As much as we sometimes may resist this reality, all of us are deeply impacted by the experience we had in our family systems growing up.
How could we not be? Expecting adults to not be impacted by their childhood is like expecting a social media feed to be unaffected by the algorithm on the backend. Early childhood relationships orient and wire our minds to the experience of living and finding safety in the family system. And eventually, in the broader systems in which we exist.
Inevitably, most adults come out of their family system with some scars, even in families where love is present. Parents cannot be perfectly present 100% of the time. Plus, many never learn how to repair moments of conflict with their children to reestablish connection and safety.
Families can benefit from attending therapy to:
- Heal the interactions that occurred in the past
- Experience a new sense of connectedness
- Create shared meaning on their history and family story.
Attachment-based family therapy is an empirically supported family therapy model designed to help families heal past ruptures. It is based on John Bowlby’s attachment theory. The premise is that children and adolescents need connection to their caregivers to feel secure and safe.
When those connections are threatened or ruptured, family conflict often follows. Conflict and dysregulation in family relationships have a significant effect on each individual member of the system.
Family cohesion is a protective factor for a myriad of mental health issues. And working toward connection and understanding can help to heal adolescent and adult members alike.
Today, we are dedicating this post to talk about attachment-based family therapy. You’ll learn how families in various stages of life and development can benefit.
What is Attachment-Based Family Therapy?
Attachment-based family therapy (ABFT) is an evidence based model of treatment based on attachment theory. This model helps us to understand human behavior, motivation, and emotion. A family therapist will use attachment theory as the guiding framework.
ABFT, a type of family of origin therapy, assumes that attachment develops when parents are accessible to children. Early relationships with caregivers form the basis of all relationships later in life.
Children who feel they can access their caregiver when they need them will have greater security in relationships. On the contrary, children who cannot reach their caregiver, or experience them as insensitive to their needs, may experience less security in relationships.
This “insecurity” can look like:
- Pushing people away
- Lack of trust in others
- Anxious clinging out of fear or losing someone
Attachment theory also posits that humans are primarily driven by an inherent need to connect with others. And that they derive existential meaning from those connections.
ABFT is unique among family therapy models in that it provides an interpersonal approach to treat the ruptures in connection. These broken bonds underlie the family conflict and presenting pain. As such, treatment goals focus on repairing and the approach is promising for family therapy for depressed individuals.
Goals of Attachment-Based Family Therapy
Similar to emotionally-focused therapy, attachment based family therapy guides attachment relationships to build secure family system relationships. Here are specific objectives based in attachment theory that help families (i.e., adult child relationships) in this work.
Reframe the problem
Often when families begin the treatment process, they are operating under an assumption that one member, often an adolescent, is the “problem.” Family therapists help shift the focus. This is the most important family intervention.
Instead of viewing the dysfunction as an issue with the adolescent, we reframe the dynamics. The “problem” is the dynamic itself, impacted by each member of the family in the household.
As such, we move the focus on each family member participating in tasks. These tasks build relationships and heal old wounds, instead of demanding behavior change in any one member.
Family members have the ability to be the medicine for each other. And shifting the perspective to focus on the potential instead of problem behaviors increases the efficacy of treatment.
Acceptance of emotions
Most therapeutic models help clients to understand and tolerate the range of emotional experiences, even the ones that are uncomfortable.
When family members can slow down and feel their own emotions, they are less likely to be in a constant state of reacting and projecting onto one another.
Families can also reprocess old, painful emotions, by revisiting a past meaningful event. They can access the softer, vulnerable, hurt feelings associated with this event, and share them with their family members.
The sharing of emotions liberates members from having to respond defensively to feeling them.
Validation of emotions
While family members are learning to access, share, and accept their emotions, they also learn to validate the experiences of one another. This validation allows members to feel seen, heard, and connected to one another.
Validation does not mean that you “agree” with the actions a family member took in the past that may have been hurtful toward you. Rather, members are able to hear the emotions experienced by the other and validate the emotional experience, not necessarily the behavior.
For example, upon learning that an adolescent was fearful and sad they may be rejected from a friend group if they did not attend a party, the parent who did not allow them to attend the party may validate their fear by saying: “it makes sense that you were angry and scared about the party if it meant losing your friends”. This is true even if the parent does not support a dramatic outburst that followed.
Validating emotions does not “reinforce” bad behavior. Rather, it allows members to feel more connected to one another and more safe in sharing the vulnerable experience so that they do not need to act out the defensive, protective reactions that come about when they are unseen and unheard.
Resolve past Injuries
Reframing the problem, experiencing emotions, and hearing each other all set the stage for repairing past wounds or ruptures. Repairing these moments is the largest central goal of ABFT.
The repair of the past wounds occurs over time as family members are able to express past hurts in an emotionally-regulated, non-attacking way, while encouraging the receiving members to express empathy, understanding, and validation. Over time, these interactions act as a corrective attachment experience that replaces the past ruptures with a new dynamic and secure attachment develops.
The secure attachment strengthens the bond between family members and also improves each member’s relationship health outside of the family in their own friendships, romantic relationships, and professional dynamics. Ultimately, when seen and heard by the members of their family system, members feel less alone and more safe.
Find balance between identity in family and individual
Ultimately, adult children are launched from their family of origin to develop an individual identity. And to eventually create an entirely new system with their own partner and children.
Finding security and safety improves individual members relationship health. At the same time, it makes them more independent to go out into the world and have their own new experiences and take risks, knowing they have a safe system to fall back on. Encouraging individuality also helps in building alliance with the adolescent, supporting them to become their own person.
Through a combination of these new and separate experiences, and the foundation of the early family system, individuals create a unique and shared family and individual identity.
Improve Communication
During therapy, the counselor will help each family member identify and articulate their own needs and concerns. The ABFT therapists will also help coach the family in how to communicate these needs and concerns, and to effectively participate as the listener for other family members.
With a reliable method of communicating in a way where needs and concerns are met, the frequency and intensity of conflict in the family system will decrease. Practicing healthy communication with children and parents in session will build healthy patterns and strengthen their skills outside of session.
Foster Resilience
Many families experience hardship and pain that brings about conflict and ineffective communication when unprocessed. Therapy encourages repair and rebuilding of trust when family members have not been able to support each other through hardship.
With trust and reliable support re-established, families are better equipped to navigate life’s stressors. Members will know that they can rely on each other and will know how to communicate their needs, making them more resilient as a family system.
Family relationships become a source of support and comfort, rather than a place of disconnection and pain.
How Can Family Members Effectively Solve Problems Together?
Families solve problems more effectively when they feel secure, understood, and emotionally connected. In attachment-based family therapy, problem-solving does not start with fixing behavior. Instead, it starts by strengthening the parent child relationship and restoring a secure based connection between members.
When family members slow down and identify what each person is feeling in the body, conversations become less reactive. From there, families can name needs clearly, listen without interrupting, and respond with curiosity rather than defensiveness. These skills are especially important for family therapy for adolescents and young adults, where autonomy and connection often feel at odds.
Effective problem-solving also involves shared responsibility. Rather than blaming one person, families learn to view challenges as relational patterns shaped by stress, unmet needs, and past ruptures. This approach reduces escalation and supports families facing mental health problems, including depression and anxiety.
Over time, families build confidence in their ability to navigate conflict together, which strengthens resilience and reduces the intensity of future disagreements.
Attachment Based Family Therapy Activities
Emotion Mapping Conversations
The therapist guides family members to describe what they feel physically and emotionally during moments of conflict. This helps each person recognize how the nervous system reacts under stress and builds empathy across the family system.
Repair Conversations
Family members revisit a specific past rupture and practice expressing hurt, fear, or disappointment in a regulated way. The receiving member practices listening, validating, and responding with care, creating a corrective emotional experience.
Accessibility and Responsiveness Exercises
Parents practice responding to their child’s emotional cues in real time during session. These activities strengthen secure based attachment and improve the parent child relationship, particularly for adolescents who feel misunderstood.
Shared Meaning-Making
Families work together to reflect on significant events in their history and discuss how those experiences shaped their relationships. This activity helps families integrate the past while creating a more compassionate shared narrative.
What Do Marriage And Family Therapists Do?
Marriage and family therapists are trained to understand how relationships impact emotional well-being. Rather than focusing on individuals in isolation, they assess patterns of interaction, attachment needs, and emotional responses within the family system.
In attachment-based family therapy, therapists guide families through specific treatment tasks designed to repair ruptures in connection. These tasks help parents become more emotionally accessible and help children and adolescents feel safer expressing vulnerability. This work is especially critical when supporting suicidal adolescents or addressing suicide ideation and behavior, where disconnection often plays a central role.
Many clinicians who practice this model complete a formal ABFT training program, which emphasizes emotion-focused interventions, relational repair, and restoring trust. Marriage and family therapists also support families in developing communication skills that last beyond therapy and apply to relationships outside the family.
Could Attachment-Based Family Therapy Help Us?
Although ABFT was designed as therapy for depressed adolescents, treating depression and suicidal ideation (along with cognitive behavioral therapy) the potential benefits expand beyond families with current adolescents.
Secure attachment based family therapy ABFT is unique in that it uses family dynamics in session as the target and mechanism of healing, creating a possibility for a new secure attachment between members.
Even if no longer living together as a family unit, adults can heal greatly through corrective interactions with their original family system by resolving attachment ruptures that impact their adult lives.
If you are interested in healing family of origin wounds but your family is not willing to participate in a structural family therapy, schedule some individual sessions with an attachment-based family therapist and share your goals. Even without the presence of your family members, healing insecure attachments is possible.
Is Family Therapy Covered By Insurance?
Family therapy is often covered by insurance, though coverage depends on the specific plan, provider credentials, and diagnosis used for billing. Many insurance plans cover family therapy for adolescents, especially when addressing diagnosed mental health problems such as depression, anxiety, or trauma-related concerns.
Some plans may also cover sessions related to suicidal adolescents or treatment connected to suicide ideation and behavior, given the clinical necessity. However, coverage can vary for adult family members or sessions focused on relational repair rather than symptom reduction.
It is recommended to contact your insurance provider directly to ask about benefits for family therapy, copays, and any limitations. If insurance coverage is limited, many therapists offer private pay options or can help families explore alternatives that still support healing and connection.
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