Attachment-Based Family Therapy for Depressed and Suicidal Adolescents: Development, Research and Clinical Practice

Chapter

Abstract

Attachment-Based Family Therapy (ABFT) is an evidence-based model designed to treat depressed and suicidal adolescents. ABFT works with adolescent psychopathology in the context of family relationships by addressing ruptures in the parent–child relationship and restoring parents’ caregiving capacities and adolescents trust in attachment security. This paper provides a rational for family-based treatments for this disorder, an overview of clinical model and a review of some of the empirically work supporting the treatment efficacy and effectiveness.

Keywords

Family therapy Adolescents Depression Suicide Attachment theory 

References

  1. Allen, J. E. (2009). Suicide prevention as a community development process: Understanding youth suicide prevention through community level outcomes. International Journal of Circumpolar Health, 68(3), 274–291.CrossRefPubMedPubMedCentralGoogle Scholar
  2. American Academy of Child & Adolescent Psychiatry. (2001). Practice guidelines for the treatment of children and adolescents (2nd ed.). Washington, DC: American Psychological Association.Google Scholar
  3. Asarnow, J. R., Porta, G., Spirito, A., Emslie, G., Clarke, G., Wagner, K. D., … Mayes, T. (2011). Suicide attempts and nonsuicidal self-injury in the treatment of resistant depression in adolescents: Findings from the TORDIA study. Journal of the American Academy of Child & Adolescent Psychiatry, 50(8), 772–781.Google Scholar
  4. Attili, G., Vermigli, P., & Roazzi, A. (2011). Rearing styles, parents’ attachment mental state, and children’s social abilities: The link to peer acceptance. Child Development Research, 1, 1–13.Google Scholar
  5. Barbe, R., Bridge, J., Birmaher, B., Kolko, D., & Brent, D. A. (2004). Lifetime history of sexual abuse, clinical presentation, and outcome in a clinical trial for adolescent depression. Journal of Clinical Psychiatry, 65(1), 77–83.CrossRefPubMedGoogle Scholar
  6. Beautrais, A. L. (2004). Further suicidal behaviour among medically serious suicide attempters. Suicide & Life-Threatening Behaviour, 34(1), 1–11.CrossRefGoogle Scholar
  7. Beavers, R., & Hampson, R. (2000). The beavers systems model of family functioning. Journal of Family Therapy, 22(2), 128–143.CrossRefGoogle Scholar
  8. Beck, A., Steer, R., & Garbin, M. G. (1988). Psychometric properties of the Beck Depression Inventory: Twenty-five years of evaluation. Clinical Psychology Review, 8(1), 77–100.CrossRefGoogle Scholar
  9. Bergen, H., Hawton, K., Waters, K., Cooper, J., & Kapur, N. (2010). Epidemiology and trends in non-fatal self-harm in three centres in England: 2000–2007. The British Journal of Psychiatry, 197(6), 493–498.CrossRefPubMedGoogle Scholar
  10. Boszormenyi-Nagy, I., & Spark, G. M. (1973). Invisible loyalties: Reciprocity in intergenerational family therapy. Oxford: Harper & Row.Google Scholar
  11. Bowlby, J. (1988). A secure base: Parent–child attachment and healthy human development. New York, NY: Basic Books.Google Scholar
  12. Brent, D. A., Greenhill, L. L., Compton, S., Emslie, G., Wells, K., Walkup, J. T., & Turner, J. B. (2009). The Treatment of Adolescent Suicide Attempters Study (TASA): Predictors of suicidal events in an open treatment trial. Journal of American Academy of Child & Adolescent Psychiatry, 48(10), 987–996.CrossRefGoogle Scholar
  13. Brent, D. A., Baugher, M., Bridge, J., Chen, T., & Chiappetta, L. (1999). Age- and sex- related risk factors for adolescent suicide. Journal of American Academy of Child & Adolescent Psychiatry, 38(12), 1497–1505.CrossRefGoogle Scholar
  14. Center for Disease Control & Prevention. (2013). Annual report on community health status and indicators. Atlanta.Google Scholar
  15. Diamond, G. S., Diamond, G. M., & Levy, S. A. (2014). Attachment-based family therapy for depressed adolescents. Washington, DC: American Psychological Association.CrossRefGoogle Scholar
  16. Diamond, G. M., Diamond, G. S., Levy, S., Closs, C., Ladipo, T., & Siqueland, L. (2012a). Attachment-based family therapy for suicidal lesbian, gay, and bisexual adolescents: A treatment development study and open trial with preliminary findings. Psychotherapy, 49(1), 62–71.CrossRefPubMedGoogle Scholar
  17. Diamond, G. S., Creed, T., Gillham, J., Gallop, R., & Hamilton, J. L. (2012b). Sexual trauma history does not moderate treatment outcome in attachment-based family therapy (ABFT) for adolescents with suicide ideation. Journal of Family Psychology, 26(4), 595–607.CrossRefPubMedGoogle Scholar
  18. Diamond, G. S., Wintersteen, M. B., Brown, G. K., Diamond, G. M., Gallop, R., Shelef, K., & Levy, S. (2010). Attachment-based family therapy for adolescents with suicidal ideation: A randomized controlled trial. Journal of the American Academy of Child and Adolescent Psychiatry, 49(2), 122–131.PubMedGoogle Scholar
  19. Diamond, G. M., Diamond, G. S., & Hogue, A. (2007). Attachment-based family therapy: Adherence and differentiation. Journal of Marital and Family Therapy, 33(2), 177–191.CrossRefPubMedGoogle Scholar
  20. Diamond, G. S. (2005). Attachment-based family therapy for depressed and anxious adolescents. In J. L. Lebow (Ed.), Handbook of clinical family therapy (pp. 17–41). Hoboken, NJ: John Wiley & Sons Inc.Google Scholar
  21. Diamond, G. S., Siqueland, L., & Diamond, G. M. (2003). Attachment-based family therapy for depressed adolescents: Programmatic treatment development. Clinical Child and Family Psychology Review, 6(2), 107–127.CrossRefPubMedGoogle Scholar
  22. Diamond, G. S., Reis, B. F., Diamond, G. M., Siqueland, L., & Isaacs, L. (2002). Attachment-based family therapy for depressed adolescents: A treatment development study. Journal of the American Academy of Child and Adolescent Psychiatry, 41(10), 1190–1196.CrossRefPubMedGoogle Scholar
  23. Diamond, G. S., Liddle, H. A., Hogue, A., & Dakof, G. A. (1999). Alliance-building interventions with adolescents in family therapy: A process study. Psychotherapy: Theory, Research, Practice, Training, 36(4), 355–368.CrossRefGoogle Scholar
  24. Diamond, G., & Liddle, H. A. (1996). Resolving a therapeutic impasse between parents and adolescents in multidimensional family therapy. Journal of Consulting and Clinical Psychology, 64(3), 481–488.CrossRefPubMedGoogle Scholar
  25. Duncan, D. T., & Hatzenbuehler, M. L. (2014). Lesbian, gay, bisexual, and transgender hate crimes and suicidality among a population-based sample of sexual-minority adolescents in Boston. American Journal of Public Health, 104(2), 272–278.CrossRefPubMedPubMedCentralGoogle Scholar
  26. Eisenberg, M. E., Ackard, D. M., & Resinick, M. D. (2007). Protective factors and suicide risk in adolescents with a history of sexual abuse. Journal of Pediatrics, 151(5), 482–487.CrossRefPubMedGoogle Scholar
  27. Eskin, M., Kaynak-Demir, H., & Demir, S. (2005). Same-sex sexual oorientation, childhood sexual abuse, and suicidal behaviour in university students in Turkey. Archives of Sexual Behaviour, 34(2), 185–195.CrossRefGoogle Scholar
  28. Feder, M., & Diamond, G. M. (2016). Parent-therapist alliance and parent attachment promoting behaviours in attachment-based family therapy for suicidal and depressed adolescents. Journal of Family Therapy, 38(1), 82–101.CrossRefGoogle Scholar
  29. Fonagy, P., Gergely, G., Jurist, E. L., & Target, M. (2002). Affect regulation, mentalization, and the development of the self. New York, NY: Other Press.Google Scholar
  30. Fonagy, P., & Target, M. (1997). Attachment and reflective function: Their role in self-organization. Development and Psychopathology, 9(4), 679–700.CrossRefPubMedGoogle Scholar
  31. Grunbaum, J., Kann, L., Kinchen, S., Williams, B., Ross, J., Lowry, R., & Kolbe, L. (2002). Youth risk behaviour surveillance—United States, 2001. Journal of School Health, 72(8), 313–328.CrossRefPubMedGoogle Scholar
  32. Hamilton, N. G., & Hamilton, C. A. (2005). Competing paradigms of response to assisted suicide requests in Oregon. The American Journal of Psychiatry, 162(6), 1060–1065.CrossRefPubMedGoogle Scholar
  33. Hammad, T. A., Laughren, T., & Racoosin, J. (2006). Suicidality in pediatric patients treated with antidepressant drugs. Archives of General Psychiatry, 63(3), 332–339.CrossRefPubMedGoogle Scholar
  34. Hazell, P. (2009). Depression in children and adolescents. BMJ Clinical Evidence, 6(4), 103.Google Scholar
  35. Henggeler, S. W., Schoenwald, S. K., Borduin, C. M., Rowland, M. D., & Cunningham, P. B. (1998). Multisystemic treatment of antisocial behaviour in children and adolescents. New York, NY: Guilford Press.Google Scholar
  36. Hogue, A., & Dauber, S. (2013). Assessing fidelity to evidence-based practices in usual care: The example of family therapy for adolescent behaviour problems. Evaluation and Program Planning, 37, 21–30.CrossRefPubMedGoogle Scholar
  37. Israel, P., & Diamond, G. S. (2013). Feasibility of attachment based family therapy for depressed clinic-referred Norwegian adolescents. Clinical Child Psychology and Psychiatry, 18(3), 334–350.CrossRefPubMedGoogle Scholar
  38. Johnson, S. (2004). The practice of emotionally focused couple therapy: Creating connection. New York, NY: Brunner-Routledge.Google Scholar
  39. Johnson, S. M., & Greenberg, L. S. (1985). Emotionally focused couples therapy: An outcome study. Journal of Marital & Family Therapy, 11(3), 313–317.CrossRefGoogle Scholar
  40. Joiner, T. J., Sachs-Ericsson, N. J., Wingate, L. R., Brown, J. S., Anestis, M. D., & Selby, E. A. (2007). Childhood physical and sexual abuse and lifetime number of suicide attempts: A persistent and theoretically important relationship. Behaviour Research and Therapy, 45(3), 539–547.CrossRefPubMedGoogle Scholar
  41. Joiner, T., Van Orden, K., Witte, T., & Rudd, M. (2009). The interpersonal theory of suicide: Guidance for working with suicidal clients. Washington, DC: American Psychological Association.CrossRefGoogle Scholar
  42. Kaslow, N., & Racusin, G. (1994). Family therapy for depression in young people. In W. M. Reynolds & H. F. Johnston (Eds.), Handbook of depression in children & adolescents (pp. 345–363). New York, NY: Plenum Press.CrossRefGoogle Scholar
  43. King, M., Semlyen, J., Tai, S. S., Killaspy, H., Osborn, D., Popelyuk, D., & Nazareth, I. (2008). A systematic review of mental disorder, suicide, and deliberate self harm in lesbian, gay and bisexual people. BMC Psychiatry, 8, 70.CrossRefPubMedPubMedCentralGoogle Scholar
  44. Klonsky, E. D., & Moyer, A. (2008). Childhood sexual abuse and non-suicidal self-injury: meta-analysis. The British Journal of Psychiatry, 192(3), 166–170.Google Scholar
  45. Kobak, R., Cassidy, J., Lyons-Ruth, K., & Ziv, Y. (2006). Attachment, stress and psychopathology: A developmental pathways model. In D. Cicchetti & D. J. Cohen (Eds.), Handbook of developmental psychopathology (pp. 333–369). Cambridge: Cambridge University Press.Google Scholar
  46. Kõlves, K., Ide, N., & De Leo, D. (2010). Suicidal ideation and behaviour in the aftermath of marital separation: Gender differences. Journal of affective disorders, 120(1), 48–53.Google Scholar
  47. Minuchin, S. (1974). Families & family therapy. New York: Harvard University Press.Google Scholar
  48. Mustanski, B., & Liu, R. T. (2013). A longitudinal study of predictors of suicide attempts among lesbian, gay, bisexual, and transgender youth. Archives of Sexual Behaviour, 42(3), 437–448.CrossRefGoogle Scholar
  49. Nock, M. K., Borges, G., Bromet, E. J., Alonso, J., Angermeyer, M., Beautrais, A., … Williams, D. (2008). Cross national prevalence and risk factors for suicidal ideation, plans and attempts. British Journal of Psychiatry, 192(2), 98–105.Google Scholar
  50. Olfson, M., Blanco, C., Liu, L., Moreno, C., & Laje, G. (2006). National trends in the outpatient treatment of children and adolescents with antipsychotic drugs. Archives of General Psychiatry, 63(6), 679–685.CrossRefPubMedGoogle Scholar
  51. Orden, V. A., Lynam, M. E., Hollar, D., & Joiner, T. E. (2006). Perceived burdensomeness as an indicator of suicidal symptoms. Cognitive Therapy and Research, 30(4), 457–467.CrossRefGoogle Scholar
  52. Ougrin, D., Tranah, T., Leigh, E., Taylor, L., & Asarnow, J. R. (2012). Practitioner review: Self-harm in adolescents. Journal of Child Psychology and Psychiatry, 53(4), 337–350.CrossRefPubMedGoogle Scholar
  53. Rees, C. A. (2005). Thinking about children’s attachments. Archives of disease in childhood, 90(10), 1058–1065.Google Scholar
  54. Rotheram-Borus, M. J., Piacentini, J., Miller, S., Graae, F., & Castro-Blanco, D. (1994). Brief cognitive-behavioral treatment for adolescent suicide attempters and their families. Journal of the American Academy of Child & Adolescent Psychiatry, 33(4), 508–517.Google Scholar
  55. Rowe, S. L., French, R. S., Henderson, C., Ougrin, D., Slade, M., & Moran, P. (2014). Help-seeking behaviour and adolescent self-harm: A systematic review. Australian and New Zealand Journal of Psychiatry, 48(12), 1083–1095.CrossRefPubMedGoogle Scholar
  56. Rudloph, K. D., Hammen, C., Burge, D., Lindberg, N., Herzberg, D., & Daley, S. E. (2000). Toward an interpersonal life-stress model of depression: The developmental context of stress generation. Development and Psychopathology, 12(2), 215–234.CrossRefGoogle Scholar
  57. Sareen, J., Cox, B. J., Afifi, T. O., Stein, M. B., Belik, S., Meadows, G., & Asmundson, G. G. (2007). Combat and peacekeeping operations in relation to prevalence of mental disorders and perceived need for mental health care: Findings from a large representative sample of military personnel. Archives of General Psychiatry, 64(7), 843–852.CrossRefPubMedGoogle Scholar
  58. Sheeber, L. B., Davis, B., Leve, C., Hyman, H., & Tildesley, E. (2007). Adolescents’ relationships with their mothers and fathers: Associations with depressive disorder and subdiagnostic symptomatology. Journal of Abnormal Psychology, 116(1), 144–154.CrossRefPubMedPubMedCentralGoogle Scholar
  59. Shelef, K., Diamond, G. M., Diamond, G. S., & Liddle, H. A. (2005). Adolescent and parent alliance and treatment outcome in multidimensional family therapy. Journal of Consulting and Clinical Psychology, 73(4), 689–698.CrossRefPubMedGoogle Scholar
  60. Siqueland, L., Rynn, M., & Diamond, G. S. (2005). Cognitive behavioural and attachment-based family therapy for anxious adolescents: Phase I and II studies. Journal of Anxiety Disorders, 19(4), 361–381.CrossRefPubMedGoogle Scholar
  61. Sroufe, A. (2005). Attachment and development: A prospective, longitudinal study from birth to adulthood. Attachment & Human Development, 7(4), 349–367.CrossRefGoogle Scholar
  62. Stanley, B., Brown, G., Brent, D. A, Wells, K., Poling, K., Kennard, B. D., … Hughes, J. (2009). Cognitive behaviour therapy for suicide prevention (CBT-SP): Treatment model, feasibility and acceptability. Journal of the American Academy of Child Psychiatry, 48(10), 1005–1013.Google Scholar
  63. Tarrier, N., Taylor, K., & Gooding, P. (2008). Cognitive-behavioural interventions to reduce suicide behaviour: A systematic review and meta-analysis. Behaviour Modification, 32(1), 77–108.CrossRefGoogle Scholar
  64. Van Heeringen, C., & Marusic, A. (2003). Understanding the suicidal brain. The British Journal of Psychiatry, 183(4), 282–284.CrossRefPubMedGoogle Scholar
  65. World Health Organization. (2015). World health statistics. Geneva: World Health Organization.Google Scholar
  66. Zayas, V., Mischel, W., Shoda, Y., & Aber, J. L. (2011). Roots of adult attachment: Maternal caregiving at 18 months predicts adult peer and partner attachment. Social Psychological and Personality Science, 2(3), 289–297.CrossRefGoogle Scholar
  67. Zimmerman, P., & Becker-Stoll, F. (2002). Stability of attachment representations during adolescence: The influence of ego-identity status. Journal of Adolescence, 25(1), 107–124.CrossRefGoogle Scholar

Copyright information

© Springer Nature Singapore Pte Ltd. 2017

Authors and Affiliations

  1. 1.Department of Couple and Family TherapyDrexel UniversityPhiladelphiaUSA
  2. 2.Family Safety Net II (FSN II), Family Intervention Science (FIS)Drexel UniversityPhiladelphiaUSA
  3. 3.Pennsylvania School of MedicinePhiladelphiaUSA
  4. 4.College of Nursing and Health ProfessionDrexel UniversityPhiladelphiaUSA
  5. 5.Family Intervention Science (FIS)Drexel UniversityPhiladelphiaUSA

Personalised recommendations