How would you feel if a therapist, who claimed to be trained in working with adopted or foster children with mental and behavioral health problems (a topic discussed last week) came into your home and encouraged you to engage your 10-year old child in a “therapeutic session” that would include you holding your child down to re-create the “childbirth experience?” How would you feel if a trauma therapist forced you to discuss a very bad experience that was traumatizing to you? Would you go along, even though it might sound ridiculous or cause you distress? Would you be afraid and totally shut down? Most parents would be enraged and most of you reading this are probably shaking your head and questioning where I am going with this. Therapy can be one of the most rewarding experiences for individuals who have struggled with trauma and attachment. But there are many types of therapies that can also be detrimental to a child, primarily an adopted or foster child. In fact, a “therapy” known as Attachment therapy (also known as holding therapy or rage reduction therapy) has always been a controversial “alternative therapy” that is used with adopted or foster children who have poor attachment with a parental figure. Similarly, a treatment technique known as a “trauma narrative” or “timeline” can also be detrimental to some kids if not completed appropriately and at the right time. Although CBT is a scientifically proven technique (that I really like) it can still be challenging (and even unhealthy) for some kids. This article will explore some common issues with different types of therapy and provide a video of Neil Feinberg, a proponent of attachment therapy, performing a “rage reduction session” with a client. We will also explore 5 types of therapy to reasearch and think twice about for adopted and foster children.
Last week we discussed the 12 things adopted and foster children wish their parents knew about their mental health challenges and being returned to foster care. But this week we will focus on the trauma that adopted and foster children sometimes experience after being placed in the wrong kind of therapy. If you are somebody who has been adopted or placed in foster care or if you have adopted a child or someone from foster care, what kind of therapy would you seek? Would you know what kind of therapist to look for ? Unfortunately a lot of people struggle with trying to determine who is the most appropriate therapist and what is the most appropriate therapeutic approach for their challenges. This is also not an easy thing for individuals who have been adopted or fostered. The issues that both adopted and foster children experience are “special issues” and require a specific approach. As a result, many families should know who to specifically work with and who to completely avoid.
If you do a simple online Google search for “attachment therapy” the results that often come up are negative. In fact, a definition provided by www.childrenintherapy.org/essays/ defines attachment therapy as:
“a growing, underground movement for the treatment of children who pose disciplinary problems to their parents or caregivers. AT practitioners allege that the root cause of the children’s misbehavior is a failure to ‘attach’ to their caregivers.”
As a child and adolescent therapist who has worked with thousands (if not more) kids and teens who have been diagnosed with multiple mental health and behavioral challenges including attachment trauma, I cannot help but be appalled and disappointed by the visibility and popularity that certainly types of “treatment” has continued to receive over the years. The population who is primarily open to treatments such as attachment therapy is often desperate and needy adoptive and foster families. Sadly, many of the adoptive and foster parents who “buy into” unproven therapeutic techniques often over-identify with a therapist (i.e., finally finding someone who claims to know what they are going through and who appears to be a good support system) or is burned out and looking for a “cure.” This makes it even more difficult for adoptive and foster families to reject questionable treatments such as attachment therapy and to continue searching for the right fit.
I have always been a big proponent of psycho-education for parents, families, and caregivers. I believe that clients and their families are best armed with “ammunition” when they are informed, educated, and aware of every piece of information available to them (the good and the bad). My duty has always been to educate my clients and their families to the pros and cons of anything we are discussing (psychotherapy, medication, mental health facilities, mental health disorders, diagnoses, etc.). Without knowledge, we are wide open to be taken advantage of and manipulated. This is exactly what happens to many adopted and foster families. Sadly, our child welfare system is broken in addition to our mental health system. Both of these systems are responsible for educating families but often fails to do it. In some situations, adopted and foster children, who are often very traumatized and struggle with mental and behavioral health problems, are continually re-traumatized while going through the system. As stated in my previous article on this topic, children who are re-homed or placed back into the foster care system are also re-traumatized. It’s a vicious cycle.
It’s important that you become aware of the various types of therapy available to adopted or foster children who struggle with mental or behavioral health challenges. These kids are a vulnerable group of kids and they deserve an adult who can not only love them until the end, but dedicate themselves to understanding what treatments are appropriate and healthy to engage in. You always want to keep in mind that if you choose the wrong kind of therapy at the wrong time, it can most likely lead to further trauma. I encourage you to consider 5 treatments that you should re-think before accepting and engaging in with your adopted and foster children:
1. Medication management: It’s a fact that some kids simply don’t need medication. We are a “medication oriented world” and almost every kid who seeks therapy is placed on medication at some point. You want a doctor who can look at the entire picture in a holistic way and offer suggestions that do not always include medication management. It is important to note that medication is often very useful for some adopted or foster children who are struggling with symptoms of post-traumatic stress disorder (flashbacks, night terrors, hypervigilance, etc), enuresis (difficulty holding urine), encopresis (difficulty holding their bowls), and a host of other physical, mental, and medical health problems. Medication can help some children control their impulsivity, inattention, anxiety, stress, or aggressive behaviors. However, one of the most important things you want to be aware of is what kind of medication a doctor may want to try with your adopted or foster child. Some kids show very complex systems and medication can only further complicated the issue at times. For example, some kids exhibit symptoms that are very similar to ADHD but are more closely related to trauma symptoms. A child who cries all of the time and feels depressed because of a traumatic rape, can most certainly look like a kid with severe depression. When speaking with a doctor, always obtain a clear rationale for the use of a medication. This is very significant for adopted and foster children who have most likely taken multiple medications over time.
2. Attachment Therapy: Attachment therapy, as stated above, can be referred to as “holding therapy.” It is widely referred to as an “abusive therapy” that should not be legal in the U.S. In fact, a young lady, Candace Newmaker died during a “rebirthing” session. Attachment therapy is primarily introduced to adoptive and foster children when a child is diagnosed with Reactive Attachment Disorder (RAD). Attachment therapy is sometimes promoted and used by therapists who believe in its power to “transform lives” and help create a lasting bond among adoptive and foster families. However, Attachment Therapy has been re-named multiple times and re-defined. I encourage you to do your research before accepting this treatment.
For an example of a form of Attachment Therapy known as “holding therapy”, view the clip below:
3. Trauma Therapy Techniques: I am a trauma therapist myself. I highly rate the Trauma-Focused CBT approach and believe that it is a very useful treatment for children who have trauma histories. However, as in everything in life, there are some downsides to this treatment modality that everyone should be aware of. For example, creating the trauma narrative (a session in which the child is to create a “time-line” of traumatic events that happened to him/her and discuss, in detail, each event) can be a big step for a kid that can lead trigger them to act out, have suicidal thoughts, or to self-injure. Another component of Trauma Therapy that we should be aware of is the parent-child sessions that occur. If a parent is disengaged, immature, rejecting, and uncaring, engaging the parent in parent-child conjoint sessions where the parent will need to be supportive of the child, is probably not a good idea. It is important to truly research your therapist or the agency where you will meet with your trauma therapist. There are many trauma therapists who claim to be certified, trained, and experienced. You certainly would want to prove this and observe the therapists interactions with your adopted/foster child.
4. CAM Therapy: Complimentary and Alternative Therapy is another word for “alternative therapy.” Alternative therapy is typically not scientifically proven to be effective or has been studied by few researchers. Some alternative therapies are useful such as using Green tea for certain physical ailments, pursuing holistic practice for mental and physical health, etc. But it is important that you are educated to the alternative mental health treatment that may be available to your adopted or foster child. Again, attachment therapy is considered an alternative therapy. You want to do as much research as you possibly can before trying a specific alternative treatment.
5. RAD therapist: A “RAD therapist” is basically an attachment therapist who believes that RAD is a disorder that must be treated in a “special way.” Most RAD therapists do not use CBT or DBT but their own philosophy which includes attachment therapy. You are likely to hear mixed reviews on RAD therapists because many believe in the above attachment therapy which has a very negative background. Proponents of RAD therapists are adamant about their “techniques” working and providing “hope” for adoptive and foster families. You certainly want to do your research, open your mind to both sides of the story, and truly consider whether a therapist is doing more harm than good.
It is important that I also mention that there are some very admirable, loving, open-minded, and even God-Fearing adoptive and foster families who adopt or foster children out of the goodness of their heart. They are people who act with integrity, grace, and love. This article, including last week’s article, is not about these adoptive and foster families. These articles were written to highlight some of the challenges faced by adopted and foster children who struggle with mental and behavioral health problems, trauma, and attachment. The only way to truly help these children is by knowing how to help. Knowing how to help involves knowing what the challenges are.
For some ideas on how to cope with a traumatized child, you might find this video by Dr Bruce Perry, Daniel Siegel, and other trauma-based experts very helpful:
As always, I wish you well