Treatment

Children with reactive attachment disorder are believed to have the capacity to form attachments, but this ability has been hindered by their experiences.

Most children are naturally resilient. And even those who've been neglected, lived in a children's home or other institution, or had multiple caregivers can develop healthy relationships. Early intervention appears to improve outcomes.

There's no standard treatment for reactive attachment disorder, but it should involve both the child and parents or primary caregivers. Goals of treatment are to help ensure that the child:

• Has a safe and stable living situation
• Develops positive interactions and strengthens the attachment with parents and caregivers

Treatment strategies include:

• Encouraging the child's development by being nurturing, responsive and caring
• Providing consistent caregivers to encourage a stable attachment for the child
• Providing a positive, stimulating and interactive environment for the child
• Addressing the child's medical, safety and housing needs, as appropriate

Other services that may benefit the child and the family include:

• Individual and family psychological counseling
• Education of parents and caregivers about the condition
• Parenting skills classes

Controversial and coercive techniques

The American Academy of Child and Adolescent Psychiatry and the American Psychiatric Association have criticized dangerous and unproven treatment techniques for reactive attachment disorder.

These techniques include any type of physical restraint or force to break down what's believed to be the child's resistance to attachments — an unproven theory of the cause of reactive attachment disorder. There is no scientific evidence to support these controversial practices, which can be psychologically and physically damaging and have led to accidental deaths.

If you're considering any kind of unconventional treatment, talk to your child's psychiatrist or psychologist first to make sure it's evidence based and not harmful.