is based on attachment theory and designed to provide the child with a trusting, nurturing, secure attachment to the parent. The second phase, Parent-Directed Interaction (PDI), addresses social learning processes by establishing consistent contingencies for the child’s behaviors that are implemented in the context of a positive parent-child relationship established through CDI.
Hypotheses: Attachment security will increase and attachment dependency will decrease during the CDI phase of treatment. Both attachment domains will continue to improve over the course of treatment.
CONCLUSIONS
Attachment Dependency
To interpret the changes in attachment during PCIT, it is important to note that PCIT begins with CDI. CDI is designed to improve attachment, and the skills that parents learn during CDI continue to be practiced during the PDI phase of treatment. Thus, changes in attachment security may result from CDI but become evident only after longer exposure to CDI. Alternatively, skills that parents learn during PDI may contribute important independent effects to the parent-child attachment relationship. It is likely that improving the relationship requires both the consistent limit-setting of PDI as well as the relationship enhancement of CDI. The current findings suggest that PCIT effectively improves the attachment relationship, which is essential for positive developmental outcomes. Dismantling studies are needed to clarify the relative contributions of CDI and PDI to attachment.
= STATISTICALLY SIGNIFICANT CHANGE