Psych CASC / OSCE · Foundations — attachment
Explain attachment to a foster carer and plan care — CASC communication station
MRCPsych/FRANZCP-style CASC: psychoeducation on secure base/safe haven, RAD/DSED vs style, BEIP-aligned caregiving priorities, and clear refusal of coercive attachment therapies with collaborative alternatives.
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Station brief
Format. Communication station, approximately 7–10 minutes active time after reading. You are the psychiatry registrar in a CAMHS clinic.[2]
Candidate instructions. Meet the foster carer of a 6-year-old boy with early severe neglect. Explain attachment in plain language (secure base / safe haven). Distinguish everyday insecure patterns from Reactive Attachment Disorder and Disinhibited Social Engagement Disorder. Validate that current caring is part of the solution, not the cause. Address an offer of holding therapy. Agree a collaborative plan: stable sensitive care, assessment of comorbidity, school strategies for social boundaries, multi-agency support. Check understanding; avoid jargon piles and blame.[1][2][3]
References5ShowHide
- [1]Bowlby J The making and breaking of affectional bonds. I. Aetiology and psychopathology in the light of attachment theory Br J Psychiatry, 1977.PMID 843768
- [2]Zeanah CH, Chesher T, Boris NW Practice Parameter for the Assessment and Treatment of Children and Adolescents With Reactive Attachment Disorder and Disinhibited Social Engagement Disorder J Am Acad Child Adolesc Psychiatry, 2016.PMID 27806867
- [3]Chaffin M, Hanson R, Saunders BE, et al. Report of the APSAC task force on attachment therapy, reactive attachment disorder, and attachment problems Child Maltreat, 2006.PMID 16382093
- [4]Fox NA, Nelson CA 3rd, Zeanah CH The Effects of Psychosocial Deprivation on Attachment: Lessons from the Bucharest Early Intervention Project Psychodyn Psychiatry, 2017.PMID 29244624
- [5]Gleason MM, Fox NA, Drury S, et al. Validity of evidence-derived criteria for reactive attachment disorder: indiscriminately social/disinhibited and emotionally withdrawn/inhibited types J Am Acad Child Adolesc Psychiatry, 2011.PMID 21334562