Therapeutic Thoughts of the Week:

Attachment in the Context of Multiple Caregivers

Therapeutic Thoughts of the Week: Attachment in the Context of Multiple Caregivers

Some of our Healthy Minds providers recently participated in the Early Childhood Service Intensity Instrument (ECSII) training which is a tool to assist providers caring for young children to determine intensity of services for infants, toddlers, and children from ages 0-5 years. The ECSII is targeted to children and their families with emotional, behavioral, and/or developmental needs, including those who are experiencing environmental stressors that may put them at risk for such problems. Domain II assesses the quality of the child-caregiver relationship and the ECSII scoring worksheet allows for 3 caregiving relationships to be assessed and scored. Due to the proximity of timing for some provider’s participation in this training this week’s Healthy Minds “Therapeutic Thoughts of the Week” pertains to the concept of attachment in the context of multiple caregivers.

John Bowlby’s (1969/1982) work on attachment proposes that a child develops a hierarchy of attachment relationships. Bowlby proposed that the infant becomes attached to the mother first as the primary caregiver and then to others, specifically the father. Mary Ainsworth’s (1967) work on attachment proposes that during the time that the infant builds an attachment with his mother that he is also building attachments with “others” during this time which may be the father, grandmother, older sibling, or other adult figure in the home. For the context of the population in which Healthy Minds provides services to (Foster Care) we will broaden the concept of attachment and consider attachment as a network of attachment relationships i.e. (foster parents/coaches/daycare providers). The inclusion of multiple caregivers in the study of attachment relationships adds new dimensions to be examined within the field of attachment research.

Who is an attachment figure?

Within most westernized cultures there is little dispute or controversy acknowledging that the mother and the father are viewed as attachment figures. However, may the grandmother, foster parent, or the full-time daycare provider may also be viewed as an attachment figure?

What criterion do we use to determine who is an attachment figure?

We may take into consideration the emotional connection developed over time between the infant/toddler and their attachment figure. Van Ilzendoorn et al research indicates that the level of caregiver sensitivity and attachment security also plays into the development of an attachment figure. Howes et al research proposes the following three criteria necessary for identification of an attachment figure: 1) provision of physical and emotional care; 2) continuity or consistency in a child’s life; and 3) emotional investment in the child. These criteria are principally meant to be applied to adults within the individual children’s social networks. Within a network of attachment relationships we must determine who these attachments figures are and in what developmental context and timeframe did this attachment relationship enter the infant/toddler’s life.

Early childhood (initial) Attachment is pivotal and directs the formation of future relationships. Howes, Hamilton, and Phillipsen, 1998 indicate that children’s attachment security with their first child care providers will predict the child’s perception of their relationships with their current teachers.

David P. Sanchez, Psy.D, LMFT
Licensed Therapist, Healthy Minds

This week’s Healthy Minds’ “Therapeutic Thoughts of the Week” is to provoke insight and reflection around the idea of our foster children possessing a “network” of attachment figures and to provide a conceptualization on how to determine a primary attachment figure in the child’s life.


  • Ainsworth, M.D.S. (1967). Infancy in Uganda: Infant care and the growth of love. Baltimore: John Hopkins University Press.
  • Ainsworth, M.D.S., Blehar, M., Waters, E., & Wall, S. (1978). Patterns of attachment.Hillsdale, NJ: Erlbaum.
  • Bowlby, J. (1958). The nature of the child’s to his mother. International Journal of Psycho-Analysis, 39, 350-373.
  • Bowlby, J. (1969/1982) Attachment and loss: Vol. 1. Attachment. New York: Basic Books.
  • Howes, C., Hamilton, C.E., & Phillipsen, L.C. (1998). Stability and continuity of child-caregiver relationships. Child Development, 69, 418-426.
  • Van Ijzendoorn, M.H., Sagi, A., & Lambermon, M. (1992). The multiple caregiver paradox: Data from Holland and Israel. In R. C. Pianta (Ed.), New directions for child development: No. 57. Beyond the parent: The role of other adults in children’s lives (pp. 5-27). San Francisco: Jossey-Bass.
2018-07-10T18:28:38+00:00November 20th, 2014|Mental Health, Psychiatry, Psychology, Therapeutic Thoughts of the Week|

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