Concerned About Unconventional Mental Health Interventions?

Concerned About Unconventional Mental Health Interventions?
Alternative Psychotherapies: Evaluating Unconventional Mental Health Treatments

Wednesday, November 11, 2015

"Faux-RAD" and the ABC 20/20 Video: Some Progress

There has been some interesting progress with respect to the letter to 20/20 I included in a post two days ago. I received a phone call from Miguel Sancho, a 20/20 producer, and another from his assistant Lynn Redmond. They plan to modify the video that caused so much concern, and to do this with the help of Dr. Anne Marie Albano of Columbia University, a clinical psychologist and one of the signers of the letter.

In talking to Sancho and Redmond, I realized how easy it is for people to assume that if an approach to childhood mental illness or problem behavior does not use holding therapy, it must be all right. Naturally I am pleased when the dangerous and physically-intrusive techniques of holding therapy are abandoned, but I continue to be concerned about the use of related methods without evidentiary foundations. There are a number of these methods that were historically associated with holding therapy and have persisted on their own as holding therapy has diminished. These methods include demands for “strong sitting”, assertion of adult authority by requiring children to ask an adult for permission to do anything they need (including toilet use), making sure that a child is within the line of sight of an adult at all times, and the assumption that physical contact between child and adult has a therapeutic value of its own.  These methods are not likely to do direct harm to the child, but they add to what Michael Linden has called the emotional burden of therapy, and because they are ineffective may cause indirect harm by keeping the child out of effective treatment.

I have been trying for years to find a term that will describe not only these methods, but the related diagnostic efforts, and the unconventional theory that supports the whole can of worms. I recently encountered the expression “faux-RAD”, which I think conveys the disparity between these beliefs and practices and those of the conventional, evidence-based practice of psychotherapy. Michael Shermer years ago referred to the suffocation of Candace Newmaker  by her therapists as “death by theory”, and I consider that insight to be essential to the understanding of faux-RAD. It is faux-RAD theory that allows the replacement of one harmful or ineffective treatment with another that is based on the same assumptions.

To deal with the faux-RAD problem, as exemplified by the 20/20 video, we need to understand the tenets of the theory. I am going to state them here in simple form:

  1. Emotional attachment normally begins before birth and is present in basic form in newborn babies.
  2. Children separated from their biological mothers are filled with rage and grief even if the separation is immediately after birth.
  3. Rage and grief prevent development of attachment to new caregivers, as do later experiences of abuse and neglect.
  4. Normally, in non-separated children, attachment advances in two stages during the first and second years.
  5. In the first year, attachment to caregivers progresses because the child comes to recognize that the caregiver is the source of all satisfactions of needs. The repeated experience of need followed by satisfaction given by a parent (called an “attachment cycle”) establishes the authority of the caregiver.
  6.  In the second year, the caregiver sets limits on the child’s behavior, further establishing authority and therefore attachment.
  7. Children are obedient, compliant, and grateful when parental authority has been established in these two ways, and they are said to be attached.
  8. Children who are disobedient, noncompliant, and ungrateful are not attached but have attachment disorders, and they do not recognize parental authority. This situation may occur because of persisting rage and grief, and/or because of the absence of the attachment cycle.
  9. To make children obedient, compliant, and grateful, they must express their rage and grief and achieve catharsis; then, they must experience re-enactments of the attachment cycle which involve complete dependence on adults for food, drink, etc. This treatment causes obedience by establishing attachment.
  10. Because infants need touch experiences, children in treatment also must experience re-enactment of frequent adult touch; this must be given at the decision of the adult and not at the request of the child, and indeed may be against the child’s wishes.
  11. Children who are not attached (have attachment disorder) by faux-RAD criteria are filled with hatred and the desire for violence; if treated by conventional psychotherapies, they will get worse; if untreated, they will grow up to be serial killers or prostitutes.

The tenets of faux-RAD described here are at odds with everything known about attachment, about parent-child relationships, about sources of violent behavior, and about effective psychotherapy, as well as with established definitions of Reactive Attachment Disorder. The confusion of attachment and authority is especially noxious, as it opens the door for practices that are distressing and potentially harmful to children.


Regrettably, a look at doctoral and master’s theses written in U.S. social work schools in recent years reveals that faux-RAD ideas are sometimes taught and accepted. This  fact, together with the state-sponsored faux-RAD trainings of adoption workers in Georgia and Utah some years ago, means that the undercurrent of these potentially harmful beliefs is still very real and may have been exacerbated by the 20/20 video. However, I look forward to correction by ABC and to increased awareness of the issues on the part of psychologists, social workers, parents, and teachers.

16 comments:

  1. I see "faux-RAD" (fRAD) beliefs wherever I look at the training offered by state and local child welfare agencies in Colorado. No one seems to be questioning the unrecognized and wildly inclusive definition of RAD, the "Needs Cycle," and the beliefs Dr. Mercer has listed above.

    In a recent class on "difficult children" offered by the state (through the state foster parent association) even Holding Therapy -- now outlawed by the state -- was still there. In a 1997 film show to the class, a "foster child" narrators asks if foster parents will care enough to hold her, and hold her more, even though she acts as if she doesn't want to be held. Later this foster child narrator implies that the foster parents need to hold her while she rages.

    Nationally, the Child Welfare League of American (CWLA) sells a foster parent training program called PRIDE. I had to make a Colorado Open Records Act request to see this training manual and class materials from my county DHS. Sure enough, the PRIDE manual has section on "attachment" which is largely fRAD, such as that ubiquitous "Needs Cycle." PRIDE claims to use the Levy & Orlans book on attachment as their major reference. This book, which has long been published by CWLA, is one of the major books pushing Attachment (Holding) Therapy, so it is especially disturbing to see it recommended by PRIDE training.

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    1. It's true, these ideas are everywhere, and are encouraged by journalists with less sophistication than Benjamin Hardy and Kathryn Joyce. People see statements about RAD, etc., and because they recognize them as familiar the next time they come around, are convinced that they must be accurate.

      Can anyone identify for me the author who coined the faux-RAD expression? It wasn't me, and I would like to acknowledge the real source.

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  2. Have you by any chance seen the new documentary out?
    www.forfeitingsanity.vhx.tv/

    I don't see how foster parents are getting away with this, my mum is a level 3 foster parent (in Australia) so we dealt with the wild ones but everything was monitored. Mum changed HER parenting methods for each child she had and the main goal was to help the child, this seems to just make the kids robots that scream how high when the parents say jump.
    Sure she kept them in her sight in the kitchen or around animals if their past warranted it, did a knife check at the end of the night and the only time an alarm was installed, was on the inside of my door (I turned it on and off) when we had kids who did abuse other children.
    Most of these parents tend to be describing the same things that our kids did but they were always diagnosed with some form of conduct disorder. Mum certainly didn't touch them if they didn't want it but over time once they went through therapy and a kind of emotional recognition treatment they warmed up and now most of them have a family of their own or at least a steady job. I really don't understand how there is no check ups with the social workers or anything like that.

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    1. I've seen it now, and thanks so much for suggesting it! It's interesting that Forrest Lien's outfit states on the website that parents whose children have accused anyone of abuse must provide a document stating this fact, so the organization can provide it to police and CPS staff if the child accuses anyone while at the treatment center. What if someone at the center actually does abuse them,you say? I guess they're just out of luck!

      It's also interesting that the sponsor of this is not an academic or professional group, but Carrie O'Toole Ministries. The link between certain kinds of maltreatment of children and evangelical Christian beliefs is a powerful one, I am sorry to say.

      As for check-ups with social workers-- a good idea, IF said social workers have not bought into the faux-RAD belief system. But regrettably many have done this already and have even been instructed on it during formal or informal training.

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  3. Wow is all I can say! maybe the kids can manipulate the adults so easily because well the adults are just too darn dumb. They cant even see the contradictions in their own program
    The children have to be responsible but the adults willing let hem fail at things like school knowing full well that their grades will impact the rest of their life. Where's the responsibility for your own child. As for abuse allegations anyone who works with children are told that any disclosure is to be treated seriously no matter what, yet they make these kids world so small that no one would listen to them. social workers talk to the children alone every visit no excuses. Attachment is taught to social workers, foster and adoptive parents over here but its more of the whole secure, insecure forms and never are the children described as evil or feral just hurt.

    I think for most of these people its easier to blame the child then it is to actually look at themselves. The fact that these kids want their birth parents shows that they can in fact form relationships or attachments. The poor kids are in a catch 22: love them too quickly there's a problem, don't love them at all there's a problem.

    Don't get me wrong some children need to be reined in but there are more affective ways of doing it without hurting anyone. I think out of the 50+ kids we fostered we had one child that a psychologist saw problems with attachment, but this child have severe FASD and once again it can be done it just takes time and patience. Did these people ever consider a trust issue?

    If it wasn't so serious I would probably laugh but I must admit to this day I have never once heard a child in the first year of life ask for a drink or to go to the toilet, they have however said da da and made bubbles.

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    1. I don't really want to say that they are dumb, tempting though that may be. I see the problem as a matter of being unable to correct assumptions they've made, or that have been given to them by people they see as authorities. Even though the methods are obviously not effective, their advocates keep on keeping on and insist that they are correct. I think part of this is a matter of identity politics, as they feel they are like others who do the same and that they are all exceptionally good and important.

      There is also a considerable association between the faux-RAD system and a set of religious beliefs that make obedience to authority a primary value. When children are disobedient, this is seen as morally dangerous for them and as an indication that the parents have not carried out their own religious obligations. When they claim that obedience demonstrates attachment, they are bringing attachment theory into a religious framework, but of course this is not explicitly stated.

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  4. Unfortunately, faux-RAD might be seen by many persons as very attractive "explanation" of all problems they meet with adopted (foster) children, because it might be more psychologically comfortable to see the roots of troubles in some false disease rather than in, e.g, adult's wrong actions, the lack of patience, understanding and so on. For this reason, the resistance to true information about RAD naturally might be very strong. It is like ruining somebody's very strong faith in something. May be it is very important that the critics of "RAD-cult" would be associated with wide enlightement as regards valid (scientifically based) positive alternatives to "faux-RAD" concepts and practices, in order the ruin of false faith would not create some depressive "dark hole"in parents mind.

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    1. How to substitute a more enlightened, rational view for that false faith-- that seems to be the important question.

      I think one step in the right direction would be to communicate that one needs to treat the individual child, not "treat RAD" or "treat autism" as if the disorders were separate from the person.

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    2. It seems that it would be very important that parents hear such kind of communications, and not for one time, from experts (e.g., during discussions in TV and so on) together with critics of faux-RAD, and that this information turns out to be more "loud" then present frightening and depressing "faux-RAD" tales already spreading worldwide due to internet and contraversional "missioners". But of course, the question arises, how to achieve this aim in practice.

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  5. Response to Yulia :

    And unfortunately the truth about Reactive Attachment Disorder is not nearly as exciting as the faux-RAD story, so people usually pay less attention to the former.

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  6. It is necessary to create a program for the treatment of traumatized children. In order to be
    Attachments powerful alternative therapists. Make good advertising, and several documentary films criticizing the unscientific methods of treatment for children. In these films should be an element of exposure. For example R. Federici writes, "I isledoval thousands of traumatized children"
    Thousands? Where to write? Where the results of these surveys? He described himself as "Russian Doctor" But is he worked in Russia? Where? In what city? In a children's home, he made his so-called issledovaniya? What kind of people he communicated in Russia? Who are these people. I even want to know what nationality were they? Yes. I want to know why these people think what they like Russian children correctly and stronger than the Russian people. Why did they have long taught us the idea that we are not able to properly educate their children and have to send them to other countries for a proper education. For example, I see only a few sluggish articles of our liberals that reference R.Federichi. These people did not work with orphans and even not visited orphanages. They are politicians but not by doctors and educators.

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    1. I would be very interested to see what Russian articles reference Federici. Could you supply links to them?

      Thank you!

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  7. Recently, an even opozitsii silent about R. Federici. Because there was a lot of revelatory articles. But 3-5 years ago there was quite a lot of articles.
    The Wild Hunt Pavel Astakhov
    Vladimir Abarinov, 13.07.2012 (The Wild Hunt Pavel Astakhov
    Vladimir Abarinov, 13.07.2012)
    "For example, a well-known throughout the country neuroscientist Ronald Federici, a father of seven adopted children, he believes that one of the conditions is not enough. The correctness of Dr. Federici confirms the fact that children who grew up on a ranch and often returned there to be older workers. But, Anyway, no harm, and life on the farm does not work. "It's like a vacation at sea, - says Federici. - On the shore of the sea always feel better. "
    http://grani.ru/opinion/abarinov/m.199013.html

    Adopting from Russia: expensive but good
    Published: February 25, 2013 (Adopting from Russia: expensive but good
    Published: February 25, 2013)
    See the original material on the site, "Top Secret": http://www.sovsekretno.ru/articles/id/3430/


    2004. At that time opozitsii admired and extolled this so-called humanist .R.Federici

    "Ronald Federici, a famous American child psychiatrist, neurologist, and his wife, Jane, decided to adopt a dark-eyed and dark-haired Lena and Kolya
    From the very first day of the Jane and Roland tried to instill in their kids, now they do not hurt anybody, do not hit. Jane learned to cook soup and sculpt dumplings, Ron kissed Lena Russian cheeks. When the first few days of perfect happiness passed, and the problems started. Nick was afraid to sleep without the light and cried at night Lena covered his head when someone close sharply waved his hand. "
    "I met Lena and Kolya four years after they moved to the United States. Lena proudly presents" Elaine Federici "great at school, she danced. Nick received at school nicknamed Coca-Kohl, became interested in history, making progress karate, and said that "girls - sucks! '

    "Nick was afraid to sleep without a light, Ronald glued to the ceiling in his room a scattering of stars that glow in the dark."
    http://www.jerusalem-korczak-home.com/dr/drN2.html

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    1. Let me fill in some other parts of this story. First, Federici,is not a psychiatrist (medical doctor) but a psychologist with the non-research degree Doctor of Psychology (Psy.D.). Unfortunately, he has often allowed himself to be identified as a medical doctor and has spoken of providing sedatives for children on flights from Europe to the U.S.

      Second, Federici was married to Jane in the 1990s, as far as I can tell. They were divorced and he had a serious girlfriend, then another wife who divorced him, and now he has a baby with a former staff member. I don;t mean to state these events as problems, just to say that it is incorrect to present Jane as the adoptive mother of the children for a long period of time.

      I have talked to Elena on the phone at some length. Some of her charges, and counterarguments by Federici supporters, can be seen at poundpuplegacu.org/node/27002.

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  8. Thank you Jean. I had suspicions, and the suspicions were true.
    There were too many lies. Now I understand why so P.Astakhov zealously struggled to stop the export of Russian orphans. He said, "We conducted studies and by now we know what is happening to our children in some foreign families." He also said, "The children have grown up and are free to talk about a" happy "life in these families. If a so-called doctors will continue to contribute to the justification sadists and murderers ..... we will find a way to talk to these kids and make public the information "I think he was talking about R. Federici and. Elena and Nikolai.

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  9. I also suspect that our children too literally perceive parting other relative or staff of the orphanage before otezdoi from Russia. Victor Tulimova grandmother told him before he left, "you're older and you have to take care of and protect iladshih brothers" Victor defended the brothers as he could. He perklyuchil the wrath and power of the adoptive parents.
    The staff of the orphanage said Elena before leaving, "You do not eat a lot in America. If you're going to eat much ... you will become fat and ugly" They joke ....... but she really tried to follow this humorous advice for a long time. It's very sad :(

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