The purpose of this study was to develop a grounded theory of earning secure attachment. This study included 15 women and 5 men who met the criteria of having a self-reported history of attachment insecurity and demonstrated evidence of earned security. The grand tour research question, How do adults with a history of insecure attachment earn security?, was explored using constructivist grounded theory and semi-structured interviews emphasizing processes of positive attachment change. The results describe a process model of change hinging on three interrelated categories: meta-conditions of positive attachment change, making intrapsychic changes, and making interpersonal changes. Clinical implications include the importance of clients committing to the process, clients working with a clinician trained in trauma-focused therapy, and clinicians being surrogate attachment figures for clients.
© 2019 American Association for Marriage and Family Therapy.