A Therapist's Guide to the Adult Attachment Scale 

Attachment theory has played a significant role in psychology since John Bowlby introduced it in the late 1960s. Initially, it focused on the bond between infants and their caregivers, but it now has also been applied to adult relationships. This shift provides valuable insights into how early experiences shape our interactions with others throughout life.

Understanding adult attachment styles helps therapists assist their clients in navigating relationship complexities. When therapists assess a client's attachment style, they gain a clearer picture of interpersonal challenges and can develop targeted interventions to encourage growth and healing. With that in mind, let’s take a closer look at a widely used self-report measure for assessing adult attachment styles: the Adult Attachment Scale (AAS-SR). We’ll discuss the purpose of the AAS-SR, its clinical applications, and how therapists can use this tool to enhance their practice and improve client outcomes.

Understanding the Four Adult Attachment Styles

‍There are four attachment styles that develop from our relationships with caregivers during our infancy that informs and shapes how we connect with others later in life. Let’s explore each of these attachment styles: 

• Secure Attachment: People with a secure attachment style feel comfortable with intimacy and usually have healthy, interdependent relationships. They trust others, communicate openly, and manage their emotions effectively.
• Anxious Attachment: Individuals with an anxious attachment style often fear abandonment and need constant reassurance from their partners. They may struggle with low self-esteem, jealousy, and worry about the availability and responsiveness of their attachment figures.
• Avoidant Attachment: Those with an avoidant attachment style tend to keep emotional distance in relationships, valuing independence and self-reliance. They may find intimacy challenging, have difficulty expressing feelings, and dismiss the importance of close bonds.
• Disorganized Attachment: People with a disorganized attachment style often show unpredictable behavior in relationships, swinging between wanting closeness and fearing intimacy or pushing loved ones away. They may experience emotional turmoil, struggle to regulate their emotions, and have difficulty with trust and consistency in their relationships.

In clinical settings, attachment styles can influence the therapeutic alliance, including through transference, and countertransference. Depending on the treatment modality a therapist uses, they may strive to understand a client's attachment style so that they can tailor their approach to address specific relational patterns and foster secure attachment. This can lead to positive changes in the client's interpersonal functioning.

Overview of the Adult Attachment Scale Self-Report Assessment (AAS-SR)

‍The Adult Attachment Scale serves as a self-report assessment to identify and categorize an individual's attachment style in adulthood. The main goal is to offer insight into how a person connects with others in close relationships, such as romantic partnerships, friendships, and family dynamics.

The AAS-SR consists of 18 items scored on a 5-point Likert scale, ranging from 1 (not at all characteristic of me) to 5 (very characteristic of me). Respondents rate their level of agreement with statements that reflect three main dimensions to inform categorization of an individual into one of the four attachment styles. Completing the assessment typically takes 5-10 minutes. Here’s how the assessment is broken down:

• Structure: The AAS includes three subscales, each with six questions: close, depend, and anxiety. 
• Depend subscale: Measures the extent to which an individual feels comfortable relying on others and believes that people will be available when needed.
• Anxiety subscale: Assesses the degree to which a person worries about being rejected, abandoned, or unloved.
• Close subscale: Evaluates an individual's comfort with intimacy and emotional closeness in relationships.

The AAS-SR is suitable for use with various populations, including individual clients and couples.  For individual therapy, clinicians can use the AAS-SR to inform treatment planning and address attachment-related issues that may be contributing to a client's current concerns. In couples therapy, the AAS-SR can assist couples in identifying and working through attachment-related challenges in their relationship, promoting better understanding and communication.

How to Administer the AAS-SR

‍Administering the AAS-SR means following a set of standardized procedures to ensure accurate and reliable results. Here's a step-by-step guide on how to conduct the assessment in both individual and group settings:

1. Obtain informed consent: Before starting the AAS-SR, explain the purpose, procedures, and possible risks and benefits of the assessment to the respondents. Address any questions or concerns they might have. Clarify how the results will be used.
2. Administer the Measure: Provide clear instructions without influencing the client’s responses, ensuring they answer honestly based on their own experiences without guidance or interpretation from the therapist. 
3. Collect and score the assessments: Once the respondent finishes, gather the completed AAS-SR form. Score the assessments following the standardized scoring procedures, calculating scores for each of the three subscales: Security, Anxiety, and Avoidance.

When administering the AAS-SR, consider the following practical tip to ensure accurate results:

• Allow sufficient time: Although it typically takes 5-10 minutes to complete, provide extra time for questions, concerns, or accommodations for individual needs.

Keep in mind, as a therapist, it is important to uphold ethical standards when administering the AAS-SR or any other psychological assessment. Protect respondents' privacy and confidentiality, and use the results only for their intended purposes in informing treatment planning and improving therapeutic outcomes.

Adult Attachment Scale Scoring

‍Scoring the Adult Attachment Scale (AAS-SR) involves a simple process that helps therapists identify an individual's main attachment style. The assessment uses a 5-point Likert scale, with responses ranging from 1 (strongly disagree) to 5 (strongly agree) for each of the 18 items.

The AAS-SR has original and alternate scoring, so let’s discuss both routes below:

Original Scoring Instructions
Average the ratings from the six items that compose each subscale, as indicated below. The items with an asterisk (*) should be reverse-scored before computing the subscale mean.  

• Close Subscale Items: 1, 6, 8*, 12, 13*, 17*
• Depend Subscale Items: 2*, 5, 7*, 14, 16*, 18* 
• Anxiety Subscale Items: 3, 4, 9, 10, 11, 15

Secure = high scores on Close and Depend subscales, low score on Anxiety subscale

Anxious = high score on Anxiety subscale, moderate scores on Close and Depend subscales

Avoidant = low scores on Close, Depend, and Anxiety subscales

Alternate Scoring Instructions
If you would like to compute only two attachment dimensions (attachment anxiety and attachment avoidance), you can use the following scoring procedure. The items with an asterisk (*) should be reverse-scored before computing the subscale mean.  

• Avoid Subscale:1*, 2, 5*, 6*, 7, 8, 12*,13, 14*, 16, 17, 18
• Anxiety Subscale Items: 3, 4, 9, 10, 11, 15

Anxious = high score on Anxiety subscale, moderate scores on Avoid subscale

Avoidant = high score on Avoid subscale, low/moderate score on Anxiety subscale 

When interpreting results, consider the relative differences between subscale scores and any mixed or borderline results. For example, an individual with moderate scores on all three subscales may have a more complex attachment profile that requires further exploration in therapy.

In clinical practice, attachment style assessment results should be combined with other sources of information, such as client history, presenting concerns, and therapeutic observations to create a full case conceptualization. This comprehensive approach allows therapists to better understand the client's relational patterns and tailor interventions accordingly.

Validity and Reliability of the AAS-SR

‍The Adult Attachment Scale shows strong psychometric properties, making it a reliable and valid tool for assessing adult attachment styles in various situations. Many studies have examined the effectiveness of the AAS-SR, providing evidence for its usefulness in both research and clinical settings.

• Reliability: The AAS-SR demonstrates high internal consistency for the three subscales (Depend, Anxiety, and Close). 
• Construct Validity: The AAS-SR has been compared to other well-established measures of adult attachment, such as the Experiences in Close Relationships (ECR) scale and the Relationship Questionnaire (RQ). Significant correlations between the AAS-SR subscales and these measures provide evidence for the construct validity of the assessment.
• Predictive Validity: Studies show the predictive validity of the assessment across multiple countries around the world, demonstrating that attachment styles assessed by the tool are linked to various relationship outcomes, such as relationship satisfaction, communication patterns, and conflict resolution strategies.

The AAS-SR offers several advantages over other adult attachment assessments:

1. Ease of Administration: The self-report nature of the AAS-SR makes it simple to administer and score, requiring minimal training for practitioners.
2. Efficiency: With only 18 items, the AAS-SR can be completed quickly, making it a practical choice for use in various settings, including clinical practice and research.
3. Comprehensive Assessment: The AAS-SR provides a thorough assessment of adult attachment styles, covering the three main dimensions of secure, anxious, and avoidant attachment.

However, it is important to acknowledge the limitations of the AAS-SR:

• Self-Report Bias: Like any self-report measure, this assessment is subject to biases such as social desirability and response bias. Individuals may not always accurately report their attachment-related thoughts, feelings, and behaviors.
• Cultural Considerations: It was developed and validated primarily with Western samples, and its applicability to specific cultural contexts requires further investigation and potential adaptations.

Despite these limitations, the AAS-SR remains a popular and well-validated tool for assessing adult attachment styles. Therapists can use this assessment effectively while being aware of its potential drawbacks and considering it as one component of a comprehensive evaluation process.

A Look at Measuring Temporary Variations in Attachment: The State Adult Attachment Measure (SAAM)

While the AAS-SR looks at the adult attachment styles, the State Adult Attachment Measure (SAAM) captures temporary variations in attachment and measures 3 aspects of adult attachment: anxiety, avoidance, and security. Attachment styles are thought to reflect individuals’ cognitive–affective “working models” (i.e., mental representations) of self and other and resulting behavioral orientations toward close relationship partners. While initially conceptualized as stable personality dimensions, recent research suggests that levels of attachment are also affected by situational factors; hence the need for a measure that captures fluctuations. Respondents rate how much they agree or disagree with the attachment symptoms listed (e.g., “I wish someone would tell me they really love me”) on a scale from “Disagree Strongly” to “Agree Strongly.”

Key Takeaways for Integrating the AAS-SR into Clinical Practice

‍The Adult Attachment Scale (AAS-SR) serves as a valuable tool for therapists aiming to understand their clients' attachment styles and enhance treatment outcomes. This self-report assessment sheds light on an individual's relational patterns, allowing therapists to tailor interventions and effectively address attachment-related challenges. Key points to keep in mind when using the AAS-SR in clinical practice:

• Comprehensive evaluation: Use the AAS-SR as part of a broad assessment process, combining results with other sources of information like mental status exam, reported client history, and therapeutic observations.
• Targeted interventions: Develop strategies that address the specific attachment-related needs and challenges highlighted by the AAS-SR, promoting healthier relational patterns and coping strategies.
• Therapeutic alliance: Use the assessment’s results to strengthen the therapeutic relationship by showing an understanding of the client's attachment style and its impact on their relationships and well-being.

Therapists can incorporate the AAS-SR into their practice by:

• Administering the assessment during the initial evaluation phase or when attachment-related issues emerge in treatment.
• Discussing AAS-SR results with clients to enhance self-awareness and insight into their relational patterns.
• Monitoring the effectiveness of Implementing attachment-focused interventions, such as emotion regulation strategies, communication skills training, and trauma processing, based on the client's identified attachment style.

As research on adult attachment progresses, the literature surrounding the AAS-SR and newer measures, such as the SAAM continues to reflect new findings and clinical applications. Therapists should stay informed about developments in attachment theory and assessment to provide the most effective, evidence-based care to their clients.