CLINICAL SERVICES

The 5-Week Diagnostic, Stabilization, and Family Treatment Program: (Theory and Treatment)

Theory: As children, our brains organize relative to the environment in which we grow up - either safe and secure or scary and sad. Our feelings are stored in the limbic system or midbrain. One of the most common adaptive behaviors in which humans engage is "pain avoidance". Thus, a child who spends the first few years in a maladaptive environment (physically or emotionally painful environment) organizes his/her brain in a maladaptive style of survival behavior. This organization of the brain creates a tendency to function more from a reasoning place of denial (which is a function of the right orbitofrontal cortex) rather than integrating the limbic system (affect regulation) into appropriate cause and effect thinking. In other words, when the emotions residing in the limbic system are triggered, the frontal lobe jumps to attention with a strategy to defend or deny those feelings. The two most common feelings triggered in these clients tend to be fear and sadness. Once these feelings are triggered, their defenses go into action to protect them from those feelings. Kids with this neurological adaptation are often diagnosed as having Post Traumatic Stress Disorder and thus struggle with a disregulated brain.

Clients with attachment difficulties want to be loved and accepted but don’t have the "tools" to achieve that goal in a reciprocal way. Their cognitive distortions sabotage what they want and need. This is why traditional therapy usually does not work for these clients. Traditional therapists are trying to create a trusting relationship with their client but the client is attempting to create safety by controlling their environment.

Parents that attempt to parent these kids(adoptive, foster, or relative placements) get frustrated because regular parenting techniques that they may have used with their own kids don’t work. Parents often have said that they thought loving these kids would turn them around. By the time we hear from parents, they are burnt out and angry.

Treatment: Treatment for attachment disorder has evolved for forty years with our agency and across the mental health arenas. It’s been a "rocky" road for the field but we’ve created a model of treatment that has taken in all the interventions over forty years and tweaked some and thrown out those that didn’t work. The adoptive/foster parents that we’ve worked with over the years have taught the field a great deal.

Developmentally, we know that kids need to learn how to be safe with their vulnerable feelings within a parenting environment. Attachment Disorder is created in the first three years of life when children are abused and/or neglected. The developmental tasks associated to the first three years are learning that their needs will get met and learn to trust caregivers, develop cause and effect thinking on getting the "wants" in their life met, develop a healthy level of guilt regarding poor choices. All of the developmental tasks can be successfully accomplished with safe, empathic, and firm caregivers. All of the children that we treat have been disrupted in their early emotional development. They don’t trust caregivers with meeting their needs, they will treat you well if they get want they want and get unreasonable angry if you say "no", they like to be in control, they will often treat adults outside the family in superficially charming ways, lie, steal, manipulate to get their way, often treat dads better than the mom(the nurturing enemy), and make other kids in the family angry and avoidant towards the child. "LOVE ISN’T ENOUGH TO TURN THESE KIDS AROUND".

We’ve learned over the years that the best chance we have to turn these kids around is to re-parent them through the developmental years that they missed. We’ve also learned that the families they’ve lived with for several years are burnt out, tired and angry and can’t accomplish the re-parenting process by themselves.

We’ve developed a therapeutic foster family program to help kids feel safe within firm and empathic parenting strategies. Most of our families have been through the program with their own adoptive and/or foster children and are well prepared to see through manipulative and controlling behaviors. The children are in line-of-sight at all times with their treatment parents directing and guiding them through all interactions and task completion. Children that are projected to stay longer than the five week program can attend our local school during treatment. Most of the children placed for the five week program work on their schoolwork from their home school.

All children receive a thorough psychiatric evaluation to rule in or rule out a possible mood disorder that may contribute to their agitated/angry/oppositional state. Our clinicians have many years of experience in treating these kids and their families. The therapist assigned to your family will develop a treatment plan unique to the child’s treatment goals. Out-of-state families can participate in therapy sessions via skype and phone calls during the 30 day period. At the end of the 30 day period the family spends a week with the child in family therapy and parent training. Children have the option of staying beyond the five week program if the family and the treatment team feel that it’s necessary. A follow-up treatment plan will be developed and the IACD team will be involved in follow-up phone calls to support the hometown therapist and the parents.

Please listen to the audio explanation of treatment


Treatment Program Audio
(Please listen through a 15 second pause in the audio).

Adult Intensive Treatment
An intensive assessment and treatment process which includes: daily therapy sessions with two therapists present, psychoeducational services, psychiatric evaluation, and team treatment planning to help the adult dealing with attachment issues. More information about this program.


Consultation & Community Services

Professional consultation to foster-adoptive agencies and treatment programs.

Case:  Assistance provided to professionals by our therapists and psychiatric consultant to assist in the treatment of children with attachment disorder.

Program: Assistance provided to individuals and organizations that need help with program development - models of treatment for children with attachment disorder.

Community Systems Approach
Success depends upon a responsive support system: follow-up therapy by a trained attachment therapist, trained and accessible respite care, parent support groups, understanding educational systems and supportive families. We facilitate the development of this system for the common purpose of helping the child develop into a healthy individual capable of reciprocal, responsible and productive behavior.

Research
The Institute for Attachment & Child Development is committed to facilitating and conducting research on a variety of aspects of attachment disorder.  The results of several completed studies on treatment outcome and the nature of attachment disorder are available from our office.

No duplication or altering without specific permission of the Institute for Attachment & Child Development