Abstract
Background: There is a dearth of research regarding the process of attachment within autistic individuals. There is also an emerging emphasis to attend directly to clients’ mental health and recovery.
Case report: This case report details an attachment intervention with a client, presenting with behaviors that challenged within a specialist inpatient autism service. It was hypothesized that attachment was partially underpinning the behavior that challenged. This was further explored by: undertaking a notes review, interviewing the direct care team, formulating within the multidisciplinary team, delivering a Psychology attachment formulation workshop as well as by meeting regularly with the client. The workshop involved facilitating staff to integrate: Crittenden's dynamic-maturational attachment model with the client’s experience whilst utilizing a CBT framework. This resulted in identifying that the client was presenting with the strategy of ‘aggression and feigned helplessness’, which emerged within a context encompassing: physical health issues, intellectual disability as well as trauma. Formulating resulted in an enhanced understanding of attachment and the client within the team. Interventions directly addressing attachment were devised in order to further mange the behavior that challenged, particularly in relation to family interactions as well as changes to the staff.
Conclusion: This case report demonstrates the clinical utility of an attachment formulation workshop within a specialist autism service. It would therefore be informative to undertake similar research within autism services.