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child you bring home. The first few days of a child’s life in your family is not a good time to start evaluating his ability to attach. He will be adjusting to having parents—possibly for the first time in his life—as well as to the sights, sounds, and smells of his new home. Your job as an adoptive parent is, at this moment, to create the stable, safe, loving and predictable environment your child needs in order to begin to feel comfortable.


What if things are not, after a matter of weeks, moving toward a positive relationship between you and your child? You will want to begin looking for a therapist who can help you. Look for a trained, licensed mental health professional with expertise in both child development and differential diagnosis. Dr. Miriam Steele says, “RAD in its ‘pure form’ is relatively rare, and it occurs most often in children who spent their early months or years in institutional settings characterized by severe deprivation. Your child may exhibit behaviors that are indicative of attachment difficulties in milder forms, but which still require careful attention and support to help get you back on track to a more satisfying way of relating for you and your child.”


A good assessment and diagnosis requires an understanding of your child’s long-term behavior in multiple settings. The therapist will want to know how your child is doing at home and at school. Ideally, an evaluation should not be done while your child is under stress because stress can cloud a diagnosis. This could


be reason enough to hold off for a while. (If your child is in significant distress, though, you will need to engage a professional sooner.) In the meantime, you can consider seeing a therapist yourself to get the guidance and support you need.


Sometimes it also makes sense to get a specialized assessment by a second professional who is an expert on a disorder your first mental health professional suspects your child has, i.e., someone who specializes in ADHD or PTSD. This may sound like a lot of work, but it is worth it to get the right diagnosis for your child, so that valuable time is not wasted treating a condition he doesn’t have.


What type of therapy is your child likely to need? The authors of the American Professional Society on the Abuse of Children’s 2006 Task Force Report* tell us that therapy based on traditional attachment theory should be the first-line of treatment. The focus should be on giving the child a stable environment and increasing the positive quality of the parent-child relationship and interactions. Focused, goal-directed, behavioral approaches should be taken, and parents should be involved in the process.


You need to be especially vigilant to stay away from controversial therapies that, confusingly, refer to themselves as “attachment therapy.” In fact, they have little to do with attachment theory or attachment research and can be very harmful. (Children have died from some of the treatments they employ.) These


THE RESOURCES LISTED IN THIS DIRECTORY ARE UNSCREENED AND SHOULD NOT BE VIEWED AS RECOMMENDATIONS OR ENDORSEMENTS, EITHER EXPRESS OR IMPLIED, BY THE AFA. 81


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