Mayo Clinic Health Manager
Get free personalized health guidance for you and your family.
Get Started
About our e-newsletters
- Free e-newsletters
- Mayo Clinic expertise
- We do not share your e-mail address
Housecall, our weekly general-interest e-newsletter, keeps you up to date on a wide variety of health topics with timely, reliable, practical information, recipes, blogs, questions and answers with Mayo Clinic experts and more. Our biweekly topic-specific e-newsletters also include blogs, questions and answers with Mayo Clinic experts, and other useful information that will help you manage your health.
Housecall Archives
Mayo Clinic Housecall
Stay up to date on the latest health information.
What you get
- Free weekly e-newsletter
- Mayo Clinic expertise
- Recipes, tools and other helpful information
- We do not share your e-mail address
Treatments and drugs
By Mayo Clinic staffTreatment of reactive attachment disorder often involves a mix of psychological counseling, medications and education about the disorder. It may involve a team of medical and mental health providers with expertise in attachment disorders. Treatment usually includes both the baby or child and the parents or caregivers.
Goals of treatment are to help ensure that the baby or child has a safe and stable living situation and that he or she develops positive interactions with parents and caregivers. Treatment can also boost self-esteem and improve peer relationships.
There's no standard treatment for reactive attachment disorder. However, it often includes:
- Individual psychological counseling
- Education of parents and caregivers about the condition
- Parenting skills classes
- Family therapy
- Medication for other conditions that may be present, such as depression, anxiety or hyperactivity
- Special education services
- Residential or inpatient treatment for children with more-serious problems or who put themselves or others at risk of harm
Other treatments for reactive attachment disorder that may be helpful include:
- Development of attachment between the child and the child's therapist
- Close, comforting physical contact
Managing reactive attachment disorder is a long-term challenge and can be quite demanding for parents and caregivers. You may want to consider seeking psychological counseling yourself or taking other steps to learn how to cope with the stress of having a child with reactive attachment disorder.
Controversial and coercive techniques
The American Academy of Child and Adolescent Psychiatry, the American Psychiatric Association, and the American Professional Society on the Abuse of Children have all criticized dangerous and unproven treatment techniques for reactive attachment disorder. Controversial practices can be psychologically and physically damaging and have led to accidental deaths.
Some unproven treatments for reactive attachment disorder include:
- Re-parenting, rebirthing
- Tightly wrapping, binding or holding children
- Withholding food or water
- Forcing a child to eat or drink
- Yelling, tickling or pulling limbs, triggering anger that finally leads to submission
Beware of mental health providers who promote these methods. Some offer research as evidence to support their techniques, but none has been published in reputable medical or mental health journals.
If you're considering any kind of unconventional treatment, talk to your child's psychiatrist first to make sure it's legitimate and not harmful.
- Reactive attachment disorder of infancy or early childhood. In: Diagnostic and Statistical Manual of Mental Disorders DSM-IV-TR. 4th ed. Arlington, Va.: American Psychiatric Association; 2000. http://www.psychiatryonline.com. Accessed June 23, 2009.
- Reactive attachment disorder. In: Moore DP, et al.: Handbook of Medical Psychiatry. 2nd ed. Philadelphia, Pa.: Mosby; 2004. http://www.mdconsult.com/das/book/body/145545363-3/0/1243/32.html?tocnode=52436085&fromURL=32.html#4-u1.0-B0-323-02911-6..50032-4_311. Accessed June 23, 2009.
- Newman L, et al. Recent advances in the theories of and interventions with attachment disorders. Current Opinion in Psychiatry. 2007;20:343.
- Haugaard JJ, et al. Recognizing and treating uncommon emotional disorders in children and adolescents who have been severely maltreated: Reactive attachment disorder. Child Maltreatment. 2004;9:154.
- Cornell T, et al. Clinical interventions for children with attachment problems. Journal of Child and Adolescent Psychiatric Nursing. 2008;21:35.
- Hanson RF, et al. Reactive attachment disorder: What we know about the disorder and implications for treatment. Child Maltreatment. 2000;5:137.
- Report of the American Professional Society on the Abuse of Children Task Force on Attachment Therapy, RAD and Attachment Problems. American Psychiatric Association. http://www.apa.org/divisions/div37/RADTaskForceManuscript.pdf. Accessed July 1, 2009.
- Coercive interventions for reactive attachment disorder. Association for Treatment and Training in the Attachment of Children. http://www.attach.org/apsac.htm. Accessed July 1, 2009.
- Child Abuse and Neglect Committee. American Academy of Child & Adolescent Psychiatry. http://www.aacap.org/cs/root/policy_statements/coercive_interventions_for_reactive_attachment_disorder. Accessed June 29, 2009.
