Reactive attachment disorder (RAD) occurs when a child hasn’t developed a healthy emotional bond with his or her primary caregivers in the first few years of life. This can lead to significant problems in their lives as adults and may affect relationships, social interactions, mental health, behavior, and intellectual development. Children who suffer from RAD can be difficult to parent or care for, but there are several treatment options.
The earliest signs of RAD are an inability to connect emotionally with others and a fear of being touched, especially by parents. Children who experience neglect, abuse or emotional trauma in their early months and years of life are more likely to develop RAD. Some children with RAD have been through repeated removals from their families and spent time in institutions, like orphanages, or multiple foster homes. Some have also experienced a number of different caregivers, which can create a sense of distrust and lack of emotional safety.
A mental health professional can diagnose a child with RAD by conducting a thorough mental health evaluation. These tests can include psychological and behavioral assessments, a medical history and a family history. The therapist will look for signs of trauma, such as an inability to trust people, frequent anger outbursts and a fear of closeness. They will also ask about any sexual or physical abuse or neglect that the child has been exposed to, as well as how long the child has been experiencing these symptoms.
Typical treatment reactive attachment disorder for RAD involves psychotherapy and medications. Psychotherapy helps to heal the damaged family system and help children with RAD develop healthy, positive relationships. During therapy, the therapist should structure and direct all sessions and not let the child guide the session. Some traditional therapists allow the child to guide their sessions, but this can make a child with RAD feel like they are being controlled.
Most children with RAD are resistant to touch and affection. They often flinch when touched or say things such as “ouch” or “no.” In addition, they have a hard time understanding and expressing emotions. Many children with RAD are disobedient, argumentative and defiant. They are very difficult to discipline.
It is important for parents and caregivers to educate themselves about RAD. A good place to start is with a child’s mental health professional, but it is also helpful to check out resources and support groups for parents who have children who have been adopted or are from orphanages or foster homes. It is very important for parents and caregivers to understand that a child with RAD needs a consistent, safe environment to form a healthy bond with his or her caregivers. There are some controversial treatment options for RAD, including holding therapy, which involves the therapist or caregiver physically restraining the child and forcing them to go through a range of emotions until they stop resisting. These treatments should only be used with the supervision of a trained mental health professional because some children have died while being held against their will.