Applying attachment theory to effective practice with hard-to-reach youth: the AMBIT approach

Attachment & Human Development
Dickon BevingtonPeter Fonagy

Abstract

Adolescent Mentalization-Based Integrative Treatment (AMBIT) is a developing approach to working with "hard-to-reach" youth burdened with multiple co-occurring morbidities. This article reviews the core features of AMBIT, exploring applications of attachment theory to understand what makes young people "hard to reach," and provide routes toward increased security in their attachment to a worker. Using the theory of the pedagogical stance and epistemic ("pertaining to knowledge") trust, we show how it is the therapeutic worker's accurate mentalizing of the adolescent that creates conditions for new learning, including the establishment of alternative (more secure) internal working models of helping relationships. This justifies an individual keyworker model focused on maintaining a mentalizing stance toward the adolescent, but simultaneously emphasizing the critical need for such keyworkers to remain well connected to their wider team, avoiding activation of their own attachment behaviors. We consider the role of AMBIT in developing a shared team culture (shared experiences, shared language, shared meanings), toward creating systemic contexts supportive of such relationships. We describe how team training may enhance the team's ...Continue Reading

References

Apr 19, 2005·Mental Health Services Research·Bruce F ChorpitaJohn R Weisz
Oct 8, 2005·Attachment & Human Development·Arietta SladeAlison Locker
Jan 3, 2006·The British Journal of Psychiatry : the Journal of Mental Science·Peter Fonagy, Anthony Bateman
Jan 27, 2007·Philosophical Transactions of the Royal Society of London. Series B, Biological Sciences·Chris D Frith
Apr 7, 2010·Journal of Evaluation in Clinical Practice·Nancy Cartwright, Eileen Munro
Mar 2, 2011·Philosophical Transactions of the Royal Society of London. Series B, Biological Sciences·Gergely Csibra, György Gergely
May 31, 2011·Journal of the American Academy of Child and Adolescent Psychiatry·Carla SharpPeter Fonagy
Jan 1, 2011·Infant Mental Health Journal·Peter FonagyLane Strathearn
May 1, 2008·Child and Adolescent Mental Health·John R Weisz, Jane Simpson Gray

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Citations

Apr 4, 2015·Attachment & Human Development·R Rogers Kobak, Patricia K Kerig
Oct 30, 2016·Children·Theresa J Donnelly, Tiina Jaaniste
Mar 17, 2018·Journal of Trauma & Dissociation : the Official Journal of the International Society for the Study of Dissociation (ISSD)·Manuela GanderKathrin Sevecke
Jun 20, 2019·Frontiers in Psychiatry·Marco ArmandoMartin Debbané
Jan 29, 2019·Early Intervention in Psychiatry·Alice ThomsonMatthias Schwannauer
Aug 10, 2018·Computational Psychiatry·Michael MoutoussisRaymond J Dolan

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Software Mentioned

Firefox
AMBIT

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