Attachment-informed Care in a Primary Care Setting

• Attachment styles are established in infancy and childhood and generally endure throughout life, influencing adult relationships, as well as physical and psychological health
• 40% of the U.S. population experiences insecure attachment in childhood
• Insecure attachment styles may be expressed in adulthood as anxiety, depression, somatic symptoms, and illness
• Nurse practitioners can provide a therapeutic relationship by using the BATHE model
• The BATHE model is a strategy to empower patients to deal with their emotional and relational difficulties, which may reduce somatic symptoms

No child grows up without an attachment pattern based on early relationships with caregiver figures. About 40% of the United States population experiences insecure attachment in childhood. When this pattern endures, it can be expressed as anxiety, depression, somatization, or illness. This article offers a framework for understanding secure and insecure attachment and suggests new strategies for helping primary care patients. The BATHE model, a therapeutic intervention for any patient with emotional and interpersonal difficulties, is described. With an attachment-informed perspective, advanced practice nurses may positively impact the quality of the patient-provider relationship, while promoting the patient's health and well-being.