The Attachment-Based Supports and Services that Adoptive Children and Families Need

The suffering of too many adoptive children runs deep. It runs deep through the spirit and into the neurology of children traumatized by abuse, neglect, abandonment and loss of primary attachment figures. I am the endlessly proud mother of a beautiful, loving, brilliant adolescent adoptive son who I love so eternally that I often forget that I didn't give birth to him. However, in the face of uncanny cycles and life's triggers, I am reminded that as happy and well attached as my son is, no matter how fulfilling and joyful his life is now, the pain of his early history looms near. It is the quality of our support system that determines how well we can weather the storms when they arrive.

In my work with children and families, I am regularly stunned by the glaring deficit in our social service and mental health system's awareness of the special needs of adoptive children. Family after family wearily recounts to me the nightmare of going through multiple therapists, programs and services only to watch their adoptive children sink deeper into detachment, depression and rage. Frivolous use of psychiatric drugs, superficial diagnoses of "ADHD" and Bipolar Disorder, individual talk therapy, "anger management" and "self esteem" groups, behavioral charts and other misguided "treatments" serve to do little more than stall healing, exhaust the family, deplete hope and increase parent-child disconnection. In some cases, the result is a disrupted or rescinded adoption, a tragedy for the child who has already suffered excruciating abandonment and trauma. 

Adoptive children are some of our world's most resilient human beings. They may have been adopted at birth, but many of them have waited, sometimes for one year, five years, a decade, or until they almost "age out" of the system. (Some children do "age out" and never find "forever families"). They come from our own country and from other countries. They are children who may have lived in foster care, residential facilities, orphanages, or in the streets. They are children who may have been shuffled from foster home to foster home, never staying anywhere long enough to understand what love and family means. They are children who may have been abandoned or orphaned. They are children who may have been birthed by parents who were unable to care for them for a number of reasons. They may be children that have suffered physical, sexual and psychological abuse and neglect at the hands of birthfamily, or the systems that were supposed to "care" for them. Too many have been exposed to horrors that many adults couldn't endure. They all have a unique and individualized story. 

However, one thing adoptees share in common is an extreme break in the human attachment cycle. The human parent-child attachment cycle is the critical developmental blueprint of a person's lifelong emotional, social and spiritual health and happiness. The attachment cycle begins in utero and its quality is critical in the first three years of life. However, the attachment cycle must be maintained all throughout childhood. It is the quality of how well and completely parents respond to and satiate the physical and emotional needs of their children, leading to feelings of relief, trust, calm, joy, self-worth and homeostasis. These feelings create attachment. Parents that respond quickly, lovingly and in a nurturing, natural manner to the majority of children's physical, emotional and developmental needs enjoy a secure parent child-attachment, regardless of the child's age. 

In our culture, the more common scenario is that parents react to children's needs based on Western cultural norms. They meet some of their children's needs, partially meet others and offer culturally-sanctioned substitutes (bottles, cribs, jumpers, carriers, stuffed animals, pacifiers, punishment, playgroups, day care, traditional school, organized sports, TV, media, material objects, etc.) to children's most critical needs. These parents note mild to moderate behavioral, learning and emotional problems manifesting in their children as early as the toddler years or beginning in the adolescent years-- problems that our culture believes are "normal" aspects of growing up ("The Terrible Twos", "Typical Teenage Behavior"). This form of attachment is called insecure- The attachment cycle has been disrupted many times, but it is not broken. Problems often resolve in young adulthood or there may be lifelong emotional challenges for children to face.

In families who are outrightly abusive, neglectful or if the child was temporarily removed from the birthparents but returned, the attachment cycle is often severely disrupted. Severe behavioral, emotional and learning problems at any age are the natural results of this level of attachment disruption. However, when a child is  removed from the birthparents, either at birth or at any later age, placed in foster care, an institution or an orphanage and never reunified with the birthparents, there is a severe break in the parent-child attachment cycle. If there is trauma
involved, which is often the case, the break will be more damaging to the child. The behavioral, emotional and learning problems at any age can be severe, extreme or even catastrophic. The collection of symptoms typical of severe attachment breaks are known as Reactive Attachment Disorder (RAD).

Parents who adopt children into their lives are generally unaware of the parent-child attachment cycle, let alone of the break in it, or of the consequences it will have in their children's lives unless the correct treatment is found. They are often unaware that the break in this "primal" attachment cycle has neurological, psychological, physical, social and spiritual effects on their children. When they turn to providers to help them with the resulting alarming behaviors, they are often offered "treatments" that exacerbate the problem.

The attachment cycle is mammalian, and is critical to healthy development in all mammals, especially humans, yet it is overlooked and ignored in the fields of human services. Many social workers, mental health professionals, counselors, psychologists and especially psychiatrists do not even know what "attachment" is or the critical nature of the human attachment cycle. I can't count how often I have heard mental health professionals incorrectly use the words "too attached" to describe clingyness or a child who has separation anxiety with a parent. Ironically, these behaviors indicate a disrupted attachment, or not enough attachment! I even hear many well-meaning mental health professionals misguidedly use the word "attached" to describe a good therapeutic rapport with a client ("Oh, s/he is very attached to me"). Breaks in the human attachment cycle are often the origins of most forms of human psychological distress, including behavioral, emotional and learning problems-- Mental health and social work professionals are truly missing the holy grail of assisting the healing process in people!

So what do adoptive families need?

Adoptive families need attachment parenting education, a solid support network, respite services and a multi-modal treatment approach by professionals who specialize in attachment disruption or brain-based trauma treatments. Following is a list of the types of supports that re-energize families, services that help preserve families and treatments that heal trauma, attachment breaks and emotional disturbance in children. No single service will be sufficient; a multi-modal approach is necessary. 

Adoptive families need:

*Comprehensive post-adoption services from the adoption agency, including post-adoptive stipends, health insurance for the child and funding for respite services and other treatments not covered by insurance (especially for single parents or lower income parents),

*A network of experienced respite providers who can provide overnight care or care for a few days when the child's behaviors are exhausting the parents,

*A strong support system of extended family and friends who are willing to learn about the unique needs and struggles of adoptive children,

*A trauma specialist who uses the brain-based trauma treatment, Eye Movement Desensitization Reprocessing (EMDR)- This is a MUST!

*An attachment specialist who understands how to facilitate attachment in adoptive families, works respectfully and ethically with children and views the parents as part of the treatment team (Some examples are Theraplay practitioners or therapists trained in the Dan Hughes Dyadic Developmental treatment model). It is preferable if the attachment specialist can also do the EMDR.

*Education about attachment parenting and how to facilitate the parent-child attachment cycle with adoptive children (of all ages). Parents must learn how they can meet some of their child's early developmental needs for intense physical affection, connection and nurturing that were unmet or incompletely met in the first three years of life. This is also a MUST!

*Books, websites and resources that support the natural attachment parenting cycle (please see my website for a list of such resources), not the dangerous, power-and-control tactics of a small group of RAD charlatans that are popular online,

*A set of very basic Family Principles that outline the values of the home, a strong set of emotional stability tools for children to use to help them cope with mood swings and emotions, and clear cause-and-effect consequences for behavior that harms the parent-child relationship,

*Information and a support network assisting parents in homeschooling their child or enrolling their child in a child-centered school-- This is very important! 

*If homeschooling, a homeschool community-- This will provide children with wholesome, accepting friendships, social skill practice and offer less opportunity for children to become influenced by the toxic peer groups in public schools,

*24 hour crisis intervention services in the community (including mobile crisis response) that will respond immediatly to families in crisis and understand Reactive Attachment Disorder and PTSD,

*A formal or informal support agency or network of other adoptive families who can share emotional support, respite and resources,

*Funding for adjunct Neurofeedback treatment, a fun brain-based brain training treatment that is an alternative to psychiatric drugs,

*Adjunct treatment with a practitioner who teaches the powerful Emotional Freedom Technique (EFT),

*Funding for homeopathy and other naturopathic and body-centered treatments that are alternatives to psychiatric drugs,

*Testing to rule out food sensitivities in children,

*Information on how dairy, gluten (wheat), soy, refined sugar and non-organic foods can cause mood swings, behavioral and learning problems in children and how to switch to an organic, healthier diet,

*Resources for connecting children to community activities that they enjoy,

*If a child is unable to live at home due to severe behaviors, children need parents to continue their commitment to them through love, support, visits and a lifetime forever family,

*Family court and law enforcement responses that are sensitive to the unique needs of children with Reactive Attachment Disorder who are in crisis,

*Lawmakers who consult with adoptive families and who do not cut funding for vital services such as respite funding and post-adoption funding.

Adopting a child requires a great deal of supports and resources. I have found many of the supports on the above list of supports, services and treatments to be essential for my own family and for many of the adoptive families I have worked with over the years. Some state adoption agencies, such as the state of Maine, lead the way in supporting adoptive children and families and provide a model that the entire country should emulate. It is crucial that social workers and mental health professionals receive the ongoing training and education that allows them to prioritize the parent-child attachment cycle and understand the unique needs of adoptive families.