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Alternative Psychotherapies: Evaluating Unconventional Mental Health Treatments

Friday, July 22, 2016

Missouri and Wyoming Take the Wrong Path on Fostering and Adoption

Twenty years ago, the state of Utah opened a can of worms by hiring trainers for adoption caseworkers from a Colorado group who advocated Attachment Therapy (AT) in its “rage reduction” form. Caseworkers were trained to teach adoptive parents that any resistance or disobedience in the children had to be met with physical force in the form of lying with the adult’s whole weight on the supine child. In the case of  Don. L. Tibbets’ adopted  preschool daughter, the child stopped breathing briefly under this treatment, and although Don reported this to the caseworker, he was told that he and his wife had to continue the restraint practice--  on pain of having the adoption stopped. Don (a registered nurse) did as he was told, but when the child stopped breathing again, she could not be resuscitated. Don was sentenced to six years in prison for his role in the death, but as I am sure you can guess, the caseworkers were not punished. 

The Colorado trainers hired by Utah left behind them the seeds of a number of catastrophes, child deaths, and injuries later caused by AT. Efforts at legislation prohibiting this type of treatment for children were successfully fought by “parents’ rights” groups and by AT therapists and clinics that had sprung up. Nevertheless,  the national furor among professional psychologists and social workers, culminating in a task force report strongly rejecting AT in the journal Child Maltreatment in 2006, helped to limit some of the more egregious AT practices in Utah and elsewhere.

But how soon they forget, right? Wyoming has recently arranged for social services training by the Institute for Attachment and Child Development of Evergreen, CO, home of at least one practitioner with AT roots going way back. The IACD website includes a requirement for parents sending their children to this residential treatment center: if the child has ever accused an adult of abusive treatment, a document to this effect must be provided, so that law enforcement and others will know how to respond to claims a child may make while at IACD.   This precaution must cut out a lot of problems like having to investigate whether a child was actually abused while at IACD, and may have appealed to Wyoming social services bureaucrats. As far as can be told from the website and from reports of personal experiences. IACD does not use any evidence-based treatments, so other than convenience and shared philosophies, reasons for choosing IACD training are difficult to find.


According to the article linked here (thanks to Linda Rosa!),

Missouri is now spending public money to send adoptive parents to an ATTACh conference, where they will receive instruction in a range of beliefs advocated by that organization. Although ATTACh, a parent/professional organization that taught AT concepts years ago, has apparently retreated from the belief in physical restraint as an appropriate way to create attachment, nevertheless the organization continues to teach that behavior problems in foster and adopted children are largely based on a failure of attachment, resulting in Reactive Attachment Disorder. Treatment of disruptive behavior, according to ATTACh, requires “fixing” a child’s attachment to an adult caregiver, even though the child in question is years beyond the developmental stage which is the focus of evidence-based therapies that nurture relationships between adults and children. These views are strongly opposed to positions taken by conventional psychologists and certainly do not provide the evidentiary basis that should be required before public funds are expended. Like Wyoming, Missouri is making a big mistake; people in both states have been conned by AT proponents.


I want to comment on one other aspect of the St. Louis Post-Dispatch article. In addition to reporting that parents will be treated to attendance at the ATTACh conference, the piece refers to a program called Extreme Recruitment, which is said to aim at adoption within 12 to 20 weeks for difficult-to-place children, including older and special needs children. Given that it is very hard on children to be unsure of their position in a family, or even where they will be sleeping the next day, and that frequent changes of foster care are to be avoided if at all possible, this rapid path to adoption nevertheless seems to be an invitation to trouble and disruption. Can either parents or children rationally know that they want to proceed to adoption after such a short period? Especially in the case of special needs children, can parents during that time period learn what they should know about a child’s medical, psychological, or educational needs?  Much as a caseworker or a parent may want to close a file, they need to consider the number of cases in which parents say that the child “came home”, all was well, then suddenly the honeymoon was over and the parents complain that no one gave them all the information they needed. Hastening to reach adoption decisions seems like a way to guarantee those kinds of difficulties, with possible dissolution of adoptions, or in the worst cases the informal Internet “rehoming” that has had such ill effects for children. When people are convinced that all problems of fostered or adopted children are attachment problems, and when they believe that they can “fix” attachment and therefore all the other troubles as well, it is easy for them to fall for the idea that speedy adoption will have positive results.  Extreme Recruitment is associated with the Carleen Goddard-Mazur Training Institute, which on its website offers no evidence of any evaluation of the outcomes of this practice, although it uses the word “replication” which would suggest to professionals that some outcome studies have been done--  but in fact seems to mean only that this approach is being tried in several places. Someone in Missouri needs to examine this program under a strong light. 

1 comment:

  1. And the AttaCh conference has been around in mid-September ever since I knew it. [2004 was the first real time I paid attention].

    EXTREME RECRUITMENT - is this another ... front group for a high-demand organisation?

    12-20 weeks.

    "Given that it is very hard on children to be unsure of their position in a family, or even where they will be sleeping the next day, and that frequent changes of foster care are to be avoided if at all possible, this rapid path to adoption nevertheless seems to be an invitation to trouble and disruption. Can either parents or children rationally know that they want to proceed to adoption after such a short period? Especially in the case of special needs children, can parents during that time period learn what they should know about a child’s medical, psychological, or educational needs? Much as a caseworker or a parent may want to close a file, they need to consider the number of cases in which parents say that the child “came home”, all was well, then suddenly the honeymoon was over and the parents complain that no one gave them all the information they needed. Hastening to reach adoption decisions seems like a way to guarantee those kinds of difficulties, with possible dissolution of adoptions, or in the worst cases the informal Internet “rehoming” that has had such ill effects for children."

    Swotting up on the Goddard-Mazur Training Institute now. [or swaddling up].

    Replication ⊄ several studies being done. "some outcome".

    Is that light ecologically valid?

    ReplyDelete