Therapist with experience with attachment/adoption issues?

[Anonymous]

Could anyone recommend a therapist who has experience dealing with attachment and adoption issues? Ideally, I'd like someone who doesn't JUST do that, because it's not clear to me that our issues are in fact adoption-related. But there's a strong possibility they are, and so I'd like to find someone knowledgeable in that area. Someone in the Alexandria-ish area or downtown would be ideal, but I'm most concerned about finding someone reputable. Many, many thanks.

[Anonymous]

Dr Nancy Colletta in Chevy Chase DC has been fantastic for our family.
Also check out the Center for Adoption Support and Education in Silver Spring. I assume they refer therapists all over the area.

[Anonymous]

We started with a therapist at CASE (Center for Adoption Support and Education) in Burtonsville. When ti became clear that our issues were not adoption-related, she referred us elsewhere. They won't keep you coming if they don't think the issue is related to adoption.

[Anonymous]

Without a fuller description of your issues and whether your child was an infant or older child adoption, domestic or intl.--is hard to give recommendation. We have been through several therapists in terms of dealing with our older adoptee's attachment and behavioral issues and here is what I have learned:

1. Run away from traditional child therapists who do play-based child therapy consisting of just them and the child---without you. While that type of therapy may work well with kids who are going through a single traumatic event (parental divorce, death or illness of loved one), it does nothing with respect to attachment.

2. Therapists who are focused on attachment need to be attuned to any underlying neurodevelopmental issues that may be affecting the child's ability to identify and process emotions. If your child had any potential prenatal exposures that could adversely affect brain development, then you may need to identify and try to treat those first with a psychiatrist in order to get the child to a point where they can benefit from therapy.

[Anonymous]

Anonymous wrote:Without a fuller description of your issues and whether your child was an infant or older child adoption, domestic or intl.--is hard to give recommendation. We have been through several therapists in terms of dealing with our older adoptee's attachment and behavioral issues and here is what I have learned:

1. Run away from traditional child therapists who do play-based child therapy consisting of just them and the child---without you. While that type of therapy may work well with kids who are going through a single traumatic event (parental divorce, death or illness of loved one), it does nothing with respect to attachment.

2. Therapists who are focused on attachment need to be attuned to any underlying neurodevelopmental issues that may be affecting the child's ability to identify and process emotions. If your child had any potential prenatal exposures that could adversely affect brain development, then you may need to identify and try to treat those first with a psychiatrist in order to get the child to a point where they can benefit from therapy.

What makes you think that?

[Anonymous]

Because attachment is at heart about the relationship between parent and child. That is the relationship that needs to be created and the therapist needs to work with parent in the room to create it. Attachment-disordered children have had the critical component of trust in a parent figure disrupted---usually during infancy or early toddler-dom---through abandonment, abuse or neglect. It is a different paradigm from a child who had their basic needs met in early childhood. Having the child who doesn't even trust their primary caretaker meet one-on-one with yet another strange adult doesn't really do anything---the child just views the therapist as yet another adult to manipulate---and will sit and play checkers (or whatever) for an hour without getting anything out of it. A complete waste of money, IMHO. (And we spent a LOT of money . . . ). It was only when we really drilled down into understanding the effects of prenatal alcohol exposure on DC's brain, and addressed that through medication, then we were able to start addressing the emotional piece. But the traditional therapists would have taken our money indefinitely, and just told us that we needed to be more patient.

When searching for a therapist to deal with serious adoption/attachment/behavior issues---do not be shy about asking for references. A therapist who has had success with this cohort of challenging patients will be happy to reach out to their current client base and see if any existing patients' parents will serve as references. A therapist that hasn't really had success with this population will hide behind claims of patient confidentiality instead of admitting that their play-based model isn't really effective for attachment disorder.

[Anonymous]

Anonymous wrote:Without a fuller description of your issues and whether your child was an infant or older child adoption, domestic or intl.--is hard to give recommendation. We have been through several therapists in terms of dealing with our older adoptee's attachment and behavioral issues and here is what I have learned:

1. Run away from traditional child therapists who do play-based child therapy consisting of just them and the child---without you. While that type of therapy may work well with kids who are going through a single traumatic event (parental divorce, death or illness of loved one), it does nothing with respect to attachment.

2. Therapists who are focused on attachment need to be attuned to any underlying neurodevelopmental issues that may be affecting the child's ability to identify and process emotions. If your child had any potential prenatal exposures that could adversely affect brain development, then you may need to identify and try to treat those first with a psychiatrist in order to get the child to a point where they can benefit from therapy.

OP here--I'd be grateful for any recommendations you might have. Our child was internationally adopted at 9 months, and has a very strong bond with his primary caregiver, but is godawful to everyone else in our family. He's 3 now, so some of it might be toddler-dom, but a couple of other unrelated issues suggest to us that there may be some attachment issues. We may start with CASE, but I'm definitely open to other suggestions.

[Anonymous]

OP---

I'm that PP. If there is any reason to believe that DC was prenatally exposed to alcohol, then I might focus on that first. If the child has a strong bond with the primary caretaker, then your issue may not be one of attachment. Is the primary caregiver you or a nanny? If a nanny, then the problem may not be that the child can't attach, but that the child just attached to the wrong person.

And 3 year olds can just be pretty godawful. Is this your first child? what are the issues making you think it is attachment related behavior?
I would recommend Deborah Grey's book---Attaching in Adoption. I found it very useful.

[Anonymous]

http://adoptionsupport.org/

CASE deals with adoption issues. They are in Burtonsville.

[Anonymous]

Anonymous wrote:OP---

I'm that PP. If there is any reason to believe that DC was prenatally exposed to alcohol, then I might focus on that first. If the child has a strong bond with the primary caretaker, then your issue may not be one of attachment. Is the primary caregiver you or a nanny? If a nanny, then the problem may not be that the child can't attach, but that the child just attached to the wrong person.

And 3 year olds can just be pretty godawful. Is this your first child? what are the issues making you think it is attachment related behavior?
I would recommend Deborah Grey's book---Attaching in Adoption. I found it very useful.

Thanks again, PP. This is our third child, although our first adopted child. I've read the book, and we remain on the lookout for issues. As I said, we really don't know if this is adoption related, which is why I was hoping to find someone who won't jump to that conclusion; it's possible he's just nasty to people in a way we didn't see with our older kids. I would respond to that differently, however, than I would if there's an attachment issue. So we'll see. It sounds like CASE might be a good place to start, and hopefully they can send us elsewhere if it doesn't seem to be adoption related.

Thank you for sharing your experience and wisdom!