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and Jeff Merkert invited me to co-author a book based on their team approach to helping children with attachment disorders and their families, I knew I had to participate. Hall and Merkert became certified to provide clinical services for families with dysfunctional “dynamics” via a category of treatment offered within Pennsylvania’s Behavioral Health Rehabilitative Services system, referred to as Family Based Mental Health Services. They became known throughout the central Pennsylvania area for their remarkable clinical success in applying the principles of Dr. Daniel Hughes’ Dyadic Developmental Psychotherapy (DDP) in the treatment of children with Reactive Attachment Disorder and other mental health diagnoses complicated by insecure attachments.

      Since Dr. Hughes relocated from Maine to my outpatient campus in Annville, Pennsylvania, several years ago, Hall and Merkert have taken advantage of their opportunity for in-person monthly supervision with him. DDP involves a set of principles and techniques developed by Dr. Hughes to specifically address the emotional and relational difficulties that are typically present in children and adults with insecure attachment histories.

In this book, we reach beyond parents and clinicians as our target audience and into the extended community. This book is about children who, for various reasons, survive through their first several years of life without having developed the ability to securely attach to caregivers. It is about those caregivers—parents, adoptive parents, foster parents, daycare workers, teachers and others—who struggle to make a meaningful connection with them. But just as importantly, it is about the village in which the struggle to connect takes place: friends, relatives, neighbors, policemen, coaches, social servants, legal and political office holders, legislators and so on. This book illustrates how we all have a crucial role to play. But beyond that, it is filled with practical suggestions as to how we can fulfill that role.

      The first part of the book focuses on the special parenting challenges presented by children with disordered attachment styles and ways to meet those challenges. Then, in the second part, the focus shifts to the assembled team of professionals who join together with caregivers and the child to address the attachment difficulties. We also discuss special environmental considerations necessary to meet the unique needs of the attachment-disordered child. The village dimension will be an important topic in this section in particular.

      The next part of the book will discuss what the authors have called Trauma-Disrupted Competencies (TDCs). That is, it will address the ways in which the early childhood trauma that leads to attachment disorders causes the child to have serious difficulty with specific areas of function that we take for granted in children. Aware of these TDCs, we can then be on the lookout for them and utilize suggested means for helping the child to overcome them. The final parts of the book will focus on practical interventions and handouts that parents and “villagers” can utilize to help their traumatized children.

      Faye Hall has experienced both the joy and anguish of working with children with an impaired attachment style from the inside out, as well as from the outside in. She raised an adopted son who had Reactive Attachment Disorder. We agreed that key parts of her narrative as a parent would help explain the content to the reader. Therefore, many chapters either begin with or contain a relevant passage from her narrative.

       —Dr. John Biever

PART 1 PART 1

       The Team Approach to Treating Attachment Disorders The Team Approach to Treating Attachment Disorders

CHAPTER 1 CHAPTER 1

       Trauma in Adopted Children: Meet the Families Trauma in Adopted Children: Meet the Families

       We were quite a typical rural central Pennsylvania family—my husband David and I and our teenaged son and two younger daughters. Traditional roles were working well for us. David was an engineer by profession. He maintained our Christmas tree farm and rental properties, while I was trained as an educator and homeschooled our daughters.

       This changed when my sister and her husband were in the midst of adopting an infant; a relative of my brother-in-law asked them whether they would be interested in adopting his nephew. He was a little boy being shuffled through the foster care system and in need of adoption. My sister thought that a second boy would create perfect gender symmetry in my family and volunteered us as foster parents!

       That little boy eventually became our adoptive son Allan. By the time David and I made the commitment to bring Allan into our family, he was in a shelter with other hard-to-place children. We had to complete foster care training and go through the clearance process. In the six hours of foster care classes we covered such topics as necessary paperwork, possible behavior problems, ways to deal with birth parent visits, legal responsibility of the agency and family and not relying on the foster care subsidy to pay bills.

       Learning of our intention to foster a child, friends were extremely enthusiastic. One woman, herself a former foster child, told us how very grateful to us any foster child would be. We heard, “The child will benefit from the pleasures your family could offer,” and “The child will thank you for rescuing him.” Such comments strengthened our resolve to become foster parents.

       —Faye Hall

Now that Faye has introduced you to her “real life” story, let’s meet four other families. We have created each of them to represent a composite of the common struggles parents have faced in enabling an attachment-disordered child to become part of a family. We will refer back to them throughout the book in order to illuminate points we are making.

       Introducing Amy’s Family, the Smiths

      James and Lori Smith adopted two-year-old Amy later in life. James was a research scientist and Lori a teacher. Lori was able to stay at home with Amy. They were happy to finally be parents; they indulged her with all her desires. Amy never had to ask for anything. Lori was in heaven, having a little girl to dote on all day. Lori bought Amy fancy dresses like she had wanted as a child but that her parents could not afford.

      Lori grew concerned when Amy began to destroy things. She ripped many of the fancy dresses, broke most of her toys and “accidently” damaged the furniture. It seemed as if her defiance was increasing daily. Lori tried to explain her fears to James. He attributed the behavior to Amy’s age.

      Lori planned fun things every day for Amy. Lori had missed having fun when she was growing up, because her mom had to work and never seemed to have time for her. Amy refused to play with Lori but demanded that Lori entertain her. By bedtime, Lori had no energy left for James. Some nights, Amy demanded that Lori sleep with her. James began to resent Amy for taking his wife’s energy and he wanted to find a babysitter. Lori refused, thinking that Amy would be too scared to be away from her. James and Lori were drifting apart.

      As Lori and James despaired over how far they were from their imagined ideal family, they decided to seek help. During the initial stages of finding answers, it was difficult and embarrassing for them to describe their parenting styles and Amy’s behaviors. Yet their shame decreased as they found professionals trained in trauma and attachment.

       Introducing Corey’s Family, the Joneses

      Rebecca and Danny Jones began fostering children soon after they were married. Danny worked second shift, leaving the house at noon every day and often working overtime to supplement their income, as Rebecca did not work outside the home. Rebecca was a good “case manager” for the foster children,

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