The development of a novel supplemental coding system for investigating the practice elements of attachment-based interventions

While research generally demonstrates the efficacy of attachment-based interventions for supporting families and children, less is known about the constituent elements of these interventions and their effects. Existing tools for extracting information about these elements from psychosocial intervention studies do not differentiate between techniques used in attachment-based interventions. Therefore, a novel extension of the PracticeWise coding system was developed for attachment-based interventions. This paper describes the development of this new extension. A systematic literature search of randomized controlled trials of attachment-based interventions (1998-2018) identified 66 publications. This led to N = 49 unique attachment-based interventions. Study authors were requested to share the intervention manuals for these trials. Publications or, if available, manuals were initially coded using the standard PracticeWise coding system. Techniques falling under the general definition of a practice element, but not captured by the standard system, formed the basis for a novel set of subcategories. To identify and develop definitions for this novel subset of practice elements, the publications and manuals were carefully examined and initial codes were developed inductively for each intervention, and then discussed to reach consensus. These codes were then applied across all interventions. Through an iterative process, 16 unique practice elements were identified and defined, and clustered into five thematic groupings: Modelling; Parent-Child Interaction (Behavior-focused); Mental Representations (Representation-focused); Education & Guidance; Other. As an illustration, the Attachment and Biobehavioral Catch-up intervention is described using the novel supplemental practice elements coding system.