Enhancing early attachment: Design and pilot study of an intervention for primary health care dyads.

The attachment style of an infant with his caregiver can greatly influence his future development. Many interventions have been proposed to enhance early secure attachment styles, but few have characteristics that make them suitable for primary health care. The objective of the study wasto design a complex intervention for promoting secure attachment in dyads detected in Primary Health Care with altered patterns of attachment styles. The methodology proposed by the UK Medical Research Council was used: (1) theoretical phase: literature review; (2) modelling phase: the main components of the intervention were defined through qualitative research; and (3) exploration phase: pilot study of the preliminary intervention. The attachment style of the dyads was evaluated using the Massie-Campbell scale prior to and four months after the pilot intervention. The preliminary intervention was designed: a group workshop (five to seven dyads, with children aged between 6 and 12 months and two health care professional monitors) structured around various activities that specifically dealt with the skills associated with parental sensitivity and addressed relevant issues to child rearing. The intervention was then tested in a pilot study of 11 dyads in two primary health care centres. The analysis was done with nine dyads (two were lost in the second evaluation), and showed an improvement of 33 per cent in the secure attachment style in the dyads (not statistically significant). An original intervention is designed and proposed for dyads who have early indicators of altered styles of attachment in primary health care.