Talking to people about reactive attachment disorder or attachment therapy, even among those who are parenting children with RAD, I find that there is a certain amount of confusion as to what attachment therapy is.
People refer to the various well-known attachment therapists and authors, such as Nancy Thomas, Dan Hughes, Gregory Keck, Foster Cline, Martha Welch and others, as if each were doing something unrelated to the other.
There also appears to be some confusion about attachment therapy itself, in part due to some high profile scandals a few years back.
As in any other profession, attachment therapy has evolved over time.
Having been a paramedic and emergency medical technology instructor for many years, I can appreciate that. Techniques that were standard practice in the 1980s could result in a malpractice suit, or worse, if practiced today. Rather than implying that paramedics were negligent 25 years ago, the field of emergency medicine has evolved.
This is a good thing, and not something to be disparaged.
Another thing to consider is that evolution in the field of attachment therapy, as in any other field, requires the existence of pioneers - learned professionals who are willing to try new things in search of better results. Those that work can be expanded upon, while those that fail may be abandoned.
This too, is a good thing, and not something to be feared.
I was once warned that I could be sued for using duct tape to secure patients to a spineboard during a mass casualty situation, yet that is now a standard practice in many systems, with a modified form of duct tape marketed specifically for such a use.
As with paramedicine, attachment therapy has evolved over time. Therapeutic techniques that worked 25 years ago have evolved into new techniques that are even more successful today. Techniques that showed promise in the past have been abandoned for methods that show even greater promise today.
Dr. Daniel Hughes, who trained our nephew’s primary therapist, and whose books have been very helpful to us, has changed his methodology somewhat even during the time that we have been acquainted with him.
Does this mean that he was wrong before? Certainly not. Constant research, evaluation, and revision is necessary in order to find the best ways of reaching children with reactive attachment disorder.
There is a certain amount of confusion about some of the techniques used in attachment therapy, in part due to misinformation from well-meaning child rights activists and an opportunistic media.
For example, an attachment technique called “holding therapy” has been given an undeserved bad name.
Martha Welch, one of the pioneers in attachment therapy, empathized the importance of holding in attachment therapy, developing a technique where a mother would hold her child in a comfortable, nurturing position, as a means of promoting bonding.
Others took this technique and added to it, some including a technique that involved intentionally inducing rage in the child. As far as I am aware, this has never been the standard in holding therapy, yet it is often used to typify the procedure.
When it is used today, holding therapy involves the child being cradles in his mother’s arms, in much the same way as you might hold a small infant. All of the key ingredients of bonding are present, including eye contact, smiles, touch, movement, and voice. This recreates the feeling of security that an infant would experience from a nurturing mother, taking the child back to a time when bonding should have taken place, in effect giving him another chance.