Many adopted and looked after children with histories of physical and sexual abuse, and severe loss and neglect, develop highly disturbed and distinctive problem behaviours. Those diagnosed suffering such ‘disorders of attachment’ put great stress on the resources and skills of their post-placement carers. Children with these behaviours have proved very difficult to treat. However, as David Howe and Sheila Fearnley discuss in their paper below, attachment therapies based on ‘cognitive restructuring’ and ‘therapeutic holding’, appear to be having some success with children who have failed to respond to other treatments employed by the child mental health services. The authors describe different patterns of attachment and the behaviours associated with children classified as disorganised and disordered in their attachment behaviours. They outline therapeutic interventions based on developmental attachment theory using a case example.
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