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Attachment therapy is a controversial category of alternative child mental health interventions intended to treat attachment disorders.〔 The term generally includes accompanying parenting techniques. Other names or particular techniques include "the Evergreen model", "holding time", "rage-reduction", "compression therapy", "rebirthing", "corrective attachment therapy" and Coercive Restraint Therapy.〔 It is found primarily but not exclusively in the United States and much of it is centered in about a dozen clinics in Evergreen, Colorado, where Foster Cline, one of the founders, established his clinic in the 1970s. This article describes this particular set of interventions although in clinical literature the term "attachment therapy" is sometimes used loosely to mean any intervention based, or claiming to be based, on attachment theory, particularly outside the USA. Attachment therapy as described in this article should not be confused with other schools of therapy which are more empirically based and which aim to address problems stemming from disrupted attachment to caregivers.〔Dozier M and Rutter M (2008). "Challenges to the Development of Attachment Relationships Faced by Young Children in Foster and Adoptive Care". In Cassidy J and Shaver PR. Handbook of Attachment: Theory, Research and Clinical Applications (2nd ed.). New York: London: Guilford Press. ISBN 978-1-60623-028-2〕 Attachment therapy is a treatment used primarily with fostered or adopted children who have behavioral difficulties, sometimes severe, but including disobedience and perceived lack of gratitude or affection for their caregivers. The children's problems are ascribed to an inability to attach to their new parents, because of suppressed rage due to past maltreatment and abandonment. The common form of attachment therapy is ''holding'' therapy, in which a child is firmly held (or lain upon) by therapists or parents. Through this process of restraint and confrontation, therapists seek to produce in the child a range of responses such as rage and despair with the goal of achieving catharsis. In theory, when the child's resistance is overcome and the rage is released, the child is reduced to an infantile state in which he or she can be "re-parented" by methods such as cradling, rocking, bottle feeding and enforced eye contact. The aim is to promote attachment with the new caregivers. Control over the children is usually considered essential and the therapy is often accompanied by parenting techniques which emphasize obedience. These accompanying parenting techniques are based on the belief that a properly attached child should comply with parental demands "fast, snappy and right the first time" and should be "fun to be around".〔 These techniques have been implicated in several child deaths and other harmful effects.〔Task Force Report, Chaffin et al. p. 77〕 This form of "therapy", including diagnosis and accompanying parenting techniques, is not scientifically validated, nor is it considered to be part of mainstream psychology. It is, despite its name, not based on attachment theory, with which it is considered incompatible. It is primarily based on Robert Zaslow's rage-reduction therapy from the 1960s and '70s and on psychoanalytic theories about suppressed rage, catharsis, regression, breaking down of resistance and defence mechanisms. Zaslow, Tinbergen, Martha Welch and other early proponents used it as a treatment for autism, based on the now discredited belief that autism was the result of failures in the attachment relationship with the mother. It has been described as a potentially abusive and pseudoscientific intervention that has resulted in tragic outcomes for children, including at least six documented child fatalities. Since the 1990s there have been a number of prosecutions for deaths or serious maltreatment of children at the hands of "attachment therapists" or parents following their instructions. Two of the most well-known cases are those of Candace Newmaker in 2000 and the Gravelles in 2003. Following the associated publicity, some advocates of attachment therapy began to alter views and practices to be less potentially dangerous to children. This change may have been hastened by the publication of a Task Force Report on the subject in January 2006, commissioned by the American Professional Society on the Abuse of Children (APSAC) which was largely critical of attachment therapy.〔Task Force Report, Chaffin et al.〕 In April 2007, ATTACh, an organization originally set up by attachment therapists, formally adopted a White Paper stating its unequivocal opposition to the use of coercive practices in therapy and parenting, promoting instead newer techniques of attunement, sensitivity and regulation.〔 Some leading attachment therapists have also specifically moved away from coercive practices. This form of treatment differs significantly from evidence-based attachment-based therapies, talking psychotherapies such as attachment-based psychotherapy and relational psychoanalysis or the form of attachment parenting advocated by the pediatrician William Sears. Further, the form of rebirthing sometimes used within attachment therapy differs from the unrelated breathing therapy known as Rebirthing. ==Treatment characteristics== The controversy, as outlined in the 2006 American Professional Society on the Abuse of Children (APSAC) Task Force Report,〔 has broadly centered around "holding therapy" and coercive, restraining, or aversive procedures. These include deep tissue massage, aversive tickling, punishments related to food and water intake, enforced eye contact, requiring children to submit totally to adult control over all their needs, barring normal social relationships outside the primary caretaker, encouraging children to regress to infant status, reparenting, attachment parenting, or techniques designed to provoke cathartic emotional discharge. Variants of these treatments have carried various labels that change frequently. They may be known as "rebirthing therapy", "compression therapy", "corrective attachment therapy", "the Evergreen model", "holding time", "rage-reduction therapy"〔Task Force Report, Chaffin et al. p. 83〕 or "prolonged parent-child embrace therapy". Some authors critical of this therapeutic approach have used the term Coercive Restraint Therapy. It is this form of treatment for attachment difficulties or disorders which is popularly known as "attachment therapy".〔 Advocates for Children in Therapy, a group that campaigns against attachment therapy, give a list of therapies they state are attachment therapy by another name. They also provide a list of additional therapies used by attachment therapists which they consider to be unvalidated. Matthew Speltz of the University of Washington School of Medicine describes a typical treatment taken from The Center's material (apparently a replication of the program at the Attachment Center, Evergreen) as follows: "Like Welsh (''sic'')(1984, 1989), The Center induces rage by physically restraining the child and forcing eye contact with the therapist (the child must lie across the laps of two therapists, looking up at one of them). In a workshop handout prepared by two therapists at The Center, the following sequence of events is described: (1) therapist 'forces control' by holding (which produces child 'rage'); (2) rage leads to child 'capitulation' to the therapist, as indicated by the child breaking down emotionally ('sobbing'); (3) the therapist takes advantage of the child's capitulation by showing nurturance and warmth; (4) this new trust allows the child to accept 'control' by the therapist and eventually the parent. According to The Center's treatment protocol, if the child 'shuts down' (''i.e.'', refuses to comply), he or she may be threatened with detainment for the day at the clinic or forced placement in a temporary foster home; this is explained to the child as a consequence of not choosing to be a 'family boy or girl.' If the child is actually placed in foster care, the child is then required to 'earn the way back to therapy' and a chance to resume living with the adoptive family." According to the APSAC Task Force, "A central feature of many of these therapies is the use of psychological, physical, or aggressive means to provoke the child to catharsis, ventilation of rage, or other sorts of acute emotional discharge. To do this, a variety of coercive techniques are used, including scheduled holding, binding, rib cage stimulation (e.g., tickling, pinching, knuckling), and/or licking. Children may be held down, may have several adults lie on top of them, or their faces may be held so they can be forced to engage in prolonged eye contact. Sessions may last from 3 to 5 hours, with some sessions reportedly lasting longer... Similar but less physically coercive approaches may involve holding the child and psychologically encouraging the child to vent anger toward her or his biological parent."〔 The APSAC Task Force describes how the conceptual focus of these treatments is the child's individual internal pathology and past caregivers rather than current parent-child relationships or current environment. If the child is well-behaved outside the home this is seen as successful manipulation of outsiders, rather than as evidence of a problem in the current home or current parent-child relationship. The APSAC Task Force noted that this perspective has its attractions because it relieves the caregivers of responsibility to change aspects of their own behavior and aspirations. Proponents believe that traditional therapies fail to help children with attachment problems because it is impossible to establish a trusting relationship with them. They believe this is because children with attachment problems actively avoid forming genuine relationships. Proponents emphasize the child's resistance to attachment and the need to break it down. In rebirthing and similar approaches, protests of distress from the child are considered to be resistance that must be overcome by more coercion.〔 Coercive techniques, such as scheduled or enforced holding, may also serve the intended purpose of demonstrating dominance over the child. Establishing total adult control, demonstrating to the child that he or she has no control, and demonstrating that all of the child's needs are met through the adult, is a central tenet of many controversial attachment therapies. Similarly, many controversial treatments hold that children described as attachment–disordered must be pushed to revisit and relive early trauma. Children may be encouraged to regress to an earlier age where trauma was experienced or be reparented through holding sessions.〔 Other features of attachment therapy are the "two week intensive" course of therapy, and the use of "therapeutic foster parents" with whom the child stays whilst undergoing therapy. According to O'Connor and Zeanah, the "holding" approach would be viewed as intrusive and therefore non-sensitive and countertherapeutic, in contrast with accepted theories of attachment.〔 According to Advocates for Children in Therapy, "Attachment Therapy almost always involves extremely confrontational, often hostile confrontation of a child by a therapist or parent (sometimes both). Restraint of the child by more powerful adult(s) is considered an essential part of the confrontation." The purported correction is described as "... to force the children into loving (attaching to) their parents; ... there is a hands-on treatment involving physical restraint and discomfort. Attachment Therapy is the imposition of boundary violations – most often coercive restraint – and verbal abuse on a child, usually for hours at a time; ... Typically, the child is put in a lap hold with the arms pinned down, or alternatively an adult lies on top of a child lying prone on the floor." Psychiatrist Bruce Perry cites the use of holding therapy techniques by caseworkers and foster parents investigating a Satanic Ritual Abuse case in the late 1980s, early 1990s, as instrumental in obtaining lengthy and detailed alleged "disclosures" from children. In his opinion, using force or coercion on traumatised children simply re-traumatizes them and far from producing love and affection, produces obedience based on fear, as in the trauma bond known as Stockholm syndrome. 抄文引用元・出典: フリー百科事典『 ウィキペディア（Wikipedia）』 ■ウィキペディアで「attachment therapy」の詳細全文を読む スポンサード リンク
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