Research has found that adoptees and their families may disproportionately experience psychological, attachment, and behavioral issues (Vandivere et al., 2011). Gagnon- Oosterwaal et al. (2012) examined reported behavioral problems in 95 international adoptees compared to 685 non- adopted international children, and found that international adoptees reported higher rates of internalizing problems (43.2%) compared to their non-adopted peers (28.6%). Researchers have found that positive family interactions can improve the overall functioning of the adoptive family; this is valuable information for helping professionals who work with this population (Allen, Timmer, & Urquiza, 2014; Brodzinsky, 2011; Ji, Brooks, Barth, & Kim, 2010; Weir et al., 2013). There are many treatment modalities with recorded usefulness with adoptive families. However, researchers focused on attachment and adoption research suggest that play therapy approaches which incorporate parents into treatment are likely to have the most impact on the adoptive family system (Carnes-Holt & Bratton, 2014). Yet according to Weir, Fife, Whiting, and Blazewick (2008), many master’s-level accrediting training programs in counseling, marriage and family therapy, and social work provide little, if any, specific coursework on adoption or foster care. Consequently, helping professionals may need to seek supplemental education post- graduation in this specialized area. The purpose of this article is to encourage readers to consider the role attachment plays in healthy child-parent interactions and inform therapists on how this factors into treatment options for play therapists who work with adoptive families.

Adoption and Attachment Treatment Child-parent interactions and behaviors are often discussed through the lens of attachment theory (Barth, Crea, John, Thoburn, & Quinton, 2005). Researchers have identified that both family relationships and parental attachment strongly influence how a child copes with stress in life and how a child perceives the world (Gfroerer, Nelsen, & Kern, 2013). McGinn (2007) explained that attachment is a term used to define “close, enduring, emotionally based interpersonal relationships” (p. 63), and how these relationships develop. Individuals can attach to others in multiple ways depending upon various circumstances. In the case of adoption, a feeling of abandonment by a biological family can lead the child to feeling a lack of trust and security with the adoptive caregivers. As well, children in foster care and who have been adopted often “miscue” their caregivers, giving misguided signals that can cause distress and confusion for the child and parent or caregiver (Ribaudo, 2016).

Several models have been cited as efficacious in repairing

COMMENTS BY CLINICAL EDITOR: Exploration of filial therapy models in working with foster and adoptive families

the broken attachment relationship for adoptees and their adoptive parents (Carnes-Holt & Bratton, 2014). For example, the systemic models of Parent-Child Interaction Therapy, Theraplay®

, and filial

therapy models, such as Child Parent Relationship Therapy and Family Filial Play Therapy, have been shown to be effective with adoptive families (Allen et al., 2014). Conversely, treatment where the parent takes control has been linked to disruptive behaviors in children and therefore decreased attachment (Chang & Shaw, 2015). Shea (2014) suggests this scenario is likely to occur with children in foster care and in adoptive families due to previous disruptions in relationships. For this group of children, there is a need to have control over the consequences of his or her own activity, not a reduction in control. Therefore, consequences and punishment-based interventions are considered coercive and less beneficial. In summary, treatment approaches that rebuild secure, responsive attachments between adopted children and their caregiver are noted as both positive and beneficial, as these modalities fit what Shea noted as a preferred treatment for this unique population (Allen et al., 2014; Baden, Gibbons, Wilson, & McGinnis, 2013; Shea, 2014). Barth et al. (2005) explained, ‘‘it is the parent-child relationship that is the central reason that adoptive parents come to therapy” (p. 264). It has been over a decade since it was first recommended that evidence-based interventions that address parent-child relationships and the parents’ expectations about them be assessed for effectiveness with adoptive families. However, this type of research continues to be rare.

Parent-Child Interaction Therapy

Parent-Child Interaction Therapy (PCIT) is an evidence-based, manualized parent training intervention that draws from parenting, social learning, and attachment theories (Eyberg, 1974; Eyberg & Robinson, 1982). In this treatment, the parent and child meet together in a playroom and the therapist provides in vivo coaching to the parent through an earbud. The model, created by Dr. Sheila Eyberg, uses both child-centered play-based strategies as well as discipline strategies from

19 PLAYTHERAPY | September 2017 | www.a4pt.org