Treatment
Outcome Research
Clinical Research
Shows Corrective Attachment Therapy™ Works
By Terry Levy and Michael Orlans
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A
retrospective longitudinal research study was recently conducted
at the Evergreen Psychotherapy Center. This study was designed
to deter-mine the effectiveness of Corrective Attachment Therapy,
a combination of emotional, cognitive and family systems therapy
as well as parenting-skills training.
The
study contained two parts. The first part examined the demographic
and clinical characteristics of 50 children and families who participated
in the two-week Corrective Attachment Therapy treatment program.
The second part examined changes in the behavior and attitudes
of children who completed therapy. Symptom reduction was determined
by comparing scores on the 50-item parent-reported Symptom Checklist
pre- and post-therapy. Following is a summary of some of the findings.
These
children had severe psycho-social problems: 92% had a prior diagnosis
of RAD, and 76% had multiple diagnoses (for example, Oppositional
Defiant Disorder, ADHD, PTSD, Depression).
Parents
reported more severe symptoms in their children prior to treatment
due to:
- parents
and child of a different citizenship (cultural and ethnic differences)
- length
of time abuse and neglect occurred prior to adoption
- number
of years child spent with biological parents
- prior
diagnosis of PTSD and/or several diagnoses in addition to RAD.
Parents
with secure attachment histories reported lowest symptom severity
(34% of mothers and 38% of fathers).
Treatment
Effectiveness
An
analysis was conducted on the pre- and post-Symptom Checklist
scores, measuring the child's improvement on six symptom categories
(behavior, emotion, cognition, relationships, physical, and moral/
spiritual).
Statistically
significant positive changes were found on all six symptom categories
up to three years after therapy. Improvements held over time.
Children
improved more when they had the following characteristics:
fewer
moves in the foster care systems
fewer pre-therapy diagnoses
were not adopted as a sibling unit
were not taking psychotropic medications during therapy
had an adoptive mother with a secure attachment history
These
research findings have important implications for children and
families. First, the research proves that Corrective Attachment
Therapy does help children with histories of maltreatment and
compromised attachment. It also confirms that multiple placements
in foster homes are damaging to children and make treatment more
difficult.
Interestingly,
although there are times when adopting sibling groups is appropriate,
the findings show that certain sibling group adoptions can result
in severe problems for children and parents, and inhibit the development
of secure attachment (for example, when the siblings have pathological
patterns of relating, such as physical and sexual abuse).
The
research also illustrates that the pros and cons of medication
must be weighed, as it can interfere with treatment results.
Finally,
the findings show that the parents' attachment history and current
level of emotional maturity play an important role in the success
of treatment and the child's long-term improvement.
For
more information on Corrective Attachment Therapy, see Attachment,
Trauma and Healing, (T. Levy and M. Orlans, Child Welfare League
of America Press, 1998).
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