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(This is not a duplicate question) This question is for a parenting expert. I have a 5 year old pre-adoptive child in my home. I am her 5th placement in 3 years. This week, she received a diagnosis of Reactive Attachment Disorder (DSM F94.1) and Trauma (DSM F43.8). On the outside, the child looks perfect but she has maladaptive psychological behaviors. For example,superficially charming to others but at home since I am the attachment object (tantrums, lying, defiance, etc). Please honestly answer whether you have seen any techniques that work with the RAD disorder? If you are aware of techniques that heal RAD, please provide some specific examples.

Submitted: 8 months ago.Category: Parenting
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Answered in 1 day by:
12/3/2017
Parenting Counselor: DrJackiePhD, Doctor replied 8 months ago
DrJackiePhD
DrJackiePhD, Doctor
Category: Parenting
Satisfied Customers: 431
Experience: I have been doing research in relational/interpersonal communication since 1998. My Ph.D. is in interpersonal communication.
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Hi, I'm Dr. Jackie, a relationship/interpersonal communications professor, relationship counselor, and behavioral therapist. And yes, I'm familiar with RAD. In my opinion, this is one of the hardest diagnoses to work with because of the trauma like you mentioned which prohibits the child from forming healthy bonds with people due to not bonding with primary care givers in the early months and couple of years of that child's life. You have your hands full! I'm not saying that to discourage you. It just is a very difficult diagnosis, especially for the primary care giver. I actually have two children right now in therapy with me. These kids typically target one person to take out their frustrations--usually the mom since the mom typically is the primary care giver. Melt downs when they do not get their own way can be so draining, especially if it occurs at a grocery store or some other public place. Other parents look at you thinking, "Why can't you control your child?" People make harsh judgments out of ignorance because they have not lived through what you do every day.

Many typical behavioral therapy techniques used with other behavioral problems do not work with RAD children. In my opinion, cognitive therapy does not work either, especially since the child is so young. The best healing techniques that I have personally seen work are LOVE, LOVE, LOVE! I'm not kidding--these kids appear with this hard shell sometimes and then can flip flop and be overly friendly with strangers--no boundaries, no real ability to discern differing behaviors toward strangers versus friends versus "family." They have no sense of this. So just like every 5-year-old needs reassurance that she is loved, these kids need this reassurance to the 5th power! In their mind, they think they will do something that one day will cause you to stop loving them. So even if she throws your favorite expensive vase on the floor on purpose and breaks it, tell her you love her always but you have home rules and must punish by taking away TV time or whatever you use for consequences.

1. So first of all, LOVE!

2. CONSISTENCY! As hard as it may be and as draining and heart-breaking and every other adjective/participle you can think of, BE CONSISTENT! It is so easy as an overworked, tired parent to give in sometimes. The common cliche is, "Pick your battles." While this is true, RAD children need consistency even more than other children. Because of their lack of emotion/ability to express or seemingly to feel emotion, having boundaries that are clear and consistent can, over time (and I emphasize OVER TIME because it can take years) can reinforce that there ARE some constants in life. And that can lead to learning to trust and have a relationship with you because it will finally break down their walls/shells that you are not going to abandon them like others have. I hope that makes sense.

3. If you have a partner, present a unified front. I have seen this happen quite a bit--the parent who is NOT TARGETED at the RAD child's "punching bag" may start to think that their darling angel is fine or almost fine and that it is the other parent who just cannot handle the child. This is NOT THE CASE! These children are incredibly manipulative and will cleverly pit one parent against another much, much more stealthily than other children. So if you are co-parenting with a partner, you need to check in every day with your game plan. If you told the kid she could not have ice cream after 7 p.m., make sure the other parent knows you have made that a rule; otherwise, you will find your darling daughter eating ice cream at 7:30 p.m. and smiling smugly at you when you discover this!

This is just a starter list. There are usually some primary goals I write up and give to the parents, and then I work with the child to work on these goals. We can amend these goals or even drop them when the child meets them. Then we can add other goals.

If this is helpful and you want to chat further, please let me know. You have taken on a very noble and very difficult "adventure." Bless you for this!

Best,

Dr. Jackie

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Customer reply replied 8 months ago
Thank you Dr Jackie! You get it!!!! It is so hard to find people who actually understand RAD. What techniques are the most effective for showing love? Hugging my RAD5 and telling her how I much care does not seem to effect her. Everything is so superficial with this child. I've heard horror stories about RAD kids ultimately ending up in residential treatment facilities. Have you seen anyone actually make true sustainable progress with RAD children to heal them? From a school perspective, what is the best school setting for RAD kids (i.e., public, private, home school, Montessori).
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