Residential childcare workers’ knowledge of reactive attachment disorder

Reactive Attachment Disorder (RAD) is associated with a history of ‘pathogenic care’ therefore residential childcare workers are likely to come into contact with children with this disorder. An ‘appropriately supportive environment’ may be a mitigating factor in terms of the disorder’s severity and duration (Corbin, 2007); therefore it is important that behaviours suggestive of RAD are recognised early and that these children are given the attention they require in the care setting. We aimed to gain an understanding of residential childcare workers’ knowledge of RAD to determine if their understanding of RAD was sufficient to recognise RAD-like behaviour. A mixed methods study (qualitative focus groups and whole population survey) was undertaken with residential childcare workers. Liaison with Child and Adolescent Mental Health Services was seen by residential workers as being useful and workers thought their knowledge of mental health problems had improved in recent years. However, less than half of respondents (49.1%) identified RAD from a case history given in the questionnaire. Child and Adolescent Mental Health Services staff and residential workers may need more specialised training on RAD to be able to recognise behaviours suggestive of the disorder and refer appropriately, ensuring the child’s needs are met as early as possible