Advice on managing attachment disorder in children

As a foster parent or carer, you may look after children who experience differing degrees of what is known as attachment disorder, an umbrella term for a number of attachment issues. It is by no means restricted to young children – you may encounter symptoms in older children and teenagers too.

You will learn more about spotting the symptoms of attachment disorder as part of your National Fostering Group training and how to manage the situation effectively. Attachment disorder is generally evaluated on a spectrum scale, so children who display more serious symptoms of attachment disorder could require therapy.

What contributes to attachment disorder?

As children, we learn how to build healthy relationships as a result of interaction and observation of the adults around us, with attachment reliant on both adult and child behaviours. When a barrier to what we would usually consider ‘normal’ relationship building occurs, this can result in attachment issues developing.

The world we experience when we are very young is known to have an impact on how we develop in later life. As babies and small children, we rely on interaction with our caregivers to help our brains develop and to provide templates for future social interaction and relationship building.

Unfortunately, for those children who may not have had the best start, problematic or disjointed relationships in early years can lead to challenges forming relationships.

This might occur because care has been inconsistent – perhaps because of a change in home set up, as a result of a parent’s substance abuse problem or even physical or mental health issues. Violence or other abuse in the home can also contribute to attachment issues, as can neglect, which may lead a child to feel rejected or to them exhibiting extreme behaviours in an effort to gain attention.

Symptoms of attachment disorder

Not all children with attachment disorders will display the same symptoms, as they are likely to have formed particular behaviours as a result of their own unique set of circumstances.

Some children become very withdrawn and inhibited whereas others may be disinhibited. There may be an aversion to physical affection or, at the opposite end of the spectrum, children and young people may be inappropriately friendly around strangers.

Difficulty managing anger, displaying empathy and a need to control situations are also common indicators of attachment disorder. Children with attachment disorders often struggle to maintain eye contact when interacting.

How to handle attachment disorder behaviours

• When a child who is known to have attachment disorders is placed with you, your care team should provide some background and guidance about their unique set of circumstances.
• However, in general you should be aiming to provide a consistent care approach with clear boundaries. The aim is to help children to feel safe and for them to learn to trust you.
• Children are likely to benefit from adopting routines and schedules and may show discomfort if you’re not where you are expected to be.
• Enforcing boundaries is likely to bring many challenges to the surface but can help the child to feel safe and nurtured when consistently applied.
• Try to avoid exerting discipline in the heat of the moment and when disagreements do occur. Make it clear you still care about your foster child to make it easy for you both to reconnect.
• As a foster carer, overcoming attachment disorder issues can be very hard. At times you may feel rejected, unappreciated or as if you’re making little progress. Look after yourself  and don’t be afraid to ask for help when you need it  – our team is always on hand to provide guidance and advice.

Treatment of complex developmental trauma – Attachment Therapies

Psychological interventions for complex developmental trauma, and its common associate Reactive Attachment Disorder, are often grouped under the general heading Attachment Therapies. As the name suggests, Attachment Therapies typically seek to repair the traumatised child’s attachment relationships and/or promote attachment security. The provision of reparative attachment experiences in therapy has a central role. With references often being made to such terms as transference and counter-transference, Attachment Therapies are often placed in the psychoanalytic tradition.

My own approach to Attachment Therapy focuses on promoting adaptive beliefs about self, other and the world (secure attachment representations), lower and improved regulation of arousal, and reduced preoccupation with access to basic needs. Therapy is experiential, just as early attachment relationships are formed through experiences.

Children referred to me are offered sustained, consistent and intense experiences of structure, direction, guidance, mastery, deep understanding of their inner world, emotional connectedness and access to needs provision. This is achieved through therapeutic activities (e.g. Theraplay) and a stream of interpretations of the child’s thoughts, feelings, perspectives and intentions (i.e. verbalising understanding – a.k.a. validation).

As to what psychotherapy school or tradition my approach to Attachment Therapy sits in, it is possible to argue one way or another. There is no doubt that I am managing transference and counter-transference to achieve desired therapeutic outcomes for traumatised, attachment disordered children on a daily basis. However, it is also my practice to explore and name the child’s maladaptive beliefs about self, other and the world and take the child on a journey whereby they experience themselves, others and the world in a different, more helpful way.

In doing so, my intent is to reorganise and restructure attachment representations and expose the traumatised, attachment disordered child in a systematic and sustained manner to the very source of their trauma: the dependency relationship. Desired outcomes include cognitive change and lowered arousal through habituation to the trauma stimulus; although arousal management techniques are also an important component of intervention. Hence, my therapeutic approach sits easily in the cognitive-behavioural tradition.

The National Fostering Group offers excellent support and training to help you throughout your fostering journey. Not started your journey yet? See if you’re eligible to foster.

If you already foster, you can transfer to one of our agencies and start receiving the fantastic benefits the NFA Group have to offer.