Tag: Adoption

Most Popular, Resources

What teachers of children experiencing the effects of early trauma need to know

If you are a classroom teacher you almost certainly have students who have experienced childhood trauma. A recent national survey on children’s health found that 47% of all children in the United States have had at least one adverse childhood experience (footnote below). For some, the unfortunate result is reactive attachment disorder (RAD), a serious disorder caused by trauma during a child’s early development.

What is Reactive Attachment Disorder?

Though reactive attachment disorder (RAD) is rare in the general population, it is more common in adopted and foster children. When a young child is neglected or abused they may fail to form a meaningful attachment to a primary caregiver. Their brain development is stymied and the flight or fight neural pathways are strengthened. As a result, even minor stressors can send them into flight-or-fight mode.

“Adults must work as a team for kids who’ve experienced early trauma. These kiddos desperately manage their surroundings to feel safe,” said Institute for Attachment and Child Development Executive Director Forrest Lien. “Though when they divide adults working to help them, as they often do, they actually feel less safe. It confirms their belief that they cannot depend on adults to care for them.”

Children with RAD often lack cause-and-effect thinking, have control and anger issues, are unable to attach to caregivers, are emotionally and physically immature and sometimes have an underdeveloped conscience. Due to their innate survival needs, they are desperate to control the people and situations around them, are resistant to treatment and tend to self-sabotage, making the disorder particularly difficult to treat.

In the school setting, children with RAD struggle to maintain friendships, are often bullied, and may become bullies themselves. Due to their disruptive and dysregulated behavior they are commonly labeled “problem kids” and struggle academically. Unfortunately, these children can find it difficult to succeed in school and too often end up involved in the juvenile justice system.

What you might see in the classroom

Students with RAD, often in survival mode, are focused on controlling their classrooms and teachers rather than learning. They may have “meltdowns” or angry outbursts, but are equally adept gaining control in more subtle ways. For example, the student may constantly interrupt their teacher. They may complete their work but choose not to turn it in, wander around the classroom when they should be seated or ask for excessive bathroom breaks.

Other ways RAD may manifest in the classroom include:

  • Developmental delays and learning disabilities – Depending on when the child experienced early childhood trauma, various areas of the brain are likely underdeveloped. Often these are lower level brain functions, and like a domino effect, higher brain functions do not develop normally either.
  • Superficial charm – Many children with RAD are polite, helpful, considerate and loving in the classroom – while wreaking havoc in their homes. This dichotomy can be so pronounced that teachers doubt parents’ reports of the student’s behavior or wonder why teachers from earlier grades thought the student was so difficult. Generally this good behavior lasts only for a short time and it often termed the “honeymoon period” by specialists of early trauma.
  • Lack of forethought and insight – In response to innate insecurity, these students use maladaptive coping strategies to gain an immediate sense of comfort without regard for the consequences. These behaviors can include stealing, violent outbursts, physical aggression and an overall lack of boundaries.
  • Manipulation and lying – These students may lie to get out of trouble, to get their own way or for no reason at all. Outwitting an adult is a way for them to gain control and feel safe. In addition, they may use manipulation and lying to triangulate adults.

Strategies that don’t work and why

Traditional classroom management techniques and strategies are ineffective and often counterproductive when working with students with RAD. This can be frustrating but understandable given that these children are stuck in survival mode and frequently default to fight-or-flight behaviors.

Here are a few strategies that don’t work:

  • Behavior modification isn’t effective because these students often lack cause and effect thinking and are not sufficiently motivated by rewards. Furthermore, these tactics convey to the student what is important to the teacher. The student can use that information to thwart the teacher and gain control of the classroom.
  • Punishments act to reinforce the student’s innate sense of worthlessness. The teacher and student will find themselves locked in an ineffective cycle of misbehavior and punishment when the teacher is punitive.
  • Multiple warnings are perceived by the student as weakness and an opportunity to continue misbehavior. These nearly always backfire.
  • Reprimanding often provokes an extreme reaction, especially when done publicly because it plays into the student’s already low self-esteem and can trigger their internalized self-loathing and anger.
  • Zero tolerance policies leave teachers with little latitude when the student refuses to comply. Teachers may find themselves shocked by the obstinacy of the student who continues to up the ante.
  • Focusing on “why” is counterproductive because these students typically lack analytical and abstract thinking skills. Asking why or explaining why is likely to be frustrating for both teacher and student.
  • Responding emotionally to a student’s behavior is unhealthy for the teacher and places the student squarely in the driver’s seat. When a teacher takes a student’s behavior personally and becomes provoked to anger, the student is in control.

Strategies that do work and why

Work as a Team

Children with RAD are adept at triangulating the adults around them in order to maintain control and thus feel safe. The student often works diligently to ensure a team approach does not ensue. They often lead teachers into believing they are being mistreated at home, while manipulating parents into believing the teacher is being unfair to them. Some children may deem the teacher his or her “preferred adult”, also leading to triangulation.

If you remember only one strategy as a teacher, remember to work alongside other adults in the best interest of the child. “Adults must work as a team for kids who’ve experienced early trauma. These kiddos desperately manage their surroundings to feel safe,” said Institute for Attachment and Child Development Executive Director Forrest Lien. “Though when they divide adults working to help them, as they often do, they actually feel less safe. It confirms their belief that they cannot depend on adults to care for them.”

Tips:

  • Engage with the parents who have a deep understanding of the child’s behavior and strategies that work. Do not rely on take home folders or sending communication notes home with the student. They likely will not make it. Instead, use direct communication like emails and phone calls.
  • Transparency is critical. Always confirm any concerning stories the child may tell you. For example, children with RAD may tell their teachers they weren’t given breakfast or that they are otherwise mistreated at home. This is meant to elicit sympathy and to have the instant gratification of having “tricked” an adult. Always let the student know that you’ll be confirming their report with their parents before proceeding.
  • Work with your school administration to develop a crisis plan. If a child’s behavior becomes unsafe, you must have a way to quickly remove other students from the situation and to keep the student who is in crisis safe. The best approach is to have a carefully detailed plan ahead of time.
  • Use 504 and IEP meetings to advocate for accommodations and modifications that will assist the student. Parents often know their child needs additional services, but do not know specifically what is needed. As an educator you have insight that can be immeasurably helpful to both students and parents.

Rely heavily upon schedules and routines

Children benefit from schedules and routines. For a child with RAD, this will begin to build a foundation of safety so they can focus on learning. Clearly identify the schedule, routines and rules with the student. During the first few days of school, do not get sidetracked by the student’s initial superficially charming behaviors as this is almost certainly the honeymoon phase. Just as you do with all students, implement a routine from day one. Know that the students with RAD often aim to bend the rules and get exceptions. However, making an exception will not build goodwill. Instead, the student will perceive it as weakness and you will spend the rest of the year trying to regain control of the classroom.

“Well-meaning adults often attempt to ‘save’ kids with RAD without realizing that they’re doing more harm,” said Executive Director of Institute for Attachment and Child Development Forrest Lien. “The best thing adults outside the home can do is to focus on their specific roles in the child’s life. Educators should focus solely on educating the child. It is the most caring thing a teacher can do for students with RAD.”

Provide frequent choices and follow through every time

As behavior modification is not effective for students with RAD, provide choices instead. Do so consistently and follow-through. For children who feel the world is innately unsafe and unpredictable, stability is key.

Tips:

  • Give choices that allow you to maintain control as the teacher, while empowering the student. For example, ask if they’d like to do their silent reading at their desk or on a pillow in the reading corner. By approaching the student this way, you can often distract them from willful disruption and obstinacy.
  • Be discrete when discussing matters with the student. Feeling backed into a corner, publicly shamed or teased is likely to trigger a negative, possibly violent reaction.
  • Rely upon natural consequences which are best for all students including those with RAD. Always use a neutral or empathetic tone and keep it as simple as possible.
  • Don’t take away recess or lunch time as consequences because these students need the physical outlet and the break away from the classroom.

Focus on teaching vs. attachment

Children with RAD struggle to form meaningful attachments with their caregivers. While it can be difficult to understand, attempting to build an attachment with the student thwarts the attachment they are working to form with their parents. Attachment work is best left to parents working alongside therapists. “Well-meaning adults often attempt to ‘save’ kids with RAD without realizing that they’re doing more harm,” said Executive Director of Institute for Attachment and Child Development Forrest Lien. “The best thing adults outside the home can do is to focus on their specific roles in the child’s life. Educators should focus solely on educating the child. It is the most caring thing a teacher can do for students with RAD.”

Tips:

  • Your relationship with the child must be consistent and neutral. Encourage students to focus on learning while at school. It may be best to think of it as a “business-like” relationship.
  • Do not allow the student to be inappropriately affectionate with you by engaging in behavior like hugs, hand-holding and secret sharing. You can affirm their parent’s role, and promote attachment healing, by consistently directing students back to their parents for advice, decisions and affection.

Recognize and act when kids go into survival mode

Unfortunately, some children with RAD have violent outbursts and engage in self-harming behaviors. It is essential that you focus on the safety of the student and the other students at these times. Acting early, before the situation escalates, is key.

  • Identify triggers such as being hungry, frustrated during math, bored during silent reading or teased by other kids to mitigate those triggers. At the very least you can be on high alert to watch for escalation signs and react quickly.
  • Recognize non-verbal clues including grimaces, stamping feet, fisting hands, or making growling noises. Recognizing these precursors is key to reacting early before a situation escalates out of control or becomes dangerous.
  • Call in help as soon as you notice the non-verbal clues that a student is escalating. Enact the student’s crisis plan, calling on administration and other appropriate support staff for help.
  • Focus on safety by moving other students out of the area per the crisis plan. Do this as quickly and efficiently as possible. When other students are away and safe, you will be able to focus on keeping the student who is in crisis safe as well.

Side step power struggles

Children with RAD tend to try to make everything into a life-or-death tug of war. This is because even minor stressors or conflicts can seem catastrophic to them. You need to drop your side of the rope.

  • Show empathy by focusing on the underlying causes of the student’s disruptive behavior and dysregulation. The behaviors can be extremely frustrating, overwhelming and hurtful. It’s normal to feel emotional, but when you lose your cool, the student is in control. Be prepared to remove yourself from the situation if you cannot cope.
  • Don’t engage in endless arguments as this is usually counterproductive. The student is likely to capitalize on any discussion as a way to thwart the rules. They also may use it as an excuse to disrupt the class and escalate the situation.

RAD is a lifelong condition that takes years of intensive therapy to successfully address. These strategies aren’t going to resolve all your student’s challenges in the classroom. However, you can set small, reasonable goals that will enable them to make progress and experience successes.

These strategies can make their behavior more manageable and create the best possible learning environment for all your students.

Download this free guide for teachers on how to work with kids who have developmental trauma. Click To Tweet
DTD and RAD Guide for TeachersDownload

Originally Published by IACD.

Footnote:  Sacks, Vanessa, et al. “Adverse Childhood Experiences: National and State-Level Prevalence.” Child Trends, Research Briefs, July 2014, www.childtrends.org/wp-content/uploads/2014/07/Brief-adverse-childhood-experiences_FINAL.pdf

In the News, Stories from other parents, We need to do better

Out Of Options, Parents Of Children With Mental Illness Trade Custody For Treatment

Illinois Newsroom–Jul 31, 2018

When Toni and Jim Hoy adopted their son Daniel as a toddler, they did not plan to give him back to the state of Illinois 10 years later.

“Danny was this cute, lovable little blonde-haired, blue-eyed baby,” Jim said. There were times Daniel would reach over, put his hands on Toni’s face and squish her cheeks.

“And he would go, ‘You pretty mom,’” Toni said. “Oh my gosh, he just melted my heart when he would say these very loving, endearing things to me.”

But as Daniel grew older, he began to show signs of serious mental illness that manifested in violent outbursts. When his parents exhausted all other options, they decided to relinquish custody to the state to get Daniel the treatment he needed.

Listen here as the Hoys tell about how they gave up custody of their son to get him needed mental healthcare.

“To this day it’s the most gut-wrenching thing I’ve ever had to do in my life,” Jim said. “But it was the only way we figured we could keep the family safe.”

To this day it’s the most gut-wrenching thing I’ve ever had to do in my life. But it was the only way we figured we could keep the family safe. Click To Tweet

Across the U.S., children encounter many barriers to mental health treatment, including a shortage of psychiatric beds and coverage denials from insurance companies. In a desperate attempt to get their child treatment, some parents have discovered a last resort workaround: they trade custody for treatment.

Known as a psychiatric lockout, a parent brings a child to a hospital and refuses to pick them up. The child then enters foster care, and the state is obligated to pay for their care.

This happened to Daniel in 2008, and has happened to thousands of other children before him, according to a report from the Government Accountability Office.

Today, despite a 2015 Illinois law that states families should never have to trade custody for mental health treatment, at least four children a month enter state custody this way, according to data obtained by Side Effects.

Out of options

Daniel grew up as the youngest of four children in Ingleside, just north of Chicago. As a baby, he’d been severely neglected — starving and left for dead — and the early trauma Daniel experienced affected his brain development.

At around age 10, his post-traumatic stress disorder manifested in violent outbursts.

“You could almost tell the stories that would describe him like a monster,” Toni said.

“He held knives to people’s throats. He tried putting his fingers and his tongue in the light sockets. He broke almost every door in the house.”

In the car, there were times when he’d reach over and grab the wheel while Toni was driving to try and force the car into oncoming traffic. Other times, he would lash out at his siblings.

“At the same time, he’s a little boy,” she said. “He didn’t want to be that way. He didn’t like being that way.”

Despite Toni and Jim’s efforts to help their son with therapy, the violence escalated. Daniel was hospitalized almost a dozen times over a period of two years.

His doctors said he needed more intensive mental health services than he could get while living at home. He needed 24/7 residential treatment, but both Daniel’s private health insurance, and the secondary Medicaid coverage he received as an adoptee, denied coverage.

So the Hoys applied for a state grant meant for children with severe emotional disorders. They also asked for help from Daniel’s school district, which is supposed to cover a portion of the costs when students need residential care. They were denied both.

“We were told we had to pay out of pocket for it,” Toni said. The treatment could cost up to $150,000 a year, and that was money they didn’t have.

Then, during Daniel’s 11th hospitalization, the Illinois Department of Children and Family Services, or DCFS, gave the Hoys an ultimatum.

“[They] basically said, ‘If you bring him home, we’re going to charge you with child endangerment for failure to protect your other kids,’” Toni said. “‘And if you leave him at the hospital, we’ll charge you with neglect.’”

Out of options, the Hoys chose the latter option as a last-ditch workaround to get treatment.

Once the DCFS steps in to take custody, the agency will place the child in residential treatment and pay for it, said attorney Robert Farley, Jr., who is based in Naperville.

“So you get residential services, but then you’ve given up custody of your child,” he said. “Which is, you know, barbaric. You have to give up your child to get something necessary.”

51+iD8IpeML._SX331_BO1,204,203,200_.jpg
Get Toni’s book here.

Taking it to the courts

The Hoys were investigated by DCFS and charged with neglect. They appealed in court and the charge was later amended to a “no-fault dependency,” meaning the child entered state custody at no fault of the parents.

Losing custody meant Toni and Jim could visit Daniel and maintain contact with him, but they could not make decisions regarding his care.

Toni spent months reading up on federal Medicaid law and she learned the state-federal health insurance program is supposed to cover all medically necessary treatments for eligible children.

The Hoys hired a lawyer, and two years after giving Daniel up, they sued the state.

Less than a year later, in 2011, they settled out of court, regained custody of Daniel, who was 15, and got the funding for his care.

Around the same time, Farley decided to take on the lack of access to mental health care on behalf of all Medicaid-eligible children in the state. He filed a class-action lawsuit, claiming Illinois illegally withheld services from children with severe mental health disorders.

“There [are] great federal laws,” Farley said. “But someone’s not out there enforcing them.”

In the lawsuit, Farley cited the state’s own data that shows 18,000 children in Illinois have a severe emotional or behavioral disorder, yet only about 200 of them receive intensive mental health treatment.

In a settlement in January, a judge ruled the state must make reforms to comply with Medicaid law. The state has until October to come up with a plan to ensure all Medicaid-eligible children in the state have access to in-home and community-based mental health services.

A law that didn’t fix the problem

While these legal battles were taking place, lawmakers began their own work to ensure parents no longer have to give up custody to get their children access to mental health services.

In Illinois, six state agencies interact with at-risk children in some form. But Democratic state Rep. Sara Feigenholtz said they operate in silos, which causes many children to slip through the cracks and end up in state custody.

“It’s almost like these there’s a vacuum, and the kids are just being sucked into DCFS,” she said.

Feigenholtz worked to get a bill passed in 2014. The Custody Relinquishment Prevention Act, which became law in 2015, orders those six agencies to work together to help families that are considering a lockout to find care for their child and keep them out of state custody.

So the agencies developed a program together that launched in 2017 — years after the deadline set by the law. It aims to connect children to services.

But Feigenholtz said the fact lockouts still happen shows a lack of commitment on behalf of the agencies.

“I think the question is: Shouldn’t government be stepping in and doing their job? And they’re not,” she said. “We just want them to do their job.”

B.J. Walker, head of DCFS, said the reasons lockouts happen are complex. “If law could fix problems, we’d have a different world,” she said.

Walker said many children in need of residential treatment for mental illness have such severe or unique conditions that it can be a struggle to find a facility that’s willing and able to take them.

Even for families that get state funding to pay for the care, families Side Effects Public Media spoke to said the waiting lists can run six months or longer. When parents are unable to arrange a placement, the child may enter state custody, and as ProPublica Illinois reports, they could languish for months in emergency rooms that are ill-equipped to provide long-term care. Some out-of-state facilities are not willing to accept Illinois children, citing concerns over severe delays in payments that stem from a recent two-year budget crisis in Illinois.

The program to prevent lockouts requires families take children home from the hospital after medical providers have done everything they can. But many parents say it’s not an option for them because their child remains too violent for home.

For these reasons, children continue to enter state custody as a final effort by their families to help them.

A spokesman for DCFS said in an email that, when the agency gets blamed for this problem, it’s like when a pitcher comes in at the end of a losing game to save the day and gets tagged with the loss.

What it will take to prevent lockouts

Lockouts can happen anywhere, but Heather O’Donnell, a lawyer with a Chicago-based mental health treatment provider, Thresholds, said the situation is particularly bad in Illinois.

She said a big part of the problem is that society sweeps mental health conditions under the rug until there’s a crisis.

“We don’t have a very good system in Illinois for children or adolescent or young adults with significant mental health conditions,” O’Donnell said. “What Illinois needs to put into place is a system that helps these families early on so that these kids never get hospitalized.”

That’s what the state is trying to fix now.

The consent decree issued as part of the class-action lawsuit settlement requires the state to propose a plan by October to ensure all Medicaid-eligible children in the state have access to mental health services in their communities, with changes slated to begin in 2019. Farley estimates the changes will cost the state several hundred thousand dollars, based on what it cost other states like Massachusetts to implement similar reforms.

The difference treatment and family can make

Daniel Hoy is now 23 and has been out of residential treatment — and stable — for five years. He has a 2-year-old daughter, works nights for a shipping company in Rantoul, in central Illinois, where he recently moved to be closer to his parents.

Daniel said treatment was tough, and he would not have gotten better without his parents’ love and support.

“Sometimes it’s so hard to do it for yourself,” he said. “It almost helps to know that I’m doing it for myself, but I’m also doing it for my family and for our relationship.”

Toni’s thankful that despite losing Daniel while trying to help him, they ultimately made it through intact. She’s in touch with other families that have gone through lockouts too and most, she said, are not as lucky.

That’s why Toni said she will continue to speak out about this issue. “Kids do need services,” she said. “But they also need the support of their families. And when they have both, a lot of kids can be a lot more successful.”

Get Toni’s book Second Time Foster Child: How One Family Adopted a Fight Against the State for their Son’s Mental Healthcare while Preserving their Family

Republished with permission. This story was produced by Side Effects Public Media, a news collaborative covering public health.

Tips to navigate "the System"

What Social Workers Need to Know When Working with Adoptive Families

By brave adoptive parent and advocate Pernell Meier

Social workers have been an ever-present part of my family. Over the course of 13 years, we have parented 7 children from foster care, 5 of whom we adopted. In that time, we have had countless social workers in and out of our lives. Some have been rock-stars and stepped-up for our family and kids, advocated and pulled strings. Others have been toxic and blatantly destructive to our well-being. And the vast majority have fallen somewhere in the middle – neither appreciably helpful, nor actively working against us. Though these workers were generally decent people with their hearts in the right place, I’ve been struck by how much even caring and well-meaning social workers can be unintentionally damaging…

This amazing post goes on to provide concrete ways social workers can support adoptive families:

#1 – We desperately need your help.  
Life with an emotionally disordered child, particularly one with attachment disorder, is profoundly hard…

#2 – We need to be believed.
Most of us present one way to the world and another way to those closest to us. They can turn on the charm and show their absolutely impressive best sides to you, while five minutes later becoming unimaginably cruel to us. I know that this is hard to believe…

#3 – You might be one of the only persons who we can talk to.
Most adoptive parents of high-needs kids have the same experience – friends and family fall away. The challenges are just too hard for people to process, so avoiding it is much easier. And venting to people can bring forth the inevitable, “You did this to yourself!” comments

#4 – We expect that you will be educated on these issues.
Over the years, we have found such an unimaginable lack of basic education on matters related to trauma, prenatal exposure and attachment that the process of trying to educate and explain becomes draining. We are turning to you as an expert…

#5 –  When we tell the truth about our lives and our children, this does not mean that we do not love them or lack commitment.
Telling social workers about what is really going on at home backfires and gets used as ammunition against us to further cement the workers’ original views of the family. This atmosphere creates self-censorship as the adoptive parents come to view most social workers as either not helpful or detrimental.

#6 – We don’t speak social work.
You have your own specific acronyms, and ways of speaking and understanding things, just as all professions do. But when you are talking to us, please consider that we are not always going to know what you mean…

#7 – No, we are not triggering them.  
Ok, let’s be real. Sometimes we do, just as any parent will occasionally handle a situation poorly.  But, these children do not turn into raging, mean, or out-of-control persons because we are in general doing something to them that makes them that way…

#8 – Yes, we have skills.  
We have read more than you could possibly know, called and talked with anyone we could, watched videos, taken trainings, and turned our values and our way of thinking inside out to try to make things better…

#9 – Your meetings can be painful and often feel like a waste of time.
Please know that we are likely dealing with quite a few different social workers, support persons, doctors, therapists, school officials, etc. and we have a lot of meetings that we need to attend…

#10 – You are not our child’s friend.
When you approach interactions with our children from the perspective that the most important thing is having a positive relationship between the two of you, you inadvertently damage our parental relationship because you put on those empathy blinders that do not allow you to even see, let alone confront deceit, poor behavior, manipulation and destructive dynamics…

#11 – You continually undermine us.
You set meetings with them without even bothering to tell us, thus keeping us out of the loop and making us play catch-up. You buy them things that we have said “no” to. When they have been behaving terribly and break the rules, you take them out for ice cream or fancy coffee…

#12 – You have enormous power over our lives and that is frustrating and scary.  
As the gatekeeper, you are the one who gets to decide if we “need” something or we do not. When you deny us what we’re asking, please understand that this is “just business” to you and to us it feels like a hot knife slicing through us…

#13 – You get to go home.
We don’t. This is our home. This is our life. At the end of your long, stressful work days trying to make the world a better place, you get to go home to a quiet house or to your attached children, where your pets and other vulnerable children are not being abused, put your purse or wallet and car keys down without thinking to lock them away, and shrug off the day’s worries. For us, our homes often feel like prisons…

#14 – You cannot imagine our grief and our guilt.
Often co-mingled with our grief is our intense guilt. Raising a child with special needs seems to inevitably bring this on as we often second-guess and agonize over so many of the decisions related to our children’s care. Often our lives are so impossible that absolutely nothing feels like the right thing…

#15 – We need you to be honest and acknowledge your mistakes.
We need to trust you because the repercussions of you either baldly lying, withholding essential information, or manipulating us to obfuscate the truth can be devastating. In this power imbalance, you hold the cards. We have little recourse when you do things that create harm…

#16 – You hurt the kids.
Social workers will come and go, but we will always be there. You are not their parent, we are, and the best thing you can do to help them is to help us with the excruciatingly hard task of standing by them…

Please be sure to read the full article here.

Most Popular, Parenting advice

Parenting a challenging child? Here’s how to increase your resilience

Do you ever roll out of bed already over it? At your limit before the day starts? Knowing you can’t take even one more surly look, one more rude comment, one more call from school, one more violent outburst? I’ve been there too.

As parents of children with reactive attachment disorder (RAD), life can be so stressful it feels impossible to face another day. When we near our tipping point, our instinct is to imagine that finding a way to “fix” our child will immediately relieve the stress we are experiencing. In reality, as necessary as it is, getting help for our child often adds more stress to our lives because it comes with therapy appointments, challenging therapeutic parenting approaches, and disputes with insurance companies. Effective treatment for kids with RAD is a daunting, long-term proposition.

Raising, finding help for, and advocating for a child with RAD is difficult. It’s stressful. Parents get PTSD, become depressed, and struggle with other mental health issues. They lose friends and family, and turn into someone they feel they don’t even know. This is why we need to find ways to increase our resilience by effectively addressing the stress in our lives.

Al Coates MBE, adoptive parent and advocate, is flipping the paradigm by focusing on practical ways we as parents can increase our resilience – our ability to take whatever’s thrown our way, figuratively or literally. With his background in social work, Al has tweaked the Stress – Vulnerability Model (1) specifically for parents who are raising challenging kids.

To understand the Stress – Vulnerability Model let’s start by imagining a bucket. Inside the bucket are your stressors – each one like a cup of water that’s filling your bucket up. For now we’ll set aside the stress specifically related to parenting a child of RAD. Instead, let’s focus on the stressors that are with you before you even start your day.

    • Money – are you scraping by and just making ends meet, worried about retirement, or struggling to pay the mortgage?

    • Career – are you in a job that’s unfulfilling, or perhaps under a great deal of stress with deadlines and frustrated customers?

    • Relationships – is your relationship with your spouse strained or do you have a toxic friend or family member in your life?

    • Other children – do you have a special needs child who requires extra help, or a high school football player that needs to get to practice on time five days a week?

    • Everyday nuisances – how about that neighbor’s dog that barks like crazy, or an air-conditioner that’s on the fritz too often leaving you hot and sweaty?

    • Social history – do you have a personal history of neglect or abuse, something that can be easily triggered?

    • Medical – are you the kind of person he needs eight hours sleep or someone who has debilitating migraines?

If we think of each of these stressors as a cup of water, it’s easy to see how we can wake up with our bucket almost full. If your bucket is already filled to a quarter of an inch from the top, you simply don’t have room for a temper tantrum, a broken window, or a screaming child. That’s how we reach our tipping point. What sloshes out – over the side of our bucket – is anger, frustration, tears, and more.

If your bucket is already filled to a quarter of an inch from the top, you simply don’t have room for a temper tantrum, a broken window, or a screaming child. Click To Tweet

Now imagine waking up with your bucket only half full. You’d have a whole lot more to give your kids in terms of time, energy, and patience. You’d be a more resilient parent, able to weather the storms that come your way.

So how can we begin to reduce our normal stress?

    1. Create a personal list of stressors and solutions. Using the list above as a starting point, write down the stressors in your life and possible solutions. For example, one of my stressors is a propensity for migraines. A solution would be to set a cell phone alarm so I remember to take my preventative medications.

    2. Go for the low hanging fruit first. Start by picking off the stressors that are easy to address. For me, that might mean asking a teammate to give my son a ride home from football practice. Look for quick and easy ways to take a scoop of stress out of your bucket.

    3. Set some longer-term goals. Other changes may be more difficult to make such as  changing jobs or affording a new air conditioner (although a rotating fan or two might be a short-term solution). Don’t stress yourself out trying to de-stress by taking on too much at one time. Pick one goal at a time to focus on.

As you work through this, remember change takes time. But, every drop of stress relief is one less drop in your bucket. Even small changes can begin to make a difference.

It’s also important to recognize that not all our buckets are the same size. Some of us have short buckets – stress is very difficult for us to handle. Others have tall buckets – they can tolerate higher levels of stress. Another way to build your resilience is to increase your stress tolerance. Here are just a few strategies to get you started.

    • Get your endorphins pumping even if the only exercise you can fit in is power walking around the field during your kids’ soccer practice.

    • Take care of yourself. It’s not as impossible as you might think. Check out our self-care list for exhausted, frazzled, frustrated parents without a minute or ounce of energy to spare.

Raising children with challenging behaviors can feel overwhelming. To be successful, we as parents, must be resilient enough to handle the inevitable stress that comes our way. Take the time to consider what stressors are in your life and ways you can lower the water in your bucket.

(1) Stress Vulnerability Model –  from Zubin & Spring (1977) Brabban & Turkington (2002).

Originally published by Institute for Attachment & Child Development

Most Popular, Resources

Dear friends & family

Dear Friend,

I’ve told you before how I’m struggling with my child’s behavior but I’m not sure you understand how serious—how desperate—things are.

Here’s the unvarnished truth—my child relies on manipulation and melt-downs to control his surroundings. He refuses to follow the simplest of instructions and turns everything into a tug-of-war as if it’s a matter of life or death. Every day, all day, I deal with his extreme behavior. He screams, puts holes in walls, urinates on his toys, breaks things, physically assaults me and so much more. I’m doing the best I can but it’s frustrating and overwhelming.

Most people, maybe even you, blame me for my child’s behavior. This makes me feel even worse. I already blame myself most of the time, especially because I’ve struggled to bond with him.It’s heartbreaking to know he only feigns affection to get something from me. There’s not a parenting strategy I haven’t tried. Nothing has worked. Often, I feel like a complete failure as a mother and struggle to face each new day.

Fortunately, my child’s behavior makes a lot more sense to me now that he’s been diagnosed with reactive attachment disorder (RAD). Let me explain. When a child experiences trauma at an early age his brain gets “stuck” in survival mode. He tries to control the surroundings and people around him to feel safe. In his attempt to do so, he is superficially charming, exhibits extreme behaviors, and rejects affection from caregivers. Unfortunately, even with a diagnosis, there are no easy answers or quick treatments.

Even though I work so hard to help my child heal, friends and family often don’t believe or support me which is incredibly painful. I understand it’s hard for you to imagine the emotional, physical, and mental toll of caring for a child with RAD when you haven’t experienced it yourself. And, you can’t possibly be expected to know the nuances of the disorder and its impact on families like mine. That’s why I’m putting myself out there about the challenges I’m facing.

What I need most from you is a shoulder to cry on and an ear upon which to vent—without being judged, second-guessed, or not believed. Click To Tweet

When you undermine me, you inadvertently set back the progress I’ve made in my already tenuous relationship with my child. I wish you could understand how good my child is at manipulating people—how he turns on that sweet, charming side you usually see. In fact, you may never witness a meltdown or even realize he’s manipulating you. Yes, he’s that good. When you think he’s bonding with you, know there’s always an end in mind. He may seek candy or toys. The biggest win of all for him, however, is to get you to side with him against me.

Here’s how easily it happens—my child is sitting in timeout, looking remorseful as he watches the other kids play. You think I’m too hard on him and say, “He’s sorry and promises he’ll make better choices next time. How about you give him another chance?” You need to understand there’s a lot going on behind the scenes that you simply don’t see or know about.

When you undermine me, you inadvertently set back the progress I’ve made in my already tenuous relationship with my child. The structured consistency—what you feel is too strict—is exactly what my child needs to heal and grow into a healthy, happy and productive adult.

Please know I’m following the advice of therapists and professionals. Strategies for raising a child with RAD are often counterintuitive and, watching from the outside, you may not agree with them. That’s okay. But, instead of interfering, would you give me the benefit of the doubt?

Over the years, well-meaning people have said some pretty hurtful things to me, things like:

•All kids have behavioral issues. It’s a phase. They’ll grow out of it.
• He’s so sweet. It’s hard to believe he does those things.
•Let me tell you what works with my child…
•Have you tried _______?
• Oh, he’s just a kid. I’m sure he didn’t do that on purpose.
• A little love and attention is all he needs.

I know these sentiments are meant to be helpful, but here’s the thing—my child isn’t like yours.

He has a very serious disorder. Statements like these minimize our situation as if there are easy solutions that I just haven’t tried. Honestly, I’m not looking for advice. What I need most from you is a shoulder to cry on and an ear upon which to vent—without being judged, second-guessed, or not believed.

Reactive attachment disorder is a challenging disorder that’s difficult to treat so we have a long road ahead of us. Everyday is a struggle and I’d love to be able to count on you but not for advice or answers. I just need you to listen and offer encouragement. I know how deeply you care for me and my child and I’m thankful to have you in our lives. I’ve lost some relationships through this incredibly difficult journey. I don’t want to lose you too.

Sincerely,

A parent of a child with reactive attachment disorder

This is my latest blog post for the Institute for Child Development and Attachment. Please share this letter to raise awareness for parents of children with reactive attachment disorder.

Our Story

Opening our foster care adoption

Published by Adoptive Families May 2018 Issue

Sarrah laughed a little too loudly, running her fingers through her long, fluorescent blue and pink hair. The only flaw on her heart-shaped face was a pale scar to one side of her mouth, like a hairline crack in porcelain. There we were, sitting across from each other in a booth at Chili’s Bar & Grill with our children—hers by birth, mine by adoption.

Sarrah was seeing them for the first time in more than a decade. Devon was 12 with light brown skin. And, now that he was sitting next to her, I could see he had her easy smile. Kayla, 11, fidgeted in the seat next to me, pulling at the strings of her ripped jeans. She cast shy looks my way.

***

My husband and I adopted Devon and Kayla from foster care when they were toddlers. Because it was a closed adoption, they received new birth certificates and social security numbers to permanently sever the relationship with their birth mother, Sarrah.

When Kayla was five, her curiosity was piqued about her birth mother. I’d patted my growing baby bump and told her and her brother that they were once in Sarrah’s belly, like the baby in mine. “What does JSarrah look like? Where does she live?” Kayla had asked.

I wasn’t sure, so I’d pulled out and read through the adoption case files. When Devon was born, Sarrah was 17 and a foster child herself. He was an infant when she left him sleeping in a motel room to meet a friend in the parking lot. Another guest heard his cries and called 911. Devon was unharmed and his diaper was still dry, but Sarrah was arrested for child abandonment. With no one to bail her out, she was in jail for a month before the charges were dropped. By that time, Devon was in foster care. Kayla was born a few months later, and, since Devon was already in foster care, social services took her too. Eventually Sarrah’s parental rights were terminated.

I told Kayla and Devon their mom was poor and had no family to help her. She loved them and wanted them to be taken care of and that’s why we became their parents. I framed a small photo—a carefully cropped mugshot—of Sarrah for each of them. Kayla, especially, treasured hers.

I kept tabs on Sarrah throughout the years in case Devon and Kayla wanted to contact her when they became adults. Several years ago, while she was serving time for check fraud, I sent her a Christmas card with pictures of the kids. Separated by hundreds of miles and thick prison walls, I didn’t want her to know where we lived, so I sent the letter through a relative.

A couple weeks later I received her forwarded reply. Sarrah’s curly script was embellished with doodled hearts and flowers. “I was so surprised to get this! I will always treasure these pictures. Thank you for taking such good care of my babies when I could not take care of them myself. ”

I read and reread the three-page letter braced for bitterness to slice me like a paper cut. Finding none, I was haunted by the suspicion that the real crime that cost Sarrah her children was being poor. After all, it’s not unheard of for parents to leave kids unattended in a hotel room—running to the lobby, grabbing something out of their car, switching a load of laundry—and they don’t get charged with child abandonment. They don’t lose their children forever.

***

After being released on parole, Sarrah joined Facebook. She had a penchant for duck-face selfies and over-the-shoulder poses that showed off her Kardashian-esque bottom. She called her boyfriend—a tall, handsome black man with an ankle monitor—her king. She was his queen. Many pictures showed “Coogie” tattooed across her chest, a term I could only find in the online Urban Dictionary: “A cool ass mutha f–er. A cool gangsta.”

Sarrah couldn’t have been more different from me, a conservative, suburban mom. Still, unable to resist dipping my toes in to test the water, I set up a new Facebook account and sent Sarrah a friend request. Seconds later she accepted. Over several months I uploaded hundreds of photos of Devon and Kayla. Sarrah giddily shared them with her Facebook friends, many of whom commented that the kids looked just like her. I noticed it too.

Sarrah and I messaged regularly. She told me about her job assembling furniture and living with her boyfriend in his mother’s house. She was especially proud to have earned her GED and cosmetology license in prison.

When I trusted her to Devon and Kayla, she sent a picture of their initials tattooed on her ankles. “You see? I’ve never forgotten you! I went through a lot when I was younger. I was living on the streets. I’m so sorry. I know you might be angry with me, and that’s OK, but can we be friends? I love you and always will.”

Devon was ambivalent about the relationship, but Sarrah and Kayla swapped emoji stories and pictures of their hairstyles and outfits nearly every morning. Some afternoons they would bike, dance to the radio, or play with the puppy together—courtesy of FaceTime.

Sarrah was seeing a court-ordered therapist, taking medication for her bipolar disorder, and submitting to regular drug testing. I was rooting for Sarrah but worried whether she could keep her life on track once off parole. This felt like a once in a lifetime opportunity for Devon and Kayla, so I booked her a flight to visit.

***

At the airport, Kayla cradled a Grande Caramel Frappuccino with whipped cream and a drizzle of caramel sauce—Sarrah’s favorite. With her fluorescent hair and bright pink jeans, we had no problem picking her out of the crowd at baggage claim. Kayla snuck up behind her, so close that when Sarrah spun around squealing, she nearly dropped the Frappuccino. Teetering on black, stiletto boots Sarrah kissed Kayla and Devon’s cheeks and pulled them into an awkward hug. Devon eagerly took the handle of her suitcase, leading the way to the exit, and Sarrah cooed at his chivalry.

Kayla climbed up on a large concrete block to give her a better vantage point, and therefore a better likelihood of seeing the shuttle before her brother. She hugged herself to keep warm. “Why didn’t you wear a coat, you silly goose?” Sarrah peeled off her thick coat and put it on Kayla, then wrapped her arms around herself against the cold.

Once in the parking garage the kids trotted ahead of us. Sarrah whispered that she hadn’t smoked for hours—since she left Colorado. “Would it be all right to have a cigarette real quick?” she asked.

“Of course. It’s fine.” I hoped my smile conveyed my sincerity. This weekend promised to be stressful enough without Sarrah having nicotine withdrawal. While she hid out of view behind other cars, I loaded the kids into my minivan.

“Doesn’t she know that’s bad for her?” Kayla blurted. “Doesn’t she know she’ll get lung cancer?”

I hushed her. Sarrah was our guest and we would let her be comfortable.

***

At Chili’s Kayla squirmed in her seat next to me, shrugging shyly whenever Sarrah asked her a question. Devon was chirpy, eager to capture and hold Sarrah’s full attention. He told her he liked bowling, video games, soccer, LEGOs, and dogs. His favorite color was green and his best friend was named Bobby.

“So, let me tell you what my boyfriend and I do—we pick each other’s noses.” Sarrah mimed the motion. “Then we make the other person eat it. Isn’t that funny?” She hooted with laughter and the kids thought she, if not the story, was hilarious. Me, not so much.

Devon nibbled on a chip and Sarrah exclaimed, “You need more cheese than that! You’re not worried about double dipping are you? Don’t be silly!” Dunking her half eaten chip into the queso Sarrah levered the whole thing into her mouth. She looked around the table, chomping enthusiastically. Then, pausing, she slowly lifted a hand to cover her mouth. “Oh,” she mumbled. “You don’t double dip, do you.”

“Don’t worry about it.” I waved my hand, permission for Devon and Kayla to double dip as well.

Sarrah’s face flushed. “I’m so embarrassed. I’m just so different than ya’ll.”

It was true. I held down a professional job and owned a house and two cars. I had student loans and no criminal record. While Sarrah spent her evenings partying, I spent mine packing school lunches and helping with homework. She double dipped. I did not.

As we left the restaurant I touched Sarrah’s arm. “You and I are different, but I’m glad we are. The kids have a special relationship with you that they can’t have with me. I’m so happy you’re here.” Beaming she gave me a quick hug.

Later that night, I supervised showers and teeth brushing, then Sarrah tucked Devon and Kayla into bed. She kissed them each good night, told them she loved them, and blew more kisses from the door.

***

The next day we went bowling and out for lunch. She gave Devon and Kayla piggy back rides and pushed them on the swings at the playground. That evening we had hot chocolate and popcorn. Devon and Kayla pulled out our scrapbooks and showed Sarrah pictures of themselves and scanned copies for her of their artwork and school work from over the years.

I asked Sarrah to tell us Devon and Kayla’s birth stories. Pulling Devon onto her lap, and with Kayla curled up next to her on the couch, Sarrah told us that Devon was her Valentine, born on February 14. Her foster mother, Teresa, had been there for the birth. Devon had soft brown eyes and all she wanted to do was hold him.

When Sarrah was pregnant with Kayla she’d had no friends to take her to the hospital. Kayla came out with a pouf of curly hair. All the nurses said she was the prettiest baby girl they’d ever seen. “You were so cute!” Sarrah tickled Kayla’s side until they both giggled and rolled off onto the floor.

Before we went to bed, Sarrah drew a thick tree trunk and the outline of a wide leaf canopy on a piece of paper. She wrote in the names of Devon and Kayla’s grandparents, aunts, uncles, and cousins. She noted that her mother, Debbie, had died from colon cancer. Aunt Darlene had breast cancer and Sarrah’s half sister, Katie, had cerebral palsy. I was touched by this simple family tree and the kids’ birth stories, gifts most adopted children never have.

***

On Sunday evening Kayla lay on the kitchen counter and Sarrah cradled her head in the sink. She massaged in shampoo and conditioner, stopping several times to gently kiss Kayla’s forehead. Sarrah blow dried and flat ironed Kayla’s hair in the playroom while they watched cartoons together. Devon had gone to bed long before and Kayla fell asleep with her head on Sarrah’s lap.

“I never abandoned Devon,” Sarrah told me. “I went to the parking lot for just a few minutes to meet a guy friend who was going to give me some money. This girl who stayed in the motel too was upset because he was her ex-boyfriend, so she called the cops on me.”

Sarrah had no family; she was 16 when her mother signed her over to social services. “I wasn’t a good kid. I know that. I stole from my mom and ran away a lot. She and her husband didn’t want me back. See this scar?” She leaned toward me and pointed to the tiny scar I’d noticed beside her mouth. “One time I got into a fight with another girl at a group home and she stabbed me in the arm and face.”

After a long silence I asked, “What happened with Kayla?”

“The social worker took her right after she was born. I’m not gonna lie to you,” she said. “I left the hospital and I sat on the curb outside. I had nowhere to go, no one to call for a ride. I just gave up. I knew I would never be able to get them back living on the street.” The despair and regret on her face made my stomach churn with nausea. I was deeply disturbed. That wasn’t how things were supposed to work.

The next morning we dropped the kids off at school before I took Sarrah to the airport. After hugs, kisses, cheek pinching, and giggling we waved goodbye. Before Sarrah entered the security line we hugged. I knew I’d always see Sarrah’s beautiful face reflected in Devon’s smile and Kayla’s dimples. We promised to do another visit soon, but that never happened.

***

As I’d feared, with the weight of a felony tethering her, Sarrah struggled to keep her head above the water when she got off parole a few months later. She struggled to find jobs and housing. Without health insurance, she stopped seeing her therapist and taking her bipolar medications.

On Christmas Eve I called Sarrah so Devon and Kayla could say Merry Christmas. No answer. No call back. She hadn’t posted on Facebook since December 21. By January, I was very concerned and scoured the Internet. I knew to start with arrest records. Sure enough, Sarrah had gotten tangled up with a gang and was arrested trying to use stolen checks. Charged with three felonies, she faced a decade or more of prison time.

Several days later, I penned the address of the jail onto an envelope and added Sarrah’s inmate number. Before sealing the envelope, I slid in pictures from her weekend visit. Later I would make a small deposit to her commissary account. When I put the envelope in the mailbox and raised the flag, I knew this would be only the first of many letters.

As I walked back inside the house, Kayla was already putting her shoes on, excited to go. She had a salon appointment to get a purple streak in her hair.

Moms matter too, Resources

15 Practical Self-Care Ideas for Parents

via Blog – Institute For Attachment and Child Development

A self-care list for the exhausted, frazzled, frustrated parents without a minute or ounce of energy to spare.

Buy little indulgences that help calm you. Nestle scented candles strategically throughout your home to provide scents for instant relaxation and calm. Pamper yourself with essential oils to make the most of your shower (perhaps one of the few moments of privacy you get).

Use simple tricks to feel better physically. Splurge on a really great refillable water bottle and stay hydrated to improve your overall energy and health. Stock up on grab-and-go healthy snacks (but don’t beat yourself up when you grab for a high-carb, high-satisfaction treat during a rough patch).

Look for support in the nooks and crannies of life (that can be so difficult to find from friends and family). Fill up your social media feeds with encouragement at your fingertips by following pages, people, and accounts that post motivational quotes and memes. Please, use the comments to share your favorites to follow.

Find creative ways to make up for enjoyable activities you don’t have time for anymore. Don’t miss your favorite shows. Consider DVR to enjoy them when you can sneak a few moments to yourself.

 Listen to short meditations. Bookmark and listen to our “Wrap yourself in hope and self compassion” meditation, created especially for the moms of kids with RAD. Also check out the free Meditation Minis podcast by Chel Hamilton for meditations that are about 10 minutes — to help you relax, de-stress, sleep, and more.

Seek the small feel-good moments in life. Open your curtains and let natural light nurture your mood and improve your concentration. Get your endorphins pumping by walking laps while your child is occupied in baseball, soccer, or football practice.

Make those few hours of sleep you get as rejuvenating as possible. Purchase a pillow that provides good support. Check out a Weighted Stress Blanket or neck wrap. (I sleep so much better with mine).

Don’t sacrifice your daily coffee even on the most chaotic of mornings. Use the app for your local coffee shop to order ahead and skip the line. (I use both Dunkin Donuts’ and Starbucks’ online apps to order ahead and earn rewards.)

Pamper yourself. Get a pedicure or manicure. Just a glimpse of my strawberry pink nails helps me feel good about myself even as I clutch the steering wheel, flip through paperwork, and wipe up messes. Drop in for a 15 minute walk-in chair massage at your local shopping mall for instant relief from tension headaches and tight muscles.

Escape into that guilty pleasure read with an audiobook. I’ve always got at least one audiobook downloaded onto my phone for those endless hours of chauffeuring kids, sitting in waiting rooms, and idling in carpool.

Hire some help for everyday tasks. Look for a maid service to clean your bathrooms and kitchen every other week. This is a big bang for your buck in terms of getting a little relief. Don’t let lawn work be a time suck when there’s probably an eager teenager in your neighborhood looking for pocket cash.

Just say ‘no’ to extra activities and volunteer work you’re signing up for only out of a sense of obligation. It’s okay to prioritize yourself right now.

Ask for help that’s actually helpful when friends and family offer. Suggestions include, “Would you bring by a meal on Tuesday? Could you drop my daughter off at piano lessons this afternoon? When you swing by would you bring a gallon of milk?”

Surround yourself with people who support the incredibly challenging work you’re doing and limit time with naysayers. Don’t seek advice or support from people, even family members, who don’t ‘get’ the very real challenges you’re facing.

Join a support group. Online support groups can be a great way to feel less alone and get practical suggestions for busy parents. A favorite of mine is the private Facebook group The Underground World of RAD.

Be your own greatest fan. Be kind to yourself. Forgive yourself. Remind yourself of all the things you do well. Give yourself a generous ‘A’ for effort for those things you don’t do so well.

Most Popular, Resources, Tips to navigate "the System"

Open letter to a therapist from a mom of a child with Reactive Attachment Disorder

Dear Therapist,

I am desperate for your help. I apologize ahead of time if I seem angry and defensive. I’m just burnt out and afraid you won’t understand. My son is completely out of control and nothing works.

I’ve tried to get help before from therapists and teachers, even police officers, but no one understands. They all think I’m exaggerating, or maybe even lying. My own mother says, “He’s just a kid,” and can’t understand what I’m dealing with is way beyond normal, way beyond safe, and way beyond what I can handle. My son went through trauma at a young age and has been diagnosed with reactive attachment disorder.

I’m not exaggerating when I say my son screams for hours. He’s torn his bedroom door off the hinges and put holes in his walls. His siblings are afraid of him. Sometimes I’m afraid he’ll burn down the house when I’m asleep.

When you meet my son, he’ll look like a very different child than he is with me. You’ll think I’m overreacting. I’m not. You see, my son is an expert at triangulating the adults around him. Due to his early trauma, he manages his surroundings and the people in them to feel safe. In doing so, he’s good at making everyone think I’m mean and crazy. Sometimes I start to believe it too.

I have a secret I should probably share with you—it’s true that I’m not perfect. I’m very aware of that fact. I’ve screamed at my son and lately I’m always angry and frustrated. I’m afraid to tell you this because you’ll think I’m a bad mom and blame me for everything. Most people blame me for my son’s problems. Yet, I’m the one person whose life has been turned inside out and upside down to try to help him.

Even though I’m not a perfect mom, I’m still a good mom trying my best. Click To Tweet

I’ve turned into an unhappy, negative, impatient person whom I don’t even recognize anymore. Sometimes I wonder if I have post-traumatic stress disorder, but feel stupid suggesting that dealing with a child could cause PTSD. It would be helpful for you to encourage me to get some therapy for myself.

Even though I’m not a perfect mom, I’m still a good mom trying my best. Before we get started, here’s what you need to know (because my son will tell you otherwise):

    • I feed my son three meals a day, plus snacks.
    • I don’t hurt my son.
    • I’m not the one who rips up his homework and throws it away.
    • He locks himself in the closet under the stairs. I don’t and wouldn’t ever do that to him.
  • Our house isn’t haunted, he’s not best friends with Justin Bieber, and he’s not going to live with his birth mom next week.

My son will tell you things in individual therapy that will take up all of our time to untangle.

In the meantime, we’ll be distracted from working on the really serious problems for which we need your help. This is why I’m going to insist on being present during all therapy sessions. Please understand it’s not because I have something to hide. I just want to keep things from getting worse than they already are.

Typical parenting strategies like sticker reward charts don’t work for my son. We’ve already tried all sorts of behavior modification strategies. I can’t ignore my son’s negative behavior either. I can’t just watch him hurt himself, his siblings, or destroy everything we own.

Please understand, our family is in crisis.

This is an emergency. We need help and we need it fast. That play therapy you do in the sand…I don’t know, maybe it works for some kids–but not for him. I’m not trying to be unreasonable; I just know what doesn’t work. If you don’t have experience working with trauma-exposed kids, please refer us to someone who does. I understand this is a very specific and serious issue that not all therapists have expertise in.

I’m willing to do whatever it takes to help my son heal and to fix our family. Please help us.

Sincerely,

Keri

Originally posted by the Institute for Attachment and Child Development.

Parenting advice

6 Steps to protect yourself from false allegations

Published by Institute for Attachment & Child Development

A sweet little kindergartener, with a Blues Clues backpack and big brown eyes, Devon went to school every morning with a hungry belly. At least that’s what he told the bus driver, his teacher, and the cafeteria ladies. When I got the call from his school, I was positively indignant. Not only did Devon eat breakfast every day, but he usually had seconds.

Within a few years, Devon’s lies had become dangerously calculated deceptions. “I’m gonna hurt myself and tell them you did it. They’ll arrest you,” he’d say cooly, before punching himself in the jaw. Other times he’d twist the tee-shirt he was wearing round-and-round, cinching it against his neck until it left a puffy, red ligature mark. He’d accuse me of strangling him.

Unfortunately, many children with reactive attachment disorder are capable of false allegations. “Due to early trauma, children with reactive attachment disorder feel safe when they can control their environments and push away people who try to get close to them,” said Institute for Attachment and Child Development Executive Director Forrest Lien. “False allegations are one way for them to achieve both.”

Even if we understand the diagnoses and social histories that prompt our children’s false allegations, however, being lied about can be infuriating and hurtful.

A child’s allegations, however outrageous or unlikely, will be investigated. This unwarranted disruption and family upheaval is collateral damage, necessary to make sure children who really are abused get the justice and safety they deserve. “By law, police officers or child protective service workers investigate all allegations of child abuse, as they should. Child abuse allegations need to be taken seriously,” says Institute for Attachment and Child Development Executive Director Forrest Lien. “On the other hand, it’s also harmful for children to falsely accuse adults of abuse charges.” The consequences of false allegations can be devastating if our children, master manipulators, manage to convince a guidance counselor, therapist, or police officer they’re telling the truth. Parents can unjustly face jail time and lose their children without reason.

Here are 6 steps you can take to protect yourself and your family if your child makes false allegations against you:

1. Keep a daily log. I use small notebooks that fit easily in my purse and document conversations with social workers and teachers, write notes after therapy appointments, and record details of any behavioral incidents. I also write down what my son eats for breakfast, what activities we do, and what time he goes to bed. The key is to be consistent and document even the mundane. Your log will be much less credible if you only log when an incident occurs.

2. Gather documentation. To establish a pattern of behavior, keep school disciplinary records, ask people to follow up on calls with an email, and, if your child is admitted to a treatment program, request their records when they are discharged. These documents may have mistakes or minimize your child’s behaviors so comb through them and request any corrections. Discuss false allegations with your child’s therapist. Your child may admit the truth to them and this can be documented.

3. Don’t lose your cool, or your credibility. When a therapist, teacher, or others bring an allegation to your attention, listen. Breathe. Keep the frustrated tone out of your voice,  don’t jump to defend yourself and never exaggerate. Sometimes you’re going to find yourself in a she said–he said and your credibility will be everything. A non-defensive response might sound like: “Gosh, I fed Devon eggs and toast this morning, but thanks for letting me know that he told you he hadn’t eaten. If he ever does miss breakfast, I’ll be sure to email you so we’ll be on the same page.”

4. Use video/audio recordings (sparingly). This is a tricky one that can backfire. First, remember that your words and actions on any recording will be judged, probably more harshly than your child’s. Second, you may be accused of provoking your child by recording them, especially if they scream at you to stop. In a few instances, I’ve been successful flipping my cell phone recorder on without my son seeing it. Give that a try.

5. Don’t go it alone. If things are spinning out of control, call a family member or friend to come over to act as a witness. Sometimes you may have to resort to desperate measures. For example, my son currently lives in a group home and I’ve refused to have visitations with him unless we are in a room with cameras and a staff member. We’ve had to cancel and reschedule visits because of this, but I cannot risk being alone with him.

6. Have a backup plan. Have a contingency plan so your other children do not end up in foster care if social workers remove them during an investigation of a false allegation. My sister and her husband have agreed to take my children if this should ever happen to me. It’s a worse case scenario, but you need to be prepared with a plan.

Though my son has hurled devastating false allegations against me, I’ve been able to avoid the worst potential outcomes by being proactive and meticulous about documentation. It’s extremely sad that I’ve had to do so. Yet, it’s a devastating reality that many parents of children with reactive attachment disorder must face to save their families.

Here’s a great resource with advice and information: Responding to Investigations Manual

Parenting advice

3 Reasons Traditional Parenting Doesn’t Work With Kids From Trauma.

For years I pulled out my hair not understanding why my parenting strategy was working with my birth and other adopted children, but not with my son, Devon. NOTHING worked. Learning that traditional parenting methods don’t work with kids who have a trauma background was a milestone for us, something I wish I’d know much earlier than I did.  How to work with these kids is counter intuitive. Check out this great post by adoptive parent Mike Berry

via 3 Reasons Traditional Parenting Doesn’t Work With Kids From Trauma. | Confessions of an Adoptive Parent

In the News, Stories from other parents

Believing “children are resilient” may be a fantasy | Psychology Today

How did resilience become a standard? How did we come to view children almost as nuisances who just need minimal support? How did children’s needs become dismissable?

via Believing “children are resilient” may be a fantasy | Psychology Today

Tips to navigate "the System"

Mental Health workers are burnt out

Mental health “workers” are chronically overworked, underpaid, and not appreciated. “Workers,” given a variety of job titles, are the day-to-day staff who work in group homes and residential treatment facilities, and provide some in-home services. Unlike licensed clinicians and supervisors they’re in the trenches with us and our kids. They’re often just as exhausted as we are.

It’s a sad truth we must face: even the most well-intentioned worker doesn’t have the capacity to give our child the quality care they otherwise would if they're burnt out. Click To Tweet

A few summers ago Natalie (not her real name) was one of our Intensive In-Home services workers. She was absolutely wonderful and dedicated to our success. She was on call 24-7 and when Devon flew into a rage she would hurry over, once rolling straight out of bed in her pajamas. “You go on and do your stuff,” she would say waving me away. “I’ll take care of him.” Natalie knew how much control Devon had over our family during his rages. It was debilitating, keeping me from my job and Devon’s siblings from soccer practice. Natalie was determined to put a stop to it. Day-after-day she spent hours shut in the garage or a back room with Devon while he screamed and raged.

While this respite breathed some life back into me, Natalie burnt out before my eyes. She was working 60+ hours a week plus taking paperwork home every night. Her employer was sometimes ‘late’ on her paychecks and she was over loaded with clients. 

It’s a sad truth we must face: even the most well-intentioned worker doesn’t have the capacity to give our child the quality care they otherwise would if they’re burnt out. 

Here are some ways you can counteract mental health worker burn out and make sure you child receives the highest quality of care possible.

Be Kind–Be polite. Often these workers can’t control the things that are upsetting you so it’s unfair to yell at them. Compliment them when you’re impressed with their work, or even just to tell them you like their new haircut. Offer the in-home workers a cool drink and snack. It is these in-the-field, on-the-ground workers that can make a huge difference in the quality of services your child receives so investing kindness is well worth it.

Do Your Research–Carefully research the agencies you receive services from. In most cases, the ones that can “get you in right away” are the ones to steer clear of. A long waiting list, or at least a few weeks wait for an intake appointment, bodes well for the quality of service you can expect. Ask for referrals from your pediatrician. It can be difficult to find people to ask for personal recommendations when you are first starting to get services, but once you’re “in the system” you’ll find yourself sitting in a lot of waiting rooms chatting with other parents. Take advantage of these opportunities to ask about their experience with various agencies even if you aren’t currently looking to switch services.

Demand Quality Service–Your first priority is your child. Don’t accept sub-standard services! When you first start services with any provider they hand you a stack of papers that outline your rights and the policy to file complaints. I used to dump those in the trash as I walked out of the building, but now I know how valuable they are. You need to know what you are entitled to and what procedures to follow if you need to escalate a complaint. If it becomes necessary, switch agencies or providers in order to get better services. Also check for a parent advocate organization in your area. They can refer you to services and will send an representative with you to meetings to advocate on your behalf.

Whenever you can, advocate for better working conditions for mental health workers. Our kids are only going to be safe if workers are qualified, well-trained, and fairly compensated. Not long ago, there was a riot in a psych facility in my area and the workers were blamed for not handling the situation better. I wrote an op-ed suggesting that we’re asking too much of these entry-level, hourly employees and that working conditions must be improved. You can read my full op-ed here: Charlotte Observer/Don’t blame workers for psych center woes