Reactive Attachment Disorder Treatment

A child who is younger than age three is at risk for developing reactive attachment disorder (RAD) when a parent or other caregiver neglects, abuses, or subjects the child to trauma.

Healing RAD with treatment, or softening the impact, requires taking a long-term view of at least several years and longer in many cases. The child needs “an emotional heart transplant,” writes Nancy Thomas, a mother, sought-after treatment specialist and host of the website Attachment.org.

Family

An adoptive or foster family needs to make expectations and rewards clear for being on time to meals, making a bed, and reading stories. Continually express love and acceptance and offer a generous thank-you when tasks are completed well.

Nancy Thomas advises mothers to give at least six months to a year to help the child with RAD begin to accept a new heart. She advises that children with RAD be the youngest in a household whenever possible.

Touch

Offering consistent and simple touches like holding hands and giving gentle hugs can help gain the trust of a child who has reactive attachment disorder. Make it fun like playing “tickle” touch football. Don’t overdo an activity to reduce the chance of emotional explosions from too many touches or frustration in not “winning.”

Eye Contact

Maintain eye contact when speaking to a child as one simple treatment for RAD. Try to get on one knee, smile, and give brief but direct eye-to-eye contact when giving a directive like saying it’s time to pick up shoes or put away toys.

Speaking

Use consistent voice tones when speaking. Do not react angrily and yell if the child throws a tantrum or upsets others at dinner. Follow through on discipline such as time outs using a specific chair in a specific location. Practice keeping a steady but reassuring voice.

Counseling

A counselor can offer services like play therapy to a child with RAD and include one or more family members on a regular basis. Counseling and support groups can also be effective for giving parents and children in the family a safe environment to process.

Writing

During pre-teen years and into the teen years, a child with RAD can be directed to write a weekly letter to her parents or another consistent parental figure in her life. The letters don’t even have to be structured. The exercise helps the child develop a focus on someone else.

Medication

Consult with a psychiatrist to determine if psychotropic medications will help. Some medications may treat another factor like extreme hyperactivity. This can improve listening skills and give the child with RAD a chance to listen and respond appropriately.

Providing appropriate medication can reduce the chance of self-medicating with alcohol and drugs.

Communication

Long-winded lectures will not work for a young child or older child who has a damaged conscience. Keep words clear and speak in brief sentences to make a point and then walk away. Speak pleasantly and with a smile as much as possible.

Consequences

For older teens and young adults with RAD, there must be consequences for refusing to follow through on directives from the people who love them. Many of these can be natural consequences. If they fail to set an alarm and get up for school or work, then the parent should not bail them out.

If the parent has to enforce consequences, use a phrase like, “what kind of a parent would I be if I like that happen and didn’t do anything?” Walk away and don’t wait for an agreement. Done consistently, this can help the child consider their actions and related consequences.

Residential programs with intensive therapy can help create an attachment to families, notes an article on NationalYouthNetwork.com.

Healing Reactive Attachment Disorder requires families to engage in a parenting lifestyle that measures success in incremental steps.