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Dustin H. Reed MHS, CRC, PLPC
Doctoral Student
Our Lady of Holy Cross College
Department of Counseling and Behavioral Sciences
New Orleans, Louisiana
Presentation Goals
Definition of Treatment
Overview of Attachment Styles
Professional/People with Disabilities Relationships
PWD and Family Relations
PWDs and Caregivers
PWD and Relationships
PWD and Healthcare Treatment
Disability, Attachment, and Pain
1.) Connect Attachment Theory with its role in
conceptualization of relationships of people with
disabilities with their caretakers, friends, and families.
2.) Connect Attachment Theory with its role in
treatment pertaining to people with disabilities.
3.) Explore how Attachment Theory relates to attitudes
and perceptions of people concerning people with
disabilities.
Kate is a 31 year old Caucasian, bi-sexual female.
She has multiple learning disabilities. Kate also
has trouble remembering to do things at times (lock
the house door when she leaves, close her car door
or house door, put away food, bring her house key
when she leaves the house). Kate talks with her
parents of wanting to have a child with someone.
When asked, Kate says that she is thinking about
having a man get her pregnant and then raise the
child with a woman (believing that the man would
just be the sperm donor and nothing more to the
child)
thinking about interrationships—the
relationships that bind…. What would your
initial impression of Kate be as a counseling
professional if she were your client? How
would you approach her situation to help
Kate help herself and in the process form a
secure bond with Kate instead of making
Kate feel fearful, insecure, or avoidant of
receiving help with her current situation?
Tim is a 16 year old African American male.
He has Type 1 diabetes. He was diagnosed
when he was 10. His parents are very
supportive and he has a very secure
relationship with them. However, Tim acts
out and has trouble in his classes. When he
isspeaking to the school counselor about his
behavior, Tim tells the counselor, “I’m
different from the other kids, they make fun
of me because I have diabetes.”
If you were Tim’s counselor, how
would you approach his situation?
Thinking about interrationships, the
relationships that bind…. What are
some approaches you could use to
help Tim be more secure about
forming relationships with his
peers?
Research suggests that psychiatric
caregivers and the psychiatric
institutions may be viewed as attachment
figures for people with psychiatric
disabilities
(Adshead, 1998)
Through utilization of attachment theory
when listening to patients’ stories, psychiatric
caregivers may provide a basis for helping to
ameliorate patients’ anxieties and allow for a
safe haven that patients with a psychiatric
disability may utilize to help with the
management of their disability.
(Adshead, 1998)
Parents who have intellectual disability
If taught and treated with respect by professionals
- allows for better adapting to parenthood
Negative perception leads to reciprocal negative perception
Secure base of support from professionals lost or strained
(Joreskog & Starke, 2013; McConnell, Llewellyn, & Bye, 1997)
Negative preconceived conceptualization:
affects how professionals treat PWD
relates to attachment style between
professional and PWD
(Joreskog & Starke, 2013)
Some people with Intellectual Disabilities are perceived to lack empathy
Thus relates to and could affect:
child/parent bonding
(Joreskog & Starke, 2013)
There are organizations that provide support for PWD.
(i.e., Disability Issues Office, Families Helping Families).
(American Psychological Association, 2015; Families Helping Families, 2015)
Attachment styles of professional
caregivers are associated with and
affect:
effective response to cues
quality of life
Direct Service Caregivers should
Assess their relationships with PWDs
Try to determine better ways to
interact
(Schuengel, Kef, Damen, & Worm, 2010)
Internal views of self are related to attachment and relationships with others (Johnson & Whiffen, 2006, p. 240).
Some people with disabilities
more than people without disabilities experience negative self-image, depressive symptoms, and suicidal ideations.
(e.g., children and adolescence with spinabifida)
(Appleton et al, 1997)
The children’s perception of the
support parents gave significantly
related to:
depressed mood
global self worth
(Appleton et al, 1997)
Findings suggest interventions aim to:
Promote child/parent communication
Help children with disabilities to feel
competent despite their disability
Help the child address negative self-
schema of body image.
(Appleton et al, 1997)
People with different types of disabilities (i.e., depression, schizophrenia, alcoholism)
Were perceived negatively by individuals according to a study done in the U.K.
(Crisp, Gelder, Rix, Meltzer, & Rowlands, 2000)
Research shows evidence linking
genes (i.e., dopamine, scrutonin,
oxytocin) to social behavior and
disability (i,e., generalized anxiety
disorder).
(Gillath, Shaver, Baek, & Chun, 2008)
Children with learning disabilities reported less secure attachments in close relationships and more anxiety and avoidance
Versus
Children who have normal development who reported more secure attachment in close relationships
(Al-Yagon & Mikulincer, 2004)
There have been cases of parents with disabilities having their rights of being parents taken away from them (i.e., Native American community).
(National Council on Disability, 2015)
Attachment style is related to reported symptoms of some PWD in healthcare
Women with fearful and preoccupied attachment
Reported higher somatic symptoms
versus secure and dismissive patients
Fearful and dismissive women
had less utilization of healthcare
(Ciechanowski, Walker, Katon, & Russo, 2002)
Why did females with fearful and preoccupied attachment report higher somatic symptoms versus secure and dismissive patients?
The authors suggest it is related to self esteem due to earlier caregiving relationships.
(Ciechanowski, Walker, Katon, & Russo, 2002)
Human rights of people with mental disabilities are a global concern advocated for by The World Health Organization (WHO)
The stigma associated with mental disability breeds prejudice among healthcare professionals and the public.
(WHO, 2007)
How well people deal with perceived pain
levels, in combination with levels of comfort
about being close to another person….
moderates the level of perceived
disability.
(Meredith, Strong, & Feeny, 2006)
People who have an insecure attachment style have vulnerability to developing disability after experiencing acute pain.
(Meredith, Ownsworth, & Strong, 2008)
1.) Connect Attachment Theory with its role in
conceptualization of relationships of people with
disabilities with their caretakers, friends, and families.
2.) Connect Attachment Theory with its role in
treatment pertaining to people with disabilities.
3.) Explore how Attachment Theory relates to attitudes
and perceptions of people concerning people with
disabilities.
Questions?
Adshead, G. (1998). Psychiatric staff as attachment figures – Understanding management problems in psychiatric services in the light of attachment theory. The British Journal of Psychiatry, 172, 64-69. doi: 10.1192/bjp.172.1.64
Al-Yagon, M. & Mikulincer (2004). Patterns of close relationships and socioemotional and academic adjustment among school-age children with learning disabilities. Learning Disabilities Research & Practice, 19(1), 12-19. The Division for Learning Disabilities of the Council for Exceptional Children.
American Psychological Association (2015). Disability issues office. Retrieved from
http://www.apa.org/pi/disability/
Appleton, P. L., Ellis, N. C., Minchom, P. E., Lawson, V., Boll, V., & Jones, P. (1997). Depressive Symptoms and self-concept in people with spina bifida. Journal of Pediatric Psychology, 22(5), 707-722.
Crawford, N. (2003). Parenting with a disability: The last frontier. Monitor on Psychology, 68. American Psychological Association. Retrieved from https://www.ncd.gov/publications/2012/Sep272012/Ch6
Ciechanowski, P.S., Sullivan, M., Jensen, M., Romano, J., & Summers, H. (2003). The relationship of attachment style to depression, catastrophizing and healthcare utilization in patients with chronic pain. Pain, 104(3), 627-637. doi: 10.1016/S0304- 3959(03)00120-9.
Ciechanowski, P. S., Walker, E. A., Katon W. J. , & Russo J. E. (2002). Attachment theory: A model for health care utilization and somatization. Psychosomatic Medicine, 64, 660-667. doi: 10.1097/01.PSY.0000021948.90613.76
Crisp, A. H., Gelder, M. G., Rix, S., Meltzer, H. I., & Rowlands, O. J. (2000).
Stigmatisation of people with mental illnesses. BJP, 177, 4-7.
Families Helping Families of Jefferson Parish, (2015). Retrieved from
http://fhfjefferson.org/
Gillath, O., Shaver, P. R., Baek, J. M., & Chun, D. S. (2008). Genetic correlates of adult
attachment. PSPB. doi: 10.1177/0146167208321484
Joreskog, K. & Starke, M. (2013). Professionals’ perceptions of and approach to parents
with intellectual disability: A question of knowledge? International Journal of Social
Sciences, 1(2), 20-30. doi: 10.11114/ijsss.vli2.134
McConnell, D., Llewellyn, G., & Bye, R. (1997). Providing services for parents with
intellectual disability: Parent needs and service constraints. Journal of Intellectual
and Developmental Disability, 22, 5-17. Retrieved from
http://informahealthcare.com/doi/abs/10.1080/13668259700033251
Meredith, P., Ownsworth, T., & Strong, J. (March, 2008). A review of the evidence linking adult attachment theory and chronic pain: Presenting a conceptual model. Clinical Psychological Review, 28(3), 407-429. Retrieved from http://www.sciencedirect.com/science/article/pii/S027273580 00 1304
Meredith, P., Strong, J. & Feeny, J. A. (2006). Adult attachment, anxiety, and pain self efficacy as predictors of pain intensity and disability. Pain, 123, 146-154.
National Council on Disability (2015). Parental disability and child welfare in the native american community.
Whiffen, V. E. & Johnson, S. M. (2006). Attachment processes: In couple and family therapy, 240. New York: The Guilford Press.
WHO (2007). Mental health legislation & human rights denied citizens: Including the excluded - Promoting the rights of people with mental
disabilities. World Health Organization.
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