A Trust-Based Intervention for Complex Developmental Trauma: A Case Study from a Residential Treatment Center

This case study, conducted in a Midwest residential treatment center, reports results from an attachment-based intervention that addressed the needs of a 16-year-old female, Rachel. Rachel had a long and documented history of severe abuse and neglect before her adoption from a Bulgarian orphanage at age 12 and numerous psychiatric hospitalizations in the years subsequent. Upon entering this residential treatment center, Rachel did not respond to traditional residential treatment modalities and was considered one of the most difficult children the facility had ever attempted to help. After the intensive attachment-based intervention for Rachel, her adoptive parents, and facility staff, dramatic increases in pro-social and attachment behaviors were noted, as well as a significant decrease in violent and self-injurious behaviors. The intervention consisted of three phases of differing levels of intensity and was designed to address the attachment system and related sub-systems in order to facilitate the development of healthy attachments.