A major issue raised in the third chapter appearing in the section of the book dealing with clinical applications of attachment theory has to do with the clinical and diagnostic utility of the Strange Situation paradigm. Put rather simply, if attachment classifications are, to a degree, predictive of later behavioral problems, can they be used to diagnose infants at-risk and initiate services for them and their families? Greenspan and Lieberman, in the course of outlining their own approach to developmental assessment, strongly articulate a position that we ourselves subscribe to; namely, that this research procedure is neither sufficiently powerful, accurate, nor comprehensive to be employed as a diagnostic clinical tool. This is not to say, however, that it cannot prove informative; as the chapter by Nezworski and her colleagues points out, not only did collateral research information reveal families of insecure infants to be under particular stress, but so too did the actual therapeutic sessions provided to mothers of insecure infants. If assessments of attachment security are to be used in making clinical diagnoses, they should not be used in isolation. To be noted, also, is the fact that the Strange Situation is by no means necessarily the best, and certainly not the only, way to evaluate the attachment relationship.
The discovery that individual differences in the security of infant-mother attachment possess some power in predicting later developmental difficulties serves to underscore the fact that attachment theory and research are of clinical significance. In this chapter we have sought to highlight what some of these central implications are and particularly those that are addressed in the chapters of this volume. As we have seen, they pertain to the characterization of variation in attachment relationships, the origins of such variation, the developmental consequences of attachment and, finally, explicit applications of the attachment framework to diagnosis and service delivery.
Bates J., Maslin C., & Frankel K. ( 1985). Attachment security, motherchild interaction, and temperament as predictors of behavior problem ratings at age three years. In I. Bretherton & E. Waters (Eds.), Growing points in attachment theory and research. Monographs of the Society for Research in Child Development (pp. 167-193), Vol. 50, Nos. 1-2.
Belsky J., & Rovine M. ( 1987). Temperament and attachment security in the Strange Situation: An empirical rapproachement. Child Development, 58.