Abstract
This paper will explore some of the ways in which attachment theory is relevant to work in institutions, with particular reference to hospital settings.
The landmark work of Bowlby and the Robertsons has been enormously influential with respect to subsequent thinking about attachment, young children and institutions. It has brought about real and lasting benefits, in the sense that paediatric hospitals now encourage admission of children along with a parent and attempt to minimize separations.
Clinical practice has also developed so that staff from many disciplines are increasingly aware of the role they can play in supporting attachment – for example, midwifery practice and very early attachment. Paediatric nurses are well placed to assist parents to sustain their role in an alien and potentially disempowering environment that can cause parents to withdraw when they are needed most. Obstacles to such attachment based practice will also be considered.
Attachment to the staff, ward or hospital itself is recognized as being significant in the lives of many children, in both paediatric and mental health settings. The meaning and consequences of this will be explored.
Finally, a mention will be made of the implications for attachment and later development in infants raised in institutions.