[Becki_in_IN]

My 12 yo has recently been diagnosed with the following:

Dysthymia (chronic mild depression)
Generalized Anxiety Disorder
Social Phobia
Reactive Attachment Disorder, inhibitive

She is currently seeing a pediatric psychiatrist who is trying to find the right medication for the depression. She is also seeing a therapist there at the psych clinic. I asked this week what the treatment plan was for the RAD when I realized that it was not listed on the treatment plan. Basically, I asked when she was to start working on it and the therapist made some flippant comment about having so much to deal with. She basically blew me off and I'm not going to allow that. I'm going to insist that she give us the plan for dealing with that in writing, but I need your help first.

Everything that I have read said that you must deal with the RAD first because the other issues will not get better until you do. Is this true or not? Will regular talk therapy make matters worse? My dd likes her therapist a lot and that is good, but I do not want to waste our time. We did that for too many years not knowing what we were dealing with. Any other advice would be appreciated.

In defense of these people, I need to say that they are on staff at a major children's hospital. They do know their stuff.

[Scatterbrain]

Mom of 11 yr. old son with RAD and generalized anxiety disorder here. We were given the diagnosis when he was 9 and we too spent many years not knowing what we were dealing with. I tried to do it all on my own until the suicidal threats, self harm, paranoid and extreme fears--the anxiety hit it's all time high and he was physically threatening his sister and myself with pretty extreme measures. He wasn't sleeping and began stealing. His rages lasted for hours and I used therapeutic holds and rocking until he would calm down.
We started with different therapists that our adoption agency recommended. I would only work with someone who understood adoption issues. We found a fabulous therapist in our area. She has made all the difference. DS has worked extremely hard over the last 2 1/2 yrs and you cannot believe the difference!!! He is currently on NO medications as we took the behavior modification route-not to say that he will never have to be on medication, but we have been able to avoid it so far. He had to work extremely hard to get better and we had to do ALOT of learning or changing to make it better for everyone. Family members and friends constantly comment on what a changed child he is. He still has poor eye contact, difficulty in school, needs a completely structured routine--any surprise will throw him into a tailspin, needs to work off physical energy or will have a melt down, and more. He will always be work in progress, but... No more stealing, eye contact is getting better, he initiates some conversation even with extended family, you can see peace in his eyes, even though he falls back into survival mode at times-he is not in a constant state of survival, he socializes at school, he sleeps now and eating has gotten so much better. Best of all--he comes to me for comfort. If feeling safe, he will climb into my lap and initiate physical contact--wanting to be held, or holding my hand-- which is HUGE for him. Touch before would have sent him into a RAGE. He is doing SO SO much better.
For DS we started on the anxiety first and worked towards attachment. He spent the first few MONTHS not talking at all. Sometimes they both just sat quietly until he could begin to trust her. You might think it is a waste of time and money, but it was the best thing for him. She just needed to wait him out. Once he realized she wasn't going away he began to open up a little bit at a time. Oh---and she is a family therapist and uses play therapy as a major tool.
Feel free to PM me with any questions. Good luck on your journey. I hope you find the right thing that works for your family!!

[Kansas Girl]

I don't know about dealing with the RAD to the exclusivity of everything else, but it does need to be addressed. At age 12 you're getting close to the teen years and the child wanting to naturally become independent, and that can make attachment even more difficult. I'd want to start working on the attachment issues right away. Talk therapy is a waste of time for a child with attachment issues - they've got to be able process the traumas (including abandonment) that they have been through. Talk therapists, including psychiatrists, base their work on a relationship with the child - if a child has attachment issues, the child can't form that relationship with them to start with! Our son even conned the first "attachment therapist" because all she did was the talk stuff - he knew that, so he was able to keep her at bay so that they never got to the painful stuff that he needed to work on - we lost two precious years there. I'm still amazed at how much of the "mainstream" counseling and psychiatric world knows so little about RAD and how to successfully treat it. Check out Attachment Disorder information and support at ATTACh.org. - they are the main organization for attachment therapists in the U.S. and have a list of standards that must be met by the therapist to belong to their organization. Nancy Thomas also has a list of parent-recommended attachment therapists on her website: Attachment Disorder | Nancy Thomas Parenting | Attachment.org | Reactive Attachment Disorder. Welcome to Attachment & Trauma Network* - ATN also has a list of therapists.

good luck - and keep posting!

Fran

[zebramom]

My guess would be that your therapist doesn't have the first clue about RAD. Most people don't understand or think that parents are crazy.

PM me and I will help you find a therapist who will address this directly. I need to know what part of IN you are in and what AREA codes, not zip codes, you are willing to drive to.

[lucyjoy]

Usually rad needs to be addressed first, but if the child hears voices or is violent, meds do need to be addressed first before the attachment can be worked on.

However, I wouldn't work with a therapist that brushed rad aside as no big deal or one that didn't include ME in the sessions.

Contact zebramom-she has an awesome list of therapists and she can help you find one.

[Scatterbrain]

I agree with the need for ME to be present and a part of the therapy especially in the beginning. For the whole first year I stayed a part of the therapy and did not leave DS's side. Now that he is exploring deeper personal issues I often step out and leave them to deal with emotions and feelings that he may not be able to process if I am in the room.

I think the key is finding someone who KNOWS adoption issues and attachment issues. If not, they really cannot grasp the whole of attachment disorder and have no way of dealing with your child. Most people I know who have children diagnosed with RAD go to the wrong counselors and/or therapists and the treatment NEVER works.

[Kansas Girl]

Originally Posted by Scatterbrain

I agree with the need for ME to be present and a part of the therapy especially in the beginning. For the whole first year I stayed a part of the therapy and did not leave DS's side. Now that he is exploring deeper personal issues I often step out and leave them to deal with emotions and feelings that he may not be able to process if I am in the room.

If this works for you and your child, great. The only "choice" we sometimes give R during therapy is whether he wants to have Dad hold him or Mom....sometimes, depending on the issue, it's not his choice, but we are always present. It's about attaching to Mom and Dad, it's about trust...the child being able to heal enough and grow to believe that mom and dad will love them no matter what they've been through or what they tell them. The relationship that needs to be worked on is the one with the parents, not the therapist. I don't believe the child has a "right" to any secrets, if healing is truly going to happen...besides, without mom or dad present, that still sets the stage for triangulation. The few times we haven't been in the room we watched (and heard) everything going on with a video system, and came back into the session when the real work started.

Just my opinion....

Fran

[Scatterbrain]

The therapist we work with is fantastic but I agree it is about the bonding with the parents. The things that they work on are attachment issues and not only holding therapy. DS has A LOT of anger. True--he is a master manipulator--Luckily she sees through ALL of that and will not allow herself to be manipulated. There are some things that he talks to her about such as being angry about being adopted, the fear that I stole him from his birthparents and they are out there looking for him, being afraid to be angry with firstmom. Some of these things they work on alone some we work through together and there is always homework where we continue working on the issues at home. It works for us, but I can see how it would not work for everyone. All RAD children are not the same and different things work for different families. DS has a long way to go, but we will get there.

[PabloandCarlosMama]

I'm the mother of a 12 year old boy whom I adopted last year from Guatemala. He has post traumatic stress disorder, bi-polar, generalized anxiety disorder, and RAD.
He has been in a residential treatment where the staff understands attachment and they do great work with the parents and children. As he was being evaluated at the pysch hospital and in RTC, I wanted to work on the attachment issues right off the bat, and they said that first he needed to be stabilized with medication and that he needed to work with his trauma first, and that duriing the course of this work, they would work with both of us on ways we could build the relationship.

Our progress has been slow, and he's not home yet. It's been like unpeeling layers of a big onion! My son is very fear based and anxious, yet he is just now able to give and receive real hugs and is calling me "Mom." Last summer, he recoiled at any type of touch from me, and wouldn't make eye contact, etc. Before working finding the right attachment therapist, he snowed the therapist in talk therapy which was pretty impressive considering he didn't know much English at the time.

While he has been in treatment, I have also been seeing a therapist who works with attachment issues, and she has given me some good, solid tangible and sensory based things to do to help reach both of the children as we learn how to become a family.

[scandi]

I found that my son was not able to address his trauma until there was some of the attachment in place. WE worked on the attachment/ anxiety for the first couple of years and now he ready to work on the trauma.

[Lorraine123]

Which needs to be addressed first - the trauma or the attachment??? I used to think that attachment had to be formed first and them trauma could be delved into. However, recently, I have changed that. I think that unresolved trauma needs to be worked on first. The child cannot move successfully into the future without resolving the past. JMO