Attachment and Biobehavioral Catch-up: An evidence-based intervention for vulnerable infants and their families

Psychother Res. 2018 Jan;28(1):18-29. doi: 10.1080/10503307.2016.1229873. Epub 2016 Oct 11.


In this paper, we highlight issues we consider key to the development of an evidence-based intervention for the parents of young children who had experienced early adversity. The intervention was initially developed for foster infants, but adapted for infants living with their neglecting parents, then for young children adopted internationally, and finally for toddlers in foster care or living with neglecting birth parents. The intervention and its adaptations share a focus on the importance of providing nurturance to children when they are distressed, and following children's lead when they are not distressed. We approached intervention development from a theoretical position, with attachment theory and stress neurobiology central. But we are, at heart, clinical scientists and have been open to confirmation or disconfirmation of our ideas and hypotheses. In this paper, we describe our approach, discuss issues and challenges central to our work, and share advice for addressing similar issues and challenges.

Keywords: attachment; child psychotherapy; outcome research.

MeSH terms

  • Adoption
  • Child Behavior Disorders / therapy*
  • Child, Institutionalized
  • Child, Preschool
  • Evidence-Based Practice / methods*
  • Female
  • Foster Home Care
  • Humans
  • Infant
  • Male
  • Object Attachment*
  • Outcome Assessment, Health Care / methods*
  • Outcome and Process Assessment, Health Care / methods*
  • Parents*
  • Program Development / methods*
  • Psychotherapy / methods*
  • Risk