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Reactive Attachment Disorder is a severe developmental disorder caused by a persisting history of maltreatment while the first combine of years of life. Reactive Attachment Disorder is oftentimes misdiagnosed by reasoning health professionals who do not have the proper training and feel evaluating and treating such children and adults. Often, children in the child welfare system have a variety of previous diagnoses. The behaviors and symptoms that are the basis for these previous diagnoses are better conceptualized as resulting from disordered attachment. Oppositional defiant Disorder behaviors are subsumed under Reactive Attachment Disorder. Post Traumatic Stress Disorder symptoms are the ensue of a primary history of abuse and neglect and are another size of attachment disorder. Attentiveness problems, and even Psychotic Disorder symptoms are often seen in children with disorganized attachment (Lyons-Ruth, K., & Jacobvitz, D., Attachment disorganization: unresolved loss, relational violence and lapses in behavioral and attentional strategies. In Cassidy, J. & Shaver, P., (Eds.) Handbook of Attachment. Pp 520-554, Ny: Guilford Press, 1999. Solomon, J. & George, C. (Eds.). Attachment Disorganization. Ny: Guilford Press, 1999. Main, M. & Hesse, E. Parents' Unresolved Traumatic Experiences are connected to child disorganized attachment status. In Greenberg, M.T., Ciccehetti, D., & Cummings, E.M. (Eds.) Attachment in the Preschool Years: Theory, Research, and Intervention, pp.161-182, Chicago: University of Chicago Press, 1990. Carlson, E.A. (1988). A prospective longitudinal study of disorganized/disoriented attachment. Child improvement 69, 1107-1128. Roughly 2% of the population is adopted, and in the middle of 50% and 80% of such children have attachment disorder symptoms (Carlson, V., Cicchetti, D., Barnett, D., & Braunwald, K. (1995). Finding order in disorganization: Lessons from research on maltreated infants' attachments to their caregivers. In D. Cicchetti & V. Carlson (Eds), Child Maltreatment: system and research on the causes and consequences of child abuse and neglect (pp. 135-157). Ny: Cambridge University Press. Cicchetti, D., Cummings, E.M., Greenberg, M.T., & Marvin, R.S. (1990). An organizational perspective on attachment beyond infancy. In M. Greenberg, D. Cicchetti, & M. Cummings (Eds), Attachment in the Preschool Years (pp. 3-50). Chicago: University of Chicago Press.) Many of these children are violent (Robins, L.N. (1978) Longitudinal studies: Sturdy childhood predictors of adult antisocial behavior. Psychological Medicine,. 8, 611-622.) and aggressive (Prino, C.T. & Peyrot, M. (1994) The ensue of child corporal abuse and neglect on aggressive withdrawn, and prosocial behavior. Child Abuse and Neglect, 18, 871-884.) and as adults are at risk of developing a variety of psychological problems (Schreiber, R. & Lyddon, W. J. (1998) Parental bonding and Current Psychological Functioning Among Childhood Sexual Abuse Survivors. Journal of Counseling Psychology, 45, 358-362. And personality disorders, including antisocial personality disorder (Finzi, R., Cohen, O., Sapir, Y., & Weizman, A. (2000). Attachment Styles in Maltreated Children: A Comparative Study. Child improvement and Human Development, 31, 113-128.) narcissistic personality disorder, borderline personality disorder, and psychopathic personality disorder(Dozier, M., Stovall, K.C., & Albus, K. (1999) Attachment and Psychopathology in Adulthood. In J. Cassidy & P. Shaver (Eds.). Handbook of Attachment (pp. 497-519). Ny: Guilford Press.). Neglected children are at risk of collective withdrawal, collective rejection, and pervasive feelings of incompetence(Finzi, R., Cohen, O., Sapir, Y., & Weizman, A. (2000). Attachment Styles in Maltreated Children: A Comparative Study. Child improvement and Human Development, 31, 113-128.). Children who have histories of abuse and neglect are at primary risk of developing Post Traumatic Stress Disorder as adults (Allan, J. (2001). Traumatic Relationships and Serious reasoning Disorders. Ny: John Wiley. Andrews, B., Varewin, C.R., Rose, S., & Kirk (2000). Predicting Ptsd symptoms in Victims of Violent Crime. Journal of Abnormal Psychology, 109, 69-73.). Children who have been sexually abused are at primary risk of developing anxiety disorders (2.0 times the average), major depressive disorders (3.4 times average), alcohol abuse (2.5 times average), drug abuse (3.8 times average), and antisocial behavior (4.3 times average)( MacMillian, H.L. (2001). Childhood Abuse and Lifetime Psychopathology in a society Sample. American Journal of Psychiatry, 158, 1878-1883.). The sufficient treatment of such children is a collective health concern (Walker, Goodwin, & Warren, 1992).Left untreated, children who have been abused and neglected and who have an attachment disorder come to be adults whose capability to produce and vocalize healthy relationships is deeply damaged. Without placement in an proper permanent home and sufficient treatment, the health will worsen. Many children with attachment disorders produce borderline personality disorder or anti-social personality disorder as adults (Allan, J. Traumatic Relationships and Serious reasoning Disorders, Ny: Wiley, 2001. Andrews, B., Varewin, C.R., Rose, S. & Kirk. Predicting Ptsd symptoms in Victims of Violent Crime. Journal of Abnormal Psychology, vol. 109, 69-73, 2000.)
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Dyadic Developmental Psychotherapy is an evidence-based and sufficient treatment for such conditions. There have been any empirical studies in pro peer-reviewed publications describing this approach. (Becker-Weidman, A., & Shell, D., (Eds.) (2005) Creating Capacity for Attachment: Dyadic Developmental Psychotherapy in the treatment of Trauma-Attachment Disorders. Ok: Woods N Barnes publishing. Becker-Weidman, A., (2006) "Treatment for Children with Trauma-Attachment Disorders: Dyadic Developmental Psychotherapy," Child and teenage collective Work Journal. Vol. 23 #2, pp. 147-171 April 2006. Becker-Weidman, A., (2006) "Dyadic Developmental Psychotherapy: A multi-year Follow-up", in, New Developments In Child Abuse Research, Stanley M. Sturt, Ph.D. (Ed.) Nova Science Publishers, Ny, 2006, pp. 43 - 60. Becker-Weidman, A., (2007) "Treatment For Children with Reactive Attachment Disorder: Dyadic Developmental Psychotherapy," town For house Development. Becker-Weidman, A., & Hughes, D., (2008)"Dyadic Developmental Psychotherapy: An evidence-based treatment for children with involved trauma and disorders of attachment," Child & teenage collective Work, 13, pp.329-337.) The research Studies house therapy, individual therapy, play therapy, residential placements, and intensive inpatient treatment, among other treatments, are often used to treat attachment disorders. However, when compared with Dyadic Developmental Psychotherapy, these treatments proved to be ineffective. A follow-up study compared the effectiveness of Dyadic Developmental Psychotherapy and "usual care," and found that Dyadic Developmental Psychotherapy produced clinically and statistically primary improvements one year after treatment ended. The study was composed of 34 families receiving Dyadic Developmental Psychotherapy and 30 families receiving "usual care." Before treatment/evaluation in both the treatment and operate groups, Randolph Attachment Disorder Questionnaire scores and Child Behavior Checklist scale scores were elevated and in clinically primary ranges (more than two proper deviations above the mean for the Cbcl). The extent and severity of these children's disorder is underscored by the fact that 82% of the treatment group and 83% of the control-group subjects had received prior treatment using other methods. The median number of previous treatment episodes was 3.2 for the treatment group and 2.7 for the operate group. The results for the treatment-group were achieved among children aged six to fifteen years, averaging 9.4 years, who received an median of twenty-three sessions over eleven months.
Dyadic Developmental Psychotherapy is sufficient because of its confidence on and improvement of affective attunement in the middle of therapist and child, caregiver and child, and therapist and caregiver. The process of maintaining affective attunement allows for dyadic regulation of influence in the middle of child and therapist so that the child feels a sense of safety and safety and can feel the influence connected with past traumas, allowing for integration of these experiences rather than dissociation of the influence and memory. Furthermore, Dyadic Developmental Psychotherapy's primary involvement of caregivers in treatment facilitates the improvement of an affectively attuned association in the middle of the child and caregiver. An affectively attuned association may be described as a association in which the two persons are experiencing the same influence and that their influence co-varies. Within the safety of the attuned association the shame of past trauma and current misbehaviors are explored, experienced, and integrated. The caregiver-child interactions build on a dyadic influence regulation process that ordinarily occurs while infancy and the toddler years. The child's past traumatic history of abuse and neglect strongly suggests that such interaction, which facilitates a health attachment and a trusting and safe relationship, did not occur or occurred in an inadequate manner. Dyadic Developmental Psychotherapy facilitates the improvement of a healthy attachment in the middle of child and caregiver, enables the child to affectively trust the caregiver, and allows the child to acquire comfort and safety from the caregiver. This study examined the effects of Dyadic Developmental Psychotherapy on children with trauma-attachment disorders who meet the Dsm Iv criteria for Reactive Attachment Disorder, all of whom were whether adopted or in bring up care. A treatment group composed of thirty-four subjects and a usual care group composed of thirty subjects was compared. All children were in the middle of the ages of five and sixteen when the study began. Seven hypotheses were explored. It was hypothesized that Dyadic Developmental Psychotherapy would reduce the symptoms of attachment disorder, aggressive and delinquent behaviors, collective problems and withdrawal, anxiety and depressive problems, understanding problems, and Attentiveness problems among children who received Dyadic Developmental Psychotherapy. primary reductions were achieved in all measures studied. The results were achieved in an median of twenty-three sessions over eleven months. These findings continued for an median of 1.1 years after treatment ended for children in the middle of the ages of six and fifteen years. There were no changes in the usual care-group subjects, who were re-tested an median of 1.3 years after the appraisal was completed. The results are particularly salient since 82% of the treatment-group subjects and 83% of the usual care-group subjects had previously received treatment with an median of 3.2 prior treatment episodes. This past history of unsuccessful treatment further underscores the significance of these results in demonstrating the effectiveness and efficacy of Dyadic Developmental Psychotherapy as a treatment for children with trauma-attachment problems. In addition, 53% of the usual care-group subjects received "usual care" but without any measurable turn in the outcome variables measured. Children with trauma-attachment problems are at primary risk of developing severe disorders in adulthood such as Post Traumatic Stress Disorder, Borderline Personality Disorder, Narcissistic Personality Disorder, and other personality disorders. This study supports any of O'Connor & Zeanah's (O'Connor, T., & Zeanah, C., (2003) Attachment Disorders: appraisal strategies and treatment approaches. Attachment & Human Development, 5, 223-245.) conclusions and recommendations regarding treatment. They state (p. 241), "treatments for children with attachment disorders should be promoted only when they are evidence-based." The results of this study are a beginning toward that end. Dyadic Developmental Psychotherapy provides caregiver hold as an integral part of its treatment methodologies. Finally, Dyadic Developmental Psychotherapy uses a multimodal arrival built around influence attunement.
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