The first time we met our soon-to-be-adopted son, we immediately sensed something was profoundly wrong. His overwhelming fear, coupled with extreme behaviors like screaming for hours and resisting physical comfort, signaled deep emotional pain. We knew these weren’t typical challenges for a toddler.
We later learned that our son had reactive attachment disorder (RAD), also known as developmental trauma disorder (DTD), and was living in a state of triggered primal brain. Our son was highly aggressive, hyperactive, and chaotic. People unfamiliar with developmental trauma would tell us that all toddlers are difficult. But no, this was different.
Neurotypical toddlers don’t stay awake all night. He slept an average of two hours per night and still had the energy of a tornado during the day. His behaviors were so extreme he was expelled from preschool at the age of three. We were told he was a safety risk to the other children and that he was never welcome back.
Our journey to support him was filled with trial and error, leading to a crucial realization: healing starts with strengthening the family as a whole. The conventional focus on the child alone overlooks the key to successful intervention — building a foundation of safety and resilience for the entire family.
The Wrong Approach to Healing Reactive Attachment Disorder
Most parents, including myself, learn the hard way what doesn’t work for healing reactive attachment disorder. Our first try was with an attachment therapist specializing in TBRI (trust-based relational intervention), a trauma-informed intervention that uses connection to help children feel safe. The "connecting principles" of TBRI are based on attachment theory and are considered the core of the intervention.
We saw the TBRI therapist for over a year, and during that time, our son got sicker. Connected parenting techniques had the opposite effect on our son. The more we tried to connect, the more threatened and triggered he felt.
The conventional focus on the child alone overlooks the key to successful intervention — building a foundation of safety and resilience for the entire family.
We kept searching for help — psychiatrists, medications, occupational therapy, play therapy, behavioral therapy — we saw countless providers, were given an alphabet soup of misdiagnoses, and our son continued to decline. It wasn’t until I found RAD Advocates many years later that I finally found helpful guidance.
A Family-First Approach to Reactive Attachment Disorder
Even the most stable families struggle once reactive attachment disorder enters the home due to its chaos-making and trigger-provoking symptoms. It’s vital to acknowledge and prepare for this reality. Yet, families are rarely given the education or resources to do so. The misconception that love and time are all that the child needs sets the family, and therefore the child, up for failure.
At RAD Advocates, we consider that the needs of the whole family — not just the child with developmental trauma — must be addressed. It’s counterintuitive for many parents, but this approach isn’t about prioritizing one family member over another. It’s about recognizing that parents need to be strong and supported to lead their family, siblings need their safety and attachment nurtured, and the child with the disorder must be placed in a position to heal.
Amy VanTine, Chief Executive Officer of RAD Advocates, emphasizes: “RAD is a family disorder — you have to treat the whole family.” By putting the family as the core of the healing process, you create an environment where the child with reactive attachment disorder has a greater chance of progress.
Meeting Parental Needs
Parents are often the linchpin holding everything together. If you aren’t well, your ability to support the rest of the family is compromised. Heather Houze, Chief Operating Officer of RAD Advocates, underscores this: “When we feel supported, we can do hard things longer.” Take care of your emotional, mental, physical, spiritual, and financial needs to feel safe first and foremost.
Parents of children with RAD are often high-achieving do-ers. We’re the people that get things done. But I quickly learned the hard way there was very little I could do given the severity of my son’s disorder, especially when I was struggling profoundly.The stress of caregiving, managing extreme behaviors, and navigating complex systems can be overwhelming.
The first step in caring for yourself is to let go of any guilt you're carrying. Reactive attachment disorder is not a parenting problem. When I first heard an advocate from RAD Advocates say these words, I wanted to listen to it again and again. It was so validating for me. I knew I had tried everything to help my son, only to watch him get sicker by the day. I knew I wasn’t the problem, even though, as his mother, I was the first to be blamed for his extreme behaviors by other parents, teachers, therapists, and family. Do your best to ignore blame and focus your time and energy on people who support you.
Taking small steps to ensure your well-being is crucial. For me, it started with addressing stress-induced neck pain. Monthly therapeutic massages and daily walks helped me reclaim my physical health. It wasn’t just self-care; it was survival. When I felt more grounded, I could approach my son’s needs with greater clarity and resilience.
VanTine reminds us: “If everything you’re doing isn’t working, don’t do more — do less. Doing more when you’re already maxed out isn’t therapeutic.” This advice was liberating. I realized that prioritizing my needs didn’t mean failing my son; it meant building a stronger foundation for us all.
Supporting Siblings of Children with Reactive Attachment Disorder
Siblings of children with reactive attachment disorder often face unique challenges. They may experience fear, resentment, or confusion about their sibling’s behaviors. It is critical to meet their emotional, physical, and mental health needs as well, not just those of the child with the disorder.
For our family, this meant spending dedicated one-on-one time with our other child, away from the chaos. We also sought external support, such as therapy and even self-defense classes, to empower him and ensure his emotional and physical safety.
Building a Team That Regards Family First
You can't heal developmental trauma through love, time or parenting techniques alone. You'll need support. While professional help is important, you may not find the right help right away. In that case, you'll need to get creative until you do.
Building a therapeutic team doesn’t have to mean a team of professionals in the traditional sense. If an intervention feels invasive (such as in-home therapeutic services), pursuing it is not in your best interest. Sometimes, the best “team” for your family may be a network of other parents to share experiences and provide emotional support.
"Reactive attachment disorder is a family disorder — you have to treat the whole family," says Amy VanTine, Chief Executive Officer of RAD Advocates.
If your family decides to work with a therapist, RAD Advocates strongly recommends that you vet them before moving forward. Parents must feel comfortable with the provider and feel they are being heard. Questions to consider when interviewing a therapist or provider include: Is the provider willing to be part of a team? Is the provider willing to collaborate and take advice from other professionals? Does the professional consider the entire family unit? Any professionals brought on board must be on the same page due to the triangular and manipulative nature of the disorder.
When Outside Placement Is Necessary
Sometimes, despite your best efforts, a child with reactive attachment disorder may not have the capacity to stay in the home. There may be safety concerns for the child and the rest of the family. Or perhaps the child with the disorder simply isn't ready to live in a family yet.
Children who cannot achieve a felt sense of safety in their homes aren’t going to heal. It’s helpful to know the severity of the child’s disorder. Many children on the moderate to severe spectrum of RAD don’t have the felt sense of safety to have therapeutic buy-in. In other words, they aren’t therapy-ready (willing to change). The child also may not be attachment-ready as healing needs to occur outside of the home before connection will feel safe to the child.
Some children need short-term opportunities outside of home whereas others need long-term placements. Options include therapeutic boarding schools, private family placement, summer camps, long-term family respite, and residential treatment centers. Whatever you decide, time apart can be life-changing for everyone involved. Consider ways to form your therapeutic team while your child is away. Progress in healing can happen while the child is in placement.
I knew I had tried everything to help my son, only to watch him get sicker by the day. I knew I wasn’t the problem, even though, as his mother, I was the first to be blamed for his extreme behaviors by other parents, teachers, therapists, and family.
While a decision of outside placement can be heartbreaking, it’s not about giving up. It’s about creating space for the child to heal and for the family to restore balance. During this time, everyone can focus on their individual needs, strengthening the family’s foundation for the future. Placement doesn’t mean abandoning the child. Instead, it allows you to build a stronger, more cohesive support system so that your family remains a source of strength and stability.
Securing Family Wellness
The missing key to supporting a child with reactive attachment disorder is shifting the focus from the child alone to the family as a whole. This family-first approach recognizes that healing isn’t a solo journey — it requires a collective effort to create a safe, supportive, and resilient environment for everyone.
If you need support, RAD Advocates is here to help you assess your family’s unique needs, build your team, and create a plan that considers the well-being of every member. While the journey is unique for each family, there is a path to safety and healing for everyone. You do not need to sabotage the wellness and safety of your family along the reactive attachment disorder journey.
I agree 100%.