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Child Attachment &
Play Assessment

Publications

The CAPA has five peer-reviewed publications and half a dozen empirical studies either under review or nearing completion. It has been used in a about a dozen doctoral dissertations and innumerable Masters theses. Published studies demonstrate: convergent validity with an observational procedure for pre-schoolers (CARE-Index) and an attachment interview for school age children (Farnfield 2015); construct validity regarding attachment insecurity and known risks in the environment such as parent mental health (Farnfield  & Onions, 2022); the CAPA distinguishes between endangered (largely children in foster care) and safe community children (Farnfield 2015), community endangered children from severely maltreated children in residential care (Farnfield & Onions, 2022); a significant association with DSM5 clinical diagnoses of anxiety disorder and of depression (Farnfield  & Onions, 2022, accepted), correlation between child attachment and risk of, or history of, maltreating animals (Wauthier et al in press). Stability of attachment using the CAPA over a two-year period with a group of highly traumatised institutional children was 64% which compares favourably with other studies (Farnfield & Onions, accepted). That study also found that nearly a third of children six months into residential care used the DMM A8 pattern (externally assembled self) and 29% two years later. So far as we know this is the first study to empirically link A8 to multiple home placements as predicted by Crittenden and Landini. The case for using the CAPA as a means of both defining and assessing developmental trauma in children is made by Farnfield 2025.

Future publications are expected to demonstrate:

  • correspondence between unresolved trauma on the CAPA and validated trauma scales (Zhang et al, submitted)
  • correspondence of CAPA constructions in case studies with (a) predicted biophysical data (heart rate variability, cortisol) (Hadiprodjo, unpublished, 2018; Zhang in preparation) and (b) cortisol & alpha amylase (Zhang in preparation).

Farnfield, S. (2015). The child attachment and play assessment (CAPA): a new approach to coding narrative stems with children aged 3 to 11 years. International Journal of Play Therapy. 25, 217-229.

Farnfield, S. (2025) Rethinking developmental trauma using the Child Attachment and Play Assessment, Invited submission special edition, Attachment theory, advances and contributions to psycotherapy. Revista de Psicoterapia, 36(130), 45-55. https://doi.org/10.5944/rdp.v36i130.44129

Farnfield, S. & Onions, C. (2025) Attachment and complex trauma: Evaluating outcomes for children in therapeutic residential care. Clinical Child Psychology and Psychiatry. DOI: 10.1177/13591045251401092

Farnfield, S. & Onions, C. (2022): The role of affect regulation in developmental trauma: an empirical study of children in residential care, Journal of Child Psychotherapy, DOI: 10.1080/0075417X.2021.2015421

Farnfield, S. (unpublished, 2020) Report for the Mulberry Bush School: attachment, trauma and play. University of Roehampton/ Mulberry Bush School.

Hadiprodjo, N. (unpublished, 2018) Heartfelt Play: An exploratory case-based analysis of cardiac activity within play therapy dyads and children’s play narratives. PhD Dissertation, University of Roehampton.

Onions, C. (unpublished, 2020) From research to practice at a residential school: The Mulberry Bush. British Educational Research Association Conference.

Wauthier, L. M., Farnfield, S., Scottish SPCA, & Williams, J. M. (2023). A preliminary exploration of the psychological risk factors for childhood animal cruelty: The roles of attachment, self-regulation, and empathy. Anthrozoös, 36(3), 447-469.

Wauthier, L. M., Farnfield, S., & Williams, J. M. (2022). The role of attachment in children’s relationships with pets: From pet care to animal harm. Human-Animal Interactions.

Zhang, F. & Farnfield, S.  (in preparation) Comparing diagnoses of child PTSD with the assessment of developmental trauma.

Zhang, F., Farnfield, S., Gibson, Leigh E., Grey, B., (submitted).Comparing diagnosis of child PTSD with a doll play assessment of developmental trauma: Exploring child PTSD with the CAPA  Clinical Child Psychology and Psychiatry

Zhang, F. (in preparation) The bio-physiology of developmental trauma: cortisol and alpha amylase.