kb/data/en.wikipedia.org/wiki/Attachment_therapy-5.md

title	chunk	source	category	tags	date_saved	instance
Attachment therapy	6/12	https://en.wikipedia.org/wiki/Attachment_therapy	reference	science, encyclopedia	2026-05-05T09:17:08.228014+00:00	kb-cron

Within mainstream practice, disorders of attachment are classified in DSM-5 and ICD-10 as reactive attachment disorder (generally known as RAD), and Disinhibited social engagement disorder. Both classification systems warn against automatic diagnosis based on abuse or neglect. Many symptoms are present in a variety of other more common and more easily treatable disorders. There is as yet no other accepted definition of attachment disorders. According to the American Academy of Child and Adolescent Psychiatry (AACAP) practice parameter published in 2005, the question of whether attachment disorders can be reliably diagnosed in older children and adults has not been resolved. Attachment behaviors used for the diagnosis of RAD change markedly with development and defining analogous behaviors in older children is difficult. There are no substantially validated measures of attachment in middle childhood or early adolescence.

== Prevalence == Holding therapy prospered during the 1980s and 1990s as a consequence of both the influx of older adopted orphans from Eastern European and third world countries and the inclusion of reactive attachment disorder in the 1980 Diagnostic and Statistical Manual of Mental Disorders which attachment therapists adopted as an alternative name for their existing unvalidated diagnosis of attachment disorder. According to the APSAC Task Force, these therapies are sufficiently prevalent to have prompted position statements or specific prohibitions against using coercion or restraint as a treatment by mainstream professional societies such as: American Psychological Association (Division on Child Maltreatment), National Association of Social Workers (and its Utah Chapter), American Professional Society on the Abuse of Children, American Academy of Child and Adolescent Psychiatry, and American Psychiatric Association. The Association for the Treatment and Training in the Attachment of Children, (ATTACh), an organization for professionals and families associated with holding therapy, has also issued statements against coercive practices. Two American states, Colorado and North Carolina, have outlawed rebirthing. There have been professional licensure sanctions against some leading proponents and successful criminal prosecutions and imprisonment of therapists and parents using holding therapy techniques. Despite this, the treatments appear to be continuing among networks of attachment therapists, attachment therapy centers, caseworkers, and adoptive or foster parents. The advocacy group ACT states, "Attachment Therapy is a growing, underground movement for the 'treatment' of children who pose disciplinary problems to their parents or caregivers." Rachel Stryker in her anthropological study The Road to Evergreen states that attachment therapies "of all stripes" are increasingly popular in the US and that the number of therapists associated with the Evergreen model registering with ATTACh grows each year. She cites the large number of formerly institutionalized domestic and foreign adoptees in the US and the apparently higher risk of disruption of foreign adoptions, of which there were 216,000 between 1998 and 2008. The practice of holding therapy is not confined to the US. Prior and Glaser cite at least one clinic in the UK. Attachment therapists from the USA have conducted conferences in the UK. The British Association for Adoption and Fostering, (BAAF), has issued an extensive position statement on the subject which covers not only physical coercion but also the underlying theoretical principles. It had been thought, until recently, that therapists calling themselves "attachment therapists" practising in the UK tended to be practising conventional forms of psychotherapy based on attachment theory. In 2009 The British Journal of Social Work accepted an article rehabilitating holding therapy, "To Have and to Hold: Questions about a Therapeutic Service for Children" describing an earlier study involving the Keys Attachment Centre in Rossendale, Lancashire and the surrounding Keys Attachment Homes. In 2012, first-hand accounts from a survivor and a number of professionals provided evidence that the coercive Evergreen model of holding therapy had been systematically used to treat children in Local Authority care within a programme in North West England.