[ahimsa]

I have a question...

We found a fairly local attachment therapist and were really excited until we saw the fees. It is about 175 for an hour of weekly therapy. An assessment and report is 750. A full psychological evaluation is 1200. A two week intensive therapy program is 8000 for the first child and 4500 for additional children.

They don't take our insurance and we can't get additional AAP money to help. OUCH!

So...I'm wondering...is this typical or are they trying to rip me off?

Thank you!!!

[sallyshore]

I've heard a huge range in fees for attachment therapy. There is no established training to allow someone to be called an attachment therapist, so be careful who you hire, and find out what their training consists of, who they trained with, what their theories are, etc. Dr. Bill Goble has a very long list of what a therapist for RAD kids needs to have trained in, including EMDR, and he feels that kids who are fully RAD should start with a two week intensive, then have follow-up therapy for many hours a week. If you don't do the intensive, you should be starting with at least 5 hours of therapy a week, according to Bill. Other big-name attachment "gurus" have their own theories on this. I am working with two women who are still in training, but have more training than anyone else in my area. They charge $100/hr. and usually work with me for 3-4 hours at a time, once a week. Dr. Buenning is coming to our area and I have been told he charges $1800 a day, but I'm not sure how many hours that includes. The intensives that I've heard about charge at least $8000 for the two weeks, but that doesn't include transporation and lodging, it only includes respite for the kids and therapy for the family.

Hope this helps!
sally

[ahimsa]

So I guess I was right! It is that expensive! I looked on radzebra and attach and the only place in Southern California that they list is the one I'm talking about.

Now, I know our kids don't have full blown RAD. They are very affectionate and bonded to us. There was a time when they would go to almost anyone including us, but now obviously prefer us to anyone else. If they have RAD, it would be very mild and it may not be RAD, just some attachment problems.

So here is where I'm torn...I don't want to spend a ton of money if we don't need to. But, I don't want to not do the right thing just because of the cost. We're thinking about paying the 750 or whatever for the assessment, then go from there. The 2 week one I just can't imagine. So many RAD parents talk about their kids never being affectionate. Ours are all the time. They'd cuddle with us 24/7 if we were up for it! So I find it hard to believe that they would need something that intensive...but I really don't know! I'm so confused!

Thanks for your input!

[sallyshore]

I don't know how many kids you need assessments for, but that seems a bit steep just for assessments. You can't get your insurance to pay for any of it? If you trust the therapist and/or organization doing the assessment, it probably is worth it just so you know for sure. The question is -- are they affectionate on your terms or theirs? Do they make eye contact when being affectionate? Does their behavior feel genuine? Sometimes this is really hard to see from the inside, and an expert coming from an outside perspective is much more likely to see the problems if they are there. Dr. Goble thinks that most parents know intuitively when something is wrong, even if they don't know what. I'm not so sure, and I'm not sure if it's a good idea to trust that you'll "just know". There are assessment questionaires you can fill out -- most attachment therapists use one of some kind. Goble has one that I gather is very good, but I haven't seen it. Having not caught this early enough for some of my kids, I would say: err on the side of caution!

Good luck!
sally

[ahimsa]

Sally,

Thanks for getting back to me. As far as affectionate, they are affectionate on our terms and on theirs, if that is possible. We couldn't believe how affectionate they were from day one. They make eye contact, hug and kiss all the time, want to cuddle and rock with us a lot. It feels very genuite. Everything felt normal and wonderful and I never dreamed there could be an attachment problem until last summer. We were at a kids' party once and after an hour of having met one kids really, really nice dad, my daughter was sitting up on his lap with her arms around his neck. As I was mulling that over the next few days I saw a letter in Adoptive Families that someone had written describing a similar thing and being told that it was attachment disorder. I was blown away! The kids had already been with us 8 months when this happened.

I began doing research and it did seem that they could have disinhibited RAD. I was already in the process of getting my daughter a therapist for hairpulling when this came up. Her first therapist after two sessions refered us to another therapist in the same office that had more experience with attachment, but wasn't "attachment trained". After five months of talk and play therapy with her, I really feel like we haven't gotten anywhere. We have made advances but mostly due to my own research and things we've tried at home, separate from therapy.

The kids are still as affectionate as ever, but learning to come to us more. We really pulled back on letting anyone else care for them, other than their preschool teachers, which we can't avoid. We began teaching them boundaries like "We hug and kiss mommy and daddy and ask them for help or to kiss our booboos. We can just hug and kiss other family. We can just hug our friends. We can just talk to our neighbors. We don't ever talk to strangers." This is helping. They are learning that there are different levels of affection for different people.

I downloaded the 36 pages of intake application that they have for this place and looked over it. When they show symptoms, my son has very few. Really only the indiscriminate affection and eating issues. My daughter has more, but a lot of the vague ones that could be other things, not as many of the biggies. So, I'm definitely going to pay 100.00 to go to a one day seminar on making our home therapeutic for a RAD child. I will most likely pay the 750 for an assessment of my daughter. If hers is really mild or nothing, then we're done. If hers is more severe, which I doubt, but could be, then I'll take my son as well and begin seriously budgeting to find a way to pay for all of this!

Aaaggghhhh!