Interview Wed. but have fears about whether we can/should take this RAD child

Well...would they let you spend some time with this child, like do respite or something? That is the only way I would be able to decide. I would also want to talk to teachers, the current foster parents etc. Sexual interest would scare the begeebers out of me. What the heck does that mean? I would want specifics on that. Do they mean that he has discovered his boy parts or are they talking about inappropriate comments or behavior? Our kids have attatchment disorder and their tantrums stopped after about 2 months. We just don't tolerate that from older kids. :cowboy: My son still has crying spells when he feels something is unfair, but no physical agression anymore, just loud crying. They have improved a lot but it is still very hard. It's the mental games and manipualtion that get to me the most. Especially with my daughter. I still don't feel like I have met the real B yet and it's been a year and a half! All that to say, not all kids with RAD are violent. Some turn more inward and that is sometimes harder to deal with than the physical stuff. My kids have never been a threat to my younger daughter in any way. They love her to pieces and I am very thankful for that! Best of luck on your journey. You are a mom. Don't underestimate your mommy gut!

One thing you may want to ask is for clarification as to physical aggression. Does he shove when they argue over a toy or does he go after them unprovoked with a bat? You need to know how serious this aggression is. Another thing is what do his tantrums look like? Does he just stomp his feet and yell and cry or does he carry on for hours and smash everything in sight? I'd ask for clarification on the age appropriate lying. Is he lying to get out of a consequence or to avoid being in trouble? That's age appropriate. Is he telling you he isn't holding a book when he is, that's crazy lying. Is he making up lies about others to get them in trouble? This is a problem. Ask for examples. You want clarification on sexual interest. Is he asking questions or touching people? Get information and if it sounds like a bad match, walk away. I will tell you, in my experience, the kids who were "just neglected" vs those who were abused, the neglected ones showed up far more disturbed and less willing to let anyone in. I'm sure that isn't all cases, just my experience so don't let them downplay this as not important.

i feel like they are maybe not being honest enough about his behaviors. if they are the ones saying he is:"sometimes" aggressivedoes not stealhas mostly age appropriate lyingwill accept some physical affectionand has to a point bonded with his foster parentsis able to bond but chooses not to bc he is leaving....then i would ask WHY the diagnosis of RAD...specifically what behaviors and how often caused them to give him THIS diagnosis. this is a serious dx....but i feel like they then followed it up by downplaying his behaviors. if the behaviors aren't that bad....i don't think he'd have a RAD label. but that is just me. i'd ask more questions if i were you. my dd has RAD....she has never been as extreme as some of the kids i read about here. i consider her to have mild RAD.....but it was/is still enough to drive me crazy. she is not violent....but sometimes i wish she were...because what she can be instead- conniving and manipulative can be so much more hurtful and harder to combat. i don't want to completely discourage you...bc someone needs to parents these children....however i encourage you to ask more questions to hopefully get a more honest picture of what you are up against before he is in your home. will they let you speak with the former or current foster parents and therapist?p.s. SLOW.....like S------L-------O-------W....that is what you have to expect when it comes to progress. it has taken us 7 years to feel like we have made some serious progress. we have a few friends with kiddos with RAD and they all experience about the same thing- very little progress....very slowly. you have to be patient and willing to celebrate the really little steps...even amongst great big steps backwards....and trust me....it is alot harder than it sounds.

Thanks for the input so far. I appreciate it. Yes, I will certainly be talking to his current foster parents and I would like to try to talk to his therapist as well. While I know he has been working with a therapist for 2 1/2 years, I do not know if it has been individual therapy (which I know is not recommended for RAD kids) or whether his foster family has been involved in his therapy as well. From what I understand, his tantrums have decreased to the point where he yells and screams and occasionally breaks things (not punches walls, etc) but he does not physically try to hurt people during tantrums. His aggression towards other children is most likely to occur during disagreements where healthy children would resolve it by talking or going to an adult for a solution, he sometimes loses his temper and pushes or hits. I don't know what the "sexual interest" is, but I intend to find out because I don't want to take a chance with our daughters. His lying is age appropriate in that it's not "outrageous" lies, more just to avoid getting into trouble but his caseworker says he lacks insight into why he does things, and will just say "I don't know" when asked why. He can accept physical affection, but it's usually superficial and on his terms. He does seek to be comforted physically when he is hurt, upset, etc, but it's usually more or an "immediate gratification" thing and not lingering or emotional. He does not steal items or money, but does tend to sneak food that he knows he's not supposed to have (candy before bed, etc). He still wets the bed sometimes at nights and wears pull ups. Once we bring a child into our home, no matter what his situation, we are committed to him 120%...for as long as it takes. I am not a "touchy feely" person who needs to be loved in that way necessarily, but I think it might be a little harder for my husband to connect if he felt constant disconnect form the child. The only reason we would ever disrupt a placement would be if he was physically or sexually harming our daughters. So I will be asking some very specific questions of caseworkers, therapists and current foster family.

The foster mom will be involved in the interview (which is why it needed to be rescheduled). I'm really glad we get to meet and talk to her as well Meanwhile, I found out who his therapist is and visited her website. Apparently she sees him weekly. I don't know. She seems to specialize in play therapy which I was told really doesn't work for RAD kids. Here are a few things from her website. Thoughts? ----------- Problem Statement: As a licensed psychologist since 1985, I have a wide range of training and experience in dealing with numerous life issues and mental health conditions, with a primary focus of providing services for the child and adolescent population. Between 1985 and 1995, the problem areas most commonly dealt with in my practice involved early trauma, including neglect and abuse; and children/adolescents in foster care and in adoptive homes. This focus led to interest in attachment issues. Since 1995, my practice has increased in terms of the number of clients being assessed and services provided for attachment issues and Attachment Disorder. At the present time, the only new clients accepted involve attachment-related issues and/or Attachment Disorder. Target Population: The current client population involves children and adolescents with attachment difficulties and/or Attachment Disorder. Parental figures of children/adolescents with attachment difficulties and/or Attachment Disorder are also involved in the client population. Program/Practice Overview: The philosophy of the services provided in my practice at Life Management Associates involves an understanding of the importance of attachment in a child's overall level of functioning and in terms of a child/adolescent's functioning within a family system. Outpatient psychotherapy services include individual and family therapy, with a focus on attachment building and resolution of attachment issues. Theraplay is frequently the modality used as a foundation for other services. Although we do not provide a two week intensive program, this psychologist is willing to make recommendations when appropriate and be involved in the treatment during a two-week intensive program as needed, as well as providing the after care psychotherapy a recommended. Description of Services: Intake/Admission Progress. The appropriateness of a referral to my practice is generally made with a brief telephone conversation with the referral agency and/or parental figures. If it is determined our services are appropriate, an appointment is scheduled. If it is determined our services are appropriate, an appointment is scheduled for a psychological assessment or psychological evaluation, unless an assessment or evaluation has been previously made by another mental health professional specializing in attachment difficulties and/or Attachment Disorder. Appropriate releases, if necessary, are obtained; for example, if a child is not in the legal custody of the parental figure. Assessment Process. A psychological assessment and/or a psychological evaluation (including intellectual measures) is the first part of the admission process. As part of the assessment/evaluation procedure, an in-depth clinical interview is conducted with parental figures and with the child/adolescent as well. Information obtained includes, but is not limited to: developmental history, attachment history, medical history, educational history, assessing symptoms related to emotional and behavioral functioning, obtaining information regarding past or current treatment history, including services provided, outcome and medication, if applicable. Although the specific assessment/evaluation tools can vary based on the age of the child, history obtained, family dynamics, and the specific referral questions, the following list includes some of the assessment/evaluation tools which can be utilized: projective measures - Draw-A-Person, House-Tree-Person, Draw-A-Family, Children's Apperception Test, Thematic Apperception Test, attachment-related tools such as the Marshak Interaction Method and checklists including the Randolph Attachment Disorder Questionnaire, and the Behavior Assessment System for Children-Second Edition; intellectual measures - Wechsler Intelligence Scale for Children -IV, Peabody Picture Vocabulary Test - III, Wechsler Adult Intelligence Scale - III. Part of the assessment process involves either verbal feedback regarding the referral questions and/or a written report, depending on the circumstances. Treatment Planning. Based on the information obtained from the psychological assessment/evaluation, a treatment plan is devised, which in the most general sense recommends whether attachment-based psychotherapy is warranted and if so, recommends a modality of attachment-based psychotherapy which is felt to be most appropriate and effective for the specific child/family. Specific treatment goals are also delineated, which include measurable goals. Regarding child clients, the treatment plan is discussed with appropriate parental figures and/or agencies. Agreement to the treatment plan is provided by written signature of the appropriate parental figure and/or agency professional. Specific verbal contracting with children depends on the type of treatment utilized. However, treatment planning always includes ensuring the least restrictive and intrusive level of therapy, which is deemed appropriate and effective, be utilized. Specific verbal contracting with child clients depends on the form of psychotherapy and the specific needs of the child/family system. With adolescent clients, the treatment planning procedure is more direct. Treatment goals and procedures are discussed. Depending on the age of the adolescent, the adolescent will also be involved in signing the treatment plan. Therefore, there is a verbal and/or written contracting which occurs between the client and therapist before any treatment begins. Treatment Techniques Used. Individual and/or family therapy, including attachment building skills and/or resolution of attachment issues can involve play therapy, art therapy, Theraplay activities, journaling, along with a variety of therapeutic techniques to be utilized to reach specific treatment goals. The majority of our child/adolescent clients are referred for Theraplay, which in our practice at Life Management Associates involves a co-therapist model - one therapist assigned to work as a primary therapist with the child/adolescent, with a second therapist assigned to work with the parental figure to provide support, education, parenting strategies, resolution of any individual issues which may impair the attachment process, etc. Therapeutic interventions can include cognitive techniques, therapeutic stories, EMDR, role playing, principles associated with dyadic developmental psychotherapy, etc., to assist the child/adolescent to reach therapeutic goals personally and within the family system. If the child/adolescent has been involved in a two week intensive program and is referred to our agency for the after care, this psychologist will follow the recommendations of the referring agency. Safety/Risk Management Plan: Before any psychological treatment is begun, risk factors are taken into consideration during the assessment/evaluation process. Our agency has a two-room suite for attachment psychotherapy, in which parental figures are either in the same room with the child/adolescent or are monitoring the interaction between the child/adolescent and the therapist with video/audio equipment. The majority of our attachment-based psychotherapy is videotaped to ensure the safety of our clients and of the therapist as well. The least restrictive, intrusive and confrontational approach which is deemed appropriate and effective will be utilized to ensure that the physical and emotional well-being of all participants are being addressed. No client is ever put in a situation which could be physically endangering. Child/adolescent clients are always informed of the reason for any therapeutic holding and any concerns which are appropriate, regarding any of the participants, are addressed and resolved to the best of the therapist's ability. Evaluation/Outcome/Follow-up: During the course of psychotherapy, the treatment plan is reviewed and appropriate additions and/or changes are made. At times, progress is assessed by having the parental figures complete once again checklists which were originally completed at the psychological assessment/evaluation, such as the Randolph Attachment Disorder Questionnaire, to determine whether or not progress is occurring and in what areas. If appropriate progress is not occurring, discussions between the parental figures and/or agencies involved, and/or including the child/adolescent as deemed appropriate, occur to determine whether or not additional services and/or different strategies would be more appropriate and/or beneficial. Referrals to outside agencies and/or other mental health professionals are made as necessary. At the time of discharge, an evaluation form regarding the services received is sent to the parental figures for completion and the results are reviewed by this therapist. Follow-up services in the form of consultation, telephone calls, and/or returning to a form of involvement in outpatient psychotherapy in the future are all possibilities and are discussed at the time of closing the case. Qualifications: ****** has a Masters of Science degree in Psychology from Millersville University (formerly Millersville State College) from 1981. She obtained her license to practice in the field of psychology in Pennsylvania in 1985. Her primary field of experience involves child and adolescent issues. Specific attachment training and education is as follows: 1994 - The Broken Connection: Attachment Theory and Therapy - 6 hours 1995 - Seventh Annual Conference on Attachment and Bonding - 20 hours 1996 - Introduction to Theraplay - 21 hours 1997 - Filial Therapy - 6 hours 1997 - Intermediate Theraplay - 21 hours 1998 - Treating the Effects of Trauma in Adults and Children - 12 hours 1999 - Treating Attachment Disorders in Foster and Adopted Children - 24 hours 2000 - 11th Annual International Conference on Attachment and Bonding - 16 hours 2002 - Eye Movement Desensitization and Reprocessing - 17 hours 2003 - Attachment... From the Beginning - 20.5 hours 2004 - "Pathways to Healing: The Role of Attachment in Families" - 22.5 hours 2005 - Childhood Developmental Disorders - 6 hours 2006 - Broken Attachments: Treating the Traumatized Child - 5.5 hours 2006 - Developing Healthy Attachments - A Dyadic Developmental Perspective - 12 hours 2006 - Trauma, PTSD, and Traumatic Grief - 6 hours 2007 - Transforming the Difficult Child - 6.5 hours 2008 - Enhancing Attachment: Strategies for Families & Professionals - 6 hours 2008 - 20th Annual ATTACh Conference: Attachment: Developing Connections/Changing Lives - 14.5 hours * This therapist has also been involved in five two week intensive programs with referred clients at the Attachment Center at Evergreen and Evergreen Consultants. During one of the intensive programs, this therapist was involved in the therapist training program. Certified Theraplay Therapist. Member of Pennsylvania Psychological Association.

It sounds like this therapist does a lot of different things. She doesn't say clearly whether she ever sees the kid without the parent. That's usually your first test. She says she usually uses Theraplay. It is a step above ordinary play therapy. The main difference is that the play is directed. They do specific play activities that are supposed to promote bonding. It doesn't deal much with the underlying trauma. She does mention that she makes at least some use of dyadic developmental psychotherapy. This method both promotes attachment and strives to work through the trauma and the root causes of the child's inability to trust and bond. That's the method we're doing and we've made some good progress, so I'm a bit biased towards it.

Yes, I'm definitely going to ask about the level of involvement of the foster parents in therapy and I'm going to be pushing for a release to talk to the therapist at some point if we decide to proceed with this referral. I have a lot to learn about the various types of therapies for RAD, but one thing is certain, I want to be fully involved in ANY type of therapy if we take this child and I will fully commit myself to attachment in any way possible to benefit both him and my family.

Today DH and I, along with our social worker from our agency, met with with this child's foster mom and the representatives from CYS that has custody. One of our most fervent prayers up to this point was that God would make it clear to us (both of us) if we were to proceed, and we feel that we did get that answer, although it's a bit disheartening. We will continue to pray, but at this point, we both have a very strong "gut feeling" that we cannot successfully integrate him into our family without significantly impacting our own kids. One thing we found out today was that in addition to his diagnosis of Reactive Attachment Disorder, he has also very recently been diagnosed as bipolar, and is being evaluated for possible skitzophrenic traits. His foster mom clearly loves him and she is a wonderful woman, but both DH and I sensed that she is afraid of him, or what he might be capable of as he grows up. There are some very disturbing behaviors presenting themselves in his life, and at this point, it feels like he would be safest in a home without children or with much older children. So...back to reading profiles and hoping workers call our worker back....

While I understand your sadness it seems that you made a good choice for your family. BEst of luck with your search.

Sorry that you had to make a tough decision. It sounds like you made the right one though. Good luck finding the right kid for your family!