Families in Crisis First, Support Later: A Costly Pattern in Reactive Attachment Disorder

The chaos isn't a reflection of your parenting — it's a sign you need support. RAD Advocates helps families connect with resources before burnout takes over.

Families rarely arrive at RAD Advocates at the beginning of their journey. More often, they come when everything is already on fire — emotionally exhausted and afraid of what comes next. We're working to change that pattern by raising awareness and helping families connect earlier in their journeys, when support can truly shift the trajectory.

Early advocacy matters. When families with children who have reactive attachment disorder (RAD) are heard sooner, they have more options — before things escalate into crisis. I spoke with Heather Houze, chief operating officer of RAD Advocates, about the patterns she consistently sees among families who come to us late — already burned out, nearing crisis, or fully immersed in it — and how earlier support could have changed the course long before reaching that breaking point.

Total Burnout After Reactive Attachment Disorder

Not enough people talk about the burnout that comes from parenting children with complex, untreated trauma and mental health needs. Parents and caregivers of children with reactive attachment disorder are often competent, high-achieving, and deeply committed — but they are not immune to burnout.

Burnout happens when you're forced to suppress your own humanity for too long. Reactive attachment disorder has a way of draining every aspect of a caregiver's life and impacting the entire family system. At the RAD Advocates biennial NavRAD event, RAD Advocates walks attendees through where they are in their journey. According to Houze, many of them are physically, emotionally, spiritually, mentally, and financially depleted.

Sign up to get our posts and announcements sent straight to your inbox.

Research indicates that parents of children with special needs experience significantly higher levels of burnout, chronic stress, and emotional exhaustion than parents of neurotypical children. To make matters worse, reactive attachment disorder is often an invisible special need, which frames expectations for outsiders differently. Outsiders typically see the child as "normal." Yet a child with reactive attachment disorder often directs their most intense behaviors toward the primary caregiver and other children in the home — and families fall apart behind closed doors. (Related: "Why a Safe Home Isn't Enough for Kids With Reactive Attachment Disorder" ).

Early advocacy matters. When families with children who have reactive attachment disorder are heard sooner, they have more options — before things escalate into crisis.

Studies also show that parents of children with severe autism spectrum disorder (ASD) face some of the highest burnout rates — and reactive attachment disorder can be comparable in intensity, complexity, and strain. A study comparing parent reports of autism spectrum disorder and attachment disorder found significant overlap in behavior challenges, social difficulties, emotional regulation, and attachment patterns. Yet while extensive resources exist for autism, support for attachment-related disorders remains profoundly lacking.

By the time families come to RAD Advocates in crisis, many have already experienced multiple out-of-home placements driven by exhaustion and survival. Parents often arrive emotionally depleted, physically unwell, and mentally overwhelmed — feeling as though no viable options remain. In many cases, families also realize they have never been connected to services that truly understand reactive attachment disorder and developmental trauma.

Diagnosis Delays and Misunderstanding

Accurate diagnosis is another major barrier. While reactive attachment disorder has been included in the DSM since 1980, many parents and professionals find the current definition too narrow to capture the full spectrum of symptoms traumatized children experience. Nearly two decades ago, Dr. Bessel van der Kolk proposed developmental trauma disorder as a more comprehensive diagnosis to describe children whose early trauma disrupted attachment and development across multiple domains. Yet it remains absent from the DSM-5, the authoritative guide used by clinicians in the United States and worldwide to diagnose, classify, and treat mental disorders.

The DSM's reluctance to recognize trauma-related diagnoses extends beyond developmental trauma disorder. While the World Health Organization's ICD-11 added complex PTSD as a distinct diagnosis in 2018 — recognizing that prolonged childhood trauma creates symptoms beyond traditional PTSD — the American DSM still has no such category. This gap leaves clinicians without a framework for understanding how early, repeated trauma fundamentally alters emotional regulation, self-concept, and relational capacity — the very issues at the heart of reactive attachment disorder. The result is fragmented care that treats symptoms in isolation rather than addressing the underlying trauma architecture.

Parents and caregivers of children with reactive attachment disorder are often competent, high-achieving, and deeply committed — but they are not immune to burnout.

There is some hope on the horizon: the American Psychiatric Association is working to make the DSM a "living document" that can be updated more frequently rather than waiting years between major revisions — though when trauma-related diagnoses will be added remains uncertain. For now, children continue to be frequently misdiagnosed or treated in fragments rather than as part of a larger developmental and relational picture. (Related: "Developmental Trauma Disorder Diagnosis").

Comorbid diagnoses — including ADHD, oppositional defiant disorder, post-traumatic stress disorder, anxiety disorders, bipolar disorder, and disruptive mood dysregulation disorder — further complicate understanding.

Are you or is someone you know parenting a child with RAD? Share NavRAD, the experience for connection and a path forward.

There is also widespread misunderstanding of how reactive attachment disorder affects family dynamics. By the time a family reaches crisis, the disorder has often learned to divide caregivers, undermine trust, and exhaust every relational support system in place.

Explaining reactive attachment disorder to professionals responsible for diagnosis can feel impossible for parents. Having a third party — such as a RAD Advocate — speak with clinicians, schools, and agencies can help families avoid being dismissed, blamed, or labeled as unstable themselves. Early advocacy protects both parents and children from years of compounding harm.

A Systemic Lack of Resources

The lack of resources for families impacted by reactive attachment disorder is systemic. Universities rarely teach attachment disorders in depth. Insurance coverage for treatment is limited or nonexistent. Respite options are scarce. School-based supports are often inadequate or unavailable. (Related: "Reactive Attachment Disorder: A Resource Desert in Treatment and Support").

Families are already financially stretched, searching for help while relational damage has accumulated across the household. In some cases, coping mechanisms — including substance use or emotional withdrawal — have taken their toll on caregivers simply trying to survive.

By the time a family reaches crisis, the disorder has often learned to divide caregivers, undermine trust, and exhaust every relational support system in place.

Most states offer early intervention programs for children with developmental delays, providing access to physical, occupational, and speech therapies. No comparable system exists for developmental trauma disorder — despite the fact that early intervention is one of the strongest predictors of long-term outcomes. Early support doesn't just help — it changes trajectories.

The Realities Families Face

Another painful reality families encounter is that effort alone does not guarantee change. Many parents come to RAD Advocates after years of relentless, informed, compassionate attempts to help their child — only to find that progress remains limited. No amount of intervention can heal a child who will not or cannot change.

Some children lack the capacity for deep relational change. For others, meaningful attachment feels too threatening. In these cases, families may need to shift expectations toward surface-level relationships that preserve safety for everyone involved. Some children simply do not buy into treatment. Their maladaptive behaviors serve a purpose, and change is not something they are willing — or able — to pursue.

Acknowledging this reality is not failure. It is clarity. And clarity allows families to make informed decisions that protect the entire household.

Finding Support Earlier Matters

If you're dealing with burnout, limited resources, or difficulty obtaining an accurate diagnosis, you are not alone. The pattern of families reaching crisis before finding support is common — and costly in multiple ways. RAD Advocates exists to interrupt that pattern by walking alongside families earlier, offering advocacy, education, and guidance rooted in lived experience.

Early support doesn't erase trauma, but it can prevent families from reaching the point where crisis feels inevitable. When parents are heard sooner, systems respond differently. And when families are supported earlier, outcomes — for everyone in the home — can look very different (Additional perspective on family-wide impact: "The Siblings We Don't See: How Reactive Attachment Disorder Affects the Whole Familiy."

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.