Children with reactive attachment disorder are believed to have the capacity to form attachments, but this ability has been compromised by their experiences. The best treatment for a child with reactive detachment disorder is a positive, loving, stable, caring environment and caregiver.
There's no standard treatment for reactive attachment disorder, but it should involve both the child and parents or primary caregivers. Early intervention appears to improve outcomes. Goals of treatment are to help ensure that the child:
- Has a safe and stable living situation
- Develops positive interactions with parents and caregivers
Treatment strategies include:
- Encouraging the child's development by being nurturing, responsive and caring
- Providing consistent caregivers to encourage a stable attachment for the child
- Providing a positive, stimulating and interactive environment for the child
- Addressing the child's medical, safety and housing needs, as appropriate
Other services that may benefit the child and the family include:
- Individual and family psychological counseling
- Education of parents and caregivers about the condition
- Parenting skills classes
Controversial and coercive techniques
The American Academy of Child and Adolescent Psychiatry, the American Psychiatric Association and the American Professional Society on the Abuse of Children have all criticized dangerous and unproven treatment techniques for reactive attachment disorder.
These techniques include any type of therapy that involves forcing or coercing a child in order to break down what is believed to be the child's resistance to attachments — an unproven theory of the cause of reactive attachment disorder. These controversial practices can be psychologically and physically damaging and have led to accidental deaths.
Beware of mental health providers who promote unorthodox or extreme methods. Some offer research as evidence to support their techniques, but none has been published in reputable medical or mental health journals.
If you're considering any kind of unconventional treatment, talk to your child's psychiatrist first to make sure it's legitimate and not harmful.
July 10, 2014
- Reactive attachment disorder of infancy or early childhood. In: Diagnostic and Statistical Manual of Mental Disorders DSM-5. 5th ed. Arlington, Va.: American Psychiatric Association; 2013. http://www.psychiatryonline.org. Accessed April 9, 2014.
- Highlights of changes from DSM-IV-TR to DSM-5. American Psychiatric Association. http://www.dsm5.org/Pages/Default.aspx. Accessed April 9, 2014.
- Reactive attachment disorder. American Academy of Child and Adolescent Psychiatry. http://www.aacap.org/aacap/Families_and_Youth/Facts_for_Families/Facts_for_Families_Pages/Reactive_Attachment_Disorder_85.aspx. Accessed April 9, 2014.
- Coercive interventions for reactive attachment disorder. American Academy of Child & Adolescent Psychiatry. http://www.aacap.org/cs/root/policy_statements/coercive_interventions_for_reactive_attachment_disorder. Accessed April 9, 2014.
- Boris NW, et al. Practice parameter for the assessment and treatment of children and adolescents with reactive attachment disorder of infancy and early childhood. Journal of the American Academy of Child and Adolescent Psychiatry. 2005;44:1206.
- Hales RE, et al. The American Psychiatric Publishing Textbook of Psychiatry. 5th ed. Washington, D.C.: American Psychiatric Publishing; 2008. http://www.psychiatryonline.org/resourceToc.aspx?resourceID=5. Accessed April 9, 2014.
- Chaffin M, et al. Report of the APSAC task force on attachment therapy, reactive attachment disorder, and attachment problems. Child Maltreatment. 2006;11:76.
- Position statement on reactive attachment disorder. American Psychiatric Association. http://www.psych.org/advocacy--newsroom/position-statements. Accessed April 9, 2014.
- Hoecker JL (expert opinion). Mayo Clinic, Rochester, Minn. April 22, 2014.
- Tervo RC (expert opinion). Mayo Clinic, Rochester, Minn. May 20, 2014.
- Mikic N, et al. Mentalization and attachment representations: A theoretical contribution to the understanding of reactive attachment disorder. Bulletin of the Menninger Clinic. 2014;78:34.