Clinical Applications of the Adult Attachment Interview

Howard Steele, PhD, is Professor and Chair of the Clinical Psychology Faculty and Co-Director of the Center for Attachment Research at The New School for Social Research. Dr. Steele is senior and founding editor of the journal Attachment and Human Development and founding and past president of the Society for Emotion and Attachment Studies. He has published more than 100 journal articles and book chapters, many in collaboration with Miriam Steele, in the areas of attachment theory and research, intergenerational patterns of attachment, mourning in response to trauma and loss, and attachment-based interventions to prevent child maltreatment and promote secure, organized attachments. With Miriam Steele and Anne Murphy, Dr. Steele has pioneered the development of Group Attachment-Based Intervention (GABI©), aimed at preventing child maltreatment and promoting attachment security. He is a recipient of the 2017 Bowlby–Ainsworth Award from the Center for Mental Health Promotion, which cited his contributions as a scientist, editor, and clinical innovator.Miriam Steele, PhD, is Professor of Psychology and Co-Director of the Center for Attachment Research at The New School for Social Research. She trained as a psychoanalyst at the Anna Freud Centre. Her work aims to bridge the world of psychoanalytic thinking and clinical practice with contemporary research in child development. She initiated the London Parent–Child Project, a major longitudinal study of intergenerational patterns of attachment that gave rise to the concept of "reflective functioning." She has published more than 100 journal articles and book chapters, many in collaboration with Howard Steele. With Howard Steele and Anne Murphy, Dr. Steele has pioneered the development of Group Attachment-Based Intervention (GABI©), aimed at preventing child maltreatment and promoting attachment security. She is a recipient of the 2017 Bowlby–Ainsworth Award from the Center for Mental Health Promotion, which cited her innovative longitudinal studies and translational research on attachment and mental representation.

• Foreword, June SroufeI. The AAI in Clinical Context1. Ten Clinical Uses of the Adult Attachment Interview, Howard Steele and Miriam Steele2. Studying Differences in Language Usage in Recounting Attachment History: An Introduction to the Adult Attachment Interview, Mary Main, Erik Hesse, and Ruth Goldwyn3. The Distribution of Adult Attachment Representations in Clinical Groups: A Meta-Analytic Search for Patterns of Attachment in 105 AAI Studies, Marinus H. van IJzendoorn and Marian J. Bakermans-KranenburgII. Intervention Research with Mothers, Infants, and Toddlers4. The AAI Anticipates the Outcome of a Relation-Based Early Intervention, Christoph M. Heinicke and Mónica Susana Levine5. Adult Attachment, Parental Commitment to Early Intervention, and Developmental Outcomes in an African American Sample, Douglas M. Teti, Lauren A. Killeen, Margo Candelaria, Wendy Miller, Christine Reiner Hess, and Melissa O’Connell6. Attachment-Theory-Informed Intervention and Reflective Functioning in Depressed Mothers, Sheree L. Toth, Fred A. Rogosch, and Dante CicchettiIII. Parent–Infant Relationships, Adolescents, and Adults in Psychotherapy7. The AAI as a Clinical Tool, Amanda Jones 8. Integrating the AAI in the Clinical Process of Psychoanalytic Parent–Infant Psychotherapy in a Case of Relational Trauma, Tessa Baradon and Miriam Steele9. Obsessive–Compulsive Disorder in Adolescence: An AAI Perspective, Tord Ivarsson 10. The AAI in a Clinical Context: Some Experiences and Illustrations, Massimo Ammaniti, Nino Dazzi, and Sergio Muscetta11. The Reciprocal Impact of Attachment and Transference-Focused Psychotherapy with Borderline Patients, Diana Diamond, Frank E. Yeomans, John F. Clarkin, Kenneth N. Levy, and Otto F. KernbergIV. The AAI and Trauma 12. The AAI and Its Contribution to a Therapeutic Intervention Project for Violent, Traumatized, and Suicidal Cases, Sonia Gojman de Millán and Salvador Millán 13. Adult Attachment and Posttraumatic Stress Disorder in Women with Histories of Childhood Abuse, K. Chase Stovall-McClough, Marylene Cloitre, and Joel F. McClough14. AAIs in a High-Risk Sample: Stability and Relation to Functioning from Adolescence to 39 Years, Judith A. Crowell and Stuart T. Hauser15. Exploring the Mind Behind Unresolved Attachment: Lessons from and for Attachment-Based Interventions with Infants and Their Traumatized Mothers, Greg Moran, Heidi Neufeld Bailey, Karin Gleason, Carey Anne DeOliveira, and David R. Pederson16. Hostile–Helpless States of Mind in the AAI: A Proposed Additional AAI Category with Implications for Identifying Disorganized Infant Attachment in High-Risk Samples, Sharon Melnick, Brent Finger, Sydney Hans, Matthew Patrick, and Karlen Lyons-RuthV. The AAI, Foster Care, and Adoptive Placements17. Forecasting Outcomes in Previously Maltreated Children: The Use of the AAI in a Longitudinal Adoption Study, Miriam Steele, Jill Hodges, Jeanne Kanuik, Howard Steele, Saul Hillman, and Kay Asquith18. Helping Foster Parents Change: The Role of Parental State of Mind, Johanna Bick and Mary DozierAfterword, Deborah Jacobvitz

"Steele and Steele have brought together a really valuable set of data and ideas concerning the Adult Attachment Interview (AAI), one of the more intriguing and powerful clinical and research tools available in psychology. The book stands out as a serious and ambitious attempt to translate the AAI--and attachment theory more broadly--to multiple clinical contexts. Chapters are written by leading clinicians and scientists, and each is focused and thoughtful, showing, for example, how the AAI informs case conceptualization in individual treatment. This volume deserves to be widely read. It is highly accessible for those just beginning to apply attachment theory to research and practice, but there is also enough that is new to please experienced fans of the AAI."--Thomas G. O'Connor, PhD, Department of Psychiatry, University of Rochester Medical Center"Exceptionally coherent and immensely helpful, this book comprehensively reviews how the Adult Attachment Interview (AAI) can be used to guide clinical work in a range of high-priority contexts. This remarkable instrument, which has more than proved itself in the developmental laboratory, also turns out to be a marvelous and versatile tool in the hands of the creative clinician. An essential book for all those who work with children and adults."--Peter Fonagy, OBE, FMedSci, FBA, FAcSS, Head, Division of Psychology and Language Sciences, University College London, United Kingdom; Chief Executive, Anna Freud Centre"This impressive volume reports novel theoretical insights and clinical practices inspired by the Adult Attachment Interview (AAI). The authors use groundbreaking empirical studies, illustrated with fascinating and emotionally moving case examples, to show how AAI-related interventions help troubled, disadvantaged parents and children. The book illustrates beautifully how science and society benefit from a coherent integration of profound theory, clinical creativity, and ambitious but careful research. It is highly relevant to researchers, clinicians, and child welfare policymakers, as well as advanced students in psychology, psychiatry, social work, social policy, and related fields."--Phillip R. Shaver, PhD, Distinguished Professor of Psychology, University of California, Davis- This book provides a thorough introduction to the instrument, its coding, and classification system. But its main contribution is the way in which it brings together leading experts in the field to present research findings and case material to show how the AAI can systematically be used in assessment and diagnosis, to design and tailor interventions, to facilitate goal setting and treatment planning, to inform and strengthen the therapeutic alliance, and to monitor therapeutic progress....[A] timely, well-presented, and valuable book, every chapter of which provides illuminating insights and evidence of the range and depth of the AAI's multiple uses. It should be of considerable interest to clinicians and practitioners from all disciplines, as well as to researchers, and students. --British Journal of Psychiatry, 3/5/2008ƒƒ Because the AAI is such a pervasive technique for conducting attachment research and understanding attachment relationships, this detailed volume is worthwhile for any practitioner interested in applying the theory of attachment. --EABP Newsletter, 9/26/2010