Conference Agenda

Despite the extensive empirical literature supporting attachment theory, its translation into structured clinical intervention in individual adult psychotherapy remains limited, particularly beyond specific, model-bound approaches. This presentation addresses this clinical gap by outlining an integrative, attachment-focused framework in which attachment functions not as a technique or modality, but as a central organising framework for case conceptualisation and clinical intervention.

The presentation examines how attachment insecurity manifests within individual therapy, focusing on attachment-related patterns of emotional regulation, defensive organisation, internal working models, self-concept, and meaning-making. These processes are discussed in relation not only to relational functioning, but also to a broader range of psychological difficulties, including symptom persistence.

Within this integrative framework, emphasis is placed on the therapeutic relationship as an intermediate attachment relationship. This relational context is not primary, yet reliably activates primary attachment systems; it does not replicate everyday relationships, yet evokes clinically meaningful attachment patterns. Positioned between the patient’s attachment history and current attachment relationships, it provides a regulated setting in which attachment strategies can be activated, observed, and reorganised in real time.

The presentation situates these interventions within an integrative clinical approach, drawing on the Integrative Approach to Psychological Consultation, with a theoretical base in Cognitive-Behavioural Psychotherapy, and incorporating elements from Emotion-Focused Therapy, Attachment-Informed Narrative Psychotherapy, and Existential-Humanistic Psychotherapy. The intermediate attachment relationship is intentionally established and maintained to be sufficiently safe to allow transient disorganisation of established attachment strategies, while remaining sufficiently bounded to permit psychological transformation without acting out. Change is conceptualised as fundamentally experiential, as attachment patterns are formed and transformed through relational experience.

Drawing on over twenty years of experience in adult psychotherapy, selected clinical examples illustrate how targeted attachment-informed interventions support emotional regulation, enhance reflective functioning, and promote adaptive psychological reorganisation following. Implications for clinical practice and therapist training are discussed.

Emotionally Focused Therapy (EFT) and improvisational music therapy share foundational principles rooted in attachment science, yet their integration remains largely unexplored. EFT operates on the core tenet that one’s capacity for emotion regulation develops through the accessibility, responsiveness, and emotional engagement of attachment figures, with therapists facilitating here-and-now emotional experiences to heighten client emotions and foster new relational patterns. Notably, EFT literature employs musical metaphors extensively, positioning music and dance as representations of emotional and relational dynamics—as the music (emotional landscape) shifts, so too does the dance (relational pattern).

The prevalence of this metaphor, combined with evident alignment between EFT objectives and improvisational music therapy outcomes, suggests significant potential for integration. Despite this, the literature remains notably silent on practical applications of a combined approach, creating a critical gap in our understanding of how these mutually enhancing modalities might elevate therapeutic outcomes when implemented in conjunction.

This phenomenological study addresses this gap by examining the lived experiences of Canadian music therapists with EFT training. Through a comprehensive review of the literature and in-depth interviews, the research illuminates current integration practices, reveals barriers to implementation, and initiates development of a unified therapeutic model. By centering practitioners' embodied knowledge, this study offers essential groundwork for bridging Emotionally Focused Therapy and music therapy, with implications for enhancing therapeutic effectiveness across both disciplines.

Purpose

Burnout among nurses significantly influences turnover rates, yet the psychological processes leading to burnout, particularly those tied to attachment styles, remain underexplored. The study aims to examine how nurses’ attachment styles impact their cognitive appraisal of conflicts with patients’ families, their behavioral responses and subsequent effects on burnout and intention to leave nursing.

Design/methodology/approach

A cross-sectional study of 140 hospital nurses utilized online questionnaires. Participants responded to three hypothetical conflict scenarios with patients’ relatives, reporting threat appraisal and behavioral responses. Standard questionnaires assessed attachment style, burnout and intention to leave the profession. A serial mediation model was examined using structural equation modeling (SEM) via SPSS Amos 23.

Findings

SEM results partially supported the mediation model [chi-square (χ²⁾(41) = 70.35, p = 0.003; comparative fit index (CFI) = 0.94; standardized root mean square residual (SRMR) = 0.071 and root mean square error of approximation (RMSEA) = 0.072]. Anxious attachment style was indirectly associated with higher burnout and intention to leave nursing. This sequential relationship was mediated through threat appraisal and subsequent escalating and self-regulating behaviors.

Practical implications

To reduce burnout and turnover, healthcare organizations should incorporate attachment theory into training programs and implement targeted interventions that address the emotional and relational challenges faced by nurses. Programs focusing on emotion regulation, adaptive coping mechanisms and conflict resolution skills can mitigate the maladaptive patterns associated with anxious attachment.

Originality/value

The study emphasizes the psychological underpinnings of burnout, providing actionable insights for occupational health practice by highlighting attachment styles’ role in shaping nurses’ cognitive and behavioral responses during emotionally charged interactions.

Attachment-based parenting interventions have gained increasing research and clinical attention for the treatment of child and adolescent mental health problems. However, limited research attention has been placed on the acceptability of these interventions, particularly from providers who are often gatekeepers to the quality and type of programs available to parents. Thus, this research aimed to better understand providers' perspectives of attachment-based parenting interventions, including relative to other parenting interventions, namely behavioral parenting programs. Twenty-four psychologists in Australia who worked with parents across varying settings, regardless of specific program affiliations were engaged in semi-structured interviews on the implementation of parenting interventions in practice. Interviews explored psychologists' perceived facilitators and barriers of parenting interventions for the treatment of child and adolescent mental health problems. Reflexive thematic analysis indicated that psychologists were generally favorable towards using parenting interventions with families, though they often described a perceived dichotomy between attachment and behavioral parenting interventions in practice. Furthermore, qualitative themes indicated several provider-level factors influencing the implementation of parenting interventions, including professional training, beliefs about research, affective experiences, and values. These findings provide a contemporary understanding on psychologists' acceptability of parenting interventions, emphasizing the importance of considering provider perspectives to bridge gaps between research and clinical practice. Results highlight the implications of future training and implementation efforts for attachment and other evidence-based parenting interventions.