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Concerned About Unconventional Mental Health Interventions?

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

Wednesday, August 29, 2012

A New and Essential Book About Holding Therapy

Some readers of this blog already know what Holding Therapy is, but I’d better describe it briefly before I talk about an important new book. Holding Therapy is an unorthodox method of treating posited childhood emotional disorders and is physically and emotionally intrusive; documented deaths and injuries to children have been associated with it. Practitioners of Holding Therapy restrain children physically and prod them in the underarms and torso while demanding that the child gaze into their eyes and shout statements like “I want to kill my mother!”. Between lengthy sessions of holding, the children are often kept in “therapeutic foster homes” where they are given limited diets and required to do tedious, unnecessary work. Proponents of Holding Therapy attribute childhood behavior problems, especially in adopted or foster children, to a failure of emotional attachment and believe that their treatment will cause attachment and [therefore, they would say] solve behavioral difficulties. Holding Therapy is an “alternative psychotherapy”, equivalent to the medical procedures often called “CAM” (complementary and alternative medicine). It is based on highly unconventional beliefs and assumptions and lacks a foundation in supporting empirical evidence. In addition, Holding Therapy has been described as a potentially harmful treatment and has been rejected in statements of a number of professional organizations, including a task force report of the American Professional Society on the Abuse of Children and a position paper of the British Association for Adoption and Fostering. (A more detailed description of Holding Therapy and its background in the U.S. can be found in Attachment Therapy On Trial [Mercer, Sarner, & Rosa,2003; Westport, CT: Praeger].)

Most of the information we have about children’s experience of Holding Therapy comes from training videotapes and published descriptions of the procedure by proponents of the treatment. A small number of individuals have come forward in adulthood to report their earlier experiences, but in most cases they have been exceedingly reluctant to be identified publicly. Some of them were legitimately concerned that they would be sued for defamation by their former therapists if they were to name names and describe methods. Others were fearful that their reports would not be believed, and even that those they spoke to would say that their statements were nothing more than proof of the mental illness for which the treatment was used. Some simply wanted to forget the whole thing, while others, who had received little schooling during the course of their treatment, were shy and inarticulate. Of those who sought legal recourse against Holding Therapy practitioners, most were told that a statute of limitations prevented them from bringing charges more than a year or two after legal adulthood.

But a new book, Invisible England: The Testimony of David Hanson  (  gives us for the first time a detailed account of Holding Therapy as experienced and recalled by a victim. Now a young man and the father of two children of his own, David Hanson, with the help of an advocate who has had to use a pen name, has told  in his own words the story of his years of repeated Holding Therapy treatments in a “home” run by a leading British child and family service organization. I’ll quote a brief passage to give you the flavor of David’s description of the treatment in which he was physically restrained:

“ One other adult usally one of the unit residential staff   had to lie down feet on the one adult who would then hold the feet down on the top half one hand behind the therapist back been held by the person sat next to her one hand place on my chest held down my the therapist and constant forced eye to eye contant if I looked way my head would have been pinned in the direction of the therapist and if I tried to say no another hand would firmly clasped over my mouth which would send me into a fit of rage all this was also backed up with a lot of shouting and swearing the therapist would say things like is this what your fucking birth mum did to you did she and the hand would come of my mouth for a responce this seemed to go on for ages”--  and in fact it did go on for hours at a time, weekly or more often, for many years.

Yes, this is Holding Therapy, the same procedure rejected by APSAC, by the British Association for Adoption and Fostering, and by a number of other professional groups--  the same procedure that even David’s advocate had thought “couldn’t happen here”. For the first time, we have a published first-person account that clearly counters claims that children receiving these treatments within the last ten years gave their informed consent to the therapists. It is also made abundantly clear that the children do not express their own feelings, but instead are required to parrot the therapists’ statements. For these essential contributions, I want to thank both David and his anonymous advocate for their courageous publication.

Why is the advocate anonymous? As Invisible England shows, it is not safe to criticize major organizations that can easily pull strings to destroy the livelihood of whistle-blowers. This sad old story is told once again as David’s narrative is embedded in the account of professionals’  efforts  to make visible the secret use of Holding Therapy.

There is much more to the story than I have told here. It’s very much worth reading for anyone who is concerned about the lives of at-risk children and families. And, just a little note for the future: it’s my impression that the organization that subjected David Hanson to Holding Therapy has recently signed on to provide services to children in another country. The problem is not resolved, although David’s account may help us move in that direction.

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