808 6th St. South
Kirkland, WA 98033
ph: (800) 550-2105
fax: (425) 636-8129
The children we see may have been involved in numerous foster care placements or have been institutionalized in an orphanage, or residential treatment facilities. Challenging adjustments to life—most often moving from one living arrangement to another—and the behavioral issues that result, are at the top of the therapeutic "to do" list. For that reason, traditional therapies are usually unable to successfully treat a child with an attachment disorder. They are unable to address the underlying grief, loss, and trauma their young client has experienced.
In addition, traditional therapy with younger children often uses play—toys, puppets, stories, games—to illuminate themes in a troubled child's life and help the child resolve an identified problem. Play therapy is designed for children with the ability to respond to its healing potential. Children with attachment disorders usually cannot find a theme to play out. And since parents are usually not involved in play therapy, the child may use the opportunity to try to disrupt any alliance and trust between the therapist and his parents.
Traditional parenting does not work with attachment-disordered children. Sticker charts, behavioral programs, and such don't work. Why? Because all these approaches require a relationship. Charts work with children when the child is attached to a caregiver and desires to please the caregiver; the child feels good when the child makes the parent happy. Your child probably has not such relationships; hence charts won't work.
So, what does work? A combination of parenting that recreates the environment of a toddler (remember while your child's body may be 10 years old, she is probably psychologically and developmentally only 2). The parenting must be VERY structured and VERY nurturing. Natural consequences, not lectures, words, or charts, work best. The key is to not let such a child make everyone feel like she does. Such children are very good at externalizing their feelings and getting everyone else to feel as miserable as the child does. While that might make the child feel a bit better in the short run, it is not healing in the long run. You have to bring the child up to your level.
Every person's ability to trust and attach to important others is on a continuum. Healthy attachment is at one end, and insecure, disorganized attachment is at the other. So treatment of attachment disorder is highly variable depending on the needs of each child or teen and his family. Treatment at ATS takes each child or teen and his family as they are, with their own constellation of strengths and challenges.
We base our treatment plan and protocols on extensive family materials and a number of diagnostic tools. The following tools help us identify and understand important information about each child:
Level of functioning
Current and past school issues
Current providers, caseworkers, etc.
Psychotherapy and medications
Testing results and recommendations such as neurological, psychological, speech, and hearing
Infancy experiences and biological mother's pregnancy and birth history
Change of caretakers
Parent(s)'s chief complaints
Our testing and intake documents
Appropriate attachment treatment and parenting can relieve the effects of a break or strain in primary attachment.
Crucial to treatment progress is the parents' commitment to keeping the child in their family.
Attachment therapy is hard work for everyone involved.
A therapeutic atmosphere must convey safety, protection, hope, empathy, and comfort to all family members.
Good work relies on both child and family having a developmentally appropriate understanding of the therapeutic process and its goals.
Attachment therapy requires a family systems approach since the heart of this disorder is the child's relationship with her primary caregiver(s).
Parents may have problems that need to be understood and addressed in order to help their child resolve attachment and other problems.
Parents and professionals need to educate the systems that impact a child's life and advocate for adequate funding.
Referrals to community providers
Sometimes we refer to other professionals to enhance our work with a child and her family. We may refer for:
· Sensory Integration Therapy
· Psychiatric evaluation and medication prescription
· Specialized therapy for predatory, sexually aggressive youth(SAY Therapy)
· Neuropsychological Evaluation
Consultation with colleagues
We use consultation to enhance our work and provide the best services possible to our clients.
We consult monthly with child psychiatrists on difficult cases.