Attachment Disorder Treatment for Adolescents
More About Attachment Disorder

Attachment theory holds that infants attach themselves to their caregivers when they encounter them for the first time. This behavior serves two functions: It helps ensure the baby’s survival. Additionally, it creates a strong bond between caregiver and baby. Infants who do not develop secure attachments may struggle to form meaningful or trusting relationships later in life. 

Most attachment therapists believe that the attachment system develops during adolescence. Young people lacking healthy attachments might experience emotional distress or symptoms related to anxiety or depression. 

Attachment disruptions can occur at various stages of childhood development. For example, secure (or insecure) attachment styles can emerge during infancy, preschool, middle school, high school, college, or adulthood. These disruptions can arise from exposure to stressors such as divorce, abuse, neglect, bullying, poverty, illness, natural disasters, and death.

Attachment Disorder Treatment for Adolescents

What are Attachment Disorders?

Attachment disorder is when children fail to develop regular emotional bonds with their parents. A common sign is having challenges in forming or maintaining relationships. This disorder can lead to problems at school and later in life.

Attachments form between babies and their caregivers. Psychiatrist John Bowlby coined the term and believed that children need secure attachments to survive. If these bonds are broken or disrupted, then they can cause lasting damage. When a child has an attachment disorder, they experience anxiety and fear relating to their caregiver and other significant adults.

Reactive Attachment Disorder

The style of parenting directly impacts the development of a child’s personality. When the parent provides a warm, positive environment during infancy, they form a secure attachment bond with the baby. The parent becomes the child’s primary source of security. 

When the relationship between the infant and caregiver breaks down, the child begins to develop a sense of insecurity and mistrust. This mistrust can lead to insecure attachments. 

Reactive Attachment Disorder is a pattern of behaviors exhibited by child and adult victims of severe abuse or neglect. Children with severe maltreatment in their caregiving experiences often develop symptoms like social withdrawal and defiance. Patients often suffer from severe emotional problems such as depression, violence, indiscipline, anxiety, social phobia, and low self-esteem

Symptoms of RAD

Reactive attachment disorder (RAD) exhibits considerable social skills and relationship problems. Adverse childhood events like physical abuse, neglect, parental separation, and divorce contribute to the onset of this disorder. Children with RAD often struggle to develop appropriate peer friendships, form close adult relationships, and maintain stable families of origin. 

Signs of reactive attachment disorder can include:

  • The child is overly dependent upon their caregiver
  • Excessive fear and anxiety around strangers
  • Exhibiting disorganized or disruptive behavior at home or school
  • Failure to develop age-appropriate social skills
  • Lacking empathy toward peers and adults
  • Lack of emotional connection between parent and child
  • The individual does not seek comfort from others
  • Avoidance of close relationships
  • Showing little interest in others
  • Anger when the patient cannot control situations
  • Transferring blame
  • Poor impulse control
Attachment Disorder Treatment for Adolescents

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Attachment Disorder Treatment for Adolescents

Disinhibited Social Engagement Disorder

Disinhibited social engagement disorder (DSED) is often associated with being highly driven and focused on achieving goals. Experiencing severe stress, fear of rejection, or embarrassment is common with this disorder. Seeking attention through risky behaviors can occur, so avoidance of drugs and alcohol should be encouraged. Disinhibited Social Engagement Disorder (DSED) has only recently gained recognition as a distinct mental health condition.

In the DSM-5, DSED has at least three significant symptoms:

feeling anxious before going out and meeting new people

avoiding certain situations

experiencing intense urges to talk about personal matters

DSED can have a prevalence of up to 20% in at-risk populations. There is no cure for DSED, but treatment options include cognitive behavioral therapy and medication.

Risk Factors of Attachment Disorders

Parental alienation is when parents alienate their children from the other parent. The child begins to believe that they are better off without the other parent. Parents may manipulate the child into believing this through emotional abuse, physical violence, threats, and even lying.

Parental alienation may also refer to a parent distancing themselves emotionally from a child. This causes the child to perceive the parent as rejecting and abandoning. This rejection can affect the child’s relationship with both parents.

Attachment disorders may occur due to early life stressors. These stressors include physical abuse, neglect, parental divorce, trauma, or loss of a caregiver before age seven. In addition, inattention, impulsiveness, and hyperactivity are common at ages 2 through 6.

Disorders characterized by poor emotional regulation and self-awareness, such as oppositional defiant disorder and conduct disorder. These specific disorders are risk factors for later attachment disorders. Children with disruptive behavior disorders may lack insight into their emotions and impulses and fail to recognize their own needs. 

A child with a history of disruptive behaviors and poor impulse control may endure repeated punishments. This leads to a sense of entitlement and low frustration tolerance.

Treatment for Adolescents with Attachment Disorders

Attachment Behavior Analysis Therapy is the first-line treatment for children and adolescents with attachment disorders. This therapy focuses on teaching parents and caregivers basic parenting skills, including emotional regulation and parent-child bonding.

Psychodynamic treatments focus on the history of the patient and its effects. They address maladaptive patterns of thinking and behavior associated with trauma in childhood. Therapists work with clients to help them understand their behaviors and emotions using concepts from psychoanalysis and psychotherapy.

This therapy has a basis in the principle that problems stem from interactions between family members rather than individual factors. A therapist works with the entire family unit to identify underlying issues that may lead to conflict, illness, and dysfunction.

Cognitive Behavioral Therapy helps patients recognize dysfunctional beliefs and develop alternative, healthier thoughts, and behavioral strategies. Patients learn to take control of their emotions and behavior through cognitive restructuring, problem-solving, and stress management techniques.

Treatment for Attachment Disorders in Massachusetts

Attachment disorders can be challenging to understand and handle, making parents feel like they are struggling to help their adolescent children. Parents of adolescents with attachment disorders can often feel lost and alone. They may not know where to turn for help or how to best support their child.

If your adolescent loved one is struggling with an attachment disorder, reach out to Massachusetts Center for Adolescent Wellness (MCAW) today. Our team can answer any questions you may have and give you a better understanding of our outpatient mental health program and what we treat. We provide treatment and resources to parents of adolescents with attachment disorders.

Clinically Reviewed by:

Dr. Melanie Carbonneau PhD, LMHC, MT-BC

Dr. Melanie Carbonneau PhD, LMHC, MT-BC

Melanie Carbonneau is the Clinical Director at Massachusetts Center for Adolescent Wellness and is a licensed counselor and certified music therapist with a Ph.D. from Lesley University. She leads MCAW with a focus on holistic care, emphasizing the importance of family and community involvement in the healing process.