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High rates of adolescent depression and suicide present as a major international public health problem. Suicidal adolescents are often a daunting population for clinicians to work with given their high-risk. Of the few effective treatments for this population, many are often multi-modal involving individual and group therapy, medication, etc. A manualized, empirically supported family therapy for adolescents struggling with depression and suicide that requires only weekly sessions and which can be conducted on an outpatient, home-based, or inpatient basis is Attachment-Based Family Therapy (ABFT). Tested with diverse families, including low-income and minority families, the model is based on an interpersonal theory of depression, which proposes that the quality of family relationships may precipitate, exacerbate, or prevent depression and suicidal ideation. It is a trust-based, emotion-focused psychotherapy model aiming to repair interpersonal ruptures and rebuild an emotionally protective, secure-based, parent-child relationship.
The therapy is trauma-focused while also being brief and structured. Treatment is characterized by five treatment tasks: a) reframing the therapy to focus on interpersonal development, b) building alliance with the adolescent, c) building alliance with the parents, d) facilitation conversations to resolve attachment ruptures and e) promoting autonomy in the adolescent.
This four-day workshop will provide an introduction to ABFT. Attendees will gain a basic understanding of how to use attachment theory to guide family intervention as well as an introduction to the task structure of the model.
Attachment-Based Family Therapy (ABFT) is a manualized, empirically supported family therapy for adolescents and young adults designed to target family and individual processes associated with depression and suicide. Tested with diverse families, ABFT is a trust-based, emotion focused, process oriented, brief therapy. The model is organized by five treatment tasks that provide directionality.
Attachment-Based Family Therapy (ABFT) is a manualized, empirically supported family therapy for adolescents ages 12-18 and young adults and their parents that is designed to treat depression, eliminate suicidal ideation, and reduce dispositional anxiety. Tested with diverse families, including low-income and minority families, the model is based on an interpersonal theory of depression, which proposes that the quality of family relationships may precipitate, exacerbate, or prevent depression and suicidal ideation. In this model, ruptures in family relationships, such as those due to abandonment, neglect, or abuse, a harsh and negative parenting environment, or caregiver misattunements and empathic failures, influence the development of adolescent depression. Families with these attachment ruptures lack the normative secure base and safe haven context needed for an adolescent’s healthy development, including the development of emotion regulation and problem-solving skills. These adolescents may experience depression resulting from the attachment ruptures themselves or from their inability to turn to the family for support in the face of trauma outside the home. ABFT aims to strengthen or repair caregiver-adolescent attachment bonds and improve family communication. As the normative secure base is restored, caregivers become a resource to help the adolescent cope with stress, experience competency, and explore autonomy.
The workshop is intended for Counselors, Couples and Family Therapists, Mental Health Professionals Psychiatrists, Psychologists, Psychotherapists, and Social Workers.
Therapists in the U.S. need to have at least a master’s degree in social work, mental health counseling, clinical or counseling psychology, couple’s and family therapy or other mental health field (e.g., psychiatry, psychiatric nursing). If therapists are not licensed, they need to be employed somewhere where they are receiving supervision. International therapists need to have local certification or licensure allowing them to practice therapy.
At the completion of the workshop participants should be able to:
• Discuss the theoretical foundation of ABFT
• Describe the five treatment task structure of the model
• Describe how to organize therapy around interpersonal growth rather than behavioral management
• Discuss the importance of each of the five treatment tasks
• Describe the specific phases within each treatment task
• Apply specific strategies for facilitating the repair of interpersonal ruptures
Therapists should leave the workshop with a practical sense of how to apply the model with at least moderately cooperative families.
Lecture, case examples, exercises, therapy videos and role-plays will be used throughout the four days to deliver this workshop.
We recommend (but do not require) that participants read our official treatment manual Diamond, G.S., Diamond, G.M., & Levy, S.A. (2014) Attachment Based Family Therapy for Depressed Adolescents. Washington D.C: American Psychological Association, 244 pages. However, we do not require that participants read this.
Additional helpful literature is:
Bosmans, G., Santens, T., Vandevivere, E., & Ewing S. (2019). Attachment-based family therapy: een evidence-based systeemtherapeutisch behandelprogramma voor depressieve adolescenten 2 (2e herziene druk). In C. Braet & S. Bögels (Eds.), Protocollaire behandelingen voor kinderen en adolescenten met psychische klachten. Boom.
Diamond, G., Mason, S., Levy, S. (2019). Psychodynamic principles in attachment based family therapy. In D. Kealy & J.S. Ogrodniczuk (Eds.) Contemporary Psychodynamic Psychotherapy. New York: Elsevier.
Diamond, G., Russon, J. & Levy, S. (2016), Attachment-Based Family Therapy: A Review of the Empirical Support. Family Process, 55(3), 595-610. doi:10.1111/famp.12241
Diamond G., Russon J., Levy S. (2018) Attachment-Based Family Therapy. In: Lebow J., Chambers A., Breunlin D. (eds) Encyclopedia of Couple and Family Therapy. Springer, Cham
Diamond, G.S, Siqueland, L. & Diamond, G.M. (2003). Attachment-based family therapy: Programmatic treatment development. Clinical Child and Family Psychology Review, 6(2), 107-127. doi: 10.1023/A:1023782510786
Feder, M.M. & Diamond, G.M. (2015). Parent-therapist alliance and parent attachment-promoting behavior in attachment-based family therapy for suicidal and depressed adolescents. Journal of Family Therapy, 38(1), 82-101 doi:10.1111/1467-6427.12078
Scott, S., Diamond, G.S., & Levy, S.A. (2016). Attachment-based family therapy for suicidal adolescents: A case study. Australian and New Zealand Journal of Family Therapy, 37, 154-176.
Tsiveli, N., Nir-Gottlieb, O., Lifshitz, C., Diamond, G., Kobak, R., Diamond, G.M. (2020). Interventions associated with productive processing in the context of attachment-based family therapy for depressed and suicdal adolescents. Family Process, 59(2), 428-444. doi: 10.1111/famp.12445
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