SynthesisHealth technology assessment (Winchester, England)2023
Routinely used interventions to improve attachment in infants and young children: a national survey and two systematic reviews.
Synthesis in Health technology assessment (Winchester, England), 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
8 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Perinatal Mental Health Interventions with a Parent-Child Relational Component: A Systematic Review of the Effects on Mothers and Dyads.Clinical child and family psychology review · 2025Pooled it
- Manualised Attachment-Based Interventions for Improving Caregiver-Infant Relationships: A Two-Stage Systematic Review.Clinical child and family psychology review · 2025Pooled it
- From Home to Hallways: How Adverse Childhood Experiences and School Context Shape Student Relationship Development.The Journal of school health · 2026Article
- The protective power of connection: a proposed conceptual model of social supports in the context of youth adversity, disrupted attachment, and trauma symptoms.Frontiers in psychology · 2026Review
- A psychometric evaluation of the NICHD Parent-Infant Interaction Scales to inform clinical practice.Frontiers in psychology · 2026Article
- The Mediational Intervention for Sensitizing Caregivers: an evaluation of feasibility and acceptability among mothers with borderline personality disorder.Borderline personality disorder and emotion dysregulation · 2025Article
- Attachment theory and research: What should be on the core curriculum for child and family social workers?Social work education (London, England) · 2025Article
- Interventions for pre-school children in foster care: A systematic review of randomised controlled trials of child-related outcomes.JCPP advances · 2025Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
14 authors.
Funding
Abstract
backgroundAttachment refers to an infant's innate tendency to seek comfort from their caregiver. Research shows that attachment is important in promoting healthy social and emotional development. Many parenting interventions have been developed to improve attachment outcomes for children. However, numerous interventions used in routine practice have a limited evidence base, meaning that we cannot be sure if they are helpful or harmful.
objectivesThis research aimed to conduct a large-scale survey to identify what interventions are being used in UK services to improve child attachment; conduct a systematic review to evaluate the evidence for parenting attachment interventions; and develop recommendations for future research and practice. DESIGN AND
methodsWe worked closely with our Expert Reference Group to plan a large-scale survey focused on relevant UK services. We then conducted two systematic reviews. One searched for all randomised controlled trial evidence for any attachment parenting intervention. The second searched for all research for the top 10 routinely used interventions identified from the survey.
resultsThe survey collected 625 responses covering 734 UK services. The results identified the 10 most commonly used interventions. The responses showed a limited use of validated measures and a wide variety of definitions of attachment. For the first review, seven studies were included from 2516 identified records. These were combined with results from previous reviews conducted by the team. Meta-analyses showed that, overall, parenting interventions are effective in reducing disorganised attachment (pooled odds ratio 0.54, 95% confidence interval 0.39 to 0.77) and increasing secure attachment (pooled odds ratio 1.85, 95% confidence interval 1.36 to 2.52). The second review searched the literature for the top 10 routinely used interventions identified by the survey; 61 studies were included from 1198 identified records. The results showed that many of the most commonly used interventions in UK services have a weak evidence base and those with the strongest evidence base are not as widely used.
conclusionsThere is a need for better links between research and practice to ensure that interventions offered to families are safe and effective. Possible reasons for the disparity include the cost and accessibility of training. There is also a need for improved understanding by professionals regarding the meaning of attachment. LIMITATIONS: Although the survey had good geographical spread, most respondents were based in England. For review 2 we were unable to access a large number of papers; however, we conducted extensive reference checking to account for this. FUTURE WORK: There is a need for robust research to test the efficacy of routinely used attachment interventions. Research could also explore why routinely used interventions are not consistently subject to thorough evaluation; how to embed dissemination, cost-effectiveness, fidelity and sustainability into research; and how to keep clinical practice up to date with research developments. STUDY REGISTRATION: This study is registered as PROSPERO CRD42019137362.
fundingThis project was funded by the National Institute for Health and Care Research (NIHR) Health Technology Assessment programme and will be published in full in
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