This study explored a potentially important intersection between behavior therapy and attachment theory in the treatment of separation anxiety disorder (SAD). Specifically, in this article, the authors describe an intervention that incorporated attachment theory in the framework of an exposure-based cognitive-behavioral treatment (CBT) for severe separation anxiety experienced by a 9-year-old boy. Assessment measures indicated that treatment gains were evident at the end of 12 sessions and that the child showed continued improvement at a 6-month follow-up session. Overall, it seemed that an attachment perspective was helpful in framing an understanding of SAD for the parent and fostering compliance with the CBT regimen. Utilization of the theory also helped the parent and therapist in determining reinforcers for the child's behavior. More detailed and controlled investigations of the effect and relative effect of the attachment focus during CBT for SAD are warranted.
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