Parent-Child Interaction Therapy as an attachment-based intervention: Theoretical rationale and pilot data with adopted children

Children with histories of child abuse and neglect, particularly children residing in foster or adoptive homes, are commonly considered by many professionals to need “attachment therapy” in order to address emotional and behavioral needs. However, evidence-based treatments rarely utilize an attachment-based justification outside of the infancy through preschooler age range. In actuality, many evidence-based treatments can be understood through the lens of attachment theory. This paper reviews the tenets of an attachment-based approach to treatment and describes how one evidence-based treatment, Parent-Child Interaction Therapy (PCIT), conforms to all expectations and requirements prescribed by attachment theory and research. Next, pilot data from an open trial of PCIT with a sample of adopted children and their adoptive caregivers (n = 85) are provided. Results demonstrate significant improvements in positive parenting techniques, reductions in parenting stress, and reductions in externalizing and internalizing concerns among the children. These results are discussed in the context of improving the quality of care for children often described as in need of “attachment therapy.”