Reflections on an article by Nancy Thomas: Reactive Attachment Disorder

September 16, 2011 · Print This Article

I was reading an article online by Nancy Thomas called “What is Reactive Attachment Disorder” and find her pre – suppositions rather disturbing. Particularly, when she has no formal training in the assessment of attachment that I can discern from the attachment and child development experts in the field. When I reviewed the list of individual she has trained with, none of them that I was able to research had any formal training in the assessment of attachment quality of children. I may have to dig deeper with whom she has trained and with her trainers have trained with…

1) She presumes attachment is an “all or none” construct. This is a false. She claims on her site ” Attachment is defined as the affectional tie between two people. It begins with the bond between the infant and mother. This bond becomes internally representative of how the child will form relationships with the world. Bowlby stated “the initial relationship between self and others serves as blueprints for all future relationships.” (Bowlby, 1975)”

Her citation by Bowlby is now an outmoded concept. Attachment researchers such as Sroufe, Carlson, Waters, Marvin, Siegel, Soloman, Bretherton and others clearly state that that attachment occurs along a developmental path, and should one have an insecure form of attachment early on, this does not preclude them from developing a secure attachment over their early life or later life with a trusted and sensitive caregiver, spouse, or therapist. For example, let’s assume a mother depressed during the first year of an infants life but during the second year, receives and responds positively to treatment and becomes sensitively attuned to her child – the attachment security and quality can be developmentally altered onto a more secure path. “Blueprints” can be changed. Very, very, very rarely does a child lack an attachment relationship to any caregiver.

2) Her statement: Attachment Disorder is defined as the condition in which individuals have difficulty forming lasting relationships. This is false. This is clearly know as a “hasty generalization” in logic and a fallacy. She has taken a very complex topic as attachment and made an over generalization about it.

3) She then launches into a discussion of “non-attached”. This is very, very rare and false and evidence of all or none thinking. Research is clear that children who have experienced maltreatment can and do often have an attachment relationship with there caregiver. It is often a form of insecure attachment with evidence of what is usually an organized pattern having disruptions to it (known as disorganization). A more accurate reference is a “child with distorted attachment that initiate a maladaptive pathway…(Alan Sroufe, personal communication 9/20/11)

4) Children with “non-attachments” are doomed. This is false. The University of Minnesota has done extensive work with children in orphanages in Romania who exhibited “no attachment pattern” who are now exhibiting increasing security in their caregivers. This is very promising. And, again, lack of attachment to any caregiver is extremely, extremely rare.  A more accurate reference is a “child with distorted attachment that initiate a maladaptive pathway…(Alan Sroufe, personal communication 9/20/11)

5) Attachment Disorder is accepted as a disorder by professionals with a clear definition and she describes the symptoms. This is false.   There is and continues to much debate about the diagnoses of RAD and while progress is being made in the upcoming DSM-V; there remains much work to be done.

6) She lists “causes” of attachment  “disorder.”  Again, the pre-supposition of disorder is rather disturbing. Attachment is a description of the quality of the relationship and how well a child has confidence in his/her caregiver to meet his/her needs consistently and sensitivity. The list she provides are certainly correlated with forms of insecure attachment, however; to claim  a cause is false. Also, children who exhibit secure attachment patterns can later develop an insecure pattern for various reasons: death of a parent, severe illness, divorce, etc.   Patterns of attachment security/insecurity occurs over a lifetime.

What does this all mean…be careful what you read on the internet. Do your research. Be critical. Ask questions. My friend is an author and said, “Writing a book has made me an expert.” I appreciated his comment on this – but writing a book makes someone a writer, not an expert. Only proper knowledge and proper training and proper ongoing research and experience make someone an expert. Clearly, Nancy may have some thoughts and skills on parenting techniques that are helpful, but an attachment expert, she appears very misinformed regarding what attachment is and  not. This is no fault of her own. It is a very misused and abused concepts among treatment professionals who lack specific training from experts in the field.

One more thing, she discusses her upcoming study on her effectiveness by reducing cortisol levels in parents proving her techniques work. The proper research based on her claims would be assessing the cortisol levels of the children and seeing if those are reduced combined with other measures of assessing attachment security in the children to determine their attachment security. After all, she claims on her website to “provide help for each wounded child….” See below for a direct pull from the site:

“We offer information on adoption / attachment and bonding issues, and Reactive Attachment Disorder (RAD) to families and professionals. We are also the official home of Families by Design providing educational materials and seminars.The goal of this site is to provide help for each wounded child with attachment disorderPTSD (Post Traumatic Stress Disorder)ODD (Oppositional Defiant Disorder)….”

After receiving a posting, I reviewed this article. It appears that the pages that were cited from the Nancy Thomas website are no longer available. I am hoping that the site has been updated to reflect what is currently known from research. Research can provide us with sound information. It allows us to take what we know and make it into models that can hopefully help - as my mentor for the past two year, Dr. Bruce Perry states, "Essentially all models are wrong...but some are useful!"

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19 Responses to “Reflections on an article by Nancy Thomas: Reactive Attachment Disorder”

  1. Momma Paige on April 9th, 2013 3:40 pm

    Clearly, you are selling something. I have raised an unattached child. Nancy Thomas was our guru and savior. He is now an adult, and although he has had some success navigating a world in which people are fairly feelings-connected, he still has a disconnect. As a soldier, he was able to clean up the remains of a suicide with no emotional response because, “It’s my job.” Superficially, he is a comical guy, and very sweet, but there is no depth to his relationships. Have you raised an unattached child? Have any of the people whose research you are using? I am a mother, a step-mother, a grandmother and a licensed special educator. I trust the words of a dedicated parent/step-parent/adoptive parent far more than the research-educated person reading/writing in scholarly journals. You can’t understand RAD unless you are the parent–or the child.

  2. tstein on April 11th, 2013 8:20 pm

    Reprinted from Woolgar and Scott (2013) The Negative Consequences of Over-Diagnosing Attachment Disorders in adopted children: The Importance of Comprehensive Formulations
    There has been increasing interest in the area of attachment disorder in the light of findings from the series of studies of children adopted from orphanages in the former Eastern Europe (e.g. Rutter, Kreppner, & Sonuga-Barke, 2009; Zeanah & Smyke, 2008). However, there is a growing mismatch between the rigour of academic studies and the application of the attachment disorder construct in everyday practice. There is widespread use of the term ‘attachment disorder’ by services for adopted
    and fostered children, but there is little scientific or diagnostic consistency in the way in which the term itself is used in these contexts (Nilsen, 2003). Frequently, the constructs used bear little resemblance to the diagnostic categories that exist in DSM-IV-TR and ICD-10 (Prior & Glaser, 2006) and there is particular concern about some of the ineffective and even dangerous treatments that have followed from its use (AACAP, 2005; Chaffin, et al., 2006; Hanson & Spratt, 2000), which raises issues about how clinicians should use them in practice (DeJong, 2010).

    The use of recognised diagnostic terms offers reliability and common understanding but is made more complicated for attachment disorder because the proposed aetiology forms part of the diagnosis (Zeanah, 1996). Both subtypes of reactive attachment disorder (RAD) in DSM-IV-TR and the equivalent diagnoses of RAD and disinhibited attachment disorder (DAD) in ICD-10 highlight pathogenic care occurring before the age of 5 (see Prior & Glaser, 2006). So there is a risk of diagnosing attachment disorder in samples of children who have been subject to early loss or trauma based primarily upon their caregiving history, without giving due attention to their current presentation. Indeed, the requirement for evidence of pathogenic care before the age of 5 is often ignored in diagnoses, but this is essential given the importance of very early experience in the development of the attachment system. The risk of misdiagnosis is further compounded by the availability of online checklists and questionnaires that claim to identify attachment disorder using lists of symptoms that span several recognised alternative diagnoses, including conduct disorders, autistic spectrum disorders, learning disability, attention deficit hyperactivity disorder (ADHD), as well as bizarre items such as ‘a fascination with fire, blood, gore, weapons, evil’ (Prior & Glaser, 2006). We argue that these complexities with the diagnosis often lead to the over-identification of attachment disorders at the expense of more common problems that may often be treatable by standard means. This over-diagnosis occurs even though clinicians have been advised to avoid the ‘allure of the rare disorder’ (Haugaard, 2004) and to consider more everyday disorders such as conduct problems, mood and anxiety in samples of maltreated and neglected children (Chaffin, et al., 2006).
    To preserve the integrity of the attachment disorder construct it is important for clinicians to keep the distinctions between attachment disorder, attachment patterns, disorganised attachments and attachment difficulties intact, together with their respective evidence bases (see O’Connor & Zeanah, 2003; Prior & Glaser, 2006). Then there is also the confusing and inappropriate description of a parent’s relationship to their child being referred to in attachment terms, especially in assessments for Court (e.g. ‘What is the carer’s attachment to their child?’), or indeed for the child’s relationship to non-attachment figures, pets or even, in our clinical experience, to inanimate objects. It is important to recall that Bowlby described attachment security arising from the child feeling safe and protected by their tie to its carer, not vice versa (Bowlby, 1958, 1982). Within the developmental psychology literature, the attachment construct is precisely operationalised, to refer to accessing protection and safety, which is quite distinct from the much wider notion of ‘relationship’ (Goldberg, Grusec, & Jenkins, 1999); however, in our experience the term attachment is often used in clinics and children’s services to refer to relationships in general. Similarly, the meaning of attachment disorder in the diagnoses of RAD and DAD refers to a severe, pathological breakdown in the normal attachment system that an infant or very young child develops with its caregiver. This means something much more substantial than problems within the child-carer relationship or difficult early experiences and, consequently, attachment disorders are thought to be very rare, even in high-risk maltreated samples (Zeanah & Smyke, 2009).

    To some extent the problems with the construct of attachment disorder that we will illustrate in this paper have probably developed in the context of an absence of effective terms to describe the sometimes bizarre and atypical presentations in children, including looked-after and adopted children, who have been subject to early disruptions in their attachment relationships or exposure to significant and persistent traumas within the caregiving relationship. The research literature has recognised this difficulty. For example, Zeanah and colleagues have proposed a range of putative clinical presentations that could indicate degrees of disordered attachment, including role reversal and compulsive compliance (Boris, et al., 2004; Zeanah & Boris, 2000). While there have been some attempts to think about the assessment of the relationships that drive secure attachments (Zeanah & Benoit, 1995) and an attempt to categorise problems at the relationship level (Zeanah & Smyke, 2008), such relationship disorders are not the same as the child’s specific attachment to a particular carer or the presence of an attachment disorder within the child. In a further complication of the picture, while the distinction between the two forms of attachment disorder in ICD-10 is well made, recent research suggests that the disinhibited form of attachment disorder is characterised by widespread deficits in brain and social function that may be best construed as a neurodevelopmental disorder and not as a malfunction of normal attachment processes (Rutter, et al., 2009).
    There is clearly cutting edge research going on in this field to further refine various attachment constructs but in the meantime we are left with diagnostic categories within the ICD-10 and DSM-IV-TR systems that can be hard for clinicians working with adopted, fostered and maltreated children to make consistent and reliable use of (Boris, et al., 2004). Fortunately, there have been some helpful guidelines suggested by Prior and Glaser, consistent with recommendations made by O’Connor and Zeanah (2003) and two sets of American practice parameters (AACAP, 2005; Chaffin, et al., 2006) to guide the clinical application of attachment disorder in a way that is also consistent with Bowlby’s original proposal. Concerning ICD-10, Prior and Glaser suggest that there needs to be evidence that the attachment system has failed and that no discriminated attachment figure has been achieved, e.g. the absence of an effective attachment figure to whom the infant or young child seeks proximity and comfort (RAD) or the lack of a specific, discriminated attachment figure (DAD). Whatever else, there needs to be good evidence that it is the attachment system itself that is not functioning, rather than the presence of behaviours that could be explained by non-attachment-specific factors, such as the result of exposure to trauma, other common psychiatric disorders or neurodevelopmental problems. Moreover, it is unhelpful to think that there is an ‘attachment disorder’ outside and distinct from one of its recognised forms of either DAD or RAD in ICD-10 or RAD-inhibited or RAD-disinhibited in DSM-IV-TR. Again, the scarcity of RAD and DAD diagnoses, even in groups at high risk of early pathogenic care such as looked-after and maltreated children, means that more common disorders should be considered first (e.g. Boris, et al., 2004; Meltzer, Gatward, Corbin, Goodman, & Ford, 2003).
    Large-scale research into the health and well-being of looked-after children in the UK has identified the types of mental health disorders commonly seen. While there are bound to be some differences between adopted and looked-after samples, most adopted children in the UK will have come through the looked-after system, for at least some part of their lives and, as such, the data from these studies can guide us to the likely range of disorders and diagnoses to consider for adopted children in the UK (Ford, Vostanis, Meltzer, & Goodman, 2007; Meltzer, et al., 2003). For example, looked-after children have significantly elevated rates of conduct problems and ADHD, compared with both high-risk and normal controls in birth families (e.g. 39% vs. 10% and 4%, for behavioural disorders respectively and 8%, 1% and 1% for hyperkinetic problems respectively; Ford et al., 2007). These are disorders for which well-established care pathways using evidence-based treatments already exist. Indeed, there is no evidence that we know of to suggest that the conventional treatments are not effective in looked-after children. The same research study also looked at the prevalence of attachment problems. Using a narrow definition that maps well onto the ICD-10 disorders, only 2% of looked-after children were identified as having a possible attachment disorder, whereas about 20% were identified with a broader set of attachment-related problems that went beyond the ICD-10 diagnoses (Meltzer, et al., 2003). It is important to note that this report specifically considered that both the narrow and the broad definition are likely to be unreliable estimates and that they should not be used to estimate attachment disorder prevalence. Indeed, because the instrument did not assess the requirement for pathogenic early experiences (Meltzer, et al., 2003, pp. 138–139) and nor could it make use of the recommended structured observations of the child’s behaviour with carers and strangers, these figures are likely to be over-estimates of attachment disorder.

  3. Dorrie on June 14th, 2013 11:29 pm

    First of all, what is your name? Didn’t see it anywhere – it feels good to attack someone with whom you do not agree if you can do it annoymously!
    Second, you are an idiot. Where are your credentials? Why should anyone believe you?
    Third, I have attended Ms. Thomas’ Workshop and I truly believe that she has discovered one of the ways to reach children suffering from RAD. I am a graduate of the UAA, with a degree in Dental Hygiene, and I am Mother of four. You don’t need a degree to help make a child’s life better.

  4. tstein on June 27th, 2013 3:29 am

    Thank you for taking the time to reply. I appreciate that the interventions were beneficial to you. I do take offense re: the derogatory remarks. The writer, myself, is posted on the site. I believe it says “written by” or “posted by”…It is easy to overlook as I do believe the font is small.

    The model is not supported by the and has been rejected by other professionals in the field. Peer review has questioned the efficacy of that model. With that said, I am certain, like many interventions in the field, there are some nuggets in the model that are beneficial.

    My credentials are as follows: Bachelors Degree in Philosophy and Psychology, Masters Degree in Community Counseling, 20 years experience in parent child interactions, family therapy, child, adolescent and adult individual therapy,and marriage therapy, Reliable in the MacArthur Preschool Method and Circle of Security Modalities for assessing attachment, 160 classroom hours in the Ainsworth Infant Attachment Assessment and working towards reliability, 80 hours of training in the Circle of Security psycho-education and therapy model, clinicians Adult Attachment Interview training, reliable in Bretherton Attachment Story Completion Task, working on the coding procedure by Dozier called “This is My Baby”, Licensed Professional Counselor, National Board Certifed Counselor, Board Certified Professional Christian Counselor, Accredited Forensic Counselor, Certified in the Parenting Your Out of Control Teenager Model and was a national trainer, Certified Practitioner in Corrective Thinking, Certified Multi-Cultural Competency, Custody and Child and Caregiving Risk Assessment Evaluator, Consultant for a Number of Counties in Assessment and Case Planning as well as program development, Clinical Supervisor of our staff (and more over the years) and and number of others…

    Regardless of the list, individuals choose to believe what they want to believe. I encourage consumers to do their research – particularly regarding the treatment of a child’s mental health.

    Your statement is true re:a degree is not necessary to make a child’s life better… We know this from research!!! 🙂

    Warm Regards
    Ted Stein

  5. Nichole Martin on September 30th, 2013 4:23 am

    I too have to come in agreement with many of the others responding to this. I have an 8 yr old daughter with RAD and after watching Nancy Thomas’s dvds and reading her material on the subject I am SOLD. I am sold because she has NEVER met me – nor been in my home – nor met my daughter and yet her writings and her dvds describe my life with Shelby to a T. It is as if she is describing MY LIFE and MY DAUGHTER specifically. All the way down to how I feel as a mother raising this young girl. Do you have a child with RAD? Or have you raised one? I can say ((hands down)) that it is the GREATEST challenge I have ever faced and Nancys understanding of it….her APPROACH to it…has been my only hope and my only comfort. My little girl recently ran away from home. Went door to door throughout my neighborhood claiming to be starving. She claimed that my husband had TOLD her to go out walking and find the family food (we have plenty of food). She talked an older lady into taking her to the store and buying her a bag full of food. Granola bars..ramen noodles…then took off running to a nearby school. She tried to break into the school. Set off an alarm. The police showed up and she proceeded to tell the police officer that she had been kidnapped “by a large black man”. She said he put a bag over her head and hog tied her. Then carried her far away from her home (on foot) and just dumped her off at the school. All this time my husband and I are frantic. We called 911 and they connected us to the little girl picked up at the school. They brought her home. Told us of her tall tales. She got out of the police car and came SKIPPING up to me with a smile on her face. This is not the first time she has done this sort of thing. Usually she is trying to triangulate me against any other adults in her life outside of the family. I had to homeschool her because she had convinced her pre-school teacher that I refused to take her to the doctor even though she told me it hurt when she pee’d. I had taken her to the doctor 3 times in one week. Nothing was wrong with her. She told ME the teacher would not LET her pee when she had to go. She said the teacher would make her go in her pantz causing her to smell. I am afraid to talk to ANYONE about her issues because she is so manipulating I am afraid I will lose her due to her lies. THat people won’t believe me. Nancy Thomas GETS that. She CONFRONTS that. Her methods work AROUND these issues. Her approach is healing the child THROUGH the parent. Conventional therapists take the child off alone. Try and earn their trust. And with a child like mine…that is a recipe for disaster.

  6. tstein on October 16th, 2013 4:19 pm

    I am glad to hear you that things are better for you and your daughter. It reads like an impossible situation that would strike fear into the heart of any parent. The behaviors that children with trauma and attachment disruptions present are difficult to understand. As you experienced, most “traditional” parenting methods are often met with resistance and with behaviors than are confusing for parents and some professionals alike. You and I agree on the main issue which is that healing the child must occur in the parent child relationship and that traditional one to one therapy does fail (sending the child with the therapist). I hope you continue to heal and forgive your daughter who clearly did not know just how much she needed you. Kudos for being the “bigger, stronger, wiser, and kind” parent!

  7. Steven Oakenbranch on November 15th, 2013 4:59 pm

    Interesting Article Ted.
    I was trying to understand the statement you made in response to Momma Paige’s comment. You wrote:

    “Fortunately, there have been some helpful guidelines suggested by Prior and Glaser, consistent with recommendations made by O’Connor and Zeanah (2003) and two sets of American practice parameters (AACAP, 2005; Chaffin, et al., 2006) to guide the clinical application of attachment disorder in a way that is also consistent with Bowlby’s original proposal. Concerning ICD-10, Prior and Glaser suggest that there needs to be evidence that the attachment system has failed and that no discriminated attachment figure has been achieved, e.g. the absence of an effective attachment figure to whom the infant or young child seeks proximity and comfort (RAD) or the lack of a specific, discriminated attachment figure (DAD). Whatever else, there needs to be good evidence that it is the attachment system itself that is not functioning, rather than the presence of behaviours that could be explained by non-attachment-specific factors, such as the result of exposure to trauma, other common psychiatric disorders or neurodevelopmental problems.”

    If “exposure to trauma” brings on attachment-like behaviors, wouldn’t that indicate that the problem is attachment? What exactly is “good evidence”? From what I have seen, the “common psychiatric disorders” are the FIRST diagnosis these children get and it is only after the failure of these treatments does attachment get mentioned to the caregivers. Meds are easier than behavioral change.

    So, if as you say Bowlby’s methods are outdated, why does the reprint say “guidelines suggested by Prior and Glaser, consistent with recommendations made by O’Connor and Zeanah (2003) and two sets of American practice parameters (AACAP, 2005; Chaffin, et al., 2006) to guide the clinical application of attachment disorder in a way that is also consistent with Bowlby’s original proposal”?

    What is your point? If as you say, Nancy Thomas is using Bowlby as a reference and is outdated, why are you using Bowlby to buttress your argument that Nancy is spreading false and dangerous information?

    When someone like Nichole, who commented above, lives through the horror that is RAD, peer review of theories and clinical applications do nothing for the child. The home is where it is at, not the clinicians office. It is the direct efforts of committed and loving parents that will effect change in the lives of the child, given the correct application of proven remedies from a competent adviser. Nancy Thomas being one of the most competent ones around.

    I met a psychiatrist who had attended one of Nancy Thomas’s camps with his 8 year old daughter. Get it? A psychiatrist couldn’t fix his own daughter using all of the stuff you wrote about above and so attended a camp by the person you are saying is dangerous. He was extremely angry that his training and his professional societies and research organizations had not provided him with the information that Nancy Thomas gave him. I am certain all of his daughters behaviors fit into some other context or contexts, but they didn’t work. What Nancy showed him did.

    I’m not sure why you cling to your credentials, accomplishments and science when people are hurting, but RAD is real to the families who experience it.

    Real people, real problems.

    Nancy Thomas has adopted and fostered and helped heal more than 35 RAD children. That is research. That is results. That is real.

    Why don’t you find someone who really is dangerous to disparage?

  8. tstein on November 16th, 2013 4:27 am

    Thank you for your thoughtful and well written response. First, what is an outmoded concept is that a child with an insecure form of attachment cannot develop attachment security at some later point in time (even into adulthood).

    When they are referring to the “attachment system has failed or is not functioning” is something that I support in determining and making a distinction for RAD. As it stands, RAD is make from an observation of behaviors not assessed using specific measures used to determine a child’s attachment pattern – (secure, avoidant, ambivalent, and/or disorganized). I currently believe that the failure to use attachment assessments of children and rendering a diagnoses of RAD is dangerous. Unfortunately, the trainings are extensive and can be expensive but are beginning to make their way down from research into the clinical world. We know that children (adopted or foster) develop an attachment pattern in as little as two to three months. The caregiver of these children have a difficult job of learning to observe a child’s behavior, read a child’s cues (or miscues), interpret said cues/miscues and respond promptly, adequately, and effectively – especially when foster or adopted children bring with them their “invisible suitcases” from the relationships with previous caregivers and/or traumas.

    Regarding “…there needs to be good evidence that it is the attachment system itself that is not functioning, rather than the presence of behaviours that could be explained by non-attachment-specific factors, such as the result of exposure to trauma, other common psychiatric disorders or neurodevelopmental problems.” This does not imply that the problem lies in the child’s attachment system. Exposure to trauma can bring on behaviors that are non-attachment related but related to affect regulation, arousal, cognitive distortions, and/or behavioral disruption. Remember, when a child’s attachment system is activated and based on their attachment pattern (secure, avoidant, ambivalent, and/or disorganized) certain behaviors are manifested depending on the child’s pattern when their attachment system is activated. Trauma can bring with it behaviors that are not related to the attachment system/behaviors.

    This is why I do believe it is critical and imperative that a formal and well accepted attachment assessment and trauma evaluation is used to determine what is really going on with a child.

    Regarding your final comment about “adopted and fostered and helped heal”. Any child who is diagnosed with RAD – I want to know if the children were assessed using the gold standard for assessing a child’s attachment to a caregiver (the strange situation, attachment q sort, attachment story telling completion tasks) and what the children’s attachment patterns were to begin with. I would then be curious about post evaluation using the same procedures (when applicable – depending on age of the child ) and then as adults, to be reassessed using the gold standard of the adult attachment interview to determine their state of of mind with respect to attachment (autonmous, dismissing, preoccupied, unresolved).

    Behaviors can improve – a child can demonstrate a disorganized attachment pattern and respond well to strong limits. While the disruptive behaviors may decrease – that does not mean the child has developed an secure pattern of attachment.

    I tend to take a developmental approach first. That means, the first things I look at are attachment and typically trauma/loss and how these impact a child’s life. I agree that our field needs to change with respect to how we assess and work with children and mental health. There has been some progress in the recent DSM-V, but much more work needs to be done.

    Frankly, I do not support a diagnosis of reactive attachment disorder. I do support wondering about a child’s attachment pattern and what that particular pattern is/is not within a relationship with a particular caregiver and how trauma/loss may be interfering with a child’s natural developmental pathway. I do support assisting a child develop a secure pattern of attachment with a caregiver and resolving a child’s trauma and loss. For some people, a child having a RAD diagnoses may bring them some comfort or relief.

  9. Wesley Brown on May 3rd, 2014 2:43 am

    I am a person who has been affected by Nancy Thomas and her Pseudoscience. Long story short, it didn’t do much other than break what faith I had in my father at the time. One of the camps she held this at did things that were pretty close to child abuse.

  10. Connie Maksemetz on March 14th, 2016 7:52 pm

    I have attended Nancy Thomas’s trainings and camp. I feel living through over 40 plus years of directly working with these children is far more experience than you can ever learn in books of “formal training” As a social worker I have seen with my own eyes 16 families with children having severe behaviors, transformed and watched them learn bonding techniques within a week…and I’m talking from 4 hour meltdowns to getting behaviors under control within 15 seconds!!! Her techniques ROCK. I credit her for saving my grandsons life. I would have never seen a good future for him and now I do.

  11. Jody on March 26th, 2016 4:26 am

    I am going to speak my mind. This woman is an abuser and a quack. I lived in this woman’s home for two weeks and was put through hell by her and also by that quack Neil Feinberg. For all of you defending this woman, try being in her home and her approach is to make a young girl who has attachment and trust issues, and she’s made to eat with her legs crossed in front of a wall. only allowed a certain amount of times a day to go to the bathroom. If you had to use the bathroom in the middle of the night, forget it.. You either piss your pants or you wait till morning cause you have an alarm on your door. I wish I would have had the guts to speak out when I was younger against her and Neil. I have dealt with the past and the events that occurred before and after that fabulous Attachment Center in Evergreen Colorado. I’m glad that Feinberg lost his license to ever practice again. And if any social worker worked with this lady and allowed her” techniques” on your kids, grandkids or clients, you were part of that abuse.

  12. WorriedMother on August 22nd, 2016 8:17 pm

    Jody, I am wondering if you are still monitoring this thread. I too have a child that has been diagnosed with RAD, have read all the books, done hundreds of hours of research and still have some questions for someone that has been through it, and a few thoughts of my own.
    I am specially speaking to the at home techniques (absolutely no holding therapy/rebirthing/or denial of basic bodily function of eat,drink, bathroom).
    I am curious how it made you feel, what behaviors your parents felt included you in the RAD diagnosis, if you still have attachment issues in your adult life, if your parents are still a part of your life. Sorry for all the questions, but while I am at the end of my rope with my foster son and am willing to do ALMOST anything if it helps, I just want to make sure I am actually helping.
    What I am interested in is knowing if the other techniques could help if implemented with common sense and love. I, myself, do not believe it will be a miracle cure in a short time, but would be excited if I was able to sleep through the night with out hearing the smoke detector or finding a razor blade meant for my throat, or any other noticible improvement.
    I genuinely believe that it doesn’t matter what “therapy” is used regardless of what disorder, there will be outliers and extremes. Ex.: there have been deaths from misuse of ECT (electro shock) therapies that have resulted in death, but overall, when used correctly, it can be effective for certain illnesses.
    Our foster son has been with us nearly 3 years, he is 7 1/2 now. We knew he had been through every type of trauma possible by the age of 4, but thought that if we loved him enough, had a rewards chart, specific rules clearly posted, etc that we could help him transition into real life with a family that wanted him. After 2 crisis admissions and one 6 month behavior hospital stay (that is ending Friday) his behavior is more out of control now than ever. It was his therapist at the hospital who told me of Nancy Thomas.
    I want to also make one very important point! I am college educated, Christian, and capable of researching and learning BUT if someone had told me that their child (foster or not) had done even half of the things that my foster son has done I would have never believed them or wondered what they as parents are doing so horribly wrong. Until you have lived it, and loved a child so much but been so afraid to even sleep with them in the house, no one can understand what it is like.
    When articles do come out about how bad AT/P is, and the author is asked if they have ever directly lived with a child with these challenges, not one can say they have. This leads me to question that if with all of these professionals experience and education not being enough for these kiddos, if there may not be a small subset of children that need something different. It is also clear that what a lot of these articles are arguing is whether attachment/adoption/bonding/trauma etc are the cause or root or byproduct, but completely missing the point that whatever the cause or reasoning there are children and mothers(caregivers) that perfectly fit into the description of what is being called attachment disorder. Discrediting the reason or name does not mean that this subset does not exist, only that it is poorly understood. I do not disagree that most traditional therapy methods can work wonders with the majority of the population if implemented properly by parent, child, and therapist.
    I may not agree with everything that goes into the different ideas of AT/P but have found and researched it because I feel as if there is no other options for my little one. Between admissions, he saw a therapist at least once a week. No progress was made. Just before his current admission he had really ramped up the wild tales and stories. So I do believe that there has to be something out there that will work and help him to become a productive, safe, and happy member of our family and of society as a whole.

    Sorry this post is long and kind of rambling, I have never posted to anything like this before, but I am desperately seeking answers and all I am finding is criticism for the people who claim to have found something that has worked instead of exploring which aspects of the theory are the ones that do work!

  13. Cynthia Nesiba on October 20th, 2016 8:58 pm

    I find your review disappointing at best. As an attachment therapist myself, anyone person who discounts the earlier work of another, is well… disappointing. We build on each other. Although we can add to her work, Nancy has educated and helped so many, I have used her book as a powerful and I have to say relieving tool with so many. A good attachment therapist never relies on any one approach or any one person, just as a previous person wrote, strong opinions and objections usually indicate someone is selling something, Usually their own services or a book. Discounting her due to “just living it,” is the greatest insult of all. Evolve with the diagnosis, but don’t discount, all mental illness diagnosis treatment and medical treatment has evolved and grown. She was truly a pioneer in treatment and helped a great many people, I have experienced this first hand.

  14. tstein on November 11th, 2016 9:18 pm

    Thank you for sharing your experiences. I hope you are healing and know there are safe people in the world.

  15. Natalie A on June 15th, 2018 1:51 am

    I like these thoughts and definitely the questions it brings up for me to look into on my own research. However, I feel like it’s just a matter of wording here. Attachment Disorder vs. Insecure Attachment Disorder. Also, its explained Nancy has stated “children are doomed” and we go on to read that it is false and children can be helped. Did Nancy say they couldn’t, or did she express in her theory that “children are doomed” for eternity? I feel like besides your good advice of asking questions, I would like to add it all depends on how literal a person is that is reading and how they take in the context. When she says “children are doomed” , I dont hear they can’t be helped or change. I hear they are in for a rough road ahead with a lot of issues to overcome. Again, it all would depend on the reader I guess. Great read however! Thanks!

  16. jayla on November 12th, 2018 12:20 pm

    I have friends who are ruining theirs and their children’s lives with this nancy thomas stuff. What are some real alternatives?

    Thank you.

  17. tstein on December 18th, 2018 2:04 pm

    There are a number of very good alternatives. Some that have very good evidence and outcomes are the Circle of Security, Parent Child Interaction Therapy, Parent Child Psychotherapy, and STEEP program. There is a good website called Adovcate for Children in Therapy as well. Evidenced Based Treatment Children in Therapy

  18. Angel S on March 31st, 2019 5:22 pm

    Hoping that there is someone out there who can help. My two daughters were adopted from a disrupted adoption. While in their previous placement they endured the Nancy Thomas therapy for nearly a year and a half. My daughter is 17 now and is exhibiting signs of Borderline Personality Disorder despite much therapy trying to help her with not only the trauma of separating from her birth family at age 6 but also the abuse of this therapy. She is currently in a long term residential center. Her current therapist believes the type of therapy done on her is the biggest issue we are facing. She said that because it happened in the developmental stage where she should have been developing her core sense of independence it disrupted her personality and because she was sent to our house after being told it was because she “couldn’t love” it has created a sense of self loathing and extreme fear of abandonment.

    Where/Who in this country has knowledge and experience of putting back together children who have been broken by this pseudoscience? We are desperate and still far too many providers and professionals have never even heard of it or have an understanding of its details or lasting ramifications.

  19. tstein on April 3rd, 2019 10:04 pm

    Hi Angel
    I am so sorry to hear about your experiences. Given those experiences, I would recommend The Child Trauma Academy as a place to start. Dr Bruce Perry is one of the countries leading and foremost experts on child trauma. I suspect there is a lot more going on there that just the therapy done on her. They will be able to direct you to someone in your area who could be helpful as Dr Perry has mentored and trained many people over the years. It can get better!
    Warm Regards

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