Individual research recommendation details

Recommendation ID

NG26/2

Question

Attachment-focused interventions:- This research recommendation is composed of 2 parts.
Develop attachment-focused interventions to treat attachment difficulties in children aged over 5 years and young people who have been adopted or are in the care system.
Develop attachment-based interventions to promote secure attachment in children and young people who have been, or are at risk of being, maltreated.

Any explanatory notes
(if applicable)

Why this is important:- Attachment-focused interventions targeting adoptive parents, carers and children and young people are scarce. Most studies have targeted families of children on the edge of care and the evidence suggests some interventions are effective, therefore it is important to know whether similar interventions will work with other populations. Even less evidence is available on children aged over 5 years and young people, therefore attachment-focused interventions should consider targeting this age group.
There is also limited evidence on attachment-based interventions targeting attachment difficulties and parental sensitivity in children and young people who have been, or are at risk of being, maltreated. Maltreatment is strongly associated with children entering care. If ways to improve the parent–child relationship and prevent maltreatment can be identified, the likelihood of children and young people entering care and having attachment difficulties can be minimised. Evidence from groups aged 11–17 years is limited, therefore age-appropriate interventions targeting this age group are needed.
A randomised controlled trial should be carried out to compare the clinical and cost effectiveness of attachment-focused interventions to treat attachment difficulties in children aged over 5 years and young people who have been adopted or are in the care system. The intervention (for example, parental sensitivity and education training) should target the adoptive parents and carers with or without the children. Primary outcome measures may include:
- attachment
- parental sensitivity
- placement disruption
- educational performance
- behavioural problems.
A randomised controlled trial should also be carried out to compare the clinical and cost effectiveness of an attachment-based intervention to promote secure  attachment in children and young people who have been, or are at risk of being, maltreated, with usual care.
The intervention may target the child and/or the parent depending on the type of maltreatment (for example, sexual abuse or neglect).
Primary outcome measures may include the above, as well as ongoing maltreatment.
For both trials, there should be at least a 6-month to 1-year follow-up. Qualitative data may also be collected on the parents and child's experience of the intervention.

Source guidance details

Comes from guidance

Children’s attachment: attachment in children and young people who are adopted from care, in care or at high risk of going into care

Number

NG26

Date issued

November 2015

Other details