Attachment-Focused Therapy Post-Graduate Certificate Program

Taught by Deborah Gray, MSW, MPA

Developed and presented by Deborah Gray, MSW, MPA, Nurturing Attachments

Sponsored by: Cascadia Training and Nurturing Attachments

Endorsed by the International ATTACh organization as a program preparing licensed therapists for a specialty in attachment-focused therapy

April 5-8, May 17-20.  84 credit hours $2,500.00 (register and pay before February 15 and receive $150.00 off. Class is limited to 11 participants)

Now accepting its Sixth cohort!

This is a small, master class designed for the clinician who wants to develop a specialty in treating the attachment/trauma issues of children.  The course is an 84-CE Program.  24 hours are on-line with readings.  The remaining 60 hours are in-class instruction.

Faculty:  Deborah Gray, MSW, MPA as core faculty,  Sally Carmen, OTL, specializing in sensory issues and mental health, and Kristie Baber, LCSW, Infant Mental Health Specialist.

The program will be phased:

Phase I: The first phase includes direct instruction in the areas of attachment, attunement, maltreatment, and grief as well as the brain development inherent in these factors.  Theory, research, model programs, and personal biases will be explored.  Therapy tapes will be shown and analyzed.  50 CEs.

Phase II:  The emphasis is therapy skill development in which participants will incorporate attachment and trauma work into their practice models. Participants will develop and present a final project demonstrating their mastery of the course material.  34 CE

Attachment-Focused Therapy Certificate awarded at the completion of Phase I & Phase II.

 Phase III: A series of case consultation groups, with advanced topic instruction and case analysis, available to attachment therapy certificate graduates.  Advanced Certificate:  30 hours

 Who may apply:

Individuals who have completed, or who are close to completing the Post-Graduate Foster Care and Adoption Therapy Certificate Programs, or individuals who have previous experience in the areas of attachment, trauma, foster care and adoption.  Participants must have a Doctorate or Master's Degree in psychology, social work or the mental health field.

Cascadia Training/Nurturing Attachments: Attachment-Focused Therapy Certificate Program

Phase I

Day 1,2,3  as well at on-line articles and readings.

This course will begin with a sound understanding of attachment theory, the context of attachment work in psychotherapy, assessment of attachment, relationships between attachment and stress regulation and evidence-based or promising practices in increasing the security of attachment.  


  • Theoretical framework of attachment, including a historical look at attachment theory and practice,
  • The adult attachment interview and the lessons from the interview,
  • Patterns of attachment interview and stress regulation systems,
  • Patterns of attachment and skill sets for attunement,
  • Attachment disorganization and cue/response patterns,
  • Disorganized attachment and behavioral expressions seen by the therapists and by parents,
  • Child Attachment Interview, by Peter Fonagy and Mary Target
  • Dysregulation, executive dysfunction, and the Adverse Childhood Experiences Study,
  • Accommodations in traditional psychodynamic approaches due to disrupted patterns of attachment and executive dysfunction,
  • Survey of Close Relationships,
  • Therapist's style in attachment,
  • Therapist's subjective attachment responses in sessions.

By the end of this segment, class members will individually and collectively explore their own concepts of family attachments.

They will come to understand how their life experiences influence their attachment-focused therapy work.  They will identify strengths that they have as a therapist and particular family situations in which they might excel.  They will also develop awareness of types of situations in which they might lose helpful objectivity.

The ways in which the attachment literature leans to or away from its support of children or their parents will be discussed throughout this first phase

Phase II, Days 4-6 as well as on-line readings

The therapist will explore the interrelationships between attachment, grief and trauma.  The contribution of neglect and its impact on attunement will be further incorporated.  This segment will incorporate evidenced-based trauma and grief methods into practice models.  Methods to enhance attachments at every developmental phase will be described-as well as the impacts of loss of attachment figures at every phase. 

This phase will also look at the maltreated child who has a history of disorganized attachment and their unique differences in the approach to the therapist and traditional play techniques.  Methods to engage such a child will be taught.

The class will look at research projects that have evidence in influencing affect regulation.  Those elements of success will be identified for use within practice models.

Participants will be taught to enhance the positive, affect-regulating potential of attachment.  The therapists' and parent(s)' dynamic contributions to children's affect regulation and emotional attunement will be described in a series of cases and case examples.  Ample descriptions of attachment and attunement-producing skills will be described.

Participants will view, analyze and discuss therapy tapes and classic cases as they apply their skills and understanding of affect and attachment.  The classes will layer more complex cases as the sessions continue, including multiple traumas, multiple placements, Dissociative Identity Disorder, static encephalopathy and FASD.

  • Attachment and Bonding Evaluation competency in completing assessments,
  • Infant Mental Health assessment and interventions,
  • Neglect, the cerebellum, and promising practices for children's neurodevelopment after neglect,
  • Sensory Integration as a part of therapy and daily life,
  • Moving children-and their attachments,
  • Dissolution and disruptions and their implications for attachment issues
  • When to refer for additional assessment and treatment,
  • Inventory of the therapists' abilities to regulate their own affect-and the selection of cases,
  • Therapists' attunement mishaps and the process of repair depending on attachment style of client,
  • Scripting ways to repair between therapist and clients,
  • Trauma work:  resource assessment, pacing, adapted models for FASD, and continuing progress towards development of attachment,
  • Trauma assessment tools, TAPS model,
  • Cognitive behavioral therapy as a part of an overall model,
  • Keeping attachment figures regulated in sessions,
  • Family attachment-oriented work for treatment of children's sexual abuse,
  • Complex case planning for issues of sexual abuse, severe neglect, parental abuse, orphanage abuse/neglect, and multiple moves between families,
  • Movement back into birth families,
  • Issues of open adoption when maltreatment is present and children have attachments to these parents,
  • Grief work as integrated into attachment and trauma work,
  • Prevention and treatment of pathological grief,
  • Designing treatment plans that are child-involved.

Participants will role-play intake sessions, attachment-focused sessions, trauma sessions and grief sessions for various age groups, practicing the skills before their peers.  They will practice using accommodated methods for children with FASD and Executive Dysfunction.

By the end of this segment participants will select areas of concentration for their practices.  They will plan cases, either currently in their practice or future sample cases, that will be selected to meet the experiential learning goals of the class.  Therapeutic caseworkers will define their areas of practice, as well, and the methods that they will use in their psycho-educational practices.  These projects (cases) will be presented as final projects.

Day 7-8 as well as on-line readings.

The concept of ambiguous grief as well as practical plans for affect support will be described.  Limits for every practitioner, as well as ways in which they can recognize their own stress, will be discussed.  We will conclude Day 9 with an exercise in which each therapist will develop a plan for support and practice balance needed to do attachment-focused therapy.

Participants will participate in a practical discussion to help them plan for: a particular type of office space, marketing assistance, insurance panel coverage, networking, and special supplies.  Connections to others to whom they can be accountable will be discussed.

Therapists will present their final projects.  Their goals, process and case planning will be analyzed.

 The final day will conclude with dinner and the awarding of the Attachment-Focused Therapy Certificate.


Deborah Gray, MSW, MPA

Deborah Gray, MSW, MPA described as "attachment guru" by Adoptive Families Magazine, specializes in attachment, grief, and trauma issues of children in her practice, Nurturing Attachments. Her passion is to help families develop close, satisfying relationships.  A clinical social worker, she has worked over 25 years in foster and adopted children's therapies and placements.  She has also been a therapeutic foster parent.

Deborah is core faculty for the award-winning Post-Graduate Certificate Program in Foster and Adoption Therapy at Portland State University.  She is main faculty in the ATTACh-recognized Post-Graduate Attachment Therapy Certificate Program through Cascadia Training.  She has taught in the Trauma Certificate Program at the University of Washington and was the 2008 Henry W. Maier Practitioner in Residence at the School of Social Work at the University of Washington.

Deborah Gray is a popular presenter due to her practical and positive approaches.  She has keynoted conferences ranging from the Joint Council of International Children's Services to Orphan Conferences.  She continues to work in a clinical practice with parents and children, who help to teach her new approaches and techniques every day.  Visit her website at

Upcoming Dates and Registration

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