Attachment Therapy - Prevalence

Prevalence

Attachment therapy prospered during the 1980s and '90s as a consequence of both the influx of older adopted orphans from Eastern European and third world countries and the inclusion of reactive attachment disorder in the 1980 Diagnostic and Statistical Manual of Mental Disorders which attachment therapists adopted as an alternative name for their existing unvalidated diagnosis of attachment disorder.

According to the APSAC Task Force, these therapies are sufficiently prevalent to have prompted position statements or specific prohibitions against using coercion or restraint as a treatment by mainstream professional societies such as: American Psychological Association (Division on Child Maltreatment), National Association of Social Workers (and its Utah Chapter), American Professional Society on the Abuse of Children, American Academy of Child and Adolescent Psychiatry, and American Psychiatric Association. The Association for the Treatment and Training in the Attachment of Children, (ATTACh), an organization for professionals and families associated with attachment therapy, has also issued statements against coercive practices. Two American states, Colorado and North Carolina, have outlawed rebirthing. There have been professional licensure sanctions against some leading proponents and successful criminal prosecutions and imprisonment of therapists and parents using attachment therapy techniques. Despite this, the treatments appear to be continuing among networks of attachment therapists, attachment therapy centers, caseworkers, and adoptive or foster parents. The advocacy group ACT states, "Attachment Therapy is a growing, underground movement for the 'treatment' of children who pose disciplinary problems to their parents or caregivers."

Rachel Stryker in her anthropological study "The Road to Evergreen" states that attachment therapies "of all stripes" are increasingly popular in the USA and that the number of therapists associated with the Evergreen model registering with ATTACh grows each year. She cites the large number of formerly institutionalized domestic and foreign adoptees in the USA and the apparently higher risk of disruption of foreign adoptions, of which there were 216,000 between 1998 and 2008.

The practice of holding therapy is not confined to the US. Prior and Glaser cite at least one clinic in the UK. Attachment therapists from the USA have conducted conferences in the UK. The British Association for Adoption and Fostering, (BAAF), has issued an extensive position statement on the subject which covers not only physical coercion but also the underlying theoretical principles. It had been thought, until recently, that therapists calling themselves "attachment therapists" practising in the UK tended to be practising conventional forms of psychotherapy based on attachment theory. In 2009 The British Journal of Social Work accepted an article rehabilitating holding therapy, "To Have and to Hold: Questions about a Therapeutic Service for Children" describing an earlier study involving the Keys Attachment Centre in Rossendale, Lancashire and the surrounding Keys Attachment Homes. In 2012, first-hand accounts from a survivor and a number of professionals provided evidence that the coercive Evergreen model of holding therapy had been systematically used to treat children in Local Authority care within a programme in North West England.