Stern Richard S, King Ashley A, Diamond Guy
Center for Family Intervention Science, Drexel University, Philadelphia, Pennsylvania, USA.
J Clin Psychol. 2023 Jan;79(1):201-209. doi: 10.1002/jclp.23399. Epub 2022 Jun 25.
This exploratory pilot study (N = 3 sessions, 793 speech units) used task analysis to refine an early model of the attachment task in attachment-based family therapy (ABFT). The attachment task aims to repair long-standing parent-adolescent relational ruptures that inhibit parents from being a resource for adolescents recovering from depression and/or suicidality.
Video recordings of three attachment task sessions with strong adherence to the model were selected for intensive study. Two sessions were rated as successful (i.e., attachment was repaired) and one as unsuccessful (i.e., attachment repair did not occur). Sessions were then coded using Structural Analysis of Social Behavior (SASB).
The current SASB analysis provided empirical support for our previous clinical impression that the task involves three parts: (I) adolescent disclosure of attachment rupture, (II) parent disclosure, and (III) a more mutual conversation. SASB also provided insights into more subtle elements of the model.
Successful attachment sessions were associated with high parent affiliation and autonomy-both while affirming the adolescent's story and when disclosing their own experience. Unsuccessful task attempts were associated with parental enmeshment and hostile belittling, blaming, and distancing. An enhanced model of ideal parent behaviors during the attachment task is offered, including space for parent disclosure-perhaps even apology-that is both warm and independent, leading to a more mutual parent-adolescent conversation. Clinically, the findings support the importance of the therapist focusing on the process and quality of parent-child interactions to facilitate attachment repair.
本探索性试点研究（N = 3次治疗，793个言语单元）采用任务分析来完善基于依恋的家庭治疗（ABFT）中依恋任务的早期模型。依恋任务旨在修复长期存在的亲子关系破裂问题，这些问题阻碍了父母成为青少年从抑郁和/或自杀倾向中恢复过来的资源。
选择了三次严格遵循该模型的依恋任务治疗视频进行深入研究。两次治疗被评定为成功（即依恋关系得到修复），一次为不成功（即依恋关系未得到修复）。然后使用社会行为结构分析（SASB）对治疗过程进行编码。
当前的SASB分析为我们之前的临床印象提供了实证支持，即该任务包括三个部分：（I）青少年披露依恋关系破裂情况，（II）父母披露情况，以及（III）更具互动性的对话。SASB还为该模型更细微的元素提供了见解。
成功的依恋治疗与父母高度的归属感和自主性相关——无论是在肯定青少年的经历时，还是在披露自己的经历时。不成功的任务尝试与父母的过度卷入以及敌意的贬低、指责和疏远有关。本文提出了一个在依恋任务中理想父母行为的强化模型，包括为父母披露——甚至可能是道歉——留出空间，这种披露既温暖又独立，从而促成更具互动性的亲子对话。在临床上，这些发现支持了治疗师关注亲子互动过程和质量以促进依恋关系修复的重要性。
