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 American Psychiatric Association opposes re-birthing treatment - psychiatrists warn coercive therapy can be fatal
There is no scientific evidence to support the effectiveness of coercive holding therapies, or so-called "re-birthing techniques," said the American Psychiatric Association in a position statement on Reactive Attachment Disorder (RAD). The position statement was approved by the APA Board of Trustees in late June. Re-birthing techniques have been used in some cases to treat children with reactive attachment disorder (RAD), a psychiatric condition affecting a small number of children and characterized by inability to form emotional attachments. Strong clinical evidence suggests that coercive therapy is not therapeutic and can even be fatal, the APA said. Children with RAD may appear detached, unresponsive, inhibited or reluctant to engage in age-appropriate social interactions; other children with RAD may be overly social and familiar with strangers. RAD children may have had problems or severe disruptions in their early relationships, and they may have suffered abuse and/or neglect. And some have had traumatic losses or multiple changes in their primary caregiver. Coercion therapy involves wrapping the child tightly in a blanket or other material for extended periods in an effort to simulate rebirth and initiate a secure attachment between parent and child. There is at least one known case in the U.S. of a child being suffocated while being subjected to this practice. "Re-birthing techniques have no place in psychiatric treatment," says Paul S. Appelbaum, M.D., APA president. "These extreme methods pose serious risk and should not be used under any circumstances." "Children with RAD will benefit most from an individualized treatment plan that will usually include work with the child's family to help them foster an attachment to their child," said the APA. "Except when complicating factors arise, hospitalization is generally contraindicated." The APA advises caregivers of children showing signs or symptoms of RAD to: seek a comprehensive evaluation by an appropriately trained and experienced mental health professional prior to initiation of a treatment plan; ask questions about the results of the evaluation; make sure they understand in detail the risks as well as the potential benefits of any intervention; and feel free to seek a second opinion if they have questions or concerns. APA Position Statements are policy documents approved by the APA Assembly and Board of Trustees that define APA official policy on specific subjects. For a copy of the position statement, go to: http://www.psych.org/archives/200205.pdf. |
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