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Considerations When Choosing A Counselor Who Works With Attachment Issues
Attachment Focused Parenting Group
Considerations When Choosing a Therapist who Works with Children With Reactive Attachment Disorder
STL Parent Article
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Considerations When Choosing A Counselor Who Works With Attachment Issues

There are two main considerations when choosing a counselor who works with attachment issues---the type of mental health professional and the training of the mental health professional.  There are many different types of professionals who provide mental health services.  First, let's start with counselors.  A Counselor has completed either a master's level program (M.A. or M.S.) or a doctoral level program (Ph.D. or Ed.D.).  In addition, a counselor also possesses a license (LPC).

Attachment Focused Parenting Group

This group is for parents/guardians of children who have expereinced abuse, neglect, or trauma and are currently experiencing behavioral difficulties (e.g., being uncooperative, anger outbursts, overactive, underactive, physically violent, lack of empathy, doesn't get along with children his/her age, bossy, controlling, etc.)  The group will be facilitated by a licensed counselor.
Topics To Be Covered Include:
Healthy vs. Unhealth Attachment
Development of children
Basic concepts of Attachment Parenting

Considerations When Choosing a Therapist who Works with Children With Reactive Attachment Disorder

The Association for Taining and Treatment in the Attachment of Children (ATTACh) has adopted a list created by Beverly Cuevas to help parents determine if a therapist is competent on issues of attachment and adoption:
Does the therapist:
  • have a current license/certification or other  credential required by their particular state?
  • belong to ATTACh?
  • have a current clinical registered membership in ATTACh or meet the standards to be a registered clinician (80 hours of specialized post0graduate training in the diagnosis and treatment of attachment disorders and regular continuing education in those issues)?

STL Parent Article

I was recently interviewed by STL Parent.  Click the link below for the article.


Hypnosis is a heightened sense of awareness where the person is receptive to suggestions.  During hypnosis, the individual is aware of what is taking place and he or she is totally in control.  I tend to use hypnosis in two ways when dealing with children with RAD.  One way I use hypnosis is when I am developing resources or coping skills with the child.  Secondly, I use hypnosis during trauma work with a client.  There has been two studies regarding hypnosis and trauma.  One study showed that hypnosis significantly decreased intrusion and avoidance symptoms and did so in fewer sessions.  I do not solely rely on hypnosis in treating trauma.  I tend to use it as an adjunct in my trauma work.

Activities That Encourage Interaction

Children with Reactive Attachment Disorder (RAD) need positive interaction.  These are some activities that encourage interaction:
  • Legos
  • Play dough
  • Clay
  • Finger painting
  • Lincoln logs
  • Constructs
  • Blocks

Eye Contact

Eye contact is crucial in attunement and ultimately the attachment process.  Some children with Reactive Attachment disorder have difficulty maintaining eye contact.  I believe that eye contact does one of two things to these children.  One, it can be perceived as threatening to some children with RAD.  Second, it elicits feelings of shame in these children as the "self" has been exposed. 
While I would not encourage a caregiver to force eye contact, I would encourage the caregiver to have the child practice eye contact.


P.L.A.C.E. is an essential part of Dyadic Developmental Psychotherapy (form of treatment for Reactive Attachment Disorder).  The parent/guardian must maintain the proper healing P.L.A.C.E. for the child:

Trauma Work

Most children with Reactive Attachment Disorder have experienced some type of trauma---most have experienced multiple traumas.  In dealing with trauma, it is important to understand a little bit of how the brain works.  The brain is divided into the left and right hemispheres.  The left hemisphere is responsible for: positive, optimistic emotions; processing of verbal communication, words, and numbers; for analyzing, problem solving, and processing information sequentially, allows for elaboration; and has a tendency to approach and explore.

Limbic System

The work of Bruce Perry describes the neurological aspects in the development of attachment.  His work describes how the brain stem develops first, followed by the midbrain, followed by the limbic system, and then the cortex.  His work shows how emotional reactivity and regulation, and belonging and attachment occurs between the caregiver and the infant's midbrain and limbic system.  He proposes that teaching attachment to an older child by cognitive means is not effective in the treatment of Reactive Attachment Disorder.