Attachment and Biobehavioral Catch-up

Domain V · Systemic, relational, group & community · Mary Dozier, Kristin Bernard · University of Delaware, USA

What it is

Attachment and Biobehavioral Catch-up (ABC) is a short, manualised, home-visiting parent-coaching programme. It is for caregivers (birth, foster, kinship and adoptive) of infants and young children who have faced early adversity: neglect, maltreatment, foster placement, institutional care,…

Format

• Session ingredients: each session has the same building blocks: manual-guided discussion of that week's target;
• video feedback, using clips of the parent from earlier sessions and the programme's standard example clips;

Who practises it, and how they are trained or regulated

• Delivery: 10 sessions, about 60 minutes each, weekly, one per family. Sessions take place where the family lives: home, shelter or temporary housing. Virtual or hybrid delivery is allowed on family request or when visits are impossible.
• Who attends: the primary caregiver must be able to attend all 10 sessions. Anyone else in the home may join. There is no group version, because the behaviours have to be practised in the family's own setting.
• Recording: every session is video recorded. The recordings feed in-session playback and fidelity supervision. Equipment: a camera, a laptop, toys, and a webcam for supervision.

Questions to explore with your client

• What drew you to it, and what are you hoping it will change?
• Does it involve any substance, plant preparation, remedy or supplement? Has your doctor or prescriber been told, especially about any medication you take?
• Does it involve intense or unusual breathing? Have you been told about the medical conditions for which that is not advised?
• Is it a group, retreat or community? How do they respond if someone wants to leave or raises a concern?
• Does it use a device, heat, cold, water or a physical procedure? Has a medical professional checked that it is safe for you?
• Who runs it, and what training or registration do they hold?
• What actually happens in a session or meeting, and how often?
• What does it cost, and is there pressure to commit to more?
• How do you feel afterwards, in the hours and days that follow?
• Does it fit with, or clash with, the work we do here?

What practitioners of it watch for

• Drift into general chat or generic praise, falling comment rates, and a growing share of missed opportunities.
• Ending anxiety, especially in parents with loss histories. Name the ending early, and plan referrals if needs remain.
• Parent overwhelm. Coach the parent's self-regulation first. Unsafe behaviour by the child. Safety comes before staying close.
• Low literacy or a busy household. Accept verbal recall, a phone note or a photo of a tick sheet. Treat any observation as success.
• Activities that turn into teaching (naming colours, testing) instead of following. A child who is asleep, ill or absent. Practice needs the dyad together.

When to involve someone else

• New or worsening physical symptoms, or advice to stop or change prescribed medication: involve the client's doctor or prescriber.
• Signs of coercion, isolation from family and friends, escalating costs or secrecy: discuss openly and consider safeguarding.
• A crisis or thoughts of suicide: follow your crisis protocol. In the US, call or text 988; in the UK and Ireland, Samaritans on 116 123.

Drawn automatically from the guide's own sections. Stay curious: neither endorse nor dismiss what the client values, and check anything that matters against the full guide and its sources. Not medical advice.