Intensive Therapy Plan for Reactive Attachment Disorder (RAD)
Shortcomings of Traditional Therapy Methods
Behaviors associated with complex developmental trauma and attachment disruptions, unfortunately do not respond well to traditional therapy methods. There are primarily two reasons for this. First, the success of psycho-dynamic and play therapies are dependent upon a trusting relationship between therapist and child. A child with complex developmental trauma is not neurologically able to form trust of Self or of primary care givers and, therefore, traditional therapy will fail. In addition, these children function from a ‘survival model’ and are experts in delivering what adults expect of them.
Most traditional therapists are not able to provide the model of intervention needed to handle the destructive behaviors. These children may display terror and rage when held accountable to their ‘survival skills’ they use on well intended, but unsuspecting care-givers. This will often exacerbates the problem. Second, traditional therapy is not conducive to the intensity, frequency, and immediacy required to reorganize the neurological developmental trauma, handle the defensive mechanisms and physiological triggered emotional reactions created from repeated early experiences of abuse, neglect, and chaos.
Intensive Treatment Plans Work Better
Children with complex developmental attachment disruptions are best served by an intensive treatment plan in which they are immersed in daily therapy with both a trained therapist and their parents for one to several weeks, followed by weekly or biweekly on-going sessions.
The intensive (and all therapy sessions) entails one or more of the following techniques: developmental movement therapy, developmental re-parenting (parenting the child as if s/he were the age at the time the trauma occurred and the age the child seems emotionally equivalent to), behavioral management (rewards and consequences), storytelling (recreate happier more secure early childhood memories), EMDR (eye movement desensitization reprocessing that stops the rumination of negative feedback loops), and psychodrama, (nonverbal physical role playing) and cognitive restructuring. All therapies occur within a nurturing, supportive, and safe environment with active parent participation.
The up-front expenses of nontraditional therapy are hefty. However, these therapies, unlike traditional therapies, do not drag on for years and years; long-term therapy can be very stressful for children and their families. Plus, a pro-active, front loading treatment plan conducted early in children’s development can stem a variety of future emotional and financial problems, and is more likely to prevent out of home placements.