Chapter

Reactive Attachment Disorder and Severe Attachment Disturbances

Child and Adolescent Disorders

II. Specific Disorders

  1. Thomas G. O'Connor1,
  2. Mary Spagnola2,
  3. J. Gerard Byrne3

Published Online: 25 JUN 2012

DOI: 10.1002/9781118156391.ebcp001018

Handbook of Evidence-Based Practice in Clinical Psychology

Handbook of Evidence-Based Practice in Clinical Psychology

How to Cite

O'Connor, T. G., Spagnola, M. and Byrne, J. G. 2012. Reactive Attachment Disorder and Severe Attachment Disturbances. Handbook of Evidence-Based Practice in Clinical Psychology. 1:II:18.

Author Information

  1. 1

    University of Rochester Medical Center

  2. 2

    University of Rochester Medical Center

  3. 3

    Lucena Clinic

Publication History

  1. Published Online: 25 JUN 2012

Abstract

The reactive attachment disorder diagnosis has been a part of psychiatric nomenclature for decades, but there is still considerable controversy on basic clinical questions of assessment and treatment. This chapter addresses some of the historical bases of the concept of attachment disorder and more recent findings from observational studies in order to inform best practice of assessment and treatment planning. A particular focus is placed on developing observational and interview methods for clinical purposes. We also review the limited data on treatment for attachment disorder-related behaviors. We conclude that there is as yet no clear evidence-based model for reactive attachment disorder and that available data do not yet make certain which conceptual approaches to treatment may yield the most benefit to children and their families; specifically, behaviorally-based approaches may be as clinically valuable as conventional attachment research-based approaches formed from the work on attachment theory. Finally, we note that this is an area in which there has been a great deal of misinformation and poor practice, and that progress in this area will require careful clinical research as well as rejection of models and methods that are without a clinical scientific foundation.

Keywords:

  • reactive attachment disorder;
  • attachment;
  • institutionalization;
  • treatment