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Bindung und Migration
21st International Attachment Conference
Disordered Attachments in Digital Ages
September 16th - September 18th, 2022
Bindung und Migration
Romero Velasco

Romero Velasco, Katrin, (Munich/Germany)

Attachment-oriented milieu therapy in inpatient psychotherapy: The group as healing attachment experience

Children who have experienced severe trauma in infancy and early childhood are generally not able to function well in groups. Because they have difficulty controlling affect and behaving empathetically, they often feel provoked by other children.

They then react with extreme aggressive behavior toward others, and in some instances they may already have been suspended from nursery school and later from classrooms. Sometimes they have even been expelled from school altogether. Other children may present problems in a group because they show signs of serious depression and anxiety, or because they dissociate.

In milieu therapy, an established structure is important at a variety of levels, because it provides the children and those who work with them a safe and protected environment. In addition, it guarantees that everyday life on the unit functions smoothly, and it enables all who are involved to manage crisis situations. Multidisciplinary cooperation is especially important in crises. The professional personnel must be supported by colleagues at all levels. Intensive information exchange about, but also with, the patients is critical to developing individually tailored strategies on the unit. Coregulation and intensive one-on-one contact help to overcome an acute crisis and make it possible for the child to return to the group. The children then come to experience the group not as a place of threat; rather, they internalize the group experience as a support and the community in the group as an additional source of emotional security. This process will be demonstrated in this presentation based on a variety of examples.


Katrin Romero Velasco has been a pediatric nurse since 2001.

In 2002-2003 she took part in a training program in psychotraumatology, trauma-centered psychotherapy, trauma counseling, and trauma education under Lutz-Ulrich Besser. She studied social education at the Katholische Stiftungsfachhochschule (KSFH) in Munich, graduating in 2010. She was trained as a SAFE mentor by Karl Heinz Brisch in 2011. In 2015, Romero Velasco obtained a certificate in attachment-based counseling and attachment therapy under Dr. Brisch.
Since 2001 she has been working as part of the unit team in the Department of Pediatric Psychosomatics and Psychotherapy at the Doctor von Hauner Children's Hospital in Munich.