Updated: Mar 2
When our adopted daughter Carly* entered our home through the foster care system, I noticed odd behaviors. She referred to my husband and I as “dad” and “mom” even though we were still complete strangers to her. She didn’t ask about her biological mother, where she was, or when she was going to see her.
I had no idea that theses odd behaviors were red flags of something serious.
So when I started to look for help for Carly, I didn’t know to specifically seek a reactive attachment disorder therapist. In fact, I didn’t really even understand what reactive attachment disorder was at the time.
And so the long and winding road began. If only I knew then what I know now.
Within the first two weeks of Carly’s placement with us, she had her first individual therapy session at our local community health center—a referral made and paid by her Medicaid coverage via the state. The therapist, a kind and earnest woman, had just completed her schooling.
Week after week, the therapist listened intently to my concerns about Carly’s behaviors. And, week after week, the behaviors grew more serious. She had become a danger to herself and others in our family. While the therapist recognized Carly’s struggles due to my reports, she didn’t give a specific diagnosis.
We tried multiple other therapy approaches as well. But after eye movement desensitization and reprocessing therapy, equine therapy, and grief counseling—all from highly credentialed and sought-after clinicians—Carly still wasn't getting better.
Carly did eventually get a diagnosis for reactive attachment disorder which was incredibly helpful. But we didn’t find relief in the trust-based model therapy we sought either, as recommended for her disorder. Nor did we get the help we needed through the in-home therapy we received from post-adoption services.
All of the therapy we had tried seemed to make matters worse. Carly had effectively triangulated nearly everyone involved, including the therapists and our individual family members. Our house had become a war zone.
I began to search frantically day and night to find anybody that could help our family. Through lots of navigating and advocacy, I was able to secure the right help. But I had wasted precious time and resources before we found that relief.
As an exhausted and overwhelmed parent, it’s difficult to even know what to look for in a therapist. For other parents navigating the therapeutic process for reactive attachment disorder, I share the following.
8 ways to spot a good reactive attachment disorder therapist for your child:
1. Your gut instinct gives you a good feeling.
If you’ve found the right clinician, you will feel comfortable that he or she understands your situation. In our case, the right therapist even completed our sentences as we explained Carly’s behaviors.
2. You’ve found a licensed professional counselor.
Some states allow people to practice without professional training. A good therapist, however, has the necessary credentials.
3. The clinician specializes in certain areas, preferably in reactive attachment disorder.
While a variety of therapeutic techniques exist, no one person can master them all. It’s a red flag when clinicians say they do. Seek those who have specific training or experience with reactive attachment disorder, which typically is not taught at the university-level but from hands-on experience. The clinician should thoroughly understand trauma and the somatic effects of trauma on the body.
4. You never feel blamed for your child’s behaviors.
A good therapist supports you as a parent. He or she should not advise you on how to parent in front of your child. Your child needs to know that you are in charge, not the therapist.
5. You are an active part of your child's healing process.
You should be considered a part of the "team", not left sitting in the lobby most of the time. This prevents the parent-child-therapist triangulation (common with reactive attachment disorder) that further damages the relationship you’re trying to establish with your child. Traditional therapists establish and build trust individually with their clients. While this is expected with other kinds of therapy, it is not the case with effective reactive attachment disorder therapy.
6. The therapist, not the child, leads the therapy sessions.
Some traditional therapists allow children to guide therapy. For children with reactive attachment disorder, however, this approach can make matters worse given the controlling and manipulative nature of their disorder. It is fine for the clinician to ask your child to check-in about how he or she is doing, etc. However, the clinician should have a plan for and direct every session with your child.
7. He or she understands that therapy is about the experiences your child had, not the details of past events.
The therapist should help your child process his or her trauma overall rather than to recount fine details. Your child needs to process how he or she experienced and felt during past events. The way your child remembers past events, often inaccurate anyhow, only distracts from the work of true healing.
8. The therapist meets where your child is developmentally, rather than chronologically, with an understanding that trauma alters brain development.
Your therapist should understand that trauma impacts the brain and tailors therapy accordingly. The ways in which a 16-year-old brain can articulate and process trauma, for example, is far different from that of a 5-year-old brain in a 16-year-old body.
We had encountered multiple kind and highly-qualified therapists on our journey to help Carly. Many of them were also open to learning about reactive attachment disorder and our family’s struggles.
But it was not enough.
We needed, specifically, a reactive attachment disorder therapist—someone we didn’t need to teach about the disorder. We needed an expert who taught and supported us.
An ethical therapist, in any area of expertise, will admit if he or she cannot help your family. Instead, the clinician can provide helpful documentation and a referral for the area of expertise outside of his or her own.
Kind, supportive, and highly-qualified reactive attachment disorder therapists exist. Admittedly, however, they’re not easy to find. But that one right person can make all the difference in the safety and future of your entire family—don’t give up on finding that person.
*name changed to protect identity