To have and to hold: questions about a therapeutic service for children

Sudbery, J, Shardlow, SM and Huntington, A 2009, 'To have and to hold: questions about a therapeutic service for children' , British Journal of Social Work .

[img] PDF - Published Version
Restricted to Repository staff only

Download (104kB) | Request a copy


Therapies for children and young people that using ‘holding’ as an intervention for severe difficulties with attachments are controversial and raise many questions. At least one major professional organisation has stated that these therapies should be banned. This paper discusses the implications of a study of a service for children (and their families where appropriate) described as having attachment difficulties or a diagnosis of attachment disorder and where ‘holding’ techniques are employed as part of the therapeutic intervention. The views of a range of stakeholders (including children, young adults who had previously used the service, purchasers, outside professionals, and staff) about this service were collated directly by interview. The article identifies how this study can refine and inform the broader questions about ‘attachment and holding’ therapies. Proponents argue that the service offered provides effective assistance for some of the most hurt and difficult children in society. Opponents state that some of the techniques involved have not been evaluated, are ethically questionable and are not based on a validated theoretical mechanism. This paper highlights a number of core questions about attachment and ‘holding’ therapy and the findings of the study provide a commentary on these questions.

Item Type: Article
Uncontrolled Keywords: Social work, children and young people, attachment, holding therapy, residential care
Themes: Subjects / Themes > R Medicine > RJ Pediatrics > RJ101 Child Health. Child health services
Health and Wellbeing
Schools: Schools > School of Nursing, Midwifery, Social Work & Social Sciences > Centre for Nursing, Midwifery, Social Work & Social Sciences Research
Journal or Publication Title: British Journal of Social Work
Publisher: Oxford University Press
Refereed: Yes
ISSN: 0045-3102
Depositing User: J Sudbery
Date Deposited: 24 Feb 2010 10:32
Last Modified: 30 Nov 2015 23:46
References: Ainsworth M. D. S., Blehar M. C., Waters E., Wall S. Patterns of Attachment: A Psychological Study of the Strange Situation (1978) Mahwah, NJ: Lawrence Erlbaum. American Psychiatric Association. Reactive Attachment Disorder: Position Statement (2002) Washington, DC: American Psychiatric Association. APA. Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (1994) Washington, DC: American Psychiatric Association. BAAF. Attachment Disorders, their Assessment and Intervention (2006) London: BAAF. Barth R. P., Crea T. M., John K., Thoburn J., Quinton D. Beyond attachment theory and therapy: Towards sensitive and evidence-based interventions with foster and adoptive families in distress. Child and Family Social Work (2005) 10(4):257.[CrossRef] Bowlby J. A Secure Base: Clinical Applications of Attachment Theory (1988) London: Routledge. Burman E. Deconstructing Developmental Psychology (1994) London and New York: Routledge. Cassidy J., Shaver P., eds. Handbook of Attachment: Theory, Research and Clinical Applications (1999) New York/London: Guilford Press. Dozier M. Attachment-based treatment for vulnerable children. Attachment and Human Development (2003) 5(3):253–6.[CrossRef][Medline] Fearnley S. The Extra Dimension (1996) Rawtenstall, Rawtenstall Keys Attachment Centre. Fonagy P. Psychoanalytic theory from the viewpoint of attachment theory and research. In: Handbook of Attachment: Theory, Research, and Clinical Applications—Cassidy J., Shaver P. R., eds. (1999) New York: Guilford Press. 595–624. Hanson R., Spratt E. Reactive attachment disorder: What we know about the disorder and implications for treatment. Child Maltreatment (2000) 5(2):137–45.[Abstract/Free Full Text] Hart A., Lubbock B., Gerhardt C. The Attachment Project in Context (2002) Brighton: University of Brighton. Howe D. Child Abuse and Neglect: Attachment, Development and Intervention (2005) Basingstoke: Palgrave Macmillan. Howe D., Fearnley S. Disorders of attachment and attachment therapy. Adoption and Fostering (1999) 23(2):19–30. Hughes D. Building the Bonds of Attachment: Awakening Love in Deeply Troubled Children (1998) Lanham, MD: Jason Aronson. Keck G., Kupecky R. Adopting the Hurt Child (1998) Colorado: Pinon Press. Keys Child Care Services. Keys Attachment Centre. Opening Doors for Children and Families Promotional folder (1998) Rawtenstall: Keys Child Care Limited. McKelvey C., ed. Give them Roots, Let them Fly (1995) Cleveland: The Attachment Centre at Evergreen. Mercer J. Critique of Research on Attachment Therapy (2001) available online at (accessed 9 April 2009). Mercer J. Child psychotherapy involving physical restraint: Techniques used in four approaches. Child and Adolescent Social Work Journal (2002) 19(4):303–14.[CrossRef] Minnis H., Keck G. A clinical/research dialogue on reactive attachment disorder. Attachment and Human Development (2003) 5(3):297–301.[CrossRef][Medline] Myeroff R. L., Mertlich G., Gross G. Comparative effectiveness of holding therapy with aggressive children. Child Psychiatry and Human Development (1999) 29(4):303–13.[CrossRef][Web of Science][Medline] North J. The uses of control. The Psychotherapist (2006) 31. (Summer). O'Connor T. G., Nilson W. Models versus metaphors in translating attachment theory to the clinic and community. In: Enhancing Early Attachments: Theory, Research, Intervention and Policy—Berlin L., Ziv Y., Amaya-Jackson L., Greenberg M. T., eds. (2005) New York and London: Guilford Press. O'Connor T. G., Zeanah C. Current perspectives on assessment and treatment of attachment disorders: Special issue. Attachment and Human Development (2003) 5(3):221–325.[CrossRef][Medline] Popper K. R. The Logic of Scientific Discovery (1965) New York: Harper. Prior V., Glaser D. Understanding Attachment and Attachment Disorders: Theory, Evidence and Practice (2006) London and Philadelphia: Jessica Kingsley. Randolph L. Does attachment disorder exist? Statistics, research, rationale. In: Give them Roots, Let them Fly—McKelvey C., Kearney N. E., eds. (1995) Kearney, NE: Morris Publishing. Rothbaum F., Weisz J., Pott M., Miyake K., Morelli G. Attachment and culture: Security in the United States and Japan. American Psychologist (2000) 55(10):1093–104.[CrossRef][Medline] Rushton A., Dance C. Adoption Support Services for Families in Difficulty: A Literature Review and Survey of UK Practice (2002) London: BAAF. Sroufe L. The role of infant–caregiver attachment in development. In: Clinical Implications of Attachment Theory—Belsky J., Nezworski T., eds. (1988) Hillsdale, NJ: Erlbaum. Srozier A., Krizek C., Sale K. Touch: Its use in psychotherapy. Journal of Social Work Practice (2003) 17(1):49–63.[CrossRef][Web of Science] Steele M., Hodges J., Kaniuk J., Hillman S., Henderson K. Attachment representations and adoption. Journal of Child Psychotherapy (2003) 29(2):187–205.[CrossRef] Thompson R. A. Multiple attachments multiply considered. Human Development (2005) 48:102–7.[CrossRef][Web of Science] Tronick E. Depressed mothers and infants: Failure to form dyadic states of consciousness. In: Postpartum Depression and Child Development (1997) London: Guilford Press. Waddell M. Inside Lives (2002) London: Kanac. Walter U. M., Petr C. Best Practices in Children's Mental Health (2004) University of Kansas/State of Kansas Dept of Social and Rehabilitation Services. Report 11. Welch M. G. Holding Time (1988) New York: Simon and Schuster. Yin R. K. The Case Study Anthology (2004) London: Sage. Zaslow R. W., Menta M. The Psychology of the Z-Process: Attachment and Activity (1975) San Jose: San Jose State University Press.

Actions (login required)

Edit record (repository staff only) Edit record (repository staff only)


Downloads per month over past year