To Have and to Hold: Questions about a Therapeutic Service for Children

Abstract

Therapies for children and young people that using ‘holding’ as an intervention for severe difficulties with attachments are controversial and raise many questions. At least one major professional organisation has stated that these therapies should be banned. This paper discusses the implications of a study of a service for children (and their families where appropriate) described as having attachment difficulties or a diagnosis of attachment disorder and where ‘holding’ techniques are employed as part of the therapeutic intervention. The views of a range of stakeholders (including children, young adults who had previously used the service, purchasers, outside professionals, and staff) about this service were collated directly by interview. The article identifies how this study can refine and inform the broader questions about ‘attachment and holding’ therapies. Proponents argue that the service offered provides effective assistance for some of the most hurt and difficult children in society. Opponents state that some of the techniques involved have not been evaluated, are ethically questionable and are not based on a validated theoretical mechanism. This paper highlights a number of core questions about attachment and ‘holding’ therapy and the findings of the study provide a commentary on these questions.