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Treatment Options for Reactive Attachment Disorder

October 22, 2010

Since I often get asked this question, I am presenting a response Randal Pennington, PsyD, recently made to someone who was asking him what treatments are available to address reactive attachment disorder (RAD) other than the ones Advocates for Children in Therapy has criticized.  Note that this assumes that a valid diagnosis of RAD has been given, since behavioral problems are commonly misdiagnosed as RAD, based on symptoms that are not in the DSM.  A recent review I conducted of the literature of RAD and adoption showed that some of the children who had been diagnosed by their therapist as having RAD, did not have attachment problems, according to the more valid assessments done by the researchers. Therefore, a second opinion by a therapist who specializes in behavioral problems and is not part of the “attachment therapy” community would be well advised. That being said, here are some recommended interventions that do have research support. Note as I have stated previously, that these are not meant to be specific recommendations for any specific individual, nor is this meant to be a complete and exhaustive list. Dr. Pennington wrote:

To help you with your questions, I am including a link to a PDF file of an important document that will guide you as you consider various treatments for reactive attachment disorder.  The citation for this document is…

Chaffin, M., Hanson, R., Saunders, B.E., Nichols, T., Barnett, D., Zeanah, C., Berliner, L., Egeland, B., Newman, E., Lyon, T., LeTourneau, E., & Miller-Perrin, C. (2006).  Report of the APSAC Task Force on attachment therapy, reactive attachment disorder, and attachment problems.  Child Maltreatment, 11(1), 76-89.

http://depts.washington.edu/hcsats/PDF/AttachmentTaskForceAPSAC.pdf

I am also giving you some other resources you can research on your own…

1.   The Circle of Security is a program that has promise.  The link to more information on this program is below…

http://www.circleofsecurity.org/

2.  Another program is the Attachment and Biobehavioral Catch-Up (ABC) intervention developed by Mary Dozier, Ph.D. that you might find useful.  For more information, go to link…

http://abcintervention.com/index.html

3.  Another program that may be of interest to you is the Incredible Years developed by Carolyn Webster-Stratton, Ph.D.

http://www.incredibleyears.com/http://www.son.washington.edu/faculty/faculty_bio.asp?id=112
4.  Sheila Eyeberg, Ph.D. has developed the Parent-Child Interaction Therapy (PCIT) which is an evidence based program for dealing with problematic behaviors of children that can be applied to children with attachment concerns.

http://pcit.phhp.ufl.edu/
I have others, but this should give you some ideas of the type of therapeutic interventions that can be used wth children who have RAD and other disorders such as oppositional defiant disorder or conduct disorders.

If you have any further questions, let me know and I’ll try my best to answer them.

Best of luck to you in finding something that works for you and your child,

Randal S. Pennington, PsyD
Provo, Utah

These references are important to keep in mind, given that some proponents of “attachment therapy” would like to have us believe that their invasive, largely untested procedures are the only alternative parents have other than so-called “talk therapy” when this is far from being the case.

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