My pediatrician believes that my child has Reactive Attachment Disorder. What can I do if there isn’t a RAD therapist within 100 miles of my home?

Reactive Attachment Disorder (RAD) is a condition in which individuals exhibit markedly disturbed and developmentally inappropriate social relatedness. Children with RAD have considerable difficulty forming meaningful, affectionate relationships. Since prenatal experience (e.g., exposure to substances), birth trauma, inconsistent or inadequate day care, separation issues, abuse and neglect are often precipitating factors that may lead to RAD, internationally adopted children evidence this disorder at a significantly higher rate than the general population.??

Since healthy attachment to a caregiver is necessary for cognitive, emotional, social and behavioral development, individuals with RAD often experience difficulties in these areas. The bottom line is that problems with attachment during the early years of life may compromise the quality of an individual’s life—particularly when it comes to relating with others.??

What can a parent do if there isn’t a specialist in RAD within 100 miles of their home?

Because children with RAD have considerable difficulty or are unable to cultivate warm trusting relationships with others, traditional counseling or psychotherapy is often ineffective. These interventions rely upon the establishment of a “therapeutic relationship.” In the same way that parents of children with medical conditions (e.g., asthma, allergies, diabetes, etc.) must become “experts” in addressing their child’s condition, so too should parents of children with RAD. Read about attachment disorder and become involved in online support groups. Be willing to try different parenting strategies. For example, instead of explaining why your child should not do something, allow him/her to see the consequences of his behavior… for himself. Become consumed with behaviors that you are so desperately looking for in your child and lose interest in maladaptive, undesirable behaviors. Instead of looking to praise the attainment of goals, try reinforcing approximations of desirable behaviors—particularly those that involve social relatedness. Finally, seize every opportunity to model healthy social interactions for your child and make brief positive comments about these interactions, in the immediate aftermath, with your child.

Rather than trying to find a specialist who will “fix” your child, find a counselor or therapist whom you feel comfortable with. Someone who can provide support and guidance for you through your unique parenting journey.
Written by Dr. Mark Lerner of