**4. Applying attachment-based intervention in a new context: The assessment of parental capacity in child protection cases**

While the contribution of attachment theory in the assessment of parental capacity in child protection cases has been proposed by many researchers [54-57], key concepts of this theory have rarely been integrated intoassessment protocols. This is surprising given that attachment theory is closely linked to the concept of parental capacity, i.e., the parent's capacity to care for their child, to protect from potential threats, and to offer an environment that promotes child emotional, cognitive, and physical development [58].A competent parent, in terms of parenting capacity, is able to adapt to the inherent developmental changes of their child: not only is the parent sufficiently competent in responding to the child's needs while adjusting to the child's changing developmental capacities, but the parent is also able to find solutions to the daily struggles encountered as a parent [54,58]. It is through a high-quality relationship, in which the parent demonstrates interest, respect, and sensitivity towards the child that a parent's competency becomes apparent [59]. The concept of parental competency is therefore closely related to the concept of parental sensitivity, as defined by attachment theory.

The assessment of parental capacity in cases of children reported for abuse or neglect is particularly important, in that it often informs the court of the child's best interest. Specifically, it

plays a role in whether the child should be removed or not from his family of origin, and if removed, the type of placement suggested for that particular child. This assessment is subsequently used by clinicians as a way to determine the most appropriate intervention plan for the family. Therefore, the assessment of parental capacity plays a major role in the life of a child. Given the seriousness of the decisions made following theseassessments, it is important that they be carried out by carefully trained professional, for whom personal biases do not interfere with the objectivity of the evaluation process. Many, concerned with the quality of parental capacity assessments, have suggested guidelines for evaluators. For example, the *American Psychological Association* (APA) suggested guidelines regarding the necessary professional competencies required for the evaluation process, as well as the ethical considerations to respect during assessments of parental capacities [60].Other researchers and clinicians have highlighted key elements to consider in such evaluations [54,61-64]. In particular, Budd [61,62] carefully outlined a list of principles that should guide such evaluations.

Attachment Theory in the Assessment and Promotion of Parental Competency in Child Protection Cases 77

capacity if parental behaviors and abilities are sufficiently adequate during parent-child interaction. Accordingly, parent-child interactive quality should be regarded as a central

Despite these aforementioned guidelines, in practice, assessmentreports of parental capacityoften remain incomplete and follow a minimalist and low-quality protocol. Budd et al. [67]examined 170 parenting capacity assessment reports for child protection cases. Researchersidentified numerous flaws that put into question the validity of these reports. In particular, results showed an over-simplification of conclusions, often based on premature evaluations, and following only one meeting with the parent outside the family home. Moreover, researchers found a lack of crucial information pertaining to the child and the quality of parent-child relationship. More information was provided on parental limitations than on parental strengths. In particular, direct observations of child and parent-child interaction were limited and assessments generally relied on questionnaires and interviews

Harnett [68] also raises the important point that parental capacity is generally evaluated under very short time frames. This suggests that parents' capacity to change is not really evaluated according to longitudinal observations of parents' interactive behavior with the child, but instead is generally estimated following short meetings with the parent. In order to assess parents' capacity to change, parents need to be able to demonstrate their ability to question themselves and take responsibility for their actions, but mostly they need to show their capacity to benefit from an intervention and change. Certainly, these abilities represent important indicators of the parent's capacity to change. It has been suggested to assess parental competency from the perspective of the parent's ability to build parenting skills, while clinical workers aim at promoting positive parenting behaviors [68,69].Accordingly, Harnett [68] proposes applying an intervention for improving the parent-child relationship as a way to evaluate parental capacity to change. However, to date, no such protocol, including an intervention centered on parent-child interaction, has been submitted to a scientific evaluation. The challenges associated with the assessment of parental capacity highlight the need to develop standardized intervention strategies that could accurately assess parental capacity to change. Such a procedure would lead to more accurate and useful evaluation reports, allowing for better decision making in the court justice system and more adaptive inter-

*The parental capacity assessment protocol at the Child Protection Services of Montreal-University-*

Recently, the Child Protection Services of Montreal-University Institute (CPS-UI) have launched the *Clinicfor the assessment and intervention of young children and their families,*for children aged 0 to 5 and their parents who have been reported for child maltreatment and for whom a parental capacity evaluation is required. In collaboration with this clinic, we developed a specialized protocol for the assessment of parental capacity [70,71]. The innovative aspect of this protocol is that we integrated into the evaluation procedure a short-term

feature in parenting assessment capacity.

vention plans for the child and family.

*Institute* 

with the parents.

The first principle proposed by Budd [61,62] is that assessments of parental capacity should center on the parent's limitations and strengths, as well as on the quality of the parent-child relationship. This principal rests on the idea that parental capacity should be understood in response to child needs, that is, how the parent's limitations and capabilities may be potential risk or protection factors for the child, and how they may influence the parent's ability to profit from clinical services. Indeed, as mentioned by the APA [60], the evaluator must not only focus on the parent's actual capacity, but also assess the parent's potential. This is in line with Haynes'[65]view, who describes core features in the assessment of parental competency as parental: 1) capacity to care (ex: parental sensitivity, emotional commitment, empathy); 2) capacity to protect (ex: safe environment, supervision, tolerance to frustration, educational practices and adequate discipline); and 3) capacity to change (ex: intellectual limits and strengths, severity of psychopathological symptoms, insights/reflective functioning, social and family support).

The second principal emphasizes the importance of favoring a functional approach in the evaluation of parental capacity, as to focus on behaviors and skills towards the child in everyday performance and daily routines. As indicated by White [58], in an extensive summary pertaining to research relating to parental capacity, it is the quality of the parent's immediate and daily behaviors towards the child that influences the child's overall well-being and development.

The third principal implies the use of a minimal parenting standard to the assessment of parental capacity. Indeed, many authors [54,61,66]have suggested that parents facing adversity should not be compared to parents presenting optimal abilities. For parents in child protection cases, meeting the minimal requirements needed to ensure child physical and emotional security should be considered sufficient and acceptable. For example, parents who experience symptoms of depression or intellectual deficits may be limited in their ability tooffer their child a safe and secure emotional environment. Nevertheless, the impact of these limitations may be reduced if the parent demonstrates insight, the ability to recognize personal limits, or the capacity to benefit from friends/family social support or a clinical treatment. Although this parent's functioning may be affected by risk factors, he or she should be considered as meeting the minimal standards required for adequate parental capacity if parental behaviors and abilities are sufficiently adequate during parent-child interaction. Accordingly, parent-child interactive quality should be regarded as a central feature in parenting assessment capacity.

76 Child Abuse and Neglect – A Multidimensional Approach

a list of principles that should guide such evaluations.

insights/reflective functioning, social and family support).

plays a role in whether the child should be removed or not from his family of origin, and if removed, the type of placement suggested for that particular child. This assessment is subsequently used by clinicians as a way to determine the most appropriate intervention plan for the family. Therefore, the assessment of parental capacity plays a major role in the life of a child. Given the seriousness of the decisions made following theseassessments, it is important that they be carried out by carefully trained professional, for whom personal biases do not interfere with the objectivity of the evaluation process. Many, concerned with the quality of parental capacity assessments, have suggested guidelines for evaluators. For example, the *American Psychological Association* (APA) suggested guidelines regarding the necessary professional competencies required for the evaluation process, as well as the ethical considerations to respect during assessments of parental capacities [60].Other researchers and clinicians have highlighted key elements to consider in such evaluations [54,61-64]. In particular, Budd [61,62] carefully outlined

The first principle proposed by Budd [61,62] is that assessments of parental capacity should center on the parent's limitations and strengths, as well as on the quality of the parent-child relationship. This principal rests on the idea that parental capacity should be understood in response to child needs, that is, how the parent's limitations and capabilities may be potential risk or protection factors for the child, and how they may influence the parent's ability to profit from clinical services. Indeed, as mentioned by the APA [60], the evaluator must not only focus on the parent's actual capacity, but also assess the parent's potential. This is in line with Haynes'[65]view, who describes core features in the assessment of parental competency as parental: 1) capacity to care (ex: parental sensitivity, emotional commitment, empathy); 2) capacity to protect (ex: safe environment, supervision, tolerance to frustration, educational practices and adequate discipline); and 3) capacity to change (ex: intellectual limits and strengths, severity of psychopathological symptoms,

The second principal emphasizes the importance of favoring a functional approach in the evaluation of parental capacity, as to focus on behaviors and skills towards the child in everyday performance and daily routines. As indicated by White [58], in an extensive summary pertaining to research relating to parental capacity, it is the quality of the parent's immediate and daily behaviors towards the child that influences the child's overall well-being and development.

The third principal implies the use of a minimal parenting standard to the assessment of parental capacity. Indeed, many authors [54,61,66]have suggested that parents facing adversity should not be compared to parents presenting optimal abilities. For parents in child protection cases, meeting the minimal requirements needed to ensure child physical and emotional security should be considered sufficient and acceptable. For example, parents who experience symptoms of depression or intellectual deficits may be limited in their ability tooffer their child a safe and secure emotional environment. Nevertheless, the impact of these limitations may be reduced if the parent demonstrates insight, the ability to recognize personal limits, or the capacity to benefit from friends/family social support or a clinical treatment. Although this parent's functioning may be affected by risk factors, he or she should be considered as meeting the minimal standards required for adequate parental Despite these aforementioned guidelines, in practice, assessmentreports of parental capacityoften remain incomplete and follow a minimalist and low-quality protocol. Budd et al. [67]examined 170 parenting capacity assessment reports for child protection cases. Researchersidentified numerous flaws that put into question the validity of these reports. In particular, results showed an over-simplification of conclusions, often based on premature evaluations, and following only one meeting with the parent outside the family home. Moreover, researchers found a lack of crucial information pertaining to the child and the quality of parent-child relationship. More information was provided on parental limitations than on parental strengths. In particular, direct observations of child and parent-child interaction were limited and assessments generally relied on questionnaires and interviews with the parents.

Harnett [68] also raises the important point that parental capacity is generally evaluated under very short time frames. This suggests that parents' capacity to change is not really evaluated according to longitudinal observations of parents' interactive behavior with the child, but instead is generally estimated following short meetings with the parent. In order to assess parents' capacity to change, parents need to be able to demonstrate their ability to question themselves and take responsibility for their actions, but mostly they need to show their capacity to benefit from an intervention and change. Certainly, these abilities represent important indicators of the parent's capacity to change. It has been suggested to assess parental competency from the perspective of the parent's ability to build parenting skills, while clinical workers aim at promoting positive parenting behaviors [68,69].Accordingly, Harnett [68] proposes applying an intervention for improving the parent-child relationship as a way to evaluate parental capacity to change. However, to date, no such protocol, including an intervention centered on parent-child interaction, has been submitted to a scientific evaluation. The challenges associated with the assessment of parental capacity highlight the need to develop standardized intervention strategies that could accurately assess parental capacity to change. Such a procedure would lead to more accurate and useful evaluation reports, allowing for better decision making in the court justice system and more adaptive intervention plans for the child and family.

#### *The parental capacity assessment protocol at the Child Protection Services of Montreal-University-Institute*

Recently, the Child Protection Services of Montreal-University Institute (CPS-UI) have launched the *Clinicfor the assessment and intervention of young children and their families,*for children aged 0 to 5 and their parents who have been reported for child maltreatment and for whom a parental capacity evaluation is required. In collaboration with this clinic, we developed a specialized protocol for the assessment of parental capacity [70,71]. The innovative aspect of this protocol is that we integrated into the evaluation procedure a short-term

attachment-based intervention[47]as a way to assess parental capacity tochange. This attachment-based protocol is currently under scientific investigation by our research team.

Attachment Theory in the Assessment and Promotion of Parental Competency in Child Protection Cases 79

*Component 4*: The last component is conducted at the end of the evaluation process. It consist of the presentation of the strengths and limitations to the parent, and the writing of the

*Preliminary results: The adapted AVI protocol as an effective tool for improving the quality of parent-*

In the scope of this research project, we have tried to answer two main objectives. The first objective concerned the efficacy of the intervention as a tool for improving parental sensitivity. The second objective was to verify whether the parental capacity assessment protocol, which included an intervention centered on parent-child interaction, was useful

Preliminary statistical analyses were conducted with a sub-sample of participants. This subsample consisted of 23 families, including 12 that were evaluated according to the AVI protocol as the activation technique for assessing parental capacity to change, and 13 were evaluated according to a second protocol, just as intensive, but relying on the standard activation techniques used by psycho-educators of the CPS-UI (e.g. modeling). The children (55% boys) had an average age of 18.21 months (*S.D.* = 18.96, range = 1 to 60 months). The majority of children were reported for neglect, although half of thesample were also victims of physical abuse. An important number of parents also experienced a troubled past including maltreatment or out-of-home placements.At a socio-demographic level, study participants represented a very high-risk sample with more than half not having a high school

Using a randomized clinical control trial design, we examined changes in the quality of parent-child interactions during a snack time procedure [19]. More specifically, we observed parents' capacity to be sensitive tochild needs and signals and to take on appropriate parental role, as well as the ability of each member of the dyad to openly and freely express emotions and intentions. In support of our hypothesis, results showed that dyads involved in the AVI assessment protocol demonstrated significant improvements in interactive quality, with mothers showing higher levels of sensitivity and dyads showing more reciprocal and synchronized interactions [71]. On average, 6 sessions of video-feedback were offered to

Moreover, at the end of each parental capacity assessment, we questioned evaluators from both protocols regarding the changes they observed in the parent-child dyads. We also asked about the usefulness of our protocol for the assessment of parental capacity. Results of statistical analyses revealed that, according to evaluators, parents' level of commitment facilitated parents capacity to learn new strategies, regardless of the complexity of the case (difficulties met during the evaluation process, the severity of abuse suffered by the child, etc). In addition, results revealed that evaluators of the AVI assessment protocol observed significantly more changes within the family, resulting in improved parental sensitivity, greater secure or organized child attachment, and improved overall child development [72]. These results support the efficacy of the AVI as a tool for promoting quality of parent-child interactions of families reported to CPS.

*child interactions and for assessing parent's capacity to change* 

for assessing parents' capacity to change.

diploma and living below the poverty threshold.

evaluation report.

participants.

We believe that an attachment-based approach is particularly appropriate for assessing parental capacity in child protection cases. Given that an assessment of parental capacity requires the description of parental deficits and limitationsin the final evaluation report, as well as during court hearings, evaluators must be able to quickly put into evidence with the parent their inappropriate behaviors during the sessions. To identify these inappropriate behaviors within a framework that highlights the positive side of the parent can: 1) increase the parent's feelings of trust towards the evaluator and the ability to commit in the evaluation process, and 2) orient intervention efforts on the reinforcement of the parent's selfrecognition and repair of inappropriate behaviors, while making use of the parent's personal strengths. Through video-feedback parents may witness their own frightening-frightened behaviors with their child, and then begin a process of change and reparation in which they increasingly learn to take responsibility for their actions.

#### *The parental capacity assessment protocol*

The parental capacity assessment protocol implemented at the clinic of the CPS-UI consists, on average, of 5 meeting of approximately 3 hours each, carried out during a 4 to 8 week period. A typical evaluation meeting includes 4 components.

*Component 1*: At each meeting, the evaluator observes parent-child interactions during daily activities and routines.

*Component 2*: A discussion period is scheduled with the parent toassess the different factors potentially explainingthe parent's behaviors and ability to recognize his or her own difficulties. This discussion is based on an adaptation [64] of the parental competence assessment guide fromSteinhauer [63], which allows for the collection of various information regarding the parent's social and familial context, the health and development of the child, the impulse control of the parent, and the parent's history of prior use of clinical services. This guide also allows the evaluator to obtain information regarding parental practices (e.g.educational methods, discipline, care for basic needs) and the parent-child relationship by orienting evaluators observations on child attachment behaviors and parental sensitivity in response to the child needs during daily activities.

*Component 3*: In addition to gathering information regarding the parent's ability to care and protect the child, an intervention protocol is used as a way to assess parental capacity to change. Here, we have used the attachment-based strategy developed by Moss et al. [47], to which we have added a focus on parental frightening or inappropriate behaviors. Therefore, this adapted version of the AVI protocol not only aims at reinforcing, via video-feedback of parent-child interactions, 1) the parent's sensitive behaviors (e.g identify and interpret child distress signals, answering them in an acceptable delay), but also 2) the recognition by the parent of his own frightening behaviors and the repair of these behaviors through sensitive behaviors.

*Component 4*: The last component is conducted at the end of the evaluation process. It consist of the presentation of the strengths and limitations to the parent, and the writing of the evaluation report.

78 Child Abuse and Neglect – A Multidimensional Approach

increasingly learn to take responsibility for their actions.

period. A typical evaluation meeting includes 4 components.

*The parental capacity assessment protocol* 

to the child needs during daily activities.

activities and routines.

behaviors.

attachment-based intervention[47]as a way to assess parental capacity tochange. This attachment-based protocol is currently under scientific investigation by our research team.

We believe that an attachment-based approach is particularly appropriate for assessing parental capacity in child protection cases. Given that an assessment of parental capacity requires the description of parental deficits and limitationsin the final evaluation report, as well as during court hearings, evaluators must be able to quickly put into evidence with the parent their inappropriate behaviors during the sessions. To identify these inappropriate behaviors within a framework that highlights the positive side of the parent can: 1) increase the parent's feelings of trust towards the evaluator and the ability to commit in the evaluation process, and 2) orient intervention efforts on the reinforcement of the parent's selfrecognition and repair of inappropriate behaviors, while making use of the parent's personal strengths. Through video-feedback parents may witness their own frightening-frightened behaviors with their child, and then begin a process of change and reparation in which they

The parental capacity assessment protocol implemented at the clinic of the CPS-UI consists, on average, of 5 meeting of approximately 3 hours each, carried out during a 4 to 8 week

*Component 1*: At each meeting, the evaluator observes parent-child interactions during daily

*Component 2*: A discussion period is scheduled with the parent toassess the different factors potentially explainingthe parent's behaviors and ability to recognize his or her own difficulties. This discussion is based on an adaptation [64] of the parental competence assessment guide fromSteinhauer [63], which allows for the collection of various information regarding the parent's social and familial context, the health and development of the child, the impulse control of the parent, and the parent's history of prior use of clinical services. This guide also allows the evaluator to obtain information regarding parental practices (e.g.educational methods, discipline, care for basic needs) and the parent-child relationship by orienting evaluators observations on child attachment behaviors and parental sensitivity in response

*Component 3*: In addition to gathering information regarding the parent's ability to care and protect the child, an intervention protocol is used as a way to assess parental capacity to change. Here, we have used the attachment-based strategy developed by Moss et al. [47], to which we have added a focus on parental frightening or inappropriate behaviors. Therefore, this adapted version of the AVI protocol not only aims at reinforcing, via video-feedback of parent-child interactions, 1) the parent's sensitive behaviors (e.g identify and interpret child distress signals, answering them in an acceptable delay), but also 2) the recognition by the parent of his own frightening behaviors and the repair of these behaviors through sensitive

#### *Preliminary results: The adapted AVI protocol as an effective tool for improving the quality of parentchild interactions and for assessing parent's capacity to change*

In the scope of this research project, we have tried to answer two main objectives. The first objective concerned the efficacy of the intervention as a tool for improving parental sensitivity. The second objective was to verify whether the parental capacity assessment protocol, which included an intervention centered on parent-child interaction, was useful for assessing parents' capacity to change.

Preliminary statistical analyses were conducted with a sub-sample of participants. This subsample consisted of 23 families, including 12 that were evaluated according to the AVI protocol as the activation technique for assessing parental capacity to change, and 13 were evaluated according to a second protocol, just as intensive, but relying on the standard activation techniques used by psycho-educators of the CPS-UI (e.g. modeling). The children (55% boys) had an average age of 18.21 months (*S.D.* = 18.96, range = 1 to 60 months). The majority of children were reported for neglect, although half of thesample were also victims of physical abuse. An important number of parents also experienced a troubled past including maltreatment or out-of-home placements.At a socio-demographic level, study participants represented a very high-risk sample with more than half not having a high school diploma and living below the poverty threshold.

Using a randomized clinical control trial design, we examined changes in the quality of parent-child interactions during a snack time procedure [19]. More specifically, we observed parents' capacity to be sensitive tochild needs and signals and to take on appropriate parental role, as well as the ability of each member of the dyad to openly and freely express emotions and intentions. In support of our hypothesis, results showed that dyads involved in the AVI assessment protocol demonstrated significant improvements in interactive quality, with mothers showing higher levels of sensitivity and dyads showing more reciprocal and synchronized interactions [71]. On average, 6 sessions of video-feedback were offered to participants.

Moreover, at the end of each parental capacity assessment, we questioned evaluators from both protocols regarding the changes they observed in the parent-child dyads. We also asked about the usefulness of our protocol for the assessment of parental capacity. Results of statistical analyses revealed that, according to evaluators, parents' level of commitment facilitated parents capacity to learn new strategies, regardless of the complexity of the case (difficulties met during the evaluation process, the severity of abuse suffered by the child, etc). In addition, results revealed that evaluators of the AVI assessment protocol observed significantly more changes within the family, resulting in improved parental sensitivity, greater secure or organized child attachment, and improved overall child development [72]. These results support the efficacy of the AVI as a tool for promoting quality of parent-child interactions of families reported to CPS. Also, our results point to the usefulness of the AVI intervention as a valuable tool for assessing parental capacity to change. Given that the potential for parents to change is more likely to result from the application of the AVI protocol than as a result of the "psycho-educational' protocol, and that evaluators from the AVI are more likely to observe this improvement, we conclude that the AVI strategy is a valuable tool for accurately assessing parents' capacity to change and show greater sensitivity towards their child.

Attachment Theory in the Assessment and Promotion of Parental Competency in Child Protection Cases 81

By helping parents, often perceived as inadequate, identify their strengths, practitioners guide parentsin the recognition of abilities and qualities, despite the fact that these may initially be limited or scarce. Working with a parent in such a context can only facilitate the parent's willingness to acknowledge deficits and inappropriate/frightening behaviors towards the child, and help to promote the development of more sensitive behaviors. Also, attachment-based protocols can facilitate parents' collaboration with child protective services. In summary, the use of an intervention protocol based on attachment-theory with parents and children reported for maltreatment, whether for assessing parental capacity, or

[1] Cicchetti D, Valentino K (2006) An Ecological-transactional Perspective on Child Maltreatment: Failure of the Average Expectable Environment and its Influence on Child Development. In: Cicchetti D, Cohen D J, editors. Developmental

[2] Cicchetti D, Lynch M (1993) Toward an Ecological/transactional Model of Community Violence and Child Maltreatment: Consequences for Children's Development.

[3] Lyons-Ruth K, Jacobvitz D (2008) Attachment Disorganization: Genetic Factors, Parenting Contexts, and Developmental Transformation from Infancy to Adulthood. In: Cassidy J, Shaver P R, editors. Handbookof attachment second edition: Theory,

[4] Weinfield N S, Sroufe A L, Egeland B, Carlson E A (2008) The Nature of Individual Differences in Infant-Caregiver Attachment. In: Cassidy J, Shaver P R, editors.

Research, and Clinical Applications. New York: Guilford Press. pp. 666-697.

Handbook of Attachment. New York: Guilford Press. pp. 520-554. [5] Bowlby J (1982) Attachment and Loss. Am. j. of orthopsychiatry. 52: 664-678.

for intervention purposes, is clearly a promising avenue.

*University of Quebec at Montreal, Dept. of Psychology, Montreal, Canada* 

*Child Protection Services of Montreal-University Institute, Canada* 

Psychopathology. New Jersey: Wiley. pp. 129-201.

Chantal Cyr, Geneviève Michel, Caroline Poulin, Valérie Losier, Marilyne Dumais and Ellen Moss

Diane St-Laurent and Karine Dubois-Comtois *University of Quebec at Trois-Rivières, Canada* 

*Montreal Sacré-Coeur Hospital, Canada* 

Psychiatry. 56: 96-118.

**Author details** 

Chantal Cyr

Karine Dubois-Comtois

Katherine Pascuzzo *McGill University, Canada* 

**6. References** 

## **5. Conclusion**

The work stemming from attachment theory offers a critical theoretical framework that helps identify 1) parental behaviors that influence the quality of the parent-child interaction and the development of the child, and 2) effective intervention strategies to promote sensitive behaviors, which are at the root of a secure child attachment pattern. Taken as a whole, the different attachment-based intervention protocols, whether short or long-term, are particularly promising. While the assessment of some of these protocols has not relied on randomized control trials, they all have been subjected to a scientific investigation. As a result, all evaluated protocols with maltreated children and their parents have supported the beneficial outcomes of this type of intervention strategy on the quality of the parent-child relationship and on the various aspects of the child's development : increase in parental sensitivity, child attachment security, and decrease in child disorganized attachment; greater development or adaptation of the child (e.g. increase in motor development, decrease in child's negative representations of the self and of the maternal figure, decrease in behavioral problems and of symptoms of posttraumatic stress). In summary, the various attachment-based protocols show impressive success rates for vulnerable populations and are therefore important practices to adopt with respect to maltreated and at-risk children. It is important to note, however, that the continuous training and supervision of the evaluators, including extensive understanding of child developmental processes and observation techniques for relational patterns are central in maintaining the integrity and successfulness of the intervention.

Following the preliminary scientific evaluation of the adapted AVI protocol for the assessment of parental capacity at the CPS-UI clinic, we conclude that the contribution of attachment theory to the assessment of parental capacity in child protection cases is considerable and significant. Not only did this intervention strategy allowed for the improvement of parental sensitivity and reciprocity during parent-child interactions of a high-risk vulnerable population, but it also enhanced quality of assessments conducted by evaluators of the CPS, particularly with respect to the evaluation of parents' capacity to show potential for change. This clinical improvement is notable, considering the impact of the decisions made following these evaluation. It is clear that a better understanding of the capacity for parents to change during the evaluation process enables family services that are better suited to answer the specific needs of parents and their child. Nevertheless, to date, these preliminary results offer only a partial understanding of the effects of an attachment-based intervention on the quality of a parental capacity assessment. Future analyses will be conducted with a larger number of participants and will examine the role of other variables that could potentially positively or negatively affect outcomes. Finally, more research is needed to corroborate the results stemming from our project.

By helping parents, often perceived as inadequate, identify their strengths, practitioners guide parentsin the recognition of abilities and qualities, despite the fact that these may initially be limited or scarce. Working with a parent in such a context can only facilitate the parent's willingness to acknowledge deficits and inappropriate/frightening behaviors towards the child, and help to promote the development of more sensitive behaviors. Also, attachment-based protocols can facilitate parents' collaboration with child protective services. In summary, the use of an intervention protocol based on attachment-theory with parents and children reported for maltreatment, whether for assessing parental capacity, or for intervention purposes, is clearly a promising avenue.
