In-Home Treatment of Reactive Attachment Disorder in a Therapeutic Foster Care System: A Case Example

Abstract

When trauma precedes a child's placement in the foster care system, it can lead to lasting mental health difficulties. Often, children who experience extreme, chronic trauma prior to age 5 develop Reactive Attachment Disorder (RAD). However, the diagnosis of RAD is often overlooked. This article discusses the characteristics of RAD as well as diagnostic criteria and possible etiology. We present the case example of an adolescent diagnosed with RAD as an example of treatment from an in-home perspective.

Intervention Effects on Foster Preschoolers’ Attachment-Related Behaviors From a Randomized Trial

“…Systematic attachment-based interventions for maltreated children (Hughes, 2004) and foster children (Howe & Fearnley, 2003;Pearce & Pezzot-Pearce, 2001;Sheperis, Renfro-Michel, & Doggett, 2003) have been developed but are not currently being widely implemented. Moreover, there is not yet an evidence base to support these interventions.…”

Factors associated with the adjustment of foster children in the Netherlands.

“…terized by attempts at exploitation and intimidation, and by the avoidance of any personal involvement (Sheperis, Renfro-Michel, & Dogget, 2003). If the foster parent is unable to cope with the behavioral strategies of an insecurely attached child, the adaptation to the family will fail.…”

Assessments of Student–Teacher Relationships in Residential Treatment Center Schools

“…Individuals who experience abuse and neglect are at risk for impairment in social interaction and communication (Mukaddes, Bilge, Alyanak, & Kora, 2000;Sheperis, Renfro-Michel, & Doggett, 2003;Weich et al, 2009), having low empathy (Hall & Geher, 2003), developing somatic complaints or other anxiety disorders (Weich et al, 2009), depressive symptoms (Cicchetti & Toth, 2009;Kaufman & Cicchetti, 1989;Salinger, Feldman, Hammer, & Rosario, 1993;Stafford, Zeanah, & Scheeringa, 2003), externalizing behaviors, substance abuse, and criminal behavior (Clausen, Landsverk, Ganger, Chadwick, & Litrownik, 1998;Dozier et al, 2006;Rogosch, Oshri, & Cicchetti, 2010). Furthermore, they suffer from more cognitive deficits and academic difficulties than nontraumatized individuals (Bücker et al, 2012;Dozier et al, 2006;Eckenrode, Laird, & Doris, 1993;Gould et al, 2012;Shonk & Cicchetti, 2001).…”