A family struggling with Reactive Attachment Disorder (RAD) is often desperate for help but doesn’t know where to turn. The unattached child needs more than love and time, but his parents become frustrated and depressed, lose hope and even abandon the desire to help him after years of dealing with his anger — not to mention expensive and often unsuccessful treatment programs. Parents feel guilty and confused as they blame themselves for their child’s problems, and the family crumbles as the child attacks both parents and siblings with emotional and physical harm.
Just as traditional discipline rarely works at home with RAD, so typical therapy is not successful either. Severely unattached children do not trust, cannot identify or verbalize their feelings, do not tell the truth and are not capable of a reciprocal relationship — all critical ingredients in an ideal model for psychological treatment.
Unfortunately, some well-intended professionals have inflicted more harm on children through techniques such as “rebirthing” (in which a child is physically confined and then encouraged to free himself, simulating the birth experience). Rebirthing (which has caused suffocation in some cases) has been specifically denounced by the American Psychological Association, the U.S. Congress and is illegal in some states. Instead, accepted treatment for RAD commonly pursues a course of three steps: to have the child acknowledge the therapist’s authority, establish trust within the family (especially between the child and mother), and then move on to healing the trauma of the past.*
Experienced professionals can help an unattached child, but given the opportunity,
the child quickly attempts to take control of all sessions. The unattached
child can manipulate therapists who have no training or experience with
treating RAD. Families who have worked through this disorder recommend
seeking out a member of the Association for Treatment and Training in
the Attachment of Children (ATTACH). The child’s parents should always be included — if not in the room, then watching via closed circuit TV — to prevent the child from creating fiction and diverting the therapist. Sessions for RAD should typically be three or four times longer than traditional visits.
Treatment involves the entire family. Many parents are advised to adjust their expectations for their child, stop being angry and learn to feel empathy for him. Sometimes the parents need to unlearn their own negative thought patterns and views of themselves that have developed as a result of their struggles with their child. Parents are trained in new parenting techniques that address the unique needs of the unattached child.
Because most causes of RAD begin before a child can talk, numerous treatment professionals do not attempt conversation-based therapy. Instead, they focus on recreating positive pre-verbal experiences in an effort to establish trust and affection between children and parents, and then develop new systems of thought, morality and action. An experienced professional will also recognize that what the child says will rarely be truthful at the beginning. Progress is measured by documentation of behavior away from the office. Once a child has learned how to express anger and fear, and the family has started to bond, the professional will go back and address the pain that caused the disorder. Sometimes traditional therapies can then be included.
Successful recovery from RAD includes more than just reducing undesirable behavior. Ultimately, the goals are to learn to function mutually in relationships, understand and take responsibility, learn productive means of identifying and dealing with emotions and stress, welcome emotional intimacy, and develop the ability to love and enjoy life, themselves and others. Parents learn to hope again as they acquire new skills for helping their child with his behavior and for establishing specific, well-enforced structure.
The additional incidence of other mental and behavioral disorders can complicate and lengthen the course of treatment. Children diagnosed with RAD commonly have trouble with sensory integration or hyperactivity, physical impairments such as fetal alcohol syndrome, and psychological disorders such as depression or bipolar, oppositional defiant disorder, and posttraumatic stress disorder. These additional problems may be treated concurrently, especially those that respond immediately to medication, or they may be addressed after the family has begun to move ahead emotionally.
There is no predetermined time frame for how long the process takes, but it’s recommended that families assess their progress after one month for each year of their child’s age. If, for example, your 4-year-old does not show any noticeable improvement within four months, then reconsider your therapist and the treatment program with which you are working.
— Alexandra Lütz
These methods were originally implemented by a treatment facility (Evergreen Consultants in Human Behavior) in Evergreen, Colorado, but are now widely applied by licensed professional psychologists. Evergreen Consultants is internationally recognized in attachment therapy utilizing the Two-week Intensive model. Source: www.attachmenttherapy.com. Evergreen is not a Christian organization.
