Clinical Applications of the Adult Attachment Interview

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The Adult Attachment Interview (AAI) is both a mainstay of attachment research and a powerful clinical tool. This unique book provides a thorough introduction to the AAI and its use as an adjunct to a range of therapeutic approaches, including cognitive-behavioral therapy, psychoanalytic psychotherapy, parent-infant psychotherapy, home visiting programs, and supportive work in the context of foster care and adoption. Leading authorities provide detailed descriptions of clinical procedures and techniques, illustrated with vivid case material. Grounded in research, the volume highlights how using the AAI can enhance assessment and diagnosis, strengthen the therapeutic alliance, and facilitate goal setting, treatment planning, and progress monitoring.

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Editorial Reviews

EABP Newsletter

"Because the AAI is such a pervasive technique for conducting attachment research and understanding attachment relationships, this detailed volume is worthwhile for any practitioner interested in applying the theory of attachment."--EABP Newsletter
From the Publisher

"Steele and Steele have brought together a really valuable set of data and ideas concerning the Adult Attachment Interview (AAI), one of the more intriguing and powerful clinical and research tools available in psychology. The book stands out as a serious and ambitious attempt to translate the AAI--and attachment theory more broadly--to multiple clinical contexts. Chapters are written by leading clinicians and scientists, and each is focused and thoughtful, showing, for example, how the AAI informs case conceptualization in individual treatment. This volume deserves to be widely read. It is highly accessible for those just beginning to apply attachment theory to research and practice, but there is also enough that is new to please experienced fans of the AAI."--Thomas G. O'Connor, PhD, Department of Psychiatry, University of Rochester Medical Center

"Exceptionally coherent and immensely helpful, this book comprehensively reviews how the Adult Attachment Interview (AAI) can be used to guide clinical work in a range of high-priority contexts. This remarkable instrument, which has more than proved itself in the developmental laboratory, also turns out to be a marvelous and versatile tool in the hands of the creative clinician. An essential book for all those who work with children and adults."--Peter Fonagy, PhD, FBA, Sub-Department of Clinical Health Psychology, University College London, United Kingdom

"This impressive volume reports novel theoretical insights and clinical practices inspired by the Adult Attachment Interview (AAI). The authors use groundbreaking empirical studies, illustrated with fascinating and emotionally moving case examples, to show how AAI-related interventions help troubled, disadvantaged parents and children. The book illustrates beautifully how science and society benefit from a coherent integration of profound theory, clinical creativity, and ambitious but careful research. It is highly relevant to researchers, clinicians, and child welfare policymakers, as well as advanced students in psychology, psychiatry, social work, social policy, and related fields."--Phillip R. Shaver, PhD, Distinguished Professor of Psychology, University of California, Davis

British Journal of Psychiatry

"This book provides a thorough introduction to the instrument, its coding, and classification system. But its main contribution is the way in which it brings together leading experts in the field to present research findings and case material to show how the AAI can systematically be used in assessment and diagnosis, to design and tailor interventions, to facilitate goal setting and treatment planning, to inform and strengthen the therapeutic alliance, and to monitor therapeutic progress....[A] timely, well-presented, and valuable book, every chapter of which provides illuminating insights and evidence of the range and depth of the AAI's multiple uses. It should be of considerable interest to clinicians and practitioners from all disciplines, as well as to researchers, and students."--British Journal of Psychiatry
Doody's Review Service
Reviewer: Gary B Kaniuk, Psy.D.(Cermak Health Services)
Description: This book describes the various clinical uses of the Adult Attachment Interview (AAI), an instrument developed in the mid 1980s in order to assess an adult's attachment history as a child and detect unresolved loss or trauma.
Purpose: According to the editors, the book "provides a thorough introduction to the AAI and its use as an adjunct to a variety of therapeutic approaches."
Audience: The intended audience includes psychiatrists, psychologists, counselors, social workers, and students and instructors in these fields, "as well as others concerned with mental health, parenting, and child development." Dr. Howard Steele, Associate Professor and Director of Graduate Studies in Psychology at the New School for Social Research, has authored numerous journal articles and book chapters in the areas of attachment, loss, and trauma. Dr. Miriam Steele, Associate Professor and Assistant Director of the Doctoral Program in Clinical Psychology at the same institution, has coordinated the London Parent-Child Project, a longitudinal study of attachment. The contributors represent an international authorship from Italy, the U.K., Mexico, Canada, the Netherlands, and the U.S.
Features: The book is organized along the five major themes of the uses of the AAI, including clinical context, intervention research, adolescents and adults, trauma, and foster care and adoption. It nicely weaves research with clinical applications, using numerous clinical examples and illustrative cases, many of them fairly extensive. Thus, readers are able to get a very good sense of how this instrument can be used clinically. All the chapters are excellent, but I was especially impressed with the first chapter's description of the 10 clinical uses of the AAI. I was also impressed with chapter 17, which details adoption research. The book is very readable, with useful tables and figures, and thorough, with clinical applications covering the whole lifespan. Although there are no obvious shortcomings, it would have been useful to include some of the psychometric properties of the test.
Assessment: The concept of attachment as proposed by Bowlby is a foundational area in the study of psychology. This book serves a very important function in describing the AAI and its clinical uses, and is full of research. Readers will not be disappointed.
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Product Details

  • ISBN-13: 9781593856960
  • Publisher: Guilford Publications, Inc.
  • Publication date: 3/21/2008
  • Pages: 501
  • Sales rank: 1,154,875
  • Product dimensions: 6.00 (w) x 9.30 (h) x 1.30 (d)

Meet the Author

Howard Steele, PhD, is Associate Professor and Director of Graduate Studies in Psychology at the New School for Social Research, where he is Codirector (with Miriam Steele) of the Center for Attachment Research. He is senior and founding editor of the journal Attachment and Human Development and is the author of more than 60 journal articles and book chapters on the impact of attachment, loss, trauma, and emotion understanding across the lifespan and across generations.

Miriam Steele, PhD, is Associate Professor and Assistant Director of the Doctoral Program in Clinical Psychology at the New School for Social Research, where she is Codirector (with Howard Steele) of the Center for Attachment Research. Dr. Steele trained as a psychoanalyst at the Anna Freud Centre. She initiated the London Parent-Child Project, a major longitudinal study of intergenerational patterns of attachment, and has also carried out longitudinal attachment research in the context of child maltreatment and adoption, about which she publishes and lectures widely.

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Table of Contents

Foreword, June Sroufe

I. The AAI in Clinical Context

1. Ten Clinical Uses of the Adult Attachment Interview, Howard Steele and Miriam Steele

2. Studying Differences in Language Usage in Recounting Attachment History: An Introduction to the Adult Attachment Interview, Mary Main, Erik Hesse, and Ruth Goldwyn

3. The Distribution of Adult Attachment Representations in Clinical Groups: A Meta-Analytic Search for Patterns of Attachment in 105 AAI Studies, Marinus H. van IJzendoorn and Marian J. Bakermans-Kranenburg

II. Intervention Research with Mothers, Infants, and Toddlers

4. The AAI Anticipates the Outcome of a Relation-Based Early Intervention, Christoph M. Heinicke and Mónica Susana Levine

5. Adult Attachment, Parental Commitment to Early Intervention, and Developmental Outcomes in an African American Sample, Douglas M. Teti, Lauren A. Killeen, Margo Candelaria, Wendy Miller, Christine Reiner Hess, and Melissa O’Connell

6. Attachment-Theory-Informed Intervention and Reflective Functioning in Depressed Mothers, Sheree L. Toth, Fred A. Rogosch, and Dante Cicchetti

III. Parent–Infant Relationships, Adolescents, and Adults in Psychotherapy

7. The AAI as a Clinical Tool, Amanda Jones

8. Integrating the AAI in the Clinical Process of Psychoanalytic Parent–Infant Psychotherapy in a Case of Relational Trauma, Tessa Baradon and Miriam Steele

9. Obsessive–Compulsive Disorder in Adolescence: An AAI Perspective, Tord Ivarsson

10. The AAI in a Clinical Context: Some Experiences and Illustrations, Massimo Ammaniti, Nino Dazzi, and Sergio Muscetta

11. The Reciprocal Impact of Attachment and Transference-Focused Psychotherapy with Borderline Patients, Diana Diamond, Frank E. Yeomans, John F. Clarkin, Kenneth N. Levy, and Otto F. Kernberg

IV. The AAI and Trauma

12. The AAI and Its Contribution to a Therapeutic Intervention Project for Violent, Traumatized, and Suicidal Cases, Sonia Gojman de Millán and Salvador Millán

13. Adult Attachment and Posttraumatic Stress Disorder in Women with Histories of Childhood Abuse, K. Chase Stovall-McClough, Marylene Cloitre, and Joel F. McClough

14. AAIs in a High-Risk Sample: Stability and Relation to Functioning from Adolescence to 39 Years, Judith A. Crowell and Stuart T. Hauser

15. Exploring the Mind Behind Unresolved Attachment: Lessons from and for Attachment-Based Interventions with Infants and Their Traumatized Mothers, Greg Moran, Heidi Neufeld Bailey, Karin Gleason, Carey Anne DeOliveira, and David R. Pederson

16. Hostile–Helpless States of Mind in the AAI: A Proposed Additional AAI Category with Implications for Identifying Disorganized Infant Attachment in High-Risk Samples, Sharon Melnick, Brent Finger, Sydney Hans, Matthew Patrick, and Karlen Lyons-Ruth

V. The AAI, Foster Care, and Adoptive Placements

17. Forecasting Outcomes in Previously Maltreated Children: The Use of the AAI in a Longitudinal Adoption Study, Miriam Steele, Jill Hodges, Jeanne Kanuik, Howard Steele, Saul Hillman, and Kay Asquith

18. Helping Foster Parents Change: The Role of Parental State of Mind, Johanna Bick and Mary Dozier

Afterword, Deborah Jacobvitz

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