Attachment Issues in Children: A Guide to Treatment Options for Parents

Most children develop secure attachments to their caregivers at an early age; however, attachment issues are common among a wide range of children, as they often result from any kind of relational problem early in life, with family members, siblings, or even friends. They not only affect a child’s relationships but also their beliefs about their ability to achieve their goals. As early interactions with others play a significant role in shaping relationship style, children who have had positive social support early in life are more protected from the effects of later relationship issues, such as being bullied or getting into arguments with family members. 

Attachment issues can cause large obstacles in forming meaningful, healthy relationships with others, if negative beliefs and fears about relationships aren’t challenged early on. At Asheville Academy, we work with children with attachment issues and their families to help them re-establish a secure relationship with a healthier communication style. 

The guide is meant to be comprehensive, but as such, not every section will be applicable to everyone. Instead, we invite you to click on the links in the table of contents to jump to the sections that most interest you.

What is Attachment?

Everyone has a primary attachment style, although it can vary from relationship to relationship.  The most significant relationships that shape teenagers’ attachment styles are their relationships with their parents. Attachment styles are usually formed in early childhood based on consistency and availability of their caregivers while they were first establishing trust in relationships.

What are Attachment Issues?

Attachment refers to the ability to form emotional bonds and empathic, enjoyable relationships with other people. Relationships with family members typically model attachment style later in life with both friends and intimate partners. Many children with attachment issues  have often learned that their needs will be met inconsistently or not at all and are sensitive to perceived rejection. This may lead to self-sabotage to confirm their beliefs about relationships. 

Some children who struggle with insecure attachment often become anxious and withdrawn around other people. Others will seek out approval or attention in unhealthy ways to get their needs met. Types of attachment issues include avoidant attachments, ambivalent attachments, and disorganized attachments. Common themes include a fear of intimacy and abandonment that gets in the way of forming healthy, positive relationships.

Signs of attachment issues in children may include the following:

• Anger issues: Children may express anger by throwing tantrums or acting aggressively or more subtly through acting out during socially acceptable behaviors. For example, they might shake hands and squeeze until it hurts, or hug someone too tightly.
• Need to be in control: Children with reactive attachment disorder must feel as though they are in control at all times. This results in defiance issues and argumentation.
• Difficulty showing appropriate affection: Some children with attachment show the same amount of affection towards strangers that they show their adoptive parents. On the other hand, they may be more willing to trust strangers with personal details, which can be unhealthy as well.
• They don’t like to be touched: Children regard being touched affectionately as a threat rather than something positive. They may act strangely if touched, like laughing or flinching.
• A lack of interest in socializing. They may avoid eye contact or have difficulty maintaining conversations with others. They may seem socially withdrawn and struggle with reaching out to others for support, preferring to do things on their own.

Types of Attachment Issues:

Signs of attachment issues depend on the individual’s style of attachment and may be more obvious in some relationships than others. Most children have a primary style of relating to others, but it depends on a variety of other situational and internal factors. 

Ambivalent attachment is often caused by inconsistent availability of caregiving and may include:

• Feelings of anger or helplessness in relationships
• Anxious around and mistrusting of strangers
• Separation anxiety 
• Reluctance to get close to others
• Fear of rejection and abandonment
• May desire attention but are less likely to seek it out

Avoidant attachment is often caused by emotionally unavailable caregiving and may include:

• Social isolation
• Overestimating self reliance
• Emotionally detached or lack of emotional awareness
• Unwilling to be vulnerable with others
• Fear of being clingy or needy
• More likely to seek out relationships but stay at a distance or avoid them altogether 

Disorganized attachment is often caused by inconsistent attention in caregiving and may include:

• Often unpredictable combination of avoidant and ambivalent attachment styles
• Switching between caregiving and pushing others away
• Attracted to others who are similarly disorganized 
• More likely to seek validation from others

What are the Causes of Attachment Issues in Teens?

Trouble Building Trust

Causes of attachment issues depend on the individual, although they usually are established in early childhood when babies learn the concept of basic trust. Essentially, secure attachments are formed when babies learn that they can rely on their caregivers to meet their basic needs. They internalize that the world is safe, and that people are inherently good. While relational styles may change depending on the relationship in question, attachment styles are based on ingrained beliefs about how to approach relationships. 

Broken Trust

In order to build secure attachments, children need a safe, consistent and nurturing environment where they can get their physical and emotional needs met. Not all children with attachment issues have a history of trauma, although it is a common risk factor for attachment issues.

Fear of Trust

Other factors include neglect, bullying, rejection, adoption, moving frequently, young parents, parent mental illness, parent divorce, parent remarriage, multiple caregivers, and growing up in foster care. Unstable or inconsistent attachments in childhood can be strong predictors for difficulty making friends, staying in relationships, and domestic abuse later in life. Attachment issues are also associated with mental health issues, such as depression, anxiety, and low self esteem. 

When Does Your Child Need Treatment for Attachment Issues?

The primary form of treatment for attachment issues is establishing a safe, consistent, and nurturing environment to help children change narratives around what healthy relationships should look like. Even when surrounded by positive mentors and like-minded peers, people with attachment issues struggle with trusting that their support is authentic and will continue. Some of the innovative Interventions offered by some of our therapists include EMDR, Theraplay, and Art therapy.

Types of Therapy for Attachment Issues

• Cognitive Behavioral Therapy helps teens think more about their thoughts, feelings, and behavior and replace negative thoughts with ones that are more realistic and positive.

• Social Skills Training helps teens learn and practice important relationship skills, like taking turns in conversation and discussing feelings when trying to resolve conflict. Within a residential group, students can explore group dynamics and practice how to stay present and connect with others in a group setting that resembles a home environment.

• Family therapy and parent seminars help students explore their family dynamics and repair relationships. Families work together to improve communication skills and help their child will be able to transition to a more understanding and supportive environment at home. 
• Equine-assisted therapy for students to explore their relationship styles and build self awareness about how to connect with and take care of others. Many of our horses struggle with attachment issues as well and together, they learn to co-regulate.

Treatment Options for Attachment Issues

• Outpatient Therapy. Some therapists in your area may specialize in attachment issues, adjustment disorders, developmental trauma, or adoption issues. Therapy may involve a few sessions or become routine to monitor adjustment.
• Wilderness Therapy. Adolescents who are struggling with behavioral issues and defiance may benefit from participating in adventure activities in a wilderness therapy program. This option appeals to teens whose family, school, or social situation has interfered with their ability to cope with problems and those who learn best through active participation.
• Residential Treatment Centers. These treatment centers work with youth struggling with attachment issues that have affected their ability to enjoy hobbies, maintain healthy friendships, and cope with stressors in a healthy way. These programs are focused on helping children establish a support system and healthy coping skills.
• Therapeutic Boarding Schools. Longer-term therapeutic boarding schools are often a good fit for adopted children who have fallen behind in school or are struggling socially as they balance group therapy with academic support in smaller classrooms. These schools offer a nurturing community environment with plenty of support from peers and mentoring from authority figures that are less restrictive than residential treatment centers. 

How Do Therapeutic Boarding Schools, like Asheville Academy, Help Teens Struggling with Attachment Issues?

Letting Go of Past Fears 

Asheville Academy is a therapeutic boarding school that understands how parent-child relationships have profound effects on cognitive, social, and emotional functioning. Many of our students struggle with attachment issues that have led to conflict at home or insecurity in friendships. Teenagers with attachment issues have a difficult time adjusting to traditional talk therapy due to its social nature and benefit from a holistic and multidisciplinary approach that focuses on identifying their personal strengths and building social skills to help with these interactions. 

Challenging Beliefs about Relationships

One of the therapeutic modalities we use, Cognitive Behavioral Therapy, focuses on helping teens think more about their thoughts, feelings, and behavior and replace negative thoughts with ones that are more realistic and positive. Between group therapy discussions on attachment issues and taking on a community role in one’s “tree group,” students explore healthier ways to connect with others and find evidence that many relationships are, in fact, positive when they share positive values. 

Building a Close Community

Our residential model emphasizes the benefits of milieu therapy and group therapy in building connections with a consistent peer group. Our community is divided into separate teams with their own Academic Advisors, Residential Advisors, and Clinicians based on students’ age and shared past experiences. Our staff rotate in weekly shifts to improve consistency and deepen connections.  We use equine-assisted therapy and offer grief, attachment, and adoption processing groups for students struggling with attachment issues.