After running the alphabet soup of misdiagnoses, someone finally comes up with a diagnosis that answers the questions of what might have gone wrong with your child. You have a diagnosis of reactive attachment disorder.
We were faced with this about six months after our nephew came to live with us at the age of twelve. He was diagnosed by a neuropsychologist who specialized in children, yet he had never treated a patient with reactive attachment disorder.
He was willing to learn but, rapidly approaching the age of thirteen, we weren't convinced that our nephew could wait. Puberty was just around the corner. Talk therapy wasn't working. Neither was play therapy, or any of the other tricks that his psychologist had up his sleeve.
Once we had a diagnosis, my wife and I did our homework. One of the first things we learned was that the diagnosis was a good fit. While he may well be suffering from depression, PTSD, and ODD, he did not suffer from ADHD, although he had taken ritalin much of his life, and it didn't seem possible to treat the associated disorders as long as the attachment disorder blocked the paths of communication.
While we were pleased with the effort put in by his neuropsychologist, we realized that we needed to find an attachment therapist.
We were fortunate. Although we didn't know at the time that he lived only a few hours from us, two of the books that we purchased while we were educating ourselves on reactive attachment disorder were written by Dr. Dan Hughes. We didn't call him because we didn't know, at the time, that he lived in Maine, or that he would be accessible.
But we did learn that there was something wrong with pretty much any kid that our nephew brought home with him. At the time, anyhow; he does somewhat better now.
One of the kids who he brought home with him had been adopted by a family living on the other end of the same street that we lived on. Being an outgoing sort of person, my wife introduced herself to the boy's mother and ... surprise, surprise - he suffered from reactive attachment disorder.
Our new friend worked for a childcare agency and was an enthusiastic advocate for attachment therapy. Through her, we were introduced to a therapist who was no longer taking attachment patients but who did refer us to a therapist by the name of Stephanie, who had just moved to Maine from Massachusetts, in order to work under Dr. Dan Hughes.
We knew that name. We'd read his books, so there was a certain comfort level reached from the onset.
Stephanie agreed to take our nephew on as her very first attachment patient here in Maine. Better yet, she hadn't yet realized that she was supposed to be charging us a whole lot more than she was. After the first year, we actually had to insist that she raise her rates.
New to the field of attachment therapy or not, Stephanie was wonderful. She consulted with Dr. Hughes as necessary and, while we met with him only twice, we were aware that she had the benefit of his many years of expertise.
While he remains a major pain in the butt (the official acronym is PITA, I think), our nephew no longer suffers from reactive attachment disorder. Now we get to work on the depression, the PTSD, and the other results of his having been nobody's priority during his younger years.
It worked for us, but a lot of it was a matter of luck. We could just as easily have wound up with someone who might have done more harm than good.
Had we not done our own homework, we might have let him remain in traditional therapy until after his window of recovery had closed.
What should you look for in an attachment therapist?
First of all, the person with the most impressive credentials might not be the best person for the job. While there is nothing to say that a psychiatrist or a psychologist can't do effective attachment therapy, my impression is that most of them don't. In too many cases, these are the same people who have been misdiagnosing your children over all of these years.