Proposal for a structured assessment of parenting based on attachment theory: theoretical background, description and initial clinical experience.

This paper proposes a structured clinical assessment of parenting and illustrates its use within child psychiatry practice. The aim was to develop a structured instrument based on current theoretical knowledge which was simple enough to be clinically viable while being precise and repeatable enough to enable quantification and research. Use is made of inpatient and daypatient resources but the assessment could be modified for outpatient practice. The assessment takes a "diagnostic" approach; concentrating on factors that have been shown in research to be good predictors of parenting dysfunction. These include parental personality, current mental state and degree of current social stress and support (including quality of marital relationship). Additionally, information regarding the adult's representation of early attachment relationships is elicited using the Adult Attachment Interview. Independent assessments of the child and the parent/child interaction are made. Initial clinical experience with this instrument is described and practical and theoretical issues raised by its use are explored.