Parents in crisis can’t parent therapeutically – so stop expecting us to.

My teenaged son called this evening to explain that he’d cursed his teacher out and thrown his desk across the classroom. He was upset because he’d lost his school issued Chrome book because he’d taken it home (not allowed, and not his first time) and had pornography on it. I listened patiently without judgement. He explained how his elopement from school ended in an entanglement in a pricker bush and contact with a concrete culvert which scratched up his arms and legs. He was covered with bloody scratches and scrapes. I expressed empathy as I sipped my coffee. I offered encouragement when he said he was going to try to earn back the Chromebook and even said I’d talk to the school to ask for a clear plan to work towards that goal. I told him I was proud of this choice to make tomorrow a new day.

Today I was a therapeutic parent superstar and here’s why:

Had this situation happened when my son was still living at home, I would have gone nuts. I would have been throwing out consequences and yelling. My anxiety would have been through the roof. I would have been angry, embarrassed, frustrated, and overwhelmed.

Back when my son was living at home, our family was in crisis. The situation had grown toxic. It took several years of his being in treatment programs, and my being in therapy and educating myself, to begin to find a positive way forward.

Unfortunately, this is not uncommon. Adoptive and foster parents aren’t prepared for the early childhood trauma most kids coming into our families have experienced. We usually reach a crisis point before we learn about therapeutic parenting. By that time, we’ve become desperate and demoralized. Our mental and physical health is so degraded that we are barely surviving. Our kids are out of control. Our life is out of control. We can’t even manage to brush our hair in the morning much less use a calm and kind voice after our child spits in our face.

No doubt, our children need us to be that calm and steady, therapeutic parent, but at that point, we simply don’t have the capacity to do it. And given the our current relationship with our kids, it’s likely we aren’t even the best person to do it. Though few dare tell the shameful truth – we likely have come to a point where we really don’t like our kid. It’s a struggle to be nice to them. It’s difficult to not feel adversarial towards them. If we’re really being honest, some days we’re as out of control as our kids.

Unfortunately, few therapists understand this. They usually underestimate our child’s extreme behaviors and the level of crisis our family is in. They assume we have the ability to parent therapeutically and shame us if we don’t. For our families to heal and thrive, this is something that must be recognized and addressed.

The only clinician I know who is talking about this and teaching other clinicians about this is Forrest Lien of Lifespan Trauma Consulting. (If you are a parent, please follow him on social media to support his efforts on our behalf.)

Families in crisis do not have the capacity to parent therapeutically. This is why we must:

1) Get help to families before they are in crisis (this means pre-adoption training and post-adoption support),

2) Support parents and families in a holistic way. Help us get to a place where we can parent therapeutically.

3) Surround families who are in crisis with supports. Stop shaming us for being broken and demoralized. Give us a hand up.

Parents must be healthy and educated to parent therapeutically.


A note about therapeutic parenting:

There are no perfect treatments for developmental trauma. My son hasn’t been able to access the highly specialized treatment he needs. My response to his phone call today doesn’t solve the problem – I realize that. However, consequences, though perhaps “deserved” won’t work, and will only further escalate my son. What I must do is choose the response that is most likely to move the ball forward. My goal is for him to remain in school and to not get kicked out of the group home. My goal is to de-escalate the situation. I highly recommend A to Z Therapeutic Parenting for practical information on therapeutic parenting.

Weekly Roundup, Sunday Sep 15, 2019

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Recommended books of the week

Videos

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Weekly Roundup, Sunday Sep 8, 2019

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Manifestation Determination from @parentcenterhub
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Best shareables

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Here’s a great video with information on early childhood trauma

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Weekly Roundup, Sunday Aug 25, 2019

Helpful for back to school…

Trauma handout for teachers

2/3 of kids with RAD are first misdiagnosed with ADHD
Kids with developmental trauma may have attention deficits and other symptoms of ADHD: inattentiveness, hyperactivity, impulsivity. However, the ADHD diagnosis doesn’t correctly point to the cause of those symptoms – the trauma. 

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What it’s like to be the sibling of a child with RAD
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Staying Calm During a Tantrum from @Foster2Forever
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How to Explain Adoption Dissolution to Adopted Kids from @creatingafamily
How do we explain an adoption dissolution to adopted kids without making them feel like they do could be given away? If you ever face this challenge here’s some helpful advice.

The Special Needs of Adopted Children
Whether you are religious or not, this list from Sherrie Eldridge is a powerful tool. She’s included Bible verses for those who would like them.

The Dismantling of a Non-Profit – A Bird’s Eye View of Traumatized Adoptive Family Systems from @followmarykalbach
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4 Questions to Ask When Early Childhood Trauma Causes Behavior Issues via @Foster2Forever
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Recommended books of the week…

In the news…

What Happens When The Adopted Kids Of Anti-Gay Parents Come Out? via @BuzzFeed
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Adopted son, 22, of ex-NFL lineman Barry Bennett is charged with shooting dead his parents via @dailymail
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Best shareables…

The Special Needs of Adopted Children

Whether you are religious or not, this list from Sherrie Eldridge is a powerful tool. She’s included Bible verses for those who would like them.

EMOTIONAL NEEDS

  • I need help in recognizing my adoption loss and grieving it. (Ecclesiastes 1:18)
  • I need to be assured that my birth parents’ decision not to parent me had nothing to do with anything defective in me. (Proverbs 34:5)
  • I need help in learning to deal with my fears of rejection–to learn that absence doesn’t mean abandonment, nor a closed door that I have done something wrong. (Genesis 50:20)
  • I need permission to express all my adoption feelings and fantasies. (Psalm 62.8)

EDUCATIONAL NEEDS

  • I need to be taught that adoption is both wonderful and painful, presenting lifelong challenges for everyone involved. (Ezekiel 17:10a, Romans 11:24)
  • I need to know my adoption story first, then my birth story and birth family. (Isaiah 43:26)
  • I need to be taught healthy ways for getting my special needs met. (Philippians 4:12)
  • I need to be prepared for hurtful things others may say about adoption and about me as an adoptee. (John 1:11)

VALIDATION NEEDS

  • I need validation of my dual-heritage (biological and adoptive). (Psalm 139:16b)
  • I need to be assured often that I am welcome and worthy. (Isaiah 43:4, Zephaniah 3:17)
  • I need to be reminded often by my adoptive parents that they delight in my biological differences and appreciate my birth family’s unique contribution to our family through me. (Proverbs 23:10)

PARENTAL NEEDS

  • I need parents who are skillful at meeting their own emotional needs so that I can grow up with healthy role models and be free to focus on my development, rather than taking care of them. (II Corinthians 12:15)
  • I need parents who are willing to put aside preconceived notions about adoption and be educated about the realities of adoption and the special needs adoptive families face. (Proverbs 23:12, Proverbs 3: 13-14, Proverbs 3:5-6)
  • I need my adoptive and birth parents to have a non-competitive attitude. Without this, I will struggle with loyalty issues. (Psalm 127:3)

RELATIONAL NEEDS

  • I need friendships with other adoptees. (Ecclesiastes 4:12)
  • I need to taught that there is a time to consider searching for my birth family, and a time to give up searching. (Ecclesiastes 3:4)
  • I need to be reminded that if I am rejected by my birth family, the rejection is symptomatic of their dysfunction, not mine. (John 1:11)

SPIRITUAL NEEDS

  • I need to be taught that my life narrative began before I was born and that my life is not a mistake. (Jeremiah 1:5a, Ephesians 1:11)
  • I need to be taught in this broken, hurting world, loving families are formed through adoption as well as birth. (Psalm 68:6)
  • I need to be taught that I have intrinsic, immutable value as a human being.
  • I need to be taught that any two people can make love but only God can create life. He created my life and I’m not a mistake.  (John 1:3)

This list is reprinted with permission from: Copyright, 1999, Sherrie Eldridge, Random House Publishers-TWENTY THINGS ADOPTED KIDS WISH THEIR ADOPTIVE PARENTS KNEW.

Weekly Roundup, Sunday Aug 18, 2019

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How the “System” Nearly Turned My Son into a Sociopath from adoptingfaithafathersunconditionallove.org
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We have to get serious about child-on-adoptive-parent violence from @CommunityCarePage
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College $$$ for foster care alumni from @RaisingDevon
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Team Sports May Help Children Deal With Trauma from @NewYorkTimes
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10 Reasons for Adoptive Parents to Be in Child’s Therapy Session from @creatingafamily
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In the news…

The connection between trauma and addiction from @carrierclinic
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Study finds psychiatric diagnosis to be ‘scientifically meaningless’ from @neurosciencenews
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Labor Dept rules IEP meetings a valid reason for family and medical leave from @EducationDive
The U.S. Department of Labor (DOL) has issued an opinion letter stating parents and guardians are allowed to use the Family and Medical Leave Act (FMLA) intermittently to attend Individual Education Program (IEP) meetings with teachers, school administrators and others involved in planning education services for children with special needs.

In a split-second, a CMPD officer shot my husband and saved my life my oped from @WBTVNews3
By vilifying officers who act in good faith we are promoting a defensive police culture that could easily cost someone their lives. It very well could have cost me mine.

Parents sue Centennial adoption agency claiming they weren’t informed of Chinese son’s sexual-abuse issues from @denverpost
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Best shareables…

Journey to the Son: One mother’s heart wrenching journey

Guest post by Carla A. Carlisle

On March 22, 2010, my life was forever changed when I became a first-time foster parent to a beautiful 10 day old, two-month premature baby boy. I knew that becoming a foster parent would mean major lifestyle changes, I didn’t know that my connection to this child would change me at the essence of my being. I was told that 99% of children taken at birth don’t go back to their birth parents, but this one fell in the 1%. At six-months-old, this dear sweet baby boy was returned to his birth mother. In the six months I interacted with his birth parents, I learned about what I can now call “generational trauma”.

Learn more here.

Years of work experience, degrees on the wall, and a tremendous support system meant nothing in the face of the next eight years. I almost immediately gave up my foster license since I couldn’t stay connected to the birth family that this precious son of my heart and be licensed by the county.  I tossed that license out like trash on Sunday because it paled in comparison to the life I knew was in the balance.

For the next six years, the birth parents and I had a tumultuous relationship. I felt, and continue to feel, such compassion for them both – as they grew up in survival mode without the foundation of love, life skills, and the village many of us take for granted.  I learned of horrific experiences the birth mother experienced. and at some point, I wondered how she could be expected to care for this child – or the other 10 she lost to the system long ago. 

At age 5, the child of my heart spoke of dying by suicide. I shouldn’t have been surprised because he heard it from his birth mom daily, but it broke my heart in a million tiny pieces. After an overnight observation, it was brushed off as bullying at school. This told me that the observation psychiatrist did not read a word of his file, did not look at birth parents’ mental health records, or even read what I shared despite my life being in danger at the hands of the parents.  At age 6, this big brown eyed angel attempted to die by suicide twice. The system told me he didn’t mean it.  They said his mom’s voice recorded death threat wasn’t made against him, it was made against me, so it didn’t matter. The son of my heart was now in patient at a behavioral health facility.  

Although I had talked to attorneys and child advocacy groups over the years, I was told there was no path to custody because there was no blood shared between us (and that meant there was no way to get him help).  But wait, I remembered my estate planning attorney shared the names of three family law attorneys and the next three days changed everything: 

Day 1 : I called all three family law attorneys and the last one was the charm. Talking to the paralegal let me know I was with the right person.  The same day, birth father terminated the service provider who was trying to provide therapeutic services. 

Day 2: I met with the attorney, he collected my evidence and made me aware of “in locos parentis” – in place of the birth parents – or simply I had been acting like his birth mother most of his life. The same day I received a call that the birth father withdrew him from school.

Day 3: We went to court and got domestic violence restraining orders on behalf of my son and me as well as emergency custody.  I took the protection orders to behavioral health immediately. Shortly thereafter, the birth father went to behavioral health to check this sweet, yet confused child out of behavioral health.  Due to the restraining order, he was not allowed on the floor.

My sweet, innocent child had experienced more trauma than anyone had imagined.  He had seen his birth mom try to kill his birth dad multiple times.  I was ashamed for a while, but he also saw his mom strike me in the face. This became a major traumatic event for him (and me). He saw drugs, domestic violence, porn and so much more.  He lived in two worlds: with me and then in a chaotic world with no boundaries – there was a mother, a father,  and a boyfriend in the house.  The husband was in prison.  My son was threatened, he was put in the position of an adult with adults who were emotionally frozen in their childhood, lacked maturity, understanding, and empathy.  But I can’t blame them; this was all they knew.  

Watch Carla read a chapter from her story below and check out her book here.

Since October 2016, we’ve been on the path to healing.  What worked best? Trauma Focused – Cognitive Behavioral Therapy (TF-CBT).  He learned at a 6/7-year-old level, he trusted, and he able to share his trauma stories with me.  We had sessions together, we processed together, and we grew together. On the other hand, I had service providers who charged for services they didn’t do (yes I reported it), and underpaid/overworked Qualified Professionals who were there for a check.  Yet, I did meet people along the way who cared, who went above and beyond like that very special teacher we all run across at least once in our lifetime.  Intensive In-Home therapy was helpful once we got to the third service provider.  We had a plan that worked for my son.  

After two years in court, tons of money, and oh so much stress and fear, the adoption is final and my son is doing well.  Despite the diagnoses of PTSD, ADHD, DMDD, major depression and anxiety, I have a resilient child who is playing tackle football, thriving from music therapy, increasing his gross motor skills through day to day activities and occupational therapy.

I’ve been diagnosed with situational depression and anxiety.  I have to force myself to focus on self-care, but I do.  I have to focus on hope; although I have moments in which I’m discouraged. I pray.  I believe in prayer with works.  I have to work to make things better. I do vent, but I keep working.  Helping one child, one parent, one situation matters. 

We’ve added two older sons to our family, which has given him the big brothers he really wanted.  I can’t say I’m going to give him the dad, he may just be stuck with a family of four and two dogs for now. 

I share my journey to motherhood; the love, isolation, failure, disappointment, drama and trauma as well as the triumphs, small steps forward and love of my son in my memoir, Journey to the Son. If nothing else, I hope our story says you are not alone. Our struggles may be different, but it is exhausting, nonetheless. Take good care of yourself. 


Carla A. Carlisle is the author of Journey to the Son, an emotionally riveting memoir about a woman’s eight-year battle with the system for the child of her heart, who suffers from prolonged trauma caused by his birth mother, a victim herself of perpetual physical, emotional, and mental abuse. Carla is a child and mental health advocate who is leading a movement to educate community and faith-based leaders, public officials, and child and family services providers about trauma and its impact on abused children to provide safe and healthy environments to keep them alive, safe, stable, and resilient. For more information, visit https://carlaacarlisle.com or find Carla on social media at @CarlaACarlisle.

Immigration isn’t the only “system” that’s harmful to children

In recent months, the stories of migrant children separated from their parents at the border have tugged at our hearts. The news media is rightly exposing how early childhood trauma – such as separation from a mother – can cause lifelong, negative impact.

The issue of childhood trauma may only recently have become front page news with the crisis at the border, but it’s all too familiar for adoptive and foster families. Reactive attachment disorder (RAD), rare among the general population, is most prevalent among adopted and foster children. Due to early childhood trauma, they are often unable to form meaningful attachments to caregivers and may exhibit extremely challenging behaviors.

Instead of enjoying playful childhoods, these children struggle to cope with everyday life. As a result, some are unable to earn a high school diploma and too often get tangled up in the criminal justice system. Disorders like RAD, that are caused by early childhood trauma, are literally stealing away our children’s future.

In advocating for children we must cast a wide net

Regardless of our politics, we can advocate together on behalf of innocent children. Let’s consider that immigration isn’t the only “system” that’s harmful to children. The foster care, adoption, and criminal justice systems are also dysfunctional with misguided policies that traumatize and retraumatize our children. The impact of this trauma is staggering, life-altering, and devastating.

Here are just a few of the ways it happens:

  • Some vulnerable kids are overlooked by “the system” and left in abusive and neglectful situations.
  • Some kids are unable to be placed in a permanent family because “the system” makes repeated, misguided attempts at reunification.
  • Some kids are unnecessarily removed from their caregivers and processed into “the system.”

Sadly, “the system,” intended to protect our vulnerable children is broken.  

These children, with trauma scars indelibly etched on their psyche, need specialized treatment to heal and thrive. Few get it. The mental health community is woefully unprepared to recognize and treat RAD. Where treatments are available, most families cannot afford them. As a result these damaged children grow into unstable and unhappy adults.

We can do better

Let’s join together for all children – migrant children, foster kids, and adopted children – who are so often collateral damage of policies not focused on their best interest and well-being. There is power in our collective outcry. It’s time to leverage our collective outrage and advocate for reform of “the system” and for meaningful treatments and resources to treat trauma-caused disorders like RAD.

Image: A boy and father from Honduras are taken into custody by U.S. Border Patrol agents near the U.S.-Mexico Border on June 12, 2018, near Mission, Texas. via @Huffington Post

Why adoption stories aren’t fairy tales

Adoption finalization is a reason to celebrate. Parents have filled out mountains of paperwork, waited months or years and shed many tears to get to that moment. They wear matching tee-shirts, eat way too much cake and splash photos all over social media. Adoption day is so momentous that it feels like a “happily ever after” in itself. After friends and family return home and the frosting is wiped clean, some adoptive families are left with a much different “ever after” than anticipated. They can struggle immensely feel completely alone. 

While a friend, family member or professional can support an adoptive family in multiple ways, one simple task is most important—to understand that adoption stories aren’t fairy tales. And the path to happily ever after can be extremely difficult to find for kids with developmental trauma. Once a person understands this reality, they can offer more effective support to an adoptive family over time.

Unfortunately, the judge’s pen isn’t a magic wand for kids who come from hard places. “While many people think that love or ‘good parenting’ will make up for the early trauma a child experienced, it’s just not that simple,” said Executive Director Forrest Lien. “Families of kids with developmental trauma need extensive support and specialized services.” 

Without early and effective intervention, many adopted children from hard places continue to struggle academically and socially[i]—even in stable, loving families. They’re at increased risk for substance abuse and criminal conduct and at higher risk for mental health issues.[ii]

When adopted kids struggle, it’s easy for those around them—family, friends, community—to point the finger at adoptive parents. They’re quick to blame the adoptive parents for not getting help for their child. Or they criticize the child for willfully squandering the opportunities given to them.  

“While many people think that love or ‘good parenting’ will make up for the early trauma a child experienced, it’s just not that simple,” said Executive Director Forrest Lien. “Families of kids with developmental trauma need extensive support and specialized services.”

But an adoptive parent cannot serve as a hero or the villain in combating the effects of a child’s early trauma. And the child cannot simply “get over” developmental trauma. 

Adoption is better likened to the nostalgic “make your own adventure books” where readers make choices that lead to different endings. But depending on their geographical location, proximity to specialized therapists, level of trauma their child experienced early on, financial situation, insurance provider, etc., adoptive parents don’t have many viable good options from which to choose. 

Make Your Own Adoption Adventure: Story of Bobbi

To begin to understand the reality for many adoptive families, take a walk through their unfortunate “adventures”—

Chapter 1

Bobbi, age 7, squirrels food away under her pillow and gets into fights at school. Her parents notice these behaviors aren’t getting better. Bobbi needs to see a therapist who has experience working with adopted kids with developmental trauma. This would put her on the path to happily ever after. However, this is unlikely to be a choice available to Bobbi and her family. Here’s why:

 No matter the path chosen, most parents unwittingly go it alone.  They often hope traditional parenting methods will eventually work. Or they find a therapist who lacks specialized training in developmental trauma. Either way, matters get worse with time.

Chapter 2

By the time Bobbi is a teenager, her behavior is increasingly risky. She’s experimenting with drugs, partying and sexting. At this point, Bobbi needs to go to a specialized in-patient treatment program for her safety and the safety of others. This would put her on the path to happily ever after. However, this is unlikely to be a choice available to her and her family. Here’s why: 

  • Most residential programs mix together kids with a variety of conditions instead of offering specialized treatment for developmental trauma.
  • Many families cannot afford the out-of-pocket costs left over after the limited insurance coverage provided. 

Chapter 3

Unfortunately, many children like Bobbi grow up in institutions where they do not get better. Others get tangled up with the juvenile justice system. By then, choices are even more limited as early intervention is key for optimal healing.  

Why the good options are limited

Developmental trauma can have far reaching and severe impacts. Kids may suffer from attention deficits, developmental delays, behavioral problems and more. Because developmental trauma is a disorder stemming from brain impact during critical developmental stages, there are no shortcuts to happily-ever-after—no quick fixes or easy solutions. Even well-informed adoptive parents and early intervention by qualified clinicians is not always enough. However, proper and early interventions definitely offers hope.

Here’s how that can happen:

  1.  Adoptive parents must be given comprehensive training on developmental trauma and therapeutic parenting. They need support to parent their child and to recognize when they need professional help. 
  2. Adopted children must have access to effective, specialized mental health services. This treatment needs to be accessible and affordable.

It’s both shockingly simple and profoundly tragic. Parent training and specialized mental health services are just common sense. Yet, far too many adoptive families are headed down a rocky and difficult path due to lack of these two basics. 

Although the path toward “happilly-ever-after” isn’t as simple as one would hope, friends, family and professionals can at least try to understand the journey. And they can advocate and educate on behalf of these families. 

The Institute for Attachment and Child Development and I invite you to choose your own adventure in creative ways to support and advocate on behalf of the adoptive families. It’s time for communities to join together to make sure our vulnerable children have every possible resource to reach their happily ever after. Because when you support adoptive families, you support children from hard places and the generations that follow.

Originally published by the Institute for Attachment and Child Development here.

[i]https://ifstudies.org/blog/the-paradox-of-adoption/
[ii]https://www.childwelfare.gov/topics/can/impact/long-term-consequences-of-child-abuse-and-neglect/crime/

RAD and Developmental Trauma in Fiction

These popular novels are twisty, psychological thrillers with surprise endings. They each feature a child with developmental trauma and/or RAD. Some details are true-to-life while others are just fiction…

Andy, a district attorney, believes his son Jacob, diagnosed with RAD, is innocent of the murder he’s been accused of. Andy puts all his efforts into Jacob’s defense despite mounting evidence against him. But is Andy really innocent?

Psychologist, Imogen, refuses to believe her new patient 11-year-old foster child Ellie, is dangerous. She’s determined to protect Ellie from the distrustful and cruel adults and children around her. But is she the one who needs protecting?

Hanna is a difficult, non-verbal child whose mother is chronically ill. She’s adored by her dad, but mistrusted by her mother, Suzette. After Hanna breaks her silence with whispers threats, bad things begin to happen. Is Hanna really dangerous?


What’s just fiction…and what’s not.

*** WARNING! SPOILERS BELOW ***


When 14-year-old Jacob is accused of murdering a classmate it seems impossible – especially to his father, Andy, who is the local district attorney. Jacob is evaluated by a psychiatrist who diagnoses him with Reactive Attachment Disorder (RAD). The psychiatrist tells the family it is “unusual” for a kid to develop RAD without experiencing any abuse, neglect, or trauma. As the investigation gets underway, Jacob’s mother Laurie begins to question his innocence.
Jacob is ultimately exonerated of the murder. A few months later, however, his girlfriend mysteriously disappears. Andy again defends Jacob vigorously and will not consider the possibly he’s capable of these crimes. However, the truth dawns on Laurie as incriminating evidence mounts. Laurie is deeply conflicted by fear, guilt, shame, love, and desperation. To atone for herself, and to save Jacob from himself, Laurie purposely crashes her minivan into a concrete barrier, killing Jacob instantly.

What’s just fiction – It’s impossible to have with RAD without an underlying trauma per the DSM-IV diagnostic criteria. The author could have incorporated one of the causes of RAD in a “typical” biological families into his plot. Also, it’s unlikely for a child with RAD to be homicidal, as Jacob is, unless he has other serious co-morbid mental illnesses.

And what’s not – The story effectively portrays the common RAD symptoms of extreme manipulation and how father’s often do not “get it.” Also, the conflicted feelings of the mother are realistic and true-to-life. While her ultimate actions are unthinkable – real-life mothers of children with RAD may understand her desperation.

Read Defending Jacob


Ellie, an 11-year-old foster child, the only survivor of a house fire that took her entire family. She’s a child with a trauma background, but is now in a nice foster home. Unfortunately, she’s facing bullying from peers and dislike from teachers. Idealistic child therapist Imogen immediately lays blame on those around Ellie and is certain they are projecting their distain onto her. Wanting to shield Ellie from the unfair treatment of others, Imogen oversteps boundaries in the therapeutic relationship.

All too coincidental “accidents” happen around Ellie. For example, her foster brother teases her at dinner then wakes up and his mouth is super glued shut. Imogen is the only one who believes Ellie is the victim, not the perpetrator. In an unexpected twist, it turns out Ellie’s foster sister, resentful of foster children coming in and out of the home, is to blame for many of the problems. However, in the final scene we find Ellie flicking a lighter and contemplating her future. We realize she murdered her family and was complicit in what happened in the foster home.

What’s just fiction – While these situations can be difficult for siblings, the foster sister’s actions seem highly unusual and unlikely. Also, the book portrays many of Ellie’s responses as involuntary which is not always the case for children with developmental trauma. They can be angry and act out quite willfully.

And what’s not – While Ellie’s behaviors may seem over-the-top, unfortunately, they are all to familiar to parents of kids with RAD. The story also effectively captures how a therapist can be manipulated and mislead in these situations complex situations.

Read The Foster Child


Hanna is a difficult, non-verbal, 7-year-old. Her mother, Suzette, has a debilitating medical condition that has left her distant. While Hanna is not formally diagnosed with RAD, the hallmarks are there and likely a result of having an unavailable primary caregiver. Hanna is highly intelligent, but has angry outbursts and is kicked out of kindergarten. Suzette must homeschool Hanna who grows increasingly defiant, rebellious and resentful towards her. Meanwhile, Hanna is charming and loving with her father, Alex. He sees only an obedient, clever child. Hanna’s first words are whispered threats towards Suzette. And as Hanna begins to target her mother with physical violence, Suzette grows increasingly fearful.

It’s only after the situation has grown frighteningly dangerous that Alex happens to witness Hanna’s violent behavior for himself and understands there is a problem. Husband and wife work together to send Hanna to a residential treatment facility and they quickly accept the reality that she will live there indefinitely. In a sinister final twist, Hanna realizes what she must do. She must follow the rules at the facility so she can go home, get rid of her mom, and have her father all to herself.

What’s just fiction – The ease at which the family finds residential treatment for Hanna, and how quickly they accept her need for long-term care does not mirror the reality of most real-life families in this situation.

And what’s not – Most children with RAD target their mother, as Hanna does. They also hide their behavior well from their father and this can cause serious marital discord. While Hanna’s behaviors seem too extreme to be believable, parents of kids with RAD know they are in fact not that far fetched.

Read Baby Teeth


Resources shared at the 2019 REFRESH conference!