Introduction

The Basics

What is Attachment-Focused Psychotherapy?

Attachment-Focused Psychotherapy (also known as Attachment-Focused Therapy or just Attachment Therapy) is a type of therapy that explores how our earliest relationships with our parents and caregivers shape the way we connect with others and manage our emotions.

Rather than focusing only on symptoms, Attachment-Focused Therapy uses the therapy relationship itself as a healing experience, helping clients feel safe, understood, and supported while learning new, more secure ways of relating. Through this process, people often find greater balance, resilience, and emotional connection in their lives.

Goal

What is the goal of Attachment-Focused Psychotherapy?

Attachment Therapy is rooted in the understanding that early caregiver experiences create “internal working models,” which are templates that we carry into adult relationships. For people who have felt inconsistency in those early relationships, therapy offers a corrective experience—the chance to feel what it’s like to build safety and trust with another person.

The goals of Attachment Therapy include:

• Helping clients develop “earned security”: the ability to form safe, nurturing relationships in adulthood even if early experiences were difficult.
• Building emotional regulation skills so clients can respond to feelings with greater balance.
• Expanding mentalizing skills: the ability to understand one’s own and others’ behavior in terms of underlying feelings and needs. This fosters empathy, perspective-taking, and healthier communication.
• Supporting clients in creating a coherent life story, where past attachment experiences are understood and integrated, making it easier to respond thoughtfully in relationships instead of reacting from old patterns.

At its heart, Attachment-Focused Therapy views healing as relational. Growth happens through the experience of connection, trust, and repair.

Uses

What does Attachment-Focused Psychotherapy treat?

Attachment Therapy can be especially helpful for:

• People who struggle in relationships or feel stuck in unhealthy patterns
• Those with histories of early trauma, neglect, or inconsistent caregiving
• Individuals who find it hard to regulate emotions
• Parents who want to strengthen their connection with their children
• People experiencing anxiety or depression rooted in attachment wounds

Subtypes

Are there any subtypes of Attachment-Focused Psychotherapy?

Yes, several approaches have grown from attachment-focused work, each emphasizing different applications:

• Dyadic Developmental Psychotherapy (DDP): Created by Daniel Hughes for children and adolescents who experienced trauma or attachment disruptions, using the therapeutic relationship as the main healing tool.
• Emotionally Focused Therapy (EFT): Developed by Sue Johnson to help couples build secure emotional bonds by addressing attachment fears and needs.
• Mentalization-Based Treatment (MBT): Created by Peter Fonagy, this approach builds the skill of understanding behavior in terms of inner thoughts and feelings, and is especially effective for borderline personality disorder.
• Circle of Security: A parent-focused model that uses simple metaphors and strategies to help caregivers better understand and respond to their child’s attachment needs.
• Attachment-Based Family Therapy (ABFT): Developed by Guy Diamond for adolescents struggling with depression and suicidal thoughts, with a focus on repairing parent–teen relationships.

Effectiveness

Origins

Who developed Attachment-Focused Psychotherapy and when?

Attachment-focused therapy grew out of attachment theory, first developed by John Bowlby in the 1950s. His research, alongside Mary Ainsworth’s groundbreaking work on attachment styles, laid the foundation for many new therapeutic approaches.

In the 1990s, Daniel Hughes developed Dyadic Developmental Psychotherapy (DDP), a specific attachment-focused method for children and families. Since then, clinicians and researchers like Peter Fonagy and others have expanded and refined attachment-based approaches to fit a wide range of needs.

Evidence Base

Is Attachment-Focused Psychotherapy evidence-based?

Yes, Attachment-Focused Therapy is supported by extensive research in developmental psychology, neuroscience, and clinical studies. Findings show it is particularly effective in helping people heal from trauma, improve relationships, and strengthen emotional well-being.

Neuroscience research supports the idea that secure, consistent relationships reshape the brain’s emotional regulation systems, which makes attachment-focused approaches both practical and scientifically grounded.

How It Works

Techniques Used

How does Attachment-Focused Psychotherapy work?

Healing in Attachment Therapy happens through the experience of a safe, secure therapeutic relationship. The therapist creates an environment of warmth and empathy, allowing clients to explore how early experiences shaped their current attachment patterns. As trust develops, clients can:

• Recognize old relational patterns and how they affect current connections
• Practice regulating emotions with the therapist’s support
• Experience new, healthier ways of relating that can extend into other relationships

Over time, clients begin to carry these new relational experiences with them, building greater security and resilience both inside and outside of therapy.

What to Expect in a Session

What can I expect from an Attachment-Focused Psychotherapy session?

An Attachment-Focused Therapy session typically feels warm, supportive, and relational. You can expect:

• A safe, non-judgmental space to share feelings and experiences
• A focus on the therapeutic relationship itself as a model of secure attachment
• Exploration of both past and present relationships
• Attention to emotional experiences, including those that arise in the room
• Insight into how early experiences influence current patterns
• Practice with new ways of relating and managing emotions

Therapists often pay close attention to nonverbal cues and emotional shifts, helping clients become more aware of their inner world. Sessions may include moments of “rupture and repair”—times when disconnection or misunderstanding happens, followed by efforts to reconnect. These moments can be profoundly healing, especially for clients who never experienced repair in past relationships.

Treatment Length & Structure

How long does Attachment-Focused Psychotherapy typically take? Is there any set structure?

The length of therapy depends on individual needs and the depth of attachment challenges. Some people notice meaningful changes within 6–12 months, while others benefit from longer-term work.

Rather than following a rigid formula, Attachment-Focused Therapy typically unfolds in phases:

1. Building safety
2. Exploring attachment history
3. Developing new relational patterns.

The pace is guided by the client’s comfort and readiness.

Getting Care

Finding a Therapist

How do I find a therapist who uses Attachment-Focused Psychotherapy?

Alma’s directory has many therapists who specialize in Attachment-Focused Psychotherapy, including: