Closing Thoughts: Special Issue on Attachment

Abstract

We would like to express appreciation to the authors of this Special Issue on Attachment for their contributions both to the Journal and the field of clinical social work. All these authors are experts in terms of their specific clinical interests, and they have provided us with a creative and stimulating look at the new directions attachment theory is taking due to the influence of contemporary attachment and neurobiological research. As co-editors, it has been exciting to work with these writers, researchers, theorists, and practitioners as we have enriched our understandings and broadened our applications of attachment theory to the conceptualization of our clinical work. We also want to take this opportunity to emphasize the saliency of ‘‘modern attachment theory’’—as Allan and Judith Schore described it in this Journal—for contemporary social work education and empirically-informed social work practice. As professors in social work programs, we are keenly aware of the current academic emphasis on ‘‘evidence-based practice’’ (EBP), a controversial concept within our profession that holds various meanings, depending on one’s understanding about practice evaluation. This concept first emerged in the medical profession to address gaps in medical practice, and as other professions embraced the EBP philosophy, debates emerged regarding how EBP should be enacted. One rather narrow interpretation within social work suggests that practitioners and administrators should dismiss theory and base interventions solely on empirical research that provides evidence of an effective model of practice. Taking a broader philosophical view, Gambrill (2006) sees EBP as a process ‘‘designed to break down the division among research, practice, and policy—highlighting ethical obligations’’ (p. 341). She has said that narrow definitions of EBP may actually be ‘‘the emperor’s new clothes,’’ consisting of ‘‘authoritarian practices’’ that include ‘‘inflated claims’’ (Gambrill 2003, p. 4) about effective interventions. She further notes that the social work literature tends to ‘‘ignore the role of flaws in published research’’ (2003, p. 12) regarding practice. In factual practice, many social workers minimize or are unfamiliar with studies evaluating treatment outcomes. Some may not realize that, with few exceptions, metaanalytic research comparing practice models has found no consistent differences in terms of treatment outcomes among different modalities or theoretical orientations (Blatt et al. 2006; Drisko 2004; Ogles et al. 1999). According to Ogles et al. (1999), clinical practice over the past 30 years has ‘‘become increasingly specific, technical, and standardized,’’ yet research on practice shows that ‘‘models and techniques have a relatively small influence on treatment outcome’’ (p. 209). Although there are few differences in treatment ‘‘efficacy’’ (i.e., outcome evaluated through randomized control trials), treatment models are not equally ‘‘effective’’ in the real world of practice (Ogles et al. 1999). This is particularly true in social work practice, where there are numerous practical, ethical, organizational, and ideological obstacles for carrying out efficacious and effective treatment (Gambrill 2006). C. Susanne Bennett and Judith Kay Nelson—Co-editors of the Special Issue on Attachment.