Emerging Therapist, Growing Child: Developing a Relationship with a Child with Reactive Attachment Disorder

Children who have had severe early childhood experiences of neglect, abuse, and/or abrupt separation from their caregivers between the ages of six months and three years are at risk for developing reactive attachment disorder. In one form of reactive attachment disorder, known as the inhibited type, the child fails to initiate interactions and positively respond in social situations. Such behaviors make it challenging for therapists to establish therapeutic relationships with children who have been diagnosed with the inhibited type of reactive attachment disorder. The purpose of this case study is to present the challenges, successes, and reactions of a neophyte dance/movement therapist in developing a therapeutic relationship during an internship experience with a 9-year-old boy who had been diagnosed with reactive attachment disorder with inhibited type characteristics. In this qualitative case study, data was collected through case notes and reflective process notes during the five-month period in which the clinician worked with the child. Attachment theory was then used to examine the process in which dance/movement therapy was utilized. Kestenberg Movement Profile and cognitive behavioral techniques are also discussed in the course of providing treatment to the child. During the time this case study was conducted, significant progress was made by the child in his ability to relate to the therapist and to the other adults working with him in a residential treatment facility