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How Attachment-Based Family Therapy Works

Attachment-Based Family Therapy (ABFT) involves working with a mental health professional to assist a parent and their child in repairing broken-down relationships and developing or rebuilding meaningful relationships.

Adolescents with suicidal ideation or depression benefit from Clearfork’s treatment plans based on attachment theory to help improve family relationships.

According to attachment theory, secure attachment develops when parents are consistently available and sensitive to their children’s needs.

A family receiving their first attachment-based family therapy here at CA; call us today to find out more!

What Types of Issues Can ABFT Help With?

The treatment of adolescent depression and suicide —typically those aged 12 to 18—is the main focus of ABFT and is informed by more contemporary systemic approaches such as multidimensional family therapy and emotionally-focused therapy.

While other types of therapy, like cognitive behavioral therapy, are commonly used to treat depression, ABFT is unique in that it addresses depression, suicidality, and trauma in adolescents through family interventions. It also incorporates elements from the structural family therapy tradition.

| The ABFT therapists believe it positively alters family conflict and negative interactions and may also benefit other mental health issues.

However, the majority of ABFT-related research to date has focused on its efficacy as a treatment for adolescents with depression and suicidal ideation. Adolescent mental health can improve through a well-structured and positive family therapy model.

Therapists use people’s instinctive desire to feel securely attached to others as the primary mechanism for change and emphasize this instinct.

Therapists encourage adolescents to engage in social activities outside of the home that will foster competence and independence as tension and conflict at home diminish. When adolescents explore these new opportunities, their parents serve as the secure foundation from which they seek comfort, guidance, support, and encouragement.

While insecure attachments can increase the likelihood of emotional and behavioral issues developing, having a secure attachment with parents and family members is an important mental health safeguard.

Negative, inconsistent, inappropriate, neglectful, or abusive early interactions between a child and their caregiver can lead to insecure attachments and negative adolescent mental health.

Behaviors stemming from insecure attachment may include:

  • Inability to form positive relationships with family and peers
  • Quick to anger or become upset
  • Scared of vulnerable emotions
  • Being withdrawn
  • Show little emotional response or confused emotional responses
  • Hyperactivity and difficulty concentrating

Behavior management may be challenging with all of these issues at home or school. Some children who are going through these things and don’t have attachment security may act in ways that are meant to help them deal with their environment, but it can be hard for parents and families to understand and handle.

Teen showing frustration and worried about her current state, while mom has news of ABFT.

How Attachment-Based Family Therapy Repairs Relationships

The ABFT model focuses on family and individual processes that are associated with adolescent depression. However, it can be used effectively with any family with teenagers. It is emotionally centered, and the model provides structure and objectives, enhancing the family therapist’s focus and intentionality.

Interpersonal theories have suggested that the quality of family psychology and relationships can either cause, exacerbate, or prevent teenage depression. It is a trust-based, emotion-focused model that aims to target family dynamics and fix interpersonal rifts and rebuild a parent-child relationship that is emotionally secure.

How Does ABFT Work to Improve the Relationship Between Parents and Their Teenagers?

Teenagers may develop depression due to the breakups of their attachments or their inability to seek support from family members when confronted with trauma. The improvement of family relationships and the strengthening or repair of parent-child attachment bonds are the goals of ABFT. Parents become a resource for assisting their children in coping with their mental health as a secure base is restored through family therapy.

Teen engaging in ABFT and feeling the power of letting go of things that are negatively impacting his life.

Phases of Attachment-Based Family Therapy

There are five distinct treatment phases in ABFT, each with specific objectives and strategies. ABFT provides a clear path to healing and recovery by repairing attachment relationship breaks at each step.

They are:

  • Interpersonal development – Therapy aims to improve the parent-child relationship rather than just the symptoms.
  • Building a bond with the adolescent – The therapist learns about the adolescent’s interests and strengths during individual sessions.
  • Building a bond with parents – Forming a relationship with the child’s parents in sessions without the child.
  • Resolving attachment ruptures – The therapist brings the parents and adolescents together to discuss the teen’s concerns when they are ready.
  • Gaining competency in adolescents – Teens are encouraged to socialize and participate in activities outside of the home by therapists.

Attachment-Based Family Therapy for Teen Depression

Attachment-based family therapy is a treatment model that is tailored to the particular requirements of depressed adolescents and their families. The framework directs the process of repairing broken relationships and rebuilding trustworthy family relationships, known as attachment theory.

The problem therapists target with specific treatment strategies or tasks is known risk factors for depression, such as criticism, hostility, parenting skills, and disengagement. They are all examples of parental problem states and can cause core family conflicts.

Motivation, a negative self-concept, poor affect regulation, and disengagement are problems in adolescents that can cause depressive symptoms. Reframing, building alliances with the adolescent and the parent, addressing attachment failures, and building competency are key aspects of multidimensional family therapy.

Attachment-Based Family Therapy and Suicidal Ideation

One of the treatments that can lower the number of attempts and thoughts of suicide is Attachment-Based Family Therapy. ABFT focuses on the clinical context – such as family trauma – which may account for this model’s effectiveness in preventing adolescent suicide and processes within the mind.

The model, which is based on attachment theory, aims to assist adolescents in regaining a more secure attachment relationship with their parents so that secure-based parenting can assist the adolescent in preventing stress, self-harm, and suicide ideation in the future.

Attachment-Based Family Therapy for Anxiety

Working with adolescents with anxiety disorders is another application of Attachment-Based Family Therapy. The combination of ABFT and Cognitive Behavioural Therapy is the basis of this strategy. For adolescents with anxiety, this can be an effective family therapy model.

The main processes investigate parents’ psychological control over family conflict, family modeling of anxious behavior, encouraging avoidance, and parents’ beliefs about anxiety.

Parents who have anxious adolescents encourage their children to avoid anxious behaviors. In addition, they make an effort to exert control over the events that their adolescent goes through to avert anxiety symptoms. Teens become overly dependent on their parents as a result.

What Is a Secure Attachment?

This is often considered the most beneficial kind of attachment. It describes an attachment in which their caregiver’s presence reassures a child, and securely attached children feel safe and has someone they can rely on.

Children with a more securely attached relationship are more comfortable exploring their environment with their caregiver present and seeking comfort in their caregiver.

A family starring into the mountains after they just finished their last attachment based therapy session here at Clearfork Academy.

What are Attachment Techniques Used in therapy?

In attachment-based family therapy, clients will often talk about events from their childhood and how they might affect their life now.

Their relationships with their primary caregiver, such as parents, grandparents, foster parents, or adoptive parents, will likely receive much attention from a family therapist. The therapist analyzes how those early dynamics still manifest today.

They will likely shift the focus to adult interpersonal relationships with friends, romantic partners, and coworkers. Everything is connected to assisting them in coping with life in the healthiest way possible, and couples, groups, and families can all benefit from attachment-based therapy.

What is the structure of ABFT treatment?

Attachment therapy is guided by two fundamental processes. The first is for the therapist and patient to develop a relationship that gradually becomes more open and secure.

In attachment-based psychotherapy, the second central process addresses the emotions and communications that the patient has learned to suppress or overemphasize in early attachment relationships; it is the facilitation and strengthening of adaptive capacities.

Attachment-Based Family Therapy at Clearfork Academy

Adolescents with attachment issues and adverse mental health need the dedicated support of a family therapist. Clearfork encourages families to take part in our family sessions and programs.

If you’re at a crossroads in your life, let Clearfork guide you in the right direction; get in touch via our website or call (866)-650-5212 at any time of the day.

FAQ About ABFT


What Type of Therapy Is Used for Attachment Issues?

Play therapy and family therapy are often used with children and adolescents. Psychotherapy aims to help the child develop strategies for coping with the symptoms of attachment difficulties while also strengthening the bond between the child and the caregiver, depending on the circumstances.

While not all of the methods are effective for every individual, they all share one thing in common – their focus on a strong family bond.


Can Other Family Members, Besides Parents, Attend ABFT Treatment?

In attachment-based family therapy, clients discuss past events and how they might affect their current situation. Family therapists will pay attention to their relationships with their primary caregivers, such as parents, grandparents, foster parents, or adoptive parents. The therapist looks at how those early dynamics are relevant today.


Is ABFT Evidence-Based?

Attachment-based family therapy is the only empirically supported family therapy model designed to treat depressed adolescents, including those at risk of suicide, and their families, according to the National Library of Medicine (NIH). ABFT aims to mend interpersonal rifts and rebuild an emotionally protective relationship.


Who Founded Attachment-Based Family Therapy?

Attachment-based family therapy applies to interventions or approaches based on attachment theory, originated by John Bowlby, a British psychologist.

Bowlby sought new understanding from disciplines like evolutionary biology, ethology, developmental psychology, and cognitive science because he was dissatisfied with conventional theories. These disciplines served as the foundation for attachment-based therapy.

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