Course Type

Attachment, Neurodevelopment Psychopathology (ANP)

Duration: 3 days


This course focuses on the development, prevention and treatment of psychological disorder from infancy to adulthood. It weaves together theory, human development, assessment, case examples and treatment applications to reframe maladaptive behavior in terms of strategies for self-protection. The course emphasizes the process of adaptation and developmental pathways that carry risk for psychopathology. The course is aimed at professionals who work with troubled families or individuals, including, psychiatrists, psychologists, lawyers, social workers, teachers and nurses.

The aspects of adult development to be covered are chosen to enhance treatment of psychological maladaptation of adults and children (including families with child maltreatment, psychiatric disorder, and criminality). The course emphasizes adaptation and ways to change developmental pathways that carry risk for psychopathology. Reorganisation and building resilience are treated as central to successful intervention. General and Family Functional Formulations will be introduced to highlight DMM Integrative Treatment.

The model used is the Dynamic-Maturational Model (DMM) of Attachment and Adaptation. The DMM is a strength-based model that is relevant to individuals who are at-risk, have been exposed to danger, display disturbed or maladaptive behaviour, or are diagnosed as having a psychiatric disorder. Emphasis is given to how attachment explains maladaptive behaviour and how that is tied to culture and dangerous conditions.

Course outline

ANP (Attachment, Neurodevelopment, & Psychopathology) is structured developmentally and consists of lecture with slides, video, and interview transcripts to demonstrate the patterns and principles of development. A set of readings and exercises, tied to each day’s material, is offered.

An introduction is given to the DMM suite of assessments of attachment and adaptation:

NOTE: ANP is prerequisite to all assessment courses, e.g., the Adult Attachment Interview.

Course text

Crittenden, P. M. (2016). Raising Parents: Attachment, Representation, and Treatment. London: Routledge.

With additional readings and written assignments, this course can count toward earning the “DMM-informed Mental Health Practitioner Certificate“.

Course programme

  • Course overview and central ideas
  • Infant development: the need for parental protection and comfort
  • The Ainsworth ABC patterns of attachment
  • CARE-Index (ICI) Assessment with video
  • Child abuse and neglect
  • Post-natal depression and psychosis
  • Preschool development: the need for parent-child protective hierarchy
  • The coercive and compulsive self-protection strategies
  • Cross-generational parent-to-child strategies
  • The Toddler CARE-Index (TCI)
  • Several of the following: Adoption, foster care, ADHD, autism, child sexual abuse
  • Reducing coercive behaviour
  • School-age development: Gaining independence, new attachment figures
  • Obsessive and deceptive strategies
  • Somatization
  • The School-age Assessment of Attachment (SAA)
  • Treatment: Hidden problems, recommended and risky practices
  • Adolescence: Integrating sexuality with attachment
  • Sexual disorders and sexual offending
  • Dangerous gaps in services and preventative opportunities
  • Overview and central ideas of treatment in adulthood
  • Adult psychological development
  • Protective strategies associated with severe psychopathology
  • Adult Attachment Interview (AAI)
  • Parent Interview
  • General & Family Functional Formulation
  • IASA Family Attachment Court Protocol
  • DMM Integrative Treatment

NOTE: Dr Crittenden and Andrea Landini intend to cover all topics listed above, but dependent on time and audience requirements, cannot guarantee that all areas will be addressed.

Each session includes:

  • A developmental overview
  • Information processing as it affects self- and child-protective behaviour
  • Description of new self-protective strategies that develop at the age level
  • An application of DMM ideas to generate a novel approach to maladaptation
  • Treatment strategies drawn from all the major theories of treatment and selected on the basis of information processing and strategy

Learning outcomes

New skills:

  • Perceiving discrepant behaviour: seeing commonly overlooked clues to trouble
  • Identifying false-positive affect: uncovering hidden problems in their early stages
  • Differentiating symptoms and self-protective strategies: specifying how symptoms function
  • Functional formulation: Moving beyond diagnoses to understanding behaviour
  • Understanding how exposure to danger stunts adults’ development
  • Matching treatment to adults’ competencies
  • Using knowledge of adults’ strategic functioning to identify strengths

Treatment planning – choosing treatment strategies to:

  • Increase efficiency
  • Lower cost
  • Reduce risk of iatrogenic harm

Take-away Tools:

  • Level of Family Functioning Scale
  • Gradient of Intervention Scale
  • Level of Parental Reasoning Scale


Patricia Crittenden

Patricia M. Crittenden, PhD is a developmental psychopathologist with many years’ experience as an academic and practitioner in child maltreatment, attachment theory and family therapy. She was taught by Mary Ainsworth and was on the Faculties of Psychology at the Universities of Virginia and Miami. She held visiting positions at the Universities of Helsinki and Bologna, the Clark Institute of Psychiatry (Canada), San Diego State University (USA) and Edith Cowan University (Australia). She developed the Dynamic-Maturational Model (DMM) of Attachment and Adaptation and is one of the founders of the International Association for the Study of Attachment (IASA). In 2004, she received a Career  Achievement Award from the European Family Therapy Association. She has published more than 150 scientific papers and several books

Andrea Landini Andrea Landini M.D. is a child and adolescent psychiatrist. He received his medical training at the University of Modena and trained as both a cognitive-constructivist psychotherapist and a family therapist. His clinical practice includes psychotherapy with adults and adolescents, as well as work with parents and supervision of residential staff. He is on the visiting faculties of several Italian schools of cognitive and family systems psychotherapy. He is implementing the IASA Family Attachment Court Protocol in the Milan courts. For two decades, he collaborated with Crittenden in the development of the Dynamic-Maturational Model, translating four books, co-authoring many research articles, and publishing numerous chapters on using the DMM to guide treatment. He has participated in numerous research projects and is an author on many books and articles resulting from them.