Parenting isn’t an easy gig, no matter who the parent or child is. But when a child has reactive attachment disorder (RAD) – the result of a brain changed by early traumatic experiences – parenting is downright painful. For those who haven't done it themselves, it’s nearly impossible to comprehend parenting a child with the complex disorder and the choices required along the way.
So when a RAD parent comes to the agonizing conclusion that they must send their child to live elsewhere, they aren’t often surrounded with the support they need. Instead, friends, family, and professionals typically judge and shame them.
After all, what parent of a child with a traumatic background could even comprehend sending them away? That’d be me. And after meeting many other parents of children with RAD, I’ve learned that it’s a dilemma for many of us.
I had the chance to attend Navigating Reactive Attachment Disorder (or NavRAD) last year, a unique experience created for RAD parents struggling to answer the question, “What can I do when I’m unable to keep my child with RAD, and the rest of my family, healthy and safe?” As I looked around the room at other grief-stricken parents, I realized that I wasn’t alone.
Let me explain why children with reactive attachment disorder often need to leave their homes and the options parents have left when they’ve done everything they can to save their families. If you’re a parent in need of further guidance, I highly recommend that you attend the next NavRAD experience. Parents leave the conference with a path forward that is best for their child and family. Some choose safer options to keep their children at home while others learn why and how to keep them safe outside of the home.
Why Kids with Reactive Attachment Disorder Often Must Leave Their Homes
Children with moderate to severe reactive attachment disorder often need treatment outside the home before there’s any hope of them functioning in a home environment. This is due to the fact that they see their primary caregivers as the “nurturing enemy” and push them away or worse yet, physically harm themselves or others in the home. However, children very rarely get the opportunity for early and appropriate treatment for various reasons. It is a problem that begs for solutions of its own, requiring a village of cooperative professionals and plenty of resources. In the meantime, it is too late for families currently living in the midst of serious struggles and chaos at home.
After all, what parent of a child with a traumatic background could even comprehend sending them away? That’d be me. And after meeting many other parents of children with RAD at NavRAD, I’ve learned that it’s a dilemma for many of us.
Children with reactive attachment disorder may function better in an out-of-home placement, where they feel less stressed and triggered. After years of living with the chaos reactive attachment disorder can bring into the home, caregivers often develop post-traumatic stress disorder or at the very least are worn down, triggered, sad, angry, and in need of a break. For all these reasons and more, many families consider out-of-home placements. The decision is never easy, and it can be costly. However, there are multiple options to consider if you’re a RAD parent, and RAD Advocates can help you determine which is best for your family. Although they offer other suggestions for keeping the child in the home, they’re realistic that it’s not always feasible. They never try to make decisions for parents either, but offer incredibly helpful guidance along the way. Here, we overview a few of the options.
1. Residential Treatment Centers
In-patient residential treatment facilities, such as psychiatric hospitals, provide intensive psychiatric and psychological care. Children who meet the facility’s admissions criteria may be accepted into short- or longer-term treatment. Short stays may be a couple of weeks, while longer ones may last a year or more. The length of stay will depend on the facility, the child’s issues, and insurance coverage. Some kids are referred to such treatment after a psychiatric-related emergency or via an evaluation from the facility itself.
Unfortunately, there’s a shortage of beds at many facilities, and you’ll likely also be limited by your insurance and which facilities will accept it. Another unfortunate aspect is that most programs do not provide effective RAD-specific treatment. Their personnel may have very little training in reactive attachment disorder.
Our son spent six months in our state mental hospital. He was admitted after their psychiatrist conducted an evaluation and determined he met the criteria. We adopted him through foster care, so his Medicaid paid for the stay. Like many facilities, it did not specialize in reactive attachment disorder, and I do not feel they treated his reactive attachment disorder. However, it did give our family a much-needed respite.
2. Boarding Schools
Boarding school is a costly option that insurance does not cover. However, it can be a good choice for some families – you’re able to stay in touch with your child and parent from afar without the stress of school and living year-round under the same roof. Some programs are therapeutic and designed for kids with mental health issues. Prices, types of schools, and admission requirements vary widely. Organizations like RAD Advocates provide guidance. Scott Smith of Best Choice Admissions will present “Seeking Alternative Placement When Home Isn't Working" at the Navigating RAD 2022 conference this October.
3. Wilderness Programs
There are a number of therapeutic wilderness programs across the country – some even specialize in attachment issues. The length of the programs and their academic and family involvement expectations vary. Most combine outdoor adventures with a therapeutic approach. These programs may last a few months but generally are not long-term, and costs vary.
4. A Change in Living Arrangements
Sometimes there’s a friend or family member who is suitable and willing to take in a child with reactive attachment disorder short or long-term. While it may seem counter-intuitive to think that our children can function better with another family if they’re not doing well with us, it can happen. Perhaps this person does not have other children or pets, making it a safer option. Or they may be less triggered, less reactive, less run down, and ready to approach the child in a new way. The child with RAD is often less triggered by people outside of their home as well. This is often due, ironically, to the fact that other adults don't try to nurture and love them as their parents do.
5. Relinquishment
Some form of relinquishment is the last option for a number of reasons. This is the option we ultimately pursued for our son, after exhausting all other options. It’s not easy, and it usually comes with lengthy legal issues. Charges may be filed against you. Before considering this option, it’s important to enlist the expertise of a RAD Advocate as well as choose an excellent lawyer.
No Easy Choices for Parents of Children with Reactive Attachment Disorder
If you’re reading this article and considering these options, I know you’re in a tough spot. I’ve been there. It’s not where any of us hoped to end up. We adopted or had children because we wanted to share our love and home with them. We never imagined that dream would turn into a nightmare. But reactive attachment disorder is complex and challenging, and most of us can’t do it on our own.
Children with RAD may function better in an out-of-home placement, where they feel less stressed and triggered. After years of living with the chaos RAD can bring into the home, caregivers often develop post-traumatic stress disorder or at the very least are worn down, triggered, sad, angry, and in need of a break.
I am incredibly thankful to RAD Advocates. They are here to come alongside us with resources, education, and guidance. If you’ve reached a point where you’re considering out-of-home placements, I highly encourage you to attend their Navigating Reactive Attachment Disorder experience. There, RAD Advocates and other professionals help you determine your child's severity of reactive attachment disorder, the level of crisis your family is in, and where you might head from here. You'll leave with a path that's right for everyone in your home.
No matter where you go from here, try not to be too hard on yourself. You're doing the best you can with what you've got. These aren't easy choices for any of us. You're not alone.
About the Author:
Micaela Myers and her husband adopted a pair of siblings from foster care in 2015, when the children were 9 and 13. Since then, she has become an advocate for foster care reform and the support and education of adoptive parents. She was a member and is a supporter of RAD Advocates. Micaela earned her MFA in writing from Vermont College of Fine Arts and works as a professional writer and editor in Wyoming.
Photo by Daniel Gonzalez on Unsplash