The "RAD" Explanation: 20/20 Improves It

 In the Nov.9 and Nov. 11 posts on this blog, I  talked about a show that appeared last month on the ABC 20/20 program, and about the trailer that preceded it. The program itself was an examination of an Arkansas case from last Spring, involving the Arkansas state legislator Justin Harris and his wife, and their adoption of three little girls whom they declared to have Reactive Attachment Disorder; after various treatment efforts, including exorcism, the Harrises “rehomed” the girls by giving them to a household where one was raped.  

In the actual program, 20/20 did an adequate job of showing the details of this case--  although for my money, not nearly as good a job as was done for the Arkansas Times by Benjamin Hardy and Leslie Peacock. However, I, as well as other people, had serious concerns about the trailer posted to advertise the program. In its original form, the trailer, entitled “RAD: Explaining Reactive Attachment Disorder”, began with two clips showing shrieking children being restrained physically. We felt this was a problematic beginning because of the implication that screaming wildly and needing restraint were particularly symptomatic of Reactive Attachment Disorder, which is not correct. The trailer continued with a view of perhaps a dozen women, not described or introduced, but rising one by one to speak about the extreme difficulty of dealing with their teenage adopted children, and their certainty that serious violence occurred because of Reactive Attachment Disorder. This last clip was problematic for several reasons: there is no method of diagnosing Reactive Attachment Disorder in older children and adolescents, there was no evidence given that there had been a professional diagnosis rather than the mothers “just knowing it was RAD”, and in any case violent behavior is not a symptom of Reactive Attachment Disorder, although of course it may be a symptom of other emotional disturbances.

After sending the multi-signer complaint letter quoted in my Nov. 9 post, I received phone calls from Miguel Sancho and Lynn Redmond, producer and assistant producer of 20/20. They told me that the two “shrieking children” clips had been provided by the residential treatment center Villa Santa Maria in Cedar Crest, New Mexico. Villa Santa Maria has for years focused on children said to have Reactive Attachment Disorder and was at one time associated with holding therapy, a physically intrusive treatment using restraint as a method of therapy (see http://poundpuplegacy.org/node/26944 ). Villa Santa Maria now uses Dyadic Developmental Psychotherapy, a non-evidence-based treatment, but shows its connection with highly authoritarian treatment forms like holding therapy by demands that children cannot be outside an adult’s eyesight without permission at any time, and that they must ask for everything they need or want so that they recognize their dependence on adults, and that they must experience non-negotiable “closeness” (www.villasantamaria.org/treatment_philosophy.asp). Assistant producer Lynn Redmond told me that she had spent a day at Villa Santa Maria, as well as receiving the video clips, so it is not surprising that the views offered at the school had considerable influence on the trailer.

Happily, Sancho and Redmond recognized the importance of what the signers of the letter were saying, and quickly agreed to make a new trailer. Dr. Anne Marie Albano of Columbia University, a clinical child psychologist, was interviewed for the trailer and made it clear that although Reactive Attachment Disorder exists, its symptoms are not those suggested by the original trailer. The new video, http://abcnews.go.com/2020/video/experts-parents-discuss-rad-reactive-attachment-disorder-34667787, begins and ends with statements by Dr. Albano and shows a much-reduced segment of comments by adoptive mothers (the statements about knives have been removed, and no shrieking or physical restraint is included).

It is really gratifying to know that a major television organization is willing to turn around when informed of a mistake. Naturally, it would be better if 20/20 had sought better information to begin with, but it’s understandable that they would be convinced by people who declare themselves “RAD experts”. It’s not very common knowledge that families don’t need a RAD expert, or an ODD expert, or an OCD expert, but that they do need a highly-trained practitioner who can treat the child and the family—not the disorder. I recommend against employing any person who claims special training in a narrow area; emotional disturbance in childhood rarely involves a single diagnosis, and families need broadly-trained professionals. The “RAD expert”, all too often, resembles the little boy who has a hammer and finds lots of things that need hammering--  having a diagnosis and a treatment, the “expert” may find reason to use the two things on people who don’t benefit in the least from being “hammered”, and even on those who suffer as a result.