Conference Agenda

Recent developments in attachment theory emphasize that attachment relationships support not only safety and regulation, but also the development of epistemic trust—the trust in information that is communicated interpersonally. This integration provides an updated framework for understanding patient-therapist interactions and translating attachment research into moment-to-moment clinical practice.

This workshop introduces participants to key concepts from the Patient Attachment Coding System (PACS), a validated research measure designed to identify attachment patterns based on how patients communicate in therapy sessions. We will review the empirical findings and clinical applications of the coding system, including discourse markers, narrative themes, and interactional patterns associated with secure/autonomous, dismissing, preoccupied, and disorganized attachment classifications.

Through clinical case examples, we will illustrate the distinctive features of each attachment classification and demonstrate how therapists can adapt their interventions to work more effectively with different communication styles, creating "windows of security" that allow epistemic trust to develop. We theorize that insecure and disorganized patterns contribute to difficulties in communication that make therapeutic change more challenging, but are not pathological in themselves. Patients come to therapy despite these patterns, not because of them.

Lastly, we will briefly address how therapists' own attachment patterns influence their capacity to trust patients and shape their interventions. Drawing from research with the Therapist Attunement Scales (TASc), we discuss how clinicians can recognize their own communication patterns and cultivate more secure therapeutic responses through empathic validation, gentle inquiry, and carefully adapted interventions—a dynamic process of developing one's authentic therapeutic voice rather than learning stock phrases.

Participants will leave with practical skills for observing attachment patterns in clinical work and strategies for tailoring interventions across theoretical orientations.