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Treatments and drugs
By Mayo Clinic staffTreatment of reactive attachment disorder often involves a mix of psychological counseling, medications and education about the disorder. It may involve a team of medical and mental health providers with expertise in attachment disorders. Treatment usually includes both the baby or child and the parents or caregivers.
Goals of treatment are to help ensure that the baby or child has a safe and stable living situation and that he or she develops positive interactions with parents and caregivers. Treatment can also boost self-esteem and improve peer relationships.
There's no standard treatment for reactive attachment disorder. However, it often includes:
- Individual psychological counseling
- Education of parents and caregivers about the condition
- Parenting skills classes
- Family therapy
- Medication for other conditions that may be present, such as depression, anxiety or hyperactivity in a child or a parent
- Special education services
- Residential or inpatient treatment for children with more-serious problems or who put themselves or others at risk of harm
Other treatments for reactive attachment disorder that may be helpful include:
- Development of attachment between the child and the child's therapist
- Close, comforting physical contact
Managing reactive attachment disorder is a long-term challenge and can be quite demanding for parents and caregivers. You may want to consider seeking psychological counseling yourself or taking other steps to learn how to cope with the stress of having a child with reactive attachment disorder.
Controversial and coercive techniques
The American Academy of Child and Adolescent Psychiatry, the American Psychiatric Association, and the American Professional Society on the Abuse of Children have all criticized dangerous and unproven treatment techniques for reactive attachment disorder. Controversial practices can be psychologically and physically damaging and have led to accidental deaths.
Some unproven treatments for reactive attachment disorder include:
- Re-parenting, rebirthing
- Tightly wrapping, binding or holding children
- Withholding food or water
- Forcing a child to eat or drink
- Yelling, tickling or pulling limbs, triggering anger that finally leads to submission
Beware of mental health providers who promote these methods. Some offer research as evidence to support their techniques, but none has been published in reputable medical or mental health journals.
If you're considering any kind of unconventional treatment, talk to your child's psychiatrist first to make sure it's legitimate and not harmful.
- Reactive attachment disorder of infancy or early childhood. In: Diagnostic and Statistical Manual of Mental Disorders DSM-IV-TR. 4th ed. Arlington, Va.: American Psychiatric Association; 2000. http://www.psychiatryonline.com. Accessed June 9, 2011.
- Haugaard JJ, et al. Recognizing and treating uncommon emotional disorders in children and adolescents who have been severely maltreated: Reactive attachment disorder. Child Maltreatment. 2004;9:154.
- Horner G. Reactive attachment disorder. Journal of Pediatric Health Care. 2008;22:234.
- Reactive attachment disorder. American Academy of Child and Adolescent Psychiatry. http://www.aacap.org/cs/root/facts_for_families/reactive_attachment_disorder. Accessed June 9, 2011.
- Newman L, et al. Recent advances in the theories of and interventions with attachment disorders. Current Opinion in Psychiatry. 2007;20:343.
- Boris NW, et al. Practice parameter for the assessment and treatment of children and adolescents with reactive attachment disorder of infancy and early childhood. American Academy of Child and Adolescent Psychiatry. http://aacap.browsermedia.com/galleries/PracticeParameters/rad.pdf. Accessed June 9, 2011.
- Cornell T, et al. Clinical interventions for children with attachment problems. Journal of Child and Adolescent Psychiatric Nursing. 2008;21:35.
- Report of the APSAC task force on attachment therapy, reactive attachment disorder, and attachment problems. Association for Treatment and Training in the Attachment of Children. http://www.attach.org/apsac.htm. Accessed June 9, 2011.
- Coercive interventions for reactive attachment disorder. American Academy of Child & Adolescent Psychiatry. http://www.aacap.org/cs/root/policy_statements/coercive_interventions_for_reactive_attachment_disorder. Accessed June 9, 2011.
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