Another day older and deeper in therapy: Can the Dynamic-Maturational Model offer a way out?

Patients referred to adolescent psychiatric units have often been in contact with services for many years. When assessing for admission we consider why the previous approaches might have failed and how milieu therapy might be more effective as the priority treatment. We propose that the information provided by an adolescent's Transition to Adulthood Attachment Interview (TAAI) and the parents' Adult Attachment Interviews (AAI) leads to an especially productive case formulation. The Dynamic-Maturational Model of attachment and adaptation (DMM) uniquely provides a detailed understanding of an extended range of Type A and Type C strategies with modifiers that are useful for planning the milieu therapy, individual and family work. In addition, this case presentation illustrates the usefulness of understanding the phenomenon of "intruded negative affect".