Larissa Rossen

Attachment theory, with its core concepts, perspectives, and insights developed over the past five decades, is influential for professionals working with young children. However, practitioners face challenges translating attachment theory and research into practical applications. This manifests in attachment myths, theoretical misinterpretations, and inconsistency of application. This state‐of‐the‐art review is authored by 47 attachment researchers and practitioners and examines key insights from attachment theory to facilitate attachment‐aware practice for professionals working with children and their caregivers. Following the ongoing debate on practical relevance in attachment theory, we present both ‘strict’ and ‘expansive’ translational perspectives on applications for addressing preventative or clinical attachment concerns. We first review core attachment propositions, based on replicated research of attachment and caregiving. We next address common misconceptions that hinder adequate practical applications. We present measures of attachment and sensitive parenting that might be helpful for practitioners. We also review evidence‐based and promising attachment interventions, discussing core components of (preventative) support for parents or caregivers and the children in their care. We emphasize that attachment theory's clinical value lies not in assigning attachment classifications, but rather in understanding crucial insights into caregiving and early socioemotional development (e.g., secure base phenomena; the value of safe, stable, and shared good‐enough care), developed in attachment research over the past 50 years, that may inform policy and clinical reasoning and areas for prevention and intervention.

Women’s career development amid the COVID-19 pandemic suggests that we may be facing a ‘female recession’, where women are at significantly increased risk for dropping out of the workforce with the gender gap in the workplace likely to grow. However, the pandemic may have presented opportunities for working mothers to engage creatively in personal career decisions due to increased opportunities to work flexibly and pivot in a very quickly changing labour market. This qualitative study used the enhanced critical incident technique to explore the intersection of working mothers and career development considering the COVID-19 pandemic. Participants for this study were a sample of 18 working mothers in North America and Australia. Key factors that were identified as helping women do well in their career development during COVID-19 included: Supportive workplaces, social support, personal protective factors, job market factors, and resources (predominantly financial). Hindering factors to working mothers’ career development included: workplace challenges, family challenges, personal stressors, job market factors, COVID-19 mandates and restrictions, and childcare. The findings from this study help elucidate factors that contribute to a meaningful and productive career so that clinicians and other professionals can support, advocate, and encourage women who remain working during motherhood.

This qualitative study explores infant‐family mental health experts' perspectives and experiences regarding the inclusion of infants in the family therapy setting. Infant socioemotional development is relational in nature and evolves in the context of both dyadic attachment relationships and broader multi‐person co‐parenting systems. Given this, we sought to understand why family therapy interventions involving families with infants rarely include the infant in a triangular or family systemic approach. Interviews were completed by clinical and/or research experts whose work integrates tenets of both infant mental health (IMH) and family theory and therapy. All interviewees brought at least 5 years of expertise and were actively engaged in the field. Interviewees expressed consistent beliefs that infants have a rightful and helpful place in family therapy approaches. They maintained that infants' innate social drive and communicative capacities position them to make meaningful and clinically significant contributions within family and systemic psychotherapy contexts. Noting that infants have remained on the periphery of these practices, experts advocated expansion and greater integration between IMH and family therapy, while preserving each field's distinctive identity. Experts reported that the interplay between IMH and family therapy fields has been uni‐directional as family systems concepts are embedded within IMH approaches, but few IMH premises are incorporated in mainstream family therapy practices. The disconnect was attributed to multiple factors, including graduate and professional training and theoretical, clinical, research, and sociocultural barriers, which were mutually reinforcing. Experts also identified clinical gains for both infants and family members when infants were meaningfully included in family interventions. Common ground was identified between the disciplines, with a belief that relationally distressed young children and parents are best served by clinical engagement with their network of relationships. Results call for greater collaboration between disciplines to challenge existing traditions and to more fully include infants in mainstream family therapy. Recommendations for integration of family therapy and IMH in clinical, theoretical, research, training, and sociocultural domains are offered.

Background: Maternal identity, a mother’s internalized view of self as mother, has not been studied in relation to perinatal loss. This study aimed to investigate how women construct a sense of maternal identity after the loss of a baby. Methods: We interviewed 10 mothers who had experienced perinatal loss. A Listening Guide framework for narrative analysis was used to identify patterns of giving voice to the mother’s own story. Results: We identified 12 overarching voices which fell within three distinct groupings: voices of motherhood, voices of grief, and voices of growth. Although bereaved mothers grappled with constructing their maternal identity, they also demonstrated how maternal identity is individually and intuitively created through an honouring and remembering of the child that was lost, resulting in significant growth. Conclusions: There is need for a broader definition of what constitutes motherhood to encapsulate diverse mothering experiences, including perinatal loss.

Single and childless women over the age of 35 constitute an expanding demographic in North America and many parts of the world, yet our society continues to place importance on marriage and family as markers of life success. This study explored how eight single (never-married) and childless women experience themselves during early midlife (ages 35–45) utilizing the Listening Guide method of analysis. Three categories of participant voices were uncovered in this research: voices which conveyed the positivity of living a single and childless identity (i.e. the voices of hope, faith, gratitude, nurturance, freedom, and resilience), voices which conveyed the struggles of living a single and childless identity (i.e. the voices of invisibility, shame, confusion, loneliness, guilt, longing, and uncertain waiting), and the voice of ambivalence. Implications for clinical practice and research are discussed.

Purpose: Maternal psychological distress and mother-infant bonding problems each predict poorer offspring outcomes. They are also related to each other, yet the extensive literature reporting their association has not been meta-analysed.Methods: We searched MEDLINE, PsycINFO, CINAHL, Embase, ProQuest DTG, and OATD for English-language peer-reviewed and grey literature reporting an association between mother-infant bonding, and multiple indicators of maternal psychological distress.Results: We included 133 studies representing 118 samples; 99 samples (110,968 mothers) were eligible for meta-analysis. Results showed concurrent associations across a range of timepoints during the first year postpartum, between bonding problems and depression (r= .27 [95% CI 0.20, 0.35] tor= .47 [95% CI 0.41, 0.53]), anxiety (r= .27 [95% CI 0.24, 0.31] tor= .39 [95% CI 0.15, 0.59]), and stress (r= .46 [95% CI 0.40, 0.52]). Associations between antenatal distress and subsequent postpartum bonding problems were mostly weaker and with wider confidence intervals: depression (r= .20 [95% CI 0.14, 0.50] tor= .25 [95% CI 0.64, 0.85]), anxiety (r= .16 [95% CI 0.10, 0.22]), and stress (r= .15 [95% CI − 0.67, 0.80]). Pre-conception depression and anxiety were associated with postpartum bonding problems (r= − 0.17 [95% CI − 0.22, − 0.11]).Conclusion: Maternal psychological distress is associated with postpartum mother-infant bonding problems. Co-occurrence of psychological distress and bonding problems is common, but should not be assumed. There may be benefit in augmenting existing perinatal screening programs with well-validated mother-infant bonding measures.

This study explored relational grieving in community by examining how community members grieve with bereaved parents after the death of a child. Three bereaved parent couples and their community members were interviewed together using the qualitative action‐project method to examine their shared grieving actions. Data was analyzed through top‐down and bottom‐up processes to understand the shared intentions of their grieving actions together. The findings of this research elicited thick descriptions of relational grieving at a community level. Four main assertions of how communities grieve with bereaved parents emerged, and include: (a) selflessly offering emotional and practical support, (b) engaging in and honouring vulnerability, (c) holding the complexity of grieving, and (d) fostering remembrance of the deceased child together. The novel descriptions of relational grieving in community contributed to the growing area of relational bereavement research. The theoretical, empirical, and clinical implications of this study are discussed.

Purpose Adopted children are at heightened risk for developing attachment insecurity due to relational disruptions experienced early in life. A newly developed therapy, Lifespan Integration (LI; Pace in Lifespan Integration: Connecting ego states through time (5th ed.), 2012), shows promise in reducing psychopathology and other detrimental outcomes with individuals exhibiting disrupted attachment. In this study, the efficacy of LI for addressing attachment processes with adopted children in middle childhood was investigated. Methods A Hermeneutic Single Case Efficacy Design (Elliott in Psychotherapy Research, 12(1), 1-21, 2002 & The handbook of humanistic psychology: Theory, research and practice (2nd ed., pp. 351-360), 2015) was used to gather quantitative and qualitative data from an adoptive parent–child dyad experiencing LI therapy for the first time. The research participant, a 12-year-old male, received 10 sessions of LI therapy with his adoptive mother present to facilitate a more secure attachment. Results Client change and the contribution of LI to this change was advocated by expert case developers, and adjudicated by three experts, who concluded that change occurred and that this change was due to LI therapy. Changes in internal attachment processes, and the attachment bond between the parent and child of this dyad, was observed. Conclusions This case provides evidence that attachment disruptions can potentially be repaired in middle childhood and ought to be targeted for intervention in early childhood and beyond to prevent later socio-emotional and psychological issues.

Childhood trauma is a devastating reality with immense psychological impact to a child. Outcome research of therapy with trauma-exposed children is scarce and mostly focuses on cognitive and behavioural changes. Anecdotal evidence suggests that Lifespan Integration (LI) therapy purports to integrate traumatic experiences into a cohesive autobiographical narrative. In this research study, we investigate the efficacy of LI with children through the careful examination of one participant. We applied Robert Elliott’s Hermeneutic Single Case Efficacy Research Design (HSCED; 2002, 2014), which uses quantitative and qualitative data to argue for and against therapy efficacy. The 12-year-old research participant received nine sessions of LI over 3 months, and data was collected before, throughout, and after therapy. The extent of the client’s change over the course of therapy was investigated, as well as LI’s contribution to the change, and what parts of LI were most helpful in bringing about change. Findings indicate that the client changed significantly over the course of therapy with lasting effects at follow-up, and that LI was substantially responsible for this change. Conclusions: The results provide evidence for LI as an important tool that mental health professionals can use to help trauma-exposed children.