Introduction & Overview

Reactive Attachment Disorder (RAD) is a serious behavioral condition seen in teens who experienced attachment issues with their primary caregiver in infancy. An infant expects to be loved, soothed, comforted and have his or needs met by its primary caregiver. In most instances, this is the mother. This process helps build self-esteem and security in the child. It teaches them to trust and rely on others to have certain needs met in personal relationships.

Having a teenaged child suffering from Reactive Attachment Disorder can be stressful, perhaps even overwhelming, for you as a parent. This is because teens with RAD look like normal teenagers but function differently in social settings. They often struggle with mental health, behavioral, cognitive or drug addiction issues normal teenagers are not usually faced with.

Once properly diagnosed, behavioral therapy tailored specially to combat teen RAD may become necessary to promote positive behavioral responses to events that trigger the disorder. Therapy can also help your child establish healthier relationships and improve their overall quality of life.

Risk Factors of Reactive Attachment Disorder

The risk factors of RAD depend on the child’s experiences with the primary caregiver, mostly by the time he or she reached the age of 5. Brain development may be adversely altered in children who lacked a safe, comfortable, and nurturing environment in infancy and early childhood.

If they were abandoned, abused or neglected, they often find it difficult to create healthy relationships as teens and adults. The risk of triggering attachment disorder symptoms related to RAD may be higher in teens who, by age 5, were:

• Physically or emotionally abused, grossly neglected or maltreated;

• Adopted and forced to detach from birth mom;

• Placed in group homes, an orphanage, or foster care at an early age;

• In homes where their physical and emotional needs were persistently disregarded; or

• Experienced irregular and unreliable care or care was non-existent

• Experienced instability through regular changing of primary caregivers, e.g., foster care

This does not mean that every child who has these unhealthy attachment experiences with their caregiver will develop RAD. Studies show that at least 8 in 10 children raised in a traumatic environment could be affected by attachment disorder. Of this number, perhaps only 1 of 10 may develop RAD.

Symptoms of Reactive Attachment Disorder in Teens

The symptoms of RAD in teens may not be easily detected since many teenagers “act out” at some point. But RAD symptoms are persistent and even chronic. Teens affected by this disorder may be socially introverted. At the other extreme, they could be totally extroverted. This extreme extroversion may include risky or delinquent behaviors or drug abuse leading to drug addiction. Teens with RAD may exhibit one or more of the following symptoms:

• Difficulty trusting others

• Detached, withdrawn or disconnected from family and friends

• Behave unusual in social settings

• Lack empathy or remorse

• Dishonesty, lying, or manipulation

• Unusual or misplaced anger or hatred

• Extremely emotional or avoid emotions

• Moody and impulsive

• Low IQ or poor social skills

The Importance of Treatment Therapy for RAD Teens

Improper attachment at infancy including attachment issues tainted with trauma, such as neglect or abuse, often have devastating, long-term impact on a child’s mental health. This is similar for teens who experienced “skipped” attachment, such as those separated from their mother or primary caregiver at an early age due to adoption or placement in a group or foster home.

While the skipped or disrupted stage of attachment cannot be reversed or cured, psychological counseling may help fill that gap. Cognitive Behavioral Therapy (CBT) and Dialectical Behavioral Therapy (DBT) are two techniques used at Hillcrest Adolescent Treatment Center. It provides a safe and trusted environment where teens can be diagnosed and begin the process of healing from RAD.

The therapists at Hillcrest Adolescent Treatment Center are licensed, skilled, and experienced in working with teens who struggle with the mental, emotional, and behavioral issues associated with RAD. The goals of residential treatment include:

• Assisting your teenager in identifying and addressing the trauma responsible for triggering the symptoms of RAD

• Helping your teen develop the skills to establish healthy interpersonal relationships and balance emotional responses

• Integrating and using other techniques such as meditation, relaxation, and sport as part of the healing process

• Allowing family members to be involved in interactive and engaging therapy sessions with their child

With skillful therapy, and with the child open and receptive to the process of healing, your teen can build self-esteem and become a confident and secure adult.


Psychology Today:


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Institute for Attachment:

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