Contingent Responsiveness Research Articles

The challenge of developing a universal case conceptualization for Functional Analytic Psychotherapy.

While Functional Analytic Psychotherapy (FAP; Kohlenberg & Tsai, 1991; Tsai, Kohlenberg, Kanter, et al., 2009) has been used as an enhancement to other psychotherapy approaches (see e.g., Kohlenberg, Kanter, Bolling, Parker & Tsai, 2002), it is also, and perhaps most commonly, used as a standalone treatment. When employed in this manner, a FAP therapist attempts to improve a client's interpersonal functioning through in-vivo contingent responding in order to ultimately increase that client's quality of life. This contingent responding by a therapist is guided by a FAP case conceptualization (Kanter et al., 2009). Kanter and colleagues (2009) provide an excellent overview of FAP assessment processes, including the development and ongoing revision of a case conceptualization. The present paper is designed to supplement earlier discussions of FAP assessment and case conceptualization by discussing the possibility of a FAP case conceptualization applicable to all clients. This paper assumes a basic knowledge of FAP, which readers can obtain from the texts summarizing FAP (Kohlenberg & Tsai, 1991; Tsai, Kohlenberg, Kanter, et al., 2009). An attempt to identify a case conceptualization applicable to all clients initially seems completely contradictory to FAP's behavior analytic foundation, which emphasizes the importance of an idiographic understanding of a client's behavior and the environment in which it is emitted (see, e.g., Callaghan, 2006; Kanter et al., 2009). From this perspective, given that each client has a unique learning history and behaves within a unique context, his or her behavior should be analyzed in an individualistic manner. Thus, each client should have his or her own unique case conceptualization. (1) Ongoing discussions of FAP, however, have noted that it, as a principle-based psychotherapy, is typically very difficult to implement (Weeks, Kanter, Bonow, Landes, & Busch, 2011). This difficulty in implementation has led to calls for descriptions of the practice of FAP that are as clear and specific as possible, allowing for easier dissemination and competent practice of FAP (Weeks et al., 2011). The present paper provides one response to this call. It specifically attempts to identify a universal case conceptualization applicable to all FAP clients that will allow therapists to more efficiently and effectively implement FAP. There are many possible components of a FAP case conceptualization. These include but are not limited to: (1) a summary of historical variables potentially influencing a client's behavior, (2) a summary of a client's goals and values, (3) a description of a client's problem behaviors in session and more effective alternative behaviors (CRB1s and CRB2s), (4) a description of a client's problem behaviors outside of session and more effective alternative behaviors (O1s and O2s), and (5) a description of therapist problem behaviors and more effective alternative behaviors (T1s and T2s; for further discussion of typical contents of a FAP case conceptualization see Kanter et al., 2009). Before proceeding it is essential to emphasize that a widely applicable, universal case conceptualization is generally not possible with respect to these specific components. For example, it is obvious that historical variables uniquely influence each client's behavior and thus need to be described idiographically. Likewise, the unique interaction between a specific client's learning history and current context must be captured in a case conceptualization's identification of both the function and form of that client's behavioral targets. As a result, the specific proximal behaviors identified in a FAP case conceptualization, including client CRB1s, CRB2s, O1s, and O2s need to be idiographically defined (Kohlenberg & Tsai, 1991; Kanter et al., 2009). In contrast, a widely applicable FAP case conceptualization may be possible, appropriate, and useful at more foundational level. …

Maternal history of parentification, maternal warm responsiveness, and children's externalizing behavior.

Destructive parentification occurs when children are expected to provide instrumental or emotional caregiving within the family system that overtaxes their developmental capacity. According to parentification theory, destructive parentification in family of origin poses a risk to child development in subsequent generations; however, there is a paucity of empirical research examining the impact of a maternal history of destructive parentification on parenting quality and child outcomes in subsequent generations. The present study examined the potential risk of maternal history of parentification on child adjustment by hypothesizing that a maternal history of parentification in family of origin would have a negative impact on quality of maternal warm responsiveness at 18 months of age which would, in turn, be associated with increased children's externalizing symptoms at 36 months. Results indicated that there was a significant indirect effect of maternal history of destructive parentification in family of origin on child externalizing behavior in the next generation through maternal warm responsiveness, supporting the hypothesized model. This finding suggests that facilitating the development of maternal contingent responsiveness among mothers with a history of destructive parentification may promote more adaptive child development in the next generation.

Interaction vs. observation: distinctive modes of social cognition in human brain and behavior? A combined fMRI and eye-tracking study

Human cognition has usually been approached on the level of individual minds and brains, but social interaction is a challenging case. Is it best thought of as a self-contained individual cognitive process aiming at an “understanding of the other,” or should it rather be approached as an collective, inter-personal process where individual cognitive components interact on a moment-to-moment basis to form coupled dynamics? In a combined fMRI and eye-tracking study we directly contrasted these models of social cognition. We found that the perception of situations affording social contingent responsiveness (e.g., someone offering or showing you an object) elicited activations in regions of the right posterior temporal sulcus and yielded greater pupil dilation corresponding to a model of coupled dynamics (joint action). In contrast, the social-cognitive perception of someone “privately” manipulating an object elicited activation in medial prefrontal cortex, the right inferior frontal gyrus and right inferior parietal lobus, regions normally associated with Theory of Mind and with the mirror neuron system. Our findings support a distinction in social cognition between social observation and social interaction, and demonstrate that simple ostensive cues may shift participants' experience, behavior, and brain activity between these modes. The identification of a distinct, interactive mode has implications for research on social cognition, both in everyday life and in clinical conditions.

Imitation Effects on Joint Attention Behaviors of Children with Autism

This study examined the effects of adult imitation on three joint attention behaviors of nonverbal preschoolers with autism including referential looking, gaze following and gesturing to the adult. Videotapes taken from a previous study were recoded for the adult’s imitation behavior and the children’s joint attention behaviors (Field, Field, Sanders, & Nadel, 2001). In the original study, twenty nonverbal, 4 - 6-year- old children with autism were randomly assigned to one of two groups, an imitation or a contingent responsivity group. Both groups of children engaged in an intervention play phase during which the adult imitated the children or contingently responded to them and a subsequent spontaneous play phase. ANOVAs revealed that the imitation group children versus the contingent responsivity group children spent a greater percent time looking at the adult during the intervention phase and looking at the adult and following the adult’s gaze during the spontaneous play phase. A correlation analysis on the data collapsed across the 2 groups yielded significant correlations between adult imitation during the intervention phase and referential looking and gaze following during the spontaneous play phase. Overall, these results revealed that adults imitating preschoolers with autism elicited joint attention behaviors, highlighting the value of imitation as an intervention.

Promoting appropriate behavior in daily life contexts using Functional Analytic Psychotherapy in early-adolescent children.

The fields of Behavioral Contextual Psychology have produced important educational and behavioral applications, which are rarely used, in a comprehensive, integrated form. Yet these newer methods that include derived relational responding and innovative third wave approaches could produce enhanced effects if combined and applied within the behavioral analytic theoretical framework Empirical Research in this field has accelerated over the last two decades, paving the way for many seminal clinical and educational applications, including some of the most currently well-known psychological intervention approaches such as Acceptance and Commitment Therapy and Functional Analytic Psychotherapy--FAP (Callaghan et al. 2004; Kohlenberg & Tsai, 1991; Tsai et al. 2009) Mounting evidence of adolescents' emotional problems, especially anxiety, led TICE center researchers (Tecnologie Individualizzate per le competenze dell'eta evolutiva--Individualized Tecnology for Developmental Skills), to examine new ways of helping adolescents with these ever more frequently reported issues in the learning center context. The researchers at TICE have begun to integrate recently developed FAP principles with more traditional behavioral analysis strategies to create more targeted interventions for assisting preadolescents and adolescents. FUNCTIONAL ANALYTIC PSYCHOTHERAPY FAP is a radical behavioral psychotherapy approach based on validated principles of behavior change, though. FAP itself is still being studied with respect to its clinical efficacy. The putative mechanism of change is contingent responding of the therapist to clinical problems and improvements, and some research on the topic has been conducted (e.g., Tsai, Kohlenberg, Kanter, and Waltz, 2009). FAP examines the therapist's direct effect on individual behavior, which must then extend into the individual's daily life through a process of promoting new derived relational responding (DRR). The approach is therefore not based on conventional generalization processes requiring a long-term instructional phase to cover a significant portion of many potential daily life situations (Hayes, Strosahl & Wilson, 1999). In principle, FAP may be readily integrated into other therapeutic approaches, such as ACT, which also shares the same pragmatic perspective and overlaps with many of its theoretical foundations. FAP uses the therapeutic relationship as a context for the advanced implementation of rigorously operationalized reinforcement strategies but also possesses concurrent and ecological validity. Although based on experimental evidence, FAP is a highly individualized, idiographic approach. One of its more innovative as well as pragmatic aspect is Tsai et al.'s (Tsai, Kohlemberg, Kanter, Kohlenberg, et al., 2009) classification distinguishing between that are directly modifiable during intervention sessions--clinically relevant behaviors (CRBs)--and their functional equivalents enacted in the natural environment--i.e., outside sessions (OS) behaviors. Intervention based on FAP principles with preadolescence and adolescence allows therapists to apply rigorous scientific principles and work within the well-defined area of behavior analysis. Intervention is therefore aimed at socially significant and observable behavioral change, by giving due consideration, however, to the fundamental relationships of preadolescents with peers. Operationalizing a therapeutic relationship that is technically based on the spontaneous and deliberate use of reinforcement strategies, makes it possible for therapists to influence these individuals' behaviors, thereby helping them broaden their social repertoires. The process leads to more flexible behavior through application of multiple source of social reinforcement, multiple topographies and different situations. This type of analysis, based on the application of functional analysis (Follette & Bonow, 2009) has demonstrated marked clinical efficacy, although the account for the positive effects is not simple. …

Functional Analytic Psychotherapy (FAP) for cluster B personality disorders: Creating meaning, mattering, and skills.

INTRODUCTION TO CLUSTER B According to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition Text Revision (DSM-IV-TR) (American Psychiatric Association [APA], 2000), the standard nosology for diagnosing psychopathology and related conditions, there are ten personality disorders classified on Axis II, with individuals identified under the broad umbrella of these disorders sorted into one of three sub-categories, or clusters. These groupings are delineated as clusters A, B, and C, and although the categorization into sub-types provides the framework for differing symptom pictures, personality disorders are a complex and fascinating class of diagnosis (Fowler, O'Donohue, & Lilenfeld, 2007), and as a whole are among the more controversial and problematic within the diagnostic manual (Widiger, 2007). Individuals with cognitive, affective, and behavioral features related to the diagnosis of a personality disorder have deeply ingrained and pathological patterns of thoughts, feelings and behaviors that can be traced back to adolescence or early adulthood (Kraus & Reynolds, 2001); yet the body of empirical literature is scant when it comes to scientific investigations of how to treat these long-standing, characterlogical disorders found on Axis II (Callaghan, Summers, & Weidman, 2003). Notably, premature termination and poor reported outcomes are problems of particular importance and impact in working with patients diagnosed with a personality disorder (Hilsenroth et al., 1998). There is general consensus that individuals with disordered personalities demonstrate pervasive and extensive interpersonal difficulties. Further, maladaptive and inflexible patterns of interacting with others can lead to functional impairment (APA, 2000). Due to space limitations, discussion within this paper will be specific to features of individuals with diagnostic patterns related to cluster B, which includes the diagnoses of Borderline Personality Disorder, Narcissistic Personality Disorder, Histrionic Personality Disorder, and Antisocial Personality Disorder. These cluster B dramatic personality disorders are all associated with pushing boundaries (Bender, 2005), and as such, clinicians must develop effective clinical formulations and make decisions on how to work with patients within the context of their particular personality organization and style (Kraus & Reynolds, 2001). The cluster B client, who may present with tendencies toward chronic self-harm, theatrical engagement in conflict, labile emotional states, dangerous antisocial sociopathy, or hyperbolic and intense displays of cognition and affect, can be challenging to manage clinically because their behaviors of interest are intrusive across domains of life functioning, including during the therapy session. FUNCTIONAL ANALYTIC PSYCHOTHERAPY Functional Analytic Psychotherapy, FAP (Tsai et al., 2009), is a contextual cognitive behavior therapy with roots in radical behaviorism. Briefly stated, FAP is a behavioral treatment that utilizes the therapeutic relationship to improve interpersonal difficulties (Nelson-Gray et al., 2009). FAP therapists endeavor to create vital, organic, meaningful, and dynamic therapeutic alliances (for an interpretation of FAP therapeutic alliance see Tsai et al., 2010) that progress and expand based on the therapist's conceptualization of the client's in-session behaviors, or clinically relevant behaviors (known in FAP terminology as CRBs). FAP conceptualizes that the mechanism of change occurs within the context of the therapeutic relationship, as the therapist shapes the client's CRBs via the process of contingent responding. The therapist pays careful attention to the communication patterns that the client exhibits, focusing on excesses and deficits in the client's interpersonal repertoire; and through the establishment and maintenance of the alliance formed via this therapeutic relationship and communication exchange, comments contingently upon the occurrence of CRBs in an effort to mold more useful skills and interactions. …

Social and linguistic input in low-income African American mother–child dyads from 1 month through 2 years: Relations to vocabulary development

ABSTRACTThe relation of social and linguistic input measures to early vocabulary development was examined in 30 low-income African American mother–infant pairs. Observations were conducted when the child was 0 years, 1 month (0;1), 0;4, 0;8, 1;0, 1;6, and 2;0. Maternal input was coded for word types and tokens, contingent responsiveness, and directiveness. Children's outcome measures included productive vocabulary at 1;6 and 2;0. Patterns of social and linguistic input were highly consistent over time. Significant positive relations were found between linguistic input measures and child vocabulary development. Findings for social input measures included positive relations between directive input and child word types, which differs from previous research with European American middle-class samples.

Toddlers' Social‐emotional Competence in the Contexts of Maternal Emotion Socialization and Contingent Responsiveness in a Low‐income Sample

AbstractEarly social‐emotional development occurs in the context of parenting, particularly via processes such as maternal emotion socialization and parent–child interactions. Results from structural equation modeling indicated that maternal contingent responsiveness partially mediated the relationship between maternal emotion socialization of toddlers (N = 119, ages 12–36 months) and toddlers' social‐emotional competence. Effect size was strongest for the direct path between maternal emotion socialization and toddler social–emotional competence. Toddler age and maternal demographic risk status (covariates) predicted toddler competence. Study results extend the previous literature on early competencies by focusing on toddlers rather than preschool‐aged children and by employing a contextual model in which both low‐income mothers' emotion socialization and their contingent responsiveness predicted toddlers' competencies.

Inexpensive video cameras used by parents to record social communication in epidemiological investigations in early childhood—A feasibility study

We tested the feasibility of parents recording social interactions with their infants using inexpensive camcorders, as a potential method of effective, convenient, and economical large scale data gathering on social communication. Participants were asked to record two short video clips during either play or a mealtime, and return the data. Sixty-five video clips (32 pairs) were returned by 33 families, comprising 8.5% of families contacted, 44.6% of respondents and 51.6% of those sent a camcorder, and the general visual and sound quality of the data was assessed.Audio and video quality were adequate for analysis in 85% of clips and several social behaviours, including social engagement and contingent responsiveness, could be assessed in 97% of clips. We examined two quantifiable social behaviours quantitatively in both adults and infants: gaze direction and duration, and vocalization occurrence and duration. It proved difficult for most observers to obtain a simultaneous clear view of the parents and infant's face.Video clips obtained by parents are informative and usable for analysis. Further work is required to establish the acceptability of this technique in longitudinal studies of child development and to maximize the return of usable data.

Mother–Infant Interaction During the First 3 Months: The Emergence of Culture‐Specific Contingency Patterns

This study analyzed German and Nso mothers' auditory, proximal, and visual contingent responses to their infants' nondistress vocalizations in postnatal Weeks 4, 6, 8, 10, and 12. Visual contingency scores increased whereas proximal contingency scores decreased over time for the independent (German urban middle-class, N = 20) but not the interdependent sociocultural context (rural Nso farmers, N = 24). It seems, therefore, that culture-specific differences in the modal patterns of contingent responsiveness emerge during the 2nd and 3rd months of life. This differential development was interpreted as the result of the interplay between maturational processes associated with the 2-month shift that are selectively integrated and reinforced in culture-specific mother-infant interaction.

Live face-to-face interaction during fMRI: A new tool for social cognitive neuroscience

Cooperative social interaction is critical for human social development and learning. Despite the importance of social interaction, previous neuroimaging studies lack two fundamental components of everyday face-to-face interactions: contingent responding and joint attention. In the current studies, functional MRI data were collected while participants interacted with a human experimenter face-to-face via live video feed as they engaged in simple cooperative games. In Experiment 1, participants engaged in a live interaction with the experimenter (“Live”) or watched a video of the same interaction (“Recorded”). During the “Live” interaction, as compared to the Recorded conditions, greater activation was seen in brain regions involved in social cognition and reward, including the right temporoparietal junction (rTPJ), anterior cingulate cortex (ACC), right superior temporal sulcus (rSTS), ventral striatum, and amygdala. Experiment 2 isolated joint attention, a critical component of social interaction. Participants either followed the gaze of the live experimenter to a shared target of attention (“Joint Attention”) or found the target of attention alone while the experimenter was visible but not sharing attention (“Solo Attention”). The right temporoparietal junction and right posterior STS were differentially recruited during Joint, as compared to Solo, attention. These findings suggest the rpSTS and rTPJ are key regions for both social interaction and joint attention. This method of allowing online, contingent social interactions in the scanner could open up new avenues of research in social cognitive neuroscience, both in typical and atypical populations.

Using Video Self-Modelled Social Stories to Teach Social Skills to a Young Child with Autism

The present study investigated the effectiveness of combining Social Stories and Video Self-Modelling (VSM) to teach social skills to a three-year-old child with autism. A multiple-baseline across behaviors design revealed that video self-modelled Social Stories were effective at improving all three target behaviors: greeting, inviting to play, and contingent responding. In addition, these behaviors successfully generalized across settings, toys, and communication partners. Concomitant behavior changes, namely, increased levels of communicative behavior and levels of social engagement were also observed. These results support the effectiveness of video self-modelled Social Stories and illustrate the potential of combined intervention techniques for remedying the social deficits faced by this population.

Depression Among a Sample of First‐Time Adolescent and Adult Mothers

Little is known about the rates, correlates, and consequences of depression among a sample of first-time mothers. Four-site prospective study of the first 3 years of life among first children born to first-time mothers, including adolescent (N= 396), lower- (N= 169), and higher-resource adult (N= 117). Mothers were administered the Beck Depression Inventory prenatally and 6 months postpartum. Measures of maternal and infant behaviors were taken at 8 months. Adolescent mothers displayed higher prenatal and 6-month rates of depression than lower- and higher-resource adult mothers, with significantly more adolescent mothers "consistently" depressed at the two time points than lower- and higher-resource adult mothers. Further, adolescent mothers were significantly more likely to become depressed after their babies were born than lower- or higher-resource adult mothers. Depression was negatively related to parenting practices and babies' behavior. As depression increased, mothers scored less favorably in maternal warmth and sensitivity, contingent responsiveness, and general verbalness; children scored less favorably in warmth seeking toward their mothers. Findings signify the need for counseling and nurse-based intervention and prevention services geared at preparing pregnant adolescents for motherhood.

The Functional Analytic Psychotherapy Rating Scale: a Replication and Extension

Few theories of psychotherapy give direction to the therapist on a moment-to-moment level or make pre- dictions about how specific therapist techniques change client behavior in session. Functional analytic psychother- apy (FAP, Kohlenberg and Tsai in Functional analytic psychotherapy: a guide for creating intense and curative therapeutic relationships. Plenum, New York 1991) pro- vides this direction and prediction. Specifically, FAP claims that client problem behaviors will be displayed in the therapeutic relationship and that the therapist can improve client in-session behavior through differential, contingent responding. Further, it is assumed that these improvements in session can be generalized to out of session relationships. The FAP rating scale (FAPRS) was developed for the purpose of coding in-session client and therapist behaviors in an effort to test FAP's purported mechanism of change. The current study seeks to replicate and extend initial FA- PRS findings (Callaghan et al. in J Contemp Psychother 33:321-339, 2003) regarding mechanism of change and to address transportability. FAPRS coding data from a single successful case of an individual diagnosed with Borderline Personality Disorder and treated with FAP is presented. Results indicate that the FAPRS system is transportable and are generally supportive of the claim that therapist contin- gent responding leads to client improvement.

Relation Between Maternal Contingent Responsiveness and Infant Social Expectations.

This study investigated the relation between maternal contingent responsiveness and 4- and 5-month-old infants' (N = 64) social expectation behavior in a still-face procedure. Mothers were asked to interact with their infants for 2 min (interactive phase), remain still-faced for 1 min (still-face phase), and resume interaction for 2 min. Mother and infant behavior was assessed for the frequency of infant and mother smiles, mother smiles that were contingent to infant smiles and infant smiles were contingent to mother smiles during the interactive phase, and infant social bids to mother during the still-face phase. Hierarchical regression showed that mother contingent smiles during the interactive phase accounted for unique variance in infant social bids during the still-face phase beyond that accounted for by the frequency of mother and infant smiles during the interactive phase. These results support the view that young infants' social expectations and sense of self-efficacy are formed within their interactions with their caregivers.

An evaluation of Intensive Interaction in community living settings for adults with profound intellectual disabilities

Intensive Interaction is an approach to enhancing the communication and social abilities of people with profound intellectual disabilities using principles from caregiver-infant interaction. Use of Intensive Interaction by novice practitioners with four women with profound intellectual disabilities living in a supported housing service in England was evaluated. It was hypothesized that staff could learn the principles of Intensive Interaction sufficiently to have a positive impact on the participants' abilities (during five sessions per week over 20 weeks) and that they would experience a better relationship. A quasi-experimental interrupted time-series multiple-baseline design was used with data collected via video observations, assessment schedules and staff questionnaires. Practitioners learned to use mirroring and contingent responding, and participants' abilities to look at faces and become engaged in interaction and joint focus developed. There was less volume of evidence for improved quality of relationship. Embedding practitioner reflection on interactions was a difficult part of the intervention to implement.

Similarities and differences in contingency experiences of 3-month-olds across sociocultural contexts

In this study we analyzed similarities and differences in the contingency experiences of 159 three-month-olds from 6 sociocultural contexts. Across contexts, caretakers responded with similar overall contingency levels, vocalizations provided the dominant response as well as the most salient signal, and there was a relative signal-response correspondence. With two exceptions, infants in all samples most often got responses addressing their sense of hearing, followed by the sense of touch and then sight. In response to nondistress vocalizations, infants from independent contexts (Berlin, Los Angeles) experienced more contingent responses addressing their sense of sight than infants from autonomous-related (Beijing, Delhi, urban Nso from Cameroon) or interdependent contexts (rural Nso). Rural Nso infants experienced more contingent responses addressing their sense of touch than infants from all other but the Los Angeles sample. These results support the interpretation of contingent responsiveness as a part of the intuitive parenting program that manifests differentially depending on culture-specific emphases on distal and proximal caretaking.

Early Child Contingency Learning and Detection: Research Evidence and Implications for Practice

The types of contingency experiences infants and young children are typically exposed to are examined with a focus on the implications for early childhood intervention with young children who have developmental disabilities and delays. Studies of response-contingent child learning, the manner in which contingencies are not under direct child control, and child/caregiver reciprocal contingencies, are reviewed in terms of how they influence child learning and development. Results indicate that the different types of contingencies all positively influence child behavior. Implications for practice are described in terms of contingency-rich everyday child learning activities, child response-contingent learning in the context of those activities, and caregiver contingent responsiveness as an instructional strategy for supporting child contingency learning.

A responsive parenting intervention: The optimal timing across early childhood for impacting maternal behaviors and child outcomes.

This study examined the optimal timing (infancy, toddler-preschool, or both) for facilitating responsive parenting and the intervention effects on maternal behaviors and child social and communication skills for children who vary in biological risk. The intervention during infancy, Playing and Learning Strategies (PALS I), showed strong changes in maternal affective-emotional and cognitively responsive behaviors and infants' development. However, it was hypothesized that a 2nd intervention dose in the toddler-preschool period was needed for optimal results. Families from the PALS I phase were rerandomized into either the PALS II, the toddler-preschool phase, or a Developmental Assessment Sessions condition, resulting in 4 groups. Facilitation of maternal warmth occurred best with the PALS I intervention, while cognitive responsive behaviors were best supported with the PALS II intervention. Behaviors that required responsiveness to the child's changing signals (contingent responsiveness, redirecting) required the intervention across both the early and later periods.

Caregiver sensitivity, contingent social responsiveness, and secure infant attachment.

A World Health Organization report (e.g., Richter, 2004) on importance of caregiver-child relationships as a context for growth and development of young children throughout world noted that: Sensitive and responsive caregiving is a requirement for healthy neurophysiological, physical and psychological development of a child. Sensitivity and responsiveness have been identified as key features of caregiving behavior related to later positive health and development outcomes in young children. (p. 1) One of developmental consequences of sensitive and responsive caregiving is secure infant/adult attachment (Bowlby, 1988). Secure attachment is generally understood to be an affectional bond between an infant and an adult caregiver (1) that has two elements: (1) infant seeking out attachment figure in times of distress and need and (2) infant having ability and confidence to engage in activities separate from attachment figure (Ainsworth, 1989). The development of attachment relationship is recognized as one of most important aspects of human social and emotional development (e.g., Lamb, Ketterlinus, & Fracasso, 1992). This is case, in part, because secure attachment has been found to be related to enhanced cognitive, social, and emotional development throughout childhood and early adolescence (Bukatko & Daehler, 2001; Fagot & Kavanagh, 1993; Hazen & Durrett, 1982; Matas, Arend, & Sroufe, 1978; Sroufe, Egeland, & Kreutzer, 1990). Many theories as well as variations of theories have been posited for explaining sources and consequences of secure infant attachment (see e.g., Cassidy & Shaver, 1999; Egeland & Erickson, 1993). John Bowlby (1969) is credited with original formulation of attachment theory, and Mary Ainsworth (Ainsworth & Wittig, 1969) is credited with highlighting importance of caregiver sensitivity as a determinant of secure attachment. Gewirtz and his colleagues proposed a behavioral, or operant learning analysis, perspective of secure infant attachment that considers caregiver sensitivity and responsiveness as having reinforcement properties and infants' responses to caregivers' behavior as having differential consequences on caregivers' reactions (e.g., Gewirtz, 1972a, 1991; Gewirtz & Boyd, 1977; Gewirtz & Pelaez-Nogueras, 1991). According to Gewirtz, attachment is parsimoniously explained by fact that child behavior is cued and reinforced by caregiver responses and may have either positive or negative effects on child behavior that in turn is directed toward caregiver (e.g., type of attachment). In Gewirtz's (1991) own words, the dyadic functional relations between cue and reinforcing stimuli from attachment figure/object person and child's responses they control that connote attachment of child to attachment figure may occur in any segment of life from infancy onward (p. 250). The purposes of this article are to summarize findings from: (a) two practice-based research syntheses of relationships between caregiver sensitivity and secure infant attachment (Kassow & Dunst, 2004, 2005) and (b) one practice-based research synthesis of interventions for strengthening caregiver sensitivity to child behavior (Dunst & Kassow, 2004). A practice-based research synthesis involves review and integration of research evidence where focus of investigation is same or similar environmental (intervention) characteristics and how variations in characteristics are related to variations in consequences of different events or experiences. These kinds of research syntheses differ from more traditional research reviews and syntheses by disentangling and unpacking what matters most in terms of explaining relationship(s) between different environmental experiences and their consequences (Dunst, 2007; Dunst, Trivette, & Cutspec, 2002). …