Reactive Attachment Disorder is a severe developmental disorder caused by a chronic history of maltreatment for the duration of the initial couple of years of life. Reactive Attachment Disorder is often misdiagnosed by mental health pros who do not have the suitable training and experience assessing and treating such children and adults. Often, children in the child welfare system have a potpourri of former diagnoses. The behavings and sensations or changes that are the basis for these former diagnoses are better conceptualized as resulting from disordered attachment. Oppositional Defiant Disorder behavings are subsumed under Reactive Attachment Disorder. Post Traumatic Stress Disorder sensations or changes are the result of a substantial history of abuse and neglect and are another dimension of attachment disorder. Attention problems, and even Psychotic Disorder sensations or changes are many times seen in children with disorganized attachment (Lyons-Ruth, K., & Jacobvitz, D., Attachment disorganization: unsolved loss, relational violence and lapses in behavioral and attentional strategies. In Cassidy, J. & Shaver, P., (Eds.) Handbook of Attachment. pp 520-554, NY: Guilford Press, 1999. Solomon, J. & George, C. (Eds.). Attachment Disorganization. NY: Guilford Press, 1999. Main, M. & Hesse, E. Parents’ Unresolved Traumatic Experiences are related to infant disorganized attachment status. In Greenberg, M.T., Ciccehetti, D., & Cummings, E.M. (Eds.) Attachment in the Preschool Years: Theory, Research, and Intervention, pp.161-182, Chicago: University of Chicago Press, 1990. Carlson, E.A. (1988). A potential longitudinal study of disorganized/disoriented attachment. Child Development 69, 1107-1128. Approximately 2% of the population is adopted, and amidst 50% and 80% of such children have attachment disorder sensations or changes (Carlson, V., Cicchetti, D., Barnett, D., & Braunwald, K. (1995). Finding order in disorganization: Lessons from exploration on maltreated infants’ affixations to their caregivers. In D. Cicchetti & V. Carlson (Eds), Child Maltreatment: Theory and exploration on the causes and aftermaths of child abuse and neglect (pp. 135-157). NY: Cambridge University Press. Cicchetti, D., Cummings, E.M., Greenberg, M.T., & Marvin, R.S. (1990). An organizational perspective on attachment beyond infancy. In M. Greenberg, D. Cicchetti, & M. Cummings (Eds), Attachment in the Preschool Years (pp. 3-50). Chicago: University of Chicago Press.) Many of these children are violent (Robins, L.N. (1978) Longitudinal studies: Sturdy childhood predictors of adult antisocial behavior. Psychological Medicine,. 8, 611-622.) and aggressive (Prino, C.T. & Peyrot, M. (1994) The effect of child physical abuse and neglect on aggressive withdrawn, and prosocial behavior. Child Abuse and Neglect, 18, 871-884.) and as adults are at peril of developing a potpourri of psychological difficultnesses (Schreiber, R. & Lyddon, W. J. (1998) Parental bonding and Current Psychological Functioning Among Childhood Sexual Abuse Survivors. Journal of Counseling Psychology, 45, 358-362. and personality disorders, including antisocial personality disorder (Finzi, R., Cohen, O., Sapir, Y., & Weizman, A. (2000). Attachment Styles in Maltreated Children: A Comparative Study. Child Development and Human Development, 31, 113-128.) narcissistic personality disorder, borderline personality disorder, and psychopathic personality disorder(Dozier, M., Stovall, K.C., & Albus, K. (1999) Attachment and Psychopathology in Adulthood. In J. Cassidy & P. Shaver (Eds.). Handbook of Attachment (pp. 497-519). NY: Guilford Press.). Neglected children are at danger of social withdrawal, social rejection, and pervasive sensations of incompetence(Finzi, R., Cohen, O., Sapir, Y., & Weizman, A. (2000). Attachment Styles in Maltreated Children: A Comparative Study. Child Development and Human Development, 31, 113-128.). Children who have histories of abuse and neglect are at significant risk of devising Post Traumatic Stress Disorder as adults (Allan, J. (2001). Traumatic Relationships and Serious Mental Disorders. NY: John Wiley. Andrews, B., Varewin, C.R., Rose, S., & Kirk (2000). Predicting PTSD sensations or changes in Victims of Violent Crime. Journal of Abnormal Psychology, 109, 69-73.). Children who have been sexually maltreated are at significant risk of formulating anxiety disorders (2.0 times the average), major depressive disorders (3.4 times average), alcohol abuse (2.5 times average), drug abuse (3.8 times average), and antisocial conduct (4.3 times average)( MacMillian, H.L. (2001). Childhood Abuse and Lifetime Psychopathology in a Community Sample. American Journal of Psychiatry, 158, 1878-1883.). The effective treatment of such children is a public health concern (Walker, Goodwin, & Warren, 1992).Left untreated, children who have been maltreated and neglected and who have an attachment disorder become adults whose capacity to develop and maintain healthful relationships is deeply damaged. Without placement in an suitable permanent home and effective treatment, the condition will worsen. Many children with attachment disorders formulate borderline personality disorder or anti-social personality disorder as adults (Allan, J. Traumatic Relationships and Serious Mental Disorders, NY: Wiley, 2001. Andrews, B., Varewin, C.R., Rose, S. & Kirk. Predicting PTSD sensations or changes in Victims of Violent Crime. Journal of Abnormal Psychology, vol. 109, 69-73, 2000.)

Dyadic Developmental Psychotherapy is an evidence-based and effective treatment for such conditions. There have been assorted empirical studies in professional peer-reviewed publications describing this approach. (Becker-Weidman, A., & Shell, D., (Eds.) (2005) Creating Capacity for Attachment: Dyadic Developmental Psychotherapy in the Treatment of Trauma-Attachment Disorders. OK: Woods N Barnes publishing. Becker-Weidman, A., (2006) “Treatment for Children with Trauma-Attachment Disorders: Dyadic Developmental Psychotherapy,” Child and Adolescent Social Work Journal. Vol. 23 #2, pp. 147-171 April 2006. Becker-Weidman, A., (2006) “Dyadic Developmental Psychotherapy: A multi-year Follow-up”, in, New Developments In Child Abuse Research, Stanley M. Sturt, Ph.D. (Ed.) Nova Science Publishers, NY, 2006, pp. 43 – 60. Becker-Weidman, A., (2007) “Treatment For Children with Reactive Attachment Disorder: Dyadic Developmental Psychotherapy,” Center For Family Development. Becker-Weidman, A., & Hughes, D., (2008)”Dyadic Developmental Psychotherapy: An evidence-based treatment for children with complex trauma and disorders of attachment,” Child & Adolescent Social Work, 13, pp.329-337.) The Research Studies Family therapy, person therapy, play therapy, residential placements, and intensive outpatient treatment, amongst other treatments, are often used to treat attachment disorders. However, when equated with Dyadic Developmental Psychotherapy, these treatments proved to be ineffective. A follow-up study equated the effectiveness of Dyadic Developmental Psychotherapy and “usual care,” and found that Dyadic Developmental Psychotherapy devised clinically and statistically substantial improvements one year after treatment ended. The study was composed of 34 families receiving Dyadic Developmental Psychotherapy and 30 families receiving “usual care.” Before treatment/evaluation in both the treatment and control groups, Randolph Attachment Disorder Questionnaire scores and Child Behavior Checklist scale scores were elevated and in clinically substantial ranges (more than two standard divergences above the mean for the CBCL). The extent and severity of these children’s disorder is underscored by the fact that 82% of the treatment group and 83% of the control-group subjects had received prior treatment using other methods. The intermediate number of former treatment sequences was 3.2 for the treatment group and 2.7 for the control group. The results for the treatment-group were achieved amongst children aged six to fifteen years, averaging 9.4 years, who received an intermediate of twenty-three sessions over eleven months.

Dyadic Developmental Psychotherapy is effective because of it is reliance on and development of affective attunement among therapist and child, caregiver and child, and therapist and caregiver. The procedure of sustaining affective attunement allows for dyadic regulation of affect amongst child and therapist so that the child feels a sense of safety and security and may experience the affect affiliated with past traumas, permitting for integration of these experiences rather than dissociation of the affect and memory. Furthermore, Dyadic Developmental Psychotherapy’s significant involvement of caregivers in treatment facilitates the development of an affectively attuned kinship among the child and caregiver. An affectively attuned kinship may be described as a kinship in which the two humans are experiencing the same affect and that their affect co-varies. Within the safety of the attuned kinship the shame of past trauma and current misbehaviors are explored, experienced, and integrated. The caregiver-child interactions build on a dyadic affect regulation procedure that ordinarily occurs for the duration of infancy and the toddler years. The child’s past traumatic history of abuse and neglect strongly proposes that such interaction, which facilitates a health attachment and a trusting and safe relationship, did not take place or occurred in an highly inadequate manner. Dyadic Developmental Psychotherapy facilitates the development of a healthful attachment amongst child and caregiver, enables the child to affectively trust the caregiver, and allows the child to secure ease and safety from the caregiver. This study examined the effects of Dyadic Developmental Psychotherapy on children with trauma-attachment disorders who meet the DSM IV criteria for Reactive Attachment Disorder, all of whom were either adopted or in foster care. A treatment group composed of thirty-four subjects and a frequent care group composed of thirty subjects was compared. All children were amid the ages of five and sixteen when the study began. Seven hypotheses were explored. It was hypothesized that Dyadic Developmental Psychotherapy would reduce the sensations or changes of attachment disorder, aggressive and delinquent behaviors, social troubles and withdrawal, anxiety and depressive problems, thought problems, and attention difficultnesses among children who received Dyadic Developmental Psychotherapy. Significant reductions were achieved in all measures studied. The results were achieved in an intermediate of twenty-three sessions over eleven months. These conclusions continued for an intermediate of 1.1 years after treatment ended for children amongst the ages of six and fifteen years. There were no changes in the standard care-group subjects, who were re-tested an intermediate of 1.3 years after the evaluation was completed. The results are particularly salient since 82% of the treatment-group subjects and 83% of the standard care-group subjects had antecedently received treatment with an intermediate of 3.2 prior treatment episodes. This past history of not successful treatment further underscores the importance of these results in demonstrating the effectiveness and efficacy of Dyadic Developmental Psychotherapy as a treatment for children with trauma-attachment problems. In addition, 53% of the ordinary care-group subjects received “usual care” but without any measurable alter in the outcome variables measured. Children with trauma-attachment difficulties are at substantial peril of devising severe disorders in adulthood such as Post Traumatic Stress Disorder, Borderline Personality Disorder, Narcissistic Personality Disorder, and other personality disorders. This study supports various of O’Connor & Zeanah’s (O’Connor, T., & Zeanah, C., (2003) Attachment Disorders: Assessment schemes and treatment approaches. Attachment & Human Development, 5, 223-245.) conclusions and recommendations concerning treatment. They state (p. 241), “treatments for children with attachment disorders must be promoted only when they are evidence-based.” The results of this study are a beginning toward that end. Dyadic Developmental Psychotherapy provides caregiver aid as an integral share of it is treatment methodologies. Finally, Dyadic Developmental Psychotherapy uses a multimodal approach built around affect attunement.

Effective Treatments For Ptsd Practice Guidelines From The

An approximated 70% of adults in the United States have experienced a traumatic event at least once in their lives. Though most recover on their own, up to 20% invent chronic Posttraumatic Stress Disorder. For these people, overcoming PTSD requires the help of a professional.

This guide gives clinicians the data they need to treat clients who exhibit the sensations or changes of PTSD. It is based on the principles of Prolonged Exposure Therapy, the most scientifically-tested and proven treatment that has been employed to efficaciously treat victims of all types of trauma. Whether your client is a veteran of combat, a victim of a physical or sexual assault, or a casualty of a motor vehicle accident, the proficiencies and systems outlined in this book will help.

In this treatment clients are exposed to imagery of their traumatic memories, as well as real-life situations related to the traumatic event in a step-by-step, controllable way. Through these exposures, your client will learn to confront the trauma and get started to think differently when it comes to it, leading to a marked decrease in levels of anxiety and other PTSD symptoms. Clients are provided education regarding PTSD and other mutual reactions to traumatic events. Breathing retraining is taught as a method for helping the client manage anxiety in every day life.

Designed to be used in conjunction with the matching client workbook, this therapist guide includes all the tools necessary to efficaciously utilise the prolonged exposure program including assessment measures, session outlines, case studies, sample dialogues, and homework assignments. This comprehensive resource is an particular treatment manual that is sure to help you help your clients reclaim their lives from PTSD.

TreatmentsThatWorkTM represents the gold standard of behavioral healthcare interventions!

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