Module 1: Introduction and Overview: The Foundations of IAT

Why should psychotherapists be interested in attachment security and insecurity?

This first module sets the context for the value of learning about attachment.  We review the high prevalence of insecurity worldwide (30-90%, depending on country/culture), and describe the significant problems associated with insecurity during adulthood, including: relationship difficulty; self and personality disorders; poor emotion regulation; a tendency to stereotype and be cognitively inflexible; and an increased vulnerability to mental health problems. 

We point out that when a patient or client comes to therapy for treatment of trauma, the healing and resolution of the trauma will be more rapid and complete if any underlying attachment insecurity is addressed in treatment first. 

This module is completed with an overview of various treatments that are available for treating adult attachment insecurity, and a presentation of the Integrative Attachment Therapy model.  IAT respects and draws from the best elements of other treatments, for providing the most effective, efficient, and comprehensive resolution of insecurity.

Module 2: The History and Understanding of Attachment

What is attachment?  And what are the foundations of its recognition and study?

In this module we answer the fundamental questions about the what "attachment " is, and why its dynamics evolved to be present in many species (not only humans!).  The innovations and contributions of the "father and mother of attachment", John Bowlby and Mary Ainsworth, are presented and appreciated. 

We then point out several dimensions of attachment: Biological, Relational, and Psychological.  Each of these is a particular way of understanding the functions, purposes, and appearances of attachment patterns. Such understanding is a very helpful for recognizing how and why it is so helpful for psychotherapists to know about attachment.

Module 3:  The Development of Attachment

How do we become secure?

Through the many decades of research about attachment, there is very good understanding about how secure attachment develops in young children.  This module presents that understanding.  While the first five years are considered, focus is placed on what happens relationally and developmentally during roughly the second year of life. 

The treatment model described in this training is based on understanding of the essential developmental factors for the formation of secure attachment, and on what happens when the conditions for attachment security are not present to a "good enough" degree.  When we understand the basic processes of attachment formation, including the interaction of the child's developmental milestones with the caregiver's behavior and responses, and what can go awry and lead to insecure attachment, it becomes obvious what the "solutions" are – the essential factors for treatment of adult attachment insecurity. 

Module 4: The Forms, Phenomena, and Causes of Attachment Patterns

What are the varieties of attachment patterns?  Why do some children develop 'insecure' patterns?

As secure attachment isn't the only form of attachment that may emerge during the first years of childhood, this module provides you with several frameworks for describing and categorizing both secure and insecure forms of attachment.  For the most commonly described subtypes of attachment -- Secure; Insecure Dismissing/Avoidant; Insecure Anxious-Preoccupied; and Insecure Disorganized/Fearful -- the specific developmental factors that contribute to their formation are presented in detail. 

When you understand the specific factors that contribute to each of the insecure forms of attachment, it makes so much sense why some treatments for adult attachment insecurity, especially Integrative Attachment Therapy, can be so effective.

Module 5: Assessment of Attachment in Adults

How can we as therapists best identify the attachment patterns in our patients?

This module presents the challenge and the opportunities for assessing attachment patterns.  The strengths and limitations of the two primary forms of assessment -- interview-based and self-report -- are presented and explained. 

The most well-known assessments, including the Adult Attachment Interview, Patricia Crittenden's variant of the AAI (the DMM-AAI), Carol George's Adult Attachment Projective Picture System (AAP), and the Experiences in Close Relationships (ECR) self-report measure.  The strengths and limitations of each method are reviewed, and we offer recommendations for practical assessment strategies for your clinical practice.

In addition to the value of knowing about the available assessment measures, learning about the bases for their scoring and categorization will help to deepen your understanding of attachment dynamics and functioning. 

Module 6: The Three Pillars Model of Integrative Attachment Therapy

What are the 'Three Pillars' of psychotherapy, and how does IAT apply them to treat attachment insecurity in adults?

This module provides you with the foundations of the Three Pillars model of psychotherapy, and of how this model is used in Integrative Attachment Therapy.  We highlight the link between the Three Pillars and research about the primary factors of effective psychotherapy.

With that understanding as a context, we then define, describe, and illustrate each 'pillar' of IAT: 

Enhancing Collaborative Ability and Skill

Developing Metacognitive Abilities

Creating Secure Internal Working Models through Embodied Mental Imagery 

From this module you will know each pillar and understand why each is particularly important as a component of resolution of insecure attachment.  You will also understand how IAT includes and transcends the traditional therapeutic approaches for adult insecurity. 

Module 7: Pillar 1: Enhancement of Collaborative Ability and Skill 

How does the therapist engage the patient collaboratively to enhance collaborative ability?

This module is the first of the 'how-to' treatment-focused modules, which give you detailed guidance about how to apply each pillar in the IAT psychotherapy process.  Here you will learn very specific collaborative problems common to your insecure patients, and very specific ways to effectively reduce them and build secure collaborative ability. 

As a conceptual and practical framework, we present a series of steps for enhancing collaboration through the therapy process. And we detail some of the signs of greater collaborative ability that results from this treatment. 

We also give particular attention to ruptures in the therapy relationship.  Therapeutic ruptures are quite common when working with people with attachment insecurity, and the most effective way to repair the ruptures is by addressing them collaboratively.  We detail how to effectively apply this approach. 

Module 8: Pillar 2: Developing Metacognitive Abilities

How does the IAT therapist explicitly and implicitly help patients to expand their metacognitive abilities?

This module presents to you the ways that IAT helps patients to develop metacognitive capacities and abilities through the course of treatment.  Any skill development benefits from multiple converging methods, practices, and experiences, and so we present to you and integrate a variety of explicit and implicit methods that we have found are effective and efficient, individually and especially together. 

Of note is that one of the very effective approaches for helping to enhance patient's metacognition is for the therapist to recognize, enhance, and model his or her own metacognition.  So in this module, in addition to several very specific methods for engaging and enhancing the patient's abilities, we suggest ways that you, as a therapist and a person, can strengthen and expand your own range of metacognitive functioning.

Module 9: Pillar 3: Using Embodied Mental Imagery to Create Secure Internal Working Models of Attachment

How does the IAT therapist overcome the limitations of traditional attachment therapy for creating secure IWMs?

We now turn to the specific and unique therapy method of IAT that effectively and efficiently contributes to the development of earned security.  With the Ideal Parent Figure (IPF) guided imagery process, a therapist and patient specifically and actively co-create a positive, stable, and resilient internal working model of secure attachment relationship.

The therapist first guides the patient toward experientially imagining being a very young child. Then the patient imagines being with caregivers who in the imagery provide a sense of safety, of being accurately attuned to, of being comforted when upset, of delighting the caregivers by simply being, and of receiving encouragement for being his or her best natural self.  Repetition and elaboration of contact with this imagery establishes the new internal model of secure attachment.

 In this module you will receive very detailed guidance for each element and step of this process.  Video and written examples from sessions are provided for illustration.  Common challenges are addressed with suggestions for their resolution.  Signs of progress and of earned security are described. You will have all that you need to begin applying this process with your patients or clients. 

Module 10: Tailoring the Three Pillars of IAT to Each Attachment Subtype

How is the IAT process modified when applied to patients with different forms of attachment insecurity?

Psychotherapy should always be applied to fit the particular patient.  Never should the therapist attempt to fit the patient to the therapy.  Though IAT has specific elements, practices, and methods, they are designed to be flexible so that the therapist makes moment-to-moment treatment choices based on presence and accurate attunement to the patient. 

One of the important considerations for treatment adjustments is that different forms of attachment insecurity are the result of different types of problematic experiences with early caregivers.  And so the therapeutic establishment of security during adulthood requires taking that into account and fine-tuning each of the three pillars of IAT to fit each patient's particular pattern and its origins. 

This module provides guidance for that fine-tuning.  For each of the primary insecure subtypes, you will receive details for providing psychoeducation about insecurity, for the therapist's most effective ways of being, and for adjusting the ways of applying each of the three pillars. 

Module 11: Synthesis of the Three Pillars for an Integrated Treatment Plan

What are the general guiding principles for the natural unfolding of an IAT process?

To help you with further understanding how an IAT therapeutic process may unfold, this module presents you with general principles for the steps and stages of treatment.  The ground for any moment in treatment is the therapist's presence and accurate-as-possible attunement to the patient.  And within that context, IAT provides a frame for the aspects of treatment that most effectively and efficiently contribute to the emergence of earned security.  This module details that frame.

Module 12: Completion of IAT Level 1 and Next Steps

Consolidate and Build Upon Your Level 1 Training

Your committed, diligent, and thorough completion of IAT Level 1 brings you understanding and skills that will immediately benefit your clinical practice.  Should you wish to further expand and deepen your abilities to apply the model and methods, there are training opportunities for that. 

This module describes in detail:

Levels 2 and 3, for obtaining registration as an IAT Therapist (IAT-T)

Level 4, for becoming an IAT Supervisor and Trainer (IAT-TST)