Before You Commit to a Therapist: The Questions Every Parent of a Child With Reactive Attachment Disorder Needs to Ask
- Anonymous
- 20 hours ago
- 6 min read
When someone makes the decision to become a foster parent, or to adopt a child who has been in foster care, there is an underlying understanding that trauma has — and will — play a role in the child’s life. In the training before you open your home, it is explained that trauma affects physical and emotional development, and there are courses on how to navigate it through connection and trust.
What that training rarely prepares you for is the moment you realize you need professional help — and that not all professional help is the same. And while foster and adoptive parents are at least offered that foundation, many parents arrive at this moment with no preparation at all. Reactive attachment disorder is not exclusive to children who have been in foster care or adopted — any child who experiences early trauma, neglect or inconsistent caregiving in the first years of life can develop the disorder.
For any parent of a child with developmental trauma or reactive attachment disorder, choosing the wrong therapist does not just slow progress. It can make things significantly worse.
Our Life With Reactive Attachment Disorder
In the case of our family, we learned the truth about developmental trauma too many years later to spare ourselves the pain and secondary trauma that eventually spread to everyone in our home. Like most parents, when we saw concerning and dangerous behaviors, we sought professional help.
Our son’s reactive attachment disorder diagnosis was revealed, and we found therapists who assured us they were trauma-informed and could help. We trusted them. For more than seven years, we sat in weekly therapy appointments describing threats, rages, fire-starting and physical violence — and were told our son simply needed more time to understand his history.
For any parent of a child with developmental trauma or reactive attachment disorder, choosing the wrong therapist does not just slow progress. It can make things significantly worse.
We were advised to stay the course, despite escalating behaviors and continuing chaos. After multiple police interventions and temporary residential stays, we ultimately realized that the therapy methods used with our family had done more harm than good.
We know now that we should have asked more questions of the professionals we trusted. These are the questions we wish we had asked before we committed to ours.
The Questions That Would Have Changed Everything
Any parent of a child with reactive attachment disorder and developmental trauma should ask these three questions before committing to a therapist and a course of action.
Do they understand the difference between “trauma-informed” and “reactive attachment-informed”?
Many therapists use different treatment methods for trauma, but treatment specific to reactive attachment disorder is rarely emphasized — because it is a specific and unique diagnosis. Many consider the diagnosis rare and therefore dismiss it — even though research shows it is highly prevalent among children who have experienced early maltreatment or foster care. This is a disservice to families worldwide. Read further about the problems that stem from RAD being considered rare by author Micaela Myers here.
Early trauma impacts development and wires a survival instinct into a child’s psyche, leaving the child without the capacity to accept nurturing and love. A therapist needs to approach treatment from this understanding, rather than trying to establish familial connection right away.
Look for professionals who have had direct contact with someone with the disorder, who is licensed, and who is trained specifically in treating reactive attachment disorder. A degree alone will not be enough — college courses on how to treat this disorder are extremely limited. RAD Advocates, an organization that supports families navigating the disorder, explains the distinction this way:
“The critical difference between trauma-informed therapists and qualified RAD/DTD-specific therapists is in how they understand trauma and the brain. A trauma-informed therapist thinks about how early trauma impacts a child’s experiences and life. A RAD/DTD-specific therapist approaches therapy from the knowledge that the child’s brain is wired by trauma and fear. The difference may seem slight, but the outcome is drastic.”
In the case of our family, we learned the truth about developmental trauma too many years later to spare ourselves the pain and secondary trauma that eventually spread to everyone in our home.
We did not ask our therapist this question until things had reached a dangerous level. We were told, “the treatment is the same for all trauma.”
That answer put an obstacle in our path that was too difficult to overcome.
Do they understand how the disorder impacts the whole family?
Reactive attachment disorder affects everyone in the home, not just the child who is diagnosed. A clinician should be deeply aware of the family dynamics at play.
The primary caregiver often becomes the “nurturing enemy.” Because of past trauma inflicted by a caregiver, a child with reactive attachment disorder needs to control the environment to feel safe — and the parent most present ultimately becomes someone to fear. The closer that parent tries to get emotionally, the harder the child pushes them away.
This frequently results in triangulation and manipulation between the therapist and the primary caregiver, giving the child a false sense of security and eroding trust between the parent and the professional. My son regularly told family members, friends, peers and his therapist things about me that were untrue — all in an effort to control the relationships around him.
For more than seven years, we sat in weekly therapy appointments describing threats, rages, fire-starting and physical violence — and were told our son simply needed more time to understand his history.
A therapist must be aware this dynamic can and does happen, so that the caregiver is believed when describing behaviors and dangers in the home. Being blamed for your child’s behaviors is a serious red flag.
Siblings are also deeply affected. They are often targeted by the child with reactive attachment disorder, and their own needs may go unmet because caregivers have little left after managing extreme behaviors. These siblings absorb the chaos of the home and carry their own trauma as a result.
The marriage, too, can suffer — manipulation and triangulation can quietly fracture the relationship between partners in ways that are hard to name until significant damage has been done.
How involved are the parents in the therapy process?
Reactive attachment disorder creates a complete family dysfunction — and it requires a complete family treatment. When caregivers are left out of the healing process, two things happen: manipulation and triangulation go unchecked, and parents lose the opportunity to understand their own role in the family dynamic and dysregulation.
Forrest Lien, a licensed clinical social worker (LCSW), developmental trauma expert and keynote speaker at NavRAD26, addresses clinicians directly in an article for RAD Advocates:
“Develop a treatment plan to help the child become a ‘family kid.’ Your goal should be to lead the family to create a circle of security around the child. In doing so, you may need to work with the parent’s triggers on the front end before you can integrate the child. Also, you may need to address a parent’s own attachment history once you’ve gained his or her trust.”
The therapeutic process must be a team effort. That is not optional.
Free resource: Not sure where to start? RAD Advocates has put together a free clinician checklist — eight qualities to look for in a therapist before you commit. Sign up for the RAD Advocates email list to receive it.
These three questions are just a starting point as you research professionals to whom you will entrust your family. If you are parenting a child with reactive attachment disorder, chances are you are already overwhelmed — by the behaviors, the doubt and maybe even fear.
The good news is that you are not alone — and you do not have to figure this out without guidance.
A trauma-informed therapist thinks about how early trauma impacts a child’s experiences and life. A RAD/DTD-specific therapist approaches therapy from the knowledge that the child’s brain is wired by trauma and fear. The difference may seem slight, but the outcome is drastic.
We found RAD Advocates in our darkest moment, when we understood little about the true complexity of this disorder. They provided resources, tools and a community that only other parents living this experience can truly offer — and for professionals seeking to better understand and treat this disorder, RAD Advocates offers a self-paced clinical training created and taught by Forrest Lien himself. This organization is one of very few dedicated to helping parents advocate for their child and their entire family — and it is growing every day, as families across the country come together to raise awareness.
You can learn how to become a member at radadvocates.org/join. Membership means a personal advocate can be assigned to your family to help navigate the often severe complications of parenting a child with developmental trauma.
If you are struggling, reach out. You do not have to do this alone.
Feeling lost on the RAD parenting journey?
You’re not alone — and you don’t have to figure it out on your own. Connect with RAD Advocates to find real answers from those who’ve walked this path, no matter where you are along the journey.