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Unread April 1st, 2005, 10:58 PM
anadolescentcure anadolescentcure is offline
Join Date: Apr 2005
Location: PA
Posts: 4
Default Reactive Attachmenet Disorder (RAD) and Neurofeedback

Hi Everyone. I am in just the beginning phase of learning about Reactive Attachment Disorder (RAD) and RAD Therapy... specifically Neurofeedback. I recently began working with a 16yr old client who has been diagnosed with this disorder and just wondering what thoughts those in this forum have on this subject?? And why does this subject seem to be a very controversial one in the Mental Health field?
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Unread April 7th, 2005, 09:52 PM
James Pretzer James Pretzer is offline
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Default Re: Reactive Attachmenet Disorder (RAD) and Neurofeedback

While I can't claim to be an expert on reactive attachment disorder, my sense is that this topic is controversial because some use the lable freely without bothering to pay attention to diagnostic criteria and use treatment approaches that are dubious at best. The following two references look as though they give a good introduction to the controversy:

Hanson, R. F.; Spratt, E. G. (2000). Reactive attachment disorder: What we know about the disorder and implications for treatment. Child Maltreatment: Journal of the American Professional Society on the Abuse of Children. 5, 137-145.

Abstract Reviews and synthesizes what is known about Reactive Attachment Disorder (RAD) and attachment disorders and discusses implications for treatment. In recent years, there has been an increase in the number of children diagnosed with RAD. There is considerable disagreement about what this entity actually entails and, in particular, what types of assessments and interventions to use with these children and families. Children with a history of maltreatment (i. e., physical, sexual, emotional abuse, and/or severe neglect) are particularly likely to receive this diagnosis, because the behavior problems often seen in these children are presumed to stem from the maladaptive relationships they have had with abusive caregivers. However, many children are receiving this diagnosis because of behavior problems that clearly extend beyond the Diagnostic and Statistical Manual of Mental Disorders-IV (DSM-IV) criteria for RAD. Perhaps the most concerning consequence of the RAD diagnosis is the emergence of novel treatments (e.g., rage reduction therapy) that lack a sound theoretical basis or empirical support, and may potentially be traumatizing and dangerous to the child. It is suggested that it is possible to use treatments that have worked among populations with similar symptom profiles and behavior problems.

Lohr, J. M.; Olatunji, B. O. (2004). Primum Non Nocere: Pseudopsychology and Its Failures. PsycCRITIQUES. 49 (Suppl 14), 2004, [np].

Abstract Reviews Attachment therapy on trial: The torture and death of Candace Newmaker (see record 2003-06149-000). This book was published as part of a series on Child Psychology and Mental Health that focuses on strengthening the science of child development and the linking of that science to mental health, childcare, and public policy. The book admirably fulfills that mandate and goes well beyond it to inform the reader of not just the dangers of a specific fringe therapy, but of a broader trend for the promotion of pseudopsychology and pseudoscience in mental health practice. Though the book is both informative and engaging, it requires an effortful reading because of the exacting documentation and thorough critical analysis. Though it is written for the educated layperson, the quality of scholarship makes it appropriate for academic text material. It's style might be best characterized as "investigative scholarship." The book employs a detailed case study as the vehicle for the critical analysis of Attachment Therapy, mental health clinicians who employ it, and the dynamic of its promotion at the edges of clinical practice. The case is that of 10-year-old Candace Newmaker, who died at the hands of 3 unlicensed mental health practitioners in Evergreen, Colorado in April of 2000. The death resulted from a lack of oxygen (suffocation) that occurred in the process of applying Attachment Therapy (AT) for Reactive Attachment Disorder (RAD) at the behest of the girl's mother. The book is organized in to 3 sections: (1) the biographical and clinical specifics of the case, (2) analysis of emotional development and relationship to childhood mental illness, (3) critique of the promotional of AT and potential remedies for that promotion. The reviewer maintains that the book is not a pleasurable read, but it is one that is both compelling and informative. For professional psychologists, it will serve as a point of departure for critical analyses of a variety of related issues. It is concluded that this book, and the incident on which it is based, presents us with a rather stark professional challenge: Perhaps the mental health profession needs to evolve to the point in which the use of a treatment that is not empirically supported could constitute malfeasance or malpractice.
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