The purpose of the article is to provide a clinical assessment model for the identification of controlling attachments among parents and pre-school children who present with behavioral, emotional or functional problems. Research indicates that a large portion of pre-school children (aged 3–6 years) presenting to children’s mental health clinics display severe attachment difficulties with their primary caregivers, that is, controlling, role-reversed attachments. Given that these children are at the greatest risk for childhood social and emotional maladjustment and adult psychopathology, there is a need for their identification so that effective intervention can be implemented to mitigate the development of further child psychopathology, and ultimately prevent the inter-generational transmission of dysfunctional parent–child attachments. Clinical assessment of controlling attachments between parents and their pre-school children presenting to mental health clinics is dependent on obtaining information regarding the child’s early attachment history, the parent’s state of mind regarding their relationship with their own parents, the parent’s and child’s representations of their relationship, and assessment of interactions between the primary caregiver and the referred child. Using parent and child interviews, as well as the clinical observation of parent–child interactions, child attachment strategies, accompanying parent caregiving behaviors and relational dynamics can be uncovered and targeted for intervention.