Ten in-home sessions changed how vulnerable infants organised their distress
A randomised trial of the Attachment and Biobehavioral Catch-up programme
Reviewed by Sian Trombley, CCCFounder, Thrive Family Company
Strong confidence
Source citation
Bernard K., Dozier M., Bick J., Lewis-Morrarty E., Lindhiem O., Carlson E. (2012). Enhancing Attachment Organization Among Maltreated Children: Results of a Randomized Clinical Trial. Child Development. https://doi.org/10.1111/j.1467-8624.2011.01712.x
Published 1 January 2012 · Added to Thrive 26 July 2026 · Reviewed 26 July 2026
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When caregiving has been frightening or inconsistent, children learn to hide distress. This trial tested whether that can be reversed quickly.
Published research findings
The study
Infants in child-welfare-involved families were randomly assigned to a ten-session in-home coaching programme or a control intervention.
What researchers examined
Whether coaching caregivers to respond warmly to distress changed infant attachment organisation.
What they found
Children in the coaching group showed substantially higher rates of secure attachment and lower rates of disorganised attachment than controls.
Thrive editorial interpretation
What this may mean for families
Even in high-adversity contexts, brief, focused, in-the-moment coaching produces measurable change.
What this doesn't tell us
Important limitations
Delivered by trained and supervised clinicians in a specific high-risk population.
Evidence confidence describes how much weight this study's design can carry — not how strongly the finding applies to any individual child or family.
Therapist perspective — Thrive interpretation, not a finding of the study
Therapist Perspective
The instruction was not 'be a better parent'. It was 'follow the child's lead and respond to distress with warmth' — repeated until it became automatic.
Practical family considerations
Respond to distress with warmth, especially when the child hides it.
This research summary is educational and does not replace individualized medical, psychological or therapeutic advice.
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