Health visitors' experiences of using a tool in assessing infant attachment

Research and government policy emphasises the importance of the first year of life for future development, and health visitors (HVs) have been identified as key professionals to support families in order to improve attachments. This qualitative study investigated the experience of health visitors in utilising an attachment assessment tool. Semi-structured interviews were conducted with a purposive sample of six experienced HVs. There is a need to develop HV knowledge and skills in assessing attachment and supporting families where there are attachment difficulties. The tool emphasised the importance of attachment and had impacted on record-keeping, but it requires modification. The majority of HVs did not share the tool with parents due to fears about its impact on parent's emotions and behaviour, and on HVs' relationships with them. HVs reported difficulties in undertaking attachment assessments as there is insufficient time to build a relationship with parents or undertake observations. The emotional impact on HVs of working with attachment difficulties highlights their need for support and supervision. The role of the HV in assessing attachment and intervention needs clarification and warrants national investigation.