Treating Reactive Attachment Disorder: What Families Need to Know
- Cami Lewis
- 4 days ago
- 9 min read
Updated: 3 days ago
Two of the most common questions we receive at RAD Advocates are, “What causes reactive attachment disorder?” (read our blog post on that here) and “How do you treat it?”
Many families search tirelessly for effective help, only to find that traditional approaches — like outpatient therapy, medication, neurofeedback, and even residential treatment — often fall short. In some cases, these methods even lead to setbacks.
A complex affliction like reactive attachment disorder — also referred to as developmental trauma disorder (learn more from APA) — requires thoughtful and multifaceted treatment. However, there is still hope, and there are people who can help.
Understanding Severity: Why Treating Reactive Attachment Disorder Requires Individualized Support
Outpatient therapy, in-home therapy, support groups, neurofeedback, EMDR, and psychiatric services might work for some children. But for those with moderate to severe reactive attachment disorder (read about the spectrum of RAD here), these services often fail — or even make things worse if the providers lack experience with the disorder.
The problem with traditional therapy for children with reactive attachment disorder is that it often causes harm — not through obvious clinical missteps, but by reinforcing damaging family dynamics. These models frequently exclude parents from the process, allowing the child to manipulate the therapist and shift blame onto the very people trying to help them heal. In many cases, the therapist — unaware of the child’s deep-seated control strategies — believes the child’s narrative and points fingers at the parents. This is especially harmful when the therapist doesn't understand that the child’s disorder developed long before they entered the family. Instead of helping, this dynamic erodes trust, undermines the parent-child relationship, and delays meaningful progress. Effective treatment must keep the parent closely involved and limit the child’s ability to control the narrative.
Even if a family does find a qualified therapist who understands reactive attachment disorder, that doesn’t guarantee the family is ready to begin therapy together. A child with reactive attachment disorder must be in a place where they are willing — and able — to be vulnerable. That is the very crux of the disorder: many children simply are not. At the same time, if the parents are suffering from post-traumatic stress disorder (PTSD) due to the intensity of parenting a child with RAD, as many do, they may not have the emotional bandwidth to participate in family therapy either. A skilled therapist in the attachment field will recognize these dynamics and assess how everyone in the home is functioning — not just the child — before recommending a treatment plan. When necessary, they will advise the family to pause, seek additional support, or take steps to prepare for more intensive therapy down the line.
Residential treatment centers (RTCs) are another common route, but they are often ill-equipped for children with reactive attachment disorder. Their rotating, inexperienced staff and behavior-focused models can actually reinforce manipulative or avoidant behaviors. In these environments, children often perform well due to external structure and emotional detachment — but fall apart when they return home to the very relationships they struggle to manage.
The problem with traditional therapy for children with reactive attachment disorder is that it often causes harm — not through obvious clinical missteps, but by reinforcing damaging family dynamics.
Some families with children who have less severe reactive attachment disorder may benefit from these approaches. But as Amy VanTine, CEO of RAD Advocates, explains, “There is no one right way to support children with RAD and their families. We don’t promote just one modality as many variables exist. Here at RAD Advocates, we meet families where they are — based on their child’s RAD severity and needs, the family’s goals and well-being, safety in the home, and more."
Evaluating Coexisting Conditions When Treating Reactive Attachment Disorder
Before families can access meaningful support, it’s critical to determine what they’re actually dealing with. A child cannot get proper treatment without a proper diagnosis — and unfortunately, that poses a particular challenge for children with traumatic backgrounds.
Because reactive attachment disorder is still widely misunderstood, parents often struggle to find professionals who can properly assess and diagnose children. These children often receive multiple diagnoses — some accurate, others not — as many conditions share overlapping symptoms. These include attention deficit hyperactivity disorder (ADHD), oppositional defiant disorder (ODD), autism spectrum disorder, anxiety disorder, depression, mood disorders, personality disorders, and dissociative disorder.
Forrest Lien, a leading expert in developmental trauma disorder treatment, notes that “in my forty years of experience working with kids with developmental trauma disorder and their families, all were labeled as ADHD. For this population especially, ADHD is extremely over-diagnosed.” Learn from one family who has a child with ADHD and how their experience compares to children with RAD in this blog post.
Although no medication exists specifically for reactive attachment disorder, retired psychiatrist Dr. John F. Alston has extensively studied its co-occurring conditions (find his article here) — particularly mood disorders like bipolar disorder — and has found that appropriate medication can calm the brain, creating a more stable foundation for therapy. His research underscores the importance of accurate diagnoses before treatment. Getting the right diagnosis — not just for reactive attachment disorder but for coexisting conditions — is a critical part of the treatment process itself. Without it, families may pursue therapies that are ineffective or even counterproductive. Learn more about Dr. Alston's findings here.
In our family’s experience, we have tried several medications for our son, who has moderate to severe reactive attachment disorder. Abilify — commonly used to treat bipolar disorder — has been the most effective so far, though it took time to learn that his symptoms required a higher dosage than many providers were comfortable prescribing.
But, like other interventions for RAD, medication is not a one-size-fits-all solution. A clinician must understand the various layers that a struggling child is dealing with before deciphering a path forward. And for children from hard places, that requires a thorough understanding of complex trauma and its co-morbidities.
A Developmental Approach to Treating Reactive Attachment Disorder
While many conventional approaches fall short, some families have found success with developmental treatment models — particularly one developed by Forrest Lien. This approach focuses on helping children become “family kids” by building emotional skills through a therapeutic family model. The nonprofit that operated this model is no longer in operation, as it did not survive the COVID-19 pandemic. However, the principles of the model remain a strong and effective alternative from which families and professionals can still learn.
The program paired therapeutic parents with an expert team — a psychiatrist, therapist, and neurofeedback provider — who worked alongside the child’s caregivers. Within this structure, children with reactive attachment disorder gradually relinquished fear-based control, learned to trust adults, and developed the confidence needed to confront emotional and behavioral struggles.
From our personal experience, I can say this model works. Our son spent six months in this therapeutic setting, and although financial constraints forced us to end the program early, the progress he made was unlike anything we saw before. Had the model been more widely accessible or integrated into residential settings, it may have changed our family’s trajectory entirely.
RAD Advocates continues to support professional education around this treatment approach. “We’re thrilled to share a learning module this summer where clinicians can learn more about this developmental model from Forrest Lien himself,” says VanTine. “This supports our mission of educating and equipping professionals to effectively support families of children with reactive attachment disorder.”
What Parents Can Do Now While Treating Reactive Attachment Disorder Remains Complex
Finding the right treatment path can be overwhelming, especially when many traditional therapies fail or worsen the situation. But help is available. One of the best starting points is reaching out to an advocate through RAD Advocates. They can help you explore options, ask the right questions, and make informed decisions — even in the most difficult circumstances.
Getting accurate diagnoses is part of that process. If your child has not yet been thoroughly assessed — or if they’ve collected multiple conflicting diagnoses — take time to revisit that step with someone experienced in developmental trauma and reactive attachment disorder. It can be the key to finding a treatment path that actually fits your child.
"Here at RAD Advocates, we meet families where they are — based on their child’s RAD severity and needs, the family’s goals and well-being, safety in the home, and more.”
If your child has moderate to severe reactive attachment disorder, respite care is essential. Ideally, therapeutic respite if available — but any type of break can help. The physical, emotional, and mental toll of parenting a child with reactive attachment disorder is substantial. It’s okay to need support.
Some children, especially those with mild reactive attachment disorder or attachment issues (not the same — read how VanTine discovered the difference), may benefit from outpatient therapy. But as Lien cautions, “Outpatient therapy is effective only depending on the severity of the child’s reactive attachment disorder and the family's ability to manage emotional and behavioral challenges. Some behaviors in children can be too extreme to handle at home. The family’s safety must never be compromised.”
Other options like neurofeedback and EMDR may also support healing — but they are only pieces of a much larger puzzle. Families often need a full-spectrum approach: psychiatric care, trauma-informed therapy that includes the entire family system, and in some cases, external placement.
Considerations About Therapy for Reactive Attachment Disorder
When therapy is appropriate — typically for children with mild to moderate reactive attachment disorder — choosing the right provider makes all the difference.
A qualified therapist will understand that reactive attachment disorder impacts the entire family, not just the child. If you feel misunderstood, blamed, or find yourself needing to explain how the disorder affects your home life, that’s a red flag. Effective therapists know to include parents in the treatment process and avoid common pitfalls like triangulation.
Look for clinicians with direct experience or training in reactive attachment disorder. Standard degrees or general trauma training are not enough (learn why here). These children require therapists who can maintain structure, redirect manipulation, and prioritize family connection over rapport-building with the child.
Therapists should also assess whether the child is ready. VanTine explains, “The child needs to have buy-in; if the child isn’t interested in change or doesn’t see a need for it, it is unlikely that any treatment will be effective.”
Buy-in begins with helping the child achieve a felt sense of safety — a state where they genuinely feel secure and are open to guidance. But not all children can reach that state in a family setting. For those with more severe reactive attachment disorder, the family home itself may be too emotionally triggering for meaningful therapeutic work to begin.
What About Other Approaches You've Heard About?
If you’ve spent time researching treatment for reactive attachment disorder, you’ve likely come across a range of popular modalities — including Dyadic Developmental Psychotherapy (DDP) and the PACE model, developed by Daniel Hughes (learn about DDP here). These attachment-based approaches emphasize Playfulness, Acceptance, Curiosity, and Empathy (PACE), with the goal of helping children feel emotionally safe and connected to their caregivers.
In theory, these models are rooted in healthy relational dynamics. But in practice, they often assume the child is capable of the emotional vulnerability needed to engage in that kind of connection. For many children with moderate to severe reactive attachment disorder, that’s not yet possible — and these approaches can leave parents feeling more frustrated or blamed when the techniques don’t work.
Other commonly recommended modalities include TBRI (Trust-Based Relational Intervention), somatic work, and narrative therapy. These tools can be helpful in the right context — usually when the child already feels safe in a family environment and the family system is relatively stable. They are not likely to be effective if the child continues to control family dynamics or if safety remains an issue. In some cases, they may never be effective for a particular child.
This doesn’t mean these approaches are without value — it just means they’re not always the right fit, especially for children in the moderate to severe range for RAD. They also are not always the best starting point. Learn, for example, how relying on therapeutic parenting can backfire if the parents and children aren't ready for it here. As VanTine reminds us, healing requires more than just picking a popular method.“Every child and family is different. What helps one family may completely miss the mark for another," she says. "That’s why it’s so important to meet families where they are — with flexibility, creativity, and the right kind of support at the right time.”
For a Recap: Practical First Steps
Treating reactive attachment disorder can feel overwhelming — especially when you’re not sure where to begin. Here’s a brief recap of practical steps you can take right now:
Revisit the diagnosis. Misdiagnosis is common, and getting clarity on coexisting conditions is essential.
Ensure safety. Prioritize the physical and emotional safety of your entire family.
Evaluate your treatment team. Are they familiar with reactive attachment disorder? Do they include you as a parent?
Don’t rush therapy. It’s okay to pause and gather support before diving into treatment.
Reach out for help. RAD Advocates exists to walk alongside families in exactly this place.
You Don’t Have to Walk This Journey Alone
Diagnosing and treating reactive attachment disorder is an exhausting, confusing process — one that rarely goes as expected. But you are not alone. VanTine reminds us: “Reactive attachment disorder is an incredibly challenging disorder, but with the right support and resources, families can find their own version of success.”
Not sure about treating reactive attachment disorder for your child?
You’re not alone — it's different for every family and you don’t have to figure it out on your own. Connect with RAD Advocates to find real answers from those who’ve walked this path.
✔️ Article content verified by RAD Advocates Approved Professional Forrest Lien, LCSW