Please read before signing the petion for post-adoptive support for adoptees with RAD

The other day an AP pointed out a comment made on an adoption forum.  The comment written by Kevin Kruetner,  active adoption forum participant and AP, urged other APs to sign a rather sloppy petition to the President asking for post-adoption support for adoptees with Reactive Attachment Disorder.  His rationale to support the proposal revolved around his own experience seeing other APs with adopted children "suffering with this disorder".  As if that limited exposure to troubled adoptees makes him an "authority" on child behavior and what an adoptee needs pre and post adoption.

What concerns me is the seemingly endless conversation I have with many APs, in private. 

I am told REPEATEDLY the pre-adoption curricula in many  ICA programs revolves around scrap-booking and other nonsensical topics that can be seen as "adoptive parent instruction".  Many private agencies do NOT provide educational programs that educate the PAP about more serious adoption issues like trauma, stages of loss and grief in a child, or how stress and trauma affect a child's ability to learn in a school environment. The Amothers who complain to me tell me they are completely unprepared to care for the children they receive -- children who have experienced trauma, and often speak a first language that is not English.  To add insult to injury, the same agencies who fail to prepare these AP are also conveniently absent when troubles begin at home and at school, after the adoption is complete.

As a result, it seems many AP "abandoned" by their adoption agencies turn to unlicensed unmonitored "parent educators" with the hope that these individuals can help the parent cope and change an adoptee's unwanted behavior.  PPL's archives feature the sad end-result when an AP takes discipline and punishment and techniques to "train and control" an out of control child to a dangerous extreme.  

[See: cases involving forced confinement, cases involving torture, cases involving Attachment Therapy, posts featuring various form of discipline, and posts featuring various forms of punishment, just to name a few.]

I personally view the urging of APs to sign the petition as an act that would relieve the directors of adoption agencies the responsibility that goes with providing quality pre-adoption education programs for PAPs.

Furthermore, I fear this post adoption service, as proposed, can be provided independently - and through the recommendation of adoption agency directors or adoption website owners- distancing those profiting from adoption services from any and all liability that's associated with any case that involves the harm, abuse or death  of an adoptee hurt by therapies gone bad. [Thoughts of a variety of questionable Attachment Therapists and "parent educators" jumping on this "independent" opportunity, and cashing-in on the Medicaid population is a real horror in my mind.]

As an adoptee and a nurse, I find this topic and privatization of post-adoption therapies very concerning and note-worthy.  I took it upon myself to contact Jean Mercer, a vocal advocate against many "therapeutic techniques", (Coercive Restraint Therapies), used on adoptees given the RAD label,  and I asked for her thoughts on this proposed petition.

The following are her remarks:


When those change.org petitions come around, it’s so hard not to sign them. They all sound good and deserving. But, of course, there’s nothing to stop petitioners from presenting inaccurate information and asking for help with a matter that is to their own benefit alone. Such seems to be the case with http://www.change.org/petitions/the-president-of-the-united-states-post-adoptive-support-for-children-with-reactive-attachment-disorder. The group posting this petition, Hopefor Healing (spacing sic), has made a series of inaccurate statements and in addition has implied that other wrong information is correct. I hope you will not sign this petition, no matter what its emotional appeal may be.

The basic ideas stated in the “RAD” petition are the following: 1) undesirable behaviors of adoptees may not be displayed until the adoption process is over; 2) these behaviors, referred to as Reactive Attachment Disorder, are highly disturbing and dangerous, and need highly specialized treatment from residential facilities that focus on RAD; 3) parents cannot afford to pay for treatment; 4) parents who relinquish custody of their children voluntarily may be prosecuted, but should be allowed to relinquish quickly; 5) pre-adoptive education should include warnings of the potential of the child for violent behavior; 6) post-adoptive services should include residential treatment for RAD (at least this is my interpretation of the words “escalated to the highest levels of care”).

Before examining these claims under a strong light, I want to refer to a related issue of genuine concern. As was pointed out in the Bazelon Center for Mental Health Law’s 2000 publication Relinquishing Custody, state laws vary on provision of mental health services for children. In some states, parents may be forced to relinquish custody of a mentally ill child to the state before treatment can be provided without charge-- a conclusion that most parents resist as long as they can. This very real problem does not appear to be what “Hopefor Healing” is talking about. They want children’s mental health interventions, as they define and desire them, to be provided at public expense, and they also want to be able to relinquish custody quickly and easily.

But let’s look at “Hopefor’s” points one by one. First, the idea that worrisome behaviors of adoptees are somehow concealed until the adoption is final. According to the long-term research done by Michael Rutter and the English-Romanian Adoptees project, children who had been in the worst of worst conditions as infants and toddlers improved gradually with time in the adoptive family, leading to the conclusion that adoption is one of the most effective developmental interventions. Among the ERA children, even those who were seen as disinhibited and too ready to go with strangers were by their teens regarded as friendly, outgoing, popular kids. I should point out too that in the ERA study, the most common problem was delayed language development, which was certainly present when the adoption was initiated.

Second, what about the idea that the children are likely to show violent, even homicidal behavior, and that this is evidence of Reactive Attachment Disorder and should be treated as such? There are two separate issues here. Yes, of course, as is the case in any population, some adopted children may be callous and unemotional in behavior and/or may be violently aggressive. However, as Charles Zeanah, the eminent child psychiatrist, has made clear in his discussion of Reactive Attachment Disorder in preparation for the DSM-5 publication (www.dsm5.org/Proposed%20Revision%20Attachments?APA%20DSM-5%20Reactive%20Attachment%20Disorder%20Review.pdf) , in fact these characteristics are not associated with Reactive Attachment Disorder. Thus, even if there were an evidence-based treatment for Reactive Attachment Disorder, it would not be relevant to these cases-- and the fact is that organizations that claim to specialize in treating RAD do not use methods of demonstrated effectiveness. “Hopefor” is asking for children to be publicly funded for treatment that is probably inappropriate for them, as well as lacking in an evidence basis.

Third, it is no doubt true that parents cannot afford to pay for expensive, intensive treatment, and as the Bazelon Center document suggested, we as a society need to correct this problem. However, it will never be appropriate for parents to demand payment for an intervention chosen by them on the basis of their beliefs about the child’s diagnosis, nor will it be appropriate for anyone but an independent evaluator to make such a diagnosis. Caseworkers from an adoption agency and prospective therapists are not the right people to make these decisions. Even if resources were not scarce, we would need to require independent assessments and avoid the apparent confusion of “Hopefor” about the nature and treatment of Reactive Attachment Disorder.

Fourth, although parents who abandon their children may be prosecuted, those who relinquish legally are not (although they may be called upon to repay funds that have been used to care for the child). States have procedures for legal relinquishment that may involve counseling and discussion of possible consequences, as well as providing simplified procedures and “safe havens” for relinquishment of young babies. In practice, also, voluntary relinquishment may be made very simple. In one case in which I testified, a couple adopting from Russia had been persuaded to take a girl as well as the boy they wanted. They did not like the girl much, placed her in attachment therapy, and often sent her to a respite home for periods of time. Finally, they decided they wanted to disrupt her adoption, and the respite family was willing to adopt; this exchange was maneuvered by the caseworkers without the usual formalities. When the girl was apparently mistreated in the new home and the authorities were notified, the family sent her to a boarding school in another state, a school that has been investigated for the use of restraint with children and has argued that this is permissible. There she remains, probably until she ages out at 18, and there has been no prosecution of the original adoptive parents.

The fifth point, the demand that pre-adoption counseling include the claims about violent and abusive behavior as a part of Reactive Attachment Disorder, may be the real focus of this petition. According to the Hague convention, to which the U.S. is a signatory, candidates for adoptive parenthood must receive a number of hours of pre-adoption education. At this point, the nature and provision of those hours are up to the adoption agency involved. Even the Russia-U.S. adoption agreement of last year (now in abeyance) did not outline the pre-adoption education required. This means that-- as most agencies do not have the time or resources to write their own curricula-- it would be much to the advantage of any interested person to seize the opportunity to write and market educational material. And if this material informed prospective adoptive parents that their children might be dangerous, that the danger was due to RAD, and that only specialized RAD treatment centers could help-- why, so much the more advantageous for the whole group that pushes misinformation about adoption and attachment.

And, sixth, as above-- the petition essentially presses the claims that there is only one set of problems, one diagnosis, and one treatment that must be part of post-adoption services-- the treatment apparently being the complementary-and-alternative, non-evidence-based approach often called Attachment Therapy, an intrusive, time-consuming intervention that is not reimbursed by third-part payers, and for good reason. But what could be better for its practitioners than being able to do an end run around public and private health insurance and have public funds support them in style?


 

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Awful self-proclaimed, unqualified "trauma mamas" who counsel

You’ve hit the nail on the head – these self-proclaimed “trauma mamas” (I loathe that term) exhibit a very strange sort of cognitive dissonance: they recognize their child is severely mentally ill and desperately in need of treatment… but send the kid off to ghastly, unlicensed places like the Ranch for Kids in Montana.

I’m especially appalled by adoptive parenting “expert” Lisa Qualls (she works with Dr. Karen Purvis and Empowered to Connect) who sent her adopted daughter “Dimples” (age 10; home 4 years) to Montana’s Ranch for Kids”
http://www.onethankfulmom.com/attachment-and-trauma/when-the-train-left-...

Lisa says the girl had RAD – and, in her mind, it is acceptable to send a severely mentally ill kid to an unlicensed place for “treatment”. What kills me is Lisa gets PAID to be an adoptive parenting expert — like, APs give her cash to hear her speak, she’s writing a book on adoptive parenting AND gets oodles of praise from trauma mamas (I loathe that term!) for being brave enough to talk about shipping her child to this Ranch!!!!

The saddest thing is that there’s a good chance this little girl would have thrived in a smaller family and with more individual attention. Lisa has 10 kids, homeschools her kids (except Dimples), takes them on family vacations (except Dimples) and managed to obtain every-day-after-school AND every-other-weekend respite care for Dimples.

Why bother adopting a kid to spend ZERO time with them? How can you expect a kid to bond with people she barely sees??

Other unqualified adoptive parents who offer services to parents of allegedly RAD kids include:
Blogger Diana who offers online “attachment focused” seminars for $8 a pop –fromsurvivaltoserenity.blogspot.com

Corey Waters who organizes an annual ‘trauma mama’ retreat in Orlando that offers seminars on RAD, treatments, etc: etaam2013.blogspot.com

Christine who has a series of “RAD parenting” videos on youtube and a “RAD parent coaching” service for $45/hr welcometomybrain.net

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A really great sounding adoptive mom called Christie (seems lovely, the opposite of the trauma mamas listed above) adopted her youngest Russian/Ukrainian girls (now in their early teens) from disrupted adoptions (i.e. first US families didn’t work out).The Evangelical families who originally adopted them disrupted because the girls allegedly had RAD, ODD and/or demons because they refused to follow instructions, etc... but it turned out the girls simply didn’t speak/understand English very well (despite YEARS with their first US adoptive families). Christie’s family figured this out in pretty short order.

Is that heartbreaking or what?? Lovely, smart, deserved-so-much-better girls who went through hell with their first US families, who were given totally incorrect diagnoses and bucketsful of medication* for illnesses they didn’t have, as a prelude to getting disrupted.

* I’ve no moral objection to giving a young child medication if she is genuinely ill and TRULY needs it, even anti-depressants, mood stabilizers, etc. Giving it to a NOT SICK kid is beyond the pale.

Caveat emptor problem

As a potential PAP who ultimately decided not to go down that road, I don't really get the point of this petition.

Any AP who goes through an agency will (probably) be told to read some books and educate themselves about potential problems that their new children may present. They are told to contact adoption medical specialists to learn about these problems. If they are thinking of adopting a post-institutionalized child, then they certainly must come across the notion of attachment and think about why time in an institution might have an adverse impact on the child's development. And they are told by social workers, even before filing a formal application, to identify resources available to them, through private insurance or through their community, that can be called in to help. In other words, after we get that kid for you, you're on your own. Caveat emptor.

The problem is that the agencies are full of happy stories about "most children adapt just fine in a loving family." And the patsies, um, I mean PAPs, likely think that chances are good that their particular case will be "just fine." I don't know if in the homestudy process social workers really try to ascertain what these people would do in the worst case scenario--we didn't get that far. From the sound of it, either they don't make a big point of it or people are too deluded to hear.

I'm all for the availability of (qualified, regulated, science-based) mental health services either via insurance or public assistance--which, as I understand, is the point of the mental health parity provisions of the healthcare reform act, provisions that are already supposed to have gone into effect. What I don't understand is the special appeal to the President, of all people, to make available assistance that you really should have lined up for this child and for yourself before starting the whole process.

The story about the disruption of the poor Russian-speaking girls really breaks my heart. People must drastically underestimate the impact on an already traumatized childof not being able to communicate in a totally strange environment.

There have been a lot of

There have been a lot of discussions about the pre as well as post adoptive proposals for kids with Reactive Attachment Disorder. It is appreciable that a few people like you are taking initiatives to fight for the rights of these children.

Pound Pup Legacy