Karen Swanay

I'm taking classes again (on-line so it doesn't disrupt the family)...I have
a paper to write for my Psychology of Adjustment class. The professor is
being very liberal with sources for this paper. So I was hoping to get some
of you experienced RU folks to chime in on my topic...because the way I feel
about these "methods" are very much RU driven. So if you don't mind, and if
the list doesn't mind, please let me know how you feel about the following,
and if you care to answer more than just "I agree" that would be good for me
because I need sources. You will of course be given credit for your answers
in APA style.
Thank you.
Karen

OK: Topic is the use of coercion in treatment of attachment disordered
adopted children (I do not have my hypothesis written just yet. I'll do
that today.)

Here's a an article from ATTACh about this practice (the entire text is
here: http://www.attach.org/WhitePaper.pdf )

The purpose of this document is to set guidelines and standards for
ethically and clinically appropriate treatment for children with attachment
problems. This document is intended to provide guidance to parents and
therapists so that they avoid the use of coercive techniques. ATTACh
believes a
central focus of treatment for children with attachment problems is to
create an
environment in which the individual can safely work to integrate previously
unmanageable information and emotions related to early traumatic experiences
with caregivers. Those post-traumatic emotional reactions interfere with the
development of healthy relationships and may have serious negative effects
on a
child's overall development.

*********
OK so that's the focus...here is a brief description of what they are
talking about...


It is important at the outset to clarify that a coercive treatment approach
is separate and
distinct from the occasional and judicious use of strategies such as logical
and reasonable
consequences, safety interventions, enforcement of limits and other
legitimate interventions in
the socialization of and provision of safety for children. Though these can
be defined as
"coercive," they are not typically accompanied by fear and are a legitimate
part of a parenting
toolbox for parents of all children. When used in the context of a loving
parent child relationship,
the occasional and judicious use of such techniques is a constructive
intervention of parenting.

Harmful and threatening forms of coercion have previously been used in
treatment with
children. Some of these practices were done in the name of attachment
therapy. Examples
include wrapping children in blankets and not allowing them to leave; poking
children during
therapy and strongly encouraging (even demanding) them to express anger at
previous abusers;
adults lying on children; and therapists forcing a child to carry out
explicit instructions for
behavior (e.g., sitting in a specific manner) as dictated by the therapist
or risk serious
consequences. These practices, and similar ones, fall in an area that is
clearly coercive. We
believe that the use of this type of coercion is not appropriate in
treatment for children.

************
Further...

In addition, ATTACh supports
recommendations in the 2006 Report of the APSAC Task Force on Attachment
Therapy,
Reactive Attachment Disorder, and Attachment Problems. (Chaffin et al.,
2006) Specifically, we
agree with following recommendation:
�techniques involving physical coercion, psychologically or physically
enforced holding, physical restraint, physical domination, provoked
catharsis,
ventilation of rage, age regression, humiliation, withholding or forcing
food or
water intake, prolonged social isolation, or assuming exaggerated levels of
control
and domination over a child are contraindicated�." (Chaffin et al., 2006, p.
86)
Each of these statements condemns the use of coercion in treatment. However,
none
gives guidance about what distinguishes coercive interventions from
acceptable authoritative
practices. It is easy to distinguish between the extremes. However, a wide
continuum exists
between the endpoints. This is the area in which parents and therapists have
struggled to find
interventions that effectively address the population of children who have
experienced early life
maltreatment and their current challenging behaviors. ATTACh believes it is
important to give
usable guidance to those courageous enough to work with these children, even
if giving such
guidance is fraught with difficulties.
The therapeutic use of confrontation and directive therapeutic techniques is
widely
viewed as appropriate and beneficial when appropriately applied (Hammond,
Hepworth, &
Smith, 2002). The phrase "confrontation" is used in therapeutic literature
as a technique to help
the clients resolve maladaptive defenses. ATTACh believes the proper use of
therapeutic
confrontation and other directive techniques may be beneficial but must be
done in a
manner that promotes attunement, sensitivity, and developmental
appropriateness.
************************

OK it's a long paper and there is more. Specifically what I'd like to see
from the RU perspective are feelings about this treatment and if you have
any real stories of RAD and treatment for it from an RU perspective that
would be perfect. I want to contend that it's possible to treat a child
with RAD with dignity and respect and still foster an attachment, but I
don't know if I'm right. My daughter has attachment issues but not severe
ones. Am I wrong about seriously disordered children? Can RU work there
too?

Thank you for your help,
Karen


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