12-May-2014
Farida Raj

I had an invite from Seva Counselling Centre, to attend a lecture on Attachment 
Based Family Therapy (ABFT) by Dr. Pravin Israel, clinical psychologist and 
senior researcher at the Akershus University Hospital in Norway, with roots 
from Hyderabad. As a teacher and Counsellor, I had practiced Solution Focused 
Brief Therapy (SFBT) but ABFT - I had no idea!
According to Dr. Pravin, in India, relatively little importance seems to be 
given to the mental health problems of young people. Young people seldom seek 
help or come to mental health clinics.
Though parenting is fundamental to the survival and success of the human race, 
yet little scientific information is available about parenting. There exists a 
strong attachment between parent and child and when that bond is strained or 
ruptured, it leads to various mental health problems, among others, depression, 
self-injury and suicide in adolescents.
The quality of interpersonal relationships in family can precipitate or 
aggravate the above mentioned problems in adolescents, he says. ABFT explores 
the relationship between parent and the adolescent. It aims to repair 
interpersonal ruptures and rebuilds emotionally protective, secure-based, 
parent-child relationships.
The primary assumption of ABFT is that high family conflict, harsh criticism, 
physical or emotional neglect or abuse, can rupture attachment bonds. Ruptured 
attachments and a negative home environment may inhibit young people from 
developing the internal and interpersonal coping skills needed to safeguard 
against stress leading to depression.
According to Dr. Pravin, the adolescent phase is a complex one with needs, 
interests and desires that are strong and complicated. The adolescent tends to 
experience opposing desires and to waver between needs for support and 
independence, selfishness and selflessness, traditional values and a desire for 
individuality. Because of ambivalence in his views and judgments, it is often 
difficult for him to take a standpoint in close relationships. Such experiences 
create feelings of inadequacy and in turn, feelings of insecurity that 
overwhelms the adolescent.
Many adolescents strive towards goals and achievement levels that are 
un-realistic in view of their actual endowments and acquired abilities; they 
repeatedly fail and experience deep disappointment and even despair. Sometimes, 
parents pressure the adolescents and young adults into striving towards goals 
they lack the ability to achieve. This is often accompanied by feelings of 
inadequacy tinted with depression.
During adolescence conflicts arise from a variety of causes - quarrelling 
parents, nagging and teasing by a family member, being misunderstood by a 
friend or rejected by the peer group cause internal stress. When conflict and 
stress increase, it may lead to mental disturbances.
Adjusting aspirations to abilities and skills is essential in avoiding 
situations of severe conflict and in promoting personality integration. ABFT 
steps in to help adolescents and their parents address relationship issues and 
thereafter turn to solve other conflicts that may be bothering the adolescent.
According to attachment theory, individuals who have a safe and sound sense of 
security, have higher self esteem, are able to adapt to situations, have 
problem solving skills and ability for direct communication - the essential 
skills needed for autonomy and individuation. In contrast individuals with 
insecure attachments most likely engage in maladaptive strategies and social 
isolation.
Dr. Pravin talked about a case where Tina, a fifteen year old was clinically 
depressed. She harboured tremendous resentment against her mother. The mother, 
a single working parent, would send her to the grandparents during summer 
holidays. Unfortunately, there the poor child was sexually harassed by a friend 
of the family. The mother had no clue and was perplexed about Tina's hostility 
towards her.
An ABFT therapist was able to help both mother and the daughter. An 
individually oriented therapist may not have uncovered and helped them resolve 
this painful experience that was causing distress and damage.
There is scarcity of family therapy treatments that are specific to 
adolescents. ABFT is a new model designed for treating depressed and suicidal 
adolescents. It was developed by Professor Guy Diamond and his team in 
Philadelphia, USA.
The model is approved by relevant authorities in USA as an empirically 
validated model. It focuses on family relationships rather than addressing 
symptoms separately. Here, the adolescent talks about what caused the rupture 
while the parent listens with respect and helps them to tell their story.
The ABFT therapist focuses on resolving past or current impasses in the 
attachment relationship. Both the parent and the adolescent take mutual 
responsibility for change thus rebuilding trust and reshaping relationships.
Listening to Dr. Pravin's brilliantly presented lecture, I could see that 
almost everyone present in the auditorium became introspective. May be thinking 
of their adolescent days and ruptured attachments!!
The premise of this article is that repairing attachments problems can promote 
better self-regulatory capacities in adolescents which in turn can lead to a 
decrease in depression and suicidal behaviour.
http://www.thehindu.com/features/metroplus/attentionbased-family-therapy/article5996204.ece

[Tags Counselling, psychology, Mental Health, India, Adolescent, family, ABFT, 
Attention based family therapy, therapist,suicidal behaviour, depression,]


                                                                                
  

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