Intervention Plan for Melisa’s Attachment Challenges




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Intervention Plan for Melisa’s Attachment Challenges


Scholars have managed to prove that indeed, early experiences have significant influences on later development. This type of influence can result in individual differences across quite a number of aspects like cognition, behavior as well as social and emotional responses among other related cases of personality. A good number of developmentalists have asserted that with early experiences, individuals are guaranteed long-term developmental results and further prevention against subsequent trauma. Early experiences, particularly those that have been effected by other individuals, may end up inducing and organizing structural growth patterns leading to expansion of a child’s functional capacities. Early experiences are responsible for shaping how a unique personality develops, its adaptive capacities alongside similar cases of vulnerability and resistance against certain types of future pathologies. On that note, this paper provides an essay on Early Development Case Intervention Analysis, with an intervention plan based on evidence-based strategies that have proven effective in similar cases, thereby making projections for possible long-term impacts of the Melisa’s current challenges.

Roots of Attachment Disorder

According to Juffer, Bakermans-Kranenburg & Van Ijzendoorn, (2012), attachment disorder (AD) arises from the absence of both bonding and security between the infant and caregiver. Infants demonstrating consistently accessible, responsive and understanding attachment figures always end up creating a positive representation for themselves; secure attachments. These kinds of attachments are said to be secure since the infants form the desired representations that consistently meet their respective needs. On the other hand, insecure attachments come into place in such cases where the caregiver inconsistently responds to some of the needs raised by the infant. Therefore, the infant lacks the surety of the expectations to have for themselves, others and the world in general when the caregiver has neglected him/her or inconsistency across attachment figures.

According to Moss, Dubois-Comtois, Cyr, Tarabulsy, St-Laurent & Bernier (2011), in some cases, Reactive Attachment Disorder (RAD) may come into play when the infant has been subjected to extreme neglect as well as both emotional and physical distress by the care giver. Generally, the distinguishing factor between AD and other infancy, mental disorders is the stemming of their representation from combined historical and biological factors among others. AD infants typically may have been subjected to abuse or neglectful care, constant changes between caregivers and surrounding or the sudden death of a parent or both parents. This may apply in the case of Melisa who was adopted in one of the orphanages in Canada, with her relevant documentations missing.

According to Madigan, Atkinson, Laurin & Benoit, (2013), negative attachment representations will always thrive when the infant has limited accessibility to a caregiver offering consistent care. This may perfectly thrive in an orphanage, where Melisa was adopted, with most of the caregivers lacking the basic skills required for effective parenting. It may also arise from parental mental disorder, when parents are drug addicts; substance abuse and a series of domestic violence. When young children are brought up in these kind of chaotic environments, they are forced to come up with different forms of control against the uncaring and frightening world. As a result, they think of these controls as the only reliable element, hence the need to adopt them in order to have their needs met and a guaranteed safety.

Long-term Impacts

According to Mayo Clinic (2014), infants developing insecure attachment are prone to social difficulties in their entire development life including their early adulthood. The same may happen in the case of Melisa, if proper interventions are not made. Some of the long-term impacts may include misbehavior, both at school and home, and constantly dissociating in a group activity. She may end up being aggressive and expressing manipulative behaviors towards her colleagues, unwilling to share, either bully or easily bullied by others and shallow friendships.

Insecurely attached children always end up being less curious, having difficulty with empathy and low self-confidence. Upon growing up, they always experience difficulties when trying to regulate their emotions, hence embark on calming self whenever they are upset. They always show symptoms of withdrawal such as being awkward while engaging in group activities and tending to avoid comforting words from their colleagues. Also, they tend to avoid expressing feelings of anger and display aggressive outburst during interaction with their peers.

Intervention Based Plan

From the provided case, psychological and behavioral interventions prove to be effective in meeting her challenges. A better way of monitoring a child’s emotional needs and fears is engaging him/her in a play therapy undertaken by a child psychotherapist in the presence of a mother; primary caregiver. In the context of the play, Melisa will be able to express her fears and anxieties. Angel seems to be sensitive to some of the issues faced by Melisa; anger due to abandonment, maltreated and loneliness while at the orphanage. When taken through a play therapy, Melisa will comfortably express her dependency needs such as infancy, prevention, safety and soothing needs.

There are a number of therapeutic ingredients that are relevant in treating RAD, including security, stability and sensitivity. Angel should consider proving these ingredients to Melisa, since they will make her experience healthy dependency, find the need to rely on her mother and generally trust her parents. This implies that, both in a short-term and long-term framework, Melisa will end up being attached, not only to her parents, but also to any other new person. Security will give her the sense of psychological safety, which in turn will assist her in creating a new attachment relationship.

A better way of correcting the scars of attachment disruption that she developed in the orphanage is listening to her without being judgmental. Both Angel and Mike, should always create time and be ready to listen to Melisa, responding to her reactions without judging. As the parents, they have to set some limits for her, though should be guided by empathy and compassion. Studies by Cassidy, Woodhouse, Sherman, Stupica & Lejuez (2011) argued that only after feeling emotionally secure is when infants will start expressing themselves and gradually developing trust with whoever is their primary caregiver.

Stability is all about the permanence created by the attachment figure. In the case of Melisa, it will take her time to develop trust in Angel, whom in this case is her new primary caregiver. After going through the disruption, Melisa has to learn to recognize her entire needs and further understand that all these needs can be met repeatedly by Angel. At times, it’s common for children to develop the fear that the caregiver may disappear or go away, hence giving room for another disruption. Some infants may take up to one year to trust a caregiver, though others may express a positive response within a few weeks of sensitive care. For Melisa, being an infant, she may take weeks, though it may be temperamental hence the need for Angel to avoid separations and disruptions since this may give rise to a defensive isolation on the infant.

According to Ludolph, & Dale (2012), sensitivity refers to the act of the caregiver being attentive to the entire needs expressed by the child. Whenever Angel is unavailable, she needs to inform other substitute caregivers that despite the immature cognition expressed by Melisa, her emotional development is always delayed when expressing emotions and attachments. Having the knowledge of delayed development, the caregiver will be in a better position to respond to the child by according her the expected level of safety, security and response.

Ideally, while undergoing this treatment, Melisa will gradually start developing feelings of dependency towards her mother once she starts developing expectations on physical and emotional availability from the caregiver during crisis. It is important for Angel to be ready for and tolerate occasional regressive behaviors from the infant and further view them as signs and symptoms that Melisa is undergoing psychological processes in her earlier phases of development. For instance, Melisa has been typically independent and suspicious, she may end up expressing needs for dependency, sleeping in Angel’s bed and at times report fears. Therefore, as the infant grows up, Angel should think of her as emotionally younger and expressing the most legitimate emotional needs that is more appropriate for her current age.


Attachment has always been an aspect that is more specific and circumcised with respect to the existing relationship between an infant and primary caregiver who is involved in ensuring child’s safety, security and protection. From Melisa’s case, it’s clear that attachment provides the room for the child to rely on the caregiver as the source of security, heaven of safety and comfort. Following her adoption from the orphanage, both Angel and Mike need to adopt the psychological and behavioral interventions that prove to be effective in meeting Melisa’s attachment challenges.


















Melisa’s Case

Melisa, was eight months at the time of her adoption by her parents, Angel and Mike, from one of the orphanages in Canada. Unfortunately, during the adoption time to date, neither family nor medical history has been availed about Melisa. Until this time when they resorted to go for the adoption, the two; Angel and Mike were working professionals. The couples have been aligned severally for medical treatment for infertility over quite a number of years. Severally, Angel has been pregnant through in-vitro fertilization, though experienced series of miscarriages, one after the other.

After the adoption leave, Mike had to report back at work with Angel staying at home with Melisa. Initially, Angel and Mike thought that Melisa was attaching to them only to find out that the opposite was true. However, with time Angel became quite emotional and cried since the infant had developed indiscriminate friendliness towards everyone she came across. In fact, Melisa didn’t prefer Angel at all.

At one time, after Melisa fell down and got injured, she sought for comfort from other ladies other than Angel, leaving her mother tearful. Melisa would seek strangers over Angel, developed poor boundaries and wandered frequently while taken for some rides in the street. Melisa had a high pain tolerance and wouldn’t bother seeking comfort when hurt in the first two weeks of adoption. According to the couples, the attachment to Melisa started developing two months down the line after adoption. They reported the infant having sensory issues, especially with food, calling for Angel to embrace all possible means to feed her. According to Angel, feeding the child was of great significance in developing attachment with the infant.

As time goes by, Melisa began attaching slowly, both to Angel and Mike. As the child was turning 18 months old, Angel described the infant’s attachment as secure, admitting that the attachment developed six months down the line, with no event defining the attachment other than a series of events that came into play. The attachment could be compared to a relationship where individuals get to familiarize with one another and it happens after given time frame.

At the second birthday, Angel reported a relatively stronger bond between Melisa and her, which she believed was a result of her interaction with the infant during the caregiving process. Over time, Melisa developed a pattern of both emotional and behavioral interaction as she interacted with her mother; caregiver. The interaction was particularly in the context of Melisa’s needs as well as bids for attention and other related cases of comfort. With the repeated interactions with her mother, Melisa recognized her mother, anticipating Angel’s behavior, whom in this case was the primary caregiver.

Two-year-old Melisa has learnt how to squirm and express herself by saying “no” when Angel makes an attempt of securing her in the car seat. She is currently developing and expressing a sense of self and autonomy, independent of Angel. Angel has been forced to consistently set limits and stick to them with Melisa, as a way of ensuring that she is safe and secure while taking her around in the car. According to Mike, they can enhance Melisa’s willingness towards compliance by issuing a particular praise along with an attractive toy to play with in such times she occupies her car seat without demonstrating any resistance.





Cassidy, J., Woodhouse, S. S., Sherman, L. J., Stupica, B., & Lejuez, C. W. (2011). Enhancing infant attachment security: An examination of treatment efficacy and differential susceptibility. Development and Psychopathology23(01), 131-148.

Juffer, F., Bakermans-Kranenburg, M. J., & Van Ijzendoorn, M. H. (Eds.). (2012). Promoting positive parenting: An attachment-based intervention. Routledge.

Ludolph, P. S., & Dale, M. D. (2012). Attachment in child custody: An additive factor, not a determinative one. Family Law Quarterly, 46(1), 1-40. Retrieved from https://search.proquest.com/docview/1271860905?accountid=45049

Madigan, S., Atkinson, L., Laurin, K., & Benoit, D. (2013). Attachment and internalizing behavior in early childhood: a meta-analysis. Developmental psychology49(4), 672.

Mayo Clinic. (2014). Fetal development: The 1st trimester. Retrieved from https://www.mayoclinic.org/healthy-lifestyle/pregnancy-week-by-week/in-depth/prenatal-care/art-20045302

Moss, E., Dubois-Comtois, K., Cyr, C., Tarabulsy, G. M., St-Laurent, D., & Bernier, A. (2011). Efficacy of a home-visiting intervention aimed at improving maternal sensitivity, child attachment, and behavioral outcomes for maltreated children: A randomized control trial. Development and psychopathology23(01), 195-210.



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