6 Ways to Save Time, Money, and Energy When Parenting a Child With Reactive Attachment Disorder

When my husband and I embarked on our foster/adoption journey, we were unprepared to parent a child with severe reactive attachment disorder (RAD), also known as developmental trauma disorder (DTD). We were unaware that children with the disorder would display significant, sometimes dangerous, behaviors — emotional outbursts and dysfunctional relationship dynamics — that would pervade every part of their and our lives.

Our foster care training barely mentioned the disorder, much less prepared us for how a child with severe RAD would interact within a family setting. Parenting children with developmental trauma was presented as being only slightly more difficult than parenting neurotypical or biological children, just with more paperwork. We quickly learned that was far from the reality.

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A 2018 Welch’s study found that the average mother works the equivalent of 2.5 full-time jobs each week, just parenting a neurotypical child (source: TMJ4). Now imagine layering in developmental trauma — and the paperwork, advocacy, damage control, and exhaustion that come with it.

That’s the reality many families face, yet almost no one warns you. We made many costly mistakes — and are here to share what we learned the hard way so you don't have to do the same.

1. Understand the Real Costs of Adoption and Parenting a Child With Reactive Attachment Disorder — Whether or Not Adoption Was Part of the Journey

Adoption was never about money for us. We wanted to give a child a home. But we didn’t know what it would cost — not just financially, but emotionally, physically, and socially — to parent a child with developmental trauma.

Not all families parenting a child with reactive attachment disorder come to it through adoption. Some step in through foster care, kinship care, or stepparenting. Others discover the effects of early trauma later, even in biological children, due to health complications for the mother or child or various other reasons. But for those who do adopt, the initial cost is often where the questions begin.

So what does it cost to adopt a child in the U.S.?

According to Parents.com, the cost of adoption in the United States varies widely depending on the type:

• Adopting through the foster care system is the least expensive option, with the average cost around $2,938 — thanks to government subsidies and assistance that often cover most legal and agency-related fees.

• Private domestic adoption typically ranges from $30,000 to $60,000. That includes legal fees ($1,500–$4,500), court documentation ($500–$2,000), home studies ($1,000–$3,000), and expenses like birth parent counseling, medical bills, and interim childcare.

• International adoption costs generally fall between $20,000 and $50,000. These fees often include travel expenses, documentation, parent training, and immigration processing.

  
  

That’s the information people usually ask about. But those are just the initial costs. What families really need to prepare for — and what we weren’t warned about — are the “hidden” costs that surface if your child ends up needing more than love can offer.

These might include:

• Travel for multiple visits and legal proceedings

• Loss of income if one parent must leave their job

• Costs of adoption-related training or parent education

• Birth parent expenses (common in private adoptions)

• Legal advocacy and home modifications

• And in some cases, the long-term costs of raising a child with reactive attachment disorder

Nobody warned us about the extent of property destruction our son Joe* would cause either. Just a few examples off the top of my head:

• Three windows

• Four kitchen light fixtures

• Every door in our home

• Three bicycles

• Three washing machines and two dryers

• Nearly every room in the house from holes

• Countless pairs of shoes, curtain rods, and clothing

We spent over a million dollars over the 10 years Joe lived in our home — between lost wages, medical expenses, legal fees, and property repairs. And that doesn’t even account for the emotional cost of living in survival mode.

We had no idea what we were walking into when we adopted our sons. The agency assured us any extra needs would be covered by the small stipend we received. It felt reasonable, so we started college savings accounts with that money — believing that one day, they’d pursue higher education. Now, that assumption feels laughable. Survival quickly replaced all other goals.

Looking back, I wish we had set that money aside for co-pays, legal advocacy, emergency interventions, and house repairs. Instead of preparing for college costs, we should have been preparing for trauma costs.

Cami Lewis, another parent of a child with reactive attachment disorder, put it this way: “The surprise wasn’t just the financial cost. It was how the trauma would consume every aspect of our lives — the time spent managing behaviors and doing damage control, the effort spent pursuing ineffective treatment, the employment losses and inability to work, the destruction in our home and schools, the inability to do the things we used to do, the toll on our health, the harm to our marriage, the loss of close relationships. No one prepares you for that.”

If you’re parenting a child with reactive attachment disorder, don’t just plan for progress — plan for survival. Set aside resources for the hard days, the breakdowns, the treatments insurance won’t cover, and the damage no one talks about. Preparing for the reality, not the fantasy, is one of the most loving things you can do for your child — and yourself.

2. Save Resources Through Focus on Safety for the Whole Family, Not Therapeutic Parenting

In the beginning, we poured our energy into therapeutic parenting — techniques rooted in nurturing and connection. But we didn’t realize that, for a child with severe developmental trauma, constant closeness can feel threatening.

Joe escalated whenever we tried to connect too deeply. We learned that empathy alone wasn’t enough — he needed space, structure, and accountability to feel safe.

As Cami Lewis, another mother of a child with reactive attachment disorder, shared from her own experience, “At first we tried TBRI (learn more here)and connected parenting techniques, which was a colossal mistake. We were told by trauma professionals to study everything we could from Karen Purvis. Little did we know, we were making our son sicker. We were also told to pursue attachment therapy, and it seemed logical, so we did. But they missed a critical step. Our son wasn’t ready to attach to anyone, and attachment therapy made things worse. If only we knew then what we know now.”

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If your child isn’t ready to trust or connect, back off before pushing connection turns dangerous. Safety has to come first — for your child and for your entire household.

As Amy VanTine, founder of RAD Advocates, explains, “Trying to force connection with a child who isn’t ready doesn’t just create stress — it can activate the child’s trauma and become unsafe for everyone in the home. The priority needs to start with safety for the entire family.”

That’s something I wish we had understood sooner. Today, RAD Advocates helps families like mine build realistic safety plans that reflect the actual behaviors happening in the home — not idealized versions of what connection is supposed to look like.

3. Rethink Rewards and Privileges Through the Lens of Emotional Age

When parenting a child with reactive attachment disorder, it’s easy to fall into the trap of trying to reward your way to better behavior. After all, that’s what works for many neurotypical kids. But children with developmental trauma don’t respond to rewards the same way — and pushing privileges too soon can backfire in painful, expensive ways.

Joe looked and sounded like his peers. But emotionally, he was stuck at a much younger developmental stage. We gave him age-appropriate toys and opportunities — and they often ended in destruction. When he asked for $200 Jordans just to learn to tie his shoes, we realized how far off track we were.

That kind of transactional thinking is common in children with RAD. At first, reward systems might seem to work — sticker charts, incentives, time with electronics — but the expectations escalate quickly. And even when rewards were given, Joe either destroyed them or sabotaged the process.

Lewis had a similar experience. “We tried every reward system imaginable,” she explained. “He would either destroy the item awarded or sabotage his progress to prove that he was in control. Earning a reward for a desired behavior from someone meant that person had power over him, and he couldn’t live with that. He’d rather die than feel vulnerable to an adult. The harder we tried to alter his behaviors, the worse the behaviors got. We learned the hard way that nothing would change his behavior except his own desire to change it.”

In another example, Lewis described the emotional age gap they faced: “Our son’s adoption trauma occurred at age 2, and he’s been stuck in perpetual toddlerhood. He threw toddler-like tantrums when he didn’t get his way for 8 years. He would fall to the ground, flailing, kicking, and screaming until age 9–10. By age 11, his toddler tantrums had morphed into violent outbursts with behaviors like punching and kicking holes in walls and attempting to stab others with sharp objects.”

No amount of money spent on privileges, devices, or ‘earned rewards’ made a difference when our child simply wasn’t emotionally ready. In fact, when we misjudged what he could handle, it often made things worse.

If you're parenting a child with reactive attachment disorder, resist the pressure to give your child what their peers have — or to rely on behavior-based incentives alone. Tailor expectations and privileges to their emotional capacity, not their age, and work with a therapist who truly understands the complexities of RAD.

4. Do Your Best to Secure a Proper Diagnosis Early On

According to Forrest Lien, LCSW, children with the disorder often go undiagnosed until they’re 10 to 12 years old. By then, the child has learned many maladaptive behaviors that have both strengthened the disorder and created collateral damage within the child’s family. In the meantime, the family has typically spent a fortune on co-pays, therapy appointments, medications and more on the wrong diagnosis.

The reasons for misdiagnosis may be that the child never had consistent caregivers to get a proper diagnosis, the child spent time in foster care where the diagnosis was removed to encourage placement of the child, or the child had been misdiagnosed by uneducated professionals and had been receiving ineffective treatment, all of which enable and worsen the disorder.

Because proper interventions for the disorder are intensive and time consuming, the prognosis for healing goes down the older the child is when proper interventions begin. The earlier the child is properly diagnosed, the better the prognosis for the child to eventually thrive within a family environment.

We began searching for answers when Joe was just 3½. His intense rages, inability to accept “no,” and sneaky behaviors were unlike anything we had seen. Initially, he was diagnosed with ADHD. When ADHD treatment didn’t help, I kept digging until Joe was diagnosed with reactive attachment disorder at seven. We were lucky to find a therapist truly experienced in developmental trauma disorder.

Lewis recalled a similar path: “We knew our son had RAD at age two, but no provider at the time would have ever considered diagnosing a toddler with RAD. Instead, he was labeled with sensory processing disorder and ADHD. His underlying mood disorder and dissociative disorder was completely missed for nearly a decade. As a result, it took 7 years to find effective treatment — which we couldn’t pursue due to the cost (not covered by insurance).”

While finding the right help often comes too late for many of us, some families do secure the right diagnosis, advocacy and intervention. Yet, it all starts with the right diagnosis as early as possible.

5. Vet Professionals Before Investing in Treatment

Families like ours often find that parents with lived experience understand the disorder far better than many professionals. A friend of mine, a sociology professor familiar with our family’s journey, regularly invites me to guest lecture in her classes since the textbook she uses only devotes one paragraph to the disorder.

The reality is that developmental trauma is not part of standard training for therapists, social workers or counselors. Some receive minimal education on the subject, but most receive none at all. This leads to misdiagnosis, ineffective treatment, and often enables the disorder. Yet, families turn to these professionals for help, unaware of the risks involved.

Amy VanTine, CEO and founder of RAD Advocates, explains, “Most well-meaning professionals and programs have no idea how quickly they make the disorder worse.”

Carrie O’Toole — a parent of a child with RAD, coach for parents, and regular presenter at NavRAD — often shares how her experience parenting a child with RAD led her to become a therapist. During her graduate studies and continuing education, even courses marketed as helpful for attachment disorders barely mentioned developmental trauma, confirming her concerns about the lack of professional knowledge.

Since the disorder involves controlling behaviors, manipulation, and triangulation within intimate relationships, traditional talk therapy tends to backfire. Children with developmental trauma learn to say what therapists want to hear, creating the illusion of progress. However, this rarely carries over into real-life behavior. As a result, therapists may assume the child is improving, while parents continue to struggle with severe behaviors at home.

Untrained professionals may unintentionally undermine the parents by offering services or gifts directly to the child. “This trauma-informed approach sends the message that the parents are unable to meet the child’s needs,” VanTine notes. In some cases, therapists even place blame on parents for the child’s behavior, reinforcing the child’s belief that their caregivers are untrustworthy and unnecessary.

When we made the difficult decision to place Joe in a residential treatment center, I knew there was a risk that the disorder would be enabled. My worst fears were confirmed during a visit. Joe proudly entered the room, showing off the new shoes and coat the staff had given him. Nearly a decade of work to build trust was undone in less than two weeks.

Vetting clinicians isn’t just important — it’s critical. The wrong provider can unintentionally reinforce the very behaviors you're trying to stop. Take a look at RAD Advocates' infographic on eight signs of a RAD-specific therapist — and find support that truly understands what your family is up against.

6. Prepare for Financial Barriers to Effective Reactive Attachment Disorder Treatment

Many families end up working with well-meaning but uneducated professionals because the most effective treatments for the disorder are usually not covered by insurance.

Unfortunately, families dealing with developmental trauma often find their mental health coverage is limited, and third-party payers typically exclude the therapeutic practices that are most effective. Or specialized providers do not take insurance because they are too busy — because there are so few of them — to deal with the logistics of handling insurance. These services include RAD-specific therapists, RAD-specialized residential treatment centers and neurofeedback therapy.

By the time Joe was age 10, every provider we consulted recommended out-of-home RAD-specialized residential treatment. However, Joe was rejected by every in-state facility that accepted Medicaid, each citing different reasons. Although a few out-of-state programs accepted him, none accepted his Medicaid coverage. We were advised to take out a second mortgage, use credit cards, ask family members for financial help or even sue the school district to cover his education costs.

The programs we considered ranged from $7,000 to $18,000 per month, with the possibility of requiring a two-year stay — all without any guarantee that Joe would make progress. In the end, the financial barriers were what prevented us from accessing the treatment Joe needed.

If we had understood the financial landscape earlier, we could have made different choices. Wherever you are in your journey, don’t wait for a crisis to start planning. Talk with families who’ve been there, research what insurance won’t cover, and ask about funding options before you’re forced to choose between your child’s safety and your family’s stability.

Final Thoughts on the Cost of the Reactive Attachment Disorder Journey

If you’re just beginning your journey with a child with reactive attachment disorder, it’s not too late to course-correct. The road ahead will be challenging, but with knowledge, planning, and the right support, you can avoid some of the costly mistakes many families make.

At RAD Advocates, we’re here to help you navigate this journey — wherever you are on the path. You don’t have to do this alone. Reach out to us to learn more about how we can support your family and help you find the resources you need.

Get an ally — someone who understands the reality of parenting a child with developmental trauma. Become a RAD Advocates member.